Approximately 1.5 million people undergo cardiac surgery every year around the world.1 In high-income countries, where the cardiac surgical capacity is largely sufficient, the ability to undergo and benefit from cardiac surgery in time is influenced by a range of factors, importantly including patients’ social determinants of health, which are “ the conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life .”2 Lai et al 3 evaluate access to cardiac surgery in England between 2010 and 2019, finding that female sex, Black ethnicity and socioeconomic deprivation were associated with poorer utilisation of cardiac surgery and higher mortality within 1 year after surgery. The authors are to be applauded for their novel work, which provides a first glimpse into variations in cardiac surgical volumes and mid-term outcomes across England. Using comprehensive data from the Hospital Episode Statistics and UK Office

Background Limited empirical evidence informs driving restrictions after implantable cardioverter-defibrillator (ICD) implantation. We sought to evaluate real-world motor vehicle crash risks after ICD implantation. Methods We performed a retrospective cohort study using 22 years of population-based health and driving data from British Columbia, Canada (2019 population: 5 million). Individuals with a first ICD implantation between 1997 and 2019 were age and sex matched to three controls. The primary outcome was involvement as a driver in a crash that was attended by police or that resulted in an insurance claim. We used survival analysis to compare crash risk in the first 6 months after ICD implantation to crash risk during a corresponding 6-month interval among controls. Results A crash occurred prior to a censoring event for 296 of 9373 individuals with ICDs and for 1077 of 28 119 controls, suggesting ICD implantation was associated with a reduced risk of subsequent crash (crude incid

Background Limited empirical evidence informs driving restrictions after implantable cardioverter-defibrillator (ICD) implantation. We sought to evaluate real-world motor vehicle crash risks after ICD implantation. Methods We performed a retrospective cohort study using 22 years of population-based health and driving data from British Columbia, Canada (2019 population: 5 million). Individuals with a first ICD implantation between 1997 and 2019 were age and sex matched to three controls. The primary outcome was involvement as a driver in a crash that was attended by police or that resulted in an insurance claim. We used survival analysis to compare crash risk in the first 6 months after ICD implantation to crash risk during a corresponding 6-month interval among controls. Results A crash occurred prior to a censoring event for 296 of 9373 individuals with ICDs and for 1077 of 28 119 controls, suggesting ICD implantation was associated with a reduced risk of subsequent crash (crude incid

Low-density lipoprotein cholesterol (LDL-C) is a well-known risk factor for cardiovascular disease, a leading cause of morbidity and mortality worldwide. Traditionally, guidelines for LDL-C management have been largely uniform across genders, with little consideration given to potential sex-based differences in response to treatment. In the realm of healthcare, understanding the intricacies of disease management is paramount to providing effective care. By analysing real-world data (RWD) from a representative population, the study by Kiss et al 1 sheds light on sex differences in the prescription of high-intensity statins and achievement of LDL-C target levels within primary care populations and contributes towards personalised and equitable healthcare. As integrated data analysis emerges as a powerful tool in this endeavour, this study using healthcare records from a population-based network of electronic healthcare data banks that combines data from different primary and secondary he

Cardiovascular alterations are common in patients who had ischaemic stroke, haemorrhagic stroke and other acute brain disorders such as seizures. These cardiac complications are important drivers of morbidity and mortality and comprise blood-based detection of cardiomyocyte damage, ECG changes, heart failure and arrhythmia. Recently, the concept of a distinct ‘stroke-heart syndrome’ has been formulated as a pathophysiological framework for poststroke cardiac complications. The concept considers cardiac sequelae after stroke to be the result of a stroke-induced disturbance of the brain–heart axis. In this review, we describe the spectrum of cardiac changes secondary to ischaemic stroke and other acute brain disorders. Furthermore, we focus on Takotsubo syndrome secondary to acute brain disorders as a model disease of disturbed brain–heart interaction. Finally, we aim to provide an overview of the anatomical and functional links between the brain and the heart, with emphasis on the auton