Background and Objectives: Pericoronary adipose tissue (PCAT) is linked to coronary artery disease (CAD) progression through compositional changes that disrupt adipose homeostasis and affect vascular biology. This study explores how PCAT characteristics - volume and fat attenuation index (FAI)-relate to CAD severity and left ventricular (LV) function. Methods: This study included 100 patients with suspected CAD who underwent coronary computed tomography angiography (CCTA) and echocardiography between September 2023 and July 2024. PCAT volume, FAI and thickness were measured along coronary arteries (right coronary artery [RCA], left anterior descending [LAD], and left circumflex [LCX]). CAD severity was assessed using the Gensini score, while LV structural and functional metrics, including diastolic function, were obtained via echocardiography. Correlations between PCAT parameters, CAD burden, and LV function were analyzed using Spearman’s correlation and p value <0.05 was considered significant. Results: RCA FAI exhibited the strongest association with CAD severity (Gensini score: r=0.416, p=0.026) and diastolic dysfunction (r=0.536, p<0.001), with progressively less negative values from Grade 1 to Grade 3 dysfunction. LAD and LCX (r=0.278, p=0.03) FAI displayed moderate associations. RCA volume correlated with LV mass index, fractional shortening and diastolic parameters. Hypertension was associated with elevated RCA FAI and volume (p<0.05), while diabetes showed no significant impact on PCAT metrics. Conclusions PCAT FAI is a sensitive marker of CAD severity and diastolic dysfunction, especially in the RCA, highlighting its value for detection, risk stratification, and personalized CAD management. Integration of PCAT metrics into routine CCTA analysis could enhance cardiovascular risk assessment and treatment planning.

The final analysis of the phase 3 Targeted Investigational Treatment Analysis of Novel Anti-androgen (TITAN) trial showed improvement in overall survival (OS) and other efficacy endpoints with apalutamide plus androgen deprivation therapy (ADT) versus ADT alone in patients with metastatic castration-sensitive prostate cancer (mCSPC). As ethnicity and regional differences may affect treatment outcomes in advanced prostate cancer, a post hoc final analysis was conducted to assess the efficacy and safety of apalutamide in the Asian subpopulation. Event-driven endpoints were OS, and time from randomization to initiation of castration resistance, prostate-specific antigen (PSA) progression, and second progression-free survival (PFS2) on first subsequent therapy or death. Efficacy endpoints were assessed using the Kaplan-Meier method and Cox proportional-hazards models without formal statistical testing and adjustment for multiplicity. Participating Asian patients received once-daily apalutamide 240 mg ( n = 111) or placebo ( n = 110) plus ADT. After a median follow-up of 42.5 months and despite crossover of 47 placebo recipients to open-label apalutamide, apalutamide reduced the risk of death by 32% (hazard ratio [HR]: 0.68; 95% confidence interval [CI]: 0.42-1.13), risk of castration resistance by 69% (HR: 0.31; 95% CI: 0.21-0.46), PSA progression by 79% (HR: 0.21; 95% CI: 0.13-0.35) and PFS2 by 24% (HR: 0.76; 95% CI: 0.44-1.29) relative to placebo. The outcomes were comparable between subgroups with low- and high-volume disease at baseline. No new safety issues were identified. Apalutamide provides valuable clinical benefits to Asian patients with mCSPC, with an efficacy and safety profile consistent with that in the overall patient population.
Male ; Humans ; Prostatic Neoplasms/pathology* ; Androgen Antagonists/therapeutic use* ; Prostate-Specific Antigen ; Castration ; Prostatic Neoplasms, Castration-Resistant/drug therapy*

To layout mHealth (mobile health) applications operating in India with the facility of either online doctor consultation or offline doctor appointment booking.

Bone metastases are the main driver of morbidity and mortality in advanced prostate cancer. Targeting the bone microenvironment, a key player in the pathogenesis of bone metastasis, has become one of the mainstays of therapy in men with advanced prostate cancer. This review will evaluate the data supporting the use of bone-targeted therapy, including (1) bisphosphonates such as zoledronic acid, which directly target osteoclasts, (2) denosumab, a receptor activator of nuclear factor-kappa B (RANK) ligand inhibitor, which targets a key component of bone stromal interaction, and (3) radium-223, an alpha-emitting calcium mimetic, which hones to the metabolically active areas of osteoblastic metastasis and induces double-strand breaks in the DNA. Denosumab has shown enhanced delay in skeletal-related events compared to zoledronic acid in patients with metastatic castration-resistant prostate cancer (mCRPC). Data are mixed with regard to pain control as a primary measure of efficacy. New data call into question dosing frequency, with quarterly dosing strategy potentially achieving similar effect compared to monthly dosing for zoledronic acid. In the case of radium-223, there are data for both pain palliation and improved overall survival in mCRPC. Further studies are needed to optimize timing and combination strategies for bone-targeted therapies. Ongoing studies will explore the impact of combining bone-targeted therapy with investigational therapeutic agents such as immunotherapy, for advanced prostate cancer. Future studies should strive to develop biomarkers of response, in order to improve efficacy and cost-effectiveness of these agents.
Bone Density Conservation Agents/therapeutic use* ; Bone Neoplasms/secondary* ; Denosumab/therapeutic use* ; Diphosphonates/therapeutic use* ; Endothelins/antagonists & inhibitors* ; Humans ; Male ; Prostatic Neoplasms/pathology* ; Protein Kinase Inhibitors/therapeutic use* ; Radioisotopes/therapeutic use* ; Radiopharmaceuticals/therapeutic use* ; Radium/therapeutic use* ; Samarium/therapeutic use* ; Strontium Radioisotopes/therapeutic use*