Anatomy-Informed Multimodal Learning for Myocardial Infarction Prediction.

In patients with coronary artery disease, the prediction of future cardiac events such as myocardial infarction (MI) remains a major challenge. In this work, we propose a novel anatomy-informed multimodal deep learning framework to predict future MI from clinical data and Invasive Coronary Angiography (ICA) images. The images are analyzed by Convolutional Neural Networks (CNNs) guided by anatomical information, and the clinical data by an Artificial Neural Network (ANN).

Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort.

Aims: The benefit of long-term beta-blocker therapy after acute coronary syndromes (ACS) without heart failure in the reperfusion era is uncertain. Two recent randomized trials found conflicting results. The present study assessed the safety of beta-blocker discontinuation within 12 months following ACS with LVEF ≥40%.

Association Between Patient Sex and Familial Hypercholesterolemia and Long-Term Cardiovascular Risk Factor Management 5 Years After Acute Coronary Syndrome.

Background: Long-term control of cardiovascular risk factors after acute coronary syndrome (ACS) is the cornerstone for preventing recurrence. We investigated the extent of cardiovascular risk factor management in males and females with and without familial hypercholesterolemia (FH) 5 years after ACS.

Methods: We studied patients hospitalized for ACS between 2009 and 2017 in a Swiss multicenter prospective cohort study.

Use of combination therapy is associated with improved LDL cholesterol management: 1-year follow-up results from the European observational SANTORINI study.

Aims: To assess whether implementation of the 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) dyslipidaemia guidelines observed between 2020 and 2021 improved between 2021 and 2022 in the SANTORINI study.

Methods And Results: Patients with high or very high cardiovascular (CV) risk were recruited across 14 European countries from March 2020 to February 2021, with 1-year prospective follow-up until May 2022. Lipid-lowering therapy (LLT) and 2019 ESC/EAS risk-based low-density lipoprotein (LDL) cholesterol (LDL-C) goal attainment (defined as <1.

[Cardiovascular risk evaluation using the coronary artery calcium score].

The coronary artery calcium score (CAC-score) using imaging is a cardiovascular screening tool that can be used in adults with no known cardiovascular disease and no symptoms suggestive of a cardiovascular pathology. It involves calculating the amount of calcification in the coronary arteries on a low-dose, non-injected chest CT-scan. A positive score above 0 is associated with more cardiovascular events.

[Epigenetic modifications and cardiovascular diseases : new Eldorado].

As the risk of developing cardiovascular disease (CVD) is strongly dependent on the environment, the study of associated epigenetic modifications is a potentially promising axe of research given that they are affected by both the environment and disease development. Importantly, it is possible to identify and characterize specific epigenetic modifications in association with a disease, or risk factors for a disease, to create a so-called "epigenetic signature". Epigenetic signatures thus provide a summary of associated epigenetic changes and have the potential for several clinical applications including diagnosis, prognosis, as well as patient monitoring.

[Identifying and assisting sedentary patients: a practical guide].

A sedentary lifestyle is a significant cardiovascular risk factor and increases premature mortality. Engaging in routine physical activity (PA) provides a wide range of health benefits. Accordingly, physical inactivity must be identified and sedentary patients supported systematically to achieve recommended levels of PA.

[Mobile cardiovascular screening and prevention in the population : useful in Switzerland?].

Mobile cardiovascular prevention interventions are still uncommon in Switzerland. Mobile clinics improve access to prevention and enable new diagnoses of hypertension or hypercholesterolemia to be identified in a cost-effective way and has shown benefits in health behaviors such as physical activity, smoking cessation and medication compliance. The Unisanté Bus Santé is a mobile clinic run by nurses that offers screening for cardiovascular risk factors, health advice and, if necessary, referral to medical care.

Comparison of the European and US guidelines for lipid-lowering therapy in primary prevention of cardiovascular disease.

Aims: Population-wide impacts of new guidelines in the primary prevention of atherosclerotic cardiovascular disease (ASCVD) should be explored in independent cohorts. Assess and compare the lipid-lowering therapy eligibility and predictive classification performance of 2016 and 2021 European Society of Cardiology (ESC), 2019 American Heart Association/American College of Cardiology (AHA/ACC), and 2022 US Preventive Services Task Force (USPSTF) guidelines.

Methods And Results: Participants from the CoLaus|PsyCoLaus study, without ASCVD and not taking lipid-lowering therapy at baseline.

Treatment gaps in the implementation of LDL cholesterol control among high- and very high-risk patients in Europe between 2020 and 2021: the multinational observational SANTORINI study.

Background: European data pre-2019 suggest statin monotherapy is the most common approach to lipid management for preventing cardiovascular (CV) events, resulting in only one-fifth of high- and very high-risk patients achieving the 2019 ESC/EAS recommended low-density lipoprotein cholesterol (LDL-C) goals. Whether the treatment landscape has evolved, or gaps persist remains of interest.

Methods: Baseline data are presented from SANTORINI, an observational, prospective study that documents the use of lipid-lowering therapies (LLTs) in patients ≥18 years at high or very high CV risk between 2020 and 2021 across primary and secondary care settings in 14 European countries.

Clinical outcomes in ST-segment elevation myocardial infarction patients undergoing percutaneous coronary interventions later than 48 h after symptom onset.

Aims: Routine revascularization in patients with ST-segment elevation myocardial infarction (STEMI) presenting >48 h after symptom onset is not recommended.

Methods And Results: We compared outcomes of STEMI patients undergoing percutaneous coronary intervention (PCI) according to total ischaemic time. Patients included in the Bern-PCI registry and the Multicenter Special Program University Medicine ACS (SPUM-ACS) between 2009 and 2019 were analysed.

History of peripheral artery disease and cardiovascular risk of real-world patients with acute coronary syndrome: Role of inflammation and comorbidities.

Background: Patients with acute coronary syndromes (ACS) remain at risk of cardiovascular disease (CVD) recurrences. Peripheral artery disease (PAD) may identify a very high risk (VHR) group who may derive greater benefit from intensified secondary prevention.

Methods: Among ACS-patients enrolled in the prospective multi-center Special Program University Medicine (SPUM), we assessed the impact of PAD on major cardiovascular events (MACE: composite of myocardial infarction, stroke and all-cause death) and major bleeding.

[A Family History of Hypercholesterolemia - the Role of Genetics].

A Family History of Hypercholesterolemia - the Role of Genetics Genetic testing is rarely used in Switzerland to confirm the clinical diagnosis of familial hypercholesterolemia. However, cascade genetic testing from an index case is recommended by the guidelines. By describing a patient and his family with severe hypercholesterolemia, we discuss the benefits, risks and barriers regarding the implementation of genetics for familial hypercholesterolemia.

Nicotine Replacement Therapy for Smokers with Acute Aneurysmal Subarachnoid Hemorrhage: An International Survey.

Introduction: Smoking prevalence is twice as high among patients admitted to hospital because of the acute condition of aneurysmal subarachnoid hemorrhage (aSAH) as in the general population. Smoking cessation may improve the prognosis of aSAH, but nicotine replacement therapy (NRT) administered at the time of aSAH remains controversial because of potential adverse effects such as cerebral vasospasm. We investigated the international practice of NRT use for aSAH among neurosurgeons.

Long-term effects of systematic smoking cessation counselling during acute coronary syndrome, a multicentre before-after study.

Trial Design: In the Special Program University Medicine-Acute Coronary Syndromes (SPUM-ACS) observational study (clinical trial registration: NCT01000701), a multicentre before-after clinical trial, we assessed 5-year outcome after acute coronary syndrome, comparing a systematic with an opportunistic smoking cessation counselling phase.

Methods: We studied smokers who were hospitalised for acute coronary syndromes (ACS), and we assessed self-reported smoking cessation, incidence of cardiovascular events and mortality 5 years after hospital discharge. In the observational phase, from August 2009 to October 2010, only smokers who requested smoking cessation counselling received it during hospitalisation.

Smoking cessation and depression after acute coronary syndrome.

Smoking and depression are risk factors for acute coronary syndrome (ACS) that often co-exist. We investigated the evolution of depression according to smoking cessation one-year after ACS. Data from 1822 ACS patients of the Swiss multicenter SPUM-ACS cohort study were analyzed over a one-year follow-up.

[Cascade genetic testing of familial hypercholesterolemia A new opportunity for prevention].

Familial hypercholesterolemia (FH) is a genetic disorder associated with an increased risk of early-onset cardiovascular events. Because lifestyle interventions and lipid-lowering drugs can strongly reduce cardiovascular risk, the early diagnosis of FH is important. Indeed, given the autosomal dominant transmission of the pathogenic variant, a genetic cascade screening program of first-degree relatives from an index case could identify patients at high cardiovascular risk.

[High-dose Omega-3 for cardiovascular prevention, a bad idea?].

Hypertriglyceridemia is a cardiovascular risk factor independent of LDL cholesterol. Omega-3 reduce triglycerides levels, but without proven benefit to reduce cardiovascular risk. Recently, two studies on high-dose omega-3 derivatives have shown contradictory results on the risk of cardiovascular events: REDUCE-IT (4 g/day of icosapent ethyl) showed a 25 % reduction; STRENGTH (4 g/day of a mixture of eicosapentaenoic acid and docosahexaenoic acid) showed no effect.

[European guidelines 2021 for the cardiovascular prevention: new concepts].

The latest European guidelines for cardiovascular prevention were published in 2021. As compared to the previous 2016 edition, these guidelines include some new concepts. First, the estimation of cardiovascular risk in apparently healthy persons now encompasses for the first time both fatal and nonfatal events, including myocardial infarction and stroke, using the new SCORE2 and SCORE2-OP.