Statin-associated muscle symptoms (SAMS) are a common clinical challenge that often lead to poor adherence or discontinuation of statin therapy, thereby undermining its well-established cardiovascular benefits. This review explores the current understanding of the epidemiology, pathophysiology, clinical presentation, and diagnostic considerations of SAMS, with a particular focus on distinguishing true statin intolerance from nonspecific muscle complaints. We discuss evidence-based management strategies, including statin dose adjustment, rechallenge protocols, and the application of alternative lipid-lowering therapies such as ezetimibe, PCSK9 inhibitors, and bempedoic acid. Recent clinical trials support the efficacy and tolerability of combination therapy with moderate-intensity statins and ezetimibe, particularly in high-risk patients. A pragmatic, patient-centered approach is crucial for maintaining lipid-lowering therapy, minimizing adverse effects, and effectively reducing cardiovascular risk.

Greenhouse gas emissions drive climate change, which in turn threatens human health through various pathways, including cardiovascular disease, respiratory illness, and infectious disease. Despite the healthcare sector accounting for 4.4% of global carbon emissions, carbon footprint analysis within the field remains limited. This perspective addresses the importance of carbon footprint assessment in healthcare, particularly in cardiovascular medicine, and illustrates the use of randomized controlled trial (RCT) data for carbon footprint comparison. Unlike other sectors, healthcare carbon footprint analysis must consider not only the emissions generated directly by medical interventions but also those produced during the subsequent clinical course and follow-up. Data routinely collected during RCT follow-up periods can be used to estimate total emissions associated with different treatment strategies. In the cardiovascular field, where procedures themselves are carbon-intensive and where serious clinical events frequently occur during long-term follow-up, such analyses are particularly relevant. For instance, based on RCT data comparing fractional flow reserve (FFR) and intravascular ultrasonography for intermediate coronary artery stenosis, we estimated that the FFR group had a lower carbon footprint during the 2-year follow-up period. Extending the analysis with a long-term simulation model over 30 years similarly revealed that the cumulative carbon emissions remained lower in the FFR group. Comparing the carbon footprint between treatment strategies using RCT data can provide meaningful insights to guide environmentally responsible healthcare decisions. Building more accurate carbon footprint databases specific to healthcare interventions and fostering greater awareness among healthcare professionals will be essential to advance this effort.

Despite advances in the outcomes of arterial switch operation (ASO), long-term complications such as neo-aortic regurgitation (AR), neo-aortic root dilatation (ARD), neo-pulmonary stenosis (PS), and coronary artery-related events (CARE) pose challenges. We aimed to evaluate the long-term outcomes of ASO following a consistent surgical strategy adopted since 2003.

We aimed to evaluate the efficacy and safety of coronavirus disease 2019 (COVID-19) vaccination in patients with heart failure (HF) using national databases.

The coexistence of severe aortic stenosis (AS) and coronary artery disease (CAD) presents complex diagnostic and therapeutic challenges, particularly as transcatheter aortic valve replacement (TAVR) expands to younger, lower-risk populations. CAD prevalence in AS patients ranges from 27.7% in low-risk cohorts to 74.9% in high-risk populations, synergistically worsening ventricular function and prognosis. Diagnostic evaluation remains challenging due to overlapping symptomatology and altered coronary physiology in severe AS. While invasive coronary angiography remains the gold standard, coronary computed tomography (CT) angiography with CT-derived fractional flow reserve (FFR) shows promise as a non-invasive alternative. Standard FFR thresholds may not be reliable in AS patients, with emerging evidence suggesting AS-specific cutoffs may be needed. Treatment strategies must balance the complexity of CAD with patient risk profiles. Current guidelines recommend bypass surgery with surgical aortic valve replacement for complex multivessel disease, while percutaneous coronary intervention (PCI) with TAVR is preferred for less complex lesions or high-risk patients. The optimal timing of PCI relative to TAVR remains debated, with recent data favoring a "TAVR-first" approach for non-critical lesions. As TAVR extends to younger patients, lifetime management considerations become paramount, including valve durability, future coronary access, and planning for potential re-interventions. Commissural alignment techniques during TAVR are crucial for preserving future coronary access. A multidisciplinary Heart Team approach with robust shared decision-making is essential for optimizing individualized care in this evolving field.

Substantial efforts have been made to categorize the diverse and broad population of individuals with primary hypertension into more defined, homogeneous subgroups according to their hormonal responses to biological stimuli, such as low-renin hypertension. This study aimed to explore the phenotype and prognosis of patients with untreated primary hypertension with high renin and aldosterone levels.

CENTUM is a biodegradable everolimus-eluting stent comprising a cobalt-chromium open-cell stent platform. In this prospective trial, we aimed to evaluate the effectiveness and safety of CENTUM™ in a clinical setting.

Data on the optimal duration of dual antiplatelet therapy (DAPT) by age in patients undergoing percutaneous coronary intervention (PCI) are limited. This study assessed clinical outcomes based on age groups and DAPT duration, focusing on patients aged ≥75 years.