Acute myocardial infarction (AMI), more commonly known as heart attack is a medical emergency and the leading cause of death for both men and women all over the world. There is a correlation between changes in the serum aspartate aminotransferase with acute myocardial infarction. This study was undertaken to evaluate the changes in serum aspartate aminotransferase status in patients with acute myocardial infarction. This cross-sectional study was carried out in the Department of Biochemistry, Mymensingh Medical College, Bangladesh with the collaboration of the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, during the period of July 2021 to June 2022. A total of 100 subjects were included in this study among them, 50 were diagnosed AMI patients denoted as case group and 50 were normal healthy individuals denoted as control group. Serum aspartate aminotransferase was determined by colorimetric method by using electrolyte analyzer for each sample. All statistical analysis was done by using SPSS (statistical package for social science) windows package version 26.0. P value <0.05 was considered significant. The mean±SD values of serum aspartate aminotransferase were 76.28±12.87 U/L and 22.58±6.24 U/L in case group and control group respectively. The analysis showed that there was highly significant increase in mean serum aspartate aminotransferase levels between two groups. This was a cross-sectional study. Analyzing the findings of the present study, highly significant increase in serum aspartate aminotransferase level was observed in AMI patients. A large-scale prospective study with the application of more sophisticated technology may be planned to find out the relationship of this biochemical variable with AMI.

Hypertensive retinopathy almost always associated with other target organ damage. Relationship of hypertensive retinopathy with left ventricular hypertrophy (LVH) and proteinuria was inconclusive in previous studies. The objective of the study was to assess the relation of Left Ventricular Hypertrophy and Proteinuria in Hypertensive Patient with Retinopathy in Tertiary Care Hospital. This is a cross-sectional observational study and conducted at the Department of Medicine and Cardiology in Dhaka Medical College Hospital. Study period was 01 year started from July 2016 to June 2017. Total 100 hypertensive retinopathy patients were included in the study. Following informed written consent, physical examination, relevant investigations were done. In all cases, Ethical issues were maintained properly and collected data were analyzed by SPSS 20.0. Among 100 participants, mean ±SD age was 57.15±12.989 years (age range 29-85) and 61.0% were male and 39.0% were female. Mean ±SD value of systolic and diastolic blood pressure in Grade (G)-1, G-2 and G-3 hypertension were 150.8±5.4) and 94.0±2.6 mm Hg, 170.3±4.9 and 101.0±4.7 mm Hg and 188.0±7.0 and 102.6±6.5 mm Hg respectively and it is significantly associated with severity of LVH (p value <0.001 in both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Proteinuria is also associated with severity of hypertension (p<0.001) but there were no association of Hypertensive retinopathy with LVH and proteinuria (p value 0.32 and 0.27 respectively). Hypertensive retinopathy is not associated with LVH and proteinuria, though further large cohort is recommended for final comment.

Levetiracetam is commonly prescribed for seizure prophylaxis after acute ischemic stroke (AIS) and often continued beyond discharge. While its short-term effectiveness for preventing poststroke seizures is established, it is unclear whether prolonged use improves survival, particularly in older adults. We estimated the effect of continued levetiracetam use on 90-day mortality among Medicare beneficiaries after AIS.

Using Traditional Medicare claims data (2008-2021), we identified beneficiaries aged ≥ 65 years hospitalized for AIS who initiated outpatient levetiracetam within 90 days of discharge. After 1 month of continued poststroke levetiracetam use (start of follow-up), we compared 90-day mortality between patients with a new levetiracetam dispensation within a 14-day grace period post-follow-up and those without one. We performed cloning, censoring, and weighting to address immortal-time bias and estimated standardized mortality risks, risk differences, and 95% confidence intervals (CIs).

Among 3212 eligible beneficiaries, 1779 (55.4%) received a new levetiracetam dispensation within the 14-day grace period. After adjustment for demographics, hospitalization characteristics, timing of initiation, and comorbidities, continued use was associated with lower 90-day mortality than discontinuation (53 vs. 62 deaths per 1000; risk difference -9 per 1000; 95% CI: -12, -5).

Among older Medicare beneficiaries who initiated levetiracetam after AIS, continued outpatient use was associated with lower short-term 90-day mortality, particularly among patients aged ≥ 75 years. These findings should not be interpreted as support for routine or indefinite continuation, because the claims-based design cannot assess seizure recurrence, functional outcomes, quality of life, treatment indication, or potential neuropsychiatric harms.

The Finnish Genetics of Pre-eclampsia Consortium (FINNPEC) study was originally established between 2008 and 2011 to develop a nationwide clinical and genomic database. By enrolling women with and without pre-eclampsia (PE), alongside their partners and infants, the study aims to identify the genetic and molecular determinants of PE. This update summarises the final dataset, reviews key findings since the 2016 cohort profile, and outlines current research directions.

FINNPEC is a multicentre, cross-sectional case-control cohort collected across five Finnish university hospitals. The final cohort comprises 2810 women (1654 PE cases and 1156 controls), with comprehensive biological samples and clinical data collected from their children and the children's fathers.A longitudinal subgroup-the FINNCARE study-enrolled 192 families with prior PE and 92 control families between 2019 and 2022. This subgroup underwent cardiovascular risk profiling and participated in a randomised controlled trial evaluating a 12-month lifestyle intervention to mitigate cardiovascular disease (CVD) risk 8-12 years postpartum.

Research within FINNPEC has provided novel insights into maternal and fetal genetic susceptibility, revealing a shared genetic architecture between PE, blood pressure regulation and CVD. Studies have also advanced our understanding of the role of angiogenic imbalance, metabolic alterations and non-traditional risk factors in the pathogenesis of PE.

The current aim is to understand the complex, long-term association of PE and CVD within families. Ongoing studies focus on (1) risk stratification using registry data to classify CVD risk in women with prior PE; (2) assessing how genetic susceptibility to PE and CVD predicts pregnancy outcomes and later-life cardiovascular health; and (3) exploring how paternal and fetal genetics influence maternal PE risk and subsequent CVD morbidity.

To evaluate the proof-of-concept feasibility of identifying individuals at high risk of cardiovascular disease through community-based PocDoc Healthy Heart point-of-care screening in a large, ethnically diverse, disadvantaged real-world cohort in the United Kingdom.

Proof-of-concept, non-randomised, non-interventional real-world cardiovascular disease risk case finding study in adults aged 18 years or older in real-world communities across the United Kingdom. Main outcome measures were identification of individuals with high risk of cardiovascular disease, defined as QRISK3 score ≥10%; and individuals meeting the criteria for weight loss, smoking cessation, or hypertension management services.

A total of 4,256 individuals (mean age 49 years, 57% male, 31% body mass index ≥30 kg/m2) were included in the Primary Cohort. The Targeted Outreach and Workplace sub-cohorts comprised 1,970 and 756 individuals, respectively. In the Primary Cohort, 35% (1,486/4,256) had high (>5.0 mmol/L) total serum cholesterol, 10% were smokers, 10% met criteria for weight loss services and 19% met criteria for hypertension management services. QRISK3 scores were generated for individuals who had not previously had a cardiovascular disease event (~90% of screened individuals). A QRISK3 score ≥10% was found in 20% (784/3,842) of individuals in the Primary Cohort, 26% (457/1,743) in the Targeted Outreach sub-cohort, and 6% (41/701) in the Workplace sub-cohort. In the Primary Cohort, 60% (472/784) of individuals with a QRISK3 score ≥10% were not being treated with a lipid-lowering therapy at the time of testing.

In this proof-of-concept study, community-based point-of-care screening identified individuals with elevated cardiovascular risk and unmet cardiovascular risk management needs. These findings are hypothesis-generating and provide the rationale for further controlled studies with systematic follow-up and health-economic analyses to evaluate whether this approach can deliver improved clinical and system-level outcomes.

ClinicalTrials.gov NCT06258005.

Choosing an appropriate imputation strategy for clinical datasets requires understanding which missing data mechanism is operative, yet most imputation benchmarks conflate performance across mechanisms. The present work addresses this gap by conducting the first mechanism-stratified comparison of three imputation approaches-CHIT, Multiple Imputation by Chained Equations via BayesianRidge (MICE), and Random-Forest-based Iterative Imputation-across Missing Completely at Random (MCAR), Missing at Random (MAR), and Missing Not at Random (MNAR) conditions. Three health datasets serve as experimental platforms: the Chronic Kidney Disease (CKD) dataset, the Heart Disease Dataset (HDD), and the Mice Protein Expression Dataset (MPED). Domain-knowledge-driven missingness patterns are constructed for each mechanism (Fig 2) at approximately 20-25% overall rates. Eight classifiers-KNN, Logistic Regression, SVC, Decision Tree, Random Forest, Gaussian Naïve Bayes, MLP, and a deep neural network-are trained on imputed data following GridSearchCV optimisation. Across all conditions, CHIT achieves near-perfect or perfect downstream classification, with SVC reaching up to 100% accuracy on the CKD dataset under MNAR, and 98.75% under MCAR and MAR. Competing methods degrade by up to 19.38 percentage points under MNAR, while CHIT's accuracy remains stable. Two structural properties account for this resilience: an iterative enrichment of the regression training set as records are completed, and a within-record prioritisation of the most data-scarce features for model-based filling. Taken together, these results provide mechanism-specific guidance for imputation selection in health informatics pipelines. Statistical significance of classifier accuracy differences between CHIT and MICE was assessed using McNemar's test (two-tailed, continuity-corrected chi-square) applied to the exact binary prediction vectors from each experiment [n_test = 80]. Ninety-five percent confidence intervals for all reported accuracy values were computed using the Wilson score method [z = 1.96]. The 42-configuration mean accuracy and standard deviation for CHIT are reported in Supplementary Table S1. Full McNemar results with confidence intervals are in Supplementary Table S2.

In Brazil, regional disparities in cardiovascular disease (CVD) mortality persist, with no population-based study having examined CVD mortality at the municipal level in the Central-West region. This study analysed the epidemiological profile, temporal trends, spatial distribution, and socioeconomic correlates of CVD mortality in Campo Grande, Mato Grosso do Sul, Brazil (2013-2022). A population-based ecological study used data from the Brazilian Mortality Information System. Five CVD groups were analysed: ischaemic heart disease (IHD), heart failure (HF), arrhythmias (ARR), cardiomyopathies (CMP), and inflammatory heart diseases (INF). Temporal trends were assessed using Poisson, Prais-Winsten, and Joinpoint regression. Spatial distribution was examined through Kernel Density Estimation and Local Indicators of Spatial Association (LISA). Socioeconomic correlates were assessed using Spearman's correlation with neighbourhood-level indicators. Of 59,392 registered deaths, 8,148 (13.7%) were CVD-related. IHD was the dominant cause (79.5%), with males accounting for 59.3% of deaths (IRR 1.59; 95% CI 1.46-1.74) and individuals aged ≥60 years representing 75.2%. Overall crude CVD mortality increased by 26.1% over the study period, with an estimated mean annual increase of 2.5% (APC + 2.5%/year; 95% CI 1.7-3.3; p < 0.001) and significant acceleration after 2019. A striking proportion of IHD deaths occurred outside hospital settings (67.3%), with home deaths alone surpassing hospital deaths (43.9% vs. 32.7%). Spatial analysis identified significant high-high mortality clusters in central-western neighbourhoods and low-low clusters in eastern neighbourhoods (13 and 5 neighbourhoods, respectively; Global Moran's I = 0.555, p < 0.001), with cluster patterns varying by disease group. Socioeconomic correlates showed a consistent pattern across most CVD groups, with higher mortality in more socioeconomically advantaged neighbourhoods, except for inflammatory heart disease, which showed the opposite pattern. This first municipal-level CVD mortality analysis in Central-West Brazil identified significant spatiotemporal heterogeneity and a high burden of out-of-hospital IHD deaths, providing actionable evidence for geographically targeted cardiovascular prevention strategies.

Atrial fibrillation (AF), highly prevalent in older individuals, is associated with frailty and disability. AF therapy is based on rhythm control (RhythmC) to restore sinus rhythm or rate control (RateC) to lower the heart rate. Published guidelines do not indicate a preference for one over the other for older people.

This study aims to evaluate whether RhythmC is more effective than RateC in hindering the progression of frailty and disability.

The Cardioversion of Atrial Fibrillation and Frailty in the Elderly (CAFFE) study is a prospective, multicenter, observational cohort study that includes 4 groups of patients: (1) adults age 75 years or older undergoing RhythmC treatment; (2) adults aged 65 to 74 years undergoing RhythmC treatment; (3) adults 65 years or older undergoing RateC treatment; and (4) adults 65 years or older without overt chronic conditions as the control group (n=40 in each group). At baseline, all participants will undergo a Comprehensive Geriatric Assessment (CGA) and analyses of inflammation and metabolomics. At home, a device will evaluate each participant's heart rhythm, activity profile, and sleep. After 1 month, the CGA will be repeated.

The CAFFE study was funded as a Research Project of National Interest by the Italian Ministry of University and Research (October 2023). Ethical committee final approval was given in June 2024. In October 2025, the coordinating center had enrolled 31 of 40 patients with AF (mean age 78, SD 9 years; 8 [25.8%] women; mean CHA₂DS₂-VA score 4.2, SD 1.2; 13 [43.3%] robust participants). All centers are now completing the enrollment (103/160 participants), and the analysis of inflammatory mediators has started. The results are expected to be published in summer 2027.

The CAFFE study will evaluate the effectiveness of AF management strategies in older patients. If RhythmC can slow the progression of frailty and disability, specific clinical trials should more definitively address this knowledge gap.

Stroke is a leading cause of long-term functional disability and often requires caregiver support during recovery. Informal caregivers of post-stroke patients face multiple challenges related to medical and nursing competence, workload, and access to information. These challenges remain insufficiently explored and inadequately addressed in healthcare systems. Using predefined criteria, we searched PubMed and Google Scholar for English-language studies involving human participants and published between January 2015 and August 2025 on issues related to informal caregiving. After initial abstract screening, we selected 60 relevant publications from each database for discussion in this narrative review, using a PRISMA-based approach. The findings reveal a multidimensional caregiving burden, with nearly 90% of caregivers reporting shortages in practical knowledge and skills training. They also often face psycho-emotional and economic strain, compounded by a lack of institutional support and social isolation. Caregivers experience chronic frustration and exhaustion, leading to depressive and somatic symptoms, while also lacking adequate medical attention. Their needs are largely unsupported and unmet by available institutional support. There is a lack of systemic solutions to integrate caregiving responsibilities with personal activities and preventive healthcare. These issues necessitate urgent research and the implementation of effective supportive interventions to enhance the quality of life of post-stroke caregivers. Key recommendations include developing standardized educational programs implemented at hospital discharge, ensuring access to professional medical support, and establishing flexible respite care services to prevent caregiver burnout. Caregivers' psychosocial and somatic wellbeing is essential for the successful rehabilitation and recovery of post-stroke patients.

Cardiovascular diseases (CVDs) remain one of the leading causes of morbidity and mortality worldwide, with cardiomyocyte death playing an important role in myocardial injury, pathological cardiac remodeling, and the progression of heart failure. Programmed cell death (PCD), including apoptosis, pyroptosis, ferroptosis, cuproptosis, and disulfidptosis, plays an essential role in maintaining cellular homeostasis; however, its aberrant activation or dysregulation can contribute to cardiovascular injury and disease progression. Increasing evidence indicates that these PCD pathways are not independent but form a complex regulatory network through shared mechanisms, including mitochondrial dysfunction, oxidative stress, inflammatory activation, and metabolic imbalance, thereby contributing collectively to the development and progression of CVDs. Therefore, targeting PCD-related pathways has emerged as a promising therapeutic strategy. Natural products and their bioactive constituents can exert cardioprotective effects by regulating PCD-related signaling networks through multiple targets and pathways, thereby alleviating cardiomyocyte death, oxidative stress, inflammation, and cardiac dysfunction. Representative bioactive compounds, including salvianolic acid B, resveratrol, quercetin, and astragaloside IV, have demonstrated potential to modulate PCD-related signaling pathways in experimental models of CVDs. This review summarizes the molecular mechanisms and pathological roles of apoptosis, pyroptosis, ferroptosis, cuproptosis, and disulfidptosis in CVDs, elucidates the regulatory crosstalk among different PCD pathways, and systematically reviews the research progress on the cardioprotective effects of natural products and their bioactive constituents through targeting PCD. In conclusion, natural products targeting dysregulated PCD pathways may represent a promising multi-target therapeutic strategy for cardiovascular protection; however, current evidence is derived predominantly from preclinical studies, and further in-depth mechanistic investigations and high-quality clinical studies are warranted to validate their therapeutic potential and clinical translational value.