Advancements in risk stratification and management strategies in primary cardiovascular prevention.

Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide, highlighting the urgent need for advancements in risk assessment and management strategies. Although significant progress has been made recently, identifying and managing apparently healthy individuals at a higher risk of developing atherosclerosis and those with subclinical atherosclerosis still poses significant challenges. Traditional risk assessment tools have limitations in accurately predicting future events and fail to encompass the complexity of the atherosclerosis trajectory. In this review, we describe novel approaches in biomarkers, genetics, advanced imaging techniques, and artificial intelligence that have emerged to address this gap. Moreover, polygenic risk scores and imaging modalities such as coronary artery calcium scoring, and coronary computed tomography angiography offer promising avenues for enhancing primary cardiovascular risk stratification and personalised intervention strategies. On the other hand, interventions aiming against atherosclerosis development or promoting plaque regression have gained attention in primary ASCVD prevention. Therefore, the potential role of drugs like statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, omega-3 fatty acids, antihypertensive agents, as well as glucose-lowering and anti-inflammatory drugs are also discussed. Since findings regarding the efficacy of these interventions vary, further research is still required to elucidate their mechanisms of action, optimize treatment regimens, and determine their long-term effects on ASCVD outcomes. In conclusion, advancements in strategies addressing atherosclerosis prevention and plaque regression present promising avenues for enhancing primary ASCVD prevention through personalised approaches tailored to individual risk profiles. Nevertheless, ongoing research efforts are imperative to refine these strategies further and maximise their effectiveness in safeguarding cardiovascular health.

Electrocardiogram Features in Non-Cardiac Diseases: From Mechanisms to Practical Aspects.

Despite the noteworthy advancements and the introduction of new technologies in diagnostic tools for cardiovascular disorders, the electrocardiogram (ECG) remains a reliable, easily accessible, and affordable tool to use. In addition to its crucial role in cardiac emergencies, ECG can be considered a very useful ancillary tool for the diagnosis of many non-cardiac diseases as well. In this narrative review, we aimed to explore the potential contributions of ECG for the diagnosis of non-cardiac diseases such as stroke, migraine, pancreatitis, Kounis syndrome, hypothermia, esophageal disorders, pulmonary embolism, pulmonary diseases, electrolyte disturbances, anemia, coronavirus disease 2019, different intoxications and pregnancy.

Significance of Mitochondrial Dysfunction in the Pathogenesis of Parkinson's Disease.

Parkinson's disease (PD) is characterized by the degeneration of the dopaminergic neurons of the corpus striatum, which can be caused by the disruption of processes of mitochondrial homeostasis, including mitophagy, mitochondrial fusion and division, mitochondrial transport, accumulation of reactive oxygen species (ROS), and calcium signaling. Dopaminergic neurons are particularly vulnerable to mitochondrial dysfunction due to their polarized and expanded structure and high bioenergy needs. The molecular basis of these disorders is manifested in mutations of mitochondrial homeostasis proteins. Understanding the functions of these proteins and the disorders caused by these mutations can be used to create therapeutics for the treatment of PD and diagnostic biomarkers of PD. A comprehensive analysis of research papers to identify promising therapeutic targets and drug compounds that target them, as well as biomarkers of mitochondrial dysfunction that can be used in clinical practice for the treatment of PD has been conducted in the current review. This practical approach advantageously emphasizes the difference between this work and other reviews on similar topics. The selection of articles in this review was carried out using the following keyword searches in scientific databases: PubMed, Google Scholar, NSBI, and Cochrane. Next, the most relevant and promising studies were re-selected.

Regional differences in presentation characteristics, use of treatments and outcome of patients with cardiogenic shock: Results from multicenter, international registry.

BACKGROUND: Concurrent evidence about cardiogenic shock (CS) characteristics, treatment and outcome does not represent a global spectrum of patients and is therefore limited. The aim of this study was to investigate these regional differences. METHODS: To investigate regional differences in presentation characteristics, treatments and outcomes of patients treated with all types of cardiogenic shock (CS) in a single calendar year on a multi-national level. Consecutive patients from 19 tertiary care hospitals in 13 countries with CS who were treated between January 1, 2018 and December 31, 2018 were enrolled in this study. RESULTS: In total, 699 cardiogenic shock patients were included in this study. Of these patients, 440 patients (63%) were treated in European hospitals and 259 (37%) were treated in Non-European hospitals. Female patients (P<0.01) and patients with a previous myocardial infarction (P=0.02) were more likely to present at Non-European hospitals; whereas older patients (P=0.01) and patients with cardiogenic shock due to acute heart failure (P<0.01) were more likely to present at European hospitals. Vasopressor use was more likely in Non-European hospitals (P=0.04), whereas use of mechanical circulatory support (MCS) was more likely in European hospitals (P<0.01). Despite adjustment for relevant confounders, 30-day in-hospital mortality risk was comparably high in CS patients treated in European vs. Non-European hospitals (hazard ratio 1.08, 95% CI 0.84-1.39, P=0.56). CONCLUSION: Despite marked heterogeneity in characteristics and treatment of CS patients, including fewer use of MCS but more frequent use of vasopressors in Non-European hospitals, 30-day in-hospital mortality did not differ between regions.

A Survey on Cardiovascular Nursing Occupational Standard: Meeting the Needs of Employers.

Occupational standard is the result of the agreement between relevant stakeholders in the labor market and education on optimal content for a particular occupation. While drafting occupational standard, the primary instrument for researching competencies at a workplace is a survey on occupational standard. This study identifies key competencies, roles, and responsibilities that are deemed necessary by employers of cardiovascular nurses. The survey addressed the responses of 41 organizations from 11 out of 21 counties in Croatia which were represented by the head nurses of cardiology departments in the hospitals. The survey consisted of 24 questions that covered the main responsibilities, competencies, generic skills, and psychometric abilities. Descriptive statistics were used to analyze the data. Conducting diagnostic and therapeutic procedures, health care, education, administration of medications, monitoring, and documentation were listed as the main responsibilities of cardiovascular nurses. The most common skills included assessment, monitoring patient's condition, knowledge of the diagnostic or therapeutic procedures and cardiovascular diseases, interpreting the electrocardiograms, preparing patients for checkups, conducting patient's education, and following practice guidelines. Generic skills included communication and organizational skills, teamwork, and responsibility. Reaction time and attention span were the most assessed psychomotor abilities. Artificial lighting and radiation were the most important environmental risk factors. The most appropriate level of education for cardiovascular nursing was specialist graduate studies. The results of the study could be used to develop occupational standards for cardiovascular nursing and to guide the curriculum for the educational program development.