Cardiology articles from across Nature Portfolio

Standard treatments to reduce cardiovascular risk, including mineralocorticoid receptor antagonists, have not lowered the high cardiovascular mortality and morbidity of patients on long-term haemodialysis. Future research should focus on targeting inflammatory pathways that are activated when blood interacts with dialysis membranes.

Genome-wide association studies (GWAS) in coronary artery disease have revealed gene variants highly expressed in vascular smooth muscles cells (SMCs). Research now suggests that loss of one, Prdm16, drives a switch toward a synthetic SMC phenotype, with robust, potentially protective extracellular matrix production and fibrous cap formation.

Anthrax toxin receptor 1 (ANTXR1), an integrin-like transmembrane protein, is a docking platform for anthrax toxin and mediates cell–extracellular matrix interactions. New work shows that ANTXR1 stabilizes transforming growth factor-β receptors on cardiac fibroblasts, leading to profibrotic signaling and pathological remodeling of the heart.

In the VESALIUS-CV trial, the PCSK9 inhibitor evolocumab reduced the risk of a first cardiovascular event in patients with atherosclerosis or diabetes mellitus but without a previous myocardial infarction or stroke.

In this Comment, I propose an outcome-oriented classification of heart failure based on skeletal muscle mass. By distinguishing between heart failure with either preserved or reduced muscle mass, this conceptual framework represents a major step towards abandoning the misleading concept of the ‘obesity–mortality paradox’ in cardiology.

Andrea Zambrano highlights the study that catalysed the field of reverse cardio-oncology by showing that myocardial infarction promotes breast tumour growth in mice.

Liu and Bursill highlight a landmark study that described the presence of in-stent neoatherosclerosis in bare-metal and drug-eluting stents, which has reshaped the clinical management of coronary artery disease.

In the DECAF trial, daily consumption of a cup of coffee reduced the rate of atrial fibrillation recurrence by almost 40% — challenging the long-held view that caffeine is pro-arrhythmic.