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Patient-Physician Language Concordance, Antihypertensive Medications, and Cardiovascular Outcomes Among Allophone-Speaking Patients with Hypertension 患者-医师语言一致性、抗高血压药物和高血压患者的心血管预后
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 DOI: 10.1016/j.cjco.2025.09.010
Michael Reaume MD, MSc , Mathieu N. Labossière MD , Ricardo Batista MD, PhD , Navdeep Tangri MD, PhD , Claudio Rigatto MD, MSc , Clara Bohm MD, MPH , Denis Prud’homme MD, MSc , Peter Tanuseputro MD, MHSc , Lisa M. Lix PhD

Background

Patient-physician language concordance is associated with better outcomes. However, the mechanism(s) explaining these associations are poorly understood. Our objective was to determine if antihypertensive medication use mediates the association between patient-physician language concordance and major adverse cardiovascular events (MACEs).

Methods

Our population-based, retrospective cohort study used data from the Canadian Community Health Survey (CCHS) from January 1, 2003 to December 31, 2014. We identified Allophone-speaking respondents (ie, the language spoken most often at home is one other than English, French, or an Indigenous language) with self-reported hypertension. We defined patient-physician language concordance as agreement between language spoken most often at home and language spoken with one’s regular medical doctor. Survey responses were linked to hospitalization and mortality records. We identified all MACEs within 5 years after survey completion. The associations between patient-physician language concordance, antihypertensive medication use, and MACEs were explored using multivariable logistic and Cox proportional hazards regression, respectively. The mediating effect of antihypertensive medication use was tested with natural effect models.

Results

We studied 5013 Allophone-speaking patients, including 1708 (34.1%) who received language-concordant care and 3305 (65.9%) who received language-discordant care. Patients who received language-concordant care were 38% less likely to experience a MACE compared to patients who received language-discordant care (hazard ratio 0.62, 95% confidence interval 0.48-0.80). No evidence was found that this association was mediated by antihypertensive medication use.

Conclusions

Patient-physician language concordance was associated with a lower risk of a MACE. However, this association was not mediated by antihypertensive medication use. Further research could explore potentially modifiable mediators of this association.
背景:医患语言一致性与更好的预后相关。然而,解释这些关联的机制尚不清楚。我们的目的是确定抗高血压药物的使用是否介导了医患语言一致性和主要不良心血管事件(mace)之间的关联。方法采用2003年1月1日至2014年12月31日加拿大社区卫生调查(CCHS)的数据,进行基于人群的回顾性队列研究。我们确定了自我报告高血压的母语为全音素的受访者(即在家中最常使用的语言不是英语、法语或土著语言)。我们将医患语言一致性定义为在家中最常用的语言与与常规医生使用的语言之间的一致。调查答复与住院和死亡记录有关。我们在调查完成后的5年内确定了所有mace。采用多变量logistic回归和Cox比例风险回归分别探讨医患语言一致性、抗高血压药物使用和mace之间的关系。采用自然效应模型检验抗高血压药物使用的中介作用。结果本研究共纳入5013例异位语患者,其中1708例(34.1%)接受语言和谐护理,3305例(65.9%)接受语言不和谐护理。与接受语言不协调护理的患者相比,接受语言协调护理的患者发生MACE的可能性要低38%(风险比0.62,95%置信区间0.48-0.80)。没有证据表明这种关联是由使用抗高血压药物介导的。结论医患语言一致性与较低的MACE发生风险相关。然而,这种关联不是由抗高血压药物的使用介导的。进一步的研究可以探索这种关联的潜在可改变的介质。
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引用次数: 0
Interventions to Enhance Early Recognition and Management of Mental Health Symptoms in Patients with Cardiovascular Disease: A Rapid Scoping Review 加强心血管疾病患者心理健康症状早期识别和管理的干预措施:快速范围综述
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 DOI: 10.1016/j.cjco.2025.10.002
Omar Dewidar MSc , Anwar Abdi BSc , Hind Sabri BSc , Haben Dawit MSc , Sarisha Philip MPH , Victoria Barbeau BSc , Pierre Benoit MBA , Paulo Antunes MD , Jonathan Jetté MA , Joël Assaouré MBA , Diane Plourde MSc , Joy Seguin , Roland Sabbagh MD , Elie Skaff MD , Doug Archibald PhD , Vivian Welch PhD , Krystal Kehoe MacLeod PhD

Background

Poor mental health is a recognized risk factor for adverse cardiovascular outcomes, yet depression, anxiety, and stress remain underdiagnosed and undertreated in individuals with cardiovascular disease (CVD). Effective strategies to promote early recognition and management of these conditions are not well established. We conducted a rapid scoping review to identify interventions aimed at improving mental health recognition and management in adult CVD population without diagnosed mental health conditions.

Methods

We systematically searched MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, Web of Science, and Epistemonikos for articles published between January 1, 2014, and December 28, 2024.

Results

Of 11,645 screened studies, 24 met inclusion criteria: 12 systematic reviews and meta-analyses, and 12 randomized controlled trials (RCTs). Most focused on coronary artery disease or stroke patients. Interventions included mindfulness interventions (n = 9), routine screening (n = 2), interactive mHealth education (n = 2), psychosocial interventions (n = 4), caregiver education (n = 4), self-care (n = 1), and integrated care (n = 1). Interventions were multimodal pairing patient education with structured clinical encounters. Reporting of delivery methods was inconsistent and fewer than half assessed adherence. Only two RCTs involved patients in intervention design. Primary outcomes included changes in psychological distress symptoms and quality-of-life measures.

Conclusion

A variety of interventions target early recognition and management of mental health symptoms in CVD patients. The approach of combining self-management with clinician check-ins aligns with contemporary models of integrated care. Standardized reporting and greater interest-holder engagement are needed to improve intervention development, implementation, and evaluation.
心理健康状况不佳是公认的心血管不良后果的危险因素,但在心血管疾病(CVD)患者中,抑郁、焦虑和压力仍未得到充分诊断和治疗。促进早期识别和管理这些疾病的有效战略尚未很好地确立。我们进行了一项快速范围综述,以确定旨在改善未诊断出精神健康状况的成年CVD人群心理健康认知和管理的干预措施。方法系统检索MEDLINE、EMBASE、CENTRAL、PsycINFO、CINAHL、Web of Science和Epistemonikos,检索2014年1月1日至2024年12月28日发表的论文。结果在11,645项筛选研究中,24项符合纳入标准:12项系统评价和荟萃分析,12项随机对照试验(rct)。大多数集中于冠状动脉疾病或中风患者。干预措施包括正念干预(n = 9)、常规筛查(n = 2)、交互式移动健康教育(n = 2)、心理社会干预(n = 4)、照顾者教育(n = 4)、自我保健(n = 1)和综合护理(n = 1)。干预措施是多模式配对患者教育与有组织的临床接触。递送方法的报告不一致,只有不到一半的人评估了依从性。只有两项随机对照试验将患者纳入干预设计。主要结局包括心理困扰症状的改变和生活质量测量。结论多种干预措施有助于心血管疾病患者心理健康症状的早期识别和管理。将自我管理与临床医生检查相结合的方法符合当代综合护理模式。需要标准化的报告和更多的利益相关者参与,以改善干预措施的制定、实施和评估。
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引用次数: 0
Life-Threatening Left Atrial Thrombi: A Case Report and Review of Diagnosis and Management Approaches 危及生命的左心房血栓:1例报告及诊断与治疗方法回顾
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 DOI: 10.1016/j.cjco.2025.09.006
Gabriela Uriarte Zavala MD , Basilio Angulo-Lara MD , Daniel García Rodríguez MD , Isabel Dolores Poveda Pinedo MD , Susana Villar García MD
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引用次数: 0
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01
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引用次数: 0
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01
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引用次数: 0
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01
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引用次数: 0
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01
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引用次数: 0
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01
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引用次数: 0
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01
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引用次数: 0
Recurrence of Postoperative Atrial Fibrillation After Cardiac Surgery: Insights from a Tertiary Follow-Up Clinic 心脏手术后房颤复发:来自三级随访临床的见解
IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2026-01-01 DOI: 10.1016/j.cjco.2025.09.016
Rubani S. Suri BHSc , Emilie P. Belley-Côté MD, PhD , Siobhan M. Baigent CCPA , Nicole P. Veloce CCPA , Muneeb Ahmed MD , P.J. Devereaux MD, PhD , Jeff S. Healey MD, MSc , Richard P. Whitlock MD, PhD , William F. McIntyre MD, PhD

Background

New-onset postoperative atrial fibrillation (POAF) complicates 30% of cardiac surgeries. Although POAF is often transient, structured follow-up care of patients with POAF may identify those with paroxysmal or persistent atrial fibrillation (AF) who will benefit from evidence-based therapies.

Methods

This retrospective study includes patients seen in a clinic dedicated to patients with POAF after cardiac surgery between 2020 and 2024. Per the clinic’s operating procedure, patients wore a 14-day continuous ambulatory electrocardiogram (ECG) monitor fpr 2 months after surgery and were assessed thereafter in clinic. The primary outcome was recurrent AF lasting ≥ 30 seconds, captured by 14-day continuous ambulatory ECG or during clinical care.

Results

The cohort included 881 patients, with a mean age of 68 ± 9 years, and a median Congestive Heart Failure, Hypertension, Age ≥ 75 Years, Diabetes Mellitus, Stroke, Vascular Disease, Age 65 to 74 Years, Sex Category (CHA2DS2-VASc) score of 2 (interquartile range [IQR] 1-3); 529 patients (60.0%) underwent isolated coronary artery bypass grafting. At discharge, 798 patients (90.6%) were prescribed amiodarone, and 435 (49.4%) were prescribed oral anticoagulation. The mean time between discharge and 14-day continuous ambulatory ECG monitor was 72 days (IQR 61-84). AF recurrence was detected in 94 patients (10.7%); 30 patients (36.1%) were not receiving oral anticoagulation at the time of recurrence. Among patients with recurrence detected by 14-day continuous ambulatory ECG, the median duration was 10 hours (IQR 2-253). Left atrial volume index was the only independent predictor of AF recurrence. Following the clinic visit, oral anticoagulation was continued in 122 patients (28.2%).

Conclusions

Among patients with POAF following cardiac surgery, 1 in 10 have AF recurrence, as determined by a structured 14-day continuous ambulatory ECG monitor utilized 2-3 months postoperatively.
背景:30%的心脏手术并发新发术后心房颤动(POAF)。虽然POAF通常是短暂的,但POAF患者的结构化随访护理可以识别出阵发性或持续性房颤(AF)患者,他们将受益于循证治疗。方法本回顾性研究纳入了2020年至2024年间在一家专门治疗心脏手术后POAF患者的诊所就诊的患者。根据诊所的操作程序,患者术后2个月连续14天的动态心电图(ECG)监护,随后在诊所进行评估。主要结局是复发性房颤持续≥30秒,由14天连续动态心电图或在临床护理期间捕获。结果纳入881例患者,平均年龄68±9岁,中位充血性心力衰竭、高血压、年龄≥75岁、糖尿病、脑卒中、血管疾病、年龄65 ~ 74岁,性别分类(CHA2DS2-VASc)评分为2分(四分位间距[IQR] 1 ~ 3);529例(60.0%)行离体冠状动脉旁路移植术。出院时,798例(90.6%)患者使用胺碘酮,435例(49.4%)患者使用口服抗凝。出院至14天连续动态心电图监测的平均时间为72天(IQR 61 ~ 84)。房颤复发94例(10.7%);30例(36.1%)患者复发时未接受口服抗凝治疗。在连续14天动态心电图检测到复发的患者中,中位持续时间为10小时(IQR 2-253)。左房容积指数是房颤复发的唯一独立预测因子。门诊随访后,122例(28.2%)患者继续口服抗凝。结论:在心脏手术后POAF患者中,每10例患者中就有1例房颤复发,这是通过术后2-3个月的结构化14天连续动态心电图监测来确定的。
{"title":"Recurrence of Postoperative Atrial Fibrillation After Cardiac Surgery: Insights from a Tertiary Follow-Up Clinic","authors":"Rubani S. Suri BHSc ,&nbsp;Emilie P. Belley-Côté MD, PhD ,&nbsp;Siobhan M. Baigent CCPA ,&nbsp;Nicole P. Veloce CCPA ,&nbsp;Muneeb Ahmed MD ,&nbsp;P.J. Devereaux MD, PhD ,&nbsp;Jeff S. Healey MD, MSc ,&nbsp;Richard P. Whitlock MD, PhD ,&nbsp;William F. McIntyre MD, PhD","doi":"10.1016/j.cjco.2025.09.016","DOIUrl":"10.1016/j.cjco.2025.09.016","url":null,"abstract":"<div><h3>Background</h3><div>New-onset postoperative atrial fibrillation (POAF) complicates 30% of cardiac surgeries. Although POAF is often transient, structured follow-up care of patients with POAF may identify those with paroxysmal or persistent atrial fibrillation (AF) who will benefit from evidence-based therapies.</div></div><div><h3>Methods</h3><div>This retrospective study includes patients seen in a clinic dedicated to patients with POAF after cardiac surgery between 2020 and 2024. Per the clinic’s operating procedure, patients wore a 14-day continuous ambulatory electrocardiogram (ECG) monitor fpr 2 months after surgery and were assessed thereafter in clinic. The primary outcome was recurrent AF lasting ≥ 30 seconds, captured by 14-day continuous ambulatory ECG or during clinical care.</div></div><div><h3>Results</h3><div>The cohort included 881 patients, with a mean age of 68 ± 9 years, and a median <strong>C</strong>ongestive Heart Failure, <strong>H</strong>ypertension, <strong>A</strong>ge ≥ 75 Years, <strong>D</strong>iabetes Mellitus, <strong>S</strong>troke, <strong>V</strong>ascular Disease, <strong>A</strong>ge 65 to 74 Years, <strong>S</strong>ex <strong>C</strong>ategory (CHA<sub>2</sub>DS<sub>2</sub>-VASc) score of 2 (interquartile range [IQR] 1-3); 529 patients (60.0%) underwent isolated coronary artery bypass grafting. At discharge, 798 patients (90.6%) were prescribed amiodarone, and 435 (49.4%) were prescribed oral anticoagulation. The mean time between discharge and 14-day continuous ambulatory ECG monitor was 72 days (IQR 61-84). AF recurrence was detected in 94 patients (10.7%); 30 patients (36.1%) were not receiving oral anticoagulation at the time of recurrence. Among patients with recurrence detected by 14-day continuous ambulatory ECG, the median duration was 10 hours (IQR 2-253). Left atrial volume index was the only independent predictor of AF recurrence. Following the clinic visit, oral anticoagulation was continued in 122 patients (28.2%).</div></div><div><h3>Conclusions</h3><div>Among patients with POAF following cardiac surgery, 1 in 10 have AF recurrence, as determined by a structured 14-day continuous ambulatory ECG monitor utilized 2-3 months postoperatively.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 1","pages":"Pages 24-30"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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