Background Cancer survivors are at increased risk of heart failure (HF). While cardiotoxicity is commonly sought at the time of cancer chemotherapy, HF develops as a result of multiple ‘hits’ over time, and there is limited evidence regarding the frequency and causes of HF during survivorship. Objectives This systematic review sought to investigate the relationship between cardiotoxic cancer therapies and HF during survivorship. Methods We searched the EMBASE, MEDLINE and CINAHL databases for studies reporting HF in adult survivors (≥50 years old), who were ≥5 years postpotential cardiotoxic cancer therapy. A random effects model was used to examine the associations of HF. Results Thirteen papers were included, comprising 190 259 participants (mean age 53.5 years, 93% women). The risk of HF was increased (overall RR 1.47 (95% CI (1.17 to 1.86)). Cardiotoxic treatment, compared with cancer alone, provided a similar risk (RR of 1.46 (95% CI 0.98 to 2.16)). The overall HF incidence rate w

Right heart failure is the most common cause of mortality in patients with pulmonary arterial hypertension.1 This includes chronic thromboembolic pulmonary hypertension (CTEPH), which through obstruction of the pulmonary arteries increases afterload on the right ventricle (RV), ultimately resulting in RV failure. Histopathologically, it is also associated with microvascular changes, with smooth muscle hypertrophy, and intimal fibrosis, which cause stiffening, reduced compliance and increased resistance, placing increased afterload on the RV.2 Current therapeutic options for CTEPH include medical therapy, pulmonary endarterectomy (PEA), and balloon pulmonary angioplasty (BPA), and a combination of these therapies is often applied to effectively target both the anatomical larger vessel, as well as the microvascular components of the disease. PEA is the definitive management in surgical candidates with proximal, and therefore surgically amenable disease, and although highly invasive, carr

Background We aimed to characterise the variation in access to and outcomes of cardiac surgery for people in England. Methods We included people >18 years of age with hospital admission for ischaemic heart disease (IHD) and heart valve disease (HVD) between 2010 and 2019. Within these populations, we identified people who had coronary artery bypass graft (CABG) and/or valve surgery, respectively. We fitted logistic regression models to examine the effects of age, sex, ethnicity and socioeconomic deprivation on having access to surgery and in-hospital mortality, 1-year mortality and hospital readmission. Results We included 292 140 people, of whom 28% were women, 11% were from an ethnic minority and 17% were from the most deprived areas. Across all types of surgery, one in five people are readmitted to hospital within 1 year, rising to almost one in four for valve surgery. Women, black people and people living in the most deprived areas were less likely to have access to surgery (CABG:

Background Integration of large proteomics and genetic data in population-based studies can provide insights into discovery of novel biomarkers and potential therapeutic targets for cardiometabolic diseases (CMD). We aimed to synthesise existing evidence on the observational and genetic associations between circulating proteins and CMD. Methods PubMed, Embase and Web of Science were searched until July 2023 for potentially relevant prospective observational and Mendelian randomisation (MR) studies investigating associations between circulating proteins and CMD, including coronary heart disease, stroke, type 2 diabetes, heart failure, atrial fibrillation and atherosclerosis. Two investigators independently extracted study characteristics using a standard form and pooled data using random effects models. Results 50 observational, 25 MR and 10 studies performing both analyses were included, involving 26 414 160 non-overlapping participants. Meta-analysis of observational studies revealed