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Chronotropic Incompetence across Heart Failure Categories. 不同心力衰竭类型的慢性失代偿能力。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-28 DOI: 10.1093/eurjpc/zwae348
Damiano Magrì, Massimo Piepoli, Giovanna Gallo, Emiliano Fiori, Michele Correale, Andrea Attanasio, Matteo Beltrami, Attilio Lauretti, Alberto Palazzuoli, Piergiuseppe Agostoni

The HF syndrome is characterized by an autonomic unbalance with sympathetic hyperactivity which contributes to increased myocardial oxygen demand, oxidative stress, peripheral vasoconstriction, afterload mismatch with a progressive desensitization and down-regulation of cardiac β1-receptors. These changes, together with a few other structural and peripheral changes, lead to chronotropic incompetence (CI), such as the inability to increase heart rate (HR) consistently with activity or demand. CI, regardless of the method and cut-off adopted to define it, is associated with reduced exercise capacity and a worse prognosis. Furthermore, different pharmacological classes might interfere with the physiologic exercise-induced HR response, thus generating some confusion. In particular, the β-blockers, albeit lowering peak HR, are known to improve prognosis and left ventricular inotropic reserve so that their withdrawal should be avoided at least in HF with reduced and mildly reduced ejection fraction. Similarly, a still debated strategy to counterbalance a blunted exercise-induced HR response, is represented by rate-adapting pacing. The present review, besides supplying an overview on possible CI definitions, discusses the clinical impact of CI and potential pharmacological and non-pharmacological therapeutic strategies.

心房颤动综合征的特点是交感神经亢进导致的自律神经失衡,交感神经亢进导致心肌需氧量增加、氧化应激、外周血管收缩、后负荷不匹配以及心脏β1受体的逐渐脱敏和下调。这些变化,再加上其他一些结构和外周变化,导致了促时性失调(CI),如心率(HR)不能随活动或需求而持续增加。无论采用哪种方法和临界值来定义 CI,CI 都与运动能力下降和预后恶化有关。此外,不同的药物类别可能会干扰生理性运动诱导的心率反应,从而产生一些混淆。尤其是β受体阻滞剂,虽然会降低峰值心率,但已知会改善预后和左心室肌力储备,因此至少在射血分数减低和轻度减低的房颤患者中应避免停用β受体阻滞剂。同样,速率适应性起搏也是一种仍有争议的策略,用于平衡运动引起的心率反应减弱。本综述除了概述可能的 CI 定义外,还讨论了 CI 的临床影响以及潜在的药物和非药物治疗策略。
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引用次数: 0
Safety of beta-blocker discontinuation after acute coronary syndromes with preserved or mildly reduced left ventricular ejection fraction: a target trial emulation from a real-world cohort. 左心室射血分数保留或轻度降低的急性冠状动脉综合征后停用β-受体阻滞剂的安全性:来自真实世界队列的目标试验模拟。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-26 DOI: 10.1093/eurjpc/zwae346
Nicolas Johner, Mattia Branca, David Carballo, Stéphanie Baggio, David Nanchen, Elena Tessitore, Lorenz Räber, Thomas Felix Lüscher, Christian M Matter, Stephan Windecker, Nicolas Rodondi, François Mach, Baris Gencer

Aims: The benefit of long-term beta-blocker therapy after acute coronary syndromes (ACS) without heart failure in the reperfusion era is uncertain. Two recent randomized trials found conflicting results. The present study assessed the safety of beta-blocker discontinuation within 12 months following ACS with LVEF ≥40%.

Methods: In a multicentre prospective real-world cohort (N=3,762) of patients hospitalized for ACS, patients with LVEF ≥40% and beta-blockers at discharge were included. Patients who continued beta-blockers at one year were compared with those who discontinued beta-blockers within 12 months post-ACS using target trial emulation and inverse probability weighting over an additional four-year follow-up. The primary endpoint was major adverse cardiovascular events (MACE), a composite of four-year cardiovascular death, myocardial infarction, stroke, transient ischemic attack, unplanned coronary revascularization, or unstable angina hospitalization.

Results: Of 2,077 patients, 1,758 (85%) continued beta-blockers and 319 (15%) had discontinued beta-blockers at one year. The risk of primary endpoint was similar in both groups (14.1% versus 14.3% with beta-blocker discontinuation versus continuation; adjusted hazard ratio [aHR]=0.98; 95% confidence interval, 0.72-1.34, P=0.91). Subgroup analysis suggested a higher risk of primary endpoint with beta-blocker discontinuation after STEMI (aHR=1.46 [0.99-2.16]) compared to NSTEMI (aHR=0.70 [0.40-1.22], Pinteraction=0.033), whereas there was no interaction with LVEF (Pinteraction=0.68).

Conclusions: Beta-blocker discontinuation within 12 months following ACS with LVEF ≥40% was not associated with an increased risk of MACE compared to long-term beta-blocker therapy. Subgroup analysis suggested potential risk in STEMI patients. Discontinuing beta-blockers 12 months after ACS appears safe in patients with LVEF ≥40%, particularly after NSTEMI.

目的:在再灌注时代,急性冠状动脉综合征(ACS)后无心力衰竭者长期接受β-受体阻滞剂治疗的益处尚不确定。最近的两项随机试验发现了相互矛盾的结果。本研究评估了LVEF≥40%的急性冠状动脉综合征后12个月内停用β-受体阻滞剂的安全性:在一项多中心前瞻性真实世界队列(N=3,762)中,纳入了因 ACS 住院的 LVEF ≥40% 且出院时服用过β-受体阻滞剂的患者。在为期四年的随访中,采用目标试验仿真和反概率加权法,将在一年后继续使用β-受体阻滞剂的患者与在ACS后12个月内停用β-受体阻滞剂的患者进行比较。主要终点是主要不良心血管事件(MACE),即四年内心血管死亡、心肌梗死、中风、短暂性脑缺血发作、非计划性冠状动脉血运重建或不稳定型心绞痛住院的综合结果:在2077名患者中,有1758人(85%)继续服用β-受体阻滞剂,319人(15%)在一年后停用了β-受体阻滞剂。两组患者的主要终点风险相似(停用β-受体阻滞剂与继续使用β-受体阻滞剂的风险分别为14.1%和14.3%;调整后危险比[aHR]=0.98;95%置信区间为0.72-1.34,P=0.91)。亚组分析表明,与NSTEMI(aHR=0.70 [0.40-1.22],Pinteraction=0.033)相比,STEMI(aHR=1.46 [0.99-2.16])后停用β受体阻滞剂的主要终点风险更高,而与LVEF(Pinteraction=0.68)无交互作用:与长期β-受体阻滞剂治疗相比,LVEF≥40%的ACS患者在12个月内停用β-受体阻滞剂与MACE风险增加无关。亚组分析表明 STEMI 患者存在潜在风险。对于 LVEF ≥40% 的患者,尤其是 NSTEMI 患者,在 ACS 后 12 个月停用β-受体阻滞剂似乎是安全的。
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引用次数: 0
Comparison of exercise training modalities and change in peak oxygen consumption in heart failure with preserved ejection fraction: a secondary analysis of the OptimEx-Clin trial. 运动训练模式与射血分数保留型心力衰竭患者峰值耗氧量变化的比较:OptimEx-Clin 试验的二次分析。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-25 DOI: 10.1093/eurjpc/zwae332
Stephan Mueller, Marina Kabelac, Isabel Fegers-Wustrow, Ephraim B Winzer, Andreas B Gevaert, Paul Beckers, Bernhard Haller, Frank Edelmann, Jeffrey W Christle, Mark J Haykowsky, Vandana Sachdev, Dalane W Kitzman, Axel Linke, Volker Adams, Ulrik Wisloff, Burkert Pieske, Emeline van Craenenbroeck, Martin Halle

Aims: Exercise training (ET) is an effective therapy in heart failure with preserved ejection fraction (HFpEF), but the influence of different ET characteristics is unclear. We aimed to evaluate the associations between ET frequency, duration, intensity [% heart rate reserve (%HRR)] and estimated energy expenditure (EEE) with the change in peak oxygen consumption (V̇O2) over 3 months of moderate continuous training (MCT, 5×/week) or high-intensity interval training (HIIT, 3×/week) in HFpEF.

Methods and results: ET duration and heart rate (HR) were recorded with a smartphone application. EEE was calculated using the HR data during ET and the individual HR-V̇O2 relationships during cardiopulmonary exercise testing. Differences between groups and associations between ET characteristics and peak V̇O2 change were assessed with linear regression analyses. Peak V̇O2 improved by 9.2 ± 13.2% after MCT and 8.7 ± 15.9% after HIIT (P = 0.67). The average EEE of 1 HIIT session was equivalent to ∼1.42 MCT sessions and when adjusted for EEE, the mean difference between MCT and HIIT was -0.1% (P = 0.98). For both MCT and HIIT, peak V̇O2 change was positively associated with ET frequency (MCT: R2 = 0.103; HIIT: R2 = 0.149) and duration/week (MCT: R2 = 0.120; HIIT: R2 = 0.125; all P < 0.05). Average %HRR was negatively associated with peak V̇O2 change in MCT (R2 = 0.101; P = 0.034), whereas no significant association was found in HIIT (P = 0.234). Multiple regression analyses explained ∼1/3 of the variance in peak V̇O2 change.

Conclusion: In HFpEF, isocaloric HIIT and MCT seem to be equally effective over 3 months. Within each mode, increasing ET frequency or duration/week may be more effective to improve peak V̇O2 than increasing ET intensity.

目的:运动训练(ET)是射血分数保留型心力衰竭(HFpEF)的一种有效疗法,但不同ET特征的影响尚不清楚。我们的目的是评估在中度持续训练(MCT,5×/周)或高强度间歇训练(HIIT,3×/周)的3个月期间,ET频率、持续时间、强度[心率储备百分比(%HRR)]和估计能量消耗(EEE)与HFpEF峰值耗氧量(V.M.O2)变化之间的关系:使用智能手机应用程序记录 ET 持续时间和心率(HR)。使用 ET 期间的心率数据和心肺运动测试期间的单个 HR-V̇O2 关系计算 EEE。通过线性回归分析评估了组间差异以及ET特征与峰值V̇O2变化之间的关联。MCT 后峰值 V̇O2 提高了 9.2 ± 13.2%,HIIT 后提高了 8.7 ± 15.9%(P = 0.67)。1 次 HIIT 的平均 EEE 相当于 1.42 次 MCT,经 EEE 调整后,MCT 和 HIIT 的平均差异为-0.1%(P = 0.98)。对于 MCT 和 HIIT,峰值 V̇O2 变化与 ET 频率(MCT:R2 = 0.103;HIIT:R2 = 0.149)和持续时间/周(MCT:R2 = 0.120;HIIT:R2 = 0.125;所有 P <0.05)呈正相关。在 MCT 中,平均 HRR%与峰值 V̇O2 变化呈负相关(R2 = 0.101;P = 0.034),而在 HIIT 中未发现显著的相关性(P = 0.234)。多元回归分析解释了峰值 V̇O2 变化的 1 ∼ 1/3:结论:在HFpEF中,3个月内等热量HIIT和MCT似乎同样有效。在每种模式中,增加 ET 频率或持续时间/周可能比增加 ET 强度更能有效改善峰值 V̇O2。
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引用次数: 0
Novel risk score for predicting acute cardiovascular and cerebrovascular events after chest radiotherapy in patients with breast or lung cancer. 预测乳腺癌或肺癌患者胸部放疗后急性心脑血管事件的新型风险评分。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-25 DOI: 10.1093/eurjpc/zwae323
Anan Abu Rmilah, Alkurashi Adham, Haq Ikram-Ul, Hossam Alzu'bi, Anevakar Nandan, Hayan Jouni, Satomi Hirashi, Dawn Owen, Anita Deswal, Steven H Lin, Jun-Ichi Abe, Tzu Cheng Chao, Jacinta Browne, Tim Leiner, Nadia Laack, Joerg Herrmann

Aims: Radiation therapy (RT) is an integral component of cancer therapy but associated with adverse events. Our goal was to establish risk prediction models for major adverse cardiovascular and cerebrovascular events (MACCE) after chest RT.

Methods and results: A retrospective study of lung/breast cancer patients who had chest RT with planning CT at Mayo Clinic between 01/2010 and 01/2014. Predictive models were developed based on weighted independent predictors using a derivation (406 lung and 711 breast cancer) and validation cohort (179 lung and 234 breast cancer). Patient characteristics, pre-RT CT for coronary artery calcification (CAC), and post-RT MACCE data were reviewed. Post-RT MACCE occurred in 6.1 and 5.6% in the derivation and validation cohort over a mean follow-up of 42 ± 13 months. Post-therapy model (C2AD2) included CAC (two points), MACCE history (two points), age ≥74 (three points), DM (two points), and mean heart radiation dose ≥ 850 mGy (two points), and pre-therapy model (C2AD) included post-therapy model parameters minus mean heart radiation dose. Both models stratified patients into three risk groups: low (0-2), intermediate (3-5), and high (≥6). Post-RT MACCE across these groups were 2.7, 8.9, and 19.8% in the derivation, and 3.9, 6.6, and 16.4% in the validation cohort for post-therapy model (C2AD2) and 2.8, 9.2, and 20.4% in the derivation and 3.7, 9.2, and 13.2% in the validation cohort for pre-therapy model. Both models showed statistically significant graded survival outcome.

Conclusion: Post-therapy (C2AD2) and pre-therapy (C2AD) models are simple, easy to use and effective tools to stratify breast and lung cancer patients undergoing chest radiation for post-RT MACCE.

目的:放射治疗(RT)是癌症治疗不可或缺的组成部分,但与不良事件相关。我们的目标是建立胸部 RT 后主要心脑血管不良事件 (MACCE) 的风险预测模型:对 2010 年 1 月 1 日至 2014 年 1 月 1 日期间在梅奥诊所接受胸部 RT 和计划 CT 的肺癌/乳腺癌患者进行回顾性研究。利用衍生队列(406 例肺癌和 711 例乳腺癌)和验证队列(179 例肺癌和 234 例乳腺癌),基于加权独立预测因子建立了预测模型。对患者特征、RT 前冠状动脉钙化 (CAC) CT 和 RT 后 MACCE 数据进行了审查。在平均 42 ± 13 个月的随访中,推导组和验证组分别有 6.1% 和 5.6% 的患者在 RT 后出现 MACCE。治疗后模型(C2AD2)包括CAC(两点)、MACCE病史(两点)、年龄≥74岁(三点)、糖尿病(两点)和平均心脏辐射剂量≥850 mGy(两点),而治疗前模型(C2AD)包括治疗后模型参数减去平均心脏辐射剂量。两种模型都将患者分为三个风险组:低(0-2)、中(3-5)和高(≥6)。对于治疗后模型 (C2AD2),这些组别的 RT 后 MACCE 分别为推导组的 2.7%、8.9% 和 19.8%,验证组的 3.9%、6.6% 和 16.4%;对于治疗前模型,推导组的 MACCE 分别为推导组的 2.8%、9.2% 和 20.4%,验证组的 3.7%、9.2% 和 13.2%。两种模型均显示出具有统计学意义的分级生存结果:治疗后(C2AD2)和治疗前(C2AD)模型是对接受胸部放射治疗的乳腺癌和肺癌患者进行放射治疗后澳门巴黎人娱乐官网分层的简单、易用且有效的工具。
{"title":"Novel risk score for predicting acute cardiovascular and cerebrovascular events after chest radiotherapy in patients with breast or lung cancer.","authors":"Anan Abu Rmilah, Alkurashi Adham, Haq Ikram-Ul, Hossam Alzu'bi, Anevakar Nandan, Hayan Jouni, Satomi Hirashi, Dawn Owen, Anita Deswal, Steven H Lin, Jun-Ichi Abe, Tzu Cheng Chao, Jacinta Browne, Tim Leiner, Nadia Laack, Joerg Herrmann","doi":"10.1093/eurjpc/zwae323","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae323","url":null,"abstract":"<p><strong>Aims: </strong>Radiation therapy (RT) is an integral component of cancer therapy but associated with adverse events. Our goal was to establish risk prediction models for major adverse cardiovascular and cerebrovascular events (MACCE) after chest RT.</p><p><strong>Methods and results: </strong>A retrospective study of lung/breast cancer patients who had chest RT with planning CT at Mayo Clinic between 01/2010 and 01/2014. Predictive models were developed based on weighted independent predictors using a derivation (406 lung and 711 breast cancer) and validation cohort (179 lung and 234 breast cancer). Patient characteristics, pre-RT CT for coronary artery calcification (CAC), and post-RT MACCE data were reviewed. Post-RT MACCE occurred in 6.1 and 5.6% in the derivation and validation cohort over a mean follow-up of 42 ± 13 months. Post-therapy model (C2AD2) included CAC (two points), MACCE history (two points), age ≥74 (three points), DM (two points), and mean heart radiation dose ≥ 850 mGy (two points), and pre-therapy model (C2AD) included post-therapy model parameters minus mean heart radiation dose. Both models stratified patients into three risk groups: low (0-2), intermediate (3-5), and high (≥6). Post-RT MACCE across these groups were 2.7, 8.9, and 19.8% in the derivation, and 3.9, 6.6, and 16.4% in the validation cohort for post-therapy model (C2AD2) and 2.8, 9.2, and 20.4% in the derivation and 3.7, 9.2, and 13.2% in the validation cohort for pre-therapy model. Both models showed statistically significant graded survival outcome.</p><p><strong>Conclusion: </strong>Post-therapy (C2AD2) and pre-therapy (C2AD) models are simple, easy to use and effective tools to stratify breast and lung cancer patients undergoing chest radiation for post-RT MACCE.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intra-individual Variability in Lipoprotein(a) Levels: Findings from a Large Academic Health System Population. 脂蛋白(a)水平的个体内变异性:大型学术卫生系统人群的研究结果。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-24 DOI: 10.1093/eurjpc/zwae341
Kamal Awad, Ahmed K Mahmoud, Mohammed Tiseer Abbas, Said Alsidawi, Chadi Ayoub, Reza Arsanjani, Juan M Farina

Aims: Lipoprotein(a) [Lp(a)] levels are known to be mainly genetically determined. However, only scarce data are available on the intra-individual variability of Lp(a) levels across time.

Methods: We included adult patients (≥18 years old) who had baseline and follow-up Lp(a) measurements (between 1997 and 2024) with a minimum of one year apart. Patients were categorized into three groups as follows: normal (<30 mg/dL), borderline (30 to 50 mg/dL) and high Lp(a) (≥50 mg/dL). Multivariable logistic regression was conducted to assess the predictors of the intra-individual changes in Lp(a) ≥10 mg/dL.

Results: A total of 11,669 individuals (median age: 54 years, 60% males) were included in our analysis, with median time between measurements of 4.5 years (IQR: 2.2, 10.6). The median Lp(a) was 16 mg/dL (IQR: 7, 52) at baseline, compared with 15 mg/dL (IQR: 7, 52) at follow-up. At follow-up, 96.4% of individuals with normal Lp(a) and 89.9% with high Lp(a) remained in their categories, while 51.2% with borderline Lp(a) changed their category. Of the included population, 24.9% had an intra-individual Lp(a) change ≥10 mg/dL. Female sex (p <0.001), history of ASCVD (p=0.003), statin therapy (p=0.003) and elevated low-density lipoprotein cholesterol (LDL-C) levels ≥100 mg/dL (p <0.001) were significantly associated with higher odds of intra-individual Lp(a) changes ≥10 mg/dL.

Conclusions: Lipoprotein(a) levels were generally stable over time; however, patients with borderline levels may require more than one Lp(a) measurement, especially if they are females, have a history of ASCVD, have elevated LDL-C levels or are on statins therapy.

目的:众所周知,脂蛋白(a)[Lp(a)]水平主要由基因决定。然而,关于脂蛋白(a)水平在不同时期的个体内变异性的数据却很少:我们纳入了对脂蛋白(a)进行基线和随访测量(1997 年至 2024 年)的成年患者(≥18 岁),测量时间至少间隔一年。患者被分为以下三组:正常组(结果:共有 11,669 人(中位年龄:54 岁,60% 为男性)被纳入我们的分析,两次测量之间的中位时间为 4.5 年(IQR:2.2,10.6)。基线时脂蛋白(a)的中位数为 16 毫克/分升(IQR:7,52),而随访时为 15 毫克/分升(IQR:7,52)。随访时,96.4% 的脂蛋白(a)正常者和 89.9% 的脂蛋白(a)偏高者仍保持其类别,而 51.2% 的脂蛋白(a)边缘者改变了类别。在纳入的人群中,24.9%的人体内脂蛋白(a)的变化≥10 mg/dL。女性随着时间的推移,脂蛋白(a)水平基本保持稳定;但是,脂蛋白(a)水平处于边缘的患者可能需要进行一次以上的脂蛋白(a)测量,尤其是女性、有 ASCVD 病史、低密度脂蛋白胆固醇水平升高或正在接受他汀类药物治疗的患者。
{"title":"Intra-individual Variability in Lipoprotein(a) Levels: Findings from a Large Academic Health System Population.","authors":"Kamal Awad, Ahmed K Mahmoud, Mohammed Tiseer Abbas, Said Alsidawi, Chadi Ayoub, Reza Arsanjani, Juan M Farina","doi":"10.1093/eurjpc/zwae341","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae341","url":null,"abstract":"<p><strong>Aims: </strong>Lipoprotein(a) [Lp(a)] levels are known to be mainly genetically determined. However, only scarce data are available on the intra-individual variability of Lp(a) levels across time.</p><p><strong>Methods: </strong>We included adult patients (≥18 years old) who had baseline and follow-up Lp(a) measurements (between 1997 and 2024) with a minimum of one year apart. Patients were categorized into three groups as follows: normal (<30 mg/dL), borderline (30 to 50 mg/dL) and high Lp(a) (≥50 mg/dL). Multivariable logistic regression was conducted to assess the predictors of the intra-individual changes in Lp(a) ≥10 mg/dL.</p><p><strong>Results: </strong>A total of 11,669 individuals (median age: 54 years, 60% males) were included in our analysis, with median time between measurements of 4.5 years (IQR: 2.2, 10.6). The median Lp(a) was 16 mg/dL (IQR: 7, 52) at baseline, compared with 15 mg/dL (IQR: 7, 52) at follow-up. At follow-up, 96.4% of individuals with normal Lp(a) and 89.9% with high Lp(a) remained in their categories, while 51.2% with borderline Lp(a) changed their category. Of the included population, 24.9% had an intra-individual Lp(a) change ≥10 mg/dL. Female sex (p <0.001), history of ASCVD (p=0.003), statin therapy (p=0.003) and elevated low-density lipoprotein cholesterol (LDL-C) levels ≥100 mg/dL (p <0.001) were significantly associated with higher odds of intra-individual Lp(a) changes ≥10 mg/dL.</p><p><strong>Conclusions: </strong>Lipoprotein(a) levels were generally stable over time; however, patients with borderline levels may require more than one Lp(a) measurement, especially if they are females, have a history of ASCVD, have elevated LDL-C levels or are on statins therapy.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Small Bouts, Big Impact: The Role of Incidental Physical Activity in Cardiovascular Prevention. 小运动,大影响:偶然的体育活动在心血管预防中的作用》。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-24 DOI: 10.1093/eurjpc/zwae338
Kyuwan Lee, Mi-Hyang Jung
{"title":"Small Bouts, Big Impact: The Role of Incidental Physical Activity in Cardiovascular Prevention.","authors":"Kyuwan Lee, Mi-Hyang Jung","doi":"10.1093/eurjpc/zwae338","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae338","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Coronary Artery Calcium Predict the Risk of Major Cardiovascular Events from Radiotherapy? 冠状动脉钙化能否预测放疗导致重大心血管事件的风险?
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-23 DOI: 10.1093/eurjpc/zwae325
Wee Loon Ng, Choon Ta Ng, Terrance Chua
{"title":"Can Coronary Artery Calcium Predict the Risk of Major Cardiovascular Events from Radiotherapy?","authors":"Wee Loon Ng, Choon Ta Ng, Terrance Chua","doi":"10.1093/eurjpc/zwae325","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae325","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lipid management in patients with atherosclerotic cardiovascular disease: it is time to apply the guidelines! 动脉粥样硬化性心血管疾病患者的血脂管理:是时候应用指南了!
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-22 DOI: 10.1093/eurjpc/zwae335
Marie Hauguel-Moreau, Maryam Kavousi
{"title":"Lipid management in patients with atherosclerotic cardiovascular disease: it is time to apply the guidelines!","authors":"Marie Hauguel-Moreau, Maryam Kavousi","doi":"10.1093/eurjpc/zwae335","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae335","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Severe infections as risk factors for acute myocardial infarction: a nationwide, Danish cohort study from 1987-2018. 严重感染是急性心肌梗死的风险因素:1987-2018 年丹麦全国范围内的队列研究。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-22 DOI: 10.1093/eurjpc/zwae344
Emilie Marie Juelstorp Pedersen, Harman Yonis, Gertrud Baunbæk Egelund, Nicolai Lohse, Christian Torp-Pedersen, Birgitte Lindegaard, Andreas Vestergaard Jensen

Aims: Infections have been associated with acute myocardial infarction (AMI), but differences in risk between infection types and age groups are unclear. This study aims to investigate whether infections are associated with subsequent AMI and whether the risk differs across infection sites and age groups.

Methods: Nationwide registers were used to include 702596 adults hospitalized between 1987-2018 with either; pneumonia (n=344319), urinary tract infection (UTI) (n=270101), soft tissue/bone infection (n=66718), central nervous system infection (CNS) (n=17025), or endocarditis (n=4433). Patients were sex- and age-matched with two unexposed controls. Outcome was first-time AMI within ten years. A time-dependent cox proportional hazards model with cut-offs at 30 and 90 days was used for calculating adjusted hazard ratios (HR).

Results: Pneumonia, UTI, and soft tissue/bone infection were associated with increased relative rates of AMI compared to matched, unexposed controls. Highest relative rates were found within the first 0-30 days post-exposure; Pneumonia: HR 3.39 (95% CI 3.15-3.65), UTI: HR 2.44 (95% CI 2.21-2.70), Soft tissue/bone infection: HR 1.84 (95% CI 1.45-2.33). Relative rates decreased over time but remained significantly elevated throughout the follow-up period and was increased in all age groups. No association was found for CNS infection and for endocarditis only at 31-90 days, HR 2.28 (95% CI 1.20-4.33).

Conclusion: Acute infections are associated with increased relative rates of AMI across different infection sites and age groups with higher relative rates found for pneumonia. This indicates that some infections may act as a trigger for AMI with a site and/or pathogen specific risk.

目的:感染与急性心肌梗死(AMI)有关,但感染类型和年龄组之间的风险差异尚不清楚。本研究旨在调查感染是否与随后发生的急性心肌梗死有关,以及不同感染部位和年龄组的风险是否存在差异:该研究使用全国性登记册,纳入了 1987-2018 年间因肺炎(n=344319)、尿路感染(UTI)(n=270101)、软组织/骨感染(n=66718)、中枢神经系统感染(CNS)(n=17025)或心内膜炎(n=4433)住院的 702596 名成人。患者的性别和年龄与两名未受感染的对照组相匹配。结果为十年内首次发生急性心肌梗死。计算调整后的危险比(HR)时,采用了以30天和90天为分界点的时间依赖性Cox比例危险模型:结果:与匹配的未暴露对照组相比,肺炎、UTI 和软组织/骨骼感染与急性心肌梗死的相对发生率增加有关。肺炎:HR 3.39 (95% CI 3.15-3.65),UTI:HR 2.44 (95% CI 2.21-2.70),软组织/骨骼感染:HR 1.84 (95% CI 3.15-3.65):HR 1.84 (95% CI 1.45-2.33)。随着时间的推移,相对比率有所下降,但在整个随访期间仍显著升高,并且在所有年龄组中都有所上升。中枢神经系统感染和心内膜炎在31-90天内没有相关性,HR为2.28(95% CI为1.20-4.33):结论:在不同感染部位和年龄组中,急性感染与急性心肌梗死的相对发生率增加有关,其中肺炎的相对发生率更高。这表明,某些感染可能是诱发急性心肌梗死的导火索,其风险与感染部位和/或病原体有关。
{"title":"Severe infections as risk factors for acute myocardial infarction: a nationwide, Danish cohort study from 1987-2018.","authors":"Emilie Marie Juelstorp Pedersen, Harman Yonis, Gertrud Baunbæk Egelund, Nicolai Lohse, Christian Torp-Pedersen, Birgitte Lindegaard, Andreas Vestergaard Jensen","doi":"10.1093/eurjpc/zwae344","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae344","url":null,"abstract":"<p><strong>Aims: </strong>Infections have been associated with acute myocardial infarction (AMI), but differences in risk between infection types and age groups are unclear. This study aims to investigate whether infections are associated with subsequent AMI and whether the risk differs across infection sites and age groups.</p><p><strong>Methods: </strong>Nationwide registers were used to include 702596 adults hospitalized between 1987-2018 with either; pneumonia (n=344319), urinary tract infection (UTI) (n=270101), soft tissue/bone infection (n=66718), central nervous system infection (CNS) (n=17025), or endocarditis (n=4433). Patients were sex- and age-matched with two unexposed controls. Outcome was first-time AMI within ten years. A time-dependent cox proportional hazards model with cut-offs at 30 and 90 days was used for calculating adjusted hazard ratios (HR).</p><p><strong>Results: </strong>Pneumonia, UTI, and soft tissue/bone infection were associated with increased relative rates of AMI compared to matched, unexposed controls. Highest relative rates were found within the first 0-30 days post-exposure; Pneumonia: HR 3.39 (95% CI 3.15-3.65), UTI: HR 2.44 (95% CI 2.21-2.70), Soft tissue/bone infection: HR 1.84 (95% CI 1.45-2.33). Relative rates decreased over time but remained significantly elevated throughout the follow-up period and was increased in all age groups. No association was found for CNS infection and for endocarditis only at 31-90 days, HR 2.28 (95% CI 1.20-4.33).</p><p><strong>Conclusion: </strong>Acute infections are associated with increased relative rates of AMI across different infection sites and age groups with higher relative rates found for pneumonia. This indicates that some infections may act as a trigger for AMI with a site and/or pathogen specific risk.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feeding the Future: The Intersection of the Planetary Health Diet and Cardiovascular Disease. 喂养未来:行星健康饮食与心血管疾病的交叉点。
IF 8.4 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-10-19 DOI: 10.1093/eurjpc/zwae342
Siobhan Hickling
{"title":"Feeding the Future: The Intersection of the Planetary Health Diet and Cardiovascular Disease.","authors":"Siobhan Hickling","doi":"10.1093/eurjpc/zwae342","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae342","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
European journal of preventive cardiology
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