Objective Whether clinical application of anthracyclines is associated with increasing arrhythmic risk remains controversial. In order to evaluate the arrhythmic risk of anthracyclines as a class, and the comparative risk for each individual drug, we conducted a systematic review, meta-analysis, and network meta-analysis. Methods Pubmed, Web of Science, EMBASE and the Cochrane Library were searched, up to March 2022, for randomized controlled trials, cohort studies, and case control studies that investigated the association between anthracyclines treatment and the risk of arrhythmia. We followed the PRISMA 2020 guidelines for data selection and extraction. Outcomes were pooled using fixed effects models in cohort studies and randomized controlled studies, and random models in single-arm studies. Direct and indirect comparisons in network meta-analysis were performed using frequentist methods. Results 4 cohort studies, 8 RCTs, and 18 single-arm studies were included in our analysis. Anthracyclines use was associated with a statistically significant 90% increase in the risk for arrhythmia (odds ratio [OR] 1.90; 95% confidence interval [CI] 1.62–2.24) and 114% increase in the risk for supraventricular arrhythmia (OR 2.14; 95% CI 1.18–3.89). And the single-arm studies also indicated that incidence of arrhythmia rate is 20%, 95%CI is 15/100 − 25/100. Epirubicin ranked most likely to have the highest risk for arrhythmia compared with non-anthracycline antineoplastic drugs in the analysis (OR 43.07 [95% CI 2.80-2105.83]) by network meta-analysis. Conclusions Our findings show a significant association between anthracyclines use and an increased risk for arrhythmia, especially supraventricular arrhythmia. Epirubicin ranked with the highest probability for arrhythmia. These results indicated cardiac rhythm should be strictly monitored during the application of anthracyclines in clinical practice, and possible therapy for anthracyclines associated arrhythmia should be explored.

Background It remains controversial regarding the association between weight change and cardiovascular disease risk in older adults (aged ≥60 years). This study aimed to evaluate the association between weight change and 10-year atherosclerotic cardiovascular disease (ASCVD) risk events in older adults. Methods This cohort study used data from the National Health and Nutrition Examination Survey (NHANES). Older adults aged 60-79 years who were free of self-reported ASCVD at the time of the NHANES interview were included. Data were collected from January 1999 to December 2018 and analyzed in March 2022. We focused on the associations between weight change and 10-year risk of ASCVD events with the percentage change in weight during short-term(1 year) and long-term (10 years), which categorized as moderate to high weight loss (≥10%), small weight loss (5.1-9.9%), stable weight (±5%), small weight gain (5.1-9.9%) and moderate to high weight gain (≥10%). Results The number of participants was 2,322 (mean age 67.90 years; 41.65% female) for the long-term interval (10 years) in our analysis, and 2543 for the short-term interval (1 years). We only observed an inverse association between long-term weight loss and predicted 10-year ASCVD risk (loss≥10%: β=2.81, 95%CI=1.46, 4.16; loss 5.1%~9.9%: β=2.75, 95% CI=1.24, 4.26), but all intervals of weight gain ≥5% were not significant associated with higher risk than stable weight. However, in the subgroup analyses, the association between long-term weight loss and 10-year ASCVD risk was not significant in old-old (aged 75-79), obesity (BMI≥30 kg/m2), intentional weight loss, moderate physical activity, smokers, and diabetics. Conclusions Older adults (aged 60-79 years) with weight loss >5% over the past 10 years have excess predicted 10-year ASCVD risk. Our study supports the benefits of stable weight in promoting cardiovascular health in the elderly.

In clinical practice, myocardial ischemia-reperfusion (MI/R) is widely used for the treatment of myocardial infarction, but reperfusion may cause secondary damage to the myocardium. The early stages of MI/R lesions are associated with ferroptosis, however, in vivo, noninvasive visualization of ferroptosis in MI/R using molecular imaging methods remains difficult. We report an Fe3O4-based probe for magnetic nanoparticle imaging of ferroptosis (feMPI) by exploiting transferrin receptor 1 (TfR1) as a typical biomarker. The feMPI, based on the TfR1-targeting and cell-penetrating peptides (CPPs) dual-targeted probe, detects cardiac injury ~48 h in advance and quantitatively determines damage degree during post-MI/R ventricular remodeling, as compared to existing clinical imaging detection methods. This new imaging strategy compensated for the difficulty in detecting I/R damage during cardiac remodeling. These findings are notably consistent with the commonly used clinical biochemical indicators in the early stage of MI/R. In addition, optical and MI/R imaging was integrated as a multimodal to precisely monitor the occurrence and development of MI/R-induced cardiac injury. This study proposes a powerful imaging-effect-based feMPI strategy for the precise assessment of MI/R-induced cardiac injury, which may help elucidate diagnostic methods for ferroptosis-related heart diseases.