American Journal of Cardiology最新文献

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Comments on: “Cardiovascular Prognosis in Limb Ischemia Patients With Heart Failure and Systolic Dysfunction Following Major Amputation”

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-05 DOI: 10.1016/j.amjcard.2025.01.036

Sravani Modumudi MD, Chandana Padmanabham Reddy MD

引用次数: 0

Better Endothelization Looking Forward to a Clinical Impact.

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-03 DOI: 10.1016/j.amjcard.2025.01.035

Antonio Colombo, Pier Pasquale Leone

引用次数: 0

Bilateral Internal Mammary Artery in Off-Pump Coronary Artery Grafting in Diabetic Patients

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-03 DOI: 10.1016/j.amjcard.2025.01.030

Giuseppe Tavilla MD, PhD, Md Anamul Islam PhD, Amber Malhotra MD, Daniel Lincoln Beckles MD, PhD

Bilateral internal mammary artery (BIMA) grafts utilization in coronary artery bypass grafting (CABG) for diabetic patients has been limited due to concerns regarding postoperative morbidity, especially sternal wound infections (SWI). However, outcomes for BIMA grafting combined with off-pump CABG (OPCAB) in diabetic patients remain underexplored. This study aimed to compare BIMA and single internal mammary artery (SIMA) grafting outcomes in diabetic OPCAB patients. A single-center retrospective analysis was conducted on diabetes patients who underwent OPCAB with BIMA or SIMA grafts from January 2020 to December 2023. Baseline characteristics, including STS risk scores, were matched between cohorts using stabilized inverse probability treatment weighting (sIPTW). The study included 412 diabetic patients: 207 (50.2%) received BIMA and 205 (49.8%) received SIMA grafts. After sIPTW matching, 30-day mortality was identical (1.4%, p = 0.40), with comparable rates of deep (0.9% vs 0.8%, p = 0.89) and superficial sternal wound infections (4% vs 1.8%, p = 0.19). Composite complication rates (40% vs 47%; p = 0.13) and individual components such as renal injury, reoperation bleeding, stroke, and atrial fibrillation were similar between groups. Rates of overall readmission and cardiac readmission, discharge-to-home versus acute care facilities, and hospital stays longer than 7 days were comparable. Notably, BIMA showed significantly lower rates of blood transfusion (31% vs 40%; p = 0.038) and prolonged ventilation (9% vs 16%; p = 0.033) than SIMA group. In conclusion, our findings suggest that BIMA grafting combined with OPCAB may be safely used in diabetic patients despite historical concern about wound healing complications.

{"title":"Bilateral Internal Mammary Artery in Off-Pump Coronary Artery Grafting in Diabetic Patients","authors":"Giuseppe Tavilla MD, PhD, Md Anamul Islam PhD, Amber Malhotra MD, Daniel Lincoln Beckles MD, PhD","doi":"10.1016/j.amjcard.2025.01.030","DOIUrl":"10.1016/j.amjcard.2025.01.030","url":null,"abstract":"<div><div>Bilateral internal mammary artery (BIMA) grafts utilization in coronary artery bypass grafting (CABG) for diabetic patients has been limited due to concerns regarding postoperative morbidity, especially sternal wound infections (SWI). However, outcomes for BIMA grafting combined with off-pump CABG (OPCAB) in diabetic patients remain underexplored. This study aimed to compare BIMA and single internal mammary artery (SIMA) grafting outcomes in diabetic OPCAB patients. A single-center retrospective analysis was conducted on diabetes patients who underwent OPCAB with BIMA or SIMA grafts from January 2020 to December 2023. Baseline characteristics, including STS risk scores, were matched between cohorts using stabilized inverse probability treatment weighting (sIPTW). The study included 412 diabetic patients: 207 (50.2%) received BIMA and 205 (49.8%) received SIMA grafts. After sIPTW matching, 30-day mortality was identical (1.4%, p = 0.40), with comparable rates of deep (0.9% vs 0.8%, p = 0.89) and superficial sternal wound infections (4% vs 1.8%, p = 0.19). Composite complication rates (40% vs 47%; p = 0.13) and individual components such as renal injury, reoperation bleeding, stroke, and atrial fibrillation were similar between groups. Rates of overall readmission and cardiac readmission, discharge-to-home versus acute care facilities, and hospital stays longer than 7 days were comparable. Notably, BIMA showed significantly lower rates of blood transfusion (31% vs 40%; p = 0.038) and prolonged ventilation (9% vs 16%; p = 0.033) than SIMA group. In conclusion, our findings suggest that BIMA grafting combined with OPCAB may be safely used in diabetic patients despite historical concern about wound healing complications.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 34-39"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254516","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}

引用次数: 0

Association of Coronary Revascularization Modality and Timing With Outcomes of Acute Coronary Syndrome in Kidney Transplant Recipients

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-03 DOI: 10.1016/j.amjcard.2025.01.029

Oh Jin Kwon MD , Esteban Aguayo MD , Joseph Hadaya MD , Kevin Tabibian BS , Dariush Yalzadeh BS , Matthew Gandjian MD , Yas Sanaiha MD , Radoslav Zinoviev MD , Peyman Benharash MD

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality among renal transplant (RTx) recipients, with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) representing a disproportionately high burden. However, the optimal revascularization strategy for NSTE-ACS in RTx recipients remains unclear. This retrospective study analyzed the 2016 to 2021 Nationwide Readmissions Database. RTx recipients (≥18 years) undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) for NSTE-ACS were included. The primary outcome was in-hospital mortality, while perioperative complications, unplanned 30- and 90-day readmissions, repeat revascularization, and renal allograft failure were also considered. Multivariable logistic regression and Royston–Parmar models were used to identify the risk-adjusted association of revascularization modality, timing, and outcomes. Of an estimated 3,323 patients, 20.5% underwent CABG and 79.5% PCI. Following adjustment, CABG was associated with higher perioperative complications (AOR 3.46, 95% CI 2.31 to 5.19) and demonstrated a trend toward increased mortality risk (AOR 1.79, 95% CI 0.76 to 4.18). Royston–Parmar analysis demonstrated no difference in freedom from readmission or renal allograft failure within 90 days of discharge, but CABG was associated with a lower hazard of repeat revascularization (HR 0.24, 95% CI 0.08 to 0.76). Timing analysis revealed stable mortality rates across intervals for both modalities. While PCI complications increased with longer delays to revascularization, CABG demonstrated a more stable pattern. In conclusion, our findings suggest that PCI appears to be associated with lower risks of mortality and complications compared to CABG in RTx recipients with NSTE-ACS. However, CABG may offer benefits of reduced risk of repeat revascularization and greater flexibility in timing without compromising renal allograft function.

{"title":"Association of Coronary Revascularization Modality and Timing With Outcomes of Acute Coronary Syndrome in Kidney Transplant Recipients","authors":"Oh Jin Kwon MD , Esteban Aguayo MD , Joseph Hadaya MD , Kevin Tabibian BS , Dariush Yalzadeh BS , Matthew Gandjian MD , Yas Sanaiha MD , Radoslav Zinoviev MD , Peyman Benharash MD","doi":"10.1016/j.amjcard.2025.01.029","DOIUrl":"10.1016/j.amjcard.2025.01.029","url":null,"abstract":"<div><div>Coronary artery disease (CAD) remains a leading cause of morbidity and mortality among renal transplant (RTx) recipients, with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) representing a disproportionately high burden. However, the optimal revascularization strategy for NSTE-ACS in RTx recipients remains unclear. This retrospective study analyzed the 2016 to 2021 Nationwide Readmissions Database. RTx recipients (≥18 years) undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) for NSTE-ACS were included. The primary outcome was in-hospital mortality, while perioperative complications, unplanned 30- and 90-day readmissions, repeat revascularization, and renal allograft failure were also considered. Multivariable logistic regression and Royston–Parmar models were used to identify the risk-adjusted association of revascularization modality, timing, and outcomes. Of an estimated 3,323 patients, 20.5% underwent CABG and 79.5% PCI. Following adjustment, CABG was associated with higher perioperative complications (AOR 3.46, 95% CI 2.31 to 5.19) and demonstrated a trend toward increased mortality risk (AOR 1.79, 95% CI 0.76 to 4.18). Royston–Parmar analysis demonstrated no difference in freedom from readmission or renal allograft failure within 90 days of discharge, but CABG was associated with a lower hazard of repeat revascularization (HR 0.24, 95% CI 0.08 to 0.76). Timing analysis revealed stable mortality rates across intervals for both modalities. While PCI complications increased with longer delays to revascularization, CABG demonstrated a more stable pattern. In conclusion, our findings suggest that PCI appears to be associated with lower risks of mortality and complications compared to CABG in RTx recipients with NSTE-ACS. However, CABG may offer benefits of reduced risk of repeat revascularization and greater flexibility in timing without compromising renal allograft function.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"242 ","pages":"Pages 53-60"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Regression and Worsening of Tricuspid Regurgitation Following Transvenous Cardiac Implantable Electronic Device Implantation 经静脉植入心脏电子装置后三尖瓣反流的消退和恶化。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-01 DOI: 10.1016/j.amjcard.2024.09.027

Gulmira Kudaiberdieva MD, PhD, DSc

引用次数: 0

Impact of Intensified Outpatient Follow-Up on Rehospitalization After Transcatheter Aortic Valve Implantation: Results From the HOSPITAVI Trial.

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-01 DOI: 10.1016/j.amjcard.2025.01.031

Pernille Steen Bække, Troels Højsgaard Jørgensen, Gintautas Bieliauskas, Lars Sondergaard, Ole De Backer

Patients undergoing transcatheter aortic valve implantation (TAVI) are at increased risk of rehospitalization in the early period after discharge from TAVI. The HOSPITAVI study aimed to compare the impact of a standard versus intensified outpatient follow-up on rehospitalization rates within 90 days after TAVI discharge. Patients were 1:1 randomized to either a standard or intensified outpatient follow-up after TAVI discharge. The primary endpoint was the 90-day hospital rehospitalization rate. In total, 300 patients were included: 150 patients were randomized to standard follow-up and 150 patients to intensified outpatient follow-up. The study population had a median age of 79 years, a median EuroSCORE II of 2.9%, and 72% were discharged the day after TAVI. Within 90 days after discharge, the mean number of all-cause hospital readmissions per patient was 0.44 versus 0.35 (HR 0.8 [95% CI, 0.6-1.2], p = 0.23) in the standard versus intensified group, respectively. The mean number of cardiovascular (CV) readmissions per patient was 0.27 versus 0.15 (HR 0.6 [95% CI, 0.4-1.0], p = 0.04) in the standard versus intensified group, respectively. This resulted in a mean number of CV readmission days per patient of 1.52 days versus 0.49 days within the first 90 days in the standard versus intensified group, respectively (p < 0.05). Following TAVI discharge, there was no significant difference in all-cause rehospitalization rates using a standard versus intensified outpatient follow-up approach. However, an intensified outpatient follow-up reduces the burden of early CV rehospitalization after TAVI discharge. (Rehospitalization after transcatheter aortic valve implantation [HOSPITAVI]; NCT05670041).

{"title":"Impact of Intensified Outpatient Follow-Up on Rehospitalization After Transcatheter Aortic Valve Implantation: Results From the HOSPITAVI Trial.","authors":"Pernille Steen Bække, Troels Højsgaard Jørgensen, Gintautas Bieliauskas, Lars Sondergaard, Ole De Backer","doi":"10.1016/j.amjcard.2025.01.031","DOIUrl":"10.1016/j.amjcard.2025.01.031","url":null,"abstract":"<p><p>Patients undergoing transcatheter aortic valve implantation (TAVI) are at increased risk of rehospitalization in the early period after discharge from TAVI. The HOSPITAVI study aimed to compare the impact of a standard versus intensified outpatient follow-up on rehospitalization rates within 90 days after TAVI discharge. Patients were 1:1 randomized to either a standard or intensified outpatient follow-up after TAVI discharge. The primary endpoint was the 90-day hospital rehospitalization rate. In total, 300 patients were included: 150 patients were randomized to standard follow-up and 150 patients to intensified outpatient follow-up. The study population had a median age of 79 years, a median EuroSCORE II of 2.9%, and 72% were discharged the day after TAVI. Within 90 days after discharge, the mean number of all-cause hospital readmissions per patient was 0.44 versus 0.35 (HR 0.8 [95% CI, 0.6-1.2], p = 0.23) in the standard versus intensified group, respectively. The mean number of cardiovascular (CV) readmissions per patient was 0.27 versus 0.15 (HR 0.6 [95% CI, 0.4-1.0], p = 0.04) in the standard versus intensified group, respectively. This resulted in a mean number of CV readmission days per patient of 1.52 days versus 0.49 days within the first 90 days in the standard versus intensified group, respectively (p < 0.05). Following TAVI discharge, there was no significant difference in all-cause rehospitalization rates using a standard versus intensified outpatient follow-up approach. However, an intensified outpatient follow-up reduces the burden of early CV rehospitalization after TAVI discharge. (Rehospitalization after transcatheter aortic valve implantation [HOSPITAVI]; NCT05670041).</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121733","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}

引用次数: 0

Beyond Angiography in Peripheral Interventions: When and How to Incorporate Peri-Procedural Physiology.

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-01 DOI: 10.1016/j.amjcard.2025.01.037

Adam S Vohra, Dmitriy N Feldman

引用次数: 0

Corrigendum to ‘Non-Invasive Assessment of Left Ventricular Pressure-Volume Relations: Inter- and Intra-Observer Variability and Assessment Across Heart Failure Subtypes’ [American Journal of Cardiology 184 (2022) 48-55] 左心室压力-容积关系的非侵入性评估：观察者之间和观察者内部的变异性以及对心衰亚型的评估"[《美国心脏病学杂志》184 (2022) 48-55]。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-01 DOI: 10.1016/j.amjcard.2024.12.016

Jonathan Edlund MD , Per M. Arvidsson MD, PhD , Anders Nelsson MD , J. Gustav Smith MD , Martin Magnusson MD , Einar Heiberg PhD , Katarina Steding-Ehrenborg RPT, PhD , Håkan Arheden MD

引用次数: 0

Low Agreement Among Guidelines for Primary Prevention Implantable Cardioverter-Defibrillator Recommendations in Hypertrophic Cardiomyopathy 肥厚型心肌病一级预防 ICD 推荐指南之间的一致性较低：简短标题：针对肥厚型心肌病的不同 ICD 建议。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-01 DOI: 10.1016/j.amjcard.2024.11.007

Fernando Luís Scolari MD, PhD , Henrique Iahnke Garbin MD , Guilherme Dagostin de Carvalho MD, MSc , Fernanda Thomaz Rodrigues MD , Rodrigo Araujo de Menezes MD , Edileide de Barros Correia MD , Marcelo Imbroinise Bittencourt MD, PhD

Sudden cardiac death (SCD) risk stratification and primary prevention implantable cardioverter-defibrillator (ICD) recommendations are based on differing strategies for hypertrophic cardiomyopathy (HCM). This study aimed to evaluate the impact of the 2023 European Society of Cardiology (ESC) guidelines on the 2014 ESC and the 2024 American Heart Association (AHA)/American College of Cardiology (ACC) systems in terms of primary prevention ICD recommendations for HCM. A cohort of 200 patients with HCM in Brazil was assessed for SCD risk profile according to current guidelines. The agreement for primary prevention ICD recommendations was evaluated among different strategies. SCD and appropriate shock were defined as the end points. Among the 200 patients, 63 (31%) received a primary prevention ICD, with 10 (15.8%) receiving appropriate shocks. Low agreement was found among the guidelines (Fleiss’ kappa 0.340, 95% confidence interval [CI] 0.286 to 0.395, p <0.001). The European systems showed moderate agreement. The 2024 AHA/ACC algorithm placed 58% of patients in class IIa, whereas only 29% achieved this recommendation with the 2023 ESC model. The end points occurred in 8% of patients over 9.4 ± 6.5 years. The 2014 ESC guidelines had the highest accuracy (77%, 95% CI 71 to 83) and negative predictive value (96%, 95% CI 90 to 98) in detecting patients in class IIa with primary end points. However, all guidelines showed a low positive predictive value. The 2024 AHA/ACC guidelines classified the largest proportion of patients (81%) with the primary end point as class IIa. Low agreement was found among guidelines regarding primary prevention ICD recommendations in HCM, particularly between the 2023 ESC and 2024 AHA/ACC systems.

背景：肥厚型心肌病（HCM）的心脏性猝死（SCD）风险分层和一级预防植入式心律转复除颤器（ICD）建议基于不同的策略：研究旨在评估2023年欧洲心脏病学会（ESC）指南对2014年ESC和2024年美国心脏协会（AHA）/美国心脏病学会（ACC）关于HCM一级预防ICD系统的影响：方法：根据现行指南，对巴西 200 名 HCM 患者进行了 SCD 风险概况评估。评估了不同策略对一级预防 ICD 建议的一致性。SCD和适当休克被定义为终点：在 200 名患者中，63 人（31%）接受了一级预防 ICD，10 人（15.8%）接受了适当电击。指南之间的一致性较低，Fleiss' Kappa为0.340（95% CI为0.286-0.395），PC结论：指南之间的一致性较低，Fleiss' Kappa为0.340（95% CI为0.286-0.395）：发现各指南对 HCM 一级预防 ICD 建议的一致性较低，尤其是在 2023 ESC 和 2024 AHA/ACC 系统之间。

{"title":"Low Agreement Among Guidelines for Primary Prevention Implantable Cardioverter-Defibrillator Recommendations in Hypertrophic Cardiomyopathy","authors":"Fernando Luís Scolari MD, PhD , Henrique Iahnke Garbin MD , Guilherme Dagostin de Carvalho MD, MSc , Fernanda Thomaz Rodrigues MD , Rodrigo Araujo de Menezes MD , Edileide de Barros Correia MD , Marcelo Imbroinise Bittencourt MD, PhD","doi":"10.1016/j.amjcard.2024.11.007","DOIUrl":"10.1016/j.amjcard.2024.11.007","url":null,"abstract":"<div><div>Sudden cardiac death (SCD) risk stratification and primary prevention implantable cardioverter-defibrillator (ICD) recommendations are based on differing strategies for hypertrophic cardiomyopathy (HCM). This study aimed to evaluate the impact of the 2023 European Society of Cardiology (ESC) guidelines on the 2014 ESC and the 2024 American Heart Association (AHA)/American College of Cardiology (ACC) systems in terms of primary prevention ICD recommendations for HCM. A cohort of 200 patients with HCM in Brazil was assessed for SCD risk profile according to current guidelines. The agreement for primary prevention ICD recommendations was evaluated among different strategies. SCD and appropriate shock were defined as the end points. Among the 200 patients, 63 (31%) received a primary prevention ICD, with 10 (15.8%) receiving appropriate shocks. Low agreement was found among the guidelines (Fleiss’ kappa 0.340, 95% confidence interval [CI] 0.286 to 0.395, p <0.001). The European systems showed moderate agreement. The 2024 AHA/ACC algorithm placed 58% of patients in class IIa, whereas only 29% achieved this recommendation with the 2023 ESC model. The end points occurred in 8% of patients over 9.4 ± 6.5 years. The 2014 ESC guidelines had the highest accuracy (77%, 95% CI 71 to 83) and negative predictive value (96%, 95% CI 90 to 98) in detecting patients in class IIa with primary end points. However, all guidelines showed a low positive predictive value. The 2024 AHA/ACC guidelines classified the largest proportion of patients (81%) with the primary end point as class IIa. Low agreement was found among guidelines regarding primary prevention ICD recommendations in HCM, particularly between the 2023 ESC and 2024 AHA/ACC systems.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 86-91"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666835","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}

引用次数: 0

Intrapericardial (A) Versus Strictly Extrapericardial (B) Involvement in Aortic Dissection: A Practical Distinction 主动脉夹层中的心包内（A）与严格意义上的心包外（B）受累：实际区别。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-02-01 DOI: 10.1016/j.amjcard.2024.09.023

Charles S. Roberts MD , Kyle A. McCullough MD

引用次数: 0

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