IJC Heart and Vasculature最新文献

英文中文

Prognostic implication of outpatient loop diuretic dose intensification trajectories in patients with chronic heart failure 慢性心力衰竭患者门诊襻利尿剂剂量强化轨迹的预后意义

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-03-03 DOI: 10.1016/j.ijcha.2025.101632

Toshiharu Koike , Atsushi Suzuki , Noriko Kikuchi , Asami Yoshimura , Kaoru Haruki , Ayano Yoshida , Maiko Sone , Mayui Nakazawa , Kei Tsukamoto , Yasutaka Imamura , Hidetoshi Hattori , Tomohito Kogure , Junichi Yamaguchi , Tsuyoshi Shiga

Background

The relationship between outpatient oral loop diuretic (OLD) dose intensification trajectories and the prognosis of patients with chronic heart failure (CHF) remains unclear.

Methods

In 832 patients with CHF, OLD dose trajectories for 1 year were consecutively investigated. OLD dose intensification was defined as the first occurrence of OLD dose increase from the baseline within the first year. Patients were classified into three groups of OLD dose intensification trajectories: irreversible, reversible, and no intensification. Irreversible intensification was defined as an OLD dose intensification wherein the dose remained above the baseline during the first year of follow-up. Reversible intensification referred to an OLD dose intensification wherein the dose returned to or dropped below the baseline within the first year of follow-up. No intensification was defined as no OLD dose intensification throughout the first year of follow-up. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular death (CVD), heart failure hospitalisation (HFH), a composite of CVD or HFH, and a composite of all-cause mortality or HFH after 1 year.

Results

During the median follow-up (57 [range, 13–102] months), 146 patients died. Irreversible intensification was associated with higher risks of all outcomes than no intensification (e.g., all-cause mortality: hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.08–2.44; HFH: HR, 2.16; 95% CI, 1.65–2.98; CVD or HFH: HR, 2.17; 95% CI, 1.59–2.96). Conversely, reversible intensification had comparable prognoses for all outcomes to no intensification.

Conclusion

OLD dose intensification trajectories could stratify the prognosis of CHF patients.

{"title":"Prognostic implication of outpatient loop diuretic dose intensification trajectories in patients with chronic heart failure","authors":"Toshiharu Koike , Atsushi Suzuki , Noriko Kikuchi , Asami Yoshimura , Kaoru Haruki , Ayano Yoshida , Maiko Sone , Mayui Nakazawa , Kei Tsukamoto , Yasutaka Imamura , Hidetoshi Hattori , Tomohito Kogure , Junichi Yamaguchi , Tsuyoshi Shiga","doi":"10.1016/j.ijcha.2025.101632","DOIUrl":"10.1016/j.ijcha.2025.101632","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between outpatient oral loop diuretic (OLD) dose intensification trajectories and the prognosis of patients with chronic heart failure (CHF) remains unclear.</div></div><div><h3>Methods</h3><div>In 832 patients with CHF, OLD dose trajectories for 1 year were consecutively investigated. OLD dose intensification was defined as the first occurrence of OLD dose increase from the baseline within the first year. Patients were classified into three groups of OLD dose intensification trajectories: irreversible, reversible, and no intensification. Irreversible intensification was defined as an OLD dose intensification wherein the dose remained above the baseline during the first year of follow-up. Reversible intensification referred to an OLD dose intensification wherein the dose returned to or dropped below the baseline within the first year of follow-up. No intensification was defined as no OLD dose intensification throughout the first year of follow-up. The primary outcome was all-cause mortality. Secondary outcomes were cardiovascular death (CVD), heart failure hospitalisation (HFH), a composite of CVD or HFH, and a composite of all-cause mortality or HFH after 1 year.</div></div><div><h3>Results</h3><div>During the median follow-up (57 [range, 13–102] months), 146 patients died. Irreversible intensification was associated with higher risks of all outcomes than no intensification (e.g., all-cause mortality: hazard ratio [HR], 1.63; 95% confidence interval [CI], 1.08–2.44; HFH: HR, 2.16; 95% CI, 1.65–2.98; CVD or HFH: HR, 2.17; 95% CI, 1.59–2.96). Conversely, reversible intensification had comparable prognoses for all outcomes to no intensification.</div></div><div><h3>Conclusion</h3><div>OLD dose intensification trajectories could stratify the prognosis of CHF patients.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101632"},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterization and anticoagulation treatment patterns of hospitalized patients with nonvalvular atrial fibrillation in Spain: The CARISMA registry

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-03-01 DOI: 10.1016/j.ijcha.2025.101639

Lorenzo Fácila , Alberto Cordero , Adrián Valverde Tavira , Irene Rilo Miranda , Alain Laskibar Asua , Laia Tirapu , Vicente Montagud , Juan Sánchez-Serna , Eloy Gómez-Mariscal , Luis Mainar , Ernesto Martín Dorado , Natalia Lorenzo , Ana María Pello Lázaro , Moisés Rodríguez-Mañero

Background

This study described the clinical and demographic characteristics of hospitalized patients with nonvalvular atrial fibrillation (NVAF) and prescriptions for vitamin-K antagonists (VKA) and direct-acting oral anticoagulants (DOAC) in Spain.

Methods

This was an observational, multicentric, retrospective study of patients treated with DOAC or VKA due to NVAF at cardiology services of hospitals in Spain. A registry (CARISMA) included patients hospitalized for any reason and discharged before July 1st, 2021, with a prescription for DOAC or VKA. Data was collected on demographic and clinical characteristics and anticoagulant treatments prescribed. Analyses were descriptive.

Results

A total of 1,041 patients were included. Mean age (SD) was 77.2 (10.3) years and 57.6 % were men. The most frequent reason for hospital admission was heart failure (43.8 %) and arrhythmias (25.0 %). The mean (SD) CHA₂DS₂-VASc score was 4.0 (1.6). Prior to admission, 75.6 % of patients had been prescribed anticoagulant treatment for NVAF. Of these, 56.0 % had received VKA and 44.0 % DOAC. At discharge, 60 % had a DOAC prescription (of these, apixaban, 37.6 %; edoxaban, 26.4 %; rivaroxaban, 25.1 %; dabigatran, 10.9 %) and 40 % a VKA. DOAC prescriptions were off-label with respect to dosing in 19–34 % of cases. Patients with off-label dosing were older and with a higher proportion of women than those with on-label doses. During hospitalization, 12.1 % of patients changed treatment, usually VKA to DOAC.

Conclusion

Before hospitalization, a quarter of patients with NVAF were not receiving anticoagulation medication. Hospitalization increased the proportion of patients receiving DOAC, but about a quarter of patients had off-label dosing prescriptions.

{"title":"Characterization and anticoagulation treatment patterns of hospitalized patients with nonvalvular atrial fibrillation in Spain: The CARISMA registry","authors":"Lorenzo Fácila , Alberto Cordero , Adrián Valverde Tavira , Irene Rilo Miranda , Alain Laskibar Asua , Laia Tirapu , Vicente Montagud , Juan Sánchez-Serna , Eloy Gómez-Mariscal , Luis Mainar , Ernesto Martín Dorado , Natalia Lorenzo , Ana María Pello Lázaro , Moisés Rodríguez-Mañero","doi":"10.1016/j.ijcha.2025.101639","DOIUrl":"10.1016/j.ijcha.2025.101639","url":null,"abstract":"<div><h3>Background</h3><div>This study described the clinical and demographic characteristics of hospitalized patients with nonvalvular atrial fibrillation (NVAF) and prescriptions for vitamin-K antagonists (VKA) and direct-acting oral anticoagulants (DOAC) in Spain.</div></div><div><h3>Methods</h3><div>This was an observational, multicentric, retrospective study of patients treated with DOAC or VKA due to NVAF at cardiology services of hospitals in Spain. A registry (CARISMA) included patients hospitalized for any reason and discharged before July 1st, 2021, with a prescription for DOAC or VKA. Data was collected on demographic and clinical characteristics and anticoagulant treatments prescribed. Analyses were descriptive.</div></div><div><h3>Results</h3><div>A total of 1,041 patients were included. Mean age (SD) was 77.2 (10.3) years and 57.6 % were men. The most frequent reason for hospital admission was heart failure (43.8 %) and arrhythmias (25.0 %). The mean (SD) CHA<sub>2</sub>DS<sub>2</sub>-VASc score was 4.0 (1.6). Prior to admission, 75.6 % of patients had been prescribed anticoagulant treatment for NVAF. Of these, 56.0 % had received VKA and 44.0 % DOAC. At discharge, 60 % had a DOAC prescription (of these, apixaban, 37.6 %; edoxaban, 26.4 %; rivaroxaban, 25.1 %; dabigatran, 10.9 %) and 40 % a VKA. DOAC prescriptions were off-label with respect to dosing in 19–34 % of cases. Patients with off-label dosing were older and with a higher proportion of women than those with on-label doses. During hospitalization, 12.1 % of patients changed treatment, usually VKA to DOAC.</div></div><div><h3>Conclusion</h3><div>Before hospitalization, a quarter of patients with NVAF were not receiving anticoagulation medication. Hospitalization increased the proportion of patients receiving DOAC, but about a quarter of patients had off-label dosing prescriptions.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101639"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Heart failure with reduced ejection fraction developed from valvular surgery: Risk factors and therapeutic effects of sacubitril valsartan

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-25 DOI: 10.1016/j.ijcha.2025.101634

Chen Yuqian , Hu Qinghua , Luo Fanyan , Huang Lingjin , Chen Xuliang , Zhang Chengliang

Objective

To investigate the risk factors for heart failure developed from cardiac valvular surgery and the efficacy of sacubitril valsartan (ARNI).

Methods

Clinical data from patients with left ventricular ejection fraction (LVEF) ≥ 50 % who consecutively underwent cardiac valvular (mitral/aortic valve) surgery in 2021 were collected. Pre − and intra − operative variables were analyzed to explore risk factors for HFrEF (LVEF ≤ 40 %). Post − operative HFrEF patients were split into ARNI − treated (n = 15) and non-ARNI − treated (n = 15) groups. Follow − up echocardiography data were compared to assess ARNI’s efficacy.

Results

Among 420 patients undergoing valve surgery (117 aortic, 133 mitral, 170 double-valve), 34 (8.1 %) developed HFrEF, showing significantly higher in-hospital mortality than non-HFrEF patients (8.82 % vs 0.52 %). Multivariate analysis identified preoperative left ventricular diameter as an independent HFrEF risk factor. During follow-up, 70 % of HFrEF patients achieved LVEF > 50 % within 6 months, Repeated-measures F test demonstrated significantly greater LVEF improvement (P = 0.036) and LVEDD reduction (P = 0.014) in the ARNI group versus non-ARNI group.

Conclusions

About 8 % of patients with LVEF ≥ 50 % developed HFrEF after cardiac valvular surgery, and large left ventricular diameter was an independent risk factor. Sacubitril valsartan is very effective in improving left ventricular remodeling and LVEF in such cohort.

{"title":"Heart failure with reduced ejection fraction developed from valvular surgery: Risk factors and therapeutic effects of sacubitril valsartan","authors":"Chen Yuqian , Hu Qinghua , Luo Fanyan , Huang Lingjin , Chen Xuliang , Zhang Chengliang","doi":"10.1016/j.ijcha.2025.101634","DOIUrl":"10.1016/j.ijcha.2025.101634","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the risk factors for heart failure developed from cardiac valvular surgery and the efficacy of sacubitril valsartan (ARNI).</div></div><div><h3>Methods</h3><div>Clinical data from patients with left ventricular ejection fraction (LVEF) ≥ 50 % who consecutively underwent cardiac valvular (mitral/aortic valve) surgery in 2021 were collected. Pre − and intra − operative variables were analyzed to explore risk factors for HFrEF (LVEF ≤ 40 %). Post − operative HFrEF patients were split into ARNI − treated (n = 15) and non-ARNI − treated (n = 15) groups. Follow − up echocardiography data were compared to assess ARNI’s efficacy.</div></div><div><h3>Results</h3><div>Among 420 patients undergoing valve surgery (117 aortic, 133 mitral, 170 double-valve), 34 (8.1 %) developed HFrEF, showing significantly higher in-hospital mortality than non-HFrEF patients (8.82 % vs 0.52 %). Multivariate analysis identified preoperative left ventricular diameter as an independent HFrEF risk factor. During follow-up, 70 % of HFrEF patients achieved LVEF > 50 % within 6 months, Repeated-measures F test demonstrated significantly greater LVEF improvement (P = 0.036) and LVEDD reduction (P = 0.014) in the ARNI group versus non-ARNI group.</div></div><div><h3>Conclusions</h3><div>About 8 % of patients with LVEF ≥ 50 % developed HFrEF after cardiac valvular surgery, and large left ventricular diameter was an independent risk factor. Sacubitril valsartan is very effective in improving left ventricular remodeling and LVEF in such cohort.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101634"},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical and hemodynamic outcomes of self-expanding and balloon-expandable valves for valve-in-valve transcatheter aortic valve implantation (ViV-TAVI): An updated systematic review and meta-analysis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-24 DOI: 10.1016/j.ijcha.2025.101627

Farah Yasmin , Abdul Moeed , Kinza Iqbal , Abraish Ali , Ashish Kumar , Jawad Basit , Mohammad Hamza , Sourbha S Dani , Ankur Kalra

Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) has emerged as a feasible alternative to reoperative surgery in patients with degenerated surgical bio-prosthesis. However, data regarding the choice of valve type in ViV-TAVI remain inconclusive. This meta-analysis compares the procedural and clinical outcomes of self-expanding (SE) vs. balloon-expandable (BE) valves in ViV-TAVI. MEDLINE and Scopus were queried to identify studies reporting outcomes of ViV-TAVI by SE/BE valve type or comparing outcomes between SE or BE valves for ViV-TAVI. The primary outcome was incidence of all-cause mortality at 30 days. Data were presented as incidence of outcomes, analyzed via random effects model using inverse variance method with 95 % confidence intervals. Further incidence rates of primary and secondary outcomes were presented as subgroups of BE and SE, with comparison in incidence rates between the subgroups made using p-interaction of proportions. 27 studies with 13,182 patients (SE: 7346; BE: 5836) were included. There were no significant differences between the BE vs. SE valves in 30-day mortality (BE 4 % vs. SE 3 %, p = 0.44), 1-year mortality (BE 12 % vs. SE 10 %, p = 0.60), and moderate-to-severe AR at 1 year (BE 1 % vs. SE 3 %, p = 0.36). However, patients with SE valves had higher rates of new permanent pacemaker insertion (BE 4 % vs. SE 9 %, p = 0.0019). There were no significant differences in the incidence of 30-day safety outcomes, including stroke, AKI, coronary obstruction, major bleeding, and major vascular complications. Both BE and SE valve types showed comparable mortality and safety outcomes in ViV-TAVI, except pacemaker insertion, which was higher in SE compared with BE valves.

瓣中瓣经导管主动脉瓣植入术（ViV-TAVI）已成为手术生物假体退化患者再次手术的可行替代方案。然而，有关 ViV-TAVI 瓣膜类型选择的数据仍无定论。这项荟萃分析比较了自扩张（SE）瓣膜与球囊扩张（BE）瓣膜在 ViV-TAVI 中的手术和临床效果。我们查询了MEDLINE和Scopus，以确定按SE/BE瓣膜类型报告ViV-TAVI疗效或比较SE或BE瓣膜用于ViV-TAVI疗效的研究。主要结果是30天内全因死亡率的发生率。数据以结果发生率的形式呈现，通过随机效应模型使用逆方差法进行分析，置信区间为 95%。主要和次要结果的进一步发病率以 BE 和 SE 亚组的形式呈现，亚组之间的发病率比较采用比例的 p-交互作用。共纳入 27 项研究，13182 名患者（SE：7346；BE：5836）。在30天死亡率（BE：4%；SE：3%；P=0.44）、1年死亡率（BE：12%；SE：10%；P=0.60）和1年中度至重度AR（BE：1%；SE：3%；P=0.36）方面，BE瓣膜与SE瓣膜无明显差异。然而，SE瓣膜患者新植入永久起搏器的比例更高（BE 4 % vs. SE 9 %，p = 0.0019）。30天安全结果（包括中风、AKI、冠状动脉阻塞、大出血和主要血管并发症）的发生率没有明显差异。在ViV-TAVI中，BE和SE两种瓣膜类型的死亡率和安全性结果相当，但起搏器植入率除外，SE瓣膜的起搏器植入率高于BE瓣膜。

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引用次数: 0

Comparative analysis of patient outcomes in pulmonary embolism with chronic inflammatory diseases

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-24 DOI: 10.1016/j.ijcha.2025.101637

Marlon V. Gatuz , Rami Abu-Fanne , Dmitry Abramov , Mamas A. Mamas , Ariel Roguin , Ofer Kobo

Background

Pulmonary embolism (PE) is a critical condition with significant morbidity and mortality, particularly among patients with chronic inflammatory diseases (CID) such as rheumatoid arthritis and systemic lupus erythematosus that are linked to a heightened risk of thromboembolic events.

Method

This retrospective analysis examined 725,725 adult patients hospitalized with a primary diagnosis of PE using the National Inpatient Sample database from 2016 to 2019. Patients were stratified by CID status. The study assessed in-hospital outcomes including all-cause mortality, major adverse cardiovascular and cerebrovascular events (MACCE), major bleeding, intracranial hemorrhage, length of stay, and total hospital charges. Multivariable logistic regression models were used to examine the association between CID and in-hospital outcomes, adjusting for baseline differences.

Results

Of the study population, 33,775 (4.6 %) had CID. Patients with CID were younger (62.07 vs 62.85 years, p < 0.001) and more likely to be female (69.9 % vs 51.0 %, p < 0.001). After adjustment, patients with CID showed an 8 % decreased mortality risk (aOR 0.92, 95 % CI: 0.86–0.98, p = 0.015) but a 15 % higher risk of major bleeding (aOR 1.15, 95 % CI: 1.08–1.23, p < 0.001). Additionally, there was a small but significant increase in the odds of MACCE for patients with CID (aOR 1.07, 95 % CI: 1.01–1.13, p = 0.014).

Conclusion

The findings indicate that while patients with CID experience lower in-hospital mortality rates, they are at a greater risk for major bleeding. This underscores the necessity for tailored treatment approaches that consider individual patient factors, such as age and comorbidities, to optimize outcomes in this vulnerable population.

{"title":"Comparative analysis of patient outcomes in pulmonary embolism with chronic inflammatory diseases","authors":"Marlon V. Gatuz , Rami Abu-Fanne , Dmitry Abramov , Mamas A. Mamas , Ariel Roguin , Ofer Kobo","doi":"10.1016/j.ijcha.2025.101637","DOIUrl":"10.1016/j.ijcha.2025.101637","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) is a critical condition with significant morbidity and mortality, particularly among patients with chronic inflammatory diseases (CID) such as rheumatoid arthritis and systemic lupus erythematosus that are linked to a heightened risk of thromboembolic events.</div></div><div><h3>Method</h3><div>This retrospective analysis examined 725,725 adult patients hospitalized with a primary diagnosis of PE using the National Inpatient Sample database from 2016 to 2019. Patients were stratified by CID status. The study assessed in-hospital outcomes including all-cause mortality, major adverse cardiovascular and cerebrovascular events (MACCE), major bleeding, intracranial hemorrhage, length of stay, and total hospital charges. Multivariable logistic regression models were used to examine the association between CID and in-hospital outcomes, adjusting for baseline differences.</div></div><div><h3>Results</h3><div>Of the study population, 33,775 (4.6 %) had CID. Patients with CID were younger (62.07 vs 62.85 years, p < 0.001) and more likely to be female (69.9 % vs 51.0 %, p < 0.001). After adjustment, patients with CID showed an 8 % decreased mortality risk (aOR 0.92, 95 % CI: 0.86–0.98, p = 0.015) but a 15 % higher risk of major bleeding (aOR 1.15, 95 % CI: 1.08–1.23, p < 0.001). Additionally, there was a small but significant increase in the odds of MACCE for patients with CID (aOR 1.07, 95 % CI: 1.01–1.13, p = 0.014).</div></div><div><h3>Conclusion</h3><div>The findings indicate that while patients with CID experience lower in-hospital mortality rates, they are at a greater risk for major bleeding. This underscores the necessity for tailored treatment approaches that consider individual patient factors, such as age and comorbidities, to optimize outcomes in this vulnerable population.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101637"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics and outcomes of hospitalized patients with Isolated and systemic cardiac sarcoidosis: Analysis of the Nationwide readmissions database 2016–2021

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-24 DOI: 10.1016/j.ijcha.2025.101636

Raheel Ahmed , Nitish Behary Paray , Hiroyuki Sawatari , Syed Emir Irfan Wafa , Kamleshun Ramphul , Mushood Ahmed , Hritvik Jain , Saurabh Deshpande , Mohammed Khanji , Athol Umfrey Wells , Peter Collins , Selma Mohammed , Omar Abou-Ezzeddine , Vasilis Kouranos , Rakesh Sharma , Anwar Chahal

Objective

To identify any differences in the characteristics and outcomes of patients with Isolated cardiac sarcoidosis (iCS) vs systemic cardiac sarcoidosis (sCS).

Patients and methods

All inpatient encounters in the Nationwide Readmission Database from 2016 to 2021 were analyzed for the rates, predictors, costs and mortality during index and unplanned 90-days readmissions for iCS and sCS patients. Patients with ischemic heart disease were excluded.

Results

1,667 patients were identified (57.8 % male), of which, 1,013 (60.8 %) had iCS and 654 (39.2 %) had sCS. The median (IQR) age of iCS patients was slightly older [57.0 (49.0–66.0) vs 56.0 (48.0–64.0), p = 0.04]. On index admission, iCS patients had higher prevalence of ventricular tachycardia (36.9 % vs 28.8 %, p = 0.001) and catheter ablation (5.6 % vs 2.8 %, p = 0.006). The predictors for all-cause readmissions were Charlson Comorbidity Index (CCI) (HR 1.19, 95 % CI 1.01–1.40, p = 0.04), age (HR 0.98 (0.97–1.00), p = 0.01) and the use of anticoagulant therapy (HR 1.92, 95 % CI 1.35–2.72, p < 0.001). Patients with sCS were more likely to be readmitted with heart failure compared to iCS patients (SHR 3.78, 95 % CI 1.11–12.94, p = 0.03). During subsequent readmission, iCS and sCS patients had comparable rates of in-hospital mortality, median length of stay and healthcare-associated costs. No independent predictors of in-hospital mortality at readmission were ascertained.

Conclusions

Isolated CS patients, when compared to systemic CS, had a greater prevalence of ventricular tachycardia and catheter ablation. They were less likely to be re-hospitalized with heart failure within 90-days. Age, higher CCI, and use of anticoagulant therapy were predictors for all-cause readmissions.

{"title":"Characteristics and outcomes of hospitalized patients with Isolated and systemic cardiac sarcoidosis: Analysis of the Nationwide readmissions database 2016–2021","authors":"Raheel Ahmed , Nitish Behary Paray , Hiroyuki Sawatari , Syed Emir Irfan Wafa , Kamleshun Ramphul , Mushood Ahmed , Hritvik Jain , Saurabh Deshpande , Mohammed Khanji , Athol Umfrey Wells , Peter Collins , Selma Mohammed , Omar Abou-Ezzeddine , Vasilis Kouranos , Rakesh Sharma , Anwar Chahal","doi":"10.1016/j.ijcha.2025.101636","DOIUrl":"10.1016/j.ijcha.2025.101636","url":null,"abstract":"<div><h3>Objective</h3><div>To identify any differences in the characteristics and outcomes of patients with Isolated cardiac sarcoidosis (iCS) vs systemic cardiac sarcoidosis (sCS).</div></div><div><h3>Patients and methods</h3><div>All inpatient encounters in the Nationwide Readmission Database from 2016 to 2021 were analyzed for the rates, predictors, costs and mortality during index and unplanned 90-days readmissions for iCS and sCS patients. Patients with ischemic heart disease were excluded.</div></div><div><h3>Results</h3><div>1,667 patients were identified (57.8 % male), of which, 1,013 (60.8 %) had iCS and 654 (39.2 %) had sCS. The median (IQR) age of iCS patients was slightly older [57.0 (49.0–66.0) vs 56.0 (48.0–64.0), p = 0.04]. On index admission, iCS patients had higher prevalence of ventricular tachycardia (36.9 % vs 28.8 %, p = 0.001) and catheter ablation (5.6 % vs 2.8 %, p = 0.006). The predictors for all-cause readmissions were Charlson Comorbidity Index (CCI) (HR 1.19, 95 % CI 1.01–1.40, p = 0.04), age (HR 0.98 (0.97–1.00), p = 0.01) and the use of anticoagulant therapy (HR 1.92, 95 % CI 1.35–2.72, p < 0.001). Patients with sCS were more likely to be readmitted with heart failure compared to iCS patients (SHR 3.78, 95 % CI 1.11–12.94, p = 0.03). During subsequent readmission, iCS and sCS patients had comparable rates of in-hospital mortality, median length of stay and healthcare-associated costs. No independent predictors of in-hospital mortality at readmission were ascertained.</div></div><div><h3>Conclusions</h3><div>Isolated CS patients, when compared to systemic CS, had a greater prevalence of ventricular tachycardia and catheter ablation. They were less likely to be re-hospitalized with heart failure within 90-days. Age, higher CCI, and use of anticoagulant therapy were predictors for all-cause readmissions.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101636"},"PeriodicalIF":2.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143478753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biomedical research as collateral damage in a new world Order?

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-20 DOI: 10.1016/j.ijcha.2025.101633

Anke C. Fender , Anke Hinney

引用次数: 0

Myocardium at risk in chronic total coronary occlusion territory collateralized by an infarct-related artery: The double jeopardy theory

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-20 DOI: 10.1016/j.ijcha.2025.101631

Yvemarie B.O. Somsen , Roel Hoek , Ruben W. de Winter , Rocco Giunta , Stefan P. Schumacher , Henk Everaars , Wynand J. Stuijfzand , Niels J. Verouden , Bimmer E.P.M. Claessen , Alexander Nap , Sebastiaan A. Kleijn , José P. Henriques , Paul Knaapen

引用次数: 0

Epicardial fat and failed recovery after TAVI: A weak yet intriguing correlation

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-15 DOI: 10.1016/j.ijcha.2025.101630

Matteo Perfetti , Greta Rende , Marco Zimarino

引用次数: 0

A CD36-based prediction model for sepsis-induced myocardial injury

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-09 DOI: 10.1016/j.ijcha.2025.101615

Yun Xie, Hui Lv, Daonan Chen, Peijie Huang, Zhigang Zhou, Ruilan Wang

Background

Sepsis-induced myocardial injury (SIMI) is a prevalent form of organ dysfunction with a significant impact on the mortality rate among sepsis patients. This study aims to develop a predictive model for SIMI using plasma CD36 levels.

Methods

A prospective study was conducted from January 1, 2023, to December 1, 2023, involving sepsis patients admitted to the Department of Intensive Care Medicine at Shanghai General Hospital. Plasma CD36 levels were measured within 48 h of ICU admission, prior to the diagnosis of sepsis-associated myocardial injury. Myocardial damage was assessed using troponin levels.

Results

Two significant risk factors for SIMI were identified: age and elevated CD36 levels. CD36, THBS1, and BNP were determined to be independent mortality risk factors. The myocardial injury group exhibited higher plasma CD36 levels compared to the non-injury group. Additionally, the deceased group had higher plasma CD36 levels than the survivors. No significant differences in CD36 levels were observed between groups with lung and stomach infections or between Gram-positive and Gram-negative infection groups. Similarly, there was no statistically significant difference in CD36 levels between surgical and medical patients. A predictive model for SIMI was formulated as follows: ln [P/(1-P)] = -0.000818age + 0.4975756CD36 − 5.400293. The model’s quality of fit was tested with a P-value of 0.4682, indicating a good degree of discrimination and calibration, as evidenced by the area under the ROC curve (0.7724).

Conclusion

The prognosis of individuals with sepsis is closely associated with elevated CD36 levels. Elevated CD36 is identified as an independent risk factor for both SIMI and mortality in sepsis patients. The predictive model suggests that high CD36 levels are indicative of SIMI and are associated with a poor prognosis.

{"title":"A CD36-based prediction model for sepsis-induced myocardial injury","authors":"Yun Xie, Hui Lv, Daonan Chen, Peijie Huang, Zhigang Zhou, Ruilan Wang","doi":"10.1016/j.ijcha.2025.101615","DOIUrl":"10.1016/j.ijcha.2025.101615","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis-induced myocardial injury (SIMI) is a prevalent form of organ dysfunction with a significant impact on the mortality rate among sepsis patients. This study aims to develop a predictive model for SIMI using plasma CD36 levels.</div></div><div><h3>Methods</h3><div>A prospective study was conducted from January 1, 2023, to December 1, 2023, involving sepsis patients admitted to the Department of Intensive Care Medicine at Shanghai General Hospital. Plasma CD36 levels were measured within 48 h of ICU admission, prior to the diagnosis of sepsis-associated myocardial injury. Myocardial damage was assessed using troponin levels.</div></div><div><h3>Results</h3><div>Two significant risk factors for SIMI were identified: age and elevated CD36 levels. CD36, THBS1, and BNP were determined to be independent mortality risk factors. The myocardial injury group exhibited higher plasma CD36 levels compared to the non-injury group. Additionally, the deceased group had higher plasma CD36 levels than the survivors. No significant differences in CD36 levels were observed between groups with lung and stomach infections or between Gram-positive and Gram-negative infection groups. Similarly, there was no statistically significant difference in CD36 levels between surgical and medical patients. A predictive model for SIMI was formulated as follows: ln [P/(1-P)] = -0.000818age + 0.4975756CD36 − 5.400293. The model’s quality of fit was tested with a P-value of 0.4682, indicating a good degree of discrimination and calibration, as evidenced by the area under the ROC curve (0.7724).</div></div><div><h3>Conclusion</h3><div>The prognosis of individuals with sepsis is closely associated with elevated CD36 levels. Elevated CD36 is identified as an independent risk factor for both SIMI and mortality in sepsis patients. The predictive model suggests that high CD36 levels are indicative of SIMI and are associated with a poor prognosis.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101615"},"PeriodicalIF":2.5,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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