This update to the JACC Report Card highlights ongoing disparities in cardiovascular mortality between Black and White Americans. While some metrics, such as ischemic heart disease, show modest improvement, excess age-adjusted mortality rates and years of potential life lost remain alarmingly high for Black Americans. These findings reinforce the urgent need for structural reform, sustained investment, and accountability to close persistent gaps in cardiovascular outcomes.

Cardiovascular devices are at the heart of modern clinical practice, yet gaps in surveillance, reporting, and clinician awareness continue to pose serious risks to patient safety. This week’s Editor’s Page highlights the urgent need for improved transparency, stronger reporting systems, and clinician-led engagement around device recalls. With expert perspectives on FDA oversight, the role of unique device identifiers (UDI), and opportunities for real-time communication and consensus-building, this commentary challenges the cardiovascular community to take an active role in shaping the future of device safety. By addressing long-standing misconceptions and systemic limitations, it calls for smarter systems, faster responses, and shared accountability in delivering safe and effective cardiovascular care.

Therapeutic breakthroughs in ATTR cardiomyopathy have ushered in a new era of treatment, with gene silencers, stabilizers, and next-generation therapies extending life and improving quality for patients once left with few options. Yet this progress has exposed a profound and growing divide—between innovation and access. This week’s Editor’s Page explores the striking disconnect between clinical value and global affordability, calling attention to pricing challenges, equity gaps, and the real-world implications of cost-based care limitations. By highlighting the urgency of equitable implementation alongside scientific success, the issue urges clinicians, manufacturers, policymakers, and journals to work together in shaping a future where life-changing therapies reach all who need them.

This issue of JACC showcases a diverse yet thematically cohesive collection of articles that explore the complexities of cardiovascular medicine, from ethical dilemmas and patient-reported outcomes to emerging therapies and methodological innovations. Highlights include a poignant HeartBeats essay on the emotional weight of clinical decisions, debates on responder analyses, promising data on Factor XI inhibitors, and groundbreaking registry findings on balloon pulmonary angioplasty. The issue also features insights into risk prediction, statistical modeling in heart failure trials, rare case reports, and a continued commitment to ethically grounded anatomical education.

This special lipid-themed issue of JACC emphasizes the importance of innovative research in lipid disorders to reduce cardiovascular risk, highlighting studies that extend our understanding of lipid biology and evaluate new treatments. Key reviews and original investigations explore novel lipid-modifying therapies, such as RNA interference and antibody therapies, demonstrating their potential in managing complex lipid disorders. The issue also includes editorials and case studies that provide critical context and underscore the need for personalized and mechanism-driven approaches in lipid management.

In a time of rising global tensions, JACC reaffirms its commitment to science as a unifying, borderless force—advocating for truth, equity, and collaboration to improve health worldwide. By fostering inclusive research, promoting open dialogue, and resisting politicization, JACC aims to build a global medical community working together to overcome disease and conflict.

Listen to the editor's page for this special issue of JACC focusing on key advancements in electrophysiology, including studies on atrial fibrillation prevention, pulsed field ablation, sudden cardiac arrest in young athletes, and efforts to reduce defibrillator use in congenital heart disease. Join Editor-in-Chief Harlan Krumholz as he covers pacemaker safety, device surveillance—including insights from former FDA Commissioner Robert Califf—and emerging topics like AI monitoring and ablation mapping strategies.

Listen to the editor's page for this special issue of JACC focusing on advancing the understanding and treatment of cardiogenic shock through pivotal clinical trials, expert consensus statements, and state-of-the-art reviews aimed at improving patient outcomes. Join Editor-in-Chief Harlan Krumholz as he highlights key contributions like the Altshock-2 trial and new ACC guidelines, the issue underscores the journal’s commitment to leading cardiovascular care in this complex field.