Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Malaria Journal
Published in: Malaria Journal 1/2020

01-12-2020 | Malaria | Research

SNP barcodes provide higher resolution than microsatellite markers to measure Plasmodium vivax population genetics

Authors: Abebe A. Fola, Eline Kattenberg, Zahra Razook, Dulcie Lautu-Gumal, Stuart Lee, Somya Mehra, Melanie Bahlo, James Kazura, Leanne J. Robinson, Moses Laman, Ivo Mueller, Alyssa E. Barry

Published in: Malaria Journal | Issue 1/2020

Login to get access

Abstract

Background

Genomic surveillance of malaria parasite populations has the potential to inform control strategies and to monitor the impact of interventions. Barcodes comprising large numbers of single nucleotide polymorphism (SNP) markers are accurate and efficient genotyping tools, however may need to be tailored to specific malaria transmission settings, since ‘universal’ barcodes can lack resolution at the local scale. A SNP barcode was developed that captures the diversity and structure of Plasmodium vivax populations of Papua New Guinea (PNG) for research and surveillance.

Methods

Using 20 high-quality P. vivax genome sequences from PNG, a total of 178 evenly spaced neutral SNPs were selected for development of an amplicon sequencing assay combining a series of multiplex PCRs and sequencing on the Illumina MiSeq platform. For initial testing, 20 SNPs were amplified in a small number of mono- and polyclonal P. vivax infections. The full barcode was then validated by genotyping and population genetic analyses of 94 P. vivax isolates collected between 2012 and 2014 from four distinct catchment areas on the highly endemic north coast of PNG. Diversity and population structure determined from the SNP barcode data was then benchmarked against that of ten microsatellite markers used in previous population genetics studies.

Results

From a total of 28,934,460 reads generated from the MiSeq Illumina run, 87% mapped to the PvSalI reference genome with deep coverage (median = 563, range 56–7586) per locus across genotyped samples. Of 178 SNPs assayed, 146 produced high-quality genotypes (minimum coverage = 56X) in more than 85% of P. vivax isolates. No amplification bias was introduced due to either polyclonal infection or whole genome amplification (WGA) of samples before genotyping. Compared to the microsatellite panels, the SNP barcode revealed greater variability in genetic diversity between populations and geographical population structure. The SNP barcode also enabled assignment of genotypes according to their geographic origins with a significant association between genetic distance and geographic distance at the sub-provincial level.

Conclusions

High-throughput SNP barcoding can be used to map variation of malaria transmission dynamics at sub-national resolution. The low cost per sample and genotyping strategy makes the transfer of this technology to field settings highly feasible.
Appendix
Available only for authorised users
Literature
1.
WHO. World malaria report 2019. Geneva: World Health Organization; 2019.
2.
Karyana M, Burdarm L, Yeung S, Kenangalem E, Wariker N, Maristela R, et al. Malaria morbidity in Papua Indonesia, an area with multidrug resistant Plasmodium vivax and Plasmodium falciparum. Malar J. 2008;7:148.PubMedPubMedCentralCrossRef
3.
Quispe AM, Pozo E, Guerrero E, Durand S, Baldeviano GC, Edgel KA, et al. Plasmodium vivax hospitalizations in a monoendemic malaria region: severe vivax malaria? Am J Trop Med Hyg. 2014;91:11–7.PubMedPubMedCentralCrossRef
4.
Tjitra E, Anstey NM, Sugiarto P, Warikar N, Kenangalem E, Karyana M, et al. Multidrug-resistant Plasmodium vivax associated with severe and fatal malaria: a prospective study in Papua Indonesia. PLoS Med. 2008;5:e128.PubMedPubMedCentralCrossRef
5.
Price RN, Seidlein L, Valecha N, Nosten F, Baird JK, White NJ. Global extent of chloroquine-resistant Plasmodium vivax: a systematic review and meta-analysis. Lancet Infect Dis. 2014;14:182–91.CrossRef
6.
Mueller I, Galinski MR, Baird JK, Carlton JM, Kochar DK, Alonso PL, et al. Key gaps in the knowledge of Plasmodium vivax, a neglected human malaria parasite. Lancet Infect Dis. 2009;9:555–66.PubMedCrossRef
7.
8.
Wang D, Li S, Cheng Z, Xiao N, Cotter C, Hwang J, et al. Transmission risk from imported Plasmodium vivax malaria in the China-Myanmar border region. Emerg Infect Dis. 2015;21:1861–4.PubMedPubMedCentralCrossRef
9.
Fola AA, Nate E, Abby Harrison GL, Barnadas C, Hetzel MW, Iga J, et al. Nationwide genetic surveillance of Plasmodium vivax in Papua New Guinea reveals heterogeneous transmission dynamics and routes of migration amongst subdivided populations. Infect Genet Evol. 2018;58:83–95.PubMedCrossRef
10.
Ohrt C, Roberts KW, Sturrock HJW, Wegbreit J, Lee BY, Gosling RD. Information systems to support surveillance for malaria elimination. Am J Trop Med Hyg. 2015;93:145–52.PubMedPubMedCentralCrossRef
11.
12.
Rosanas-Urgell A, Mueller D, Betuela I, Barnadas C, Iga J, Zimmerman P. Comparison of diagnostic methods for the detection and quantification of the four sympatric Plasmodium species in field samples from Papua New Guinea. Malar J. 2010;9:361.PubMedPubMedCentralCrossRef
13.
Arnott A, Barry AE, Reeder JC. Understanding the population genetics of Plasmodium vivax is essential for malaria control and elimination. Malar J. 2012;11:14.PubMedPubMedCentralCrossRef
14.
Pearson RD, Amato R, Auburn S, Miotto O, Almagro-Garcia J, Amaratunga C, et al. Genomic analysis of local variation and recent evolution in Plasmodium vivax. Nat Genet. 2016;48:959–64.PubMedPubMedCentralCrossRef
15.
Obaldia N, Baro NK, Calzada JE, Santamaria AM, Daniels R, Wong W, et al. Clonal outbreak of Plasmodium falciparum infection in eastern Panama. J Infect Dis. 2015;211:1087–96.PubMedCrossRef
16.
Preston MD, Campino S, Assefa SA, Echeverry DF, Ocholla H, Amambua-Ngwa A, et al. A barcode of organellar genome polymorphisms identifies the geographic origin of Plasmodium falciparum strains. Nat Commun. 2014;5:4052.PubMedCrossRef
17.
Auburn S, Benavente ED, Miotto O, Pearson RD, Amato R, Grigg MJ, et al. Genomic analysis of a pre-elimination Malaysian Plasmodium vivax population reveals selective pressures and changing transmission dynamics. Nat Commun. 2018;9:2585.PubMedPubMedCentralCrossRef
18.
Volkman SK, Neafsey DE, Schaffner SF, Park DJ, Wirth DF. Harnessing genomics and genome biology to understand malaria biology. Nat Rev Genet. 2012;13:315–28.PubMedCrossRef
19.
20.
Escalante AA, Ferreira MU, Vinetz JM, Volkman SK, Cui L, Gamboa D. Malaria molecular epidemiology: lessons from the International Centers of Excellence for Malaria Research Network. Am J Trop Med Hyg. 2015;93:79–86.PubMedPubMedCentralCrossRef
21.
Omedo I, Mogeni P, Rockett K, Kamau A, Hubbart C, Jeffreys A, et al. Geographic-genetic analysis of Plasmodium falciparum parasite populations from surveys of primary school children in Western Kenya. Wellcome Open Res. 2017;2:29.PubMedPubMedCentralCrossRef
22.
Bousema T, Drakeley C, Gesase S, Hashim R, Magesa S, Mosha F, et al. Identification of hot spots of malaria transmission for targeted malaria control. J Infect Dis. 2010;201:1764–74.PubMedCrossRef
23.
Daniels RF, Rice BL, Daniels NM, Volkman SK, Hartl DL. The utility of genomic data for Plasmodium vivax population surveillance. Pathog Glob Health. 2015;109:153–61.PubMedPubMedCentralCrossRef
24.
Karunaweera ND, Ferreira MU, Hartl DL, Wirth DF. Fourteen polymorphic microsatellite DNA markers for the human malaria parasite Plasmodium vivax. Mol Ecol Notes. 2006;7:172–5.CrossRef
25.
de Souza AM, de Araujo FC, Fontes CJ, Carvalho LH, de Brito CF, de Sousa TN. Multiple-clone infections of Plasmodium vivax: definition of a panel of markers for molecular epidemiology. Malar J. 2015;14:330.PubMedPubMedCentralCrossRef
26.
Gunawardena S, Karunaweera ND, Ferreira MU, Phone-Kyaw M, Pollack RJ, Alifrangis M, et al. Geographic structure of Plasmodium vivax: microsatellite analysis of parasite populations from Sri Lanka, Myanmar, and Ethiopia. Am J Trop Med Hyg. 2010;82:235–42.PubMedPubMedCentralCrossRef
27.
Anderson TJ, Su XZ, Bockarie M, Lagog M, Day KP. Twelve microsatellite markers for characterization of Plasmodium falciparum from finger-prick blood samples. Parasitology. 1999;119:113–25.PubMedCrossRef
28.
29.
Madesis P, Ganopoulos I, Tsaftaris A. Microsatellites: evolution and contribution. Methods Mol Biol. 2013;1006:1–13.PubMedCrossRef
30.
Havryliuk T, Orjuela-Sánchez P, Ferreira MU. Plasmodium vivax: microsatellite analysis of multiple-clone infections. Exp Parasitol. 2008;120:330–6.PubMedCrossRef
31.
McTavish EJ, Hillis DM. How do SNP ascertainment schemes and population demographics affect inferences about population history? BMC Genomics. 2015;16:266.PubMedPubMedCentralCrossRef
32.
Ferreira MU, Rodrigues PT. Tracking malaria parasites in the eradication era. Trends Parasitol. 2014;30:465–6.PubMedCrossRef
33.
Baniecki ML, Faust AL, Schaffner SF, Park DJ, Galinsky K, Daniels RF, et al. Development of a single nucleotide polymorphism barcode to genotype Plasmodium vivax infections. PLoS Negl Trop Dis. 2015;9:e0003539.PubMedPubMedCentralCrossRef
34.
Daniels R, Volkman SK, Milner DA, Mahesh N, Neafsey DE, Park DJ, et al. A general SNP-based molecular barcode for Plasmodium falciparum identification and tracking. Malar J. 2008;7:223.PubMedPubMedCentralCrossRef
35.
Ball AD, Stapley J, Dawson DA, Birkhead TR, Burke T, Slate J. A comparison of SNPs and microsatellites as linkage mapping markers: lessons from the zebra finch (Taeniopygia guttata). BMC Genomics. 2010;11:218.PubMedPubMedCentralCrossRef
36.
37.
Nielsen R. Population genetic analysis of ascertained SNP data. Hum Genomics. 2004;1:1–7.CrossRef
38.
Lachance J, Tishkoff SA. SNP ascertainment bias in population genetic analyses: why it is important, and how to correct it. BioEssays. 2013;35:780–6.PubMedPubMedCentralCrossRef
39.
Sunyaev SR, Lathe WC, Ramensky VE. SNP frequencies in human genes: an excess of rare alleles and differing modes of selection. Trends Genet. 2000;16:335–7.PubMedCrossRef
40.
41.
Hetzel MW, Morris H, Tarongka N, Barnadas C, Pulford J, Makita L, et al. Prevalence of malaria across Papua New Guinea after initial roll-out of insecticide-treated mosquito nets. Trop Med Int Health. 2015;20:1745–55.PubMedCrossRef
42.
Koepfli C, Rodrigues PT, Antao T, Orjuela-Sanchez P, Van den Eede P, Gamboa D, et al. Plasmodium vivax diversity and population structure across four continents. PLoS Negl Trop Dis. 2015;9:e0003872.PubMedPubMedCentralCrossRef
43.
Delgado-Ratto C, Gamboa D, Soto-Calle VE, Van den Eede P, Torres E, Sanchez-Martinez L, et al. Population genetics of Plasmodium vivax in the Peruvian Amazon. PLoS Negl Trop Dis. 2016;10:e0004376.PubMedPubMedCentralCrossRef
44.
Getachew S, To S, Trimarsanto H, Thriemer K, Clark TG, Petros B, et al. Variation in complexity of infection and transmission stability between neighbouring populations of Plasmodium vivax in Southern Ethiopia. PLoS ONE. 2015;10:e0140780.PubMedPubMedCentralCrossRef
45.
Waltmann A, Koepfli C, Tessier N, Karl S, Fola A, Darcy AW, et al. Increasingly inbred and fragmented populations of Plasmodium vivax associated with the eastward decline in malaria transmission across the Southwest Pacific. PLoS Negl Trop Dis. 2018;12:e0006146.PubMedPubMedCentralCrossRef
46.
Koepfli C, Timinao L, Antao T, Barry AE, Siba P, Mueller I, et al. A large Plasmodium vivax reservoir and little population structure in the South Pacific. PLoS ONE. 2013;8:e66041.PubMedPubMedCentralCrossRef
47.
Jennison C, Arnott A, Tessier N, Tavul L, Koepfli C, Felger I. Plasmodium vivax populations are more genetically diverse and less structured than sympatric Plasmodium falciparum populations. PLoS Negl Trop Dis. 2015;9:e0003634.PubMedPubMedCentralCrossRef
48.
Koepfli C, Ome-Kaius M, Jally S, Malau E, Maripal S, Ginny J, et al. Sustained malaria control over an eight-year period in Papua New Guinea: the challenge of low-density asymptomatic infections. J Infect Dis. 2017;216:1434–43.PubMedPubMedCentralCrossRef
49.
Kattenberg JH, Razook Z, Keo R, Koepfli C, Jennison C, Lautu-Ninda D, et al. Monitoring of Plasmodium falciparum and Plasmodium vivax using microsatellite markers indicates limited changes in population structure after substantial transmission decline in Papua New Guinea. Mol Ecol. 2020; https://​doi.​org/​10.​1111/​mec.​15654 ahead of print.
50.
McKenna A, Hanna M, Banks E, Sivachenko A, Cibulskis K, Kernytsky A, et al. The Genome Analysis Toolkit: a mapReduce framework for analyzing next-generation DNA sequencing data. Genome Res. 2010;20:1297–303.PubMedPubMedCentralCrossRef
51.
Hupalo DN, Luo Z, Melnikov A, Sutton PL, Rogov P, Escalante A, et al. Population genomics studies identify signatures of global dispersal and drug resistance in Plasmodium vivax. Nat Genet. 2016;48:953–8.PubMedPubMedCentralCrossRef
52.
Carlton JM, Adams JH, Silva JC, Bidwell SL, Lorenzi H, Caler E, et al. Comparative genomics of the neglected human malaria parasite Plasmodium vivax. Nature. 2008;455:757–63.PubMedPubMedCentralCrossRef
53.
54.
Lu J, Johnston A, Berichon P, Ru K-l, Korbie D, Trau M. PrimerSuite: a hig-throughput web-Based primer design program for multiplex bisulfite PCR. Sci Rep. 2017;7:41328.
55.
Henegariu O, Heerema NA, Dlouhy SR, Vance GH, Vogt PH. Multiplex PCR: critical parameters and step-by-step protocol. Biotechniques. 1997;23:504–11.PubMedCrossRef
56.
Holbrook JF, Stabley D, Sol-Church K. Exploring whole genome amplification as a DNA recovery tool for molecular genetic studies. J Biomol Tech. 2005;16:125–33.PubMedPubMedCentral
57.
Hosono S, Faruqi AF, Dean FB, Du Y, Sun Z, Wu X, et al. Unbiased whole-genome amplification directly from clinical samples. Genome Res. 2003;13:954–64.PubMedPubMedCentralCrossRef
58.
Ewels P, Magnusson M, Lundin S, Käller M. MultiQC: summarize analysis results for multiple tools and samples in a single report. Bioinformatics. 2016;32:3047–8.PubMedPubMedCentralCrossRef
59.
60.
García-Alcalde F, Okonechnikov K, Carbonell J, Cruz LM, Götz S, Tarazona S, et al. Qualimap: evaluating next-generation sequencing alignment data. Bioinformatics. 2012;28:2678–9.PubMedCrossRef
61.
62.
63.
64.
Chang HH, Worby CJ, Yeka A, Nankabirwa J, Kamya MR, Staedke SG, et al. THE REAL McCOIL: a method for the concurrent estimation of the complexity of infection and SNP allele frequency for malaria parasites. PLoS Comput Biol. 2017;13:e1005348.PubMedPubMedCentralCrossRef
65.
Lischer HEL, Excoffier L. PGDSpider: an automated data conversion tool for connecting population genetics and genomics programs. Bioinformatics. 2012;28:298–9.PubMedCrossRef
66.
Librado P, Rozas J. DnaSP v5: a software for comprehensive analysis of DNA polymorphism data. Bioinformatics. 2009;25:1451–2.PubMedCrossRef
67.
68.
Dixon P. VEGAN, A Package of R Functions for Community Ecology. J Veg Sci. 2003;14:927–30.CrossRef
69.
Pritchard JK, Stephens M, Donnelly P. Inference of population structure using multilocus genotype data. Genetics. 2000;155:945–59.PubMedPubMedCentral
70.
Jombart T. Adegenet: a R package for the multivariate analysis of genetic markers. Bioinformatics. 2008;24:1403–5.PubMedCrossRef
71.
Jombart T, Devillard S, Balloux F. Discriminant analysis of principal components: a new method for the analysis of genetically structured populations. BMC Genet. 2010;11:94.PubMedPubMedCentralCrossRef
72.
Katterberg JH, Gumal DL, Ome-Kaius M, Kiniboro B, Philip M, Jally S, et al. The epidemiology of Plasmodium falciparum and Plasmodium vivax in East Sepik Province Papua New Guinea, pre- and post-implementation of national malaria control efforts. Malar J. 2020;19:198.CrossRef
73.
Nkhoma SC, Nair S, Cheeseman IH, Rohr-Allegrini C, Singlam S, Nosten F, et al. Close kinship within multiple-genotype malaria parasite infections. Proc R Soc Bio Sci. 2012;279:2589–98.CrossRef
74.
Omedo I, Mogeni P, Bousema T, Rockett K, Amambua-Ngwa A, Oyier I, et al. Micro-epidemiological structuring of Plasmodium falciparum parasite populations in regions with varying transmission intensities in Africa. Wellcome Open Res. 2017;2:10–5.PubMedPubMedCentral
75.
Nkhoma SC, Nair S, Al-Saai S, Ashley E, McGready R, Phyo AP. Population genetic correlates of declining transmission in a human pathogen. Mol Ecol. 2013;22:273–85.PubMedCrossRef
76.
Daniels R, Chang HH, Séne PD, Park DC, Neafsey DE, Schaffner SF, et al. Genetic surveillance detects both clonal and epidemic transmission of malaria following enhanced intervention in Senegal. PLoS ONE. 2013;8:e60780.PubMedPubMedCentralCrossRef
77.
Daniels RF, Schaffner SF, Wenger EA, Proctor JL, Chang HH, Wong W. Modeling malaria genomics reveals transmission decline and rebound in Senegal. Proc Natl Acad Sci USA. 2015;112:7067–72.PubMedCrossRefPubMedCentral
78.
Volkman SK, Ndiaye D, Diakite M, Koita O, Nwakanma D, Daniels R, et al. Application of genomics to field investigations of malaria by the International Centers for Excellence in Malaria Research. Acta Trop. 2012;121:324–32.PubMedCrossRef
79.
Fola AA, Abby Harrison GL, Hazairin MH, Barnadas C, Hetzel MW, Iga J, et al. Higher complexity of infection and genetic diversity of Plasmodium vivax than Plasmodium falciparum across all malaria transmission zones of Papua New Guinea. Am J Trop Med Hyg. 2017;96:630–41.PubMedPubMedCentral
80.
Waltmann A, Darcy AW, Harris I, Koepfli C, Lodo J, Vahi V, et al. High Rates of Asymptomatic, sub-microscopic Plasmodium vivax infection and disappearing Plasmodium falciparum malaria in an area of low transmission in Solomon Islands. PLoS Negl Trop Dis. 2015;9:e0003758.PubMedPubMedCentralCrossRef
81.
Campos M, Conn JE, Alonso DP, Vinetz JM, Emerson KJ, Ribolla PE. Microgeographical structure in the major Neotropical malaria vector Anopheles darlingi using microsatellites and SNP markers. Parasit Vectors. 2017;10:76.PubMedPubMedCentralCrossRef
82.
Ryynanen HJ, Tonteri A, Vasemagi A, Primmer CR. A comparison of biallelic markers and microsatellites for the estimation of population and conservation genetic parameters in Atlantic salmon (Salmo salar). J Hered. 2007;98:692–704.PubMedCrossRef
83.
Jeffries DL, Copp GH, Lawson Handley L, Olsen KH, Sayer CD, Hanfling B. Comparing RADseq and microsatellites to infer complex phylogeographic patterns, an empirical perspective in the Crucian carp Carassius carassius. Mol Ecol. 2016;25:2997–3018.PubMedCrossRef
84.
Henden L, Lee S, Mueller I, Barry A, Bahlo M. Identity by descent analyses for measuring population dynamics and selection in recombining pathogens. PLoS Genet. 2018;14:e1007279.PubMedPubMedCentralCrossRef
85.
Taylor AR, Schaffner SF, Cerqueira GC, Nkhoma SC, Anderson TJC, Sriprawat K, et al. Quantifying connectivity between local Plasmodium falciparum malaria parasite populations using identity by descent. PLoS Genet. 2017;13:e1007065.PubMedPubMedCentralCrossRef
86.
Hartl DL, Clark AG. Principles of Population Genetics. 4th ed. Oxford: Blackwell Science; 2006.
87.
Metadata
Title
SNP barcodes provide higher resolution than microsatellite markers to measure Plasmodium vivax population genetics
Authors
Abebe A. Fola
Eline Kattenberg
Zahra Razook
Dulcie Lautu-Gumal
Stuart Lee
Somya Mehra
Melanie Bahlo
James Kazura
Leanne J. Robinson
Moses Laman
Ivo Mueller
Alyssa E. Barry
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2020
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-020-03440-0

Other articles of this Issue 1/2020

Malaria Journal 1/2020 Go to the issue

Opinion

District-level approach for tailoring and targeting interventions: a new path for malaria control and elimination

Update

Update to: A stakeholder workshop about modelled maps of key malaria indicator survey indicators in Madagascar

Research

Community perception of malaria in a vulnerable municipality in the Colombian Pacific

Meeting report

Tools to accelerate falciparum malaria elimination in Cambodia: a meeting report

Research

Prevalence of sickle cell disorders and malaria infection in children aged 1–12 years in the Volta Region, Ghana: a community-based study

Research

Capacity of National Malaria Control Programmes to implement vector surveillance: a global analysis
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits