Rising Prevalence of Unruptured Intracranial Aneurysms Over the Past Two Decades

A systematic review and meta-analysis found that the prevalence of unruptured intracranial aneurysms (UIAs) is increasing, particularly over the past two decades, and that the rise is only partly explained by improved detection of small aneurysms and population ageing. The analysis included 162 studies involving 316,131 participants and 11,822 people […]

Silent Atherosclerosis Common in Early Adulthood and Progressively Worsening with Age

Silent atherosclerosis was detectable as early as young adulthood and became progressively more prevalent and extensive with age, with a later and steeper increase among women. In this prospective cohort study conducted in Denmark and Spain, 16,808 adults aged 18 to 70 years without known atherosclerotic cardiovascular disease underwent three-dimensional […]

Higher Parental Vitamin B12 and Maternal Folate Levels Linked to Lower Birth Defect Prevalence

Higher periconception parental vitamin B12 levels and higher postconception maternal red blood cell (RBC) folate levels were associated with lower predicted prevalences of birth defects in a prospective cohort study from Shanghai, China. The study included 3032 couples with biomarker measurements obtained within 4 months before conception and 17,765 women […]

Function-Guided Complete Revascularization Improves Outcomes in STEMI

In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease, complete coronary revascularization guided by functional coronary angiography significantly reduced both major cardiovascular events and key safety events compared with conventional angiography-guided treatment. In this international randomized trial, 1,823 patients whose culprit lesion had been successfully treated […]

2026 Fifth Universal Definition of Myocardial Infarction

The Fifth Universal Definition of Myocardial Infarction (MI) updates the classification of MI by defining three major clinical settings—primary MI, secondary MI, and procedure-related MI—to better reflect underlying pathophysiology, support clinical evaluation, and incorporate objective diagnostic criteria. Primary MI occurs spontaneously because of an acute coronary pathology; although most cases […]

Updated US Guideline on Pharmacologic Prevention of Migraine in Adults

The US updated evidence-based recommendations provide clinicians with comprehensive guidance on when to initiate pharmacologic migraine prevention, how to select an appropriate preventive medication, and how to monitor treatment effectiveness, adverse effects, and medication discontinuation in adults. Developed by a multidisciplinary panel using a systematic review of studies published through […]

Catheter-Directed Thrombolysis Improves Outcomes in Intermediate-High–Risk Pulmonary Embolism

In patients with intermediate-high–risk acute pulmonary embolism, catheter-directed thrombolysis with alteplase plus anticoagulation significantly reduced the 7-day risk of death, recurrent pulmonary embolism, or cardiorespiratory decompensation or collapse compared with anticoagulation alone, without a significant increase in clinically relevant or major bleeding. In this Czech multicenter, open-label, randomized trial, 558 […]

Atorvastatin Prevents Cardiovascular Events in Older Adults without Prior Cardiovascular Disease

In a large randomized trial, atorvastatin 40 mg daily significantly reduced major cardiovascular events by 30% among community-dwelling adults aged 70 years or older without prior cardiovascular disease, diabetes, or dementia, but it did not significantly prolong disability-free survival over a median follow-up of 5.9 years. The double-blind, placebo-controlled trial […]

Aficamten Improves Exercise Capacity and Health Status in Nonobstructive HCM

In patients with symptomatic nonobstructive hypertrophic cardiomyopathy (HCM), aficamten significantly improved exercise capacity and patient-reported health status compared with placebo at 36 weeks. In this phase 3 multinational, double-blind trial, 517 adults were randomly assigned to receive aficamten or placebo for up to 72 weeks. At week 36, the Kansas […]

DOACs Reduce Cardiovascular Events in Atrial Fibrillation at Intermediate Stroke Risk

In patients with atrial fibrillation at intermediate risk for stroke, direct oral anticoagulant (DOAC) therapy significantly reduced the 24-month risk of a composite of stroke, systemic embolism, major bleeding, or cardiovascular death compared with no anticoagulation. In the Korean multicenter, open-label, adjudicator-masked randomized trial, 1,803 patients with a CHA₂DS₂-VASc score […]