Preventive Cardiology Research Updates

The LOSE-AF randomized trial enrolled 118 patients aged 60–85 years with BMI ≥27 and persistent atrial fibrillation undergoing cardioversion, randomizing them to an 8-month low-calorie diet plus behavioral support (n=59) versus usual care (n=59). The intervention produced significant weight loss (baseline-adjusted mean difference −6.9 kg; 9.7% vs 3.1% weight reduction) but did not significantly change AF symptom severity at 8 months (between-group difference −0.9, 95% CI −3.3 to 1.4; P = .43) nor AF burden, cardiac imaging measures, blood pressure, lipid profile, or need for additional rhythm-control procedures, and no serious adverse events related to the trial were reported.

A meta‑analysis of 139 randomized HF trials (292,027 patients; 28.1% women) found no difference in pharmacological treatment efficacy between women and men on the primary clinical efficacy endpoint (pooled delta ln[REM] 0.00; 95% CI -0.04 to 0.03). Meta‑regression showed no association between the proportion of women enrolled and sex differences in treatment effect or overall efficacy.

In 391,078 UK Biobank participants followed a median 13.35 years, incident arrhythmias (including AF, bradyarrhythmia/conduction block, and ventricular arrhythmia) were independently associated with increased risks of all-cause, vascular, and Alzheimer dementia, with a dose-response relationship for accumulated arrhythmia exposure driven largely by combined AF and brady/conduction disease. Concurrent AF with AV block/SND or BBB conferred higher dementia risk than either alone, pacemaker implantation related to lower risk compared with AVB/SND without pacing, and brain MRI showed arrhythmia-associated atrophy and white-matter injury.