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Articles by Peter Libby
Machine learning–driven spleen imaging and genomics uncover a splenic connection to coronary artery disease
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Abstract Supplementary Materials REFERENCES AND NOTES Information & Authors Metrics & Citations Check Access References Figures Tables Media Share This article has 0 eLetter . Abstract Despite advances in managing traditional risk factors, coronary artery disease (CAD) remains the leading cause of mortality. Circulating hematopoietic cells influence risk for CAD separately from traditional risk factors, but the role of a key regulating organ, the spleen, is unknown.
By Ki Baek Lee, Anne Maguire, Joshua Levitt, Meghana Kamineni, Vineet K Raghu, Haodong Tian, Buu Truong, Ahmed Alaa, Art Schuermans, Sam Friedman, Christopher Reeder, Romit Bhattacharya, Peter Libby, Patrick T. Ellinor, Mahnaz Maddah, Anthony Philippakis, Whitney E. Hornsby, Zhi Yu, Pradeep Natarajan, Zhanqing Hua
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Science Magazine
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Eugene Braunwald (1929–2026) - Nature Reviews Cardiology
Eugene Braunwald leaves an indelible imprint on our entire biomedical enterprise. He pioneered numerous areas of cardiology that have evolved into their own subspecialties, such that no individual will ever again be able to make ground-breaking contributions of such breadth1. Dr Braunwald led three departments of medicine: at the University of California San Diego, Brigham and Women’s Hospital and Beth Israel Hospital.
Author Correction: The AIM2 inflammasome exacerbates atherosclerosis in clonal haematopoiesis
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Correction to: Nature https://doi.org/10.1038/s41586-021-03341-5 Published online 17 March 2021 In the version of this article initially published, due to mistakes during file revision and figure assembly, there was a duplication error in Extended Data Fig. 10l, where the top-right 20% Control IL-1β image was a repeat of the lower-left 20% Jak2VF IgG image. In the initial submission, where current Extended Data Fig. 10l was originally presented as Fig.
By Trevor P. Fidler, Chenyi Xue, Mustafa Yalcinkaya, Brian D. Hardaway, Tong Xiao, Wenli Liu, David Thomas, Joachim Pircher, Carlos Silvestre-Roig, Andriana G. Kotini, Larry L. Luchsinger, Ying Wei, Marit Westerterp, Hans-Willem Snoeck, Eirini P. Papapetrou, Christian Schulz, Steffen Massberg, Oliver Soehnlein, Benjamin Ebert, Ross Levine, Muredach P. Reilly, Peter Libby, Nan Wang, Alan R. Tall, Sandra Abramowicz, Mohammad Ali Hajebrahimi
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Nature
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Preemptive cardioprotection with a small molecule in rodents that suppresses genes predictive of heart failure
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Abstract INTRODUCTION RESULTS DISCUSSION MATERIALS AND METHODS Acknowledgments Supplementary Materials REFERENCES Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Ischemic heart disease is a leading cause of death worldwide. While percutaneous coronary intervention (PCI) restores blood flow in acute coronary syndrome (ACS), reperfusion injury exacerbates myocardial damage, contributing to heart failure (HF).
By Xuhong Yang, David Anthony Verified, Dazhi Wang, Yue Li, Matthew Andrews, David Humphreys Verified, Eric Lam Verified, Christopher J. O’Keeffe, Michaella N. Albao, Zuhayr Jafri, Mark J. Raftery, Ling Zhong, Connor H. O’Meara, Iveta Slapetova, Maria Kasherman, Vaibhao Janbandhu, Ravinay Bhindi, Peter Libby, Levon M. Khachigian
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Science Magazine
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Gamut of Patients Referred to Cardiology for Question of Clonal Hematopoiesis
Get full access to this article View all available purchase options and get full access to this article. References 1. Jaiswal S, Libby P. Clonal hematopoiesis: connecting ageing and inflammation in cardiovascular disease. Nat Rev Cardiol. 2020;17:137–144. doi: 10.1038/s41569-019-0247-5 2. DeZern AE, Malcovati L, Ebert BL. CHIP, CCUS, and other acronyms: definition, implications, and impact on practice. Am Soc Clin Oncol Educ Book. 2019;39:400–410. doi: 10.1200/EDBK_239083 3.
Secondary Prevention After Myocardial Infarction in the United States
JACC Journals › JACC › Archives › Just Accepted Share on : JACC Just Accepted Get full access to this article View all available purchase options and get full access to this article. References 1. Wang Y., Leifheit E.C., Krumholz H.M. Trends in 10-year outcomes among Medicare beneficiaries who survived an acute myocardial infarction. JAMA Cardiol. 2022;7:6: 613-622. https://doi.org/10.1001/jamacardio.2022.0662. 2. Wadhera R.K., Dhruva S.S., Bikdeli B., et al.
New Horizons in Dyslipidaemia 2026
Overview Watch the on-demand version of New Horizons in Dyslipidaemia (NHD) 2026, a virtual educational event designed for healthcare professionals involved in the management of cardiovascular risk and other lipid-related conditions. The programme is led by course directors Dr Peter Libby (Brigham and Women’s Hospital, Boston, US), Prof Kausik Ray (Imperial College London, London, UK) and Prof Erik Stroes (Academic Medical Centre, Amsterdam, NL).
Frailty Meets Cardio-oncology: A New Frontier in Personalised Cancer Care
Average (ratings) Abstract In recent years, novel cancer therapies have significantly improved patient survival, but they have also introduced clinical challenges, particularly regarding treatment-related cardiovascular toxicity. Frailty is a clinical syndrome characterised by reduced physiological reserve, and is associated with poorer clinical outcomes and an elevated risk of cardiovascular disease.
The Role of Glucagon-like Peptide-1 in the Pathophysiology of Heart Failure: A Special Focus
Average (ratings) Keywords Glucagon-like peptide-1 receptor agonists, heart failure with preserved ejection fraction, cardiometabolic syndrome, Received: 01 December 2025 Accepted: 13 December 2025 Published online: 06 February 2026 Disclosure: AR is on the Cardiac Failure Review editorial board; this did not influence acceptance. AZ has no conflicts of interest to declare. Correspondence: Anton Zatsarinnyy, City Cardiology Center, Tole Bi Street 93, Almaty 050000, Kazakhstan.
Non-invasive Coronary Functional Tests in Patients with Angina and Non-obstructive Coronary Artery Disease
Average (ratings) Abstract Background: Invasive coronary functional tests (I-CFTs) can identify the mechanism(s) of angina in patients with non-obstructed coronary arteries (ANOCA). In this study, we assessed whether non-invasive coronary functional tests (NI-CFTs) can also produce reliable results when assessing these mechanisms.
Revascularisation in Cancer Patients: A Comprehensive Review
Average (ratings) Abstract The emerging field of cardio-oncology has grown considerably over the past two decades. While the issue of myocardial cardiotoxicity has received the most attention, it is now recognised that cardio-oncology encompasses the full spectrum of cardiovascular disease, which includes invasive therapy as part of management. Historically, these were seldom considered in cancer patients, due to their perceived poor prognosis and high risk of complications.
Ethical and Regulatory Frameworks for Artificial Intelligence in Clinical Research: A European Perspective on the Artificial Intelligence Act for Ethics Committees and Researchers
Average (ratings) Abstract The rapid integration of artificial intelligence (AI) into clinical research is transforming the landscape of biomedical innovation, influencing numerous phases of research, with critical ethical and legal implications.
The Art and Science of Congestion Diagnosis and Management in Heart Failure
Average (ratings) Keywords Congestion, heart failure, intravascular, extravascular, biomarkers, pathophysiology, devices, Received: 19 November 2025 Accepted: 26 November 2025 Published online: 23 December 2025 Disclosure: JAB is on the Cardiac Failure Review editorial board; this did not influence acceptance. DM has no conflicts of interest to declare.
Targeting Obesity to Combat Heart Failure
Average (ratings) Abstract Obesity is a growing global health challenge and a significant contributor to the rising prevalence of heart failure (HF), affecting both HF with preserved and reduced ejection fraction. While obesity increases HF incidence through haemodynamic stress, neurohormonal activation, metabolic dysfunction and systemic inflammation, the so-called ‘obesity paradox’ complicates our understanding of prognosis in established HF.
Phrenic Nerve Stimulation for Central Sleep Apnoea: When and Why?
Average (ratings) Abstract Central sleep apnoea (CSA) is a sleep-disordered breathing condition characterised by diminished or absent respiratory effort during sleep due to instability in the respiratory control system. While various treatments exist, ranging from positive airway pressure therapy to pharmacological interventions, many patients’ symptoms remain refractory to standard therapies.
Reverse Remodelling, Myocardial Recovery and Remission in Heart Failure with Reduced Ejection Fraction: Clinical Implications and Management Strategies
Average (ratings) Abstract Cardiac reverse remodelling (RR) is a complex process involving structural and functional recovery of the myocardium, with significant implications for the prognosis of patients with heart failure (HF). This review summarises current concepts, underlying mechanisms, therapeutic strategies, and clinical implications of RR, while distinguishing it from myocardial recovery and remission.
Expert Opinion on Targeted Lipid Control for Very-high-risk Indian Patients: Bridging the Gap in Real-world Practice
Average (ratings) Abstract Despite robust clinical guidelines and the availability of potent lipid-lowering therapies (LLTs), many very-high-risk dyslipidaemia patients fail to achieve target LDL cholesterol (LDL-C) levels, primarily due to poor adherence and delayed treatment intensification. Two virtual meetings were convened involving a panel of senior cardiologists. Insights were synthesised into an expert framework, developed through polling and collective inputs from expert.
Ventricular–Arterial Coupling in Heart Failure with Preserved Ejection Fraction: A Bibliometric Review and Clinical Implications
Heart failure (HF) affects approximately 55 million people worldwide by 2021 – more than doubling since 1990.1 Its rising prevalence, high mortality, and frequent hospitalisations demand better prevention and therapy.
Impact of Hypopnoea Classifications on the Assessment of Sleep Disordered Breathing in Heart Failure
Average (ratings) Abstract Sleep-related breathing disorders (SRBD), particularly central sleep apnoea and obstructive sleep apnoea, are highly prevalent among individuals with heart failure (HF). Accurate classification of SRBD is critical for accurate diagnosis and to improve management by limiting treatment failures.
Positive Airway Pressure Therapies for Heart Failure: What Do the Trials Tell Us?
Average (ratings) Abstract Sleep-disordered breathing (SDB) represents a modifiable treatment target in patients with heart failure (HF). Despite the evolution of positive airway pressure (PAP) therapy over the past several decades, randomised controlled trials have not demonstrated a consistent benefit in reducing mortality or hospital admissions related to HF. As a result, the use of PAP therapy has been primarily limited to symptom control of SDB.
Human plasma proteomic profile of clonal hematopoiesis - Nature Communications
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Abstract Plasma proteomic profiles associated with subclinical somatic mutations in blood cells may offer insights into downstream clinical consequences. Here we explore these patterns in clonal hematopoiesis of indeterminate potential (CHIP), which is linked to several cancer and non-cancer outcomes, including coronary artery disease (CAD).
By Zhi Yu, Amélie Vromman, Art Schuermans, Tetsushi Nakao, Mesbah Uddin, Abhishek Niroula, Gabriel K. Griffin, Michael C. Honigberg, Christopher Gibson, Daniel Katz, Usman Tahir, Jacqueline S. Dron, Michael Pan, Shriienidhie Ganesh, Joshua Weinstock, Ramachandran S. Vasan, Gina M. Peloso, Peter Ganz, JoAnn E. Manson, Joann Manson, Bernhard Haring, Charles Kooperberg, Joshua C. Bis, Bruce M. Psaty, Yuan-I Min, Adolfo Correa, Jerome I. Rotter, Stephen S. Rich, Benjamin Ebert, Bing Yu, Christie M. Ballantyne, Josef Coresh, Vijay Sankaran, Alexander Bick, Siddhartha Jaiswal, Robert Gerszten, NHLBI Trans-Omics, Peter Libby, Rajat Gupta
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Nature
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Refine Your Ideas for Better Outcomes
Average (ratings) Keywords ICD, heart failure, guidelines, Received: 17 October 2025 Accepted: 20 November 2025 Published online: 26 November 2025 Disclosure: GD is on the European Cardiology Review editorial board; this did not influence acceptance. Correspondence: Gheorghe-Andrei Dan, Carol Davila University, Academy of Romanian Scientists, Dionisie Lupu St, No. 37, Sector 2, Bucharest, Romania.
The Role of Frailty in Cardio-oncology and its Challenges
Cardiovascular disease (CVD) and cancer are among the leading causes of mortality, particularly in older populations.1 Cardio-oncology is a dynamic and interdisciplinary field that brings together a diverse team of specialists, including oncologists, cardiologists, and other dedicated healthcare providers, to identify and address cardiovascular complications that can arise as a result of cancer and its treatments, particularly for patients exposed to potentially cardiotoxic therapies.2–4...
Home Sleep Apnoea Testing: Advances, Challenges and Considerations in Heart Failure
Average (ratings) Abstract Sleep-disordered breathing (SDB), including obstructive and central sleep apnoea, is highly prevalent in heart failure (HF) and contributes to adverse outcomes. In-lab polysomnography is the diagnostic gold standard, but is limited by cost and accessibility. Home sleep apnoea testing (HSAT) offers an accessible alternative, but its accuracy in HF populations remains under evaluation.
The Coronary Microcirculation Re-explored: Pathophysiological Insights and Clinical Implications
The human heart is a highly demanding organ because of its substantial need for oxygen and nutrients. It relies on a specialised and intricate network of blood vessels known as the coronary circulation to meet these demands. The coronary microvessels are those elements of this circulation that are less than 500 µm in diameter and are critical in transporting vital elements necessary for myocardial metabolism.
AHA 25: CRISPR-Cas9 Gene Editing Therapy Targeting ANGPTL3
Video Published: Likes: 0 Average (ratings) AHA 2025 - Phase 1 results show the CRISPR-Cas9 gene editing therapy is a safe treatment option targeting ANGPTL3 in patients with lipid disorders. Prof Stephen Nicholls (Monash Victorian Heart Institute, Clayton, AU) joins us to share results from a first-in-human phase 1 trial investigating a one-time infusion of CTX310, a CRISPR-Cas9 gene editing therapy, at different doses targeting angiopoietin-like protein 3 (ANGPTL3).
Decoding Immune Influence: A Mendelian Randomisation Study on Dilated Cardiomyopathy
Average (ratings) Abstract Background: Dilated cardiomyopathy (DCM) is a significant contributor to heart failure, originating from complex interactions between genetic and environmental factors. Although the immune system has been implicated in various cardiovascular diseases, its precise role in DCM pathogenesis remains ambiguous. This study uses Mendelian randomisation (MR) to explore the causal relationship between diverse immune cell traits and DCM risk.
Patient Perspective: How Patient Values Set a Historic Benchmark for the ESC/EACTS Guidelines 2025 for the Management of Valvular Heart Disease
Approximately 60 years ago, Dr David Sackett started the movement for evidence-based medicine (EBM). EBM uses all the available scientific proof to come to a decision on the best possible treatment for patients.1 Guidelines improve economic efficiency in healthcare, quality of care and patient outcomes. Their importance cannot be underrated.
Inflammation in atherosclerosis: Lessons and therapeutic implications
Keywords inflammation atherosclerosis cardiovascular disease macrophages hematopoiesis neutrophils Introduction The human heart daily pumps 8,000 L of blood through the arterial tree to carry nutrients, oxygen, and immune cells to tissues and organs. Yet, arteries are not mere tubes. Indeed, their mutable functions constantly adapt to maintain homeostasis, fight invaders, and respond to injury, and when misdirected, contribute to many diseases.
Myocardial infarction, stroke and arterial stenosis: time to reassess a major misunderstanding - Nature Reviews Cardiology
Abstract A misconception persisting among the scientific and clinical communities relates to the correlation between arterial stenosis and acute ischaemic events, including myocardial infarction and cerebral stroke. This Perspective article challenges the approach that most of the current guidelines codify, which is based on the concept that occlusive arterial stenosis generally provokes ischaemic events.
Sex and the Garden of Eden - Nature Cardiovascular Research
Despite only one chromosome differing between men and women, sex makes an enormous difference in clinical cardiovascular diseases. Recent multi-omic data expand our understanding of the underlying mechanisms that may contribute to this disparity in humans.
Circulating neutrophil-related proteins associate with incident heart failure and cardiac dysfunction: The ARIC study.
AIMS: Neutrophil activity contributes to adverse cardiac remodelling in experimental acute cardiac injury and is modifiable with pharmacologic agents like colchicine. METHODS AND RESULTS: Neutrophil activity-related plasma proteins known to be affected by colchicine treatment were measured at Visit 3 (1993-1995) and Visit 5 (2011-2013) of the ARIC cohort study. A protein-based neutrophil activity score was derived from 10 candidate proteins using LASSO Cox regression.
Volume 46 Issue 2
Skip to Main Content Browse issues Year Issue Volume 46, Issue 2 ISSN 0195-668X EISSN 1522-9645 Issue @ A Glance CardioPulse Happy birthday, Dr Braunwald! Peter Libby Marc A Pfeffer View article Focus Issue on Trials, Epidemiology, Prevention, and Health Care Policies Fast Track – Clinical Research Editorial Fast Track – Clinical Research Editorial Clinical Research Editorial Clinical Research Editorial Clinical Research Editorial Clinical Research Editorial Cardiovascular Flashlights...
Endothelial inflammation in COVID-19
The vascular endothelium forms a crucial interface between tissues and the blood stream and maintains normal blood flow (1). In its homeostatic state, the endothelium resists blood clotting, vasoconstriction, and inflammation and maintains selective barrier functions.
Clonal Hematopoiesis of Indeterminate Potential
Throughout life, stem cells in our bone marrow replenish white and red blood cells that circulate throughout the body, and certain mutations in stem cells can promote cardiovascular disease. With age, these stem cells can undergo genetic mutations. Most of these acquired mutations will never provoke a disease. It takes multiple mutations in certain specific genes to cause a blood cancer, such as leukemia.
Clonal hematopoiesis and atherosclerosis
Abstract Clonal hematopoiesis of indeterminate potential (CHIP) has emerged as a previously unrecognized, potent, age-related, and common risk factor for atherosclerosis. Somatic mutations in certain known leukemia driver genes give rise to clones of mutant cells in peripheral blood. The increased risk of developing hematologic malignancy does not, on its own, explain excess mortality in individuals with CHIP. Cardiovascular disease accounts for much of this gap.
Differential roles of eosinophils in cardiovascular disease - Nature Reviews Cardiology
Abstract Eosinophils are essential innate immune cells in allergic responses. Accumulating evidence indicates that eosinophils also participate in the pathogenesis of cardiovascular diseases (CVDs). In clinical studies, high blood eosinophil counts and eosinophil cationic protein levels have been associated with an increased risk of CVD, including myocardial infarction (MI), cardiac hypertrophy, atrial fibrillation, abdominal aortic aneurysm (AAA) and atherosclerosis.
Long-term longitudinal analysis of 4,187 participants reveals insights into determinants of clonal hematopoiesis - Nature Communications
Abstract Clonal hematopoiesis of indeterminate potential (CHIP) is linked to diverse aging-related diseases, including hematologic malignancy and atherosclerotic cardiovascular disease (ASCVD). While CHIP is common among older adults, the underlying factors driving its development are largely unknown. To address this, we performed whole-exome sequencing on 8,374 blood DNA samples collected from 4,187 Atherosclerosis Risk in Communities Study (ARIC) participants over a median follow-up of 21 years.
Fundamental Pathobiology of Coronary Atherosclerosis and Clinical Implications for Chronic Ischemic Heart Disease Management-The Plaque Hypothesis: A Narrative Review | Cardiology | JAMA Cardiology | JAMA Network
Fundamental Pathobiology of Coronary Atherosclerosis and Clinical Implications for Chronic Ischemic Heart Disease Management—The Plaque Hypothesis: A Narrative Review Abstract Importance Recent clinical and imaging studies underscore that major adverse cardiac events (MACE) outcomes are associated not solely with severe coronary obstructions (ischemia hypothesis or stenosis hypothesis), but with the plaque burden along the entire coronary tree.
Clonal hematopoiesis, cardiovascular events and treatment benefit in 63,700 individuals from five TIMI randomized trials - Nature Medicine
Abstract Clonal hematopoiesis of indeterminate potential (CHIP) has been associated with an increased risk of cardiovascular (CV) disease in the general population. Currently, it is unclear whether this association is observed in large clinical trial cohorts with a high burden of existing CV disease or whether CV therapies can mitigate CHIP-associated CV risk.
Inflammation unites diverse acute and chronic diseases
CONFLICT OF INTEREST STATEMENT RS and EJR report no conflicts. MKG serves on advisory boards for Bellerophon Therapeutics, Inc., Boehringer-Ingelheim, Bristol Myers Squibb, Esperion, Genentech/Roche and Surrozen; MKG is the Co-Chair for DSMB Red-X. MKG has received research support from Genentech/Roche. MEF reports research grant support from Amgen, Astra Zeneca, Novartis and Novo Nordisk; MEF serves as a consultant to Otitopic. RSR reports the following patents: 1.
USPSTF Recommendation on Screening for Lipid Disorders in Children and Adolescents
USPSTF Recommendation on Screening for Lipid Disorders in Children and Adolescents US Preventive Services Task Force USPSTF Recommendation: Screening for Lipid Disorders in Children and Adolescents US Preventive Services Task Force; Michael J. Barry, MD; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MD, MPH; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E.
Loss-of-function mutations in Dnmt3a and Tet2 lead to accelerated atherosclerosis and concordant macrophage phenotypes - Nature Cardiovascular Research
Abstract Clonal hematopoiesis of indeterminate potential (CHIP) is defined by the presence of a cancer-associated somatic mutation in white blood cells in the absence of overt hematological malignancy. It arises most commonly from loss-of-function mutations in the epigenetic regulators DNMT3A and TET2. CHIP predisposes to both hematological malignancies and atherosclerotic cardiovascular disease in humans.
Circulating Neutrophil‐Related Proteins Associate with Incident Heart Failure and Cardiac Dysfunction: The ARIC Study
Supporting Information Filename Description ejhf3008-sup-0001-Supinfo.docxWord 2007 document , 18.3 MB Data S1 Supporting information
Vitamin D in Atherosclerosis and Cardiovascular Events
Abstract and Introduction Abstract Graphical Abstract Pleiotropic effects of vitamin D on the cardiovascular system. Sunlight exposure, exogenous dietary, and pharmacological supply primarily determine vitamin D levels. Vitamin D is then stored within the adipose tissue which influences its systemic availability.
Low-Density Lipoprotein Cholesterol Levels in Adults With Coronary Artery Disease in the US
Low-Density Lipoprotein Cholesterol Levels in Adults With Coronary Artery Disease in the US, January 2015 to March 2020 Adults with coronary artery disease (CAD), a leading cause of death in the US, have especially high risk for secondary cardiovascular events. Lipid control is a proven strategy to decrease risk.1 This study estimated lipid control among US adults with reported CAD.
International Atherosclerosis Society guidance for implementing best practice in the care of familial hypercholesterolaemia - Nature Reviews Cardiology
Screening FH meets all the criteria for screening for a health-related condition38,39. The value of early detection derives from the premise that the burden of ASCVD owing to genetically elevated plasma LDL-cholesterol concentrations in FH begins at birth and accumulates over time13,40 and that initiation of treatment in childhood can cost-effectively prevent coronary events, improve quality of life and reduce mortality2,13,40,41.
Blockade of IL-6 signaling alleviates atherosclerosis in Tet2-deficient clonal hematopoiesis - Nature Cardiovascular Research
Abstract Clonal hematopoiesis (CH) increases the risk of atherosclerotic cardiovascular disease possibly due to increased plaque inflammation. Human studies suggest that limitation of interleukin-6 (IL-6) signaling could be beneficial in people with large CH clones, particularly in TET2 CH.
IL-6 helps weave the inflammatory web during acute coronary syndromes
Commentary Open Access | 10.1172/JCI167670 Published in Volume 133, Issue 11 on June 1, 2023 J Clin Invest. 2023;133(11):e167670. https://doi.org/10.1172/JCI167670. © 2023 Nakao,,,, et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
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