Observational studies have identified an association between cardiovascular diseases (CVDs) and vestibular dysfunction, but the underlying causal mechanisms remain unclear. This study employs Mendelian randomization (MR) to systematically evaluate, for the first time, the potential causal relationships between multiple CVDs and vestibular dysfunction, providing new insights into the pathological mechanisms involved. Correlations between exposures (atrial fibrillation, angina pectoris, heart failure, myocardial infarction, high blood pressure and coronary atherosclerosis) and outcomes (vestibular dysfunction) were analyzed by 2-sample MR using a dataset of cardiovascular diseases from the Genome-Wide Association Study and a vestibular dysfunction dataset from a FinnGen database (N = 4,08,645) and a reverse MR study was also performed. The inverse variance weighting (IVW) method, MR-Egger method, and weighted median method were chosen, supplemented by various sensitivity analyses to ensure the robustness and reliability of the results. MR analysis showed that angina pectoris (IVW: P = 4.71E-06), heart failure (IVW: P = .017), myocardial infarction (IVW: P = 4.09E-05), high blood pressure (IVW: P = .029), coronary atherosclerosis (IVW: P = 7.76E-07) and vestibular dysfunction were genetically causally associated. However, MR analysis showed no genetic causality between atrial fibrillation and vestibular dysfunction (P = .27). In the reversibility study, no significant associations were found between vestibular dysfunction and outcomes (atrial fibrillation, angina pectoris, heart failure, myocardial infarction, high blood pressure and coronary atherosclerosis) in any of the MR analysis results. Sensitivity analyses showed no horizontal pleiotropy, but there was heterogeneity in some of the results. This study is the first to use MR analysis to demonstrate that multiple CVDs can increase the risk of vestibular dysfunction, providing genetic evidence for early clinical screening of high-risk populations. Future research should further explore the molecular mechanisms, particularly the specific pathways of the cardiovascular-vestibular axis, and conduct interventional studies to validate targeted preventive measures. These findings lay a theoretical foundation for developing novel diagnostic and therapeutic strategies, offering significant potential for clinical translation.

The study aimed to investigate the relationship between the systematic immune-inflammation index (SII) and stroke among American adults using data from the National Health and Nutrition Examination Survey from 2011 to 2020. The SII was calculated as the platelet count multiplied by the neutrophil count divided by the lymphocyte count. Weighted multivariate logistic analysis was used to estimate the relationship between SII and stroke, with subgroup and sensitivity analyses conducted to explore potential moderators and ensure result stability. The findings revealed that a higher SII was associated with increased susceptibility to stroke, particularly in females, after adjusting for covariates. Further prospective studies are needed to investigate the relationship between SII and different subtypes of stroke.

This study investigates the relationship between the composite dietary antioxidant index (CDAI) and the risk of all-cause and cardiovascular mortality in individuals with hypertension, aiming to provide dietary recommendations to reduce mortality. Data were sourced from the National Health and Nutrition Examination Survey (NHANES) database. The best cut-off for CDAI in relation to survival outcomes was determined using the maximally selected rank statistics method. Multivariate Cox regression analysis was used to examine the association between CDAI and mortality risks, and hazard ratios with 95% confidence intervals were calculated. Restricted cubic spline (RCS) curves were used to visualize the correlations. After analyzing data from 22,591 hypertensive adults, the optimal CDAI cut-off was found to be -1.23, categorizing participants into high and low CDAI groups. The results showed that the high CDAI group had a lower risk of cardiovascular and all-cause mortality (HR [95% CI]: 0.73 [0.61-0.87] and 0.79 [0.71-0.88], respectively). RCS analysis indicated a negative linear relationship with cardiovascular mortality and a nonlinear relationship with all-cause mortality. Subgroup and sensitivity analyses confirmed these findings. In conclusion, CDAI is a valuable predictor of long-term mortality risks in hypertensive individuals and can serve as a cost-effective tool for assessing their prognosis.

The key drivers of symptom severity in atrial fibrillation (AF) patients remain unclear. The study aimed to explore associations between anxious and depressive status and AF-related symptoms as expressed by the modified European Heart Rhythm Association (mEHRA) score. The study enrolled 182 AF patients admitted to the Cardiology Department of Peking University Third Hospital between February 2017 to January 2020. Anxious and depressive status were assessed by "Generalized Anxiety Disorder-7" and "Patient Health Questionnaire-9," respectively. The severity of AF-related symptoms was scored by mEHRA and classified into 2 groups: low mEHRA group (mEHRA = 1 or 2a) and high mEHRA group (mEHRA ≥ 2b), according to whether they were troubled or affected by AF-related symptoms. In all 182 AF patients, 56.0% (n = 102) patients presented mEHRA ≥ 2b. The high mEHRA group had significantly higher Patient Health Questionnaire-9 score [4.0 (2.0-7.0) vs 2.5 (0-4.8), P < .001] and Generalized Anxiety Disorder-7 score [3 (0-5) vs 0 (0-3), P < .001]. After adjusted for other covariates, persistent AF (odds ratio, OR = 0.48, 95% confidence interval [CI]: 0.23, 0.99), heart failure (OR = 2.91, 95% CI: 1.08, 8.43), depressive status (OR = 2.15, 95% CI: 1.01, 4.65), and anxious status (OR = 2.83, 95% CI: 1.17, 7.38) were independently associated with high mEHRA score (≥2b). Increased anxiety and depression levels was associated with feeling troubled or limited by AF-related symptoms scored by mEHRA.

Stereotactic hematoma aspiration surgery was introduced to mitigate the mass effect and subsequent secondary injuries caused by spontaneous intracerebral hemorrhage (sICH) in the basal ganglia. This study posited that the supraorbital keyhole (SOK) route, along with its longer axial trajectory, may achieve improved hematoma aspiration rates and functional outcomes compared with the traditional Kocher's point (KP) route for the evacuation of hematomas in the basal ganglia.

Seventy-six patients were enrolled between January 2010 and December 2021 (KP [n = 41] and SOK [n = 35]). Frameless stereotactic hematoma aspiration was performed under a neurosurgical navigation system. Comparison analyses of radiologic and clinical data and logistic regression analyses for identifying the parameters of "well-aspirated (> 70%)" were performed. Additionally, subgroup analyses (KP [n = 22] and SOK [n = 28]) were performed in patients with "typical" shape of hematomas.

In the comparative analyses, the aspiration rate of the hematoma was lower in the SOK group (50.71% vs. 38.49%) than that in the KP group; however, this difference was not significant (P = 0.077). In the subgroup analysis, the aspiration rate was significantly higher in the SOK group than that in the KP group (52.6% vs. 33.6%, P = 0.039), and good functional outcomes (modified Rankin Scale score, 0-2) were significantly higher in the SOK group (71.4% vs. 28.6%, P = 0.049) than those in the KP group. Univariate and multivariate logistic regression analyses identified "lesser midline shifting" and "SOK approach" as the significant predictors of better aspiration rates (> 70%), suggesting that these factors are beneficial for achieving optimal surgical outcomes.

Considering the unique lentiform shape and deep-seated location of basal ganglia sICH, stereotactic aspiration of the SOK route is recognized for its safety and efficacy in achieving a high rate of hematoma aspiration.

To examine the performance in adults of the European Alliance of Associations for Rheumatology (EULAR)/Pediatric Rheumatology European Society (PReS)-endorsed Ankara 2008 classification criteria for IgA vasculitis (IgAV).

The EULAR/PReS/Ankara 2008 classification criteria for IgAV were applied to patients enrolled in an international observational cohort which included patients with IgAV and comparators with other forms of small-vessel and medium-vessel vasculitis. After the initial assessment of the performance of the criteria, possible revisions to increase the performance were tested. The revised criteria were then assessed in an independent validation cohort within a multicentre Turkish vasculitis registry.

The dataset consisted of 178 IgAV cases and 1705 comparators. The Ankara 2008 criteria require skin involvement plus one of the following four criteria: abdominal pain, a biopsy showing IgA deposition, arthritis or arthralgia, or renal involvement (any haematuria and/or proteinuria). The specificity of the criteria improved when a positive test for anti-neutrophil cytoplasmic autoantibody or blood cryoglobulins was considered an exclusion criterion. The revised criteria had a sensitivity of 76.4% (95% CI 69.8% to 82.2%) and a specificity of 94.5% (95.0% CI 93.4% to 95.1%). In the validation set, the sensitivity and specificity of the revised criteria were 97.8% (95% CI 94.0% to 99.0%) and 85.0% (95.0% CI 78.0% to 90.0%), respectively.

The revised EULAR/PReS-endorsed Ankara 2008 IgAV classification criteria perform well in adults with IgAV and are appropriate for use in clinical research.

Current guidelines for statin use in primary prevention of cardiovascular disease (CVD) predominantly rely on absolute 10-year CVD risk scores. However, this approach may not adequately capture heterogeneity in the potential benefit of low-density lipoprotein cholesterol (LDL-C) reduction. This study compares the absolute risk-based approach with an individualized benefit approach, based on the Causal-Benefit model considering predicted lipid-lowering effects, for statin eligibility in Chinese populations.

We analyzed nationally representative data from the China Health and Retirement Longitudinal Study, including adults aged 40-80 years, free of diabetes and CVD history, with LDL-C levels between 1.8 mmol/L and 4.9 mmol/L, and no prior statin use. Statin eligibility was determined using two strategies: (i) the absolute risk-based approach (10-year CVD risk), and (ii) the individualized benefit approach (using the Causal-Benefit model framework incorporating predicted individual absolute risk reduction [iARR]). We estimated eligible populations, CVD events averted, and number needed to treat (NNT) both at population and individual level (iNNT) over 10 years versus no treatment, assessed discordance, and primarily calibrated the benefit threshold to match event prevention by the risk-based approach for comparison. A total of 7,287 adults were analyzed, forming a cohort reflective of 324.6 million Chinese adults (mean age 57 years; 51.7% women). To prevent a similar number of CVD events (2.19 million vs. 2.16 million), 49.2 million (95% confidence interval [CI]: 45.3,53.0) and 50.3 million (95% CI: 46.0,54.6) adults would be eligible for statins therapy under the individualized benefit and absolute risk-based approaches, respectively. Among 58.9 million adults eligible for either strategy, the concordance was only 68.9%. The benefit approach alone identified 8.6 million people highly benefit from statin therapy, who would not be eligible for statin therapy under the absolute risk-based approach, and this includes 1.3 million people with borderline risk (5% to 7.5%). Conversely, the risk-based approach selected more individuals with low predicted benefit (minimum iARR: 2.5% vs. 3.4%), resulting in a less efficient individual-level targeting profile (maximum iNNT: 41 vs. 29). A key limitation of this study is that benefit was estimated primary from LDL-C reduction, which may neglect other biological mechanisms of statin effects and underestimate the total benefit.

The individualized benefit approach prioritizes individuals most likely to benefit from statin therapy, differing from conventional risk-based selection through its superior individual-level precision. This approach can enhance the capacity to discriminate treatment effects at the individual level, making it particularly valuable for shared decision-making in resource-constrained settings.

Revakinagene taroretcel (NT-501) is an encapsulated cell therapy producing ciliary neurotrophic factor that slowed retinal degeneration in patients with macular telangiectasia type 2 (MacTel) in phase 2 trials.

In NTMT-03-A and NTMT-03-B - identically designed phase 3, multicenter, randomized sham-controlled trials - we evaluated efficacy and safety of NT-501 in MacTel. The primary end point was rate of change in ellipsoid zone area (EZA) (photoreceptor) loss over 24 months (mm²/24 months). Secondary outcomes included changes in retinal sensitivity, reading speed, and National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) scores (range, 0 to 100; higher scores indicate better function). Safety end points included the proportion of participants experiencing one or more treatment-emergent serious adverse event(s) and loss of 15 or more letters in best-corrected visual acuity (BCVA). Delayed dark adaptation and miosis were among the monitored adverse events.

In NTMT-03-A, adjusted rates of change of EZA loss were 0.075 mm²/24 months (95% confidence interval [CI], 0.051 to 0.099) and 0.166 mm²/24 months (95% CI, 0.141 to 0.191) in the NT-501 (n=58) and sham (n=57) groups, respectively, with a difference of -0.091 mm²/24 months (95% CI, -0.125 to -0.056; P<0.001) between groups. In NTMT-03-B, rates of EZA loss were 0.111 mm²/24 months (95% CI, 0.084 to 0.139) and 0.160 mm²/24 months (95% CI, 0.131 to 0.189) in the NT-501 (n=59) and sham (n=54) groups, respectively, with a difference of -0.049 mm²/24 months (95% CI, -0.089 to -0.008; P=0.02). Retinal sensitivity and reading-speed changes between groups were inconsistent in the trials. NEI VFQ-25 scores, BCVA loss, and treatment-emergent serious adverse events did not differ between treatment groups. Miosis was experienced by 17% and 14% of participants receiving NT-501 in NTMT-03-A and NTMT-03-B, respectively, and by none of the participants in sham groups. Delayed dark adaptation was experienced by 17% and 24% of participants receiving NT-501 in NTMT-03-A and NTMT-03-B, respectively, by none in the NTMT-03-A sham group, and by 2% in the NTMT-03-B sham group.

NT-501 for MacTel resulted in statistically significantly reduced EZA loss compared with sham procedures. (Funded by Neurotech Pharmaceuticals; ClinicalTrials.gov numbers, NCT03316300 and NCT03319849.).

Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD) and atrial fibrillation (AF), yet data on the clinical outcomes and management of AF in RA patients remain limited.

This study aimed to evaluate the impact of RA on AF-related outcomes and treatment strategies.

We conducted a retrospective cohort study using the TriNetX US collaborative network database, including adult patients diagnosed with AF between 2015 and 2025. Patients were divided into two cohorts based on the presence or absence of RA. Propensity score matching was performed to balance baseline characteristics.

A total of 33,922 RA-AF patients and 33,922 non-RA AF patients were analyzed after matching. RA-AF patients exhibited a significantly higher risk of all-cause mortality (24.5% vs. 21.0%, OR: 1.216, p<0.001) and hospitalization or emergency department visits (72.2% vs. 69.2%, OR: 1.153, p<0.001). Additionally, RA-AF patients had a higher incidence of ischemic stroke or transient ischemic attack (13.2% vs. 11.4%, OR: 1.180, p<0.001) and composite hemorrhagic events (14.4% vs. 10.6%, OR: 1.411, p<0.001). Notably, AF with rapid ventricular response (RVR) was more common in RA-AF patients (36.1% vs. 33.5%, OR: 1.122, p<0.001). Despite the elevated thromboembolic risk, RA-AF patients demonstrated lower utilization of anticoagulation (46.9% vs. 49.4%, OR: 0.905, p<0.001) and a preference for rate control over rhythm control strategies.

RA-AF patients experience higher mortality, increased stroke and hemorrhagic risk, and more frequent hospitalizations compared to non-RA AF patients. Despite these risks, anticoagulation underutilization remains a concern.

Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, increasing morbidity, ICU stay, dialysis need, hospitalization length, and costs. Despite prophylactic strategies, POAF incidence remains high, especially in moderate and high risk patients.

To assess the effect of amiodarone on POAF incidence and onset timing in moderate and high risk patients.

This prospective observational study included 454 patients undergoing elective coronary artery bypass grafting (CABG). Risk stratification of patients was based on the McSPI AFRisk Index, compared with the POAF Score and CHA2DS2-VASc Score. Moderate and high risk patients received amiodarone in combination with beta blockers (Amiodarone group), while low risk patients received beta blockers only. The primary outcome was POAF incidence, analyzed via Kaplan-Meier and Cox regression. Secondary analysis compared POAF rates between groups using the χ2 test.

POAF occurred in 5.95% of the Amiodarone group versus 9.25% in the beta blocker group (overall incidence: 15.2%). The relative risk reduction was 27% (RR = 0.27, 95% CI = 0.105-0.689, p = 0.006). POAF incidence was significantly lower in the Amiodarone group (p = 0.008, χ2 test). Kaplan-Meier analysis showed delayed POAF onset in the Amiodarone group (median: 48h vs. 33h, p = 0.0007). Cox regression confirmed a 73% lower risk of early POAF (HR = 0.27, 95% CI = 0.105-0.689, p = 0.006).

Amiodarone combined with beta blockers reduces POAF incidence and delays its onset after CABG. Keywords: POAF, CABG, amiodarone, risk stratification. Keywords: Body Dysmorphia, PCOS patients, prevalence.