Non-alcoholic fatty liver disease (NAFLD) is a prevalent liver condition that affects people who do not overconsume alcohol. Uncertainties exist over how microRNAs (miRNAs) in the blood and liver relate to NAFLD. The aim of this narrative review was to investigate the role of miRNAs in the onset and progression of non-alcoholic steatohepatitis (NASH) from NAFLD, and explore their potential as diagnostic tools and treatment targets for NAFLD patients. Liver miRNA-34a levels were found to accurately represent the degree of liver damage, with lower levels suggesting more damage. In patients with NAFLD and severe liver fibrosis, higher levels of miRNA-193a-5p and miRNA-378d were found. Moreover, miRNA-34a, miRNA-122, and miRNA-192 levels might aid in differentiating NASH from NAFLD. Similar to this, miRNA-21 and miRNA-27 levels in rats were able to distinguish between steatosis and steatohepatitis. High-fat diets enhanced the expression of 15 distinct miRNAs in rats, and there were substantial differences in the miRNA expression patterns between obese and lean people. The results from the present review imply that miRNA microarrays and sequencing may be helpful diagnostic tools, and miRNAs may be a possible treatment target for patients with NAFLD.

Background: Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) greatly influence morbidity and mortality, with COPD patients frequently suffering from cardiovascular comorbidities like coronary heart disease and stroke. This study analyzes mortality trends and disparities among individuals in the United States (US) affected by both CVD and COPD. Methods: This study analyzed death certificates from the CDC WONDER database for individuals aged 25 and older who died between 1999 and 2020 with both CVD (ICD I00-I99) and COPD (ICD J41-J44). Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age group, race/ethnicity, geographic region, and urbanization status. Results: Between 1999 and 2020, there were 3,590,124 reported deaths due to coexisting CVD and COPD, with overall AAMR slightly changing from 82.2 to 81.2 per 100,000 population, and a notable rise from 2018 to 2020 (APC: 5.28; 95% CI: 1.83 to 7.22) coinciding with the onset of COVID-19 pandemic. A similar surge in mortality was observed across multiple demographic subgroups, particularly among older adults. Disparities across age groups, sex, race, and geographic location were also observed in the mortality rates due to CVD and COPD. When analyzed by age group, older adults exhibited the highest AAMR at 824.1. Men had higher AAMRs than women (96.5 vs. 60.7). Ethnoracial analysis showed that non-Hispanic (NH) White individuals had the highest AAMRs (82.0), followed by NH American Indian or Alaska Native (74.5), NH Black (63.6), Hispanic (38.1), and NH Asian or Pacific Islander (25.1) individuals. Additionally, non-metropolitan areas had higher AAMRs compared to metropolitan areas (96.2 vs. 70.9). Conclusions: The findings suggest that mortality rates for CVD and COPD have increased in recent years, coinciding with the onset of the COVID-19 pandemic, which may have exacerbated outcomes in vulnerable populations. The study highlights the need for targeted interventions to address the overlapping impacts of CVD and COPD, especially in high-risk groups.

Introduction: Cardiovascular-kidney-metabolic (CKM) syndrome, driven by metabolic risk factors like obesity, type 2 diabetes (DM-2), chronic kidney disease (CKD), and cardiovascular disease (CVD), leads to poorer health outcomes. Despite its rising prevalence and promising new therapies, trends and demographic disparities in CKM-related mortality among adults in the United States remain underexplored. Methodology: The study examined CDC WONDER death certificates for individuals aged 25+ who died from 1999 to 2022, with CVD as the main cause, while CKD and DM-2 as contributing factors. Age-adjusted mortality rates (AAMRs) and annual percent change (APC) were calculated by year, sex, age, race/ethnicity, region, and urbanization status. Results: From 1999 to 2022, 25,980 CKM-related deaths were recorded, with the AAMR decreasing from 5.3 to 0.4 per 1,000,000 population. AAMR rose significantly from 1999 to 2012 (APC: 7.03; p<0.001), sharply declined from 2012 to 2015 (APC: -65.55; p<0.001), and then increased from 2015 to 2022 (APC: 15.98; p = 0.101). Men had higher AAMRs than women (6.9 vs. 4.3), and older adults (65+) had the highest AAMR (23.3), followed by middle-aged adults (2.2). Among racial groups, non-Hispanic (NH) American Indian/Alaska Native had the highest AAMR (11.2), followed by NH Black (8.6), Hispanic (6.6), NH White (4.8), and NH Asian/Pacific Islander (4.7). Rural areas showed the highest AAMRs (6.8), compared to medium-small metro (6.1) and large metro areas (4.4). Conclusions: CKM-related mortality trends have varied widely over the past two decades, with men, older adults, American Indian/Alaska Native, and non-metropolitan populations experiencing the highest AAMRs, underscoring the need for targeted interventions.

Introduction: Sarcoidosis is an inflammatory disease characterized by granulomas, the etiology of which remains unclear. This study examines sarcoidosis-related mortality trends in the United States from 1999 to 2020, with a focus on disparities pertaining to patient sex, geographical location, and urbanization status. Methods: We analyzed death certificate data from the CDC WONDER database, using ICD-10 code D86. Age-adjusted mortality rates (AAMR) per 1,000,000 people were calculated. Trends were analyzed using Joinpoint regression models to determine annual percentage changes (APC). Results: A total of 37,956 Sarcoidosis-related deaths were documented from 1999 to 2020 in the United States. The AAMR increased from 3.9 in 1999 to 6.4 in 2020. Significant mortality increases were observed from 1999–2001 and again from 2018–2020. Mortality rates were consistently higher among women compared to men. A significant difference in AAMR was observed across states, with highest mortality in the South region and lowest in the West region. Urbanization trends shifted from higher AAMR rates in metropolitan to non-metropolitan areas post-2018. Non-Hispanic Black individuals experienced the highest mortality rates throughout the study period. Conclusions: This study highlights significant racial and geographic disparities in sarcoidosis-related mortality. Women, Black patients, and those residing in non-metropolitan areas are at the highest risk for Sarcoidosis associated mortality. Targeted public health interventions are required to address these prevalent disparities.

Background: Recent guidelines suggest that antiplatelet therapy (APT) is the standard of care in the absence of long-term oral anticoagulation (OAC) indications in patients post-transcatheter aortic valve replacement (TAVR). The superiority of one method over the other remains controversial. Materials and methods: Several databases, including MEDLINE, Google Scholar, and EMBASE, were electronically searched. The primary endpoint was the all-cause mortality (ACM) rate. Secondary endpoints included cardiovascular death, myocardial infarction (MI), stroke/TIA, haemorrhagic stroke, bleeding events, systemic embolism, and valve thrombosis in post-TAVR patients receiving APT and oral anticoagulants (OACs). Forest plots were generated using Review Manager version 5.4, with a p value less than 0.05 indicating statistical significance. Subgroup analysis was performed to explore potential sources of heterogeneity. Results: Twelve studies were selected. No significant differences were observed in APT and OAC group for ACM [risk ratio (RR): 0.67; 95% CI:0.45–1.01; P=0.05], cardiovascular death [RR:0.91; 95% CI:0.73–1.14; P=0.42], MI [RR:1.69; 95% CI:0.43–6.72; P=0.46], Stroke/TIA [RR:0.79; 95% CI:0.58–1.06; P=0.12], ischaemic stroke [RR:0.83; 95% CI:0.50–1.37; P=0.47], haemorrhagic stroke [RR:1.08; 95% CI: 0.23–5.15; P=0.92], major bleeding [RR:0.79; 95% CI:0.51–1.21; P=0.28], minor bleeding [RR:1.09; 95% CI: 0.80–1.47; P=0.58], life-threatening bleeding [RR:0.85; 95% CI:0.55–1.30; P=0.45], any bleeding [RR:0.98; 95% CI:0.83–1.15; P=0.78], and systemic embolism [RR:0.87; 95% CI:0.44–1.70; P=0.68]. The risk of valve thrombosis was higher in patients receiving APT than in those receiving OAC [RR:2.61; 95% CI:1.56–4.36; P =0.0002]. Conclusions: Although the risk of valve thrombosis increased in patients receiving APT, the risk of other endpoints was comparable between the two groups.