Cardiovascular diseases are common for women and men but there are differences between the sexes in terms of clinical symptoms, pathophysiology and response to the treatment. CVD in women is commonly underdiagnosed and often women tend to have a lower perception of the risk. That can lead to delayed diagnosis and failed recognition of symptoms. Women develop heart disease later than men because of the protection that exists in the reproductive phase of their life. Once they enter menopause the risk increases. Estrogen provides a protective effect against heart disease in women. Therefore, the risk of CVD increases after menopause in most cases. Presented work emphasizes the importance of the menopausal period as the time of increasing CVD risk. Emphasize the importance of monitoring the health of women in their middle age, a critical time in which early intervention strategies should be implemented to reduce the risk of CVD.

Familial hypercholesterolemia (FH) is an inherited disorder. The level of low-density lipoprotein cholesterol (LDL-C) in patients with homozygous FH can be twice as high as that in patients with heterozygous FH. The inhibition of ANGPTL3 shows an important therapeutic approach in reducing LDL-C and triglycerides (TG) levels and, thus, is a potentially effective strategy in the treatment of FH. Evinacumab is a monoclonal antibody inhibiting circulating ANGPTL3, available under the trade name Evkeeza® for the treatment of homozygous FH. It was reported that evinacumab is effective and safe in patients with homozygous and heterozygous FH, as well as resistant hypercholesterolemia and hypertriglyceridemia. This paper summarizes existing knowledge on the role of ANGPTL3, 4, and 8 proteins in lipoprotein metabolism, the findings from clinical trials with evinacumab, a fully human ANGPTL3 mAb, and the place for this new agent in lipid-lowering therapy.

Background Among many complications of coronavirus disease 2019 (COVID-19) there is a wide range of cardiovascular (CV) problems ranging from mild to severe ones. Even asymptomatic patients and those with mild course of COVID-19 may develop severe CV complications. Factors leading to such state have not been extensively studied so far. Purpose We aimed to assess which factors were linked to the severe complications of COVID-19. Methods We included 200 consecutive patients admitted to the Department of Cardiology and Adult Congenital Heart Diseases of the Polish Mother's Memorial Research Institute (PMMHRI) due to post-Covid cardiovascular complications. SARS-CoV2 infection was confirmed with real-life PCR testing. Laboratory tests, 24-hour ECG monitoring and echocardiography were performed in all patients from the investigated group. For the purposes of our study severe complications were defined as: myocarditis, a decrease of ejection fraction >10% from the pre-disease value, thromboembolic complications, angina pectoris requiring myocardial revascularization and the new onset of atrial fibrillation of supraventricular tachycardia. Some patients presented more than one of the above. Statistical analysis was performed using the software Statistica v.13 (TIBCO Software Inc., Palo Alto, CA, USA). Data were presented as mean ±SD or median (25th-75th percentile) for continuous variables and as proportions for categorical variables. Comparisons between groups were performed using Student's t-test for independent variables and the Mann-Whitney U test or χ2 test with Yates's correction, as appropriate. For all calculations p-values <0.05 were considered statistically significant. Results Finally, we included 200 consecutive patients (aged 54±16 years, 76 males – 38%), hospitalized for COVID-19 complications after a median 3 (2–6) months following the acute phase of infection. On admission patients presented with dyspnea (23%), impairment of exercise tolerance (47%), chest pain (32%), increase in blood pressure (29%), palpitations (25%), weight loss (13%), brain fog (6%), general malaise (11%), headache (5%), limb pain (13%), swelling (14%). Severe complications of COVID-19 were diagnosed in 31 patients (16%).Taking into consideration symptoms, the presence of severe COVID-19 complications was significantly associated with dyspnoea and deterioration of exercise tolerance. In comparison to patients with mild complications, severe ones were linked to age (the older patients, the higher risk), previous history of heart failure and diabetes mellitus. We did not observe statistically significant differences in severity of complications depending on smoking status (Tables 1 and 2). Conclusions Previous history of heart failure and diabetes mellitus as well as symptoms (dyspnoea and deterioration of exercise tolerance) along with older age are related to more severe complications following COVID-19. Funding Acknowledgement Type of funding sources: None.

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): statutory measures. Purpose The aim of the study was to identify factors correlating with estimated an individual’s 10-year risk of fatal and non-fatal CVD events (myocardial infarction, stroke) in apparently healthy people aged 40-69 years with risk factors that are untreated or have been stable for several years and independent predictors of high and very high CVD risk. Methods 148 patients from high-risk country without established ASCVD, diabetes mellitus, CKD, Familial Hypercholesterolemia were included in the study. The clinical examination, laboratory results, chest x-ray, echocardiography using Vivid E95 - GE Healthcare, non-invasive body mass analysis using Body Composition Analyzer (Tanita Pro), spiroergometry using The MetaSoft® Studio application were performed. The subjects were divided into a low-risk group with low-to-moderate CVD risk in SCORE2 (70 pts) and a high risk group with high and very high CVD risk (78pts). Results Pts from high risk group had significantly more frequently s arrythmia (23 vs 2%; p<0,001) and obesity (45 vs 10%; p<0.001), they more often use too much amounts of alcohol (8 versus 0%; p=0.02) compared to low risk group. High risk pts had also significantly higher BMI (29 vs 24 kg; p<o.001), fat (27 vs 19 kg; p<0,001) and TBW (41 vs 38kg; p=0.03); higher LAVI (35 vs 27 ml/m2; p<0.001), left ventricular mass index (86 vs 73 g/m2; p<0,001); E/E’ (7,5 vs 6 cm/s; p=0,0002) but lower V02AT (13 vs 15 ml/min/kg; p=0,01), V02/kg (20 vs 22 ml/min/kg; p=0.008) compared to counterparts. High risk pts presented also higher values of hs of TnT (6,8 vs 3,2 pg/ml; p<0,001 ) and NTproBNP (100 vs 5 pg/ml; p<0,001) and lower level of eGFR (82 vs 98 ml/min/1,73m2). In a multiple logistic regression model the following variables were independently associated with high and very high CVD risk: : E/E’>6,75 cm/s (OR 3.9 95% CI: 1.5-10.3; p=0.004) and hs TnT >4.8 pg/ml (OR6.02, 95% CI: 2.3-15.8; p=0.0002) SCORE 2 (%) correlated positively with metabolic age (R Spearman= 0,79; p<0.0001), hs TnT (R=0.6;p<0.001), NT-proBNP (R=0,5;p<0.001) and negatively with eGFR (R=-0,5; p<0/001), VO2max (ml/min/kg) (R=-0,3; p=0.0008) -Figure 1. Conclusions Higher left ventricular filling pressure assessed by E/E’ and higher hsTnT level are independent predictors of high and very high risk in SCORE 2. The increasing 10-year cardiovascular disease risk correlates with higher metabolic age, higher level of NT-proBNP and hsTnT and lower level of eGFR.