Nutrition insecurity is a major driver of poor cardiovascular health in Indigenous communities. Medically tailored meals may improve heart failure outcomes and quality of life. There is growing momentum among Indigenous communities to reclaim traditional precontact foods to improve cardiovascular health. In this context, utilizing community-based-participatory methods, we designed MUTTON-HF (Medically Utilized Tailored Traditional Foods to Optimize Nutrition in Heart Failure)-an Indigenous culturally and medically tailored meals program that locally sources Native produce and meat and incorporates traditional Diné (Navajo) foods and recipes.

Mortality from acute myocardial infarction (MI) has declined significantly in the past decade for nondiabetic patients. However, both morbidity and mobility of ischemic heart failure (IHF) persistently escalate in the diabetic population via incompletely understood mechanisms. Recent studies demonstrated that small extracellular vesicles (sEVs) released from nondiabetic and diabetic adipocytes (ADps) exert opposite effects on acute myocardial ischemia and reperfusion (MI/R) injury. However, whether and how ADp sEVs may protect against post-MI remodeling and IHF, and more important, whether and how diabetes may impair this protective effect, remain unknown.

Ischemic heart disease remains a leading cause of mortality worldwide, with adverse remodeling after myocardial infarction driven by inflammation and cardiomyocyte loss. Although cytotoxic lymphocytes exacerbate myocardial injury and P16 marks cellular senescence in diseased hearts, the cell type-specific functions of P16+ populations remain unclear.

Patients with peripheral artery disease (PAD) undergoing lower extremity revascularization (LER) are at high risk of major adverse limb events (MALE) and major adverse cardiovascular events. The VOYAGER-PAD trial demonstrated that rivaroxaban 2.5 mg twice daily on top of antiplatelet therapy significantly reduced this risk. Whether the risk of major adverse cardiovascular events and MALE and the effect of rivaroxaban are consistent in patients with a history of prior LER versus those without has not been described.

Atrial fibrillation (AF) is associated with reduced quality of life and frequent hospitalizations. Integrated nurse-led care (NLC) has proven beneficial in unselected AF patients, but evidence specific to patients undergoing catheter ablation is limited. We aimed to assess the impact of a structured nurse-led intervention in patients undergoing first-time AF ablation.

A genotype-guided de-escalation strategy-switching from a potent P2Y12 inhibitor to clopidogrel-may reduce bleeding risk in patients with acute coronary syndrome (ACS). This analysis evaluated the safety and effectiveness of routine genetic testing to guide antiplatelet therapy in clinical practice.

Atrial cardiopathy often precedes atrial fibrillation (AF) and has emerged as an independent risk factor for cardiovascular outcomes. However, previous studies have been limited in size and have overlooked the right atrium.

Mapping of heart rhythms is influenced by the size and configuration of the mapping electrodes. Whether a recorded electrogram represents near (local) or remote activity influences diagnosis and treatment, yet is affected by mapping characteristics that are often undefined.

The current guidelines contraindicate intravenous amiodarone in patients with Wolff-Parkinson-White syndrome presenting with preexcited atrial fibrillation (AF) due to the risk of degeneration into ventricular fibrillation (VF). However, these recommendations are based predominantly on isolated case reports, which is concerning given the drug's widespread global use as a first-line antiarrhythmic in resource-limited settings. To evaluate the safety of intravenous amiodarone in this context, we conducted a systematic review of (1) studies enrolling patients with electrocardiographically confirmed preexcited AF who received intravenous amiodarone and (2) studies quantifying antegrade accessory-pathway effective refractory period during intravenous amiodarone administration. All observational and interventional studies assessing patients with preexcited AF were pooled under a conjugate β-binomial model with prespecified weak priors to estimate the risk of VF during or following infusion. Concomitantly, to assess real-world access to alternative class IIa/IIb European Society of Cardiology-recommended antiarrhythmic agents for preexcited AF, we performed a multinational survey of Latin American emergency departments. Twelve studies comprising 177 patients were included in the review (7 case reports, 2 cohorts, 3 before-and-after interventional studies). Four case reports described transient ventricular rate acceleration or VF following intravenous amiodarone. However, across the observational and interventional cohorts assessing patients with preexcited AF (n=146), no acceleration or VF was observed. The posterior mean estimates of VF risk ranged 0.12% to 0.68% over priors. Across 3 interventional before-and-after studies, there was a significant increase in the anterograde effective refractory period of the atrioventricular node and AP following amiodarone administration. The survey responses from 10 emergency centers indicated that none had access to class IIa/IIb indicated agents, while all had intravenous amiodarone available. Taken together, population-level evidence suggests that the risk of VF in preexcited AF following intravenous amiodarone administration is rare. In settings where guideline-recommended drugs are inaccessible, intravenous amiodarone may represent a clinically reasonable alternative for rhythm or rate control.

Forecasts for the future prevalence of cardiovascular disease and stroke are crucial to guide efforts to improve health outcomes across the life course for women.

Malnutrition can affect patients with various acute cardiovascular disease conditions, including acute coronary syndromes, arrhythmias, or valvular disease; however, most of the literature has focused on patients with heart failure. Malnutrition prevalence estimates range from 20% to 60% for hospitalized patients. Use of Global Leadership Initiative on Malnutrition criteria for malnutrition diagnosis for patients with cardiovascular disease has confirmed prognostic value, correlating with poorer physical function and higher mortality. Nutritional support plays a key role for inpatients, particularly in the cardiac intensive care unit, and includes initiation of feeding within 48 hours of hospitalization, preferably through enteral nutrition. Enteral nutrition is more cost-effective compared with parenteral nutrition and can decrease mortality and shorten lengths of stay. Parenteral nutrition is reserved for patients with severe gastrointestinal dysfunction or to supplement nutrition when enteral nutrition is contraindicated, for example, during high pressor doses that preclude adequate intestinal perfusion or when achieving <70% of nutritional targets after the first week. The optimal protein intake for patients with cardiogenic shock is an area of ongoing research, with higher protein approaches not appearing beneficial in recent critical care trials.

Novel treatments are needed for the primary and secondary prevention of heart failure in patients with type 2 diabetes, including individuals with and those without a history of heart failure. Conflicting trial evidence exists on whether glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce the risk of hospitalization for heart failure (HHF) in this broad population and whether this is a class effect or varies by specific agent. Furthermore, their comparative effectiveness against sodium-glucose cotransporter-2 inhibitors (SGLT-2is) is unknown.

The tenet of cardiac amyloidosis (CA) as a paradigm of heart failure with restrictive ventricular physiology and preserved systolic function has come under scrutiny. We aimed to evaluate the prevalence and clinical significance of left ventricular (LV) systolic dysfunction versus restriction in a large real-world cohort with CA, assessed at the time of diagnosis.