Recent meta-analyses of randomized controlled trials have raised concerns that treatment with omega-3 fatty acids may increase the risk of atrial fibrillation (AF). However, these meta-analyses included at most 8 trials. The aim of this current meta-analysis was to expand the search by including other eligible omega-3 randomized controlled trials with AF incidence data, incorporating both published and unpublished data.

Eligible studies were randomized controlled trials investigating daily doses of ≥500 mg/d of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Additional inclusion criteria included ≥12 months of treatment with EPA/DHA, participants ≥50 years of age, and, where possible, the absence of known AF/atrial flutter at baseline. The primary outcome was the occurrence of new-onset AF. Our primary hypothesis was that risk for AF would simultaneously depend on both omega-3 dose (above or below 1500 mg/d) and background cardiovascular disease risk status, and that their combined impact on AF risk would be synergistic.

A total of 35 randomized controlled trials (37 data sets; n=114 592) were included in this meta-analysis. Only studies including patients at high-risk for cardiovascular disease who were treated with high-doses of EPA/DHA (>1500 mg/d) showed a statistically significant increase in AF risk with a pooled odds ratio (OR) of 1.43 (95% CI, 1.14-1.79) and an absolute risk difference of 0.8% (0.40%-1.1%). None of the other 3 groups showed statistically significant levels of AF risk (odds ratios, 1.07 [high risk-low dose], 1.06 [low risk-low dose], and 1.03 [low risk-high dose]).

This meta-analysis suggests that high-dose EPA/DHA treatment is associated with an increased risk of AF in patients at high cardiovascular disease risk, whereas low-dose EPA/DHA does not appear to increase AF risk, even in high-risk populations. Further prospective studies are needed to evaluate any potential increased risk of higher doses balanced against potential benefits.

The conceptual landscape of cell death has evolved beyond the traditional dichotomy of apoptosis and necrosis to encompass diverse regulated pathways including necroptosis, autophagy, ferroptosis, and pyroptosis. Necroptosis, a caspase-independent inflammatory form of programmed cell death, has emerged as a critical driver of the pathogenesis of cardiovascular disorders, neurodegenerative diseases, and cancer. Concurrently, our understanding of mitochondrial biology has undergone a paradigm shift: mitochondria are no longer viewed merely as bioenergetic powerhouses, but as dynamic signalling hubs that orchestrate metabolic reprogramming, cellular homeostasis, and ultimate cell fate decisions. In this regard, a growing body of evidence suggests that mitochondrial dysfunction is a central rheostat that enables necroptotic execution. This review delineates the mechanistic interplay between necroptosis and mitochondrial dysfunction and systematically analyzes the key molecular mediators and pathological pathways through which mitochondrial dysregulation drives necroptotic activation. Furthermore, this review identifies actionable therapeutic targets and translational strategies for modulating necroptosis in related diseases.

Cardiovascular and cerebrovascular diseases remain the leading cause of death worldwide. Myocardial infarction-associated transcript (MIAT), a type of long non-coding RNA, has been reported to exert regulatory functions across multiple diseases in studies, and may serve as a promising therapeutic candidate in certain pathological conditions. This review provides a comprehensive analysis of the basic characteristics of MIAT, the latest research advancements, its involvement in cardiovascular and cerebrovascular diseases, and its potential as a biomarker and therapeutic target. The objective is to summarize the current understanding and mechanisms of MIAT, offering further scientific evidence to support its role in the treatment of cardiovascular and cerebrovascular diseases associated with MIAT. Additionally, this review explores the challenges and practical considerations for the clinical application of MIAT, aiming to provide new perspectives on its clinical translation.

Cardiac masses represent a rare but clinically significant diagnostic entity. Morphological assessment alone is often insufficient for definitive diagnosis. Cardiovascular magnetic resonance (CMR) provides comprehensive tissue characterization.

We present a case series illustrating the heterogeneous spectrum of cardiac masses encountered in both oncologic and non-oncologic patients. Clinical scenarios included intracardiac metastases, tumour-related thrombus, bland thrombi, and benign primary tumours, such as rhabdomyoma and myxoma. In all cases, CMR was pivotal for tissue characterization using multiparametric assessment.

This series highlights the limitations of morphology-based assessment and emphasizes the value of a structured multiparametric CMR approach. Key features, such as perfusion, enhancement pattern, tissue heterogeneity, and infiltrative behaviour, allow reliable differentiation between thrombi and neoplastic lesions. Beyond illustrating individual cases, this series proposes a structured multiparametric CMR algorithm applicable across diverse clinical scenarios, emphasizing its role in medical practice and diagnostic decision-making.

The optimal duration of dual antiplatelet therapy (DAPT) for high bleeding risk (HBR) patients undergoing percutaneous coronary intervention (PCI) can vary based on individual clinical and lesion characteristics. As bifurcation lesions are associated with a greater risk of ischemic events, it is unknown whether HBR patients with bifurcation lesions can be safely treated with abbreviated DAPT.

We examined ischemic and bleeding outcomes in patients with and without bifurcation lesions who underwent PCI with the Resolute Onyx zotarolimus-eluting stent (Medtronic) from the Onyx ONE Clear study. HBR patients free of events through 1 month were prescribed 1 month of DAPT. Outcomes from 1 month to 2 years were analyzed among patients with HBR who underwent successful PCI for at least 1 bifurcation lesion followed by 1-month DAPT.

Of 1507 total HBR patients, 215 (14.3%) underwent PCI of a bifurcation lesion, with 86.6% treated with a provisional approach. Included patients had an average of 1.6 HBR criteria. Patients with bifurcation lesions treated had more stents implanted and longer total length of stents implanted. The composite of cardiac death or myocardial infarction was similar for patients with vs without bifurcation lesions (12.2% vs 11.6%, P = .92). There were no differences in any clinical or angiographic outcomes between groups, including BARC 3 to 5 bleeding events.

In the Onyx ONE Clear study, HBR patients with bifurcation lesions treated with the Resolute Onyx zotarolimus-eluting stent and 1-month DAPT had comparable ischemic event rates at 2 years compared with patients without bifurcation lesions, despite greater lesion and procedural complexity.

In 567 PH-COPD patients from the PVRI GoDeep Meta-Registry, ACE inhibitor use was associated with improved survival only in severe PH (PVR > 5 WU), supporting prospective trials targeting this high-risk subgroup.

Pulmonary hypertension (PH) is a chronic and devastating disease that currently lacks effective therapies, often ultimately requiring lung transplantation. Pulmonary vascular cells are subjected to various mechanical forces, which contribute to cardiovascular remodeling in PH. In recent years, Piezo ion channels have been instrumental in shaping the field of mechanobiology. However, a growing body of evidence underscores the critical role of Piezo channels in PH. As mechanosensitive channels, Piezo1 and Piezo2 directly transduce external mechanical stimuli into vascular cells and, as such, initiate intracellular biochemical cascades. Piezo ion channels contribute to the pathogenesis of pulmonary hypertension. In this review, we summarize the latest advances in Piezo channels research and focus on their role as key mechanotransducers in the progression of PH. Additionally, we explore the multifunctionality of Piezo channels in mechanobiology and propose new insights for preclinical animal studies and clinical trials. With a deeper understanding of Piezo-mediated activation and modulation mechanisms, Piezo channels are emerging as promising therapeutic targets for the future treatment of PH.

This study aimed to determine the prevalence of cardiac arrhythmias in COVID-19 patients undergoing Continuous Renal Replacement Therapy (CRRT) during the first 24 hours of ICU admission.

This cross-sectional study was conducted to assess the prevalence of cardiac arrhythmias among 78 COVID-19 patients undergoing CRRT hemoperfusion during the first 24 hours of hospitalization in the ICU of Kowsar Hospital, Semnan, in 2020. Data were collected using a checklist that included demographic characteristics, underlying diseases, and types of cardiac arrhythmias, extracted from patients' medical records in the hospital's medical records department. Data analysis was performed using SPSS software, version 26.

The mean (± SD) age of the patients was 54.68 ± 1.61 years. The proportions of males and females were 41% and 59%, respectively. The overall prevalence of cardiac arrhythmia was 21.8%, with bradycardia being the most common type (7.7%). The prevalence rates of heart disease, hypertension, diabetes, and hyperlipidemia were 48.7%, 39.7%, 28.2%, and 26.9%, respectively. Additionally, 20.5% of patients had a history of cardiovascular disease. No statistically significant associations were found between cardiac arrhythmia and age, gender, or underlying conditions such as heart disease, hypertension, diabetes, and hyperlipidemia (P>0.05). However, the prevalence of supraventricular arrhythmia (100%) and ventricular arrhythmia (66.7%) was significantly higher among patients with a history of cardiovascular disease (P<0.001).

Our study demonstrated a substantial prevalence of cardiac arrhythmia in COVID-19 patients undergoing CRRT within the first 24 hours of ICU admission. The findings emphasize the importance of recognizing this vulnerable period for arrhythmia development and highlight the need for proactive measures to mitigate risks in this high-risk population.

Hypertension is the primary modifiable risk factor for cardiovascular disease. Our study aimed to assess the prevalence, awareness, treatment, and control of hypertension in southwest Iran.

This population-based cross-sectional study was conducted in the enrollment phase of Hoveyzeh cohort study in 10,009 adults aged 35-70 in southwest Iran between 2016 and 2018. Information on demographic characteristics socioeconomic status, Hypertension, comorbidities, family history of Hypertension was collected. Logistic regression was employed to identify the factors associated with hypertension, as well as awareness, treatment, and control.

The overall prevalence of hypertension was 26.4% (95% confidence interval [CI]:25.5, 27.3). Among the population, 86.04% (95%CI: 84.7, 87.3) were aware of their condition, 81.18% (95%CI: 79.5, 82.8) were receiving treatment, and blood pressure was controlled in 70.15% (95%CI: 68, 72.2) of the treated hypertensive patients. In the adjusted model, older participants, those with low physical activity, individuals with a family history of hypertension, and patients with a history of diabetes or comorbidities of diabetes and dyslipidemia exhibited higher odds of having hypertension, as well as increased awareness. Additionally, being overweight or obese, married, and illiterate were associated with hypertension. Based on gender, women are more aware of their hypertension, receive more treatment, and have better control than men.

The prevalence of hypertension is relatively high; therefore, health promotion strategies, including lifestyle modifications to reduce overweight and obesity and to increase physical activity, are recommended.

Janus kinases (JAKs) are a family of intracellular, non-receptor tyrosine kinases that play a crucial role in the JAK signaling pathway involved in the inflammatory process. Over the years, this pathway has garnered significant interest among researchers, leading to the development of various therapeutic agents aimed at blocking the pathway, thereby contributing to remarkable progress in the management of inflammatory diseases across multiple medical specialties. Although the use of JAK inhibitors in ophthalmology is still limited, evidence is gradually emerging on their role in managing uveitis and scleritis. One such agent is tofacitinib, a small-molecule pan-JAK inhibitor. Its therapeutic profile differs from that of biologics due to its partial and reversible inhibition of cytokines. Additionally, owing to its smaller molecular size, the drug is available in an oral formulation. In recent years, there has been a growing interest in JAK inhibitors, particularly tofacitinib, as a potential therapeutic option for refractory uveitis and scleritis in both adult and pediatric populations. Tofacitinib, either as monotherapy or in combination, has shown effectiveness in managing various uveitis cases that were unresponsive to conventional immunosuppressive therapies. It has also been explored in treatment-resistant scleritis. However, concerns persist regarding the potential adverse effects of tofacitinib, including cardiovascular events, thromboembolism, malignancies, and infections. This review aims to provide a comprehensive update on the role of tofacitinib in ocular inflammation, with particular emphasis on its clinical efficacy, safety profile, and the emerging literature surrounding its risks and side effects.