The European Society of Cardiology (ESC) has developed quality indicators (QIs) specifically for evaluating the care and outcomes for patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to evaluate TAVI care in all patients undergoing such procedures in Sweden using the ESC 2023 QIs for TAVI.

The European Society of Cardiology (ESC) guidelines are foundational for diagnosing, treating, and managing cardiovascular conditions, emphasizing efficacy through the Class of Recommendation (COR) and Level of Evidence (LOE) system. However, these guidelines do not systematically integrate considerations on economic feasibility and implementation complexity, crucial for decision-making in resource-limited settings. This paper reflects the work and discussion of the ESC Clinical Practice Guidelines Committee to address these gaps and proposes a novel framework which integrates two metrics: the number needed to treat (NNT) at five years as a measure of clinical effectiveness, and a qualitative assessment of implementation complexity. A three-dimensional grid visualises these metrics alongside disease prevalence, providing policymakers and healthcare resource planners with a structured tool for prioritising interventions.The framework is intended as a tool to support the implementation of guideline-based recommendations in specific health system contexts. Using the 2021/23 ESC heart failure (HF) guidelines and the focused update as a case study, the pilot framework evaluates pharmacological and device-based therapies with Class Of Recommendation I, LOE A, incorporating data from randomised trials underpinning the recommendations. NNT values are calculated for mortality and hospitalisation endpoints, while implementation complexity is assessed through a Delphi process, considering factors such as cost, infrastructure, and patient access. This approach offers a standardized method to compare interventions and their feasibility, bridging to current ESC guidelines. It could be particularly relevant in resource-constrained and high-cost environments, supporting informed decision-making and equitable adoption of evidence-based therapies. While promising, the framework requires further validation, and complexity assessments must be tailored to local contexts. By integrating clinical impact, implementation complexity, and disease prevalence, this proposed framework aims to bridge the gap between the guidelines' focus on treatment efficacy and the practical need for prioritisation in implementation and healthcare planning.

The impact of menopausal hormone therapy (HT), and its timing on cardiovascular disease (CVD) remains controversial in women.

To examine the associations of cardiorenal-inflammatory biomarkers with cardiac versus cancer mortality in cancer survivors.

Acute decompensated heart failure (ADHF) represents a major clinical and economic burden in Germany, primarily due to the frequent need for hospitalizations and high rehospitalization rates. Acetazolamide, a carbonic anhydrase inhibitor, has been shown in the ADVOR trial to improve early decongestion when added to loop diuretics. However, its economic impact within the German healthcare system has not yet been evaluated.

Individuals with suspected ischaemia but no obstructive coronary arteries (INOCA) experience persistent chest pain (PChP) at rates comparable to those with obstructive coronary artery disease (CAD). We analysed the National Heart, Lung, and Blood Institute-sponsored Women's Ischaemia Syndrome Evaluation (WISE) (NCT00000554) to compare patterns in chest pain persistence, cardiac medication use, and major adverse cardiovascular events (MACE) among women with INOCA and those with obstructive CAD.

Enterococcal infective endocarditis (EIE) represents a growing proportion of infective endocarditis (IE) cases, particularly among elderly and comorbid patients. EIE poses diagnostic and therapeutic challenges, notably regarding optimal antimicrobial therapy and surgical decision-making. We aimed to compare the clinical characteristics, management, and outcomes of EIE versus non-enterococcal IE (NEIE) in the ESC-EORP EURO-ENDO registry.

GLP-1 receptor agonists (GLP1-RAs) lower cardiovascular risk in type 2 diabetes (T2D), but their impact in patients with valvular heart disease, including those undergoing transcatheter aortic-valve implantation (TAVI), remained unexplored.

Hypertension is a common and serious medical condition affecting millions of people worldwide. While existing treatments are effective for many hypertensive patients, up to one-third fail to achieve adequate blood pressure control-often due to poor adherence, complex polypharmacy, or true pharmacological resistance. In this context, novel precision medicine approaches such as RNA-targeted therapeutics may represent tailored, long-acting alternatives particularly beneficial for patients with resistant hypertension, poor compliance, or multiple comorbidities. Small interfering RNAs (siRNAs) and antisense oligonucleotides (ASOs) have shown promising results as potential treatments for hypertension. On the one hand, zilebesiran (formerly ALN-AGT01) is currently in phase 2 clinical trials and targets the hepatic synthesis of angiotensinogen through a novel mechanism of action. On the other hand, IONIS-AGT-LRX is a hepatocyte-directed antisense oligonucleotide designed to target AGT mRNA in hepatocytes, thereby reducing angiotensinogen synthesis and circulating plasma levels. Furthermore, literature show sparse trials on RNA-targeted nucleic acid therapeutics as potential hypertension treatment, in preclinical and clinical phases, in animal and human targets, analyzed in this review in their safety and efficacy. RNA-based drugs, administered as subcutaneous injections, offer several advantages over traditional antihypertensive agents, including greater target specificity and prolonged duration of action, potentially improving adherence and long-term blood pressure control.. However, these therapies are not suitable for the acute management of hypertensive emergencies or urgencies, and evidence regarding their effects on cardiovascular outcomes, target organ protection, and mortality is still lacking. Further studies are warranted to define their role in clinical practice.

Antithrombotic therapy is a cornerstone of secondary prevention of atherosclerotic cardiovascular disease (ASCVD). The main drawback of antithrombotic therapy is the associated bleeding risk. The correlation between the magnitude of antithrombotic efficacy and the severity of bleeding risk remains unclear, rendering the comparative evaluation of antithrombotic regimes based on their therapeutic advantages and risks challenging. This study aims to establish a benchmark for evaluating the trade-off between ASCVD prevention and bleeding risk through a systematic analysis of extant trial data.

Sex-related differences in the development of heart failure (HF) during hospitalization for ST-segment elevation myocardial infarction (STEMI) remain underexplored. This study aimed to assess sex-specific differences in the development of in-hospital HF among STEMI patients admitted in Killip class I and evaluate its impact on in-hospital mortality.