Volume 14 Issue 11, November 2017

Initial randomized trials of cholesteryl ester transfer protein (CETP) inhibitors were terminated early owing to adverse effects or futility. The REVEAL trial now shows the benefit of CETP inhibition in coronary heart disease. Despite raising HDL-cholesterol levels, the cardiovascular effect of CETP inhibitors is probably due to lowering of non-HDL-cholesterol levels.

Derailment of cellular protein homeostasis (proteostasis) and loss of protein quality control (PQC) are central factors in ageing and contribute to cardiovascular disease. In this Review, Henning and Brundel describe the mechanisms by which PQC can fail. Targeting PQC to maintain cardiac proteostasis offers a novel therapeutic strategy to promote cardiac health and combat cardiac disease.

Cardiovascular disease (CVD) follows a seasonal pattern in many populations, often peaking after 'cold snaps'. In this Review, Stewart and colleagues identify the physiological and environmental factors that contribute to seasonality in nearly all forms of CVD, and describe the potential strategies that might attenuate peaks in cardiovascular events during cold and hot periods of the year.

The optimal reperfusion strategy in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease is still uncertain. In this Review, Mehran and colleagues discuss the available evidence on the different treatment options for patients with STEMI and multivessel disease, highlighting current guideline recommendations and providing future directions on reperfusion strategies in these patients.

Strategies to reduce myocardial infarct size beyond early reperfusion have thus far yielded disappointing results in clinical trials. In this Review, Kloner and co-workers discuss several new approaches to preserve the reperfused myocardium, including those that target mitochondrial bioenergetics and autophagy.