Everest Pharmaceutical

15/09/2025

e-Updates

"Repeated measurement of lipoprotein(a): technical versus biological variability"

The Lipoprotein(a) [Lp(a)] concentrations of sample pairs were strongly correlated (r = 0.98). Individuals were grouped according to risk categories from the baseline Lp(a) measurement of

05/09/2025

e-Updates

"Electromechanically Optimized Right Ventricular Pacing for Obstructive Hypertrophic Cardiomyopathy (EMORI-HCM)"

Between October 2021 and October 2024, 117 screened patients met the inclusion criteria, of whom 60 were randomized. atrio-ventricular delay (AVD)-optimized right ventricular pacing (RVP) improved the Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS) (+4·505, 95% CrI 1·307 to 8·090, probability of benefit (Prbenefit)=0·997) and daily symptom scores (odds ratio 1.29, 95% CrI 0.978 to 1.676, Prbenefit=0.969) compared to back-up only pacing. AVD-optimized RVP improved exercise capacity (+1.048ml/kg/min, 95% CrI 0.065 to 2.043, Prbenefit=0.984) and left ventricular outflow tract gradient (LVOTg) (−7.327mmHg, 95% CrI −13.526 to −1.074, Prbenefit=0.010). It had no effect on BNP (Prbenefit=0.893) and ejection fraction was preserved (Prbenefit=0.409).

In patients with symptomatic obstructive hypertrophic cardiomyopathy , RVP delivered at electromechanically optimized AVD improves symptoms and exercise capacity.

(The Journal of the American College of Cardiology. 2025)
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31/08/2025

29/08/2025

e-Updates

"Demystifying the nuances of the lipid patient: a guide for primary care providers"

Atherosclerosis, a major cause of mortality and morbidity in the United States (US), is driven by complex factors, including the cumulative burden of low-density lipoprotein cholesterol (LDL-C) and other atherogenic lipids and lipoproteins. Lipid management in US primary care aims to prevent atherosclerotic cardiovascular disease (ASCVD) events through screening and LDL-C lowering to risk-based goals. However, lipid screening and ASCVD treatment is often inadequate, with few patients meeting LDL-C goals in clinical practice. Primary care providers have a vital role in identifying patients most at risk of ASCVD to prevent ASCVD events and improve patient outcomes. There are multiple different management guidelines, risk stratification tools, tests, and management strategies available to primary care physicians. Understanding the nuances of the lipid patient and how to employ these tools can be challenging. Here, we aim to summarize what primary care providers need to know about the lipid patient and why. We review recent updates in ASCVD prevention, including the Predicting Risk of Cardiovascular Disease Events (PREVENT™) tool and nonstatin lipid-lowering therapy management approaches.

(American Journal of Preventive Cardiology. 2025)
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21/08/2025

e-Updates

"Agreement Between Different Types of Blood Pressure Monitoring: A Systematic Review and Network Meta-analysis"

Sixty-five studies encompassing 40 022 participants were analyzed. Compared with research office systolic BPM, the pooled mean differences from corresponding systolic BPs were 2.69 mm Hg (95% CI, −0.13 to 5.51 mm Hg) higher for convenient OBPM, 4.57 mm Hg (CI, 2.54 to 6.60 mm Hg) lower for automated OBPM, 4.59 mm Hg (CI, 2.83 to 6.34 mm Hg) lower for home BPM, 4.22 mm Hg (CI, 2.62 to 5.82 mm Hg) lower for daytime ambulatory BPM (ABPM), 18.14 mm Hg (CI, 16.21 to 20.06 mm Hg) lower for nighttime ABPM, and 8.63 mm Hg (CI, 6.97 to 10.28 mm Hg) lower for 24-hour ABPM. Differences varied by reference research OBPM levels: Higher reference BP levels are associated with larger differences between research office and other BPM methods.

(Annals of Internal Medicine. 2025)
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13/08/2025

e-Updates

"Impact of baseline and trajectory of the cardiometabolic indices on incident microvascular complications in patients with type 2 diabetes"

During a median follow-up of 3.69, 3.69 and 3.78 years, 2289 diabetic kidney disease (DKD), 2227 diabetic neuropathy (DN) and 2420 diabetic retinopathy (DR) events were recorded. Elevated the triglyceride-glucose (TyG) index, the atherogenic index of plasma (AIP) , the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) were significantly associated with an increased risk of DKD (P < 0.05), and AIP demonstrated superior predictive capacity. The fully-adjusted HR (95 % CI) for the highest quartile of TyG index, AIP and NHHR for DKD risk were 1.307 (1.174–1.455), 1.341 (1.202–1.496) and 1.341 (1.202–1.496), respectively. Three distinct trajectories of Tyg index, AIP, NHHR were identified: low-stable, moderate-stable and high-stable. The incidence of DKD in the TyG index, AIP and NHHR with high-stable trajectory increased by 41.3 %, 47.3 % and 20.7 %, respectively, whereas the incidence of DN in the AIP increased by 19.3 % compared with low-stable trajectory.

The baseline levels and trajectories of cardiometabolic indices are associated with an increase in the risk of microvascular complications (MVCs) in patients with T2D. Regular monitoring and sustained stabilization of these indicators at low levels are vital for preventing and managing MVCs.

(Atherosclerosis. 2025)
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09/08/2025

e-Updates

"Heat Stress Nephropathy in CKD of Uncertain Etiology Hotspots of Bargarh District Odisha, India"

Out of the total screened population, 157 potential cases of heat stress nephropathy were identified, with 63.3% of affected individuals being farmers. The Attabira block recorded the highest heat stress index and the most CKD of uncertain etiology (CKDu) cases among farmers. Markers of dehydration, including the simplified wet bulb globe temperature (sWBGT) index, urine specific gravity (64.09%), albumin-to-creatinine ratio (5.88%), blood urea nitrogen (BUN, 63.2%), and heat shock protein (HSP), were significantly elevated in the farming population compared with the control group. Renal histopathological analysis revealed tubulointerstitial nephritis with signs of fibrosis.

Heat stress nephropathy was commonly observed among individuals involved in farming activities. Renal histopathological analysis, along with elevated levels of HSP70 and HSP27 confirmed the diagnosis.

(Kidney International Reports. 2025)
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01/08/2025

31/07/2025

e-Updates

"Trajectories of Physical Activity Before and After Cardiovascular Disease Events in CARDIA Participants"

The cohort analysis included 3068 participants, among whom mean (SD) age at baseline was 25.2 (3.6) years, and 1743 participants (56.8%) were female. Race was self-reported; the sample included 529 Black men, 834 Black women, 796 White men, and 909 White women. The nested case-control analysis included 236 incident CVD cases, each matched 1:1 to control participants by age, s*x, and race. Moderate to vigorous–intensity physical activity (MVPA) decreased steadily from young adulthood into middle age, stabilizing in later years. Black men had a more sustained decline, while Black women consistently reported the lowest MVPA. In the nested analysis, MVPA in case participants began declining approximately 12 years before CVD, with accelerated declines within 2 years of the event. Post-CVD, the case-control gap persisted. MVPA trajectories by type of CVD revealed steeper pre-CVD declines in heart failure and consistently low post-CVD levels across all types. Adjusting for pre-CVD MVPA, cases were more likely than controls to exhibit low MVPA post-CVD (OR, 1.78; 95% CI, 1.26-2.50), with the highest risk in Black women (OR, 4.52; 95% CI, 2.29-8.89).

In this cohort and nested case-control study among CARDIA participants, MVPA declined from early adulthood to midlife then plateaued, with notable demographic differences; cases experienced steep declines before CVD, and gaps compared to controls persisted afterward. Black women had the lowest MVPA across adulthood and the highest risk of low MVPA post-CVD, underscoring the need to support lifelong physical activity and address group differences.

(JAMA Cardiology. 2025)

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