Journal of Cardiovascular Medicine最新文献

Background: Differences in prevalence of cardiovascular risk factors, prevention of cardiovascular disease and cardiovascular outcomes in migrants are well established when compared with host populations. Less is known, however, with respect to acute coronary syndrome (ACS), its occurrence and possible differences in management and outcome in immigrant populations. We therefore aimed in this study to assess in a comparative analysis possible differences in the occurrence and outcome of ACS between immigrants and the host population in a real-world setting.

Methods: Patients urgently admitted to the acute cardiac care unit (ACCU) for ACS were included in the study: in-hospital survival outcome was analyzed and immigrants were compared with the resident population.

Results: A total of 1199 consecutive patients were enrolled in the 2.5 years of the study: 40 (3.3%) were immigrants, mortality rate was 2.6%, mean hospital stay 7.7 ± 6 days. Hospitalized immigrants for ACS were in 65% of cases Eastern Europeans, 20% North-Africans-Middle-Easterns. Annual incidence of hospitalization in the ACCU for ACS was 0.18% in immigrants vs. 0.30% in residents (P = 0.0010); in-hospital death rates were comparable (2.5% vs. 2.6%, P = n.s.). When split for background world region, mortality rates were highest in the Eastern-Europe an women (10%, P = n.s.).

Conclusions: In an observational study on ACCU hospitalized ACS patients, ACS occurrence was lower in immigrants when compared with residents, while clinical outcomes were comparable. Among immigrants, worse prognosis and higher female prevalence were observed in the Eastern-European group; less ACS was found among women from Africa and the Middle East.

The 2025 Focused Update of the 2019  ESC/EAS Guidelines for the management of dyslipidaemias incorporates significant new evidence from major randomized controlled trials, as well as relevant systematic reviews and meta-analyses published since 2019 and up until 31 March 2025. The Update targets specific areas in which new data on prognostics models, diagnostic accuracy studies and therapeutics, including assessment of risk-benefit ratios, could immediately influence clinical practice, providing revised or new recommendations.

Objective: Air pollution contributes to cardiovascular diseases through oxidative stress, inflammation, autonomic nervous system imbalance, and direct particle translocation. This study examines the relationship between air pollution parameters and risk factors in patients presenting with ST-elevation myocardial infarction (STEMI).

Methods: This prospective, cross-sectional study included STEMI patients aged at least 18 years in a tertiary hospital. Demographics, comorbidities, seasonal variations, comorbidities, vital signs, hourly air pollution and weather parameters on admission, hospital length of stay, treatment modalities, and outcomes were recorded.

Results: Among 1413 patients, 75.1% were men. The median age of female patients [65 (IQR: 58-73)] was significantly higher that of than males [55 (IQR: 50-66), P < 0.001]. Median air quality index (AQI) [53 (IQR: 37-55)] and particulate matter (PM2.5) levels [18 (IQR: 11-27)] on admission were above Environmental Protection Agency limits. Patients with prior coronary artery disease (P = 0.037) and female patients (P = 0.018) had significantly lower PM10 exposure. PM2.5 levels were significantly higher in patients aged >75 years [20.5 (IQR: 13-29)] than in younger patients [18 (IQR: 11-27), P = 0.022]. Those recommended for coronary artery bypass grafting had lower sulfur dioxide levels [6 (IQR: 4-9) vs. 8 (IQR: 5-13), P = 0.003].

Conclusion: When AQI and PM2.5 levels exceed EPA limits, they may interact with cardiovascular risk factors such as age, sex, and comorbidities, contributing to the development of STEMI. Elderly individuals, women, and those with a history of cardiovascular disease may be more susceptible to the adverse effects of air pollution.

Aim: To identify risk factors that may be associated with lack of improvement in quality of life (QoL) in patients undergoing transcatheter aortic valve implantation (TAVI).

Methods: We analyzed data from 116 patients with severe aortic stenosis (AS) undergoing TAVI in a tertiary center. QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) at baseline and then at 1-3 months (first follow-up with a bounded time frame), 6 months and 12 months after the procedure. The primary outcome was the MLHFQ score, with higher scores indicating worse QoL. Mixed-effects modeling was used to evaluate predictors of longitudinal changes in QoL.

Results: The mean MLHFQ score improved significantly from 41.1 ± 16.6 at baseline to 23.4 ± 10 at 12 months (P < 0.001), indicating enhanced QoL post-TAVI. However, several variables were associated with worse QoL trajectories over time. These included peripheral artery disease (PAD), paravalvular leak (PVL) ≥ grade 2, contrast-induced nephropathy, moderate-to-severe tricuspid regurgitation, pulmonary hypertension (PH), elevated creatinine, lower hemoglobin, reduced left ventricular ejection fraction, and increased left atrial diameter. PAD and PVL were consistent predictors of impaired QoL both early and late after TAVI.

Conclusion: TAVI significantly improves QoL in most patients with severe AS, but certain comorbidities and complications - particularly PAD, PVL, and PH are associated with suboptimal recovery. Identifying these risk factors may help guide individualized follow-up and supportive strategies to optimize patient-centered outcomes.