Myocardial infarction is a major public health concern for women. Hospitalization rates are increasing, particularly among young women. This trend is probably linked to the growing prevalence of cardiovascular risk factors and specific conditions that can increase the risk of myocardial infraction, such as early menopause, estrogen-progestogen contraception, endometriosis and chest radiation therapy for breast cancer. From a patho-physiological perspective, women have distinct characteristics. They have a higher proportion of myocardial infraction without significant coronary obstruction, including spontaneous coronary dissection, which can occur during pregnancy. Women also have smaller coronary and radial arteries with more frequent tortuosity, which can complicate interventional procedures. Additionally, disparities in the management of myocardial infraction in women have been observed. They tend to seek medical attention later and are less likely to benefit from invasive strategies, such as revascularization or coronary artery bypass grafting. In conclusion, myocardial infraction in women have many clinical and pathophysiological specificities. Additional efforts are needed to improve care and ensure equality in treatment by taking into account the specific characteristics of women.

In women, cardiovascular risk is influenced by factors that differ from those in men, including hormonal status, obstetric complications, and specific conditions such as migraine, endometriosis, or chronic inflammatory diseases. These factors affect both arterial and venous risk, which are often not accounted for by standard risk scores. This literature review highlights these women-specific factors, emphasizing the need for appropriate risk stratification tools, personalized prevention strategies, and improved information for women throughout their lives.

BackgroundThe risk of venous thromboembolism (VTE) among patients with atopic dermatitis (AD), especially when receiving treatment with Janus kinase inhibitors (JAKi), has been reported in observational studies. however, the causal relationships between them remain unclear. We aim to explore the causal effects of AD and JAKi on VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE).MethodsTwo-sample Mendelian randomization (MR) analyses were conducted to examine the causal between genetic susceptibility to AD or JAKi target genes (including JAK1, JAK2, JAK3 and tyrosine kinase 2 [TYK2]) and VTE (encompassing DVT and PE) using summary statistics from genome-wide association studies and eQTLGen project. Inverse variance weighting with random effect method was used as the main analytic approach. Pleiotropy and heterogeneity tests were conducted to assess the robustness of the findings.ResultsNo significant causal effects were found between AD and the risk of (odds ratio [OR]: 0.97, 95% confidence interval [CI]: 0.91-1.03, P = .352), DVT (OR: 0.99, 95% CI: 0.89-1.10, P = .789), and PE (OR: 1.06, 95% CI: 0.93-1.20, P = .387). Similarly, there was no causal association between the expression of JAK1, JAK2, JAK3 or TYK2 and VTE, DVT and PE.ConclusionThe MR analysis revealed no genetic causal relationships between either AD or JAKi target genes and VTE. These findings may provide a reference for clinicians in prescribing JAKi for patients with AD.

Deep vein thrombosis (DVT) poses a significant global health challenge that affects patients' physical function and symptom burden. Evidence on the health-related quality of life (HRQoL) of patients with DVT remains scarce in Ethiopia. This study aimed to assess DVT-specific quality of life and associated factors among patients with DVT. A hospital-based cross-sectional study was conducted at Tikur Anbessa Specialized Hospital, Ethiopia, in which 123 adults with confirmed DVT were recruited. Data were collected using the Amharic version of the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QOL/Sym) questionnaire, supplemented with clinical and demographic data. VEINES-QOL/Sym scores were standardized to T-scores (mean = 50, SD = 10), with raw scores scaled 0-100 (higher values indicated better HRQoL). Data were analyzed using Statistical Package for the Social Sciences version 28. Binary logistic regression was used to identify factors associated with HRQoL, with statistical significance set at P < .05. Among 123 patients (73.2% provoked, 93.5% unilateral DVT), VEINES-QOL ranged 33.4-59.6 and VEINES-Sym 26.7-58.7, both with a mean value of 50. Longer time since diagnosis was significantly associated with improved QoL (AOR = 1.922; 95% CI 1.155-3.199; P = .012), while proximal DVT (AOR = 0.240; P = .008), combined proximal/distal DVT (AOR = 0.136; P = .014), and post-thrombotic syndrome (PTS) (AOR = 0.108; P = .017) predicted poorer outcomes. In conclusion, VEINES-QOL/Sym scores indicated average QoL with modest improvement over time. Routine HRQoL assessment, PTS prevention, and improved monitoring, adherence, and patient education are recommended to strengthen DVT care in Ethiopia.

BackgroundSelected cardiovascular factors, APOE4 carriership, and family history (FH) are robust risk factors for Alzheimer's disease and dementia. While cardiovascular risk tends to affect cognition from midlife, it remains unclear whether heritable risk predicts cardiovascular health in young adulthood and midlife, and whether young-adult cardiovascular health predicts midlife cognition.ObjectiveWe sought to examine how heritable dementia risk relates to cardiovascular health and how these cardiovascular risk factors in young adulthood predict midlife brain volumes and cognition.MethodsWe used data from the CARDIA study, which followed 5115 individuals aged 18-30 at baseline over 30 years. Analyses focused on 2808 participants (Mean age = 60, SD = 3.58) who attended the 30-year visit. We examined associations between APOE4 and FH with baseline and 30-year follow-up measures of cardiovascular risk factors (LDL-C, HDL-C, glucose, blood pressure, body mass index (BMI), smoking), cognition, and brain volumes.ResultsAPOE4 carriers with FH had higher LDL-C and lower HDL-C levels as early as young adulthood, persisting into midlife. BMI and smoking were the only cardiovascular risk factors from young adulthood that predicted midlife cognition. There was no association between young adult cardiovascular risk factors and midlife brain volumes, but those with heritable dementia risk had larger brain volumes in regions vulnerable to midlife atrophy.ConclusionsAPOE4 carriership was associated with an unfavorable lipid profile that started in early adulthood and persisted to later life. Early cardiovascular risk was also associated with midlife cognition, which is earlier than studies typically focusing on later-life cognition.

Children with cardiac channelopathies face significant challenges, including exposure to medical trauma, complex genetic testing options, activity restrictions, lifelong surveillance, and increased risk of sudden death. This study assessed parental perceptions of child health-related quality of life (HRQOL) and unmet cardiac care needs, as well as predictors of traumatic stress among parents of children with a cardiac channelopathy.

Parents of children diagnosed with Long QT Syndrome, Catecholaminergic Polymorphic Ventricular Tachycardia, or Brugada Syndrome were invited to participate in a cross-sectional study. Sixty-eight parents from 45 families (response rate: 75%) completed measures assessing child HRQOL, unmet cardiac care needs, and parent symptoms of traumatic stress, anxiety, and depression.

Prior to attending their first multidisciplinary arrhythmia clinic, parents reported an average of 12 unmet needs. Half of mothers (50%) and 38% of fathers indicated their child was at-risk in terms of emotional functioning. Having a cardiac implantable electronic device, lower social support, and greater parental psychological stress predicted lower child HRQOL. Child out-of-hospital cardiac arrest was the strongest predictor of parent post-traumatic stress.

Psychosocial screening and access to integrated, trauma-informed, family-centered psychological care should form part of best practice recommendations for children with cardiac channelopathies.

The hepatic steatosis index (HSI) is a reliable predictor of non-alcoholic fatty liver disease (NAFLD), a condition that can increase the risk of atherosclerosis. However, limited data are available on the association between HSI and asymptomatic intracranial arterial stenosis (aICAS).

This cross-sectional study aimed to investigate the association between HSI and aICAS among Chinese rural residents. The study enrolled 1788 participants aged ≥ 40 years without a history of clinical stroke or transient ischemic attack from the Rose Asymptomatic Intracranial Artery Stenosis (RICAS) cohort. We defined aICAS as ≥ 50% stenosis in intracranial arteries confirmed through combined transcranial Doppler (TCD) ultrasound and magnetic resonance angiography (MRA). The HSI was calculated based on gender, diabetes, body mass index (BMI), and transaminases level. The multivariate logistic regression models were deployed to explore the association of HSI with aICAS.

Of the 1788 participants, the participants with aICAS comparing with those without aICAS had a significantly higher HSI. Controlling for confounding factors, HSI ≥ 36 was significantly associated with aICAS (OR = 3.08; 95%CI: 1.46-6.49, P = 0.003), especially multiple aICAS (OR = 4.21; 95%CI: 1.31-13.47, P = 0.016). The prevalence of aICAS increased with the value of HSI (P for trend = 0.001). Subgroup analysis further showed the association between HSI and aICAS risk only in non-abdominally obese populations (P for interaction = 0.023).

HSI may serve as a practical non-invasive biomarker for aICAS risk stratification, thus facilitating early detection in community settings, particularly in non-abdominally obese populations.

Spinal cord injuries and disorders (SCI/D) have been reported by some studies to correlate with increased risk of ischemic cerebral stroke. However, the reports are sparse, conflicting, generally lacked SCI/D-specific analysis, and commonly had small sample sizes.

To determine whether SCI/D are a risk factor for ischemic stroke and evaluate for underlying SCI/D-related stroke risk correlations.

Using a retrospective design aimed to capture a large sample with SCI/D, first-ever stroke incidence was estimated by Poisson regression models for US Veterans with and without SCI/D during fiscal years 2017-2021 using US Veterans Health Administration and Medicare utilization data. Models were adjusted for Veteran characteristics, common stroke risk factors, and prescriptions for stroke-prophylactic medications.

Analyses included 560,314 Veterans, including 12,450 with SCI/D. Adjusting for person-days, age, sex, smoking, diabetes, hypertension, atrial fibrillation, race, ethnicity, and stroke-prophylactic medications, Veterans with SCI/D had a 19% higher stroke incidence compared to controls [incidence rate ratio (IRR) 1.19, 95%CI: 1.11-1.28]. Compared to controls, stroke incidence was 50% and 31% higher with high and low tetraplegia, respectively [IRR 1.50, 95%CI: 1.17-1.92 and IRR 1.31, 95%CI: 1.02-1.67], and markedly higher for younger Veterans with SCI/D (ages < 40 years) [IRR 2.25, 95%CI: 1.24-4.08]. Relative to controls, stroke incidence was 36% higher with non-traumatic SCI/D [IRR 1.36, 95%CI: 1.24-1.49], but not with traumatic spinal cord injury [IRR 1.05, 95%CI: 0.95-1.17].

SCI/D are a risk factor for ischemic stroke in US Veterans, especially for Veterans with tetraplegia, non-traumatic SCI/D, and younger age.

Phase I single and multiple ascending dose studies are more and more often used to evaluate QT liability of new drugs. However, these studies are not primarily tailored to concentration-QT analysis and to control or document influential factors such as meal intake. In addition, sampling times may vary over the day for operational reasons. This simulation analysis evaluates the reliability of the standard pre-specified linear model (PLM) proposed by a publication of Garnett et al. and an adjusted PLM accounting for food effect and clock time. The QTcF-time profile of a drug with a mild QT-liability (upper bound of the 90% confidence interval close to the 10 ms threshold) resulting from a well-controlled study was simulated 1000 times and evaluated with the unadjusted PLM (Scenario A, negative rate: 20.8%). Compared to suboptimal study designs with uncontrolled and unbalanced (i.e., differences between active treatment and placebo) differences in meal intake and dosing/sampling times, the unadjusted PLM led to an inflated negative rate (≤ 50%), while the adjusted PLM was able to correct for the imbalances resulting in similar negative rates as the reference scenario or lower, i.e., being more conservative. In conclusion, good documentation in Phase I trials and adjusting for known influential factors can help to analyze QT effects reliably and waive with relevance QT/QTc studies.

There is less evidence on the association between long-term PM_2.5, O₃, greenness exposure and cardiometabolic multimorbidity (CMM), and the aim of this study was to investigate the combined effects of PM_2.5, O₃ and greenness exposure on the risk of developing CMM.Our findings demonstrated that a 10 µg/m³ rise in PM_2.5 concentration led to a 23.8% increased CMM risk (HR = 1.238, 95%CI: 1.202,1.275). A 0.1 increase in NDVI reduced CMM risk by 18.9% (HR = 0.811, 95% CI: 0.779,0.845). A 10 µg/m³ O₃ concentration increase surprisingly lowered CMM risk by 30.8% (HR = 0.692, 95% CI: 0.649,0.738). Positive interactions were seen between high PM_2.5+low O₃ and low O₃ + low NDVI, while high PM_2.5+low NDVI had negative interactions regarding CMM. PM_2.5 mediated the link between NDVI and CMM, heart disease, and stroke.This study emphasizes that long-term high PM_2.5 exposure ups CMM risk in Chinese middle-aged and older adults, yet NDVI exposure reduces it, with PM_2.5 as a mediator. The O₃-CMM relationship remains unclear.