Background: The impact of oral anticoagulants (OACs) on cognitive impairment and dementia in patients with atrial fibrillation (AF) is not well characterized. This systematic review aims to address this knowledge gap. Methods: SCOPUS and PubMed searches were conducted to identify articles in the English language investigating the association between the use of OACs and cognitive impairment and dementia. We excluded non-original research studies and studies that did not report data on cognitive impairment or included patients who underwent open heart surgery or had psychiatric illnesses or cancer. Results: Out of 22 studies (n = 606,404 patients), 13 studies (n = 597,744 patients) reported a reduction in cognitive impairment/dementia in those undergoing thromboprophylaxis. Using direct oral anticoagulants (DOACs) was associated with a lower incidence of cognitive impairment in 10 studies (n = 284,636 patients). One study found that patients undergoing dual therapy (n = 6794 patients) had a greater incidence of cognitive impairment compared to those undergoing monotherapy (n = 9994 patients). Three studies (n = 61,991 patients) showed that AF patients on DOACs had a lower likelihood of dementia diagnosis than those on vitamin K antagonists (VKAs). Dementia incidence was lower when VKAs were under good control. Conclusions: The use of oral anticoagulants has the potential to prevent cognitive impairment and dementia in patients with AF. Since most of the published research on this subject is observational in nature, more randomized controlled trials are needed to fully understand the effect of anticoagulants on cognitive function.

Background: This systematic review aims to determine the impact of isolated diastolic hypertension (IDH) on cardiovascular outcomes. Methods: We searched only English language articles on PubMed and SCOPUS until July 31, 2023 to investigate the association between IDH and cardiovascular outcomes. Results: This meta-analysis of 19 studies evaluated the impact of different hypertension diagnostic guidelines (ACC/AHA: American Heart Association/American College of Cardiology; JNC7: Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; NICE/ESC: National Institute for Health and Care Excellence/European Society of Cardiology) on hypertension-related outcomes. Studies had varying sample sizes (173 to 2,969,679 participants) and study designs. In cohort studies using JNC7 guidelines, IDH was linked to increased cardiovascular disease (CVD) risk (HR: 1.45, 95% CI 1.17, 1.74), CVD mortality (HR: 1.54, 95% CI 1.23, 1.84), and coronary heart disease (CHD) risk (HR: 1.65). In studies using ACC/AHA guidelines, associations with CVD risk and CVD mortality were weaker [HR: 1.16 (95% CI 1.06, 1.25) and 1.10 (95% CI 0.95, 1.25), respectively]. Subgroup analysis revealed differences in outcomes on the basis of age and sex. Cross-sectional studies did not show significant associations with JNC7 and ACC guidelines; NICE guidelines were not used in cross-sectional studies. Conclusion: IDH is associated with an increased risk of CVD. Higher diastolic blood pressure cutoffs were associated with higher cardiovascular risk. This association varied by study design and effect modification by sex and race influenced the association.

COVID-19, caused by the SARS-CoV-2 virus, initially identified as a respiratory illness, has increasingly been linked to a broader range of organ complications. This systematic review explores the impact of COVID-19 on cardiovascular and cerebrovascular health, focusing on thromboembolic events in post-COVID patients. A comprehensive literature search was conducted in PubMed and Google Scholar databases up to July 2023, utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies meeting eligibility criteria were analyzed for outcomes and associations between COVID-19 and cardiovascular and cerebrovascular events. The review includes 6 studies involving over 12 million patients, demonstrating a strong connection between COVID-19 and elevated risks of cardiovascular and cerebrovascular thromboembolic events. The risk of these events is evident in conditions such as ischemic heart disease, stroke, and cardiac arrhythmias. The burden of these events beyond the acute phase of the disease is concerning, warranting further exploration of long-term implications. Variability in event rates among different cohorts and healthcare settings underscores the need for understanding underlying factors influencing these differences. Potential mechanisms behind these events include endothelial dysfunction, systemic inflammation, and viral invasion. Implications for public health policies, clinical guidelines, and future research directions are discussed. This review serves as a valuable resource for healthcare providers, policymakers, and researchers to enhance patient care, outcomes, and preparedness for future waves of COVID-19 infections. However, there remain unexplored aspects of the COVID-19 and thromboembolic events relationship, urging further investigations into mechanistic insights and potential therapeutic interventions.

Smoking cessation decreases the chances of cardiovascular disease (CVD) and improves medical outcomes in public health. Cessation of smoking is associated with many important health and quality of life benefits. The use of withdrawal medications is recommended to increase the probability of cessation. However, there is a longstanding and growing concern that smoking cessation treatments may increase the risk of cardiovascular events during the cessation period. The purpose of this study is to specifically assess the importance of smoking cessation and the use of smoking cessation treatments for their effects on cardiovascular outcomes, including lipid profiles, coronary artery disease, peripheral vascular disease, carotid atherosclerosis, intimal thickness, and body mass index. weight changes. Cardiovascular disease (CVD) is a major public health problem, and smoking cessation has been shown to be an effective strategy for reducing CVD risk and improving overall health outcomes. Smoking cessation medications and therapies are recommended to increase your chances of successful cessation of smoking. However, concerns have been raised about a potential transient increase in cardiovascular events associated with smoking cessation treatment during the cessation period. The aim of this systematic review is to find out the effects of smoking cessation and smoking cessation treatment on various cardiovascular outcomes. This systematic review provides valuable information about smoking, the application of smoking cessation therapies, and their effects on cardiovascular disease.

Stress Echocardiography (ECG) is a commonly used modality for detection and assessment of Ischemic heart diseases (IHD). Its non-invasive nature makes it a more reliable diagnostic tool. This modality induces myocardial stress through exercise or pharmacological agents. Stress Echocardiography induced by exercise stress tests are more physiologic than pharmacologic stress tests as its finding tells about a patient’s exercise capacity which is prognostically important. Thus, if a patient can exercise, this is the preferred stress modality. Moreover, its radiation-free nature makes it a preferred option for individuals with contraindications to other stress imaging techniques and also decreases complications associated with other cardiac imaging modalities. Clinical conditions can be accurately assessed by comparing the findings of the heart rate and electrocardiograms after stress echocardiography with normal state. Analysis of stress echocardiography is done by visual precise evaluation of impaired myocardial contractility and regional wall motion abnormalities. This modality shows excellent results with current technology and by using an image enhancing agent, where necessary. It can identify the location of myocardial ischemia as well. Stress echocardiography holds significant potential in changing outcomes for a large population of patients with its high diagnostic accuracy, risk stratification capabilities, and cost-effectiveness.

Atrial fibrillation (AF) affects a substantial population of individuals aged ≥55 years globally and has been associated with an increased risk of cognitive impairment (CImp) due to the shared risk factors such as aging, obesity, and diabetes. It is essential to comprehend their unique relationship to manage them effectively to reduce its impact on public health systems. We performed a PubMed search of English language papers published till 31 May 2023. Data was extracted and effect measures were calculated. Meta-analysis of 33 studies revealed a significant association between AF and CImp after adjusting for comorbidities, with considerable between-study heterogeneity (pooled OR: 1.62; 95% CI: 1.43, 1.81, I ² = 94.143). Prospective and cross-sectional studies revealed substantial associations. CImp in AF may be mediated through silent brain infarctions, microemboli, brain atrophy, and inflammation. Future research should prioritize investigating the mechanisms and etiology of this association, as well as potential treatment options.