Cardiovascular (CVD) and cerebrovascular diseases (CeVD) are leading causes of mortality. The Pooled Cohort Equations (PCE) are widely used for ASCVD risk prediction, but face calibration concerns, particularly in diverse populations. The Revised Pooled Cohort Equations (RPCE) were developed to address these limitations. While prior research has evaluated these models for ASCVD, less is known about their performance for CVD and CeVD mortality outcomes.

This study aimed to comprehensively compare the association of PCE and RPCE with CVD mortality and combined CVD and CeVD mortality, including subgroup analyses by race and gender, within a nationally representative US adult population.

We analyzed 16,584 primary prevention participants (aged 40-79 years) from National Health and Nutrition Examination Survey (1999-2018), linked to National Death Index mortality data. We calculated 10-year ASCVD risk using both PCE and RPCE. Bland-Altman plots assessed score agreement. Cox proportional hazards models evaluated the association of standardized PCE and RPCE scores with CVD and combined CVD and CeVD mortality, adjusting for confounders and stratifying by race and gender.

Both PCE and RPCE were significantly associated with CVD mortality (adjusted hazard ratio (HR) for PCE: 1.91 [95% CI: 1.82-2.01]; RPCE: 1.65 [95% CI: 1.59-1.72]) and combined CVD and CeVD mortality (adjusted HR for PCE: 1.91 [95% CI: 1.82-2.00]; RPCE: 1.65 [95% CI: 1.60-1.72]). Bland-Altman analyses revealed PCE consistently overestimated risk compared to RPCE, with differences increasing at higher risk levels. RPCE demonstrated improved calibration, especially in racially diverse populations, where PCE overestimation was more pronounced.

Both PCE and RPCE are robust prognostic tools for vascular mortality. However, RPCE offers improved calibration, particularly in racially diverse populations, by providing more conservative yet comparably predictive risk estimates. These findings highlight the importance of selecting risk models tailored to target populations to optimize prevention and avoid potential overtreatment.

Women with hypertensive postpartum syndrome (HDP) are more prone to negative emotions that affect their recovery, while magnesium sulfate has an anti-anxiety effect.

This study aims to evaluate the efficacy of magnesium sulfate therapy, administered intravenously or intramuscularly, in preventing complications such as eclampsia and managing blood pressure (BP) in patients with hypertension.

This research adopted a quantitative research paradigm and participants were assigned to the intervention and the control groups (70 participants each). The control group received their regular postpartum medical care that included antihypertensive medications and health education but did not receive magnesium sulfate treatment and designated physical rehabilitation. The data collected were then sorted and categorized genetically and were analyzed using the SPSS software program version 25.0 to enhance reliability of statistics.

The intervention group demonstrated significant improvements across physical, emotional and functional recovery, including BP compared with the control group. There was significant lowering of both systolic (-20.1 mmHg) and diastolic (-14.2 mmHg) BP, reduced fatigue, improvement in quality of life and decrease in pain (All P < 0.05). A regression analysis confirmed the treatment and health promotion as the positive indicators of the recovery rates while body mass index (BMI) and increased baseline diastolic BP as negative indicators. The convergence of pharmacological and non-pharmacological approaches made postpartum management more effective in terms of short-term as well as extended health problems.

These results are a robust starting off point for the application of a more comprehensive postpartum care framework in clinical care.

Entry of air into the extracorporeal circuit and inappropriate anticoagulation are significant factors associated with clotting. Even with systemic heparination, microbubbles can be implicated as sites for thrombosis and accelerate heparin metabolism. Fluid Stop devices, which prevent fluid from flowing during line drainage, have been shown potentially to decrease air embolism and improve hemostasis within circuits, but there is no concrete evidence available regarding simultaneous heparin use.

The objective of this trial was to determine whether the use of systemic heparin and a portable fluid stop device can decrease air embolism and clotting within hemodialysis circuits compared with traditional infusion sets. Anticoagulation stability, risk of bleeding, and patient satisfaction were also measured.

In this prospectively conducted single-center randomized controlled trial, 80 hemodialysis patients receiving maintenance hemodialysis were randomly assigned either to a control group with standard infusion sets or an observation group with fluid-stopping sets and all receiving standard heparin doses. A total of 800 hemodialysis sessions were conducted prospectively with observation for air bubble entrance, line draining, and clotting. Secondary endpoints included ACT variability, satisfaction rates, and instances of bleeding complications.

A significantly lower number of line emptying procedures (3 vs. 24; 5.0% vs. 27.5%), air bubble entries (4 vs. 28; 7.5% vs. 32.5%), and clotting incidents (2 vs. 12; 2.5% vs. 22.5%) were seen in the observation group compared with controls (P < 0.01). The stability of ACT values with smaller ranges of fluctuation was better in the observation group. Scores on satisfaction were higher, and there were no complications seen with bleeding.

Findings from these preliminary studies indicate that fluid-stopping devices may potentially improve heparin efficacy by preventing air embolism and clotting with no loss of safety. Based on these preliminary findings, larger multicenter trials are needed.

In recent years, the incidence of type B aortic dissection (TBAD) has shown an upward trend.

This study investigated the impact of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel on TBAD, providing valuable insights for clinical management.

A total of 120 TBAD patients admitted to our hospital between January 2022 and December 2023 were enrolled and randomized into two groups: A control group receiving standard treatment without DAPT and a research group receiving DAPT. Recovery time was measured in both groups. Cardiac function, coagulation parameters, inflammatory markers (interleukin [IL]-1β, IL-6, IL-10, tumor necrosis factor [TNF]-α, and systemic immune-inflammation index [SII]), and oxidative stress indicators (superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], and malondialdehyde [MDA]) were assessed before and after treatment. Additionally, pain levels and adverse events, including bleeding and thrombotic risks, were monitored throughout the treatment period.

DAPT significantly shortens postoperative recovery time compared to aspirin monotherapy, highlighting its potential benefits in TBAD treatment. After treatment, analysis revealed more significantly improved cardiac and coagulation functions in the research group. Furthermore, compared with the control group, the research group had significantly lower levels of inflammatory factors and stress response and significantly higher levels of anti-inflammatory factors and antioxidant factors (P<0.05). During the short-term follow-up, the research group showed more pronounced pain relief and a reduced risk of thrombosis, albeit with an increased risk of bleeding.

DAPT with aspirin and clopidogrel is more conducive to enhancing postoperative cardiac and coagulation functions and reducing inflammation in TBAD patients.

Living with chronic heart failure (CHF) implies physical consequences but also alterations in personal identity, family and social roles, and spiritual needs. No patient-reported outcome measures have been identified to know the meaning of living with CHF for the person. The aim of the study was to analyze the psychometric properties of the Spanish Version of the Experience of Living with CHF-University of Navarra Scale using a Spanish-speaking population. An observational, multicenter, cross-sectional study with retesting was conducted among 299 patients with CHF from five hospitals. Data quality, acceptability, and reliability were tested using techniques from classical test theory. Fit to the Rasch model, reliability, unidimensionality, item local independency, adequacy of response scale, and differential item functioning were tested following item response theory. The sample included 63% men, with a mean age of 69.34 years. The scale resulted in 30 items and five dimensions. Cronbach's alpha values ranged from 0.73 to 0.85, and the intraclass correlation coefficient from 0.79 to 0.87. Direct summative and linear scores could be calculated for each subscale. This is the first scale that favors knowledge on the experience of living with CHF.

The incidence of ischemic stroke among young adults (aged 18-49 years) has risen over recent decades, particularly in high-income countries, contrasting with the decline seen in older populations. This trend represents a growing public health concern, as stroke at young age often leads to long-term psychosocial consequences and loss of productive life years. The increasing incidence may partly reflect a higher prevalence of traditional vascular risk factors, as well as the identification of non-traditional risk and trigger factors such as air pollution, sleep apnea, long working hours, vigorous exercise, and illicit drug use. Diagnostic evaluation in this young population is typically more extensive than in older patients, given the broad spectrum of potential underlying causes. A structured, multidisciplinary approach integrating vascular, hematologic, and cardiac assessment is essential for accurate etiological classification. Although functional outcomes are generally favorable, many young stroke survivors experience persistent psychosocial sequelae, including cognitive impairment, depression, anxiety, and fatigue, which significantly affect quality of life. Recurrence risk varies according to stroke etiology, with the lowest rates observed in patients with a cryptogenic stroke. These findings highlight the importance of more tailored secondary prevention strategies, as antiplatelet therapy is not without risks. Further research is needed to identify novel risk and trigger factors, refine prognostic tools, optimize secondary prevention, and develop interventions addressing the psychosocial recovery of young stroke survivors.

The goal of this review is to evaluate the evolving role of triglycerides (TGs) and TG-rich lipoproteins (TRLs) in cardiovascular disease (CVD) risk and prevention. We examine the mechanistic rationale, genetic and epidemiological evidence, and therapeutic potential of targeting TGs in residual risk reduction, particularly in high-risk populations.

Emerging data from Mendelian randomization studies and large clinical cohorts support a causal link between elevated remnant lipoproteins and atherosclerotic CVD, in which apolipoprotein B may be the principal driver. Although traditional triglyceride-lowering agents have produced mixed results on cardiovascular outcomes, emerging therapies-such as ApoC-III and ANGPTL3 inhibitors-show robust lipid-lowering effects, while selective PPAR modulators have thus far not demonstrated cardiovascular benefit. However, outcome data remain limited. Residual CVD risk persists despite aggressive LDL-C reduction, especially in patients with diabetes, metabolic syndrome, or chronic kidney disease. Selective TG-lowering strategies targeting TRLs-especially those that decrease apolipoprotein B-may provide clinical benefit in high-risk phenotypes. Ongoing trials will clarify whether these promising agents confer meaningful cardiovascular protection and warrant integration into future guidelines.

Coronary artery disease, a leading cause of mortality, underscores the need for biomarkers that can predict acute coronary syndrome (ACS) occurrence and outcomes. MicroRNAs (miRNAs) are increasingly recognized as potential markers. This study aimed to identify a plasma miRNA signature in ACS patients undergoing elective cardiac catheterization and to investigate miR-100's potential as an ACS prognostic biomarker. Plasma samples from 100 patients with suspected ACS were analyzed. qPCR revealed significantly elevated plasma miR-29a-3p, miR-100, miR-192, and miR-194-5p in ACS patients, and multiplex ELISA showed increased myeloperoxidase. Sub-network enrichment analysis identified TP53 as a central regulator of the miRNA-gene interaction network. In H9c2 cardiomyoblasts, hypoxic treatment (1% O₂) induced significant cytotoxicity and increased intracellular and released miR-100 levels. Western blotting further showed that hypoxia suppressed p53, HMGB1, NF-κB, and Bcl-2 expression. Consistent with the predicted regulatory network, siRNA-mediated p53 silencing markedly reduced constitutive miR-100 expression and triggered compensatory upregulation of inflammatory and survival-related proteins, including TLR4, NF-κB, and Bcl-2. Conversely, miR-100 overexpression significantly increased p53 protein levels and reduced the pro-survival factor Mcl-1, whereas miR-100 inhibition produced the opposite effect. These findings define a reciprocal p53/miR-100 regulatory axis that influences inflammatory and survival signaling in cardiomyoblasts. In conclusion, both clinical profiling and mechanistic studies support miR-100 as a promising early prognostic biomarker for ACS and suggest that hypoxia-induced disruption of the p53/miR-100 axis may contribute to cardiomyoblast vulnerability. Further studies are warranted to explore its therapeutic potential.

A borderline small left ventricle (LV), in which the LV is underdeveloped but not diminutive, represents an ongoing area of research and a challenge in clinical management. In this paper, the authors aimed to review the definition of borderline LV and recruitment strategies with a focus on hybrid, and wholly transcatheter approaches, to achieve the goal of two ventricle circulation.

Hampered by a lack of consensus definition; historically, patients with borderline LV were managed with single-ventricle palliation. However, due to the suboptimal long-term outcomes with single-ventricle palliation, many programs have adopted strategies to promote LV growth with the goal of achieving two-ventricle circulation with different outcomes. Initially dominated by surgical staging, there is growing evidence to support the use of hybrid or entirely transcatheter techniques to achieve first stage palliation in patients with borderline LV. Regardless of technique used (surgical and/or transcatheter), recruiting the LV into a successful biventricular circulation typically requires multiple interventions aimed at improving blood flow through the left heart structures and increasing LV volume loading in an effort to promote LV remodeling. Scoring systems can be helpful tools in determining the candidacy for LV recruitment strategy; however, the optimal scoring system has yet to be established.

Vitamin D is an essential pro-hormone that helps to regulate mineral metabolism and skeletal health. Epidemiological data suggest that many individuals have insufficient serum levels of 25-hydroxy vitamin D, the marker of vitamin D status, for most of the year. Recognition of this observation has led to replacement regimens for vitamin D that have often led to its overuse even in disorders not related to bone homeostasis. Since vitamin D toxicity is rare, safety issues related to vitamin D supplementation have not been carefully addressed recently. Overall safety issues related to administration of vitamin D pro-hormones from nutritional sources and from supplements are reviewed, along with recommendations for correct intakes. Traditional and new areas in which an improper use of vitamin D may occur are specifically addressed. Supplementation with vitamin D pro-hormones is effective and safe at usual daily, weekly or monthly doses that are recommended to maintain optimal mineral homeostasis. Monitoring is generally not mandatory once the desired level of serum 25(OH)D is obtained. However, clinical circumstances often change from year to year, in which cases confirmation of the adequacy of 25(OH)D is reasonable. When calcidiol is used, long term, monitoring is expected. Ingestion of excessive amounts of vitamin D, either through overprescribing or overdosing, is potentially harmful.