IJC Heart and Vasculature最新文献

英文中文

Temporal changes in prevalence and severity of pulmonary hypertension, and relationship to outcomes in coarctation of aorta

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-07 DOI: 10.1016/j.ijcha.2025.101626

Ahmed Younis , Yogesh N.V. Reddy , William R. Miranda , Ahmed T. Abdelhalim , Barry A. Borlaug , Heidi M. Connolly , Alexander C. Egbe

Background

Pulmonary hypertension (PH) affects 20% of adults with coarctation of aorta (COA). What is not known is whether PH prevalence and severity increased over time, and the prognostic implications of such changes. The purpose of this study was to assess temporal changes in PH prevalence and severity (PH progression), and to determine the correlates and prognostic implications of pH progression in adults with COA.

Method

Retrospective cohort study of adults with repaired COA with ≥ 2 echocardiograms > 5 years apart. PH was defined as Doppler-derived right ventricular systolic pressure (RVSP) > 40 mmHg.

Results

Of 392 patients (age 35 years [24–49]; females 154 [39 %]), median RVSP was 30 (26–35) mmHg, and 76 (19 %) had PH at baseline echocardiogram. There was a temporal increase in PH severity (ΔRVSP 6 ± 9 mmHg, p = 0.008), and PH prevalence (19 % versus 27 %, p = 0.01). The correlates of Δ RVSP were older age, left atrial (LA) dysfunction, left ventricular (LV) hypertrophy, high LV global afterload, and atrial fibrillation. Of 392 patients, 50 (13 %) died, and Δ RVSP was associated with mortality (adjusted hazard ratio 1.19 [1.08–1.31] per 5 mmHg increase, p = 0.006) after adjustment for baseline RVSP, demographic indices, comorbidities, and echocardiographic indices.

Conclusions

These findings underscore the clinical importance of pH in COA and supports the need for new strategies for prevention and treatment of LA and LV dysfunction, which should in turn, slow the pace of pH progression in this population. Such strategies should include early detection and treatment of hypertension and atrial fibrillation.

{"title":"Temporal changes in prevalence and severity of pulmonary hypertension, and relationship to outcomes in coarctation of aorta","authors":"Ahmed Younis , Yogesh N.V. Reddy , William R. Miranda , Ahmed T. Abdelhalim , Barry A. Borlaug , Heidi M. Connolly , Alexander C. Egbe","doi":"10.1016/j.ijcha.2025.101626","DOIUrl":"10.1016/j.ijcha.2025.101626","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary hypertension (PH) affects 20% of adults with coarctation of aorta (COA). What is not known is whether PH prevalence and severity increased over time, and the prognostic implications of such changes. The purpose of this study was to assess temporal changes in PH prevalence and severity (PH progression), and to determine the correlates and prognostic implications of pH progression in adults with COA.</div></div><div><h3>Method</h3><div>Retrospective cohort study of adults with repaired COA with ≥ 2 echocardiograms > 5 years apart. PH was defined as Doppler-derived right ventricular systolic pressure (RVSP) > 40 mmHg.</div></div><div><h3>Results</h3><div>Of 392 patients (age 35 years [24–49]; females 154 [39 %]), median RVSP was 30 (26–35) mmHg, and 76 (19 %) had PH at baseline echocardiogram. There was a temporal increase in PH severity (ΔRVSP 6 ± 9 mmHg, p = 0.008), and PH prevalence (19 % versus 27 %, p = 0.01). The correlates of Δ RVSP were older age, left atrial (LA) dysfunction, left ventricular (LV) hypertrophy, high LV global afterload, and atrial fibrillation. Of 392 patients, 50 (13 %) died, and Δ RVSP was associated with mortality (adjusted hazard ratio 1.19 [1.08–1.31] per 5 mmHg increase, p = 0.006) after adjustment for baseline RVSP, demographic indices, comorbidities, and echocardiographic indices.</div></div><div><h3>Conclusions</h3><div>These findings underscore the clinical importance of pH in COA and supports the need for new strategies for prevention and treatment of LA and LV dysfunction, which should in turn, slow the pace of pH progression in this population. Such strategies should include early detection and treatment of hypertension and atrial fibrillation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101626"},"PeriodicalIF":2.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143360667","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

Evaluation of the ABC pathway in patients with atrial fibrillation: A machine learning cluster analysis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-05 DOI: 10.1016/j.ijcha.2025.101621

Jingyang Wang , Haiyang Bian , Jiangshan Tan , Jun Zhu , Lulu Wang , Wei Xu , Lei Wei , Xuegong Zhang , Yanmin Yang

Background

Atrial fibrillation Better Care (ABC) pathway is recommended by guidelines on atrial fibrillation (AF) and exerts a protective role against adverse outcomes of AF patients. But the possible differences in its effectiveness across the diverse range of patients in China have not been systematically evaluated. We aim to comprehensively evaluate multiple clinical characteristics of patients, and probe clusters of ABC criteria efficacy in patients with AF.

Methods

We used data from an observational cohort that included 2,016 patients with AF. We utilized 45 baseline variables for cluster analysis. We evaluated the management patterns and adverse outcomes of identified phenotypes. We assessed the effectiveness of adherence to the ABC criteria at reducing adverse outcomes of phenotypes.

Results

Cluster analysis identified AF patients into three distinct groups. The clusters include Cluster 1: old patients with the highest prevalence rates of atherosclerotic and/or other comorbidities (n = 964), Cluster 2: valve-comorbidities AF in young females (n = 407), and Cluster 3: low comorbidity patients with paroxysmal AF (n = 644). The clusters showed significant differences in MACNE, all-cause death, stroke, and cardiovascular death. All clusters showed that full adherence to the ABC pathway was associated with a significant reduction in the risk of MACNE (all P < 0.05). For three clusters, adherence to the different ‘A’/‘B’/‘C’ criterion alone showed differential clinic impact.

Conclusion

Our study suggested specific optimization strategies of risk stratification and integrated management for different groups of AF patients considering multiple clinical, genetic and socioeconomic factors.

{"title":"Evaluation of the ABC pathway in patients with atrial fibrillation: A machine learning cluster analysis","authors":"Jingyang Wang , Haiyang Bian , Jiangshan Tan , Jun Zhu , Lulu Wang , Wei Xu , Lei Wei , Xuegong Zhang , Yanmin Yang","doi":"10.1016/j.ijcha.2025.101621","DOIUrl":"10.1016/j.ijcha.2025.101621","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation Better Care (ABC) pathway is recommended by guidelines on atrial fibrillation (AF) and exerts a protective role against adverse outcomes of AF patients. But the possible differences in its effectiveness across the diverse range of patients in China have not been systematically evaluated. We aim to comprehensively evaluate multiple clinical characteristics of patients, and probe clusters of ABC criteria efficacy in patients with AF.</div></div><div><h3>Methods</h3><div>We used data from an observational cohort that included 2,016 patients with AF. We utilized 45 baseline variables for cluster analysis. We evaluated the management patterns and adverse outcomes of identified phenotypes. We assessed the effectiveness of adherence to the ABC criteria at reducing adverse outcomes of phenotypes.</div></div><div><h3>Results</h3><div>Cluster analysis identified AF patients into three distinct groups. The clusters include Cluster 1: old patients with the highest prevalence rates of atherosclerotic and/or other comorbidities (n = 964), Cluster 2: valve-comorbidities AF in young females (n = 407), and Cluster 3: low comorbidity patients with paroxysmal AF (n = 644). The clusters showed significant differences in MACNE, all-cause death, stroke, and cardiovascular death. All clusters showed that full adherence to the ABC pathway was associated with a significant reduction in the risk of MACNE (all P < 0.05). For three clusters, adherence to the different ‘A’/‘B’/‘C’ criterion alone showed differential clinic impact.</div></div><div><h3>Conclusion</h3><div>Our study suggested specific optimization strategies of risk stratification and integrated management for different groups of AF patients considering multiple clinical, genetic and socioeconomic factors.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101621"},"PeriodicalIF":2.5,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143287963","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

Long-term cardiovascular outcomes after percutaneous coronary intervention in patients with systemic sclerosis

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-04 DOI: 10.1016/j.ijcha.2025.101625

Kazutoshi Hirose , Hiroyuki Kiriyama , Shun Minatsuki , Yugo Nagae , Tatsuki Furusawa , Takashi Hiruma , Atsushi Kobayashi , Masataka Sato , Shinnosuke Sawano , Tatsuya Kamon , Hiroki Shinohara , Mizuki Miura , Akihito Saito , Satoshi Kodera , Junichi Ishida , Norifumi Takeda , Hiroyuki Morita , Issei Komuro , Norihiko Takeda

Background

Recent data have shown that systemic sclerosis (SSc) is a significant risk factor for coronary artery disease (CAD) and poorer cardiovascular outcomes in the setting of acute coronary syndrome. However, the morphological characteristics of CAD and the long-term cardiovascular outcomes in patients with concurrent SSc and CAD remain unclear.

Methods

We retrospectively investigated 3,300 patients with CAD who underwent percutaneous coronary intervention (PCI) without prior myocardial infarction or coronary artery revascularization. Laboratory, echocardiographic and angiographic characteristics, and clinical outcomes were compared between patients with and without SSc according to a 1:3 propensity score-matching analysis adjusted for patient demographics and comorbidities. The primary outcome was a composite of cardiac death, myocardial infarction, and stroke, and the secondary outcome was a composite of the primary outcome and heart failure hospitalization.

Results

Among all 3,300 patients, 17 (0.5 %) had SSc. The patients were classified into an SSc group (n = 17) and non-SSc group (n = 51) by propensity score matching. There were no significant differences in laboratory or echocardiographic parameters between the two groups. However, CAD tended to be more complex in the SSc group because of the higher proportion of left main trunk lesions (p = 0.100) and higher SYNergy between PCI with TAXUS™ and Cardiac Surgery (SYNTAX) score (p = 0.030). During a median follow-up of 3.1 years, patients with SSc more frequently experienced primary and secondary outcomes than those without SSc (both log-rank p < 0.02).

Conclusions

Among patients with CAD, long-term cardiovascular outcomes after PCI were poorer in those with than without SSc.

{"title":"Long-term cardiovascular outcomes after percutaneous coronary intervention in patients with systemic sclerosis","authors":"Kazutoshi Hirose , Hiroyuki Kiriyama , Shun Minatsuki , Yugo Nagae , Tatsuki Furusawa , Takashi Hiruma , Atsushi Kobayashi , Masataka Sato , Shinnosuke Sawano , Tatsuya Kamon , Hiroki Shinohara , Mizuki Miura , Akihito Saito , Satoshi Kodera , Junichi Ishida , Norifumi Takeda , Hiroyuki Morita , Issei Komuro , Norihiko Takeda","doi":"10.1016/j.ijcha.2025.101625","DOIUrl":"10.1016/j.ijcha.2025.101625","url":null,"abstract":"<div><h3>Background</h3><div>Recent data have shown that systemic sclerosis (SSc) is a significant risk factor for coronary artery disease (CAD) and poorer cardiovascular outcomes in the setting of acute coronary syndrome. However, the morphological characteristics of CAD and the long-term cardiovascular outcomes in patients with concurrent SSc and CAD remain unclear.</div></div><div><h3>Methods</h3><div>We retrospectively investigated 3,300 patients with CAD who underwent percutaneous coronary intervention (PCI) without prior myocardial infarction or coronary artery revascularization. Laboratory, echocardiographic and angiographic characteristics, and clinical outcomes were compared between patients with and without SSc according to a 1:3 propensity score-matching analysis adjusted for patient demographics and comorbidities. The primary outcome was a composite of cardiac death, myocardial infarction, and stroke, and the secondary outcome was a composite of the primary outcome and heart failure hospitalization.</div></div><div><h3>Results</h3><div>Among all 3,300 patients, 17 (0.5 %) had SSc. The patients were classified into an SSc group (n = 17) and non-SSc group (n = 51) by propensity score matching. There were no significant differences in laboratory or echocardiographic parameters between the two groups. However, CAD tended to be more complex in the SSc group because of the higher proportion of left main trunk lesions (p = 0.100) and higher SYNergy between PCI with TAXUS™ and Cardiac Surgery (SYNTAX) score (p = 0.030). During a median follow-up of 3.1 years, patients with SSc more frequently experienced primary and secondary outcomes than those without SSc (both log-rank p < 0.02).</div></div><div><h3>Conclusions</h3><div>Among patients with CAD, long-term cardiovascular outcomes after PCI were poorer in those with than without SSc.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101625"},"PeriodicalIF":2.5,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143172058","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

Transcatheter versus surgical aortic valve replacement in patients with aortic stenosis with a small aortic annulus: A meta-analysis with reconstructed time to event data 经导管与手术主动脉瓣置换术治疗伴有小主动脉环的主动脉狭窄患者：一项具有重建时间到事件数据的meta分析。

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101578

Ahmed K. Awad , Zina Otmani , Mazen Negmeldin Aly Yassin , Ahmed Mazen Amin , Farouq Bahaa Alahmed , Zineddine Belabaci , Haya A. Hegazy , Unaiza Ahmad , Mohamed Abuelazm

Background

Aortic stenosis (AS) remains a prevalent and serious global health concern, exacerbated by an aging population worldwide. This valvular disease, when symptomatic and without appropriate intervention, severe AS can drastically reduce life expectancy. In our systematic review and meta-analysis, we aim to synthesize available evidence to guide clinical decision-making by comparing the performance of TAVR and SAVR, specifically in patients with severe AS and a small aortic annulus.

Methods

We searched PubMed, EMBASE, Cochrane, Web of Science, and Scopus from inception till May 2024. The risk ratio (RR) and mean difference (MD) with a 95 % confidence interval (CI) are provided as effect size estimates, with all analyses being conducted using RevMan 5.4.

Results

Eleven studies with 3,670 patients were included. TAVR significantly increased the risk of 2-year new permanent pacemaker implantation (PPI) (RR = 2.42; 95 % CI: [1.70–3.44], P < 0.0001) and major vascular complications (RR = 3.73; 95 % CI: [1.98–6.99], P < 0.0001) than SAVR. However, TAVR significantly decreased the risk of patient-prosthesis mismatch (PPM) (RR = 0.56; 95 % CI: [0.48–0.65], P < 0.00001) and new-onset atrial fibrillation (AF) (RR = 0.31; 95 % CI: [0.23–0.41], P < 0.00001). Also, SAVR reduced the risk of paravalvular leak (PVL) (RR = 3.35; 95 % CI: [1.79–6.27], P = 0.0002).

Conclusion

TAVR had a significantly reduced risk of PPM and new-onset AF but with increased PPI and vascular complications. Also, TAVR significantly improved EOA and iEOA. Furthermore, SAVR had less risk of PVL, and better LVEF improvement at predischarge. Therefore, TAVR and SAVR remain valid alternatives, and decisions should be based on anatomy of the annulus and aortic root,operative risk, and comorbidities.

背景：主动脉瓣狭窄（AS）仍然是一个普遍而严重的全球健康问题，并因全球人口老龄化而加剧。这种瓣膜疾病，如果没有适当的干预，严重的AS会大大降低预期寿命。在我们的系统综述和荟萃分析中，我们的目标是通过比较TAVR和SAVR的表现来综合现有证据，以指导临床决策，特别是在严重AS和小主动脉环患者中。方法：检索PubMed、EMBASE、Cochrane、Web of Science和Scopus数据库，检索时间为建站至2024年5月。以95%置信区间（CI）的风险比（RR）和平均差（MD）作为效应大小估计，所有分析均使用RevMan 5.4进行。结果：纳入11项研究，共3670例患者。TAVR显著增加2年新的永久性起搏器植入术（PPI）的风险(RR = 2.42；95% CI: [1.70-3.44], P < 0.0001)和主要血管并发症(RR = 3.73；95% CI: [1.98 ~ 6.99], P < 0.0001)高于SAVR。然而，TAVR显著降低了患者-假体不匹配（PPM）的风险(RR = 0.56；95% CI: [0.48-0.65], P < 0.00001)和新发心房颤动（AF） (RR = 0.31；95% ci: [0.23-0.41], p < 0.00001)。此外，SAVR降低了瓣旁漏（PVL）的风险(RR = 3.35；95% ci: [1.79-6.27], p = 0.0002)。结论：TAVR显著降低了PPM和新发房颤的风险，但增加了PPI和血管并发症。TAVR显著改善了EOA和iEOA。此外，SAVR具有较低的PVL风险和较好的LVEF改善。因此，TAVR和SAVR仍然是有效的选择，决定应基于环和主动脉根的解剖结构、手术风险和合并症。

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引用次数: 0

Atrial fibrillation does not equal atrial fibrillation: The important prognostic implications of new-onset atrial fibrillation 心房颤动不等于心房颤动：新发心房颤动的重要预后意义。

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101572

Andreas Goette, Raffaele De Caterina, Joris R. de Groot, Dobromir Dobrev

引用次数: 0

The inflammatory and nutritional status in patients with dilated cardiomyopathy: Different impact for distinct phenogroups?

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101610

Tobias Lerchner , Anke Fender , Dobromir Dobrev , Tienush Rassaf , Lars Michel

引用次数: 0

Combining D-dimer and LDL/HDL ratio to predict the absence of atrial fibrillation in patients with an Implantable Loop Recorder for embolic stroke of Undetermined source

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101611

Kosuke Yoshikawa , Taku Asano , Yoshimi Onishi , Yuki Takai , Hiroto Sugiyama , Shuhei Arai , Toshihiko Gokan , Yuya Nakamura , Koichiro Inokuchi , Miwa Kikuchi , Tatsuya Onuki , Hitoshi Ezumi , Shinji Koba , Kaoru Tanno , Youichi Kobayashi , Toshiro Shinke

Background and Objective

Embolic stroke of undetermined source (ESUS) patients undergoing long-term rhythm monitoring with Implantable Loop Recorder (ILR) have an atrial fibrillation (AF) detection rate of approximately 12 % at 1 year and 30 % with extended follow-up over 3 years. However, research specifically focusing on the majority of patients in whom AF is not detected through implantable cardiac monitors remains limited. Abnormal lipid profiles may be associated with embolic risks from non-AF sources. This study aimed to develop a model to predict the absence of AF in patients with ESUS using multiple variables, including lipid profiles.

Methods

A retrospective, multicenter cohort study was conducted across four institutions, involving 99 ESUS patients. Patients were categorized based on AF detection via ILR. Patient characteristics, blood test results, and echocardiographic findings were assessed through univariate and multivariate logistic regression analyses. ROC curve analysis was performed to evaluate the biomarkers’ predictive accuracy.

Results

AF was detected in 30.3 % of patients over a median follow-up of 25.5 months. Multivariate analysis confirmed elevated D-dimer (OR: 2.77, p = 0.002), low LDL/HDL ratio (OR: 2.0, p = 0.01), and CHA2DS2-VASc score (OR: 1.4, p = 0.04) as independent predictors of AF detection. The CHA2DS2-VASc score was excluded due to multicollinearity, and patients with D-dimer < 0.9 μg/ml and LDL/HDL ratio > 1.98 had significantly lower AF detection rates (6.8 %, P < 0.001; sensitivity 93.1 %, specificity 44.2 %).

Conclusion

Combining D-dimer and LDL/HDL ratios provides an effective and accessible method for predicting the absence of AF in patients with an ILR for ESUS.

{"title":"Combining D-dimer and LDL/HDL ratio to predict the absence of atrial fibrillation in patients with an Implantable Loop Recorder for embolic stroke of Undetermined source","authors":"Kosuke Yoshikawa , Taku Asano , Yoshimi Onishi , Yuki Takai , Hiroto Sugiyama , Shuhei Arai , Toshihiko Gokan , Yuya Nakamura , Koichiro Inokuchi , Miwa Kikuchi , Tatsuya Onuki , Hitoshi Ezumi , Shinji Koba , Kaoru Tanno , Youichi Kobayashi , Toshiro Shinke","doi":"10.1016/j.ijcha.2025.101611","DOIUrl":"10.1016/j.ijcha.2025.101611","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Embolic stroke of undetermined source (ESUS) patients undergoing long-term rhythm monitoring with Implantable Loop Recorder (ILR) have an atrial fibrillation (AF) detection rate of approximately 12 % at 1 year and 30 % with extended follow-up over 3 years. However, research specifically focusing on the majority of patients in whom AF is not detected through implantable cardiac monitors remains limited. Abnormal lipid profiles may be associated with embolic risks from non-AF sources. This study aimed to develop a model to predict the absence of AF in patients with ESUS using multiple variables, including lipid profiles.</div></div><div><h3>Methods</h3><div>A retrospective, multicenter cohort study was conducted across four institutions, involving 99 ESUS patients. Patients were categorized based on AF detection via ILR. Patient characteristics, blood test results, and echocardiographic findings were assessed through univariate and multivariate logistic regression analyses. ROC curve analysis was performed to evaluate the biomarkers’ predictive accuracy.</div></div><div><h3>Results</h3><div>AF was detected in 30.3 % of patients over a median follow-up of 25.5 months. Multivariate analysis confirmed elevated D-dimer (OR: 2.77, p = 0.002), low LDL/HDL ratio (OR: 2.0, p = 0.01), and CHA2DS2-VASc score (OR: 1.4, p = 0.04) as independent predictors of AF detection. The CHA2DS2-VASc score was excluded due to multicollinearity, and patients with D-dimer < 0.9 μg/ml and LDL/HDL ratio > 1.98 had significantly lower AF detection rates (6.8 %, P < 0.001; sensitivity 93.1 %, specificity 44.2 %).</div></div><div><h3>Conclusion</h3><div>Combining D-dimer and LDL/HDL ratios provides an effective and accessible method for predicting the absence of AF in patients with an ILR for ESUS.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"56 ","pages":"Article 101611"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081381","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

Aortic valve replacement in uncontrolled diabetes: a matter of causes – effect

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101616

Luca Scorpiglione, Gino Duronio, Marco Zimarino

引用次数: 0

Prognostic value of TIMI risk score combined with systemic immune-inflammation index and lipoprotein(a) in patients with ST-Segment elevation myocardial infarction after percutaneous coronary intervention

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2025.101599

Yuankun Gu , Yu Zhang , Deshan Yao , Hui Shen , Xin Pan , Kaizheng Gong

Background

Thrombolysis in Myocardial Infarction (TIMI) risk score in patients with ST-segment elevation myocardial infarction (STEMI) is associated with major adverse cardiovascular events (MACE). This study aimed to develop a prediction model based on the TIMI risk score for MACE in STEMI patients after percutaneous coronary intervention (PCI).

Methods

We conducted a retrospective data analysis on 290 acute STEMI patients admitted to the Affiliated Hospital of Yangzhou University from January 2022 to June 2023 and met the inclusion criteria. The primary endpoint was the occurrence of MACE. Multivariate logistic regression was used to identify independent predictors that could predict the likelihood of MACE, and R software was utilized to construct and validate the prediction model.

Results

Systemic immune-inflammation index (SII), lipoprotein(a) [Lp(a)], and TIMI risk score were identified as independent risk factors for MACE in STEMI patients (p < 0.05). A nomogram was constructed based on these factors. The area under the receiver operating characteristic curve values for the training and validation sets were 0.883 (95 % CI: 0.836–0.930) and 0.841 (95 % CI: 0.756–0.925), respectively. The calibration curves displayed a high consistency between prediction and observation in the training and validation sets. Additionally, decision curve analysis (DCA) demonstrated the clinical usefulness of the nomogram.

Conclusions

SII, Lp(a), and TIMI risk score are independent risk factors for MACE within one year in STEMI patients after PCI. Incorporating SII and Lp(a) into the TIMI risk score enhances the predictive value for adverse outcomes, thereby supporting healthcare professionals in clinical decision-making.

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引用次数: 0

Spontaneous echo contrast in the left atrial appendage is linked to a higher risk of thromboembolic events and mortality in patients with atrial fibrillation 心房颤动患者左心耳自发性回声造影与血栓栓塞事件和死亡率增高有关。

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature

Pub Date : 2025-02-01 DOI: 10.1016/j.ijcha.2024.101590

Jan Traub , David Hettesheimer , Jule Pinter , Floran Sahiti , Georg Fette , Carsten Henneges , Caroline Morbach , Sebastian Herrmann , Frank Puppe , Anna Frey , Stefan Störk , Martin Christa

Background

Cardioversion, a rhythm control treatment for atrial fibrillation (AF), requires ruling out cardiac embolic sources, often originating from the left atrial appendage (LAA). Transesophageal echocardiography (TEE) is used for LAA evaluation, but it is invasive and not widely available. This study aimed to identify cardiovascular risk factors linked to LAA abnormalities and predictors of thromboembolic events and all-cause mortality.

Methods

A single-center retrospective analysis included AF patients admitted to the University Hospital Würzburg between 2009 and 2018 undergoing TEE.

Results

Among 2400 AF patients (median age 72; 36 % women), 469 (20 %) had LAA abnormalities: 282 (60 %) had spontaneous echo contrast (SEC), 72 (15 %) had thrombus formation (THR), and 115 (25 %) had both. Predictors of LAA abnormalities included age (OR 1.04; p = 0.002), congestive heart failure (OR 1.70; p = 0.009), diabetes (OR 1.74; p = 0.007), stroke history (OR 3.36; p = 0.001), vascular disease (OR 1.57; p = 0.026), elevated alkaline phosphatase (OR 1.15; p = 0.003), prior VKA intake (OR 1.53; p = 0.002), and DOAC intake (OR 0.57; p = 0.038). SEC with or without THR independently predicted thromboembolic events (HR 1.74, p = 0.031 and HR 1.53, p = 0.006) and all-cause mortality (HR 1.77, p = 0.011 and HR 1.57, p = 0.002), adjusted for cardiovascular risk factors, anticoagulation, and laboratory data.

Conclusions

In AF patients undergoing TEE, SEC, often overlooked in cardioversion decisions, independently predicted thromboembolic events and mortality.

背景：心律转复是心房颤动（AF）的一种心律控制治疗方法，需要排除心脏栓塞源，通常起源于左心房附件（LAA）。经食管超声心动图（TEE）用于LAA评估，但它是有创的，并没有广泛使用。本研究旨在确定与LAA异常相关的心血管危险因素以及血栓栓塞事件和全因死亡率的预测因素。方法：采用单中心回顾性分析，纳入2009年至2018年在德国 rzburg大学医院接受TEE治疗的房颤患者。结果：2400例房颤患者(中位年龄72岁；36%的女性)，469例（20%）有LAA异常，282例（60%）有自发性回声造影剂（SEC）， 72例（15%）有血栓形成（THR）， 115例（25%）两者都有。LAA异常的预测因素包括年龄(OR 1.04；p = 0.002)，充血性心力衰竭(OR 1.70；p = 0.009)，糖尿病(OR 1.74；p = 0.007)、卒中史(OR 3.36；p = 0.001)，血管疾病(OR 1.57；p = 0.026)，碱性磷酸酶升高(OR 1.15；p = 0.003)，先前的VKA摄入量(OR 1.53；p = 0.002)， DOAC摄入量(OR 0.57；p = 0.038)。经心血管危险因素、抗凝和实验室数据校正后，伴有或不伴有THR的SEC可独立预测血栓栓塞事件（HR 1.74, p = 0.031和HR 1.53, p = 0.006）和全因死亡率（HR 1.77, p = 0.011和HR 1.57, p = 0.002）。结论：在接受TEE治疗的房颤患者中，在转复决策中经常被忽视的SEC可以独立预测血栓栓塞事件和死亡率。

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