Volume 14 Issue 3, March 2017

The ACCORDION trial, an extension of the ACCORD trial, confirms earlier findings showing that addition of fenofibrate to background statin therapy does not reduce cardiovascular events. However, cardiovascular events are reduced in patients with dyslipidaemia. Future trials with fibrates should restrict inclusion to patients with dyslipidaemia that persists despite statin therapy.

Inflammatory processes are central to the development and complications of atherosclerosis and acute myocardial infarction. In this Review, Ruparelia et al. summarize the inflammatory pathways involved in these cardiovascular diseases, highlight contemporary techniques to characterize and quantify inflammation, and consider how they might be used to guide specific treatments.

Depression is a highly prevalent risk factor for incident coronary heart disease (CHD) and for cardiovascular morbidity and mortality in patients with established CHD. In this Review, Carney and Freedland consider the evidence for depression as a cardiac risk factor, and summarize the biological and behavioural mechanisms that might link depression to CHD. They also consider whether treatment of depression can prevent cardiac morbidity and mortality in patients with CHD.

Peripheral artery disease (PAD) is undergoing a major epidemiological transition, with a rapid shift from high-income to low-income and middle-income countries. In this Review, Fowkes et al. describe the measurement of PAD in populations, as well as the worldwide prevalence, risk factors, and burden of the disease.

The dual-acting angiotensin-receptor–neprilysin inhibitor (ARNI) LCZ696, approved for treatment of heart failure with reduced ejection fraction, is the first approval for chronic neprilysin inhibition. Neprilysin metabolizes many peptides, suggesting many potential consequences of chronic neprilysin inhibition, both beneficial and adverse. This Review summarizes current knowledge on neprilysin inhibitor therapy, and the possible consequences of chronic inhibition.