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Reduction in Acute Limb Ischemia With Rivaroxaban Versus Placebo in Peripheral Artery Disease After Lower Extremity Revascularization: Insights From VOYAGER PAD
Connie N. Hess, E. Sebastian Debus, Mark R. Nehler, Sonia S. Anand, Manesh R. Patel, Michael Szarek, Warren H. Capell, Judith Hsia, Joshua A. Beckman, Marianne Brodmann, Rafael Diaz, Peter Habertheuer, Nicholas J. Leeper, Richard J. Powell, Henrik Sillesen, Eva Muehlhofer, Scott D. Berkowitz, Lloyd P. Haskell, Rupert M. Bauersachs, and Marc P. Bonaca
doi : 10.1161/CIRCULATIONAHA.121.055146
Circulation. 2021;144:1831–1841
Patients with peripheral artery disease (PAD) are at heightened risk of acute limb ischemia (ALI), a thrombotic event associated with amputation, disability, and mortality. Previous lower extremity revascularization (LER) is associated with increased ALI risk in chronic PAD. However, the pattern of risk, clinical correlates, and outcomes after ALI early after LER are not well-studied, and effective therapies to reduce ALI post-LER are lacking.
Navigating the Passage for Better Understanding and Prognosis for Acute Limb Ischemia After Lower-Extremity Revascularization
Mette Søgaard, Nikolaj Eldrup, and Peter Brønnum Nielsen
doi : 10.1161/CIRCULATIONAHA.121.057577
Circulation. 2021;144:1842–1844
Icosapent Ethyl Reduces Ischemic Events in Patients With a History of Previous Coronary Artery Bypass Grafting: REDUCE-IT CABG
Subodh Verma, Deepak L. Bhatt, Ph. Gabriel Steg, Michael Miller, Eliot A. Brinton, Terry A. Jacobson, Nitish K. Dhingra, Steven B. Ketchum, Rebecca A. Juliano, Lixia Jiao, Ralph T. Doyle Jr., Craig Granowitz, C. Michael Gibson, Duane Pinto, Robert P. Giugliano, Matthew J. Budoff, R. Preston Mason, Jean-Claude Tardif, and Christie M. Ballantyne
doi : 10.1161/CIRCULATIONAHA.121.056290
Circulation. 2021;144:1845–1855
Despite advances in surgery and pharmacotherapy, there remains significant residual ischemic risk after coronary artery bypass grafting surgery.
CARMN Is an Evolutionarily Conserved Smooth Muscle Cell–Specific LncRNA That Maintains Contractile Phenotype by Binding Myocardin
Kunzhe Dong, Jian Shen, Xiangqin He, Guoqing Hu, Liang Wang, Islam Osman, Kristopher M. Bunting, Rachael Dixon-Melvin, Zeqi Zheng, Hongbo Xin, Meixiang Xiang, Almira Vazdarjanova, David J.R. Fulton, and Jiliang Zhou
doi : 10.1161/CIRCULATIONAHA.121.055949
Circulation. 2021;144:1856–1875
Vascular homeostasis is maintained by the differentiated phenotype of vascular smooth muscle cells (VSMCs). The landscape of protein coding genes comprising the transcriptome of differentiated VSMCs has been intensively investigated but many gaps remain including the emerging roles of noncoding genes.
Mitochondrial Telomerase Reverse Transcriptase Protects From Myocardial Ischemia/Reperfusion Injury by Improving Complex I Composition and Function
Niloofar Ale-Agha, Philipp Jakobs, Christine Goy, Mark Zurek, Julia Rosen, Nadine Dyballa-Rukes, Sabine Metzger, Jan Greulich, Florian von Ameln, Olaf Eckermann, Klaus Unfried, Fedor Brack, Maria Grandoch, Matthias Thielmann, Markus Kamler, Nilgün Gedik, Petra Kleinbongard, Andre Heinen, Gerd Heusch, Axel Gödecke, Joachim Altschmied, and Judith Haendeler
doi : 10.1161/CIRCULATIONAHA.120.051923
Circulation. 2021;144:1876–1890
The catalytic subunit of telomerase, telomerase reverse transcriptase (TERT), has protective functions in the cardiovascular system. TERT is not only present in the nucleus but also in mitochondria. However, it is unclear whether nuclear or mitochondrial TERT is responsible for the observed protection, and the appropriate tools are missing to dissect this.
Persistent Heart Effects of COVID-19 Emphasize the Need for Prevention
Bridget M. Kuehn
doi : 10.1161/CIRCULATIONAHA.121.058074
Circulation. 2021;144:1891–1892
Acute Inferior Wall Myocardial Infarction: What Is the Culprit Artery?
Qinghua Chang, Zhaolong Xu, and Renguang Liu
doi : 10.1161/CIRCULATIONAHA.121.057659
Circulation. 2021;144:1893–1895
High Prevalence of Unrecognized Congenital Heart Disease in School-Age Children in Rural China: A Population-Based Echocardiographic Screening Study
Quming Zhao, Hongyan Chen, Guowen Zhang, Weicheng Chen, Bing Jia, Fang Liu, Xiaojing Ma, Weili Yan, Conway Niu, and Guoying Huang
doi : 10.1161/CIRCULATIONAHA.121.056455
Circulation. 2021;144:1896–1898
Letter by Chiang et al Regarding Article, “Late Outcomes of the RAPID-TnT Randomized Controlled Trial: 0/1-Hour High-Sensitivity Troponin T Protocol in Suspected ACS”
Cho-Han Chiang, Cho-Hung Chiang, and Chien-Chang Lee
doi : 10.1161/CIRCULATIONAHA.121.057146
Circulation. 2021;144:e457–e458
Response by Lambrakis and Chew to Letter Regarding Article, “Late Outcomes of the RAPID-TnT Randomized Controlled Trial: 0/1-Hour High-Sensitivity Troponin T Protocol in Suspected ACS”
Kristina Lambrakis and Derek P. Chew
doi : 10.1161/CIRCULATIONAHA.121.057470
Circulation. 2021;144:e459–e460
Impact of the COVID-19 Pandemic on Cardiovascular Science: Anticipating Problems and Potential Solutions: A Presidential Advisory From the American Heart Association
Elizabeth M. McNally, Mitchell S.V. Elkind, Ivor J. Benjamin, Mina K. Chung, Glenn H. Dillon, Adrian F. Hernandez, Chinwe Ibeh, Donald M. Lloyd-Jones, Louise D. McCullough, Loren E. Wold, Davene R. Wright, Joseph C. Wu, on behalf of the American Heart Association
doi : 10.1161/CIR.0000000000001027
Circulation. 2021;144:e461–e471
The coronavirus disease 2019 (COVID-19) pandemic has had worldwide repercussions for health care and research. In spring 2020, most non–COVID-19 research was halted, hindering research across the spectrum from laboratory-based experimental science to clinical research. Through the second half of 2020 and the first half of 2021, biomedical research, including cardiovascular science, only gradually restarted, with many restrictions on onsite activities, limited clinical research participation, and the challenges associated with working from home and caregiver responsibilities. Compounding these impediments, much of the global biomedical research infrastructure was redirected toward vaccine testing and deployment. This redirection of supply chains, personnel, and equipment has additionally hampered restoration of normal research activity. Transition to virtual interactions offset some of these limitations but did not adequately replace the need for scientific exchange and collaboration. Here, we outline key steps to reinvigorate biomedical research, including a call for increased support from the National Institutes of Health. We also call on academic institutions, publishers, reviewers, and supervisors to consider the impact of COVID-19 when assessing productivity, recognizing that the pandemic did not affect all equally. We identify trainees and junior investigators, especially those with caregiving roles, as most at risk of being lost from the biomedical workforce and identify steps to reduce the loss of these key investigators. Although the global pandemic highlighted the power of biomedical science to define, treat, and protect against threats to human health, significant investment in the biomedical workforce is required to maintain and promote well-being.
2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association
Alice H. Lichtenstein, Lawrence J. Appel, Maya Vadiveloo, Frank B. Hu, Penny M. Kris-Etherton, Casey M. Rebholz, Frank M. Sacks, Anne N. Thorndike, Linda Van Horn, Judith Wylie-Rosett, on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Clinical Cardiology; and Stroke Council
doi : 10.1161/CIR.0000000000001031
Circulation. 2021;144:e472–e487
Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. This scientific statement emphasizes the importance of dietary patterns beyond individual foods or nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns, and highlights structural challenges that impede adherence to heart-healthy dietary patterns. Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following: (1) adjust energy intake and expenditure to achieve and maintain a healthy body weight; (2) eat plenty and a variety of fruits and vegetables; (3) choose whole grain foods and products; (4) choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms); (5) use liquid plant oils rather than tropical oils and partially hydrogenated fats; (6) choose minimally processed foods instead of ultra-processed foods; (7) minimize the intake of beverages and foods with added sugars; (8) choose and prepare foods with little or no salt; (9) if you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake; and (10) adhere to this guidance regardless of where food is prepared or consumed. Challenges that impede adherence to heart-healthy dietary patterns include targeted marketing of unhealthy foods, neighborhood segregation, food and nutrition insecurity, and structural racism. Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.
Correction to: Novel Criteria for the Observe-Zone of the ESC 0/1h-hs-cTnT Algorithm
doi : 10.1161/CIR.0000000000001045
Circulation. 2021;144:e488
Correction to: Reduced Mitochondrial Oxidactive Capacity and Increased Mitochondrial Uncoupling Impair Myocardial Energetics in Obesity
doi : 10.1161/CIR.0000000000001046
Circulation. 2021;144:e489
Correction to: Electrocardiographic Manifestations of Immune Checkpoint Inhibitor Myocarditis
doi : 10.1161/CIR.0000000000001042
Circulation. 2021;144:e490
