Archives of Cardiovascular Diseases最新文献

{"title":"Impact of a pneumococcal vaccination incentive campaign in chronic heart failure patients in France: A cluster-randomized trial","authors":"H. Guillermou ,&nbsp;G. Mercier ,&nbsp;B. Litovsky ,&nbsp;L. Papinaud ,&nbsp;F. Roubille","doi":"10.1016/j.acvd.2025.10.063","DOIUrl":"10.1016/j.acvd.2025.10.063","url":null,"abstract":"<div><h3>Introduction</h3><div>Pneumococcal vaccination rates are critically low among high-risk patients, particularly those with heart failure (HF), who face increased risk of severe infections and complications.</div></div><div><h3>Objective</h3><div>A prospective interventional trial was designed to evaluate the impact of an incentive campaign carried out by the French health insurance.</div></div><div><h3>Method</h3><div>Is study was an open-label pragmatic cluster randomized controlled trial involving general practitioners (GPs) and their related patients with chronic HF in a French region, identified through the regional health insurance database. HF patients were assigned to intervention or control groups based on the randomized allocation of their treating GPs. In the intervention group, both GPs and their patients received two vaccination incentive letters, whereas the control group was only observed.</div></div><div><h3>Results</h3><div>3952 GPs and 12,285 corresponding patients with HF were included between Mar 23, 2023 and Mar 23, 2024. The pneumococcal vaccination rate at one year was 35% in the intervention group (<em>n</em> <!-->=<!--> <!-->6140) versus 3.5% in the control group (<em>n</em> <!-->=<!--> <!-->5937). Multivariable analyses showed a 15-fold higher probability of vaccination in patients receiving the intervention. The vaccination rate increased with male patients, female GP, and previous influenza vaccination but decreased in younger (&lt;70 years) and older patient age (&gt;85 years). The pneumococcal vaccination was associated with a notable reduction in overall mortality (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>This randomized study demonstrated the effectiveness of a mail-in promotion to sustainably increase pneumococcal vaccination coverage in a frail high-risk population. Furthermore, pneumococcal vaccination was associated with a notable reduction in overall mortality.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S35"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of sodium-glucose cotransporter-2 inhibitors in heart failure patients: A nationwide population-based cohort study","authors":"P. Gautier ,&nbsp;M. Elbaz ,&nbsp;J. Bezin ,&nbsp;C. Delmas ,&nbsp;M. Cherbi ,&nbsp;F. Bouisset ,&nbsp;C. Vindis ,&nbsp;A. Renoux ,&nbsp;M. Lafaurie ,&nbsp;F. Montastruc","doi":"10.1016/j.acvd.2025.10.055","DOIUrl":"10.1016/j.acvd.2025.10.055","url":null,"abstract":"<div><h3>Introduction</h3><div>Sodium-Glucose cotransporter-2 inhibitors (SGLT-2i) has demonstrated substantial benefit in heart failure (HF) patients in clinical trials. However, the real-life effectiveness of SGLT-2i in HF patients remains unexplored.</div></div><div><h3>Objective</h3><div>This study aims to compare, in HF patients, SGLT-2i initiation with standard care regarding all-cause mortality and HF hospitalization.</div></div><div><h3>Method</h3><div>A nationwide, population-based cohort study was conducted with a new-user design, using the French National Healthcare Database “Système National des Données de Santé” (SNDS) from January 2021 to December 2023. Patients with first hospitalization for HF and initiating SGLT-2i at discharge versus standard of care were matched using a 1:1 calendar-time-specific propensity score. The primary outcome was a composite of all-cause death and hospitalization for HF. Secondary outcomes were the individual determinants of the primary outcome.</div></div><div><h3>Results</h3><div>After matching, 52,838 patients (56.4% males, median age 79 years) were followed over a mean duration of 9.0 months. Initiation of SGLT-2i was associated with a lower rate of all-cause mortality or hospitalization for HF (adjusted hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.67 to 0.75) compared to standard of care. The adjusted HR for all-cause mortality was 0.70 (95% CI 0.65–0.74) and 0.71 (95% CI 0.64–0.78) for HF hospitalization. Results were consistent across subgroups, including SGLT-2i agents (empagliflozin and dapagliflozin), left ventricular ejection fraction (LVEF), age, sex and diabetes.</div></div><div><h3>Conclusion</h3><div>This large population-based cohort study of HF patients reported that SGLT-2i reduced the composite of all-cause mortality and hospitalization for HF, regardless of diabetes, age, LVEF and SGLT-2i agent (empagliflozin and dapagliflozin). These findings support their broader use in patients with HF, including in older people.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S30"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic variants associated with acute coronary syndrome: A pilot study in a northern Moroccan population","authors":"M.H. Abaydi ,&nbsp;I. Mouhrach ,&nbsp;A. Ech-Chenbouli ,&nbsp;B. El Boussaadani ,&nbsp;L. Bouguenouch ,&nbsp;K. Ouldim ,&nbsp;Z. Raissouni","doi":"10.1016/j.acvd.2025.10.017","DOIUrl":"10.1016/j.acvd.2025.10.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute coronary syndrome (ACS) remains a major cause of cardiovascular morbidity and mortality. While classical risk factors such as hypertension, diabetes, and smoking are well established, genetic susceptibility is increasingly recognized in atherosclerosis. This pilot study aims to explore the association between specific gene polymorphisms and ACS in a northern Moroccan population.</div></div><div><h3>Objective</h3><div>To assess the prevalence of polymorphisms in <em>TGFB1</em>, <em>IGF1</em>, <em>PDGFB</em>, <em>VEGFA</em>, and <em>FGF2</em> genes among patients with ACS and controls, and explore interactions with traditional risk factors.</div></div><div><h3>Method</h3><div>A case-control study included 64 patients with ACS (STEMI and NSTEMI) and 48 healthy controls. Patients were stratified into STEMI and NSTEMI groups. Mean age was 61 years; 70.3% were male (74% in STEMI, 68% in NSTEMI). Genotyping was performed for <em>TGFB1</em> (rs1800470), <em>IGF1</em> (rs35767), <em>VEGFA</em> (rs699947), <em>PDGFB</em> (rs2285094), and <em>FGF2</em> (rs308395). Allelic and genotypic frequencies were compared between groups, and the sequencing workflow is illustrated in <span><span>Fig. 1</span></span>.</div></div><div><h3>Results</h3><div><em>TGFB1</em>: G allele present in 39% of cases, absent in controls. Genotypes: A/A (34%), A/G (53%), G/G (12%) in cases; A/A (100%) in controls. <em>IGF1</em>: G allele detected in 83% of cases, 0% of controls. G/G genotype in 69% of cases; A/A in 100% of controls. <em>PDGFB</em>: T and C alleles evenly distributed. Cases: C/C (23%), T/C (50%), T/T (27%); controls: C/C (17%), T/C (62%), T/T (21%). <em>FGF2</em>: C allele more frequent in cases (72%) than in controls (57%). Genotypes in cases: C/C (50%), C/G (44%), G/G (6%); in controls: C/C (27%), C/G (61%), G/G (12%). <em>VEGFA</em>: C allele less frequent in cases (62%) than controls (78%). Case genotypes: A/A (16%), C/A (45%), C/C (39%); controls: A/A (15%), C/A (15%), C/C (71%).</div></div><div><h3>Conclusion</h3><div>This pilot study reveals significant associations between ACS and genetic polymorphisms, notably in <em>TGFB1</em> and <em>IGF1</em>. Despite the modest sample size, the findings contribute to understanding genetic risk factors in North African populations and support further research into personalized cardiovascular prevention.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S13"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote management of heart failure patients in medically underserved areas","authors":"J. Florence ,&nbsp;S. Ploux ,&nbsp;R. Eschalier","doi":"10.1016/j.acvd.2025.10.073","DOIUrl":"10.1016/j.acvd.2025.10.073","url":null,"abstract":"<div><h3>Introduction</h3><div>Medically underserved areas (MUA) are associated with higher rates of adverse health outcomes, such as preventable hospitalizations, emergency department visits and death. While remote management (RM) programs can reduce unplanned hospitalizations for heart failure (HF) and all-cause mortality, its effectiveness has not been evaluated in MUA.</div></div><div><h3>Objective</h3><div>To describe the effect of an RM program on a composite outcome including all-cause mortality and HF hospitalizations among chronic HF patients in MUA.</div></div><div><h3>Method</h3><div>Between April 2020 and December 2022 we included all consecutive patients in the same multiparametric heart failure RM program of two French University Hospitals. Follow-up data were collected until February 2023. Inclusion criteria were chronic HF with New York Heart Association<!--> <!-->≥<!--> <!-->II and an elevated B-type natriuretic peptide (BNP<!--> <!-->&gt;<!--> <!-->100<!--> <!-->pg/mL or N-terminal-pro-BNP<!--> <!-->&gt;<!--> <!-->1000<!--> <!-->pg/mL) and/or at least an episode of HF hospitalization within the last year. Patient assessments were performed remotely and included measurements of body weight, blood pressure, heart rate, symptoms, biochemical parameters, and data from cardiac implantable electronic devices when available. We used the national definition of the French Government to define MUA. The primary outcome was the association of HF hospitalization and all-cause mortality.</div></div><div><h3>Results</h3><div>A total of 1040 patients (72<!--> <!-->±<!--> <!-->12 years old, 70% male), were followed for a median [IQR] of 20 [10; 24] months with a mean adherence to the remote management program of 69<!--> <!-->±<!--> <!-->29%. The annualized rate of the primary outcome was 13.7% in the overall population, without significant difference between MUA and no MUA patients (13.5%/year vs 13.9%/year; <em>P</em> <!-->=<!--> <!-->0.852). In multivariable Cox analysis, baseline dose of furosemide, NYHA status<!--> <!-->&gt;<!--> <!-->II, eGFR and NTproBNP were significantly associated with the primary outcome in the overall population. However, MUA was not associated with the primary outcome (adjusted HR: 0.93 [95% CI: (0.68–1.27)]; <em>P</em> <!-->=<!--> <!-->0.839). Using Kaplan-Meier analysis, unadjusted survival curves for MUA showed no difference in risk of the primary outcome (log-rank <em>P</em> <!-->=<!--> <!-->0.831; <span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>Our study suggests that the expansion of heart failure RM in MUA has the potential to reduce preventable hospitalizations and deaths in these areas.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S41-S42"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can LGE granularity inform revascularization strategies in ischemic cardiomyopathy?","authors":"A. Unger ,&nbsp;S. Toupin ,&nbsp;S. Duhamel ,&nbsp;P. Garot ,&nbsp;F. Sanguineti ,&nbsp;T. Hovasse ,&nbsp;M. Akodad ,&nbsp;T. Goncalves ,&nbsp;E. Gall ,&nbsp;A. Léquipar ,&nbsp;J. Hudelo ,&nbsp;J.-G. Dillinger ,&nbsp;P. Henry ,&nbsp;A. Bondue ,&nbsp;V. Bousson ,&nbsp;J. Garot ,&nbsp;T. Pezel","doi":"10.1016/j.acvd.2025.10.076","DOIUrl":"10.1016/j.acvd.2025.10.076","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of cardiovascular magnetic resonance (CMR) in guiding coronary revascularisation based on myocardial viability remains debated, particularly after the REVIVED trial. Our group has recently introduced the concept of “late gadolinium enhancement (LGE) granularity”, incorporating LGE extent and location to refine myocardial characterization.</div></div><div><h3>Objective</h3><div>To assess whether CMR-guided coronary revascularisation, based on the LGE granularity, predicts mortality in patients with ischaemic cardiomyopathy (ICM), reduced left ventricular ejection fraction (LVEF<!--> <!-->&lt;<!--> <!-->50%), and viable myocardium (ischaemic-LGE transmurality<!--> <!-->&lt;<!--> <!-->50%).</div></div><div><h3>Method</h3><div>We conducted a retrospective analysis of a multicentre study including consecutive ICM patients referred for CMR-based viability assessment between 2008 and 2022. Eligibility criteria included left ventricular ejection fraction (LVEF)<!--> <!-->&lt;<!--> <!-->50%, viable myocardium, and at least one of the following:<!--> <!-->≥<!--> <!-->70% stenosis in<!--> <!-->≥<!--> <!-->1 epicardial coronary artery, prior myocardial infarction, or previous coronary revascularization. LGE parameters and revascularization within 90 days of CMR were collected. The primary endpoint was all-cause mortality. Cox proportional hazards regression analysis was performed to assess the predictive value of LGE parameters and revascularization status for all-cause mortality.</div></div><div><h3>Results</h3><div>Among 1698 patients (mean age 64<!--> <!-->±<!--> <!-->12 years; 74% male), 1502 (88%) underwent revascularisation within 90 days. LGE extent was low (1–2 segments) in 729 (43%), moderate (3–5 segments) in 922 (54%), and high (≥6 segments) in 47 (3%). Antero-septal LGE was present in 318 patients (19%). Over a median follow-up of 8.9 years (IQR 6.7–11.5 years), 79 patients (4.7%) died. In univariate analysis, revascularisation was associated with lower mortality (HR: 0.28, 95% CI: 0.17–0.45, <em>P</em> <!-->&lt;<!--> <!-->0.001). Subgroup analyses revealed that revascularisation particularly improved survival in patients with moderate LGE extent (3–5 segments, <em>P</em> <!-->=<!--> <!-->0.002) and antero-septal LGE (<em>P</em> <!-->&lt;<!--> <!-->0.001, <span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>Using the LGE granularity concept, we showed that in ICM patients with viable myocardium, revascularisation was associated with improved survival, particularly in those with moderate ischaemic LGE extent and an antero-septal distribution.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S43-S44"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous coronary artery dissection vs atherosclerostic acute coronary syndrome: A propensity-matched study of long-term prognosis","authors":"A. Granier ,&nbsp;A. Trimaille ,&nbsp;A. Carmona ,&nbsp;A. Elidrissi ,&nbsp;M.C. Vu ,&nbsp;K. Roulot ,&nbsp;M. Kibler ,&nbsp;L. Jesel ,&nbsp;P. Ohlmann ,&nbsp;O. Morel","doi":"10.1016/j.acvd.2025.10.011","DOIUrl":"10.1016/j.acvd.2025.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of type 2 myocardial infarction, primarily affecting middle-age women with few cardiovascular risk factors. Although recent research has increased, SCAD management remains uncertain. Current guidelines generally advocate for conservative treatment due to high complication rates with percutaneous coronary intervention (PCI) but these recommendations are largely based on expert consensus and there remains a critical gap in long-term outcome data.</div></div><div><h3>Objective</h3><div>To compare clinical profiles, management strategies, and outcomes of SCAD patients with those of patients with atherosclerotic acute coronary syndrome (ACS).</div></div><div><h3>Method</h3><div>This retrospective, observational and single-center study included all patients hospitalized for SCAD at Strasbourg University Hospital between March 13, 2009, and July 20, 2022. Clinical, biological, angiographic, and prognostic data were compared to patients admitted for atherosclerotic ACS. Propopensity score matching (1:3) was performed based on age, sex, and follow-up duration.</div></div><div><h3>Results</h3><div>We included 42 SCAD and 891 patients. SCAD patients were younger, predominantly female, and had fewer traditional cardiovascular risk factors. Unlike the ACS group, in which all patients underwent revascularization, over half of the SCAD patients (54.8%) were managed conservatively. Among those treated with PCI, SCAD patients required significantly longer stent lengths. After propensity score matching, no significant differences were observed in all-cause or cardiovascular mortality between groups. Recurrent myocardial infarction was more frequent in the atherosclerotic cohort (16 vs 0 <em>P</em> <!-->=<!--> <!-->0.012). No stent thrombosis occured in the SCAD group; only one case of in-stent restenosis was reported. The median follow-up duration was 1507 days, allowing for robust long-term outcome assessment.</div></div><div><h3>Conclusion</h3><div>SCAD mainly affects younger women with few traditional cardiovascular risk factors. Although concerns persist regarding PCI in this population, our findings suggest that when revascularization is required, outcomes are comparable to those in patients with atherosclerotic ACS. Furthermore, complications such as stent thrombosis and restenosis were more common in the atherosclerotic group. These findings supports the individualized management in SCAD and challenge the blanket recommendation for conservative treatment in all cases.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S10-S11"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical revascularization in acute coronary syndromes: Seven-years single center experience","authors":"M. Laali ,&nbsp;C. D’Alessandro ,&nbsp;S. Manzo-Silberman ,&nbsp;R. Choussat ,&nbsp;D. Pichoy ,&nbsp;C. Juvin ,&nbsp;G. Lebreton ,&nbsp;P. Leprince","doi":"10.1016/j.acvd.2025.10.019","DOIUrl":"10.1016/j.acvd.2025.10.019","url":null,"abstract":"<div><h3>Introduction</h3><div>In Acute Coronary Syndromes (ACS) urgent Coronary Artery Bypass Grafting (CABG) is infrequently performed. Percutaneous Coronary Interventions (PCI) are the preferred option because they are more expeditious, while CABG is usually reserved for cases where PCI is not feasible or unsuccessful.</div></div><div><h3>Objective</h3><div>We reviewed our seven-year experience in patients undergoing CABG for ACS according to perioperative characteristics and urgency status.</div></div><div><h3>Method</h3><div>A single center retrospective analysis included 2076 patients undergoing CABG between 2018 and 2024. Patients were divided into three groups according to their EuroSCORE II Urgency Status: Elective (<em>n</em> <!-->=<!--> <!-->1322), Urgent (<em>n</em> <!-->=<!--> <!-->663), Emergency (<em>n</em> <!-->=<!--> <!-->88).</div><div>Patients’ data and outcomes were extracted from the French Society of Thoracic and Cardiovascular Surgery database (EPICARD). Primary end-point was the occurrence of Major Adverse Cardiac Events (MACE), including coronary graft malfunction, perioperative myocardial infarction, cardiac arrest, the need for extra-corporeal membrane oxygenation (ECMO) or Intra-Aortic Balloon Pump (IABP) and in-hospital mortality.</div></div><div><h3>Results</h3><div>Preoperative characteristics, operative data and postoperative outcomes are resumed in <span><span>Fig. 1</span></span>a. Even if MACE occurrence was concordant with urgency status (2.9% in elective, 7.4% in urgent, 18% in emergency patients, <em>P</em> <!-->&lt;<!--> <!-->0.001), urgency status alone was not significantly associated with adverse events at multivariate analysis (Urgent vs Elective OR 1.59 [0.948; 2.66], <em>P</em> <!-->=<!--> <!-->0.076; Emergency vs Elective OR 0.974 [0.339; 2.53], <em>P</em> <!-->=<!--> <!-->0.96). Forestplot of independent predictive risk factors for MACE occurrence at multivariate analysis is shown in <span><span>Fig. 1</span></span>b: previous PCI (OR 1.79 [1.11; 2.85], <em>P</em> <!-->=<!--> <!-->0.015), Left Main Disease (LMD) (OR 1.83 [1.15; 2.95], <em>P</em> <!-->=<!--> <!-->0.012), critical preoperative status (OR 4.12 [1.40; 11.7], <em>P</em> <!-->&lt;<!--> <!-->0.01), EuroSCORE II, (OR 1.16 [1.08; 1.24], <em>P</em> <!-->&lt;<!--> <!-->0.001) and number of grafts (OR 0.766 [0.604; 0.969], <em>P</em> <!-->=<!--> <!-->0.027).</div></div><div><h3>Conclusion</h3><div>In our recent experience, surgical revascularization for ACS can be performed in the emergency setting with satisfactory outcomes. The occurrence of MACE appears to depend more on the clinical presentation and risk profile of the patient than on the urgency status alone. On-pump total arterial revascularization can be performed safely and complete revascularization may protect against adverse events.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S14-S15"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based differences in phenotypic expression and prognosis of hereditary transthyretin cardiac amyloidosis associated with the Val122Ile mutation","authors":"A. Monfort ,&nbsp;T. Damy ,&nbsp;M. Kharoubi ,&nbsp;P. Réant ,&nbsp;P. Charron ,&nbsp;F. Roubille ,&nbsp;J.C. Eicher ,&nbsp;A. Hagège ,&nbsp;B. Funalot ,&nbsp;O. Lairez ,&nbsp;J. Inamo ,&nbsp;A. Zaroui","doi":"10.1016/j.acvd.2025.10.088","DOIUrl":"10.1016/j.acvd.2025.10.088","url":null,"abstract":"<div><h3>Introduction</h3><div>Transthyretin cardiac amyloidosis (ATTR-CA) is an under-recognized cause of heart failure with preserved ejection fraction (HFpEF), resulting from either the wild-type (ATTRwt) or hereditary form (ATTRv). In France, the valine-to-isoleucine substitution (Val122Ile) is the most common inherited variant.</div></div><div><h3>Objective</h3><div>Difference on gender differences in phenotype, prognosis, and the impact of tafamidis treatment in patients with Val122Ile-associated ATTR-CA remain limited.</div></div><div><h3>Method</h3><div>From the 5151 ATTR patients of the Healthcare European Amyloidosis Registry (HEAR,) 830 (16.1%) patients were ATTRv of whom and 513(9.9%) were patients with symptomatic ATTRv Val122Ile, the rest were ATTRv asymptomatic carriers (167 (3.2%)) and other type of ATTRv mutation. Gender differences in clinical presentation, echocardiographic parameters at diagnosis, and prognosis were assessed.</div></div><div><h3>Results</h3><div>150 (29.2%) were women and they were significantly older at diagnosis than men (83 [77–87] years vs. 77 [72–82] years; <em>P</em> <!-->&lt;<!--> <!-->0.001). Neuropathy symptoms, including carpal tunnel syndrome, were more frequent in women. Women also had lower septal wall thickness than men, even after adjusting for body mass index. Regarding left ventricular function, women exhibited higher LVEF and longitudinal strain (GLS) compared than men (LVEF: 54 [44–62] vs. 48 [38–56]; GLS: -10.6 [8.7–13.1 9.7] vs. −7.5–12.4]; <em>P</em> <!-->=<!--> <!-->0.001 and <em>P</em> <!-->=<!--> <!-->0.003, respectively). While NT-proBNP and troponinT HS levels were similar between genders, bilirubin levels were lower in women than men. The 48-month mortality rate did not differ significantly between women and men (74% vs. 63%; <em>P</em> <!-->=<!--> <!-->0.07). Among the 430 (83.8) patients receiving treatment, the therapeutic benefit was consistent across genders. Women had significantly better 48-month survival than men (81% vs. 69%; <em>P</em> <!-->=<!--> <!-->0.02). The adjusted 48-month mortality risk for women treated with Tafamidis was 0.452 [0.332–0.614] vs 0.767 [0.356–0.877] for men, <em>P</em> <!-->=<!--> <!-->0.02.</div></div><div><h3>Conclusion</h3><div>ATTR Val122Ile women are underrepresented in this hereditary disease, are diagnosed at an older age and exhibit a different extracardiac phenotype, better cardiac function, and improved prognosis with or without treatment compared to men.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S50"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors of cardiogenic shock in patients with Acute Coronary Syndrome (ACS)","authors":"Y. El Grini,&nbsp;H. Dahmani,&nbsp;A. Islam,&nbsp;L. Oukerraj,&nbsp;M. Cherti","doi":"10.1016/j.acvd.2025.10.042","DOIUrl":"10.1016/j.acvd.2025.10.042","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiogenic shock is a serious and potentially fatal complication in patients with acute coronary syndrome, often developing unpredictably. This study aims to identify independent predictive factors of cardiogenic shock in patients with ACS.</div></div><div><h3>Objective</h3><div>Early diagnosis and rapid, appropriate management in high-risk patients in order to improve prognosis.</div></div><div><h3>Method</h3><div>This is a retrospective, analytical, and comparative study conducted in a single center. It includes 156 patients hospitalized for ACS between January 2024 and December 2024 in the cardiology department B of IBN SINA University Hospital. Patients presenting with cardiogenic shock at admission were excluded. The population was divided into two groups: the ‘shock’ group, consisting of patients who developed cardiogenic shock during hospitalization, and the ‘non-shock’ group, without cardiogenic shock. The clinical characteristics and outcomes of the two groups were compared.</div></div><div><h3>Results</h3><div>Among the 156 patients included, 12 (7.8%) developed cardiogenic shock. The main predictive factors identified were:.<ul><li><span>•</span><span><div>the presence of acute heart failure at admission;</div></span></li><li><span>•</span><span><div>a GRACE score<!--> <!-->≥<!--> <!-->140;</div></span></li><li><span>•</span><span><div>a left ventricular ejection fraction<!--> <!-->&lt;<!--> <!-->50%;</div></span></li><li><span>•</span><span><div>eccentric left ventricular hypertrophy;</div></span></li><li><span>•</span><span><div>right ventricular dysfunction;</div></span></li><li><span>•</span><span><div>patients in the ‘shock’ group had a higher rate of complications and increased mortality.</div></span></li></ul></div></div><div><h3>Conclusion</h3><div>Cardiogenic shock occurring in the context of acute coronary syndrome is associated with a poor prognosis, marked by increased mortality. These findings highlight the importance of early diagnosis and rapid, appropriate management in high-risk patients in order to improve clinical outcomes.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S25"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health as a predictor of cardiovascular outcomes in coronary artery disease","authors":"Y. Ayadi ,&nbsp;S. Charfeddine ,&nbsp;A. Ghrab ,&nbsp;M. Jabeur ,&nbsp;T. Ellouze ,&nbsp;R. Gargouri ,&nbsp;Z. Triki ,&nbsp;F. Triki ,&nbsp;A. Bahloul ,&nbsp;L. Abid","doi":"10.1016/j.acvd.2025.10.029","DOIUrl":"10.1016/j.acvd.2025.10.029","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychological distress—such as anxiety, depression, and stress—is common in coronary artery disease (CAD) and contributes to worse outcomes, yet it is often overlooked in standard cardiac care.</div></div><div><h3>Objective</h3><div>To assess the relationship between mental health disorders and clinical outcomes in CAD patients, and to compare findings between acute coronary syndrome (ACS) and chronic coronary syndrome (CCS) groups.</div></div><div><h3>Method</h3><div>This prospective study was conducted between Novembre 2023 and April 2025 at the Department of Cardiology in a tertiary care center. We included patients with CAD admitted for ACS, those undergoing coronary angiography (CAG) for CCS, and patients seen in routine follow-up. Stress, anxiety, and depression were assessed using the PSS, GAD-7, and PHQ-9 scales, respectively. We aim to compare the characteristics of the two groups: ACS and CCS. Patients were followed for a period ranging from 9 months to 1 year after inclusion. Major adverse cardiovascular events (MACE) were recorded. Psychological scores were monitored over the follow-up period.</div></div><div><h3>Results</h3><div>This study included 51 patients with a mean age of 57.86 years. No significant differences were found between the ACS and CCS groups regarding Cardiovscular Risk Factors. However, sedentarity was more prevalent in the CCS group (<em>P</em> <!-->=<!--> <!-->0.03). Both anxiety (GAD-7<!--> <!-->≥<!--> <!-->9) (<em>P</em> <!-->=<!--> <!-->0.024) and depression (PHQ-9<!--> <!-->≥<!--> <!-->9) (<em>P</em> <!-->=<!--> <!-->0.020) were significantly more prevalent in the ACS group than in the CCS group, whereas stress levels (PSS<!--> <!-->≥<!--> <!-->15), although higher in ACS, did not differ significantly (<em>P</em> <!-->=<!--> <!-->0.44) (<span><span>Fig. 1</span></span>). Over the 9–12-month follow-up, the prevalence of depression, anxiety and stress declined. However, persistent depression was significantly associated with major adverse cardiovascular outcomes (ACVo) (<em>P</em> <!-->=<!--> <!-->0.041) while anxiety and stress were not (<em>P</em> <!-->=<!--> <!-->0.43 and 0.59, respectively). Treatment non-adherence tended to cluster with psychological distress—83%had at least one elevated score—but this trend did not reach statistical significance (<em>P</em> <!-->=<!--> <!-->0.13).</div></div><div><h3>Conclusion</h3><div>CAD patients, particularly with ACS, face significant psychological challenges. Persistent depression predicts ACVo. Mental health integration in CAD care may improve overall prognosis, warranting further research.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S19"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}