Search Results (2,816)

Background and Objectives: Infective endocarditis (IE) remains a severe infection with high morbidity and mortality, particularly among people who inject drugs (PWID). Data from Eastern Europe are limited, despite the increasing burden of intravenous drug use in the region. Materials and Methods: We conducted a retrospective, observational cohort study of 153 patients diagnosed with IE and admitted to the “Dr. Victor Babeș” Clinical Hospital for Infectious and Tropical Diseases in Bucharest, Romania, between August 2019 and July 2024. Patients were classified into PWID (n = 51) and non-PWID (n = 102). Clinical characteristics, microbiological profiles, echocardiographic findings, complications, and outcomes (in-hospital, 10-week, and 12-month mortality) were compared between groups. Results: PWID were significantly younger (mean 34.0 ± 6.6 years vs. 64.3 ± 13.1 years; p < 0.001), predominantly male (86.3% vs. 62.7%; p = 0.003) and had higher rates of HIV (64.7%) and HCV (98.1%). Right-sided IE and larger vegetations were more common in PWID, whereas non-PWID had more left-sided disease, pre-existing valvular pathology, and prosthetic valve involvement. Staphylococcus aureus predominated in PWID (68.6% vs. 27.5%; p < 0.001), while non-PWID had more Streptococcus spp. and Coxiella burnetii cases. Embolic complications, particularly pulmonary emboli, and valvular rupture were significantly more frequent in PWID, while non-PWID had higher rates of heart failure and surgical interventions. In-hospital mortality was similar (17.6% vs. 11.8%; p = 0.318), but 12-month mortality was higher in PWID (27.5% vs. 13.7%; p = 0.038). Conclusions: IE in PWID shows a distinct clinical and microbiological profile, with more aggressive complications and worse long-term survival. Tailored management, early diagnosis, harm reduction programs, and dedicated follow-up are urgently needed in this high-risk population. Full article

Background: Type 2 diabetes (T2D) is associated with reduced cardiorespiratory fitness (CRF), a critical predictor of cardiovascular disease and all-cause mortality. CRF relies upon the coordinated action of multiple systems including the skeletal muscle where the mitochondria metabolize oxygen and substrates to sustain ATP production. Yet, previous studies have shown that impairments in muscle bioenergetics in T2D are not solely due to mitochondrial deficits. This finding indicates that factors outside the mitochondria, particularly within the local tissue microenvironment, may contribute to reduced CRF. One such factor is the extracellular matrix (ECM), which plays structural and regulatory roles in metabolic processes. Despite its potential regulatory role, the contribution of ECM remodeling to metabolic impairment in T2D remains poorly understood. We hypothesize that pathological remodeling of the skeletal muscle ECM in overweight individuals with and without T2D impairs bioenergetics and insulin sensitivity, and that exercise may help to ameliorate these effects. Methods: Participants with T2D (n = 21) and overweight controls (n = 24) completed a 10-day single-leg exercise training (SLET) intervention. Muscle samples obtained before and after the intervention were analyzed for ECM components, including collagen, elastin, hyaluronic acid, dystrophin, and proteoglycans, using second harmonic generation imaging and immunohistochemistry. Results: Positive correlations were observed with elastin content and both glucose infusion rate (p = 0.0010) and CRF (0.0363). The collagen area was elevated in participants with T2D at baseline (p = 0.0443) and showed a trend toward reduction following a 10-day SLET (p = 0.0867). Collagen mass remained unchanged, suggesting differences in density. Dystrophin levels were increased with SLET (p = 0.0256). Conclusions: These findings identify that structural proteins contribute to aerobic capacity and identify elastin as an ECM component linked to insulin sensitivity and CRF. Full article

Background/Objective: Systemic inflammation is a hallmark of end-stage renal disease (ESRD) and contributes to the high burden of cardiovascular morbidity and mortality in hemodialysis (HD) patients. The systemic immune–inflammation index (SII), derived from peripheral neutrophil, lymphocyte, and platelet counts, has emerged as a promising biomarker of immune–inflammatory status. This study aimed to assess the acute effect of a single HD session on systemic inflammation and to identify metabolic predictors associated with this response. Methods: In this single-center observational before–after study, 44 chronic HD patients were enrolled. Blood samples were collected immediately before and after a single HD session. SII was calculated as platelet count × neutrophil count/lymphocyte count. Subgroup analyses were conducted based on renal disease etiology and diabetic status. Multivariable linear regression models identified baseline predictors of SII variation. Results: Median SII significantly decreased post-HD in the overall cohort (from 553.4 [342.6–847.5] to 449.1 [342.6–866.6], p = 0.001), with a more pronounced reduction in patients with cardiometabolic etiologies (from 643.4 [353.3–1360.0] to 539.1 [324.8–1083.4], p = 0.007) and diabetes (from 671.1 [408.7–1469.1] to 458.3 [285.7–1184.4], p = 0.028), but not in those with nephroangiosclerosis (p = 0.182). Baseline total cholesterol (p = 0.001) and gamma-glutamyl transferase (p = 0.034) were positively associated with smaller reductions in SII, while higher baseline glycaemia predicted a greater decrease in post-dialysis SII (p = 0.021). Conclusions: HD acutely modulates systemic inflammation, as reflected by reduction in SII. The magnitude of this response is significantly influenced by individual metabolic profiles. These findings highlight the relevance of metabolic–immune crosstalk in ESRD and suggest that SII may serve as a dynamic biomarker integrating inflammatory and metabolic signals, deserving further validation in larger, outcome-driven studies. Full article

Objectives: Atherectomy use for the treatment of femoropopliteal lesions has significantly increased. This study aimed to assess the clinical benefits of percutaneous atherectomy (PA) over balloon angioplasty and/or stenting (PTA ± stent) for femoropopliteal arterial disease using a nationwide prospective multicenter registry. Methods: Using data from the Damoeum registry of the Korean Society for Vascular Surgery, we identified patients with revascularization due to lower-extremity arterial disease. After excluding patients who underwent open and hybrid revascularization, we compared the clinical outcomes of the patients in the PA group versus the PTA ± stent group. We investigated the target lesion patency and functional and safety outcomes during the follow-up. Results: A total of 424 patients were included in the final analysis: 90 in the PA group and 334 in the PTA ± stent group. There were 344 men and 79 women (mean age: 71.1 years). The preprocedural ankle–brachial index (ABI) was significantly increased in both groups (p = 0.015). When we compared 90 patients of the PA group and 270 patients of the matched PTA ± stent cohort (1:3 propensity-matched cohort), the overall 1-year primary patency rate was not significantly different (83.8% vs. 80.0%; p = 0.895). However, the PA group showed a significantly lower risk of occlusion compared with the PTA ± stent group during the follow-up (adjusted HR: 0.01; p < 0.001). Overall mortality was similar in the two groups (p = 0.695). Conclusions: The use of atherectomy was not associated with improvement in target lesion patency. However, the use of atherectomy devices demonstrated a significant reduction in target lesion occlusion during the follow-up. Full article

Background/Objectives: Heart failure with reduced ejection fraction (HFrEF) is a leading cause of hospitalization and functional decline in older adults, accounting for over 80% of all heart failure cases. Given the narrow therapeutic window of currently available inotropes and the vulnerability of this population, levosimendan has been proposed as a potential alternative. This systematic review aimed to evaluate the clinical efficacy and safety of levosimendan in older adults with decompensated HFrEF. Methods: A systematic search of PubMed, Embase, Scopus, and the Cochrane Library was conducted between January and May 2025, following PRISMA 2020 guidelines. The review was registered in PROSPERO (CRD420251032329). Of 379 articles initially identified, 8 studies (randomized, observational, and single-arm designs) enrolling patients aged ≥65 years with decompensated HFrEF met the inclusion criteria. Study quality was assessed using the Cochrane RoB-2 tool and JBI Critical Appraisal Checklists. No meta-analysis was performed due to heterogeneity in study designs, populations, and interventions. Results: A total of 2838 patients were analyzed. Levosimendan was associated with short-term improvements in hemodynamic parameters, including an increase in cardiac index (from 1.65 to 2.37 L/min/m²) and a reduction in pulmonary capillary wedge pressure (from 31 to 16 mmHg) within 24–72 h (p < 0.002). However, no statistically significant differences were observed in 30-, 90-, or 180-day mortality (p > 0.05), and findings on rehospitalization were inconsistent. Reported adverse events included hypotension (36–57%) and atrial arrhythmias (9–50%), with low treatment discontinuation rates (5–8%). Conclusions: Levosimendan may improve short-term hemodynamic parameters in older adults with decompensated HFrEF, but the available evidence is limited and heterogeneous. Its effects on mortality and rehospitalization remain inconclusive. Clinical use should be individualized and closely monitored, particularly in frail patients. Full article

Background/Objectives: Infant diarrhea is a major global cause of morbidity and mortality. While Bifidobacterium is linked to diarrhea, its preventive effects, underlying mechanisms, and potential synergistic benefits with prebiotics remain unclear. The objective of this study was to explore the efficacy of a synbiotic composed of Bifidobacterium animalis subsp. lactis BB-12 (BB-12) and 2′-fucosyllactose (2′-FL) in alleviating infant diarrhea. Methods: One-week-old C57BL/6J mice were used to construct a model of infant diarrhea via infection with enteropathogenic Escherichia coli (EPEC) O127. Mice were administered BB-12 (10⁸ CFU per mouse), 2′-FL (1 g/kg), or their combination (synbiotic) for three consecutive weeks. Results: Administration of the synbiotic not only markedly improved diarrhea, anxiety-like behavior, colon inflammation, and gut barrier function but also positively reshaped the microbial community. This was achieved through a significant rise in short-chain fatty acid (SCFA)-producing bacteria (e.g., Akkermansia and Paraprevotella), a rise in fecal SCFAs, and a reduction in harmful bacteria such as Escherichia. Conclusions: The synbiotic effectively relieves EPEC-induced infant diarrhea by regulating gut microbiota composition and metabolic functions. These findings highlight its potential as a dietary intervention in infant diarrhea and provide new insights into infant health applications. Full article

Colorectal cancer (CRC) remains a major contributor to global cancer-related mortality, with rising incidence observed in several regions, including Saudi Arabia. This review compiles and critically analyzes recent preclinical research from Saudi-based institutions that investigates the anti-CRC potential of natural and synthetic compounds. Numerous natural products such as Nigella sativa, Moringa oleifera, Curcuma longa, and marine-derived metabolites have demonstrated cytotoxic effects through pathways involving apoptosis induction, reactive oxygen species (ROS) generation, and inhibition of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and cyclooxygenase-2 (COX-2). In parallel, synthetic and semi-synthetic agents, including C4–G4 (semi-synthetic hybrids designed from flavonoids and benzoxazole scaffolds that act as dual epidermal growth factor receptor (EGFR)/COX-2 inhibitors)), oxazole derivatives, and camptothecin-based nanocarriers, exhibit promising anti-tumor activity via molecular targeting of cyclin-dependent kinase 8 (CDK8), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), and β-catenin pathways. Selected in vivo studies primarily utilizing xenograft and chemically induced rodent models have shown reductions in tumor volume and modulation of apoptotic and inflammatory biomarkers. Additionally, green-synthesized metallic nanoparticles (NPs) and polyethylene glycol (PEG)-modified carriers have been investigated to improve bioavailability and tumor targeting of lead compounds. While these findings are encouraging, the majority remain in preclinical phases. Limitations such as poor solubility, lack of pharmacokinetic data, and absence of clinical trials impede translational progress. This review highlights the need for standardized evaluation protocols, mechanistic validation, and region-specific clinical studies to assess efficacy and safety. Given Saudi Arabia’s rich biodiversity and growing research capacity under national strategies like Vision 2030, the country is well-positioned to contribute meaningfully to CRC drug discovery. By integrating bioactive natural products, rationally designed synthetics, and advanced delivery platforms, a pipeline of innovative CRC therapeutics tailored to local and global contexts may be realized. Full article

Lymphomas remain a significant cause of morbidity and mortality among patients living with HIV. Although the introduction of antiretroviral therapy has led to a reduction in the incidence of AIDS-related lymphomas (ARL) and an overall improvement in prognosis, these malignancies continue to pose a considerable clinical challenge. Beyond the inherent complexity of lymphoma treatment itself, the management of comorbidities, particularly infections, represents a therapeutic obstacle. Here, we review the published evidence on ARL complicated by COVID-19. Despite the fact that nearly 800 million confirmed cases of SARS-CoV-2 infection have been reported so far, only five cases of ARL and COVID-19 have been published, among whom most patients experienced a mild course of SARS-CoV-2 infection, with only one case progressing to severe COVID-19 that required oxygen therapy and prolonged hospitalization. Additionally, we present another case of a 49-year-old male patient with newly diagnosed ARL, Epstein–Barr virus (EBV)-positive, diffuse large B-cell lymphoma, not otherwise specified, complicated by prolonged SARS-CoV-2 infection. Although initially asymptomatic, the patient subsequently experienced transient respiratory failure. Despite administration of molnupiravir, both SARS-CoV-2 antigen and RT-qPCR tests remained positive for a minimum of 113 days. The prolonged SARS-CoV-2 infection, in conjunction with other opportunistic infections, impeded the delivery of adequate chemotherapy dose intensity and contributed to disease progression and ultimately the patient’s death. This case and review of the literature underscores the diversity of the clinical course of SARS-CoV-2 infection in patients with ARL and highlights the associated challenges in delivering optimal anti-lymphoma therapy in those patients. Full article

Acute pulmonary embolism (APE) remains a significant cause of mortality and morbidity despite increasing prophylaxis for deep venous thrombosis (DVT). The IVC filter is a temporary or permanent intravascular device that traps migrating thrombi from their origin in the pelvis or a lower limb into the pulmonary vasculature, thereby preventing significant APE. The current and longstanding indications for placing an IVC filter are in patients with documented lower extremity DVT and acute APE who also have absolute contraindications to anticoagulation or have experienced an acute, hemodynamically unstable APE requiring ventilatory and vasoactive support, with limited cardiovascular reserve. Updated guidelines have led to a significant rise in IVC filter placements for specific therapeutic indications of venous thromboembolism compared to prophylactic use. Meta-analyses show that IVC filter placement is associated with a lower risk of subsequent APE but an increased risk of DVT. However, there appears to be no significant reduction in APE-related mortality and no change in all-cause mortality. Early complications after IVC filter placement typically relate to procedural issues and include bleeding or infection at the venous access site, development of arteriovenous fistulas, accidental arterial puncture, and post-procedural access site hematoma or thrombosis. Additional early complications include IVC filter malposition, incomplete expansion, IVC penetration, or guidewire entrapment. Delayed complications may involve DVT below the filter, IVC occlusion due to the filter, IVC filter migration, fracture of one of the IVC filter components, IVC rupture, or IVC thrombosis. Retrieval of IVC filters by simple, advanced, or open techniques should be considered after weighing the risk-to-benefit for the individual patient. Deployment of the IVC filter remains an important component of interventional APE management within the narrow indications currently proposed. Current guidance recommends that an untethered temporary IVC filter should be placed and retrieved once the contraindication to anticoagulation is resolved. Full article

Background: The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for control of noncompressible torso hemorrhage remains controversial. We aimed to utilize a novel and transparent/interpretable artificial intelligence (AI) method called Optimal Policy Trees (OPTs) to improve the appropriate use and decrease the misuse of REBOA in hemodynamically unstable blunt trauma patients. Methods: We trained and then validated OPTs that “prescribe” REBOA in a 50:50 split on all hemorrhagic shock blunt trauma patients in the 2010–2019 ACS-TQIP database based on rates of survival. Hemorrhagic shock was defined as a systolic blood pressure ≤90 on arrival or a transfusion requirement of ≥4 units of blood in the first 4 h of presentation. The expected 24 h mortality rate following OPT prescription was compared to the observed 24 h mortality rate in patients who were or were not treated with REBOA. Results: Out of 4.5 million patients, 100,615 were included, and 803 underwent REBOA. REBOA patients had a higher rate of pelvic fracture, femur fracture, hemothorax, pneumothorax, and thoracic aorta injury (p < 0.001). The 24 h mortality rate for the REBOA vs. non-REBOA group was 47% vs. 21%, respectively (p < 0.001). OPTs resulted in an 18% reduction in 24 h mortality for REBOA and a 0.8% reduction in non-REBOA patients. We specifically divert the misuse of REBOA by recommending against REBOA in cases where it leads to worse outcomes. Conclusions: This proof-of-concept study shows that interpretable AI models can improve mortality in unstable blunt trauma patients by optimizing the use and decreasing the misuse of REBOA. To date, these models have been used to predict outcomes, but their groundbreaking use will be in prescribing interventions and changing outcomes. Full article

Pneumocystis jirovecii pneumonia (PCP) remains a frequent cause of intensive care unit (ICU) admission among people living with HIV (PLWH), despite widespread antiretroviral therapy (ART) use. We conducted a retrospective cohort study of 39 PLWH with PCP admitted to the ICU at the Croatian national HIV referral center between 2002 and 2023. Patients were grouped by calendar period (pre-2015 vs. post-2015, reflecting the adoption of the “test and treat” strategy in 2015). Primary outcomes included ICU, 30-day, and 1-year mortality. We also evaluated the association between in-ICU ART initiation and survival. There were 37 (94.9%) males with a median age of 49 years (Q1–Q3, 37.5–54.5). Thirty-three (84.6%) were newly diagnosed with HIV. There were no differences between the observed periods regarding demographic characteristics. ART was initiated in the ICU in 21 (53.8%) patients, more frequently after 2015 (p < 0.001). ICU, 30-day, and 1-year mortality rates were 53.9% (n = 21), 51.3% (n = 20), and 66.7% (n = 26), respectively. Survival significantly improved in the later period, with 1-year survival reaching 54.5% (12/22). In-ICU ART initiation was associated with improved survival in univariable analysis, but this effect attenuated after adjusting for APACHE II or calendar year. Early ART may offer benefit but remains confounded by disease severity and evolving care standards. Full article

Background/Objectives: Tuberculosis (TB) remains one of the most pressing global health challenges, ranking among the leading infectious causes of mortality worldwide. Medicinal plants possess antimycobacterial potential, warranting the isolation and characterization of their bioactive compounds to address bacterial infections. The study aimed to determine five selected traditional medicinal plants’ in vitro antioxidant and antibacterial activities and the isolation of active phytoconstituents. Methods: Powdered leaf material was extracted using n-hexane, dichloromethane, acetone, methanol, and water. The quantity of phytochemicals and antioxidants was determined using colorimetric assay, The antimycobacterial activity and combination effects were determined using microbroth dilution assay. Cell viability was determined using the [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] MTT reduction assay. Bioassay-guided fractionation was used to isolate bioactive compounds. Results: Polar solvents had high extraction yields, and all extracts had varying phytoconstituents. Active extracts were selected for fractionation and isolation of pure compounds using gradient elution column chromatography. Rhoicissus tridentata water extracts had the highest total phenolic (335.20 ± 8.26 mg GAE/g) and tannin (103.48 ± 7.36 mg GAE/g) content, while Rosmarinus officinalis (45.90 ± 11.04 mg QE/g) methanol extract had the highest total flavonoid. Ximenia caffra had promising antioxidant activity. R. officinalis had prominent antimycobacterial. Rhoicissus tridentata had the highest percentage cell viability. Two compounds were isolated, and they were active against Mycobacterium smegmatis with minimum inhibitory concentration values ranging from 0.125 to 0.25 mg/mL. Conclusions: The selected medicinal plants contain phytochemicals with antioxidant and antimycobacterial activities, supporting their pharmacokinetic studies and evaluation against Mycobacterium tuberculosis H37Rv. Full article

Background: Post-extubation hypoxaemia and postoperative pulmonary complications (PPCs) are common in surgical patients and contribute significantly to morbidity and prolonged recovery. High-flow nasal oxygen therapy (HFNOT) has been proposed as an alternative to conventional oxygen therapy (COT) in improving oxygenation and reducing PPCs postoperatively. Objectives: To evaluate the effectiveness of HFNOT compared to COT in reducing post-extubation hypoxaemia and PPCs in adult surgical patients, and to assess its impact on other clinical outcomes including ICU and hospital length of stay, mortality, and the need for escalation of respiratory support. Methods: A systematic review and meta-analysis of randomized controlled trials was conducted following PRISMA guidelines. Studies were identified from five databases including PubMed, Scopus, EBSCOHost, ProQuest, Ovid MEDLINE and Web of Science. Adult postoperative patients who received HFNOT after extubation were compared to those receiving COT. Primary outcomes included PaO₂/FiO₂ (PF) ratio and incidence of PPCs. Secondary outcomes were hospital and ICU length of stay, mortality, and need for escalation of therapy. Results: Seventeen trials comprising 1830 patients were included. HFNOT significantly improved PF ratio post-extubation and reduced the incidence of hypoxaemia and PPCs compared to COT. For secondary outcomes, HFNOT was associated with a reduced hospital length of stay and lower postoperative mortality, while no significant difference was found for ICU stay. Escalation of respiratory support was more frequent in the COT group. Subgroup analyses indicated greater improvements in oxygenation with HFNOT of shorter duration (<24 h) and in non-cardiothoracic patients. Conclusions: HFNOT is associated with improved postoperative oxygenation and a reduction in respiratory complications following extubation in surgical patients. The most pronounced benefits were observed in non-cardiothoracic populations and with short-duration applications. While the beneficial effects of HFNOT appear consistent across the included randomized controlled trials, further large-scale studies with standardized intervention durations, surgical populations, and clearly defined criteria for escalation of therapy are needed to strengthen and confirm these findings. Full article

Objectives: This study aims to examine the impact of Diagnosis-Related Group (DRG) payment on medical costs, efficiency, and quality of healthcare services in public hospitals, providing policy recommendations for further health insurance payment reforms in China. Methods: Utilizing inpatient medical insurance settlement data from 2020 to 2023 in the selected city, we constructed a regression discontinuity design (RDD) and an interrupted time series (ITS) model to evaluate the causal effects of the DRG reform. The analysis includes 66,533 inpatient settlement records. Results: Following the reform, the average length of stay (LOS) decreased by 2 days (95% CI: −3.43 to −0.70, p < 0.01), total hospitalization expenditures dropped by 13% (95% CI: −0.26 to −0.00, p < 0.05), and expenditures from the medical insurance fund declined by 25% (95% CI: −0.39 to −0.12, p < 0.01). Additionally, examination and consultation fees were reduced by 23% (95% CI: −0.41 to −0.05, p < 0.05), although patients’ out-of-pocket burden increased by 8% (95% CI: 0.05 to 0.10, p < 0.01). In terms of healthcare quality, the 30-day readmission rate decreased by 1% (95% CI: −0.01 to −0.00, p < 0.01), and the mortality rate among low-risk patients declined by 4% (95% CI: −0.04 to −0.03, p < 0.01). We found no evidence of patient selection or denial of admission. Heterogeneity analysis revealed that the reduction in hospital stay was concentrated among enrollees under the Urban and Rural Resident Basic Medical Insurance and those treated in secondary hospitals. The policy’s effects peaked shortly after implementation but gradually attenuated over time. Conclusions: Our study offers hospital-level evidence indicating that the initial stage of DRG implementation achieved its preliminary goals of optimizing medical resource allocation and improving the efficiency of medical insurance fund utilization. However, the reform still faces several challenges. These findings may offer valuable references for developing countries pursuing reforms in primary healthcare and health insurance payment systems. Full article

Glucagon-like peptide-1 (GLP-1) receptor agonists now serve as therapeutic agents for cardiovascular diseases (CVDs) beyond their original use for treating type 2 diabetes mellitus (T2DM). This review combines molecular mechanisms with clinical evidence to demonstrate how GLP-1 agonists help lower cardiovascular risk for conditions, including atherosclerosis, heart failure, stroke, and vascular dementia. These agents produce multiple beneficial effects, which include anti-inflammatory action along with anti-atherogenic effects, endothelial-protective benefits, and cardioprotective actions to minimize major adverse cardiovascular events (MACEs). GLP-1 agonists achieved substantial reductions in myocardial infarction, stroke, cardiovascular mortality, and heart failure events according to major cardiovascular outcome trials (CVOTs). Recent research, notably the pivotal SELECT trial, has confirmed their suitability for non-diabetic subjects with obesity and established CVD. New drug delivery methods and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonists demonstrate potent efficacy, with tirzepatide showing significant MACE reduction in its own CVOT. However, significant challenges related to high cost, long-term safety uncertainties, and implementation barriers remain, requiring a balanced perspective. The review presents both mechanistic data and clinical evidence to demonstrate how GLP-1 agonists function as vital cardiovascular medications and outlines future research directions to address critical evidence gaps and maximize their therapeutic effectiveness. Full article