American heart journal plus : cardiology research and practice最新文献_第7页

Mortality trends in heart failure and colon cancer: Insights into gender, ethnic, and regional disparities in the United States (1999–2020) 心力衰竭和结肠癌的死亡率趋势：对美国性别、种族和地区差异的见解（1999-2020）

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2026-01-01 Epub Date: 2025-12-16 DOI: 10.1016/j.ahjo.2025.100699

Hafsah Alim Ur Rahman , Nimrah Iqbal , Muhammad Ahmed Ali Fahim , Fayza Salman , Syed Hassan Ahmed , Omama Asim , Taha Mansoor , Muhammad Zain Farooq , Muhammad Sohaib Asghar

Background

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.

Methods

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).

Results

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.

Conclusion

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.

背景心力衰竭（HF）和结直肠癌（CRC）是美国老龄化人口中主要的公共卫生问题。本研究旨在调查年龄≥65岁的HF和CRC成人死亡率的时间、地区、城市化和种族趋势。方法死亡率数据来自疾病控制和预防中心流行病学研究广泛在线数据（CDC WONDER）数据库，利用ICD-10代码识别1999年至2020年与结肠癌和心力衰竭相关的死亡。计算每10万人的年龄调整死亡率（AAMRs），以及年百分比变化（APCs）及其各自的95%置信区间（ci）。结果aamr在1999年（8.5）~ 2004年（7.3）之间保持相对稳定（APC: - 2.61; 95% CI: - 3.86, 0.09）。从2004年到2009年，观察到显著下降到5.0 （APC: - 7.08; 95% CI: - 9.28, - 3.58）。随后，该比率在2015年稳定下来（3.8）（APC: - 4.84; 95% CI: - 6.58至2.04），但在2020年小幅上升至4.4 （APC: 2.55; 95% CI: 0.08至8.19）。男性死亡率一贯较高（6.7比4.5），不同种族/族裔群体的死亡率不同，非西班牙裔（NH）白人（5.7）和NH黑人/非洲裔美国人（5.4）的死亡率最高，而西班牙裔（2.8）和NH亚洲人/太平洋岛民（2.3）的死亡率最低。从地区差异来看，中西部地区的aamr最高（6.5），其次是东北部（5.4）、西部（5.2）、南部（4.8）。此外，非大都市地区的自杀率明显高于大都市地区（分别为7.1比5.0）。aamr排名第90百分位的州是西弗吉尼亚州、密西西比州、南达科他州、内布拉斯加州和北达科他州。结论：尽管在研究期间死亡率总体下降，但差异仍然明显，男性、非西班牙裔白人、中西部居民和非大都市地区的个体死亡率较高。这突出了有针对性的公共卫生干预的必要性。

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引用次数: 0

Impact of baseline anemia on outcomes following chronic total occlusion percutaneous coronary intervention 基线贫血对慢性全闭塞经皮冠状动脉介入治疗后预后的影响

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2026-01-01 Epub Date: 2025-12-25 DOI: 10.1016/j.ahjo.2025.100708

Chloe Kharsa , Gal Sella , Yasser Sammour , Rody G. Bou Chaaya , Mangesh Kritya , Jerrin Philip , Muhammad Hassan Masood Virk , Muhammad Haisum Maqsood , Neal S. Kleiman , Alpesh R. Shah

Background

Anemia is a common comorbidity in patients undergoing percutaneous coronary intervention (PCI) and may signal worse post-procedural outcomes. Its prognostic impact in the context of chronic total occlusion (CTO) PCI remains underexplored.

Objectives

To evaluate procedural and clinical outcomes following CTO PCI in patients with and without anemia using real-world data from a high-volume tertiary care center.

Methods

We conducted a retrospective observational study using data from 504 patients who underwent CTO PCI between January 2018 and December 2023 at Houston Methodist. Patients were stratified by anemia status, defined using World Health Organization hemoglobin thresholds. Primary endpoints included procedural success, one-year all-cause mortality, and target lesion revascularization (TLR). Secondary endpoints included target lesion failure (TLF) and in-hospital complications.

Results

Of the cohort, 163 patients (32.3 %) had anemia. Patients with anemia were older, more often female, and had a greater burden of comorbidities, including CKD and heart failure. Despite similar lesion complexity and procedural success rates (80.4 % vs. 81.5 %; p = 0.79), patients with anemia had higher rates of in-hospital complications and one-year mortality (18.1 % vs. 5.0 %; HR = 4.0, p < 0.001)one-year target lesion failure (HR = 1.9; 95 % CI [1.2–2.9]; p = 0.005). Multivariate analysis identified age, heart failure, anemia and multivessel PCI as independent predictors of mortality at one-year, while CKD, and ISR lesion were predictors of TLF at one-year. The severity of anemia was not independently associated with all-cause mortality.

Conclusion

Pre-procedural anemia is associated with markedly worse in-hospital and long-term outcomes in patients undergoing CTO PCI, despite comparable technical success. These findings highlight anemia as a marker of systemic vulnerability and underscore the need for comprehensive risk stratification and multidisciplinary care in this high-risk population.

背景：在接受经皮冠状动脉介入治疗（PCI）的患者中，贫血是一种常见的合并症，可能预示着更糟糕的术后结果。其在慢性全闭塞（CTO） PCI背景下的预后影响仍未得到充分探讨。目的利用来自高容量三级医疗中心的真实世界数据，评估有或无贫血患者CTO PCI治疗的程序和临床结果。方法：我们对2018年1月至2023年12月在休斯顿卫理公会医院接受CTO PCI治疗的504例患者的数据进行了回顾性观察研究。根据世界卫生组织血红蛋白阈值定义的贫血状态对患者进行分层。主要终点包括手术成功、一年全因死亡率和靶病变血运重建术（TLR）。次要终点包括靶病变失败（TLF）和院内并发症。结果163例（32.3%）患者有贫血。贫血患者年龄较大，多为女性，并且有更大的合并症负担，包括CKD和心力衰竭。尽管病变复杂性和手术成功率相似（80.4% vs. 81.5%; p = 0.79），但贫血患者的住院并发症和一年内死亡率更高（18.1% vs. 5.0%; HR = 4.0, p < 0.001），一年内目标病变失败（HR = 1.9; 95% CI [1.2-2.9]; p = 0.005）。多因素分析发现，年龄、心力衰竭、贫血和多血管PCI是1年死亡率的独立预测因素，而CKD和ISR病变是1年TLF的预测因素。贫血的严重程度与全因死亡率没有独立的相关性。结论CTO PCI患者术前贫血与较差的住院和长期预后相关，尽管技术上取得了相当的成功。这些发现强调了贫血是系统性易感性的标志，并强调了在这一高危人群中进行全面风险分层和多学科护理的必要性。

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引用次数: 0

The role of Id genes on pulmonary hypertension development in left heart failure Id基因在左心衰肺动脉高压发展中的作用

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2026-01-01 Epub Date: 2025-12-10 DOI: 10.1016/j.ahjo.2025.100692

Christelle Lteif , Paula Wachs , Ravindra K. Sharma , Julio D. Duarte

Objective

To investigate the role of Id genes in the development of pulmonary hypertension (PH) in heart failure (HF) and evaluate genetic variants of the ID genes associated with HF-PH.

Design

Experimental study using an AKR/J mouse model of HF-PH and a genetic association study using the UK Biobank cohort.

Setting

Laboratory animal study and population-based cohort study.

Participants

AKR/J mice with HF-PH and participants with HF from the UK Biobank cohort.

Interventions

Administration of tacrolimus (Id signaling inducer) in the mouse model.

Main outcome measures

Tissue-specific gene expression of Id1, Id2, and Id3 in HF-PH mice; severity of HF-PH after tacrolimus treatment; associations of single nucleotide polymorphisms of ID1, ID2, and ID3 with PH development and mortality in participants with HF.

Results

Id1 was upregulated in the left ventricle (Fold Change (FC) = 1.65; P = 3.0 × 10⁻⁴) of HF-PH mice. In adipose tissue, Id1 and Id3 were downregulated (FC = 0.33; P = 5.2 × 10⁻³ and FC = 0.50; P = 0.01, respectively), while Id2 was upregulated (FC = 1.78; P = 7 × 10⁻⁴). Tacrolimus worsened PH and diastolic dysfunction, upregulating only Id2 in adipose tissue. In the clinical cohort, rs7425561 and rs10174593 (expression quantitative loci for ID2) trended toward reduced risk of PH in HF and all-cause mortality in participants with HF-PH.

Conclusion

The results suggest ID1, ID2, and ID3 are involved in HF-PH pathogenesis, but more research is needed to characterize their exact role.

目的探讨Id基因在心力衰竭（HF）肺动脉高压（PH）发生中的作用，并评价与HF-PH相关的Id基因的遗传变异。设计：使用AKR/J小鼠模型进行HF-PH的实验研究，并使用UK Biobank队列进行遗传关联研究。实验动物研究和基于人群的队列研究。参与者：来自UK Biobank队列的HF- ph的sakr /J小鼠和HF的参与者。干预措施：他克莫司（Id信号诱导剂）在小鼠模型中的应用。主要结果测量：在HF-PH小鼠中Id1、Id2和Id3的组织特异性基因表达；他克莫司治疗后HF-PH的严重程度；ID1、ID2和ID3单核苷酸多态性与HF患者PH发展和死亡率的关系结果左心室sid1表达上调(Fold Change (FC) = 1.65；P = 3.0 × 10−4)。在脂肪组织中，Id1和Id3表达下调（FC = 0.33, P = 5.2 × 10−3,FC = 0.50, P = 0.01）， Id2表达上调（FC = 1.78, P = 7 × 10−4）。他克莫司恶化PH和舒张功能障碍，仅上调脂肪组织中的Id2。在临床队列中，rs7425561和rs10174593 （ID2的表达定量位点）倾向于降低HF-PH患者的PH风险和全因死亡率。结论ID1、ID2和ID3参与了HF-PH的发病机制，但其具体作用尚需进一步研究。

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引用次数: 0

The ‘obesity paradox’ in patients undergoing transcatheter aortic valve implantation. A specialized narrative review 经导管主动脉瓣植入患者的“肥胖悖论”。专门的叙事性评论

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2026-01-01 Epub Date: 2025-12-08 DOI: 10.1016/j.ahjo.2025.100695

Johao Escobar , Iqra Riaz , Muzamil Khawaja , Hafeez Ul Hassan Virk , Joshua Hahn , Fu'’ad Al-Azzam , Zhen Wang , Mahboob Alam , Markus Strauss , Chayakrit Krittanawong

Obesity has long been identified as a noteworthy risk factor for cardiovascular diseases, including aortic stenosis. Nevertheless, an unexplained phenomenon known as the obesity paradox has arisen in the context of transcatheter aortic valve implantation (TAVI), inquiring conventional beliefs. The obesity paradox refers to better clinical outcomes observed in obese individuals undergoing TAVI. These include reduced all-cause mortality, lower rates of procedural complications, and improved long-term survival rates compared to their lean counterparts. Several theories have been proposed to explain the obesity paradox in TAVI. One of the most popular is the adipose tissue-mediated cardioprotective effect hypothesis. It is known that adipose tissue could offer both protective and harmful effects on the cardiovascular system. These effects can be linked to the adipose tissue's distribution, extension, and intrinsic biological characteristics. Obesity has been associated with adipose tissue malfunction, leading to proinflammatory and deleterious effects on the cardiovascular system. As opposed to what is believed, it is suggested that a healthy obese phenotype might be facilitated by exercise, leading to outstanding cardiovascular benefits. A healthy obese phenotype is also associated with a secretome profile that has unique adipose tissue features like adequate fat storage and formation of lipid droplets, a significant capacity for adipogenesis, minimal extracellular matrix fibrosis, potential for angiogenesis, adipocyte browning, and limited infiltration or activation of macrophages. This article is presented as a specialized narrative review, synthesizing current evidence on the relationship between obesity and outcomes in patients undergoing TAVI.

长期以来，肥胖一直被认为是心血管疾病（包括主动脉狭窄）的一个值得注意的危险因素。然而，在经导管主动脉瓣植入（TAVI）的背景下，出现了一种无法解释的肥胖悖论现象，质疑传统观念。肥胖悖论指的是在接受TAVI的肥胖个体中观察到更好的临床结果。这包括降低了全因死亡率，降低了手术并发症的发生率，并提高了长期生存率。人们提出了几种理论来解释TAVI中的肥胖悖论。其中最流行的是脂肪组织介导的心脏保护作用假说。众所周知，脂肪组织对心血管系统既有保护作用，也有有害作用。这些影响可能与脂肪组织的分布、延伸和内在生物学特性有关。肥胖与脂肪组织功能障碍有关，导致对心血管系统的促炎和有害影响。与人们所认为的相反，有人认为，健康的肥胖表型可能是通过运动促进的，从而对心血管有显著的好处。健康的肥胖表型还与具有独特脂肪组织特征的分泌组相关，如充足的脂肪储存和脂滴的形成，显著的脂肪生成能力，最小的细胞外基质纤维化，血管生成的潜力，脂肪细胞褐变，以及有限的巨噬细胞浸润或激活。本文是一篇专门的叙述性综述，综合了目前关于肥胖与TAVI患者预后之间关系的证据。

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引用次数: 0

Association between a reduction in triglyceride levels and risk of cardiovascular events 甘油三酯水平降低与心血管事件风险之间的关系

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1016/j.ahjo.2025.100647

Izuki Yamashita , Masanobu Ishii , Tatsuya Tokai , So Ikebe , Yoshinori Yamanouchi , Taishi Nakamura , Kenichi Tsujita

Background

Previous analyses have reported that low triglyceride (TG) levels were associated with a reduced risk of cardiovascular events in a primary prevention cohort. However, it remains unclear whether a reduction in TG levels directly contributes to cardiovascular risk reduction.

Objective

To investigate whether a reduction in TG levels is associated with a decreased risk of cardiovascular events in primary and secondary prevention cohorts.

Methods

This retrospective study was conducted with a nationwide health insurance claims database, with medical checkups between January 2005 and August 2020 in Japan. We included patients with baseline TG levels ≥150 mg/dL and classified them into primary or secondary prevention of cardiovascular events. TG levels at one year were used to stratify patients into four groups: low (≤100 mg/dL), normal (100–149 mg/dL), high (150–499 mg/dL), and very high (≥500 mg/dL). The primary outcome was major adverse cardiovascular events (MACE).

Results

In the primary prevention cohort, a reduction TG levels to ≤150 mg/dL was significantly associated with a reduced risk of MACE. No significant association was observed in the secondary prevention cohort. In subgroup analyses stratified by LDL-C target achievement, patients with elevated LDL-C showed a trend toward lower event risk with decreasing TG levels.

Conclusion

A weak association was found between a reduction in TG levels and a reduced risk of cardiovascular events in the primary prevention population. However, prospective, randomized, placebo-controlled, and large cardiovascular outcomes trials are needed to prove that substantial reductions in TG levels correlate with cardiovascular event risk reduction.

背景：先前的分析报道，在一级预防队列中，低甘油三酯（TG）水平与心血管事件风险降低相关。然而，目前尚不清楚TG水平的降低是否直接有助于心血管风险的降低。目的探讨在一级和二级预防队列中，TG水平的降低是否与心血管事件风险的降低相关。方法本回顾性研究是在日本全国健康保险索赔数据库中进行的，并在2005年1月至2020年8月期间进行了医疗检查。我们纳入了基线TG水平≥150mg /dL的患者，并将其分为一级预防或二级预防心血管事件。使用一年的TG水平将患者分为四组：低（≤100 mg/dL）、正常（100 - 149 mg/dL）、高（150-499 mg/dL）和非常高（≥500 mg/dL）。主要终点为主要不良心血管事件（MACE）。结果在一级预防队列中，TG水平降低至≤150 mg/dL与MACE风险降低显著相关。在二级预防队列中未观察到显著相关性。在按LDL-C目标实现程度分层的亚组分析中，LDL-C升高的患者随着TG水平的降低，事件风险降低。结论在初级预防人群中，TG水平的降低与心血管事件风险的降低之间存在弱关联。然而，需要前瞻性、随机、安慰剂对照和大型心血管结局试验来证明TG水平的显著降低与心血管事件风险降低相关。

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引用次数: 0

Phase-dependent iron dysmetabolism in myocardial ischemia-reperfusion injury: From mechanisms to therapies 心肌缺血再灌注损伤的相依赖性铁代谢异常：从机制到治疗

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-12-01 Epub Date: 2025-10-22 DOI: 10.1016/j.ahjo.2025.100653

Yilin Huang , Shuang Li , Yuanlin Zeng , Zeyu Zhang

Myocardial ischemia-reperfusion injury (MIRI) remains a critical clinical challenge, often worsening myocardial damage after reperfusion therapy for acute myocardial infarction (AMI). Phase-dependent dysregulation of iron homeostasis is critically involved in the pathogenesis of MIRI. Ischemia leads to depletion of the labile iron pool (LIP) and iron accumulation in cardiomyocytes, whereas reperfusion leads to iron overload and oxidative stress. These changes destroy cellular homeostasis, triggering ferroptosis and other programmed cell death pathways. Potential therapeutic targets have been identified through molecular mechanisms regulating ferritinophagy, hepcidin modulation, and transferrin receptor 1-mediated iron transport. This review summarizes research progress in these phase-specific changes in iron metabolism during myocardial ischemia and reperfusion, emphasizing their roles in oxidative stress and cell damage. Potential therapeutic strategies integrate the correction of dysregulated homeostasis into clinical trials using drugs that target AMI and MIRI, offering perspectives for the development of novel treatments.

心肌缺血-再灌注损伤（MIRI）是急性心肌梗死（AMI）再灌注治疗后心肌损伤恶化的关键临床挑战。铁稳态的相位依赖性失调在MIRI的发病机制中起关键作用。缺血导致心肌细胞不稳定铁池（LIP）耗竭和铁积累，而再灌注导致铁过载和氧化应激。这些变化破坏细胞内稳态，引发铁下垂和其他程序性细胞死亡途径。通过调节铁蛋白自噬、hepcidin调节和转铁蛋白受体1介导的铁转运的分子机制，已经确定了潜在的治疗靶点。本文综述了心肌缺血再灌注时铁代谢的阶段性变化的研究进展，重点介绍了它们在氧化应激和细胞损伤中的作用。潜在的治疗策略是利用靶向AMI和MIRI的药物将失调的体内平衡的纠正整合到临床试验中，为开发新的治疗方法提供了前景。

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引用次数: 0

Letter by Zhang regarding article, “supersaturated oxygen therapy using radial artery access to prevent left ventricular remodeling after anterior ST-segment elevation myocardial infarction: A randomized, controlled trial” Zhang关于文章“桡动脉过饱和氧治疗预防st段抬高型心肌梗死后左室重构：一项随机对照试验”的来信。

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ahjo.2025.100641

Zonglei Zhang

引用次数: 0

Sodium-glucose cotransporter 2 inhibitors for wild-type transthyretin amyloidosis: Insights from a global database 钠-葡萄糖共转运蛋白2抑制剂治疗野生型转甲状腺蛋白淀粉样变性：来自全球数据库的见解

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-12-01 Epub Date: 2025-09-23 DOI: 10.1016/j.ahjo.2025.100625

Z. Zathar , D.G. Wilson

Background

Wild-type transthyretin amyloidosis (wtATTR) is an increasingly recognised cause of infiltrative cardiomyopathy, particularly in the elderly population. The use of traditional heart failure prognostic therapies in this group may be limited by age-associated comorbidities and heightened vulnerability to changes in renal function and blood pressure. We aimed to assess the potential prognostic impact of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in wtATTR.

Methods

Using data from a federated global electronic medical record database (TriNetX), patients diagnosed with wtATTR between 2005 and 2025 were identified and followed for up to 5 years. Patients were stratified into two groups based on SGLT2i use with 1:1 propensity score matching (PSM) between the cohorts. The primary outcome was all-cause mortality, and secondary outcome was clinical decompensation for heart failure.

Results

A total of 1,160 patients treated with SGLT2i and 2,325 patients without SGLT2i met inclusion criteria for the study. After PSM, each group contained 909 patients with comparable covariates. Mean age was 77.3±9.2 years (81.4% male) in the treatment group and 77.9±7.5 years (82.5% male) for control. Median follow-up was 297 days in the treatment group and 438 days in the control group. Patients treated with SGLT2i had lower all-cause mortality (hazard ratio [HR] 0.62; 95% CI 0.49-0.79) and clinical decompensation for heart failure (odds ratio [OR] 0.61; 95% CI 0.40-0.94).

Conclusion

SGLT2i use was associated with better survival and a lower incidence of clinical heart failure. These findings signal a potential prognostic benefit of SGLT2i in wtATTR that should be explored further.

野生型甲状腺转蛋白淀粉样变（wtATTR）是一种越来越被认可的引起浸润性心肌病的原因，特别是在老年人中。由于年龄相关的合并症和对肾功能和血压变化的易感性增加，在这一组中使用传统的心衰预后治疗可能受到限制。我们的目的是评估钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）在wtATTR中的潜在预后影响。方法使用联邦全球电子病历数据库（TriNetX）的数据，确定2005年至2025年间诊断为wtATTR的患者，并进行长达5年的随访。根据SGLT2i的使用情况将患者分为两组，队列之间采用1:1的倾向评分匹配（PSM）。主要结局是全因死亡率，次要结局是心力衰竭的临床失代偿。结果共有1160例SGLT2i患者和2325例非SGLT2i患者符合本研究的纳入标准。PSM后，每组包含909例具有可比协变量的患者。治疗组平均年龄77.3±9.2岁（男性占81.4%），对照组平均年龄77.9±7.5岁（男性占82.5%）。治疗组的中位随访时间为297天，对照组为438天。接受SGLT2i治疗的患者具有较低的全因死亡率（危险比[HR] 0.62; 95% CI 0.49-0.79）和心力衰竭的临床失代偿（优势比[OR] 0.61; 95% CI 0.40-0.94）。结论sglt2i的使用与更好的生存率和更低的临床心力衰竭发生率相关。这些发现表明SGLT2i在wattr中的潜在预后益处有待进一步探讨。

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引用次数: 0

Comparison of all-cause and cause-specific mortality after myocardial infarction – a Hungarian registry study 心肌梗死后全因死亡率和特异性死亡率的比较——匈牙利的一项登记研究

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-12-01 Epub Date: 2025-10-30 DOI: 10.1016/j.ahjo.2025.100663

Tamás Ferenci , András Jánosi

Study Objective

Despite advances, myocardial infarction remains a significant public health concern, with survival being a crucial outcome measure. While all-cause mortality is well-studied, less is known about causes of death following an infarction. This study aimed to analyse cause-specific mortality after myocardial infarction and to compare it with the analysis of all-cause mortality.

Design

Data from a nationwide Hungarian myocardial infarction registry from January 2020 to June 2022 were linked with official cause of death information. Cumulative incidence functions and multivariable modelling of subdistribution hazard were used for cause-specific survival analysis, accounting for competing risks. Standard all-cause survival analysis (Cox proportional hazards model) was also carried out as a comparison.

Results

Among 27,965 patients with acute myocardial infarction, 25.0 % died during follow-up (of a median of 661 days). Myocardial infarction was the primary cause of death in 38.6 % of cases, followed by other cardiovascular causes (37.5 %). Factors associated with higher cause-specific mortality for infarction included older age, male sex, ST-elevation infarction, diabetes, prior stroke, peripheral artery disease, and heart failure. Percutaneous coronary intervention and hypertension was associated with lower hazard. Results largely matched all-cause survival analysis, except for ST-elevation, where hazard was much higher in cause-specific analysis.

Conclusions

While overall and cause-specific analyses aligned in this large registry study, a notable difference was observed for ST-elevation infarction, where hazard was substantially higher in the cause-specific analysis. This highlights the potential relevance of distinguishing between causes of death for a more precise understanding of outcomes.

尽管取得了进展，但心肌梗死仍然是一个重大的公共卫生问题，生存率是一个关键的结局指标。虽然全因死亡率研究得很好，但对梗死后死亡的原因知之甚少。本研究旨在分析心肌梗死后的死因特异性死亡率，并将其与全因死亡率分析进行比较。从2020年1月至2022年6月，匈牙利全国心肌梗死登记处的设计数据与官方死亡原因信息相关联。累积关联函数和亚分布风险的多变量模型用于原因特异性生存分析，考虑竞争风险。标准全因生存分析（Cox比例风险模型）也进行了比较。结果在27,965例急性心肌梗死患者中，25.0%的患者在随访期间死亡（中位时间为661天）。心肌梗死是38.6%病例的主要死亡原因，其次是其他心血管原因（37.5%）。与梗死较高的病因特异性死亡率相关的因素包括年龄较大、男性、st段抬高性梗死、糖尿病、既往卒中、外周动脉疾病和心力衰竭。经皮冠状动脉介入治疗和高血压的风险较低。结果与全因生存分析基本一致，除了st段抬高，其风险在病因特异性分析中要高得多。结论：虽然在这项大型登记研究中，总体分析和病因特异性分析一致，但在st段抬高性梗死中观察到显著差异，在病因特异性分析中，st段抬高性梗死的危险要高得多。这突出了区分死亡原因对于更精确地了解结果的潜在相关性。

{"title":"Comparison of all-cause and cause-specific mortality after myocardial infarction – a Hungarian registry study","authors":"Tamás Ferenci , András Jánosi","doi":"10.1016/j.ahjo.2025.100663","DOIUrl":"10.1016/j.ahjo.2025.100663","url":null,"abstract":"<div><h3>Study Objective</h3><div>Despite advances, myocardial infarction remains a significant public health concern, with survival being a crucial outcome measure. While all-cause mortality is well-studied, less is known about causes of death following an infarction. This study aimed to analyse cause-specific mortality after myocardial infarction and to compare it with the analysis of all-cause mortality.</div></div><div><h3>Design</h3><div>Data from a nationwide Hungarian myocardial infarction registry from January 2020 to June 2022 were linked with official cause of death information. Cumulative incidence functions and multivariable modelling of subdistribution hazard were used for cause-specific survival analysis, accounting for competing risks. Standard all-cause survival analysis (Cox proportional hazards model) was also carried out as a comparison.</div></div><div><h3>Results</h3><div>Among 27,965 patients with acute myocardial infarction, 25.0 % died during follow-up (of a median of 661 days). Myocardial infarction was the primary cause of death in 38.6 % of cases, followed by other cardiovascular causes (37.5 %). Factors associated with higher cause-specific mortality for infarction included older age, male sex, ST-elevation infarction, diabetes, prior stroke, peripheral artery disease, and heart failure. Percutaneous coronary intervention and hypertension was associated with lower hazard. Results largely matched all-cause survival analysis, except for ST-elevation, where hazard was much higher in cause-specific analysis.</div></div><div><h3>Conclusions</h3><div>While overall and cause-specific analyses aligned in this large registry study, a notable difference was observed for ST-elevation infarction, where hazard was substantially higher in the cause-specific analysis. This highlights the potential relevance of distinguishing between causes of death for a more precise understanding of outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100663"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467525","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}

引用次数: 0

Artificial intelligence enhanced contemporary pulmonary hypertension care 人工智能增强当代肺动脉高压护理

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice

Pub Date : 2025-12-01 Epub Date: 2025-11-12 DOI: 10.1016/j.ahjo.2025.100673

Pyi Naing , Gregory M. Scalia , Dale Murdoch , Isuru Ranasinghe , Doug L. Forrester , Geoff Strange , David Playford

All-cause pulmonary hypertension (PH) is associated with increased mortality and an enormous public health concern. However, given its complexity, multiple potential etiologies and inherent diagnostic challenges, PH diagnosis may be delayed or missed entirely. Artificial Intelligence (AI) shows potential to provide a simple but multifaceted, personalized approach for early identification of PH. AI-assisted patient triage may help highlight individuals requiring further investigation. Echocardiography may improve the identification of PH due to left heart disease and PH from other causes using a combination of AI systems such as image guidance, auto-measurement, deep phenotyping and smart reporting. Multi-level AI integrating clinical and echocardiographic data has the potential to democratize access to medical care and assist in selecting those most at risk for thorough evaluation at expert centers. In this state-of-the-art review, we discuss how new technology including AI can assist in improving the diagnosis and management of PH.

全因肺动脉高压（PH）与死亡率增加有关，是一个巨大的公共卫生问题。然而，由于其复杂性，多种潜在病因和固有的诊断挑战，PH诊断可能会延迟或完全错过。人工智能（AI）显示出提供一种简单但多方面的个性化方法来早期识别ph的潜力。人工智能辅助的患者分诊可能有助于突出需要进一步调查的个体。超声心动图可以通过结合人工智能系统，如图像引导、自动测量、深度表型和智能报告，提高左心疾病和其他原因引起的PH值的识别。整合临床和超声心动图数据的多层次人工智能有可能使医疗保健大众化，并帮助选择风险最大的患者在专家中心进行全面评估。在这篇最新的综述中，我们讨论了包括人工智能在内的新技术如何帮助改善PH的诊断和管理。

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引用次数: 0