Clinical Cardiology最新文献

{"title":"Trends in Chronic Ischemic Heart Disease-Related Mortality in Older Adults With Atrial Fibrillation (1999–2023): A CDC WONDER Database Analysis","authors":"Muhammad Shaheer Bin Faheem,&nbsp;Syed Tawassul Hassan,&nbsp;Tehreem Asghar,&nbsp;Nafila Zeeshan,&nbsp;Sumaya Samadi","doi":"10.1002/clc.70267","DOIUrl":"10.1002/clc.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Atrial fibrillation (AF) is the most common and persistent type of arrhythmia that frequently co-exists with chronic ischemic heart disease (IHD), increasing the risk of adverse cardiovascular outcomes and mortality. We aim to analyze chronic IHD-related mortality trends in patients with AF from 1999 to 2023 in the United States (U.S.).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to conduct a retrospective analysis of death records of adults (aged 65 ≤) with chronic IHD as the underlying cause and co-existent AF as a contributing cause of death. Age-adjusted mortality rates (AAMR) per 100 000 population and annual percent changes (APC) in age-adjusted mortality rates were determined and measured across different demographics and geographies in the U.S.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AF was recorded in almost 460,196 deaths caused by chronic IHD. The AAMR increased from 38.2 in 1999 to 52.2 in 2023, showing a prominent increase shift from 2010 to 2023 (APC: 2.72). Recorded AAMR in Males (54.8) was doubled that of females (33.2), while a top AAMR of 44.7 was seen in non-Hispanic (NH) Whites was doubled that of other racial/ethnic groups. Geographically, AAMR was higher in non-metropolitan areas (43.3) and the Northeast region (42.8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Proper resource distribution and more targeted interventions are needed to address the rising trends in chronic IHD mortality among AF patients across different geographic and demographic groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Considerations in Evaluating CTRP12 as a Biomarker for In-Stent Restenosis","authors":"Saleha Khattak,&nbsp;Syed Muhammad Rayyan,&nbsp;Syed Huzaifa Khan","doi":"10.1002/clc.70271","DOIUrl":"10.1002/clc.70271","url":null,"abstract":"&lt;p&gt;We read with great interest the study by Botao Zhao and Yuchan Shen, which evaluates changes in serum CTRP12 in patients with coronary artery disease (CAD) after the treatment of percutaneous coronary intervention (PCI) and its relationship with in-stent restenosis (ISR). The authors have addressed an emerging area of vascular biology and present CTRP12 as a possible biomarker with significant prognostic value. Although the findings are intriguing and novel, some aspects of the study must be discussed to appropriately contextualize the conclusions [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The selection of patients for the ISR group relied on follow-up coronary angiography rather than protocol-mandated, systematic surveillance [&lt;span&gt;2&lt;/span&gt;]. As patients who undergo repeat angiography are more likely to be symptomatic or high risk, this raises the possibility that the observed association between CTRP12 levels and ISR may reflect correlations with severity of the disease or symptom burden instead of true anatomical restenosis, potentially overstating the stated predictive ability of the biomarker.&lt;/p&gt;&lt;p&gt;Next, the study does not establish CTRP12 as an independent predictor of ISR. The lack of a multivariable model limits the interpretation of the results as validated predictors of ISR, such as angiographic disease severity (e.g., Gensini score), inflammatory markers like hs-CRP, and clinical risk factors were not adjusted for [&lt;span&gt;3&lt;/span&gt;]. Without demonstrating incremental prognostic value beyond these existing variables, CTRP12 may present as a mediator of underlying inflammation or disease burden rather than an independent biomarker [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Moreover, the immediate post-PCI period is marked by acute vascular injury, endothelial disruption, and inflammatory activation related to balloon inflation and stent deployment. Hence, changes in CTRP12 levels at 24 hours post-procedure indicate acute procedural trauma rather than mechanisms directly involved in the longer-term development of ISR [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Also, procedural factors such as total stent length, number of stents implanted, lesion complexity, and duration of balloon inflation are known to influence inflammatory responses and ISR risk. Such variables were not accounted for; therefore, lower CTRP12 levels may simply reflect more complex or injurious interventions [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Lastly, the single-center design with a relatively limited sample size restricts external validity. The optimal cut-off values concluded from a single population may not be generalizable across other demographics. External validation in independent and multicenter cohorts is essential before CTRP12 can be considered for clinical practice.&lt;/p&gt;&lt;p&gt;In summary, while the study contributes valuable data on CTRP12 and its prognostic value, verification bias, absence of a multivariable model, ambiguity related to the timing of biomarker measurement, and possible restricted generalizability hinder the str","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Naples Prognostic Score and Clinical Outcomes After PCI for Acute Coronary Syndrome: A Systematic Review and Meta-Analysis”","authors":"Bin Cao,&nbsp;Rengyun Xiang","doi":"10.1002/clc.70270","DOIUrl":"10.1002/clc.70270","url":null,"abstract":"&lt;p&gt;We read with interest the meta-analysis by Özen et al. on the Naples Prognostic Score (NPS) in ACS patients undergoing PCI [&lt;span&gt;1&lt;/span&gt;]. The study confirms that a higher NPS is associated with increased mortality, no-reflow, and lower LVEF, contributing to the field of biomarker-based risk stratification. We wish to highlight several limitations that merit further discussion.&lt;/p&gt;&lt;p&gt;First, the study overlooks the methodological limitation of dichotomizing continuous biomarkers. The NPS components (e.g., albumin, NLR) are continuous and may have non-linear relationships with outcomes. Forcing them into binary categories loses gradient risk information and masks component interactions. For instance, different combinations of albumin and NLR levels may yield the same NPS but carry distinct risks. This oversimplification likely contributes to the high heterogeneity observed, particularly for LVEF. Birdal et al. showed that while the high-NPS group had lower LVEF (45.2 ± 8.7% vs. 50.1 ± 8.2%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), the impact of individual components varied significantly—a nuance obscured by dichotomization [&lt;span&gt;2&lt;/span&gt;]. Thus, future studies should treat biomarkers as continuous variables and use advanced models (e.g., splines, machine learning) to capture non-linear relationships and enable personalized risk stratification.&lt;/p&gt;&lt;p&gt;Second, the study neglects that the NPS's simple summation of nutrition (albumin, cholesterol) and inflammation (NLR, LMR) markers may blur distinct pathophysiologies (“nutritional depletion” vs. “inflammatory storm”). Keskin et al. identified two high-NPS subtypes in NSTEMI patients: a “low-albumin, low-inflammation” group with higher heart failure/infection rates, and a “normal-albumin, high-inflammation” group with higher reinfarction rates [&lt;span&gt;3&lt;/span&gt;]. Targeted interventions yielded subtype-specific benefits (nutrition support reduced heart failure risk by 41% in the former; anti-inflammatory therapy reduced reinfarction by 53% in the latter). These critical differences are masked by the total NPS. Future work should use methods like cluster analysis to identify such phenotypes and test targeted therapies, transforming the NPS from a “black-box” score into a actionable phenotyping tool.&lt;/p&gt;&lt;p&gt;Third, the study underemphasizes that current evidence is largely observational, limiting causal inference. It remains unclear whether a high NPS directly contributes to poor outcomes or merely reflects overall disease severity. Genc et al. found that after adjusting for disease severity markers, the independent association between NPS and prolonged hospitalization was attenuated (p-value increased from &lt; 0.01 to 0.08) [&lt;span&gt;4&lt;/span&gt;], suggesting NPS may be a severity marker rather than an independent driver. Therefore, the next step should be prospective validation and randomized trials testing whether NPS-guided interventions improve hard endpoints, elevating it from a predictor to an intervention target.&lt;/p&gt;&lt;p&gt;F","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CTRP12: A Novel Biomarker in Predicting In-Stent Restenosis Occurrence","authors":"Ya Nie,&nbsp;Wanmei Song","doi":"10.1002/clc.70268","DOIUrl":"10.1002/clc.70268","url":null,"abstract":"<p>We read with great interest the recent study entitled <i>“Changes of Serum CTRP12 in Patients With Coronary Artery Disease After the Treatment of Percutaneous Coronary Intervention and Its Relationship With In-Stent Restenosis”</i>. The authors provide compelling evidence supporting C1q/tumor necrosis factor–related protein 12 (CTRP12) as a promising biomarker for both coronary artery disease (CAD) severity and the prediction of in-stent restenosis (ISR) after PCI [<span>1</span>]. We believe this work adds important translational value to the field of interventional cardiology. Several aspects underscore why CTRP12 may be regarded as a novel and clinically meaningful biomarker.</p><p>The demonstrated negative correlations between serum CTRP12 levels and the Gensini score as well as hs-CRP highlight its close association with coronary atherosclerotic severity and systemic inflammation. Unlike traditional biomarkers that primarily capture either ischemic burden or inflammation, CTRP12 appears to integrate both structural disease severity and inflammatory activity, two central drivers of ISR pathophysiology [<span>2</span>].</p><p>The observed acute decline in CTRP12 levels at 24 h after PCI, followed by partial recovery at 72 h, suggests that CTRP12 is sensitive to procedural vascular trauma and early inflammatory responses induced by stent implantation. This dynamic behavior distinguishes CTRP12 from static baseline biomarkers and supports its role as a real-time indicator of vascular healing or maladaptive repair processes that predispose to restenosis [<span>3</span>].</p><p>Notably, CTRP12 levels at 24 h post-PCI showed the highest predictive accuracy for ISR, and patients who developed ISR consistently exhibited lower CTRP12 levels at all measured time points. This temporal predictive capacity positions CTRP12 as a potentially actionable biomarker, enabling early risk stratification and closer surveillance or intensified therapy in high-risk patients.</p><p>In summary, CTRP12 emerges as a novel biomarker that links inflammation, coronary disease severity, and post-PCI vascular response. Future prospective studies and mechanistic investigations are warranted to validate its clinical utility and to explore whether modulation of CTRP12-related pathways could represent a therapeutic target for preventing ISR.</p><p>The authors declare no conflicts of interest.</p><p>The data supporting this study are available upon reasonable request from the corresponding author.</p>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12859750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critique on “Evaluation of Sex-Based Differences in the Prescription of the Combination of Evidence-Based Medicine After the Occurrence of an Acute ST-Elevation Myocardial Infarction”","authors":"Maiza Naseer,&nbsp;Sameer Haider,&nbsp;Touqeer Rehman","doi":"10.1002/clc.70239","DOIUrl":"10.1002/clc.70239","url":null,"abstract":"&lt;p&gt;Evelo et al. published an article entitled “Evaluation of Sex-Based Differences in the Prescription of the Combination of Evidence-Based Medicine After the Occurrence of an Acute ST-Elevation Myocardial Infarction” which we read with interest [&lt;span&gt;1&lt;/span&gt;]. The authors examined an important clinical question: Are women less likely than men to be discharged with the full combination of evidence-based medicine (cEBM) after STEMI? In a retrospective cohort of 1467 patients in a teaching hospital in the Netherlands, they demonstrated that women were significantly less likely to be prescribed cEBM, particularly ACEi/ARB and statins. However, sex was not an independent predictor following multivariable adjustment [&lt;span&gt;1&lt;/span&gt;]. This work is particularly important, especially in the context of studying a sizable real-world cohort and establishing prescribing patterns in contemporary STEMI care. Sensitivity analyses for left ventricular ejection fraction and subgroup comparisons add further robustness to the work. More importantly, their study illustrates that even with guideline-directed therapy, women continue to experience elevated rates of stroke and mortality when compared to men, reinforcing existing sex differences in cardiovascular care. There are some other limitations, not explicitly recognized by the authors, that should be considered when applying their findings in practice.&lt;/p&gt;&lt;p&gt;First, the single-center design limits the generalizability of the findings. All patients were treated at a Dutch Teaching Hospital that offers a range of cardiology services, where the guideline treatment is often well followed. Prescribing patterns and patient characteristics will likely vary considerably in a community or rural hospital setting. As a result, the findings may not be generalizable to larger or more diverse populations [&lt;span&gt;2&lt;/span&gt;]. Multicenter registries could help clarify if the finding that sex was not an independent predictor holds true across health care systems.&lt;/p&gt;&lt;p&gt;Second, medication prescriptions were measured only at the time of discharge, and there was no record of dose, intensity, or longitudinal adjustments. In the study, cEBM was defined operationally as a “recommendation” for prescription of all five drug classes on the day after the index discharge [&lt;span&gt;1&lt;/span&gt;]. This binary definition totally ignores underdosing (e.g., low-intensity statins, subtarget ACEi/ARB), titration, or discontinuation at a later date. Previous studies have demonstrated that underdosing and discontinuation, which are more frequently observed among women, are related to worse outcomes [&lt;span&gt;3, 4&lt;/span&gt;]. By ignoring these variables, there is a risk that sex differences in secondary prevention will be underestimated.&lt;/p&gt;&lt;p&gt;Third, this study did not assess physician and system factors. The analysis was limited to patient-level factors. However, cardiovascular care disparities are often a reflection of provider practice patterns, implicit bias, a","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12834462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Long-Term Outcomes of Catheter Ablation in Ventricular Tachycardia Electrical Storm","authors":"Sohana Memon,&nbsp;Gaaitri Lohano","doi":"10.1002/clc.70265","DOIUrl":"10.1002/clc.70265","url":null,"abstract":"&lt;p&gt;The research by Çöteli et al. [&lt;span&gt;1&lt;/span&gt;], titled &lt;i&gt;“Long-Term Outcomes of Catheter Ablation in Ventricular Tachycardia Electrical Storm: A Retrospective Cohort Study,”&lt;/i&gt; caught our interest. The authors deserve praise for their methodical evaluation of a high-risk patient population presenting with electrical storm and for providing a comprehensive description of their retrospective cohort study design, patient selection criteria, and procedural methods. Their detailed documentation of VT induction strategies, ICD therapy monitoring, catheter ablation techniques, and follow-up procedures offers valuable insight into real-world management. These methodological strengths reinforce the reliability of the reported findings regarding procedural success, VT recurrence, ICD interventions, and survival outcomes. Nevertheless, certain limitations related to risk stratification and outcome assessment may influence the interpretation and generalizability of the results.&lt;/p&gt;&lt;p&gt;First, in high-risk cardiac populations, procedural tolerance, mortality, and post-ablation outcomes are influenced not only by left ventricular ejection fraction and comorbidities but also by overall physiological reserve. Patients with similar LVEF profiles may differ substantially in frailty status, which has been shown to be an independent predictor of cardiovascular mortality. The absence of frailty assessment in the current study limits granular risk stratification and may complicate interpretation of long-term mortality and morbidity outcomes. Although frailty evaluation can be challenging in retrospective cohorts, incorporating validated frailty measures in future studies could enhance prognostic accuracy and clinical applicability [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Second, an important methodological consideration is the lack of a standardized ventricular tachycardia induction protocol during catheter ablation. While programmed ventricular stimulation and burst pacing were employed, details regarding pacing sites, number of extrastimuli, and stimulation parameters were not uniformly defined. Such variability may influence VT detection and the prognostic interpretation of post-ablation non-inducibility, even if it does not undermine procedural efficacy itself. Prior high-risk VT ablation studies have demonstrated that variability in stimulation methodology can affect the predictive value of inducibility for long-term clinical outcomes [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Finally, the influence of operator experience on procedural outcomes was not addressed. Given the prolonged study period and the complexity of VT ablation procedures, including combined endocardial and epicardial approaches, operator-related variability may have affected outcomes. Recent evidence demonstrates that higher procedural volume is associated with improved safety and efficacy in VT ablation: Bansal et al. (2025) showed that high-volume centers had significantly lower in-hospital mortality and major complications ","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12831169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loop Diuretic Therapy in Severe Aortic Stenosis: Marker or Mediator of Adverse Outcomes?","authors":"Masaki Miyazawa,&nbsp;Teruhiko Imamura","doi":"10.1002/clc.70264","DOIUrl":"10.1002/clc.70264","url":null,"abstract":"&lt;p&gt;The association between loop diuretic therapy (LDT), congestion, heart failure severity, and post-procedural outcomes in patients with severe aortic stenosis (AS) undergoing aortic valve replacement (AVR) remains incompletely understood. In this well-conducted observational study, the authors demonstrated that pre-procedural LDT was associated with more advanced cardiac remodeling, greater systemic and pulmonary congestion, unfavorable invasive hemodynamics, and increased long-term mortality after AVR [&lt;span&gt;1&lt;/span&gt;]. Several points merit further discussion.&lt;/p&gt;&lt;p&gt;Although the authors clearly demonstrated robust associations between LDT, congestion markers, and adverse outcomes [&lt;span&gt;1&lt;/span&gt;], the causal relationship remains uncertain. It is unclear whether LDT merely reflects advanced disease severity or actively contributes to worse clinical outcomes. In other words, LDT may function as a marker rather than a mediator of poor prognosis. To better disentangle this relationship, it would be informative to compare outcomes among patients with comparable doses of loop diuretics but different congestion severity. For example, matching patients with similar doses of loop diuretics but differing pulmonary artery wedge pressure or radiographic congestion scores might help clarify whether congestion itself, rather than LDT, primarily drives prognosis.&lt;/p&gt;&lt;p&gt;A substantial proportion of patients receiving LDT still exhibited elevated filling pressures [&lt;span&gt;1&lt;/span&gt;], suggesting suboptimal congestion control. If congestion is the principal determinant of poor outcomes [&lt;span&gt;2&lt;/span&gt;], more aggressive or optimized decongestive strategies—rather than avoidance of LDT—might theoretically improve hemodynamics and prognosis. This perspective is particularly relevant given the paradoxical positive association between loop diuretic dose and filling pressures observed in the study [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Another hypothesis is that LDT is a major driver of worse clinical outcomes. Background-matched comparisons between patients receiving LDT and those not receiving LDT would further strengthen causal inference. Because LDT prescription was left entirely to the discretion of treating clinicians [&lt;span&gt;1&lt;/span&gt;], confounding by indication is unavoidable (i.e., patients with more severe congestion tend to receive LDT). Although the authors appropriately acknowledge this limitation, advanced statistical approaches such as propensity score matching or inverse probability weighting could provide additional insights into whether LDT independently contributes to mortality risk beyond reflecting advanced cardiac damage.&lt;/p&gt;&lt;p&gt;If LDT is rather the major driver of worse clinical outcomes, the potential role of alternative or adjunctive therapies deserves consideration. If LDT is associated with renal dysfunction or neuro-hormonal activation, partial substitution with other agents—such as vasopressin V2 receptor antagonists or sodium–glucose cotransporter-2 inhibitors","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146028525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Age on Improvement in Health-Related Quality of Life After Percutaneous Coronary Intervention","authors":"Laura Lappalainen,&nbsp;Piia Lavikainen,&nbsp;Risto P. Roine,&nbsp;Harri Sintonen,&nbsp;Janne Martikainen,&nbsp;Anna-Maija Tolppanen,&nbsp;Juha Hartikainen","doi":"10.1002/clc.70260","DOIUrl":"10.1002/clc.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Percutaneous coronary intervention (PCI) is the first-line therapy in patients scheduled for coronary revascularization, aiming to relieve symptoms of coronary artery disease (CAD) and improve health-related quality of life (HRQoL) and prognosis. Particularly, in older adults, symptom alleviation and HRQoL are emphasized. However, it is not known whether older patients benefit from PCI equally to their younger peers. We used disease-specific and generic instruments to evaluate the improvement in HRQoL after PCI, comparing changes in three age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Altogether 300 patients undergoing PCI were divided into three age groups: ≥ 75 years (<i>n</i> = 89), 66–74 years (<i>n</i> = 117), and ≤ 65 years (<i>n</i> = 94). HRQoL was measured using the disease-specific Seattle Angina Questionnaire (SAQ-7) and the generic 15D instrument at baseline, one, and 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Statistically and clinically significant improvements in the SAQ-7 and 15D scores were observed after one- and 12-month follow-up in all age groups. There were no differences in the 12-month improvements in the SAQ-7 and 15D scores between the groups. The 15D score started to decline after 1 month, particularly in the oldest group. The decline was associated with age-related rather than CAD-related 15D dimensions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings on comparable improvement in disease-specific and generic HRQoL after PCI in older and younger patients are encouraging, particularly considering that the aims of PCI in older adults are predominantly symptom alleviation and improvement of daily activities. In addition, to overcome age-related changes in HRQoL, a disease-specific instrument should be incorporated in the evaluation of PCI on HRQoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical trial registration</h3>\u0000 \u0000 <p>5101114.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"States With Highest and Lowest Cardiovascular Disease-Related Mortality in the United States (1999−2019): Top and Bottom 3","authors":"Muhammad Umer Sohail,&nbsp;Ruqiat Masooma Batool,&nbsp;Muhammad Saad,&nbsp;Saad Ahmed Waqas,&nbsp;Asad Ali Ahmed Cheema,&nbsp;Abdul Mannan Khan Minhas","doi":"10.1002/clc.70256","DOIUrl":"10.1002/clc.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite declines since the 1960s, cardiovascular diseases (CVDs) remain the leading cause of mortality in the United States. However, recent data indicate stabilization or increases in certain regions, highlighting persistent disparities. This study analyzes trends in states with the highest and lowest CVD-related age-adjusted mortality rates (AAMRs) from 1999 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using CDC WONDER, we conducted a retrospective analysis of CVD-related mortality in adults aged ≥ 25 years. AAMRs were calculated using ICD-10 codes I00-I99, and trends were assessed using Joinpoint regression for annual percent change (APC) and average annual percent change (AAPC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 1999 and 2019, national AAMR declined from 798.47 to 595.56 per 100 000 (AAPC: −1.5%, 95% CI: −1.8% to −1.2%). Mississippi had the highest AAMR (902.23) with the slowest decline, whereas Arizona had the lowest (530.40) with a steeper reduction. Males (702.15), non-Hispanic Black individuals (850.32), and nonmetropolitan populations (645.21) had persistently higher mortality. Urban-rural disparities widened over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>State-level variations in CVD mortality reflect persistent socioeconomic, behavioral, and healthcare disparities. These findings highlight widening regional gaps and emphasize the need for stronger, state-specific public health strategies, improved access to preventive care, and targeted interventions for disproportionately affected groups. Strengthening surveillance systems, expanding evidence-based cardiovascular prevention programs, and addressing structural determinants of health will be essential to reduce the observed disparities and sustain long-term progress in CVD mortality reduction across the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12809465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apical Sparing of Longitudinal Strain and Myocardial Fibrosis in Hypertensive Patients and Spontaneously Hypertensive Rats: Based on Speckle Tracking and Histological Analysis","authors":"Chunyan Huang,&nbsp;Yongxin Wu,&nbsp;Meiyan Lin,&nbsp;Yupeng Chen,&nbsp;Shengnan Lin,&nbsp;Liyun Fu,&nbsp;Huimei Huang","doi":"10.1002/clc.70255","DOIUrl":"10.1002/clc.70255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to investigate regional myocardial strain and fibrosis distribution to analyze the apical sparing pattern and the relation with hypertrophy in hypertension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included clinical and experimental animal investigations. Seventy-three hypertensive patients were divided into two groups: hypertension without left ventricular hypertrophy (HT-NLVH) and hypertension with LVH (HT-LVH). Six 16-week-old male spontaneously hypertensive rats (SHR) and six age-matched male Wistar-Kyoto (WKY) rats were included in this experiment. Echocardiographic measurements were obtained. Myocardial strain indexes, including global longitudinal strain (GLS), the basal, middle, and apical segmental LS (LS-bas, LS-mid, LS-ap), and the proportion of LS-ap/(LS-bas + LS-mid + LS-ap) (P-ap) were measured. The histological collagen volume fraction (CVF) and perivascular collagen area (PVCA) of basal and apical segments (CVF-bas, CVF-ap, PVCA-bas, PVCA-ap) were observed in all rats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite preserved systolic function (FS, LVEF), the HT-NLVH and HT-LVH groups exhibited diastolic impairment (elevated LAVI, E/e’) (all <i>p</i> &lt; 0.05). LS-ap declined only in HT-LVH, while LS-mid and LS-bas worsened from HT-NLVH to HT-LVH, and the HT-LVH group exhibited a significantly elevated P-ap (all <i>p</i> &lt; 0.05). P-ap was associated with LV remodeling indexes and E/e’ (all <i>p</i> &lt; 0.05). Compared with WKY, LS-bas decreased in SHR (<i>p</i> &lt; 0.05). The SHR group demonstrated significantly elevated PVCA-bas, PVCA-ap, and CVF-bas (<i>p</i> &lt; 0.05), while the CVF-ap had no significant difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Myocardial dysfunction and fibrosis exhibited regional heterogeneity with predominant basal damage and apical sparing in hypertensive cardiac hypertrophy. This apical-sparing pattern correlated significantly with both diastolic dysfunction and hypertrophic progression, suggesting its potential as a clinically observable hallmark.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"49 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12805527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}