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Editorial articles

April 2025 Br J Cardiol 2025;32(2) doi:10.5837/bjc.2025.016 Online First

Cardiac Risk in the Young: 30 Years of Supporting Families and Preventing Young Sudden Cardiac Deaths

Steven Cox

Abstract

For more than 30 years, Cardiac Risk in the Young (CRY) has been at the forefront of efforts to prevent sudden cardiac deaths in young people. Established in 1995, CRY has transformed the landscape of cardiac screening, research, and bereavement support in the UK and beyond. Through pioneering research, large-scale screening initiatives, and raising awareness, CRY has saved lives, supported affected families, and driven critical policy changes. This article explores CRY’s impact over the past three decades and its continuing efforts to prevent young sudden cardiac death (YSCD).

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March 2025 Br J Cardiol 2025;32:3–5 doi:10.5837/bjc.2025.012

Acute coronary events in kidney patients: the dialysis dilemma

Jemima Scott

Abstract

Acute coronary syndrome (ACS) events in people receiving long-term haemodialysis (HD) are common, present atypically and are associated with poor outcomes.1–3 Diagnosis is challenging, and treatment even more so. The complexity of this population drives their exclusion from clinical trials, resulting in a scarcity of evidence supporting any ‘optimal’ treatment strategy.4 Guidelines are, as a result, vague and, to a degree, contradictory.5–7 These are some of the reasons that the combination of cardiac and renal disease strike fear into even the most seasoned clinicians. Is it this fear that underlies the observed conservatism in treatment of those with advanced chronic kidney disease (CKD), and are we, therefore, contributing inadvertently to the adverse outcomes we are simultaneously striving to avoid? I commend Muhammad Haider and colleagues for tackling this challenging area, and attempting to summarise our knowledge in their review: “Diagnosis and management of ACS in patients with ESRD on haemodialysis: a comprehensive review”.8

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December 2024 Br J Cardiol 2024;31:126–7 doi:10.5837/bjc.2024.051

SGLT2 inhibitors: cardiac superheroes with caveats

Ismail Sooltan, Hesham Ismail, Aqib Khan, Sudantha Bulugahapitiya

Abstract

The arrival of sodium-glucose cotransporter type 2 (SGLT2) inhibitors has ushered in a new era in the management of cardiometabolic diseases. These innovative agents, initially developed for glycaemic control in type 2 diabetes, have unexpectedly demonstrated significant cardiovascular benefits, revolutionising cardiologists’ approach to the prevention and treatment of heart failure and cardiovascular events.1

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November 2024 Br J Cardiol 2024;31:128 doi:10.5837/bjc.2024.048

Empowering hearts: advancing cardiovascular research for women’s health

Elizabeth S Goh, Krithikalakshmi Sathiyamoorthy, Annaliese Carey, Elizabeth Cox, Sarah M Birkhoelzer

Abstract

Cardiovascular disease remains the leading cause of death for women, responsible for over a third of all deaths.1 In contrast, women remain widely under-represented in cardiovascular trials,2 as well as in their roles as physicians and trialists.3

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October 2024 Br J Cardiol 2024;31:123–5 doi:10.5837/bjc.2024.042

Grüntzig’s technique, relearnt

Pitt O Lim

Abstract

A quiet revolution without fanfare took place at a meeting, witnessed by over 1,000 people both in London and live streamed across the globe on 31 January 2024. It was unprecedented, going against received wisdom. That, it was possible to treat atherosclerotic coronary artery disease with an updated Andreas Grüntzig’s balloon alone, without the safety net and comfort of implanting a single stent. Three interactive cases were treated with the drug-coated balloon and all patients were same-day discharged. Seemingly a show of simplicity, parsimony and bravado, but dive a little deeper, the skill set for stent-free coronary intervention has been meticulously studied over the last 20 years by pioneers and early adopters alike. The sacred cow slayed on this historic day was that balloon-inflicted coronary dissection rarely leads to occlusion, having effective antiplatelet therapy on board. And, potentially occlusive dissection is, not only predictable, but this method can be used in the ambulatory care setting. Thus, saving hospital bed stays. This event will be remembered as the tipping point at which a paradigm shift has occurred, but going back to embracing Grüntzig’s lessons. This is timely too, considering that two decades of systematic stenting has led to stent failures comprising nearly a third of daily interventional workload.

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September 2024 Br J Cardiol 2024;31:85–7 doi:10.5837/bjc.2024.039

Integrated working in cardiovascular care

Raj Thakkar

Abstract

There is little doubt that demand on the National Health Service (NHS) has exceeded supply. Given the rhetoric of no more money, no new workforce, and no new estates, it is incumbent on us all to make better and more efficient use of the limited resource we do have, improve how we work together as one integrated health, community and social care ecosystem, and increase the value of every action we take. Cardiovascular services are no exception.

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August 2024 Br J Cardiol 2024;31:88–91 doi:10.5837/bjc.2024.034

Mentorship for cardiology trainees: appealing or appalling?

Alysha Bhatti, Pok-Tin Tang, Michael Drozd, C Fielder Camm

Abstract

Training and development of cardiology trainees in the UK at a local level, is usually delivered through senior supervision by a consultant cardiologist. This training is overseen by clinical and educational supervisors, whose role is to set goals in line with existing training curricula. This is crucial to ensuring trainee development and attainment of skills in line with a pre-determined ‘gold standard’ for independent practice.

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July 2024 Br J Cardiol 2024;31:83–4 doi:10.5837/bjc.2024.027

Understanding the failings of yesterday to improve the outcomes of tomorrow: a cardiorenal story

Matthew P M Graham-Brown, James O Burton, Rupert W Major

Abstract

“In spite of the accumulating evidence of their efficacy, established treatments for maintaining renal function remain woefully underutilized. Clinicians and health care systems must be encouraged to make use of these treatments.”1

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May 2024 Br J Cardiol 2024;31:45–8 doi:10.5837/bjc.2024.019

Cardiac ejection fraction as a problematic metric for heart failure phenotyping

Rienzi A Diaz-Navarro, Peter L M Kerkhof

Abstract

“Seek simplicity and distrust it.”
Alfred North Whitehead (1861–1947), English philosopher and mathematician

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April 2024 Br J Cardiol 2024;31:43–4 doi:10.5837/bjc.2024.013

The impact of air pollution on atherosclerotic cardiovascular disease development

Clayton Tewma, Justin Lee Mifsud

Abstract

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide, causing around 17.9 million deaths annually, a third of whom are adults aged <70 years.1 In addition to genetic and behavioural risk factors (unhealthy diet, physical inactivity, and tobacco and alcohol abuse), inhaling airborne pollutants, such as fine particulate matter (<2.5 µm [PM2.5] and <10 µm [PM10]), ultrafine particles (UFPs; <100 nm), nitrogen dioxide (NO2), ozone (O3), and sulphur dioxide (SO2), are associated with ASCVD among adults.2

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