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The VITAL trial showed that neither vitamin D nor fish oil supplementation significantly reduced the incidence of cardiovascular disease (CVD). Conversely, current evidence supports the benefits of multiple dietary patterns, especially the Mediterranean diet, in primary prevention of CVD. Health effects of low-carbohydrate diets depend on the food sources of macronutrients.
More than 150 years after acetylsalicylic acid was synthesized by French chemist Charles Frédéric Gerhardt, aspirin is still one of the most prescribed medications worldwide. In 2018, several trials have suggested that the role of aspirin in the contemporary era might be less pre-eminent than in previous decades.
The main advances in interventional cardiology in 2018 include the new European guidelines on revascularization, new developments in the treatment of cardiogenic shock, novel stent technology from Asia and clinical trial data showing no benefit of dropping aspirin after stenting.
A number of papers published in 2018 have provided important information expected to influence clinical practice, particularly for the management of functional mitral regurgitation in patients with heart failure caused by ischaemic or non-ischaemic cardiomyopathy and for the treatment of severe aortic stenosis in patients at low surgical risk.
Precision cardiology is a vision of a health-care approach that identifies the optimal course of care for each patient. Although precision cardiology is still in its nascent stage, new approaches and methodologies are being developed to achieve this goal and to overcome technical and implementation barriers. In 2018, several high-impact studies made progress in this direction.
Considerable evidence supports a role for low-grade chronic inflammation in the atherothrombotic process, from plaque initiation to acute plaque rupture preceding myocardial infarction. Publications in 2018 revealed both the promise and challenges of targeting inflammation to treat atherosclerotic cardiovascular disease and highlighted the importance of understanding the mechanistic diversity of inflammatory pathways contributing to atherosclerosis.
Fully bioresorbable scaffolds (BRS) were designed to overcome the limitations of metallic drug-eluting stents, but long-term results with these devices have been disappointing. In this Review, the authors discuss the available preclinical and clinical data for BRS and how this information can inform the development of next-generation BRS.
This Review summarizes the mechanisms of ectopic calcification processes in the cardiovascular system, with an emphasis on emerging knowledge obtained from advances in imaging methods, experimental models and multiomics-generated big data. This Review highlights the potential and challenges of artificial intelligence, machine learning and deep learning to integrate imaging and mechanistic data to identify biomarkers and effective treatments for cardiovascular calcification
Stent thrombosis is a rare but severe complication of coronary intervention and has a complex underlying pathophysiology. In this Review, Gori and colleagues describe the risk factors for stent thrombosis and discuss how a better understanding of the mechanisms underlying this complication can inform its prevention and treatment.