The new guidelines update is a joint effort of the American College of Cardiology (ACC), the American Heart Association (AHA), and the Society for Cardiovascular Angiography and Interventions (SCAI). It simultaneously brings focused updates to two separate clinical guidelines, one on the management of patients with ST-elevation myocardial infarction (STEMI) — a major heart attack — and the other on percutaneous coronary intervention (PCI)—a set of procedures in which a tiny balloon is inflated in a narrowed coronary artery to widen the blockage (it often includes inserting a small metal tube, or stent, into the artery to better maintain blood flow).

This prospective study—the first to evaluate factors affecting left atrial remodeling during aging over 10 years—found obesity and hypertension to be independent predictors of LAE, both resulting in a variety of structural and functional changes in the heart. The highest measures of left atrial volume (iLA) were seen in obese patients with high blood pressure; this group also had the greatest increase in iLA (+6ml/m) and the highest incidence of LAE upon follow-up (31.6 percent compared to baseline prevalence of 10 percent among all participants). In linear regression models, the effect of obesity was almost twice that of hypertension.