Pub Date : 2026-02-01DOI: 10.1016/j.ejim.2025.106515
William F. McIntyre , Linda S. Johnson , Alexander P. Benz , Maria E. Vadakken , Nicole R. Latendresse , Chinthanie Ramasundarahettige , Faith Kirabo , Jorge A. Wong , Jason D. Roberts , Jeff S. Healey
Background
Approximately one-third-of patients with transient new-onset atrial fibrillation (AF) during hospitalization for noncardiac surgery or medical illness will have recurrent AF within 1 year when assessed using two 14-day ECG monitors. The proportion of patients that would be diagnosed with recurrent AF with less monitoring is unknown.
Methods
We used data from a prospective cohort of participants with transient new-onset AF while hospitalized for noncardiac surgery or medical illness, who wore one or two 14-day ECG monitors. We calculated the proportion of patients that would be diagnosed with recurrent AF with different durations of ECG monitoring and the median time-to-detection of recurrent AF lasting ≥30 s.
Results
A total of 139 participants (41.0 % female, median CHA2DS2-VASc 3) wore an ECG monitor a median of 1.5 months following hospital discharge; 83 (59.7 %) wore a second monitor at median of 5.8 months after the first monitor. Recurrent AF was detected in 5.0 % of participants by 1 day, 5.8 % by 2 days, 6.5 % by 3 days, 12.2 % by 7 days, 21.6 % by 14 days and in 28.8 % by the end of the second 14-day monitor. Median monitoring time to recurrent AF was 5.3 (IQR 1.4–9.7) days.
Conclusions
In patients with transient new-onset AF during hospitalization for another reason, the rate of detection of recurrent AF increased with longer monitoring durations. Approximately 80 % of diagnoses were made after 2 days of monitoring; the likelihood of capturing recurrent AF was 4 times higher with 14 days of monitoring compared to 2 days.
{"title":"Monitoring time-to-detection of recurrent atrial fibrillation in patients with transient new-onset atrial fibrillation detected initially during hospitalization for noncardiac surgery or medical illness","authors":"William F. McIntyre , Linda S. Johnson , Alexander P. Benz , Maria E. Vadakken , Nicole R. Latendresse , Chinthanie Ramasundarahettige , Faith Kirabo , Jorge A. Wong , Jason D. Roberts , Jeff S. Healey","doi":"10.1016/j.ejim.2025.106515","DOIUrl":"10.1016/j.ejim.2025.106515","url":null,"abstract":"<div><h3>Background</h3><div>Approximately one-third-of patients with transient new-onset atrial fibrillation (AF) during hospitalization for noncardiac surgery or medical illness will have recurrent AF within 1 year when assessed using two 14-day ECG monitors. The proportion of patients that would be diagnosed with recurrent AF with less monitoring is unknown.</div></div><div><h3>Methods</h3><div>We used data from a prospective cohort of participants with transient new-onset AF while hospitalized for noncardiac surgery or medical illness, who wore one or two 14-day ECG monitors. We calculated the proportion of patients that would be diagnosed with recurrent AF with different durations of ECG monitoring and the median time-to-detection of recurrent AF lasting ≥30 s.</div></div><div><h3>Results</h3><div>A total of 139 participants (41.0 % female, median CHA<sub>2</sub>DS<sub>2</sub>-VASc 3) wore an ECG monitor a median of 1.5 months following hospital discharge; 83 (59.7 %) wore a second monitor at median of 5.8 months after the first monitor. Recurrent AF was detected in 5.0 % of participants by 1 day, 5.8 % by 2 days, 6.5 % by 3 days, 12.2 % by 7 days, 21.6 % by 14 days and in 28.8 % by the end of the second 14-day monitor. Median monitoring time to recurrent AF was 5.3 (IQR 1.4–9.7) days.</div></div><div><h3>Conclusions</h3><div>In patients with transient new-onset AF during hospitalization for another reason, the rate of detection of recurrent AF increased with longer monitoring durations. Approximately 80 % of diagnoses were made after 2 days of monitoring; the likelihood of capturing recurrent AF was 4 times higher with 14 days of monitoring compared to 2 days.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"144 ","pages":"Article 106515"},"PeriodicalIF":6.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276587","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}
Pub Date : 2026-02-01DOI: 10.1016/j.ejim.2025.106582
Hui Chen
{"title":"Methodological considerations for interpreting the association between central systolic blood pressure and brain health","authors":"Hui Chen","doi":"10.1016/j.ejim.2025.106582","DOIUrl":"10.1016/j.ejim.2025.106582","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"144 ","pages":"Article 106582"},"PeriodicalIF":6.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446515","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}
{"title":"Antibiotic use in hospitalized older adults according to WHO AWaRe classification: data from the REPOSI register","authors":"Chiara Elli, Chiara Crippa, Luca Pasina, REPOSI, Investigators","doi":"10.1016/j.ejim.2025.106551","DOIUrl":"10.1016/j.ejim.2025.106551","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"144 ","pages":"Article 106551"},"PeriodicalIF":6.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642191","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}
Pub Date : 2026-02-01DOI: 10.1016/j.ejim.2025.106597
Sabrina Scilletta, Antonino Di Pino, Salvatore Piro, Roberto Scicali
{"title":"Cognitive impairment in familiar hypercholesterolemia: How much is vascular and how much is confounding? Author's reply","authors":"Sabrina Scilletta, Antonino Di Pino, Salvatore Piro, Roberto Scicali","doi":"10.1016/j.ejim.2025.106597","DOIUrl":"10.1016/j.ejim.2025.106597","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"144 ","pages":"Article 106597"},"PeriodicalIF":6.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558411","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}
Pub Date : 2026-02-01DOI: 10.1016/j.ejim.2025.106602
Yulin Liu , Lu Wang
{"title":"Bronchoscopy, ventilator dose and outcomes in severe CAP: reading the sex signal","authors":"Yulin Liu , Lu Wang","doi":"10.1016/j.ejim.2025.106602","DOIUrl":"10.1016/j.ejim.2025.106602","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"144 ","pages":"Article 106602"},"PeriodicalIF":6.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582629","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}
Pub Date : 2026-02-01DOI: 10.1016/j.ejim.2025.106589
Mauro Gori , Luca Fazzini , Jennifer Meessen , Raul Limonta , Samuela Carigi , Matteo Bianco , Luisa De Gennaro , Concetta Di Nora , Paolo Manca , Maria Vittoria Matassini , Vittoria Rizzello , Denitza Tinti , Aldo Pietro Maggioni , Francesco Orso , Marco Gorini , Renata De Maria
Background
Dihydropyridine calcium channel blockers (DHP-CCB) are widely used in heart failure (HF), despite the lack of data regarding their safety, especially in patients with reduced ejection fraction (HFrEF). We aimed to evaluate DHP-CCB prescription trends over time, their association with GDMT uptake and related outcomes across the spectrum of EF.
Methods
We studied outpatients with chronic HF prospectively enrolled in the nationwide observational INHF registry from 1998 to 2022. We used Cox regression methods to analyze all-cause mortality and cardiovascular hospitalization at 1-year according to DHP-CCB exposure, applying inverse probability of treatment weighting (IPTW).
Results
We included 15785 outpatients. 10829 (69 %) had HFrEF, and 4956(31 %) an EF>40 %. Median age was 69; 26.6 % were females. Overall, 1458 patients (9.1 %) received a DHP-CCB. DHP-CCB administration was twice as prevalent in patients with an EF>40 % than in those with HFrEF (13.9 %¦vs 7.1 %, respectively p<0.001). DHP-CCB prescription rates increased over time (p<0.001). Patients who received DHP-CCB were older, more comorbid, had a higher EF, and were less frequently prescribed GDMT than those who were not on DHP-CCB. After multivariable adjustment, using IPTW analysis, DHP-CCB prescription was associated with a higher risk of the outcome in the overall cohort (HR 1.11, 95 % CI 1.09-1.12, p<0.001), among HFrEF patients (HR 1.14, 95 % CI 1.12-1.16, p<0.001), and those with EF>40 % (HR 1.07, 95 % CI 1.04-1.10, p<0.001).
Conclusion
DHP-CCB use in HFrEF was associated with less GDMT prescription and worse outcomes. Additionally, DHP-CCB safety needs to be further explored in HFmrEF/HFpEF.
背景：二氢吡啶钙通道阻滞剂（DHP-CCB）广泛用于心力衰竭（HF），尽管缺乏关于其安全性的数据，特别是在射血分数降低（HFrEF）患者中。我们的目的是评估DHP-CCB处方随时间的变化趋势，它们与GDMT摄取的关系以及EF谱的相关结果。方法：我们研究了1998年至2022年在全国观察性INHF登记处登记的慢性HF门诊患者。采用治疗加权逆概率（IPTW），采用Cox回归方法分析DHP-CCB暴露1年的全因死亡率和心血管住院率。结果：纳入15785例门诊患者。10829例（69%）有HFrEF， 4956例（31%）有EF bb0（40%）。中位年龄为69岁；26.6%为女性。总体而言，1458名患者（9.1%）接受了DHP-CCB。DHP-CCB在EF患者中的应用是HFrEF患者的两倍(13.9% vs 7.1%，分别为p40% （HR 1.07, 95% CI 1.04-1.10）。结论：HFrEF患者使用DHP-CCB与较少的GDMT处方和较差的预后相关。此外，DHP-CCB在HFmrEF/HFpEF中的安全性有待进一步探讨。
{"title":"Effects of calcium channel blockers on GDMT prescription and outcomes according to ejection fraction: IN-HF real world data","authors":"Mauro Gori , Luca Fazzini , Jennifer Meessen , Raul Limonta , Samuela Carigi , Matteo Bianco , Luisa De Gennaro , Concetta Di Nora , Paolo Manca , Maria Vittoria Matassini , Vittoria Rizzello , Denitza Tinti , Aldo Pietro Maggioni , Francesco Orso , Marco Gorini , Renata De Maria","doi":"10.1016/j.ejim.2025.106589","DOIUrl":"10.1016/j.ejim.2025.106589","url":null,"abstract":"<div><h3>Background</h3><div>Dihydropyridine calcium channel blockers (DHP-CCB) are widely used in heart failure (HF), despite the lack of data regarding their safety, especially in patients with reduced ejection fraction (HFrEF). We aimed to evaluate DHP-CCB prescription trends over time, their association with GDMT uptake and related outcomes across the spectrum of EF.</div></div><div><h3>Methods</h3><div>We studied outpatients with chronic HF prospectively enrolled in the nationwide observational IN<img>HF registry from 1998 to 2022. We used Cox regression methods to analyze all-cause mortality and cardiovascular hospitalization at 1-year according to DHP-CCB exposure, applying inverse probability of treatment weighting (IPTW).</div></div><div><h3>Results</h3><div>We included 15785 outpatients. 10829 (69 %) had HFrEF, and 4956(31 %) an EF>40 %. Median age was 69; 26.6 % were females. Overall, 1458 patients (9.1 %) received a DHP-CCB. DHP-CCB administration was twice as prevalent in patients with an EF>40 % than in those with HFrEF (13.9 %¦vs 7.1 %, respectively p<0.001). DHP-CCB prescription rates increased over time (p<0.001). Patients who received DHP-CCB were older, more comorbid, had a higher EF, and were less frequently prescribed GDMT than those who were not on DHP-CCB. After multivariable adjustment, using IPTW analysis, DHP-CCB prescription was associated with a higher risk of the outcome in the overall cohort (HR 1.11, 95 % CI 1.09-1.12, p<0.001), among HFrEF patients (HR 1.14, 95 % CI 1.12-1.16, p<0.001), and those with EF>40 % (HR 1.07, 95 % CI 1.04-1.10, p<0.001).</div></div><div><h3>Conclusion</h3><div>DHP-CCB use in HFrEF was associated with less GDMT prescription and worse outcomes. Additionally, DHP-CCB safety needs to be further explored in HFmrEF/HFpEF.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"144 ","pages":"Article 106589"},"PeriodicalIF":6.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524136","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}
Pub Date : 2026-02-01DOI: 10.1016/j.ejim.2025.106583
Ann-Kristin Porth , Anete Palma , Burcu Sallarel , Dimitrios Patoulias , Dirk Müller-Wieland , Dror Dicker , Ieva Ruža , Ilya Davidenko , Jan Škrha jr. , Julia Brandts , Ricardo Gomez-Huelgas , Shiran Gruber , Sindija Smirnova , Theocharis Koufakis , Yusuf Ziya Sener , Zuzana Kršáková , Alexandra Kautzky-Willer , EFIM Diabetes and Obesity Working Group
Background
People with diabetes and obesity have an increased risk of hospitalisation and in-hospital complications. Rising prevalence of diabetes and obesity, including their co-occurrence, “diabesity”, make guideline-compliant treatment increasingly important. However, evidence on specific in-hospital diabesity treatment is limited. We aimed to characterise inpatients with diabetes/diabesity and evaluate their in-hospital care to identify challenges in inpatient diabetes/diabesity management.
Methods
Cross-sectional data was collected from patient records and ward charts. We analysed differences between inpatients with and without diabesity and explored in-hospital diabetes treatment. We further compared inpatients with type 2 diabetes who started insulin treatment or received cardioprotective glucose-lowering agents to those who did not and used logistic regression to identify predictors of insulin initiation and use of cardioprotective agents.
Results
We included 207 people with diabetes from eight European hospitals, 50 % with diabesity. Most inpatients had a HbA1c >6.5 % (48 mmol/mol). Among inpatients with type 2 diabetes, one third did not have a recent HbA1c reading, blood glucose levels were monitored <3 times daily, and only 40 % of those with cardiovascular/renal disease received cardioprotective therapies. HbA1c, creatinine and at-home medications predicted insulin initiation, while admission cause and BMI predicted use of cardioprotective agents.
Conclusions
We observed an underuse of cardioprotective glucose-lowering therapies, low rates of glycaemic monitoring, and low availability of HbA1c readings, concluding that clinical guidelines are not sufficiently implemented in everyday practice in Europe. Based on this, we advocate for better staff training, involvement of diabetologists, and raising awareness of the benefits of cardioprotective agents in the hospital.
{"title":"Gaps in Glycaemic Monitoring and Underuse of Cardioprotective Glucose-lowering Agents: Challenges of inpatient diabetes care identified by EFIM’s Diabesity Day Survey 2024","authors":"Ann-Kristin Porth , Anete Palma , Burcu Sallarel , Dimitrios Patoulias , Dirk Müller-Wieland , Dror Dicker , Ieva Ruža , Ilya Davidenko , Jan Škrha jr. , Julia Brandts , Ricardo Gomez-Huelgas , Shiran Gruber , Sindija Smirnova , Theocharis Koufakis , Yusuf Ziya Sener , Zuzana Kršáková , Alexandra Kautzky-Willer , EFIM Diabetes and Obesity Working Group","doi":"10.1016/j.ejim.2025.106583","DOIUrl":"10.1016/j.ejim.2025.106583","url":null,"abstract":"<div><h3>Background</h3><div>People with diabetes and obesity have an increased risk of hospitalisation and in-hospital complications. Rising prevalence of diabetes and obesity, including their co-occurrence, “diabesity”, make guideline-compliant treatment increasingly important. However, evidence on specific in-hospital diabesity treatment is limited. We aimed to characterise inpatients with diabetes/diabesity and evaluate their in-hospital care to identify challenges in inpatient diabetes/diabesity management.</div></div><div><h3>Methods</h3><div>Cross-sectional data was collected from patient records and ward charts. We analysed differences between inpatients with and without diabesity and explored in-hospital diabetes treatment. We further compared inpatients with type 2 diabetes who started insulin treatment or received cardioprotective glucose-lowering agents to those who did not and used logistic regression to identify predictors of insulin initiation and use of cardioprotective agents.</div></div><div><h3>Results</h3><div>We included 207 people with diabetes from eight European hospitals, 50 % with diabesity. Most inpatients had a HbA1c >6.5 % (48 mmol/mol). Among inpatients with type 2 diabetes, one third did not have a recent HbA1c reading, blood glucose levels were monitored <3 times daily, and only 40 % of those with cardiovascular/renal disease received cardioprotective therapies. HbA1c, creatinine and at-home medications predicted insulin initiation, while admission cause and BMI predicted use of cardioprotective agents.</div></div><div><h3>Conclusions</h3><div>We observed an underuse of cardioprotective glucose-lowering therapies, low rates of glycaemic monitoring, and low availability of HbA1c readings, concluding that clinical guidelines are not sufficiently implemented in everyday practice in Europe. Based on this, we advocate for better staff training, involvement of diabetologists, and raising awareness of the benefits of cardioprotective agents in the hospital.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"144 ","pages":"Article 106583"},"PeriodicalIF":6.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483578","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}
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