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Mosaic loss of chromosome Y (mLOY) refers to the condition in male individuals in which a detectable fraction of cells lose the Y chromosome. Prevalent in haematopoietic cells, this common somatic mutation is associated with decreased longevity and an increased risk of age-related diseases, including cardiovascular disease. Haematopoietic mLOY provides further insight into the sex-specific disparities that exist in disease susceptibility.
Left atrial appendage occlusion (LAAO) has been rapidly adopted for stroke prevention in patients with non-valvular atrial fibrillation and a contraindication to oral anticoagulation. Ongoing and planned clinical trials on LAAO and the development of new devices might expand clinical indications and address the remaining challenges of device-related thrombus and peridevice leak.
Anti-inflammatory therapy involving IL-1β inhibition might reduce the risk of cardiovascular events in individuals with clonal haematopoiesis by increasing the number of fibroblast-like cells in the fibrous cap region of atherosclerotic plaques, thereby stabilizing the plaque and reducing the likelihood of rupture.
In this Review, Swirski and co-workers discuss how lifestyle factors modulate haematopoiesis and leukocyte migration in the context of cardiovascular homeostasis and disease, with particular focus on the role of the nervous system as the key executor connecting environmental influences to leukocyte behaviour.
In this Review, Tsimikas and Witztum discuss the role of oxidized phospholipids (OxPLs) in atherosclerosis, describe the methods for measuring OxPLs on apolipoprotein B-containing lipoproteins (OxPL–apoB) and their relationship with lipoprotein(a), and discuss the clinical applications of the OxPL–apoB measurement for improving diagnosis, prognosis, risk reclassification and therapeutic interventions in patients with atherosclerotic cardiovascular disease.
Myocardial infarction with non-obstructive coronary arteries (MINOCA) has been the focus of an increasing number of studies in the past decade. In this Review, Tavella and colleagues detail the prevalence and clinical presentation of MINOCA, describe the mechanisms underlying the syndrome, and summarize the sex-specific and ethnicity-specific differences in the clinical features, pathophysiological mechanisms, treatment and prognosis of MINOCA.
The menopausal transition period, which begins with irregular menstrual cycles and ends with the final menstrual period, is associated with an increase in cardiovascular risk. In this Review, Mehta and Manson describe the metabolic and cardiovascular changes that occur during the menopausal transition period and summarize the evidence on the use of targeted interventions to slow the progression of atherosclerosis.
