Archives of Cardiovascular Diseases最新文献

{"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}

{"title":"PHM Ratio < 0.82 predicts mortality after heart transplant: Evidence from the French CRISTAL Cohort","authors":"A. Buschiazzo ,&nbsp;G. Lebreton ,&nbsp;R. Dorent ,&nbsp;E. Flécher ,&nbsp;A. Vincentelli ,&nbsp;J.-C. Roussel ,&nbsp;T. Senage ,&nbsp;C.-H. David","doi":"10.1016/j.acvd.2025.10.056","DOIUrl":"10.1016/j.acvd.2025.10.056","url":null,"abstract":"<div><h3>Introduction</h3><div>Predicted heart Mass (PHM) is recommended to assess donor-recipient size matching and predict mortality after heart transplant, based on the UNOS Cohort. UNOS and French cohort presents differences regarding donors and recipients. UNOS and French cohort presents differences regarding donors and recipients.</div></div><div><h3>Objective</h3><div>To ensure that PHM accurately predicts mortality following heart transplant in France, we assessed survival according to PHM ratio, compared to conventional metrics, in the French cohort.</div></div><div><h3>Method</h3><div>We analyzed data from the CRISTAL registry (2000–2018), including 5091 heart transplant recipients. For each matching metric, the cohort was divided into 11 equal strata. Survival was assessed at 1 month and 3 years using Kaplan-Meier estimators. Multivariate Cox models were used to compute hazard ratios.</div></div><div><h3>Results</h3><div>A PHM ratio<!--> <!-->&lt;<!--> <!-->0.825 was associated with significantly increased 1-month mortality (HR 1.45; 95% CI 1.09–2.03; <em>P</em> <!-->=<!--> <!-->0.044) and 3-year mortality (HR 1.21; 95% CI 1.05–1.39; <em>P</em> <!-->=<!--> <!-->0.001). No other size-matching metric showed increased risk at 1 month. At 3 years, undersized BSA ratio was also associated with higher mortality (HR 1.66; 95% CI 1.15–2.40; <em>P</em> <!-->=<!--> <!-->0.034), while other metrics were not significant (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>The PHM ratio is a robust predictor of post-transplant mortality in the French population. We identified a lower threshold (&lt;<!--> <!-->0.82) than previously reported, which could enhance donor-recipient matching strategies in France.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S31"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903939","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":"Molecular diagnostic classification for heart allograft rejection: A validated and automated system","authors":"G. Coutance ,&nbsp;A. Giarraputo ,&nbsp;J. Patel ,&nbsp;M. Fedrigo ,&nbsp;S. Varnous ,&nbsp;J.-P. Duong ,&nbsp;J. Dagobert ,&nbsp;P. Rouvier ,&nbsp;P. Leprince ,&nbsp;P. Achouh ,&nbsp;X. Jouven ,&nbsp;P. Bruneval ,&nbsp;A. Angelini ,&nbsp;J. Kobashigawa ,&nbsp;A. Loupy","doi":"10.1016/j.acvd.2025.10.058","DOIUrl":"10.1016/j.acvd.2025.10.058","url":null,"abstract":"<div><h3>Introduction</h3><div>Endomyocardial biopsies (EMB) gene expression profiling is a promising companion tool for rejection diagnosis after heart transplantation. We developped and validated a tissular-based molecular diagnostic system of cardiac allograft rejection.</div></div><div><h3>Objective</h3><div>Our aim to design an automated report accessible for routine application in clinical practice to support diagnosis of rejection after heart transplantation.</div></div><div><h3>Method</h3><div>We performed a multicenter, retrospective study (<span><span>NCT06436027</span><svg><path></path></svg></span>), collecting 591 FFPE-EMBs between 2011 and 2021 representative of the landscape of rejection (antibody-mediated rejection-AMR, <em>n</em> <!-->=<!--> <!-->188; acute cellular rejection-ACR, <em>n</em> <!-->=<!--> <!-->289; non-rejection, <em>n</em> <!-->=<!--> <!-->114). Tissue gene expression was analyzed using the consensus Banff Human Organ Transplant gene panel. Molecular classifiers for AMR and ACR were built using a supervised model, assessing thoroughly the performance. An automated molecular report was developed to provide a comprehensive visualization for clinical use.</div></div><div><h3>Results</h3><div>In the validation cohort (<em>n</em> <!-->=<!--> <!-->116), the molecular classifiers demonstrated strong diagnostic performance: AMR detection achieved an accuracy of 81.89% (ROC-AUC<!--> <!-->=<!--> <!-->0.831, Brier score<!--> <!-->=<!--> <!-->0.143), while ACR detection achieved 77.58% accuracy (ROC-AUC<!--> <!-->=<!--> <!-->0.812, Brier score<!--> <!-->=<!--> <!-->0.176). The molecular report provided real-time assessment of molecular-based rejection scores, while allowing to contextualize a novel biopsy within the reference set rejection landscape (<span><span>Fig. 1</span></span>). In addition to delivering quantitative scores for AMR and ACR, clinical and biological information are recapitulated in each report, correlating the molecular findings with the pathophysiological insights from primary molecular pathways involved. This tool captured subtle molecular signals in cases of early or sub-clinical rejection, offering insights into potential risks even when histology was inconclusive. The automated nature of the report minimizes variability and considerably reduces turnaround time, seamlessly integrating into clinical workflows.</div></div><div><h3>Conclusion</h3><div>The molecular diagnostic system, validated and supported by an automated report, demonstrated high reproducibility and reliability in identifying cardiac rejection. This system can complement standard pathology, reduce diagnostic uncertainty, and serve as a practical companion tool in the clinical management of heart transplant patients, ensuring timely and accurate diagnosis.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S32-S33"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903941","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":"Early introduction of SGLT2 inhibitors in patients with Heart Failure reduced ejection fraction hospitalized for acute heart failure: Results from Real-world observations","authors":"A. Bouchlarhem,&nbsp;Z. Bazid,&nbsp;N. Ismaili,&nbsp;E.O. Noha","doi":"10.1016/j.acvd.2025.10.080","DOIUrl":"10.1016/j.acvd.2025.10.080","url":null,"abstract":"<div><h3>Introduction</h3><div>The early introduction of SGLT2 inhibitors during acute heart failure was studied in the empulse trial with positive results, but limited reel-world data are currently available.</div></div><div><h3>Objective</h3><div>Assessing the efficacy of early introducing of ISGLT2 during the acute heart failure.</div></div><div><h3>Method</h3><div>We prospectively analyzed patients admitted for acute heart failure with an ejection fraction of less than 40%. We excluded patients with glomerular filtration rate (GFR)<!--> <!-->&lt;<!--> <!-->20<!--> <!-->ml/min, cardiogenic shock, and ejection fraction<!--> <!-->&gt;<!--> <!-->40%. We studied all-cause mortality as the primary outcome, and as secondary outcomes the duration of decongestion and pro-BNP levels at discharge.</div></div><div><h3>Results</h3><div>We included 516 patients who met the inclusion criteria. Early introduction of ISGLT2 was adopted in 270 patients (52.8%). No differences were observed in mean age (ISGLT vs. standard car;65.89 vs 65.58 years; <em>P</em> <!-->=<!--> <!-->0.129), female gender (38.9% vs. 38.2%; <em>P</em> <!-->=<!--> <!-->0.473), diabetes (48.1% vs. 51.6%; <em>P</em> <!-->=<!--> <!-->0.242) and hypertension (44.4% vs. 45.5%; <em>P</em> <!-->=<!--> <!-->0.437). At admission, Ejection fraction was higher in the ISGLT2 group (34% vs. 32%; <em>P</em> <!-->=<!--> <!-->0.033), and systolic pulmonary pressure was lower (37.4mmhg vs. 41.5mmhg; <em>P</em> <!-->&lt;<!--> <!-->0.001).GFR was higher in the ISGLT2 group (72 vs 64<!--> <!-->ml/min; <em>P</em> <!-->=<!--> <!-->0.005), with lower Pro-BNP levels in this group but without significant difference (7635 vs 9839<!--> <!-->ng/ml; <em>P</em> <!-->=<!--> <!-->0.063).</div><div>Over a mean follow-up of 22 months, the primary endpoint was observed in 95 patients (18.4%), with significantly higher mortality in the standard group (28.5% vs. 9.3%; <em>P</em> <!-->&lt;<!--> <!-->0.001). After multivariate adjusted Cox proportional hazards analysis, early introduction of ISGLT2 was independently associated with a 23% reduction in all-cause mortality with (HR: 0. 862; 95%CI; 0.444–0.902; <em>P</em> <!-->=<!--> <!-->0.039), as well as a significant difference on Kaplein meirer survival analysis (Log-rank test <em>P</em> <!-->&lt;<!--> <!-->0.001) (<span><span>Fig. 1</span></span>). For the secondary endpoints, the introduction of ISGLT2 significantly reduced the duration of decongestion (6.25 days in vs. 7.37 days; <em>P</em> <!-->=<!--> <!-->0.017; with a mean reduction of 1.17 days). ISGLT2 also significantly reduced Pro-BNP levels at discharge (3986 vs. 7029<!--> <!-->ng/ml; <em>P</em> <!-->=<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>The results of our study support the hypothesis that SGLT2 should not only be introduced in HFrEF patients, but should also be rapidly introduced even during acute heart failure.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S46"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904046","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":"Cardiac amyloidosis and heart failure phenotypes: A prognostic study of systolic function markers","authors":"A. Zaroui ,&nbsp;S. Belaid ,&nbsp;M. Kharoubi ,&nbsp;S. Oghina ,&nbsp;S. Odouard ,&nbsp;E. Teiger ,&nbsp;T. Damy","doi":"10.1016/j.acvd.2025.10.086","DOIUrl":"10.1016/j.acvd.2025.10.086","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiac amyloidosis (CA), including light chain (AL), hereditary transthyretin (ATTRv), and wild-type transthyretin (ATTRwt), leads to heart failure (HF). Cardiologists use the ESC guidelines to classify patients with HF tailoring HF treatment accordingly. CA is commonly associated with HFpEF, with a smaller proportion presenting with HFmrEF and HFrEF.</div></div><div><h3>Objective</h3><div>This study aimed to assess the distribution of HF types in CA and their relationship with other left ventricular (LV) systolic function parameters such as global longitudinal strain (GLS) and cardiac index (CI) across amyloidosis subtypes.</div></div><div><h3>Method</h3><div>We retrospectively included symptomatic AL, ATTRv, and ATTRwt CA patients from our French referral center. LVEF was classified per ESC guidelines and compared to GLS and CI. Survival was assessed using Kaplan-Meier analyses and Cox regression. A decision tree incorporating LVEF, GLS, and CI was used to stratify patients into prognostic groups.</div></div><div><h3>Results</h3><div>Among 2244 patients, 557 AL, 392 ATTRv, 1137A TTRwt. Of these, 61.4% presented with HFpEF, 19.0% with HFmrEF, and 19.6% with HFrEF. In AL, 13.6%, 18%, and 68.4% were classified as HFrEF, HFmrEF, and HFpEF, respectively. In ATTRv, 28.3%, 15.3%, and 56.4% were HFrEF, HFmrEF, and HFpEF, respectively. In ATTRwt, 20.2%, 21.2%, and 58.6% were HFrEF, HFmrEF, and HFpEF, respectively. LVEF correlated moderately with GLS (<em>r</em> <!-->=<!--> <!-->0.673), with stronger correlations in ATTRv (<em>r</em> <!-->=<!--> <!-->0.776) compared to AL (<em>r</em> <!-->=<!--> <!-->0.650) and ATTRwt (<em>r</em> <!-->=<!--> <!-->0.644). LVEF correlated weakly with CI (<em>r</em> <!-->=<!--> <!-->0.392). Median survival was 7 months [3–31] for AL, 28 months [12–54] for ATTRv, and 23 months [10–38] for ATTRwt. Survival differed by HF type: 30 months [18–41] for HFrEF, 40 months [20–42] for HFmrEF, and 51% survival at 48 months for HFpEF. A CI<!--> <!-->≤<!--> <!-->1.96<!--> <!-->L/min/m² was associated with a median survival of 29 months [17–37], with better outcomes in higher CI quartiles. A decision tree identified four prognostic groups, with hazard ratios for 4-year mortality ranging from 1.63 (LVEF<!--> <!-->≥<!--> <!-->50%, GLS<!--> <!-->≤<!--> <!-->11%) to 3.68 (LVEF<!--> <!-->≤<!--> <!-->49%, CI<!--> <!-->≤<!--> <!-->1.96 L/min/m²), reaching 12.34 in AL amyloidosis for the most severe group.</div></div><div><h3>Conclusion</h3><div>In CA, about 40% of patients present with reduced LVEF. Cardiologists should be aware that CA is not exclusively associated with HFpEF and that patients with reduced LVEF have worse prognosis. LV systolic function, assessed via LVEF, GLS, and CI, is a critical predictor of survival in CA, with distinct patterns across AL, ATTRv, and ATTRwt subtypes.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S49"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904061","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":"Effect of telemonitoring implementation on heart failure hospitalization profiles: A real-world analysis","authors":"P. Lemiere ,&nbsp;J. Quilici ,&nbsp;A.-S. Canu ,&nbsp;L. Querion ,&nbsp;E. Saunier ,&nbsp;A. Vaudron","doi":"10.1016/j.acvd.2025.10.090","DOIUrl":"10.1016/j.acvd.2025.10.090","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) remains a leading cause of hospitalization and mortality worldwide. Remote monitoring programs (RMP) are increasingly implemented to optimize care, yet their real-world impact on hospitalized patient characteristics remains underexplored.</div></div><div><h3>Objective</h3><div>This study aimed to assess changes in the clinical profiles and outcomes of patients hospitalized for acute heart failure (AHF) before and after the implementation of a RMP in a rural cardiology department.</div></div><div><h3>Method</h3><div>We conducted a retrospective, single-center, study focusing HF-related hospitalizations (HFRH) in two periods: 2018–2019 with standard care; and 2023–2024 post RMP implementation, combining non-invasive remote weight monitoring, therapeutic education, and early home-based intervention by a mobile HF team. Data were extracted using ICD-10 codes.</div></div><div><h3>Results</h3><div>Among 4092 admissions, we selected 1364 HFRH (610 in 2018–2019 vs. 754 in 2023–2024), patients in the post RMP period showed higher severity (High GHM levels 51.5% vs. 45.6%, <em>P</em> <!-->=<!--> <!-->0.031; mean IGS2 score: 37.7 vs. 35.1, <em>P</em> <!-->&lt;<!--> <!-->0.0001), longer hospital stays (mean 9.5 vs. 8.9 days, <em>P</em> <!-->&lt;<!--> <!-->0.001), more emergency admissions (66.6% vs. 39.4%, <em>P</em> <!-->&lt;<!--> <!-->0.0001), non-significant increased mortality (6.1% vs 3.9%, <em>P</em> 0.07). However, rehospitalizations decreased (13.4% vs. 18.1%, <em>P</em> <!-->=<!--> <!-->0.03), and discharges to home increased (61.0% vs. 49.3%, <em>P</em> <!-->&lt;<!--> <!-->0.0001) (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>The implementation of the RMP improved post-discharge outcomes and was associated with a shift toward hospitalization of more severe heart failure patients, likely reflecting earlier outpatient management of milder cases. These findings support telemonitoring as an effective tool in real-world heart failure management and underscore its role in the ongoing digital transformation of care pathways.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S51"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904072","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":"Variability in ACT response to standard UFH bolus during PCI: A prospective study on determinants of subtherapeutic anticoagulation","authors":"M.C. Vu ,&nbsp;A. Trimaille ,&nbsp;A. Granier ,&nbsp;A. Carmona ,&nbsp;A. Elidrissi ,&nbsp;M. Kibler ,&nbsp;L. Jesel ,&nbsp;P. Olhmann ,&nbsp;L. Sattler ,&nbsp;O. Morel","doi":"10.1016/j.acvd.2025.10.006","DOIUrl":"10.1016/j.acvd.2025.10.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Unfractionated heparin (UFH) remains the standard anticoagulant during percutaneous coronary intervention (PCI), with guidelines recommending a target activated clotting time (ACT)<!--> <!-->≥<!--> <!-->250<!--> <!-->seconds. However, despite receiving a standardized bolus dose, many patients fail to achieve this target.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of standard UFH bolus dosing in achieving target ACT and to identify patient-related factors associated with suboptimal anticoagulant response.</div></div><div><h3>Method</h3><div>This single-center, prospective, observational study included 171 adult patients undergoing PCI between October 2024 and April 2025. All patients received a 100-IU/kg intravenous UFH bolus immediately prior to PCI. ACT was measured 5<!--> <!-->minutes post-administration, additional 50<!--> <!-->IU/kg boluses were given as needed to achieve the target ACT<!--> <!-->≥<!--> <!-->250<!--> <!-->seconds. The primary endpoint was the percentage of patients achieving this target. The secondary endpoint was the identification of factors associated with suboptimal anticoagulation.</div></div><div><h3>Results</h3><div>Among 171 patients (mean age, 68<!--> <!-->±<!--> <!-->12 years; 26.3% women), the target ACT was achieved in 35.7% (<em>n</em> <!-->=<!--> <!-->61), while 64.3% (<em>n</em> <!-->=<!--> <!-->110) did not (<span><span>Table 1</span></span>). Active smoking was independently associated with failure to reach the target ACT (adjusted OR, 6.06; 95% CI, 1.41 to 43.8; <em>P</em> <!-->=<!--> <!-->0.032) (<span><span>Fig. 1</span></span>). Despite similar initial UFH dosing and timing to ACT measurement, smokers had significantly lower ACT values (<em>P</em> <!-->&lt;<!--> <!-->0.001) and required higher cumulative UFH dose during PCI (<em>P</em> <!-->=<!--> <!-->0.043) (<span><span>Fig. 2</span></span>). Propensity score matching confirmed this independent association (<em>P</em> <!-->=<!--> <!-->0.004) (<span><span>Fig. 3</span></span>).</div></div><div><h3>Conclusion</h3><div>Nearly two-thirds of patients failed to achieve the recommended target ACT following a standard UFH bolus during PCI, in which active smoking was independently associated with a more than sixfold reduction in the likelihood of reaching therapeutic anticoagulation.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S7-S8"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904080","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":"Impact of daily coronary CT angiography implementation on invasive coronary angiography in chronic coronary syndrome: A single-center experience","authors":"C. Thuaire,&nbsp;F. Bahri,&nbsp;A. Benjemaa,&nbsp;C.A.B. Samb,&nbsp;R. Hakim,&nbsp;G. Rangé,&nbsp;F. Albert","doi":"10.1016/j.acvd.2025.10.007","DOIUrl":"10.1016/j.acvd.2025.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Coronary computed tomography angiography (CCTA) has become a first-line imaging modality for the diagnosis of coronary atherosclerosis in patients with chronic coronary syndrome (CCS). It is primarily considered a means to reduce unnecessary invasive procedures, particularly normal or non-significant coronary angiographies.</div></div><div><h3>Objective</h3><div>To evaluate the impact of the implementation of a daily CCTA activity on the rate and diagnostic yield of invasive coronary angiographies performed for CCS at Chartres Hospital.</div></div><div><h3>Method</h3><div>In February 2024, daily CCTA was introduced at Chartres Hospital using a Canon Aquilion One® wide-detector CT scanner (16<!--> <!-->cm coverage). Each scan was systematically coupled with a cardiology consultation at the time of result delivery, including treatment prescription and patient orientation based on CAD-RADS classification. A total of 2490 CCTAs were performed over the year, representing a 2.9-fold increase in imaging activity compared to previous years.</div><div>Using data from the France PCI registry, we assessed the impact of this implementation on coronary angiographies performed for stable angina and/or silent ischemia by comparing the rates of normal angiograms, lesions<!--> <!-->&lt;<!--> <!-->50%, and lesions<!--> <!-->&gt;<!--> <!-->50% from February 2024 to April 2025 against the mean of the three previous years (February 2021 to January 2024).</div></div><div><h3>Results</h3><div>Although total annual coronary angiography volume did not significantly increase (adjusted total for 2024–2025: 846 patients vs. 701 in previous years; <em>P</em> <!-->=<!--> <!-->0.13), we observed a significant rise in the number of angiographies with lesions<!--> <!-->&lt;<!--> <!-->50% (248 vs. 181; <em>P</em> <!-->=<!--> <!-->0.029), but more importantly a highly significant increase in angiographies showing lesions<!--> <!-->&gt;<!--> <!-->50%: monovessel (245 vs. 155; <em>P</em> <!-->=<!--> <!-->0.0017), bivessel (197 vs. 113; <em>P</em> <!-->=<!--> <!-->0.0009), and trivessel disease (169 vs. 119; <em>P</em> <!-->=<!--> <!-->0.045).</div></div><div><h3>Conclusion</h3><div>Compared to the average of the three previous years, daily CCTA implementation did not significantly change the overall volume of coronary angiography in CCS patients in our center, nor did it significantly reduce the rate of normal angiograms. However, it was associated with a moderate but significant increase in<!--> <!-->&lt;<!--> <!-->50% lesions, and most importantly a marked and highly significant increase in angiographies with<!--> <!-->&gt;<!--> <!-->50% stenosis.</div><div>Daily CCTA combined with structured cardiology consultation improves patient selection and substantially enhances the diagnostic yield of invasive coronary angiography.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S8-S9"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904081","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":"ExtraCorporeal life support versus IMPELLA® pump as Bridge to Left ventricular Assist Device (ECI-BLAD trial)","authors":"O. Simon ,&nbsp;A. Quessard ,&nbsp;N. Labaste ,&nbsp;P.-G. Guinot ,&nbsp;N. Nesseler ,&nbsp;A. Beurton ,&nbsp;P. Gaudard ,&nbsp;A. Ouattara","doi":"10.1016/j.acvd.2025.10.072","DOIUrl":"10.1016/j.acvd.2025.10.072","url":null,"abstract":"<div><h3>Introduction</h3><div>Among patients treated by temporary mechanical circulatory support (tMCS) for refractory cardiogenic shock, some of them suffer from persistent cardiac dysfunction incompatible with a successful weaning. In eligible patients, the heart transplantation is still the gold standard therapy. However, due to the shortage of grafts and/or contraindications, some patients will not be transplanted. In these patients, for whom the Left ventricular Assist Device (LVAD) represents an alternative therapy, the best approach of tMCS as a bridge to durable LVAD remains to be clarified.</div></div><div><h3>Objective</h3><div>We tested the hypothesis that the use of IMPELLA® as bridge to LVAD should improve early postoperative outcomes by offering the opportunité of active rehabilitation under tMCS.</div></div><div><h3>Method</h3><div>The ECI-BLAD trial was a multicentre retrospective study including adults, supported with IMPELLA® or ECLS as a bridge to LVAD between January 2012 and December 2020 in 5 French cardiac intensive care units. The IMPELLA® group included patients assisted by an IMPELLA® alone at least five days prior the implantation of the LVAD while the ECLS group included patients treated by a ECLS with or without IMPELLA®. The primary endpoint was the proportion of patients alive with a John Hopkins Highest Level of Mobility score<!--> <!-->=<!--> <!-->8, discharged from the critical care unit and not perfused at 30 days after LVAD implantation. Secondary endpoints included rehabilitation under tMCS (tracheal extubation, mobilization to chair, walking and cyclo-ergometer), 6-month survival rate after the LVAD implantation. This study was approved by our ethics committee and registered on Clinical trials (<span><span>NCT04480151</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>From 388 consecutive patients implanted by LVAD, 92 patients treated as bridge to LVAD have been included in our study (ECLS group <em>n</em> <!-->=<!--> <!-->42/IMPELLA group <em>n</em> <!-->=<!--> <!-->50). Most of patients of IMPELLA group (72%) were implanted through an axillary approach. Early mobilization on tMCS was more frequently achieved in IMPELLA group (seating 50% vs 2%, <em>P</em> <!-->&lt;<!--> <!-->0.001 and walking 18% vs 0%, <em>P</em> <!-->&lt;<!--> <!-->0.01). A larger proportion of patients in IMPELLA group reached the primary endpoint (52% vs 26%, <em>P</em> <!-->=<!--> <!-->0.018). The 6-month survival rate after LVAD implantation was significantly better in IMPELLA group (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>Implantation of IMPELLA through axillary approach as bridge to LVAD by allowing active and early rehabilitation might be associated with better outcomes.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S41"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904082","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":"Correlation between perivascular retinal ischemic lesions (RIPL) and the severity of coronary lesions in patients with acute coronary syndrome","authors":"A. Hassimi,&nbsp;Y. Outifa,&nbsp;A. Ech-Chenbouli,&nbsp;B. El Boussaadani,&nbsp;Z. Raissouni","doi":"10.1016/j.acvd.2025.10.013","DOIUrl":"10.1016/j.acvd.2025.10.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Perivascular retinal ischemic lesions (RIPL) may represent an ophthalmological marker of the severity of coronary artery disease.</div></div><div><h3>Objective</h3><div>Evaluate the correlation between the presence of RIPL and the severity of coronary lesions detected by coronary angiography in patients with acute coronary syndrome (ACS).</div></div><div><h3>Method</h3><div>This study included 200 patients who had presented with acute coronary syndrome (ACS) and significant coronary lesions (≥50% stenosis). All patients underwent a systematic ophthalmological evaluation to screen for perivascular retinal ischemic lesions (RIPL). To minimize bias related to diabetic retinopathy, diabetic patients were excluded from the study. The mean age of the patients was 61.4 years (±12.3), with a sex distribution of 41.1% male and 57.9% female. The most prevalent cardiovascular risk factors included hypertension (49.6%) and smoking (34.9%). The mean SYNTAX score was 14.3 (±5.0), reflecting varying degrees of coronary lesion complexity. Regarding the extent of coronary involvement, 16.4% of patients had single-vessel disease, 11.6% had two-vessel disease, and 9.6% had three-vessel disease. The most commonly affected arteries were the left anterior descending artery (75.7%), the circumflex artery (52.0%), and the right coronary artery (50.9%). In terms of treatment approach, 41.2% of patients underwent percutaneous coronary intervention (PCI) with stenting, while 14.6% required coronary artery bypass grafting (CABG) due to the complexity of their coronary disease.</div></div><div><h3>Results</h3><div>The results were satisfactory, highlighting an association between the presence of RIPL and the severity of coronary lesions. The presence of RIPL was significantly associated with multivessel disease (≥2 vessels) and bifurcation lesions. Furthermore, patients who underwent coronary artery bypass grafting or complex percutaneous intervention had an increased frequency of RIPL.</div></div><div><h3>Conclusion</h3><div>These findings suggest that the presence of RIPL could serve as a non-invasive ophthalmological marker to identify patients at high risk of developing ACS (STEMI, NSTEMI). A multidisciplinary approach integrating ophthalmology into cardiovascular risk assessment could improve coronary risk stratification. Long-term follow-up of patients with RIPL is necessary to confirm their prognostic value and refine their role in early diagnostic strategies.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S11-S12"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904114","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}