Heart & Lung最新文献

{"title":"Antiplatelet pretreatment effects in patients with non-ST-segment elevation acute coronary syndromes in a center without daily 24 hours access to the catheter laboratory","authors":"Gabriel Torres-Ruiz M.D,&nbsp;Jordi Sans-Roselló M.D, PhD,&nbsp;Eduard Bosch-Peligero M.D,&nbsp;Paola Rojas-Flores M.D,&nbsp;Jordi Cahís-Vela M.D,&nbsp;Meritxell Lloreda-Surribas M.D,&nbsp;Mario Sutil-Vega M.D,&nbsp;Marcelo Rizzo M.D,&nbsp;Nuria Mallofré-Vila M.D,&nbsp;Josep Guindo-Soldevila M.D,&nbsp;Victor García-Hernando M.D,&nbsp;Gala Caixal-Vila M.D, PhD,&nbsp;Pablo Del Castillo-Vázquez M.D,&nbsp;Pablo Carrión-Montaner M.D,&nbsp;Daniel Valcárcel-Paz M.D, PhD,&nbsp;Antoni Martínez-Rubio M.D, FESC, FACC","doi":"10.1016/j.hrtlng.2026.102728","DOIUrl":"10.1016/j.hrtlng.2026.102728","url":null,"abstract":"<div><h3>Background</h3><div>Pretreatment in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) is controversial.</div></div><div><h3>Objectives</h3><div>Evaluate the safety and efficacy of pretreatment in a center without daily access to the catheter laboratory (CL).</div></div><div><h3>Methods</h3><div>This prospective observational single-center study (June 2021-June 2024) included patients with suspected NSTE-ACS undergoing coronary angiography (CAG). Clinical, biochemical and CL data were registered. Patients were monitored during their hospital stay for bleedings events (BE), ischemic events (IE) and misdiagnosis.</div></div><div><h3>Results</h3><div>443 consecutive patients with suspected NSTE-ACS were included. Median age was 70.0 years (IQR 60.0-77.0) and 71.8 % were male. 84.0 % were under pretreatment. IE, BE and cardiovascular death were of 5.0 %, 4.1 % and 1.8 %, respectively. IE were more frequent in the non-pretreatment group (10.3 % vs 4.1 %; <em>p</em> = 0.030), whereas there was no significant difference in BE (1.4 % vs 4.6 %; <em>p</em> = 0.216). Myocardial infarction (MI) before CAG and type 4b MI rate were lower in the pretreatment group (1.6 % vs 8.5 %; <em>p</em> &lt; 0.001 and 0.3 % vs 2.8 %; <em>p</em> = 0.016, respectively). After adjusting for covariates, pretreatment was associated with a lower incidence of IE (OR 0.35 95 % CI 0.135-0.928; <em>p</em> = 0.035) whereas it was not associated with BE (OR 3.68 95 % CI 0.427-31.651; <em>p</em> = 0.236). A lower estimated glomerular filtration rate and active malignancy were associated with BE, while chronic ischemic heart disease was associated with IE.</div></div><div><h3>Conclusions</h3><div>Pretreatment was associated with a lower incidence of IE in NSTE-ACS patients with lower rates of MI before CAG and type 4b MI, without a significant increase in BE.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102728"},"PeriodicalIF":2.6,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S-S.M.A.R.T score for mortality prediction in sepsis: Comparative analysis with qSOFA and a novel SSMART-MC model","authors":"Serdar Özdemir,&nbsp;İbrahim Altunok,&nbsp;Merve Osoydan Satıcı M.D.,&nbsp;Hilal Sümeyye Körelçiner MD","doi":"10.1016/j.hrtlng.2026.102735","DOIUrl":"10.1016/j.hrtlng.2026.102735","url":null,"abstract":"<div><h3>Background</h3><div>Early risk stratification in sepsis is essential for guiding timely clinical decisions in the emergency department (ED). While several prognostic scores exist, many rely on laboratory parameters that may not be immediately available at triage.</div></div><div><h3>Objective</h3><div>To evaluate the prognostic performance of the S-S.M.A.R.T score for predicting 30-day mortality in patients with Sepsis-3–defined sepsis and to assess whether incorporating comorbidity and biomarker data enhances predictive accuracy.</div></div><div><h3>Methods</h3><div>This prospective observational study included adult patients (≥18 years) presenting to a ED with sepsis defined by Sepsis-3 criteria. Demographic, clinical, and laboratory data were collected at ED presentation. The S-S.M.A.R.T score, SOFA score, and a novel SSMART-MC model (S-S.M.A.R.T plus malignancy and CRP) were calculated. Logistic regression identified independent predictors of 30-day mortality. Prognostic performance was assessed using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and overall accuracy.</div></div><div><h3>Results</h3><div>Among 180 patients, 104 (57.8%) died within 30 days. Median S-S.M.A.R.T and SOFA scores were higher in non-survivors (3 vs. 2 and 9 vs. 6; <em>p</em> &lt; .001). S-S.M.A.R.T predicted 30-day mortality with an AUC of 0.718, similar to SOFA (AUC 0.735; <em>p</em> = .701). Incorporating malignancy and CRP, the SSMART-MC model achieved an AUC of 0.867, with 87.3% sensitivity, 72.0% specificity, and 80.8% overall accuracy.</div></div><div><h3>Conclusions</h3><div>In this Sepsis-3 cohort, the S-S.M.A.R.T score showed performance comparable to qSOFA for predicting 30-day mortality. The incorporation of malignancy and CRP appeared to improve prognostic accuracy. However, given the limited sample size and lack of external validation, the SSMART-MC model should be considered a promising tool that requires confirmation in larger, multicenter studies before routine clinical use.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102735"},"PeriodicalIF":2.6,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How usual is usual care in Chronic Obstructive Pulmonary Disease trials? A systematic review on quality of reporting and validity of comparator interventions","authors":"Ana Paula Coelho Figueira Freire ,&nbsp;Mark R Elkins ,&nbsp;Marceli Rocha Leite ,&nbsp;Ryan Galindo ,&nbsp;Italo Ribeiro Lemes ,&nbsp;Hailey McNeill ,&nbsp;Bo Warner ,&nbsp;Jacob Crumb ,&nbsp;Nathan Herde ,&nbsp;Heloisa Rocha Reverte Siqueira Ribeiro ,&nbsp;Karen Roemer ,&nbsp;Francis Lopes Pacagnelli ,&nbsp;Rafael Z Pinto","doi":"10.1016/j.hrtlng.2026.102733","DOIUrl":"10.1016/j.hrtlng.2026.102733","url":null,"abstract":"<div><h3>Background</h3><div>‘Usual care’ is a term that can refer to a variety of control conditions in randomized controlled trials (RCTs). The lack of standardization of usual care groups can lead to problems for clinical decision-making.</div></div><div><h3>Objectives</h3><div>1) Systematically describe the types and characterizations of “usual care” interventions in COPD RCTs. 2) Determine how well RCTs report usual care interventions and the extent to which COPD guideline-recommended treatment components are a part of usual care interventions.</div></div><div><h3>Methods</h3><div>Systematic review design. Two investigators screened studies and independently extracted data. We extracted type of usual care described, quality of reporting, and classification of usual care components as validated (i.e., aligned with guidelines) or unvalidated comparators.</div></div><div><h3>Results</h3><div>We included 233 studies. The most frequently described usual care intervention included patient education (n = 72, 31%) and continued care with the general practitioner (n = 67, 29%). Only 7% of the studies provided a complete description of the usual care intervention. Almost half of usual care interventions (49%) were deemed unvalidated. Higher PEDro scores were associated with greater odds of the intervention being validated (Exp(B) = 1.32; 95% CI: 1.04 to 1.66).</div></div><div><h3>Conclusion</h3><div>There is significant variability and frequent lack of reporting in the characterization of ‘usual care’ comparators in RCTs involving patients with COPD. Usual care is often poorly described, inconsistently delivered, and commonly not aligned with clinical guidelines. Higher quality trials had better odds of providing valid usual care.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102733"},"PeriodicalIF":2.6,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146133681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrow wide-complex surprise.","authors":"Anthony H Kashou, Nicholas Y Tan, Gurukripa N Kowlgi","doi":"10.1016/j.hrtlng.2025.102720","DOIUrl":"https://doi.org/10.1016/j.hrtlng.2025.102720","url":null,"abstract":"<p><p>Herein, we present a 65-year-old woman with recurrent palpitations and a wide complex tachycardia consistent with atriofascicular (Mahaim) tachycardia. We review Mahaim pathway physiology, embryologic basis, characteristic ECG features, and key electrophysiologic study findings that guide diagnosis and ablation strategy.</p>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":" ","pages":"102720"},"PeriodicalIF":2.6,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sedentary behavior and physical health status explain the relationship between years of residence in socioeconomically distressed counties and risk for Cardiovascular diseases","authors":"Ifeanyi Madujibeya PhD, APRN, AGACNP-BC ,&nbsp;Debra K. Moser PhD, RN, FAHA, FAAN","doi":"10.1016/j.hrtlng.2026.102726","DOIUrl":"10.1016/j.hrtlng.2026.102726","url":null,"abstract":"<div><h3>Background</h3><div>Residents of rural, socioeconomically distressed counties,such as Appalachian Kentucky, experience disproportionately high cardiovascular disease (CVD) risk, compounded by sedentary behavior and poor self-reported physical health.</div></div><div><h3>Objectives</h3><div>This study investigates whether sedentary behavior and poor self-reported physical health serially mediate the relationship between years of residence in rural Appalachian Kentucky counties and CVD risk.</div></div><div><h3>Methods</h3><div>This secondary analysis included 309 adults residing in rural Appalachian counties. Sedentary behavior was measured as daily minutes in sedentary activity using an Actiwatch. Self-reported physical health was assessed using the Short-Form Health Survey-12, and CVD risk was measured using the Framingham risk score. Serial mediation analysis with two mediators was conducted using the PROCESS macro, controlling sociodemographic and lifestyle covariates.</div></div><div><h3>Results</h3><div>The participants’ mean age was 57.3 (±15) years, with an average residence duration of 42.7 (±22.2) years. Participants spent an average of 751.6 (±215.3) minutes per day in sedentary behavior, and the mean CVD risk was 15.3% (±10.4%). Years of residence were directly associated with increased CVD risk (direct effect = 0.168; 95% Boot CI [.117, 0.219]) and indirectly associated through sedentary behavior (indirect effect = 0.016; 95% Boot CI [.006, 0.039]). An additional indirect effect emerged through sedentary behavior leading to poorer self-reported physical health (indirect effect = 0.002; 95% Boot CI [.001, 0.004]).</div></div><div><h3>Conclusion</h3><div>These findings indicate that interventions targeting CVD risk reduction in rural socioeconomically distressed counties should include strategies to reduce sedentary behavior, which may improve self-reported physical health status and decrease CVD risk.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102726"},"PeriodicalIF":2.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise tolerance in patients with chronic thromboembolic pulmonary hypertension after balloon pulmonary angioplasty","authors":"Zhihui Lu MD ,&nbsp;Chen Zhang MD ,&nbsp;Jun Wan MD ,&nbsp;Yao Xiao MD ,&nbsp;Lei Zhao MD ,&nbsp;Guanyu Lu MD ,&nbsp;Hongbo Zhang MD ,&nbsp;Lanling Wang MD ,&nbsp;Yuhan Yi MD ,&nbsp;Lili Wang MD ,&nbsp;Xiaohai Ma MD","doi":"10.1016/j.hrtlng.2026.102725","DOIUrl":"10.1016/j.hrtlng.2026.102725","url":null,"abstract":"<div><h3>Background</h3><div>Balloon pulmonary angioplasty (BPA) is an effective therapeutic alternative for patients with chronic thromboembolic pulmonary hypertension (CTEPH), which improved pulmonary arterial compliance (C_PA) and pulmonary vascular resistance (PVR).</div></div><div><h3>Objective</h3><div>To investigate whether the C_PA is a predictor of exercise tolerance after BPA.</div></div><div><h3>Methods</h3><div>The correlations between changes in each parameter and changes in six-minute walking distance (6MWD) were evaluated by Pearson’s test. The determinants of functional capacity that was defined as 6MWD ≥440 m were assessed with a logistic regression model. Multiple linear regression analysis was used to identify the independent variables related to △6MWD.</div></div><div><h3>Results</h3><div>We enrolled 70 patients (female/male: 40/30, mean age: 64 years) who underwent a total of 271 BPA sessions which significantly increased C_PA [1.0 (0.7, 1.3) vs. 2.1 (1.7, 2.5) mL/mmHg], and decreased PVR [6.7 (3.6, 9.7) vs. 3.0 (2.1, 4.3) wood units]. The correlation coefficient between improvement in 6MWD and changes in C_PA was r = 0.328 (<em>P</em> = 0.006). At univariate analysis, duration of pulmonary hypertension symptoms and pulmonary arterial compliance were found to be associated with good exercise tolerance. Multivariate analysis demonstrated that C_PA (95 %CI: 1.23 to 3.75, <em>P</em> = 0.026) was an independent predictor of exercise tolerance after BPA. The multiple linear regression analysis demonstrated that △C_PA (β= 0.292, <em>P</em> = 0.019) was an independent predictor of △6MWD.</div></div><div><h3>Conclusion</h3><div>BPA significantly improved C_PA in inoperable patients with CTEPH and the resistance-compliance relationship maintained inversely associated. After successful BPA, baseline C_PA is an important determinant of exercise tolerance.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102725"},"PeriodicalIF":2.6,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146039329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and prognostic impact of cognitive frailty in older adult patients with heart failure: A prospective cohort study","authors":"Jian Liu ,&nbsp;Yu Wu ,&nbsp;Zhiwei Wang ,&nbsp;Shicai Wu","doi":"10.1016/j.hrtlng.2026.102727","DOIUrl":"10.1016/j.hrtlng.2026.102727","url":null,"abstract":"<div><h3>Background</h3><div>Current research indicates that cognitive frailty has a high prevalence among older adult patients with heart failure, but there is still a lack of longitudinal evidence on its impact on prognosis.</div></div><div><h3>Objectives</h3><div>This study aims to describe the prevalence of cognitive frailty and its prognostic significance.</div></div><div><h3>Methods</h3><div>This study was conducted from September 2023 to December 2024 at a comprehensive hospital affiliated with a university. Cognitive frailty was defined as the coexistence of physical frailty and cognitive impairment. Physical frailty was assessed using the FRAIL frailty scale, while cognitive impairment was evaluated using the Montreal Cognitive Assessment and the Clinical Dementia Rating scale. The Cox proportional hazards regression model was used to analyze the impact of cognitive frailty on all-cause mortality within one year and the combined endpoint of readmission and all-cause mortality.</div></div><div><h3>Results</h3><div>This study enrolled a total of 350 patients, with 334 completing one-year follow-up after discharge, resulting in a loss to follow-up rate of 4.5%. The prevalence of cognitive frailty was very common, reaching 31.7%. After adjusting for confounding factors, cognitive frailty still had a significant effect on one-year all-cause mortality (HR = 2.256; 95%CI: 1.209-4.208; <em>P</em> = 0.011) and combined endpoints (HR = 1.563; 95%CI: 1.158-2.111; <em>P</em> = 0.004).</div></div><div><h3>Conclusion</h3><div>The high prevalence of cognitive frailty in older adult patients with heart failure and its significant increase in the risk of adverse outcomes such as all-cause mortality and readmission after discharge should alert healthcare providers to pay more attention to cognitive frailty and provide evidence for follow-up studies.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102727"},"PeriodicalIF":2.6,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia in heart failure: Demographics, nutritional status, and patient-reported outcomes","authors":"Juvel-Lou P. Velasco ,&nbsp;Shenghao Xia ,&nbsp;Shu-Fen Wung","doi":"10.1016/j.hrtlng.2026.102724","DOIUrl":"10.1016/j.hrtlng.2026.102724","url":null,"abstract":"<div><h3>Background</h3><div>Dysphagia, or difficulty swallowing, is an often underrecognized comorbidity in individuals with heart failure (HF), which can potentially affect nutrition, symptom burden, and overall well-being. Patients with HF may experience dysphagia due to the anatomical proximity of the heart and esophagus. Cardiac remodeling, such as cardiomegaly and left ventricular dilation, can result in external compression of the esophagus, disrupting normal swallowing function. Despite these plausible mechanisms, there is limited large-scale data on evaluating the prevalence and clinical impact of dysphagia in HF populations.</div></div><div><h3>Objectives</h3><div>This study aimed to compare nutritional status, health perception, quality of life, and fatigue among HF patients with and without dysphagia.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on HF patients enrolled in the All of Us Research Program. Nutritional status was assessed using serum albumin levels, body weight, and body mass index (BMI). Health perception and fatigue were evaluated through responses to the Overall Health Survey.</div></div><div><h3>Results</h3><div>Within the analysis of the All of Us Research Program, 14,243 participants with HF were identified, of which 2,903 (20.4%) reported dysphagia after excluding those with a history of cerebrovascular accidents. The HF cohort was predominantly aged ≥65 years (53.2%), predominantly non-Hispanic or Latino (81.7%), and mainly White (51.3%), with a slight female predominance (55.1%). Among participants with available left ventricular ejection fraction (LVEF) data, 64.1% had preserved ejection fraction (&gt;50%). Dysphagia was more frequently observed in older individuals and women, and it was associated with significantly lower body weight (mean 89.3 vs. 93.5 kg) and serum albumin levels (35.3 g/L vs. 36.2 g/L; p &lt; 0.001), despite both groups having BMI (mean ∼32 kg/m², indicating Class I obesity). Individuals with dysphagia consistently reported poorer general, physical, and mental health, along with lower quality of life; and greater fatigue severity compared to those without dysphagia (all p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Dysphagia is a prevalent and clinically significant comorbidity in patients with HF, especially in those with preserved ejection fraction and advanced age. HF patients with dysphagia experience worse nutritional status and patient-reported outcomes compared to those without dysphagia. These findings underscore the need for routine screening for dysphagia and a comprehensive nutritional assessment to improve management and outcomes in HF populations.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102724"},"PeriodicalIF":2.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of life's essential eight and inflammatory markers on long-term cardiovascular disease risk and all-cause mortality: Insights from the Heart SCORE study","authors":"Claudia E. Bambs ,&nbsp;Ian Pollack ,&nbsp;Justin Swanson ,&nbsp;Jiaxuan Duan ,&nbsp;Christopher McKennan ,&nbsp;Kevin Kip ,&nbsp;Daniel Buysse ,&nbsp;Steven E. Reis ,&nbsp;Anum Saeed","doi":"10.1016/j.hrtlng.2025.102710","DOIUrl":"10.1016/j.hrtlng.2025.102710","url":null,"abstract":"<div><h3>Background</h3><div>Life’s Essential 8 (LE8) are the American Heart Association’s metrics for cardiovascular health. Despite the association of cardiovascular diseases with inflammation, LE8 does not include inflammatory markers as a component. We examined the association of baseline LE8 components and inflammatory measures with long-term cardiovascular and mortality outcomes among a community-based population.</div></div><div><h3>Objectives</h3><div>To determine if inflammatory markers independently predict atherosclerotic cardiovascular disease (ASCVD) or all-cause mortality beyond LE8 metrics.</div></div><div><h3>Methods</h3><div>Baseline LE8 metrics and inflammatory markers (interleukin-6 [IL-6] and high sensitivity C-reactive protein [hsCRP]) were measured among 1869 participants (age 59±7.5 years, 41.9% Black) in the longitudinal Heart SCORE study. Cox-proportional hazard ratios were used to assess associations between LE8 score, inflammatory markers, and risk of ASCVD and all-cause mortality over 12 years.</div></div><div><h3>Results</h3><div>Higher LE8 Scores were significantly associated with lower all-cause mortality and ASCVD. After adjusting for LE8 metrics and demographics, ideal level of blood glucose was the most significant factor associated with lower ASCVD (HR 0.26 [0.12–0.58], <em>p</em> = 0.001). For all-cause mortality, no smoking emerged as the main protective LE8 component (HR 0.29 [0.16–0.53], <em>p</em> &lt; 0.001). Increased IL-6 was independently associated with ASCVD (HR 1.54 [1.05–2.25], <em>p</em> = 0.03), and lower IL-6 was associated with lower all-cause mortality (HR 0.52 [0.30–0.90], <em>p</em> = 0.02). HsCRP was not associated with either outcome.</div></div><div><h3>Conclusion</h3><div>Higher LE8 Scores are linked to reduced risk of ASCVD and all-cause mortality. IL-6 independently predicts adverse outcomes beyond LE8, suggesting inflammatory burden may represent an additional, modifiable target for cardiovascular risk reduction.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"77 ","pages":"Article 102710"},"PeriodicalIF":2.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study on the association between C-Reactive Protein-Albumin-Lymphocyte (CALLY) index and adverse prognosis in patients with chronic heart failure (CHF) at different glucose metabolic states","authors":"Yuting Liu ,&nbsp;Guo Song ,&nbsp;Heyu Chu ,&nbsp;Xiaoli Liu ,&nbsp;Xue Bao ,&nbsp;Rong Gu","doi":"10.1016/j.hrtlng.2025.102693","DOIUrl":"10.1016/j.hrtlng.2025.102693","url":null,"abstract":"<div><h3>Background</h3><div>C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index has been proposed as a novel composite predictor based on inflammation, nutrition and immunity. And its clinical significance in patients with chronic heart failure (CHF) at different glucose metabolism states has not previously been studied.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the association between the CALLY index and adverse cardiovascular outcomes in CHF patients, and to examine its interaction with glucose metabolic status.</div></div><div><h3>Methods</h3><div>This retrospective cohort study enrolled 1674 hospitalized CHF patients between December 2018 and August 2022. The primary endpoints were cardiovascular (CV) death and major adverse cardiac and cerebrovascular events (MACCEs). The CALLY index was used to stratify patients into tertiles. Regression models with multivariable Cox proportional hazards were employed to evaluate the association between CALLY levels and primary endpoints.</div></div><div><h3>Results</h3><div>During median follow-up of 876 days, MACCEs were observed in 580 patients (34.6%) and CV death were 219 patients (13.1%). After adjustment, the highest CALLY(&gt;2.05) was linked to the lowest incidence of MACCEs (HR=0.74 CI= 0.60 - 0.92 <em>p</em> = 0.021) and CV death (HR=0.36 CI= 0.25–0.53 <em>p</em> &lt; 0.001). At various glucose metabolic stages, the highest CALLY reduced MACCE risk in diabetic patients (HR = 0.64, 95% CI =0.47–0.86,<em>P</em> = 0.004), but patients with prediabetes and normoglycemia groups did not have the same connection (both <em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Higher CALLY values were correlated with a protective effect against adverse prognosis in CHF, particularly against MACCEs in diabetic individuals, highlighting the importance of inflammation, nutrition, and immunity in this patient population.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"78 ","pages":"Article 102693"},"PeriodicalIF":2.6,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}