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Introduction: Mixed hyperlipidemia represents a substantial public health issue and a considerable burden on healthcare systems. Although the introduction of statins and LDL-cholesterol lowering agents have significantly reduced the incidence of atherosclerotic cardiovascular diseases (ASCVD), a significant portion of the population continues to exhibit ASCVD progression due to elevated triglyceride-rich lipoprotein (TRL) levels. This persistent risk has catalyzed the development of novel pharmacological interventions targeting these lipoproteins. Areas covered: Our special report commenced with a targeted PubMed search using keywords such as 'plozasiran,' 'zodasiran,' and terms related to APOC3 and ANGPTL3. As the review progressed, emergent research questions guided further searches, allowing for the inclusion of additional relevant articles to comprehensively illustrate the linkage between TRLs and cardiovascular disease, discuss the roles of APOC3, ANGPTL3, and the pharmaceutical agents that target these proteins, and provide a comparison on the ARCHES-2 and MUIR trials. Expert opinion: The ARCHES-2 and MUIR trials demonstrated effective triglyceride reduction by these therapies, yet it is uncertain if this correlates with significant clinical benefits. Advances in antisense oligonucleotide technology, especially the GalNAc delivery platform, show promise for personalized lipid management, though challenges such as cost and safety concerns remain. [ABSTRACT FROM AUTHOR]

Tenecteplase (TNK), as a thrombolytic treatment for acute ischemic stroke (AIS), has been found to be effective when used within 4.5 hours of symptom onset. However, the efficacy of TNK after 4.5 hours is not well established, especially in patients with large vessel occlusion and with no access to thrombectomy. In this article, we will discuss the results of the recently published TRACE-III trial. The study involved 516 patients with large vessel occlusion, either proximal middle cerebral artery or internal carotid artery, with salvageable brain tissue and no endovascular thrombectomy access. Key safety outcomes included symptomatic intracranial hemorrhage and death. TNK treatment resulted in a higher percentage of patients with a modified Rankin scale score of 0 or 1 at 90 days than standard medical treatment. Mortality at 90 days was 13.3% with TNK and 13.1% with standard medical treatment. The trial found that TNK treatment for Chinese patients with ischemic stroke resulted in less disability and similar survival compared to standard medical treatment. However, there was a higher incidence of symptomatic intracranial hemorrhage within 36 hours. [ABSTRACT FROM AUTHOR]

The article explores the potential benefits of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in the management of acute myocardial infarction (AMI). SGLT2i medications have shown promise in reducing cardiovascular events in patients with diabetes. Observational studies and recent trials have shed light on the role of SGLT2i in this critical setting. While SGLT2i have positive effects on various organs, potential side effects should be acknowledged and patients should be monitored carefully. The trials evaluated the efficacy of dapagliflozin and empagliflozin in AMI patients, with dapagliflozin showing statistically superior outcomes in cardio-metabolic factors and empagliflozin showing a significant reduction in heart failure hospitalization rates. Further research is needed to fully understand the potential benefits of SGLT2 inhibitors in AMI patients. [Extracted from the article]

The article discusses the importance of cholesterol in cardiovascular diseases (CVDs) and the role of high-density lipoprotein (HDL) in protecting against CVDs. It highlights the challenges in measuring cholesterol efflux capacity (CEC) and the limitations of focusing solely on HDL cholesterol (HDL-C) levels. The article also presents the results of the AEGIS-II trial, which tested the efficacy of CSL112, a form of Apolipoprotein A-I (ApoA-I), in reducing cardiovascular events after acute myocardial infarction (AMI). The trial found no significant difference in the primary endpoint between the CSL112 and placebo groups, suggesting the need for further research and a reevaluation of the HDL hypothesis. [Extracted from the article]

Actinomyces neuii (also known as Winkia neuii nowadays), quite different from its genus,is a facultatively anaerobic organism that rarely causes human infections.Like the rest of its genus, it usually has a good prognosis. In this case report, we present an interesting case of a middle-aged female who presented to the emergency department (ED) with fever and dyspnea, eventually diagnosed with infective endocarditis (IE) caused by A. neuii. To the best of our knowledge, it is the first reported case of  A. neuii  causing right-sided infective endocarditis in a middle-aged female with no residual or prosthetic valvular disease., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Zaman et al.)