American heart journal plus : cardiology research and practice最新文献

{"title":"Mortality trends in heart failure and colon cancer: Insights into gender, ethnic, and regional disparities in the United States (1999–2020)","authors":"Hafsah Alim Ur Rahman ,&nbsp;Nimrah Iqbal ,&nbsp;Muhammad Ahmed Ali Fahim ,&nbsp;Fayza Salman ,&nbsp;Syed Hassan Ahmed ,&nbsp;Omama Asim ,&nbsp;Taha Mansoor ,&nbsp;Muhammad Zain Farooq ,&nbsp;Muhammad Sohaib Asghar","doi":"10.1016/j.ahjo.2025.100699","DOIUrl":"10.1016/j.ahjo.2025.100699","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) and colorectal cancer (CRC) are major public health concerns among the aging population in the United States. This study aimed to investigate temporal, regional, urbanization and racial trends in mortality among adults with HF and CRC aged ≥65 years.</div></div><div><h3>Methods</h3><div>Mortality data were sourced from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database, utilizing ICD-10 codes to identify deaths related to colon cancer and heart failure from 1999 to 2020. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated, along with Annual Percentage Changes (APCs) and their respective 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The AAMRs remained relatively stable between 1999 (8.5) and 2004 (7.3) (APC: −2.61; 95 % CI: −3.86, 0.09). From 2004 to 2009, a significant decline to 5.0 was observed (APC: −7.08; 95 % CI: −9.28, −3.58). Subsequently, the rates stabilized by 2015 (3.8) (APC: −4.84; 95 % CI: −6.58 to 2.04) but demonstrated a modest increase to 4.4 by 2020 (APC: 2.55; 95 % CI: 0.08 to 8.19). Mortality rates were consistently higher among males (6.7 vs. 4.5 for females) and varied across racial/ethnic groups, with Non-Hispanic (NH) Whites (5.7) and NH Black/African Americans (5.4) exhibiting the highest rates, while Hispanics (2.8) and NH Asians/Pacific Islanders (2.3) had the lowest. Regional disparities showed that the Midwest had the highest AAMRs (6.5) followed by the Northeast (5.4), West (5.2), and South (4.8). Additionally, non-metropolitan areas exhibited significantly higher rates than metropolitan areas (7.1 vs. 5.0, respectively). The states in the 90th percentile for AAMRs were West Virginia, Mississippi, South Dakota, Nebraska, and North Dakota.</div></div><div><h3>Conclusion</h3><div>Although there was an overall decline in mortality rates during the study period, disparities remained evident, with higher mortality observed among males, non-Hispanic Whites, residents of the Midwest, and individuals in non-metropolitan areas. This highlights the need for targeted public health intervention.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100699"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery disease in patients undergoing transcatheter aortic valve replacement: Current evidence and future directions","authors":"Bahaa El Deen Wehbeh ,&nbsp;Moied Al Sakan ,&nbsp;Jamil Francis ,&nbsp;Rachad Ghazal ,&nbsp;Samir Alam ,&nbsp;Fadi Sawaya","doi":"10.1016/j.ahjo.2025.100710","DOIUrl":"10.1016/j.ahjo.2025.100710","url":null,"abstract":"<div><div>Coronary artery disease (CAD) coexists frequently with aortic stenosis (AS), and the optimal management of CAD in patients undergoing transcatheter aortic valve replacement (TAVR) remains incompletely defined due to limited and heterogeneous evidence. This review aims to integrate the current evidence on the epidemiology and shared pathophysiology of CAD and AS, summarize the diagnostic algorithms for CAD in the TAVR population, and evaluates revascularization strategies with a focus on the timing of percutaneous coronary intervention relative to valve replacement. Current evidence suggests that while routine PCI in TAVR candidates for stable CAD may offer limited benefit, revascularization in patients with complex CAD or high anatomical burden may improve outcomes. This review further characterizes the incidence, proposed mechanisms, and prognostic significance of post-TAVR coronary events and outlines emerging strategies to optimize ischemic and procedural outcomes in this high-risk cohort.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100710"},"PeriodicalIF":1.8,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary artery calcium score of zero does not rule out obstructive CAD in young adults","authors":"O. Smettei ,&nbsp;R.M. Abazid ,&nbsp;J.G. Romsa ,&nbsp;C. Akincioglu ,&nbsp;J.C. Warrington ,&nbsp;T.B. Alshaar ,&nbsp;P.J. Teefy ,&nbsp;S. De ,&nbsp;N. Tzemos ,&nbsp;R. Zareardalan ,&nbsp;M. Badreddine ,&nbsp;Y. Bureau ,&nbsp;W.C. Vezina","doi":"10.1016/j.ahjo.2025.100707","DOIUrl":"10.1016/j.ahjo.2025.100707","url":null,"abstract":"<div><h3>Purpose</h3><div>Young adults are more likely to have non-calcified coronary plaques. Purpose to assess the predictive value of a zero-coronary artery calcium (CAC) score in young adults and to determine which clinical characteristics are associated with obstructive coronary heart disease.</div></div><div><h3>Methods</h3><div>6775 patients were prospectively entered a registry. They all had a CAC. Mean age 63 +/− 18 years. 56.2 % males. 3525 patients underwent coronary CT angiography (CCTA). 3250 patients underwent single photon emission tomography (SPECT). SPECT patients were mainly outpatients. CCTA patients also were almost exclusively outpatients. Thus, the population was generally a low-risk population.</div></div><div><h3>Results</h3><div>Among the CCTA patients, 1888 had a 0 CAC score. 175/1888 (9 %) had less than 70 % stenosis, while 41/1888 (2.2 %) had ≥70 % stenosis. Patients with ≥70 % stenosis: were younger 45 ± 12 yr versus 59 ± 11 yr, <em>p &lt;</em> <em>0.001,</em> predominantly males <em>(51.2</em> <em>%</em> versus <em>38.8</em> <em>% p</em> <em>&lt; 0.001),</em> had a slightly greater prevalence of family history of CAD (58.5 % vs 57.9 % <em>p</em> = 0.04), smoking history (68.3 % VS.44.6 % <em>p</em> &lt; 0.001), hypertension (61 % versus 39.2 % <em>p</em> = 0.004), dyslipidemia (56.1 % versus 36.2 % p &lt; 0.001), and obesity (70.7 % VS 11.7 % p &lt; 0.001). 3250 patients had CAC and SPECT. Of these, 1161 had a zero CAC score. Of these 42 patients had significant ischemia &gt;10 % of LV, Patients with ischemia &gt;10 % of LV mass, and they were younger 44 ± 10 yr versus 60 ± 12 yr, <em>p &lt; 0.001,</em> had a slightly greater prevalence of family history of CAD 61 % versus 57 % <em>p</em> = 0.07, smoking history (64.3 % versus 48.5 % <em>p</em> = 0.045), hypertension (69 % versus 45.5 % <em>p</em> = 0.003), obesity 19 % versus 11.7 %, and diabetes (35.7 % versus 14.5 % <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>A zero CAC does not rule out significant CAD in young adults with chest pain with CAD risk factors. These patients may need further investigations.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100707"},"PeriodicalIF":1.8,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of caffeine levels with myocardial perfusion during pharmacological stress cardiac magnetic resonance imaging","authors":"Ana Iribarren ,&nbsp;Okezi Obrutu ,&nbsp;Jenna Maughan ,&nbsp;Galen Cook-Wiens ,&nbsp;C. Noel Bairey Merz ,&nbsp;Debiao Li ,&nbsp;Daniel S. Berman ,&nbsp;Alan C. Kwan ,&nbsp;Janet Wei","doi":"10.1016/j.ahjo.2025.100709","DOIUrl":"10.1016/j.ahjo.2025.100709","url":null,"abstract":"<div><h3>Background</h3><div>Caffeine, a nonselective adenosine A2 receptor antagonist, blunts adenosine-induced coronary hyperemia. Despite recommended abstinence before adenosine stress cardiac magnetic resonance imaging (CMRi), residual caffeine may affect myocardial perfusion reserve index (MPRI), a marker of coronary microvascular dysfunction.</div></div><div><h3>Methods</h3><div>Symptomatic patients without obstructive coronary artery disease underwent adenosine stress-rest CMRi after 48-h abstinence from caffeine and vasoactive medications. Plasma caffeine was measured pre-scan and subjects were categorized into 2 groups according to caffeine levels (&lt;1 mg/L and ≥ 1 mg/L). Hemodynamics, MPRI and splenic switch-off were compared to assess adequate adenosine stress response during imaging.</div></div><div><h3>Results</h3><div>Of 109 patients studied, 15 (14 %) had detectable caffeine level. Other than sex, there were no significant differences between the two groups. Transmyocardial MPRI did not correlate with caffeine level ≥ 1 mg/L (<em>r</em> = 0.12, <em>p</em> = 0.66).</div></div><div><h3>Conclusion</h3><div>Mildly elevated plasma levels of caffeine did not affect measures of adequacy of response to adenosine during stress CMRi.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100709"},"PeriodicalIF":1.8,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short dual antiplatelet therapy after PCI with Resolute Onyx drug-eluting stents in high bleeding risk patients: One-year outcomes from a South Asian cohort","authors":"Pankaj Jariwala ,&nbsp;Guna Sai Vallapuri ,&nbsp;Bharat Kumar Reddy Konda ,&nbsp;Sukesh Kumar Jangam","doi":"10.1016/j.ahjo.2025.100703","DOIUrl":"10.1016/j.ahjo.2025.100703","url":null,"abstract":"<div><h3>Background</h3><div>The optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) in patients with high bleeding risk (HBR) remains unclear. This study evaluated the safety and efficacy of a shortened DAPT strategy (3-month DAPT followed by ticagrelor monotherapy) in patients with HBR receiving Resolute Onyx zotarolimus-eluting stents (ZES).</div></div><div><h3>Methods</h3><div>This retrospective observational study was conducted at the Yashoda Hospitals in Hyderabad. A total of 150 HBR patients who underwent PCI with Resolute Onyx ZES between June 2023 and June 2024 were included in the study. All patients received DAPT (aspirin 75 mg + ticagrelor 90 mg BID) for three months, followed by ticagrelor monotherapy for nine months. The primary outcome was a composite of cardiac death or MI from three months to one year. The secondary endpoints included stent thrombosis, target lesion failure (TLF), target lesion revascularization (TLR), stroke, and bleeding events (BARC classification).</div></div><div><h3>Results</h3><div>The mean age was 75.5 years, and 42.3 % were female. Diabetes was observed in 33.5 % of patients, prior revascularization in 46.4 %, and acute coronary syndrome in 58.3 %. Most lesions were calcified (60.8 %) or complex (88.2 % B2/C lesions). The patients met an average of 1.9 HBR criteria, and 54.6 % met at least two criteria. The primary composite endpoint occurred in 5.7 % of the patients (cardiac death-2.3 %; MI-3.4 %). Definite/probable stent thrombosis occurred in 0.3 %, TLF in 3.0 %, clinically driven TLR in 1.7 %, stroke in 0.6 %, and BARC 1–3 bleeding in 2.1 %. No BARC 3–5 bleeding events were recorded.</div></div><div><h3>Conclusion</h3><div>In this real-world HBR cohort treated with Resolute Onyx ZES, a strategy of 3-month DAPT followed by ticagrelor monotherapy was associated with low rates of ischemic events and the absence of major bleeding at one year. These findings suggest a favorable safety–efficacy balance for DAPT de-escalation in carefully selected patients; however, this requires confirmation in larger, prospective studies.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100703"},"PeriodicalIF":1.8,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can magnetocardiography decrease ED overcrowding, increase hospital bed capacity, and save hospitals money?","authors":"Margarita E. Pena ,&nbsp;Sharon E. Mace ,&nbsp;Griffin Bleecker ,&nbsp;Kaitlin Kreuser Girard ,&nbsp;Praveen Mital ,&nbsp;Pawan Suri ,&nbsp;Robert E. Takla","doi":"10.1016/j.ahjo.2025.100705","DOIUrl":"10.1016/j.ahjo.2025.100705","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives of this study are to demonstrate the time and cost savings of magnetocardiography (MCG) compared to other noninvasive cardiac imaging (NCI) tests, specifically in regard to time, number of skilled healthcare personnel (HCP), and cost of skilled HCP, medications and supplies, including contrast agents and radiotracers required to perform each test.</div></div><div><h3>Design</h3><div>This is a multicenter study comparing the time, skilled HCP, and costs needed to perform MCG and other NCI from four urban and community hospitals.</div></div><div><h3>Outcome measures</h3><div>Time needed to perform each test, the number of skilled HCP required, and costs for labor, supplies/drugs and contrast agents/radiotracers.</div></div><div><h3>Results</h3><div>Median time in minutes for obtaining ETT 60, SE 75, DSE 75, MPI-SPECT 225, MPI-PET 180, cMRI 90, and cCTA 75, MCG 15. Median number of skilled HCP required for performing the NCI were ETT 1.5, SE 2.5, DSE 2.5, MPI-SPECT 3.0, MPI-PET 3.0, cMRI 2.5, cCTA 2, and MCG 1. Median skilled HCP and their costs was ETT $71.23, SE $150.43, DSE $153.91, MPI-SPECT $625.18, MPI-PET $403.62, cMRI $95.41, cCTA $138.03, and MCG $8.75.</div></div><div><h3>Conclusion</h3><div>There is a time, skilled HCP and cost savings by using MCG versus other NCI for the evaluation of chest pain. Further studies are needed to validate MCG as an alternative to other NCI so these benefits can be realized.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100705"},"PeriodicalIF":1.8,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-blocker therapy after myocardial infarction with preserved LVEF (≥50%): a systematic review and Bayesian meta-analysis with time-to-event reconstruction","authors":"Ali Saad Al-Shammari ,&nbsp;Yousif Hameed Kurmasha ,&nbsp;M Rafiqul Islam ,&nbsp;Bara M. Hammadeh ,&nbsp;Nabeel Ibraheem Khaleel ,&nbsp;Belal Mohamed Hamed ,&nbsp;Haider Altaii ,&nbsp;Nihar Jena ,&nbsp;Jennifer Gerdes ,&nbsp;George Sokos ,&nbsp;Ramesh Daggubati ,&nbsp;Yasar Sattar ,&nbsp;Marwan Refaat","doi":"10.1016/j.ahjo.2025.100706","DOIUrl":"10.1016/j.ahjo.2025.100706","url":null,"abstract":"<div><h3>Background</h3><div>The role of β-blockers in MI with preserved LVEF (≥50%) remains unclear. This Bayesian meta-analysis assessed their effect on mortality and major cardiovascular outcomes.</div></div><div><h3>Methods</h3><div>A systematic search was performed in PubMed, Embase, and Scopus from database inception to September 2025 for studies assessing BB use in post-MI patients with preserved LVEF. All-cause mortality was the primary outcome. A Bayesian random-effects model was applied using the bayesmeta package in RStudio, with effect sizes expressed as risk ratios (RRs) and 95% credible intervals (CrIs). Between-study heterogeneity was assessed through posterior τ estimates. Time-to-event outcomes were analyzed using reconstructed individual patient data from published Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>Six studies, including 17,068 patients, met the inclusion criteria. BB therapy was associated with a posterior risk ratio (RR 0.79; 95% CrI 0.55–1.06) suggesting a possible reduction in all-cause mortality; however, the credible interval included the null, indicating uncertainty in the magnitude or direction of effect. The posterior estimates for cardiovascular death (RR 0.84; 95% CrI 0.55–1.23), stroke (RR 0.92; 95% CrI 0.58–1.49), myocardial infarction (RR 1.04; 95% CrI 0.80–1.40), heart failure (RR 0.84; 95% CrI 0.55–1.23), MACE (RR 1.09; 95% CrI 0.76–1.51), and unplanned revascularization (RR 1.06; 95% CrI 0.75–1.48) also showed wide credible intervals overlapping 1.0, reflecting uncertainty in potential treatment effects. Heterogeneity across outcomes was generally low to moderate. In time-to-event analyses, the frequentist stratified model showed a statistically significant survival benefit with β-blockers (HR 0.87; 95% CI 0.81–0.92), whereas the Bayesian model indicated a similar trend, but the credible interval (HR 0.60; 95% CrI 0.26–1.41) included the null, suggesting no strong evidence of effect.</div></div><div><h3>Conclusion</h3><div>β-blockers were not associated with a clear reduction in all-cause mortality or other outcomes, as credible intervals included the null. Large, randomized trials are needed to define their long-term role in this population.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100706"},"PeriodicalIF":1.8,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetocardiography for noninvasive surveillance of rejection and cardiac allograft vasculopathy in heart transplant recipients","authors":"Christian Eskander ,&nbsp;Matthew Peters ,&nbsp;Dipankar Gupta ,&nbsp;Katelyn A. Bruno ,&nbsp;Juan R. Vilaro","doi":"10.1016/j.ahjo.2025.100704","DOIUrl":"10.1016/j.ahjo.2025.100704","url":null,"abstract":"<div><div>Heart transplantation is the definitive treatment for end-stage heart failure, yet long-term graft survival is hindered by two major complications: acute/chronic rejection (cellular or antibody mediated) and cardiac allograft vasculopathy (CAV). Standard surveillance is performed to screen for these issues and predominantly consists of cardiac catheterization with hemodynamics, endomyocardial biopsy and invasive coronary angiography, with intravascular ultrasound (IVUS) and coronary flow reserve. The use of IVUS increases the sensitivity for CAV detection. Overall, these procedures have associated morbidities, need anesthesia and have associated patient discomfort and substantial cost. Magnetocardiography (MCG), a noninvasive modality that measures cardiac magnetic fields, has emerged as a potential tool for early detection of complications in post-transplant patients. Unlike electrocardiography, MCG provides spatially resolved data on depolarization and repolarization, independent of body habitus or tissue conductivity. Early studies suggest that MCG can identify electrophysiologic abnormalities associated with both acute rejection and CAV, in some cases preceding histologic or angiographic confirmation. Rejection is reflected by alterations in magnetic dipole strength and repolarization heterogeneity, while CAV correlates with repolarization dispersion indices such as QTc heterogeneity and Magnetic Dispersion Velocity. Despite promising pilot data, MCG remains underutilized, largely due to small study sizes, lack of standardized interpretation, and limited availability of equipment. This review synthesizes the existing evidence, highlights potential advantages and limitations, and outlines future directions for integrating MCG into standard post-transplant surveillance protocols.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100704"},"PeriodicalIF":1.8,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is predictive modeling the missing link for post-STEMI recovery in rural and resource-poor regions?","authors":"Jose Eric M. Lacsa","doi":"10.1016/j.ahjo.2025.100697","DOIUrl":"10.1016/j.ahjo.2025.100697","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100697"},"PeriodicalIF":1.8,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom experience of women with ischemia and no obstructive coronary artery disease: A mixed-methods approach","authors":"Sneha Thandra ,&nbsp;Esha Dave ,&nbsp;Ana Leon ,&nbsp;Jingwen Huang ,&nbsp;Arielle Schwartz ,&nbsp;Scott Gaignard ,&nbsp;Melinda Higgins ,&nbsp;Laura P. Kimble ,&nbsp;Puja K. Mehta","doi":"10.1016/j.ahjo.2025.100696","DOIUrl":"10.1016/j.ahjo.2025.100696","url":null,"abstract":"<div><h3>Background</h3><div>Women with myocardial ischemia with no obstructive arteries (INOCA) often have coronary microvascular dysfunction (CMD) or coronary vasospasm. INOCA is associated with adverse cardiovascular event risk, recurrent angina hospitalizations, and reduced health-related quality of life (QoL).</div></div><div><h3>Objectives</h3><div>In this mixed-methods study we used qualitative data to understand angina burden, while considering overall symptom experience of patients living with INOCA.</div></div><div><h3>Methods</h3><div>Twenty-four women with INOCA confirmed by coronary angiography were enrolled. A majority (<em>n</em> = 20) had coronary function testing to diagnose CMD or vasospasm. In addition to demographics and risk factors, angina and QoL were evaluated using the Seattle Angina Questionnaire (SAQ) (scored 0–100, higher score being better), along with Duke Activity Score Index and PHQ-8. Qualitative telephone interviews were conducted, recorded, transcribed, and analyzed for themes to explore patients' experiences. Descriptive statistics were performed for quantitative data.</div></div><div><h3>Results</h3><div>Mean age was 53.2 ± 10.8 years and body mass index was 30.8 ± 6.9 kg/m². Cardiac risk factors were prevalent with 63 % having hypertension, 75 % hyperlipidemia, and 25 % diabetes. SAQ scores indicated high angina frequency (50.5 ± 21.2), low angina stability (35.2 ± 31.5), physical limitations (37.7 ± 24.3), and poor QoL (41.3 ± 23.2). Qualitative analysis identified four major themes: <em>Invisible inscrutable threat</em>, <em>Longing for a normal/safe life</em>, <em>Rejecting labels</em>, and “<em>It has a toll</em>”. All patients expressed both diagnosis related emotional burden and explicit frustration.</div></div><div><h3>Conclusions</h3><div>This study highlights the substantial emotional and physical challenges women living with INOCA experience, emphasizing critical care gaps. Research efforts should prioritize understanding pathophysiologic mechanisms and improving symptom management to better support patient QoL.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100696"},"PeriodicalIF":1.8,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}