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ABSTRACT Background Almost half of the US adult population has obesity, which predisposes to atherosclerosis and can lead to poor prognosis in coronary artery disease (CAD). We aim to identify CAD and obesity‐related mortality trends among adults in the United States stratified by age, sex, race and geographical location. Methods The CDC‐WONDER database was used to extract death certificate data for adults aged ≥ 25 years. Crude mortality rates (CMR) and age‐adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and temporal trends were described by calculating annual percent change (APC) and the average APC (AAPC) in the rates using Joinpoint regression analysis. Results From 1999 to 2022, a total of 273,761 CAD and obesity‐related deaths were recorded in the United States. The AAMR increased consistently from 1999 to 2018 (APC: 4.3, 95% confidence interval (CI): 3.4–4.9) and surged thereafter till 2022 (APC: 11.4; 95% CI: 7.7–19.1). During the COVID‐19 pandemic (2020–2022), AAMR almost doubled that of the rest of the study period. Additionally, the AAMR for males was nearly twice that of females. Non‐Hispanic (NH) Blacks or African Americans displayed the highest AAMR, followed by NH Whites, Hispanic or Latino, and other NH populations. AAMRs showed minimal variation by census regions. Rural areas exhibited a higher AAMR (AAMR: 5.9, 95% CI: 5.8–5.9) than urban areas (AAMR: 4.4, 95% CI: 4.4–4.5). Conclusions We observed increasing trends in CAD and obesity‐related deaths throughout the study period reaching a peak during the COVID‐19 pandemic.

ABSTRACT Background Sodium‐glucose cotransporter 2 (SGLT2) inhibitors improve cardiovascular (CV) outcomes in patients with or without Type 2 diabetes and heart failure (HF). However, studies have shown conflicting evidence regarding their efficacy in patients following acute myocardial infarction (MI). We conducted a pilot systematic review and meta‐analysis to synthesise the available evidence regarding the effectiveness of SGLT2 inhibitors in MI. Methods A systematic literature search was conducted using PubMed/MEDLINE, the Cochrane Library and Embase databases to identify randomised controlled trials (RCTs) that compared clinical outcomes of SGLT2 inhibitors with placebo following MI. We conducted the statistical analysis using RevMan, version 5.4 and pooled risk ratios (RRs) along the corresponding 95% confidence interval (CI) for all outcomes. Results Five RCTs reporting data for 11,211 patients were included in our study. The mean follow‐up duration was 43.8 weeks. Our pooled analysis showed that SGLT2 inhibitors significantly reduced the risk of hospitalisations for heart failure (HHF) (RR = 0.76, 95% CI: 0.61–0.88, p = 0.001) in patients with MI. However, the risk of all‐cause mortality (RR = 1.05, 95% CI: 0.78–1.41, p = 0.76), CV mortality (RR = 1.04, 95% CI = 0.84–1.29, p = 0.73) and all‐cause hospitalisations (RR = 1.06, 95% CI: 0.96–1.17, p = 0.25) remained comparable across the two groups. Conclusion SGLT2 inhibitors reduce HHF without affecting all‐cause mortality, CV mortality and all‐cause hospitalisations. However, further evidence is required to reach a definitive conclusion.

ABSTRACT Aims The once‐weekly insulin icodec, a new basal insulin analog, may positively support a reduction in injection frequency and improve adherence to therapy in type 2 diabetes (T2D). This study aimed to evaluate the safety and efficacy of insulin icodec compared with those of once‐daily glargine U100. Methods A comprehensive literature search was conducted using PubMed/MEDLINE, Embase and the Cochrane Library from inception till September 2023. Data about clinical outcomes in both groups were extracted. Forest plots were generated using the random‐effects model by pooling odds ratios (ORs) and mean differences (MDs). Results Five randomised controlled trials and 2019 individuals with T2DM were included. In the pooled analysis, time in range was significantly higher (MD = 4.35; 95% CI: 1.65 to 7.05; p = 0.002) in the icodec group than in the once‐daily glargine group. The HbA1c levels were significantly reduced (MD = −0.13; 95% CI: −0.24 to −0.03; p = 0.02) in the weekly icodec group compared with those in the once‐daily glargine group. The weight gain was significantly less in the glargine group than in the weekly icodec group (MD = 0.41; 95% CI: 0.04 to 0.78; p = 0.03); however, in the subgroup analysis, this change became statistically insignificant in both insulin‐naïve and previously insulin‐treated individuals. The results were comparable across two groups for fasting plasma glucose levels, hypoglycaemia alert (Level 1), clinically significant (Level 2) or severe hypoglycaemia (Level 3), and adverse events. Conclusion Insulin icodec was associated with a reduction in glycated haemoglobin levels and higher time in range, with a similar safety profile as compared to insulin glargine U100. However, further evidence is still needed to reach a definitive conclusion.