American Journal of Cardiology最新文献

英文中文

Delayed Aortic Dissection After Transcatheter Aortic Valve Replacement for Stenotic Bicuspid Valve 狭窄二尖瓣TAVR术后延迟主动脉夹层。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-08 DOI: 10.1016/j.amjcard.2025.01.001

Charles S. Roberts MD , Murad H. Hassan BS , Kyle A. McCullough MD , John B. Eisenga MD

引用次数: 0

Intravascular Ultrasound for Lower Extremity Arterial Interventions: What was Once Peripheral is Now Mainstream. 下肢动脉介入的血管内超声：曾经是次要的，现在是主流。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-07 DOI: 10.1016/j.amjcard.2025.01.005

Ramya C Mosarla, Eric A Secemsky

引用次数: 0

The Impact of Right Atrial Function on Prognosis and Renal Function in Patients With Tricuspid Regurgitation 三尖瓣反流患者右心房功能对预后及肾功能的影响。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-07 DOI: 10.1016/j.amjcard.2025.01.003

Elvin Tafciu MD, Matteo Pilan MD, Bianca Rocca MD, Ilaria Minnucci MD, Caterina Maffeis MD, PhD, Corinna Bergamini MD, PhD, Giovanni Benfari MD, PhD, Flavio L. Ribichini MD

Tricuspid regurgitation (TR) is related to survival, and right atrial (RA) size and function may play a role. This study aimed to assess the impact of RA function measured by strain (RA strain [RAS]) on outcome and end-organ congestion. We enrolled 134 patients (mean age 73 ± 13 years, 62% women) with any TR grade or etiology and a complete echocardiogram, clinical follow-up, and renal function assessment. The primary end point was a combination of overall mortality and right-sided heart failure hospitalization, and the secondary end point was worsening renal function (WRF). After a median follow-up of 23.5 months (interquartile range 12 to 34 months), the combined end point was reached by 31% of patients. Patients with RAS ≤18% showed lower event-free survival (log-rank p <0.001). In the multivariable analysis, RAS ≤18% (HR 3.1, 95% CI 1.1 to 8.8) and pulmonary artery systolic pressure (PASP) (hazard ratio [HR] 1.02, 95% confidence interval [CI] 1 to 1.05) were independent predictors of the primary end point. Patients with RAS ≤18% and PASP >45 mm Hg had the worst outcome (HR 4.3, 95% CI 2 to 9.5). RAS ≤18% (odds ratio 3.22, 95% CI 1.11 to 9.33) and PASP >45 mm Hg (OR 3.2, 95% CI 1.15 to 8.88) were independent predictors of WRF, adjusting for TR severity, left and right ventricular function, age, gender, diabetes, diuretics, atrial fibrillation. The addition of RAS ≤18% had incremental power over PASP and echocardiographic variables of TR severity and right or left ventricular function to predict WRF (p = 0.026). In conclusion, RA function measured by RAS independently predicts mortality and hospitalizations in patients with TR and independently and incrementally predicts WRF over time.

三尖瓣反流（TR）与生存有关，右心房（RA）的大小和功能可能起作用。我们的目的是评估通过应变（RAS）测量RA功能对结局和终末器官充血的影响。我们招募了134例患者（平均年龄73±13岁，62%为女性），他们有任何TR级别或病因，并进行了完整的超声心动图、临床随访和肾功能评估。主要终点是总死亡率和右侧心力衰竭住院（HFH），次要终点是肾功能恶化（WRF）。中位随访23.5个月（四分位数间隔12-34个月）后，31%的患者达到了联合终点。RAS≤18%的患者无事件生存率较低(LogRank p45 mmHg预后最差（HR 4.3, 95% CI 2-9.5）。RAS≤18% （OR 3.22, 95% CI 1.11-9.33）和PASP bb0 45 mmHg （OR 3.2, 95% CI 1.15-8.88）是WRF调整TR严重程度、左右心室功能、年龄、性别、糖尿病、利尿剂、房颤的独立预测因子。RAS≤18%的增加比PASP和超声心动图变量TR严重程度和左右心室功能预测WRF的能力增加（p=0.026）。总之，RAS测量的RA功能可独立预测TR患者的死亡率和住院率，也可随时间独立且递增地预测WRF。

{"title":"The Impact of Right Atrial Function on Prognosis and Renal Function in Patients With Tricuspid Regurgitation","authors":"Elvin Tafciu MD, Matteo Pilan MD, Bianca Rocca MD, Ilaria Minnucci MD, Caterina Maffeis MD, PhD, Corinna Bergamini MD, PhD, Giovanni Benfari MD, PhD, Flavio L. Ribichini MD","doi":"10.1016/j.amjcard.2025.01.003","DOIUrl":"10.1016/j.amjcard.2025.01.003","url":null,"abstract":"<div><div>Tricuspid regurgitation (TR) is related to survival, and right atrial (RA) size and function may play a role. This study aimed to assess the impact of RA function measured by strain (RA strain [RAS]) on outcome and end-organ congestion. We enrolled 134 patients (mean age 73 ± 13 years, 62% women) with any TR grade or etiology and a complete echocardiogram, clinical follow-up, and renal function assessment. The primary end point was a combination of overall mortality and right-sided heart failure hospitalization, and the secondary end point was worsening renal function (WRF). After a median follow-up of 23.5 months (interquartile range 12 to 34 months), the combined end point was reached by 31% of patients. Patients with RAS ≤18% showed lower event-free survival (log-rank p <0.001). In the multivariable analysis, RAS ≤18% (HR 3.1, 95% CI 1.1 to 8.8) and pulmonary artery systolic pressure (PASP) (hazard ratio [HR] 1.02, 95% confidence interval [CI] 1 to 1.05) were independent predictors of the primary end point. Patients with RAS ≤18% and PASP >45 mm Hg had the worst outcome (HR 4.3, 95% CI 2 to 9.5). RAS ≤18% (odds ratio 3.22, 95% CI 1.11 to 9.33) and PASP >45 mm Hg (OR 3.2, 95% CI 1.15 to 8.88) were independent predictors of WRF, adjusting for TR severity, left and right ventricular function, age, gender, diabetes, diuretics, atrial fibrillation. The addition of RAS ≤18% had incremental power over PASP and echocardiographic variables of TR severity and right or left ventricular function to predict WRF (p = 0.026). In conclusion, RA function measured by RAS independently predicts mortality and hospitalizations in patients with TR and independently and incrementally predicts WRF over time.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"241 ","pages":"Pages 1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942740","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 Postprocedure Ankle-Brachial Index With Outcomes Following Drug-Coated Balloon Angioplasty in Femoropopliteal Artery Disease 股腘动脉疾病药物包被球囊成形术后踝肱指数与预后的关系

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-07 DOI: 10.1016/j.amjcard.2025.01.004

Jooyeon Lee MD , Young-Guk Ko MD , Seung-Jun Lee MD , Chul-Min Ahn MD , Cheol Woong Yu MD , Jae-Hwan Lee MD , Seung-Whan Lee MD , Young Jin Youn MD , Jong Kwan Park MD , Chang-Hwan Yoon MD , Pil-Ki Min MD , Seung-Hyuk Choi MD , Donghoon Choi MD , K-VIS ELLA Investigators

Endovascular treatment of femoropopliteal artery (FPA) disease with drug-coated balloons (DCBs) may face complications such as arterial recoil, dissection, and residual stenosis. Angiography has limited accuracy for evaluating blood flow through revascularized target lesions. Thus, there is a need for postprocedure hemodynamic assessment in treated limbs. This study aims to explore how postprocedure ankle-brachial index (ABI) influences outcomes following DCB treatment for FPA disease. This study included patients in a multicenter registry (K-VIS ELLA) treated with DCB for FPA disease between January 2006 and August 2021. Optimal postprocedure ABI cutoff for predicting clinically driven target lesion revascularization (TLR) was determined using receiver operating characteristic curve analysis. Independent predictors of TLR were identified using multivariable Cox regression analysis. A total of 654 limbs (514 patients) treated with DCB for FPA were evaluated by ABI at 1-day (median, interquartile range, 1 to 2 days) postprocedure and followed up for a median of 370 days. The optimal immediate postprocedure ABI cutoff value for predicting TLR was 0.72 (area under the curve, 0.68). Significantly improved TLR-free and major adverse limb event-free survival rates were observed with a postprocedure ABI ≥ 0.72 (hazard ratio [HR] = 0.24, 95% confidence intervals [CI] = 0.16 to 0.37, p < 0.001; HR = 0.25, 95% CI = 0.16 to 0.38, p < 0.001, respectively). Independent predictors of TLR were postprocedure ABI < 0.72 (HR 3.76; 95% CI, 2.33 to 6.07; p < 0.001) and presence of anemia (HR 2.01; 95% CI, 1.03 to 3.92; p = 0.041). An immediate postprocedure ABI is a significant predictor of TLR risk following DCB treatment for FPA disease, underscoring the value of hemodynamic assessment in optimizing angioplasty outcomes.

用药物包覆球囊（DCBs）治疗股腘动脉（FPA）疾病可能面临动脉反冲、夹层和残余狭窄等并发症。血管造影在评估经血管重建的目标病变的血流时准确性有限。因此，有必要对手术后的肢体进行血流动力学评估。本研究旨在探讨术后踝肱指数（ABI）对FPA疾病DCB治疗后预后的影响。该研究纳入了2006年1月至2021年8月期间接受DCB治疗FPA疾病的多中心登记（K-VIS ELLA）患者。通过受试者工作特征曲线分析确定预测临床驱动的靶病变血运重建（TLR）的最佳术后ABI截止值。采用多变量Cox回归分析确定TLR的独立预测因子。采用DCB治疗FPA的654条肢体（514例患者）在术后1天（中位数，四分位数间距，1-2天）进行ABI评估，随访中位数为370天。预测TLR的最佳术后ABI截止值为0.72（曲线下面积为0.68）。术后ABI≥0.72 （HR=0.24, 95% CI=0.16-0.37）时，无tlr和无主要不良肢体事件生存率显著提高

{"title":"Association of Postprocedure Ankle-Brachial Index With Outcomes Following Drug-Coated Balloon Angioplasty in Femoropopliteal Artery Disease","authors":"Jooyeon Lee MD , Young-Guk Ko MD , Seung-Jun Lee MD , Chul-Min Ahn MD , Cheol Woong Yu MD , Jae-Hwan Lee MD , Seung-Whan Lee MD , Young Jin Youn MD , Jong Kwan Park MD , Chang-Hwan Yoon MD , Pil-Ki Min MD , Seung-Hyuk Choi MD , Donghoon Choi MD , K-VIS ELLA Investigators","doi":"10.1016/j.amjcard.2025.01.004","DOIUrl":"10.1016/j.amjcard.2025.01.004","url":null,"abstract":"<div><div>Endovascular treatment of femoropopliteal artery (FPA) disease with drug-coated balloons (DCBs) may face complications such as arterial recoil, dissection, and residual stenosis. Angiography has limited accuracy for evaluating blood flow through revascularized target lesions. Thus, there is a need for postprocedure hemodynamic assessment in treated limbs. This study aims to explore how postprocedure ankle-brachial index (ABI) influences outcomes following DCB treatment for FPA disease. This study included patients in a multicenter registry (K-VIS ELLA) treated with DCB for FPA disease between January 2006 and August 2021. Optimal postprocedure ABI cutoff for predicting clinically driven target lesion revascularization (TLR) was determined using receiver operating characteristic curve analysis. Independent predictors of TLR were identified using multivariable Cox regression analysis. A total of 654 limbs (514 patients) treated with DCB for FPA were evaluated by ABI at 1-day (median, interquartile range, 1 to 2 days) postprocedure and followed up for a median of 370 days. The optimal immediate postprocedure ABI cutoff value for predicting TLR was 0.72 (area under the curve, 0.68). Significantly improved TLR-free and major adverse limb event-free survival rates were observed with a postprocedure ABI ≥ 0.72 (hazard ratio [HR] = 0.24, 95% confidence intervals [CI] = 0.16 to 0.37, p < 0.001; HR = 0.25, 95% CI = 0.16 to 0.38, p < 0.001, respectively). Independent predictors of TLR were postprocedure ABI < 0.72 (HR 3.76; 95% CI, 2.33 to 6.07; p < 0.001) and presence of anemia (HR 2.01; 95% CI, 1.03 to 3.92; p = 0.041). An immediate postprocedure ABI is a significant predictor of TLR risk following DCB treatment for FPA disease, underscoring the value of hemodynamic assessment in optimizing angioplasty outcomes.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"240 ","pages":"Pages 38-45"},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942593","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

Elevated Plasma Nitrate Levels in Patients with Acute Coronary Syndrome 急性冠脉综合征患者血浆硝酸盐水平升高。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-06 DOI: 10.1016/j.amjcard.2025.01.002

C. Venkata S. Ram MD, MACP, FACC, FAHA , Ferid Murad MD, PhD , A. Sreenivas Kumar MD, DM, FACC , Baby Shalini Muppalla MBBS, MD , Asma Niloufer MBBS, MD , Praveen Gajjela MSc , Gokul Reddy Mandala MD, DM, FACC , Ramakrishna Janapati MBBS, MD, DM (NIMS) , Sanjeeva Kumar E MD, DM

Acute coronary syndrome (ACS) encompasses a spectrum of coronary artery diseases, including unstable angina, non-ST segment elevation myocardial infarction, and ST-segment elevation MI. At present, ACS is a major cause of mortality and morbidity in the community. The diagnosis of ACS is of critical importance for guiding appropriate therapeutic strategies, although this can be onerous if the standard presenting manifestations are lacking. While high-sensitivity cardiac troponin (hs-cTn) is a proven biomarker of ACS, additional markers to support the clinical diagnosis could be valuable. Since nitrate metabolism is crucial to the vasomotion of coronary arteries, in this study, we compared the plasma nitrate levels in consecutive patients with ACS and healthy volunteers. Systemic hemodynamic parameters were also compared between the groups. The pulse wave velocity of individuals with ACS was higher than that in healthy volunteers, thereby verifying the association between coronary artery disease and a loss of vascular elasticity in the circulatory system. Notably, median plasma nitrate levels were significantly higher in patients with ACS compared to healthy volunteers. Although plasma nitrate levels seem to be higher in patients with ACS, whether this finding is incidental, contributory, or a consequential factor in the pathogenesis of ACS remains to be determined.

{"title":"Elevated Plasma Nitrate Levels in Patients with Acute Coronary Syndrome","authors":"C. Venkata S. Ram MD, MACP, FACC, FAHA , Ferid Murad MD, PhD , A. Sreenivas Kumar MD, DM, FACC , Baby Shalini Muppalla MBBS, MD , Asma Niloufer MBBS, MD , Praveen Gajjela MSc , Gokul Reddy Mandala MD, DM, FACC , Ramakrishna Janapati MBBS, MD, DM (NIMS) , Sanjeeva Kumar E MD, DM","doi":"10.1016/j.amjcard.2025.01.002","DOIUrl":"10.1016/j.amjcard.2025.01.002","url":null,"abstract":"<div><div>Acute coronary syndrome (ACS) encompasses a spectrum of coronary artery diseases, including unstable angina, non-ST segment elevation myocardial infarction, and ST-segment elevation MI. At present, ACS is a major cause of mortality and morbidity in the community. The diagnosis of ACS is of critical importance for guiding appropriate therapeutic strategies, although this can be onerous if the standard presenting manifestations are lacking. While high-sensitivity cardiac troponin (hs-cTn) is a proven biomarker of ACS, additional markers to support the clinical diagnosis could be valuable. Since nitrate metabolism is crucial to the vasomotion of coronary arteries, in this study, we compared the plasma nitrate levels in consecutive patients with ACS and healthy volunteers. Systemic hemodynamic parameters were also compared between the groups. The pulse wave velocity of individuals with ACS was higher than that in healthy volunteers, thereby verifying the association between coronary artery disease and a loss of vascular elasticity in the circulatory system. Notably, median plasma nitrate levels were significantly higher in patients with ACS compared to healthy volunteers. Although plasma nitrate levels seem to be higher in patients with ACS, whether this finding is incidental, contributory, or a consequential factor in the pathogenesis of ACS remains to be determined.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"240 ","pages":"Pages 68-70"},"PeriodicalIF":2.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942659","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

Multiple Biomarkers to Predict Major Adverse Cardiovascular Events in Patients With Coronary Chronic Total Occlusions 多种生物标志物预测冠脉慢性全闭塞患者的主要不良心血管事件。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-06 DOI: 10.1016/j.amjcard.2024.12.037

Srikanth Adusumalli MBBS, FRACP , Cian P. McCarthy MB, BCh, BAO, SM , Craig A. Magaret MS , Rhonda F. Rhyne MBA , Farouc A. Jaffer MD, PhD , James L. Januzzi MD

There are limited tools available to predict the long-term prognosis of persons with coronary chronic total occlusions (CTO). A previously described blood biomarker panel to predict cardiovascular (CV) events was evaluated in patients with CTO. From 1,251 patients in the CASABLANCA study, 241 participants with a CTO were followed for an average of 4 years for occurrence of major adverse CV events (MACE, CV death, nonfatal myocardial infarction or stroke) and CV death/heart failure (HF) hospitalization. Results of a biomarker panel (kidney injury molecule-1, N-terminal pro-B-type natriuretic peptide, osteopontin, and tissue inhibitor of metalloproteinase-1) from baseline samples were expressed as low-, medium-, and high-risk. By 4 years, a total of 67 (27.8%) MACE and 56 (23.2%) CV death/HF hospitalization events occurred. The C-statistic of the panel for MACE through 4 years was 0.79 (p < 0.001). Considering the low-risk group as referent, the hazard ratio (HR) of MACE by 4 years was 6.65 (95% confidence interval [CI]: 2.98 to 14.8) and 12.4 (95% CI:5.17 to 29.6) for the medium and high-risk groups (both p < 0.001). The C-statistic for CVD/HF hospitalization by 4 years was 0.84 (p < 0.001). Compared to the low-risk score group, the medium and high-risk groups had HR of 5.61 (95% CI: 2.33 to 13.5) and 15.6 (95% CI: 6.18, 39.2; both p value <0.001). In conclusion, a multiple biomarker panel assisted in discriminating a broad range of risk for adverse outcomes in patients with coronary CTO. These results may have implications for risk stratification, patient care and could have a role for clinical trial enrichment.

目前用于预测冠状动脉慢性全闭塞（CTO）患者长期预后的工具有限。先前描述的用于预测CTO患者心血管（CV）事件的血液生物标志物面板进行了评估。从CASABLANCA研究的1251名患者中，241名CTO参与者平均随访4年，以了解主要不良CV事件（MACE、CV死亡、非致死性心肌梗死或卒中）和CV死亡/心力衰竭（HF）住院的发生情况。基线样本的生物标志物面板（肾损伤分子-1、n端前b型利钠肽、骨桥蛋白和金属蛋白酶-1组织抑制剂）的结果被表达为低、中、高风险。4年后，共发生67例（27.8%）MACE和56例（23.2%）CV死亡/HF住院事件。MACE组4年c统计量为0.79 （P < 0.05）

{"title":"Multiple Biomarkers to Predict Major Adverse Cardiovascular Events in Patients With Coronary Chronic Total Occlusions","authors":"Srikanth Adusumalli MBBS, FRACP , Cian P. McCarthy MB, BCh, BAO, SM , Craig A. Magaret MS , Rhonda F. Rhyne MBA , Farouc A. Jaffer MD, PhD , James L. Januzzi MD","doi":"10.1016/j.amjcard.2024.12.037","DOIUrl":"10.1016/j.amjcard.2024.12.037","url":null,"abstract":"<div><div>There are limited tools available to predict the long-term prognosis of persons with coronary chronic total occlusions (CTO). A previously described blood biomarker panel to predict cardiovascular (CV) events was evaluated in patients with CTO. From 1,251 patients in the CASABLANCA study, 241 participants with a CTO were followed for an average of 4 years for occurrence of major adverse CV events (MACE, CV death, nonfatal myocardial infarction or stroke) and CV death/heart failure (HF) hospitalization. Results of a biomarker panel (kidney injury molecule-1, N-terminal pro-B-type natriuretic peptide, osteopontin, and tissue inhibitor of metalloproteinase-1) from baseline samples were expressed as low-, medium-, and high-risk. By 4 years, a total of 67 (27.8%) MACE and 56 (23.2%) CV death/HF hospitalization events occurred. The C-statistic of the panel for MACE through 4 years was 0.79 (p < 0.001). Considering the low-risk group as referent, the hazard ratio (HR) of MACE by 4 years was 6.65 (95% confidence interval [CI]: 2.98 to 14.8) and 12.4 (95% CI:5.17 to 29.6) for the medium and high-risk groups (both p < 0.001). The C-statistic for CVD/HF hospitalization by 4 years was 0.84 (p < 0.001). Compared to the low-risk score group, the medium and high-risk groups had HR of 5.61 (95% CI: 2.33 to 13.5) and 15.6 (95% CI: 6.18, 39.2; both p value <0.001). In conclusion, a multiple biomarker panel assisted in discriminating a broad range of risk for adverse outcomes in patients with coronary CTO. These results may have implications for risk stratification, patient care and could have a role for clinical trial enrichment.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"242 ","pages":"Pages 25-31"},"PeriodicalIF":2.3,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942736","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

Postcardiac Injury Syndrome Following Transcatheter Aortic Valve Implantation: A Brief Report and Review 经导管主动脉瓣植入术后心脏损伤综合征：简要报告和回顾。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-03 DOI: 10.1016/j.amjcard.2024.12.036

Mehmet Eren MD, Yalcin Velibey MD

引用次数: 0

Differences in Statin Eligibility With the Use of Predicting Risk of Cardiovascular Disease EVENTs Versus Pooled Cohort Equations in the UK Biobank 在英国生物库中，他汀类药物适格性与预测心血管疾病事件风险的差异与合并队列方程的差异

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-03 DOI: 10.1016/j.amjcard.2024.12.034

Jasninder S. Dhaliwal MD , Mokshad Gaonkar MS , Nirav Patel MD, MSPH , Naman S. Shetty MD , Peng Li PhD , Nehal Vekariya MS , Rajat Kalra MBChB , Garima Arora MD , Pankaj Arora MD

The Pooled Cohort Equations (PCEs), developed by the American Heart Association (AHA) and American College of Cardiology, have been widely used since 2013 to estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk and guide statin therapy. Recently, the AHA introduced the Predicting Risk of CVD EVENTs (PREVENT) equations to improve ASCVD risk estimation. However, the effect of using PREVENT instead of PCEs on risk classification and statin eligibility remains unclear. This retrospective cohort study analyzed 261,303 UK Biobank participants, aged 40 to 69 years, who were free from cardiovascular disease and not on statin therapy. The PCEs and the base PREVENT equations were used to estimate 10-year ASCVD risk, categorize risk levels, and determine statin eligibility based on a common risk threshold of 7.5%. The median 10-year ASCVD risk was 5.2% (2.2%, 10.6%) using the PCEs and 3.5% (1.8%, 5.8%) with the PREVENT equations. The PREVENT equations classified 14.0% of participants as high-risk (ASCVD risk >7.5%), compared to 36.9% classified by PCEs. Among participants classified as intermediate-risk by PCEs, 75.3% were reclassified as low-risk by PREVENT. The proportion of individuals eligible for statin use by the PREVENT equation was 19.9%, and by the PCEs was 40.7%. The corresponding difference was 20.8% (95% confidence intervals [CI]: 20.6% to 20.9%). More men (33.0% [95% CI: 32.7% to 33.3%]) than women (11.5% [95% CI: 11.3% to 11.7%]) and more individuals in the older age group (60 to 69 years: 34.0% [95% CI: 33.7% to34.3%]) than in the younger age group (40 to 49 years: 3.5% [95% CI: 3.3% to 3.6%]) would not be recommended for statin consideration with the PREVENT equations. In conclusion, based on the common risk threshold of 7.5%, replacing the PCEs with the base PREVENT equation would reduce statin eligibility in the UK Biobank participants by ∼20%, especially among men and older adults.

由美国心脏协会（AHA）和美国心脏病学会（ACC）开发的合并队列方程（pce）自2013年以来被广泛用于评估10年动脉粥样硬化性心血管疾病（ASCVD）的风险并指导他汀类药物治疗。最近，美国心脏协会（AHA）引入了CVD事件风险预测（prevention）方程，以改善ASCVD风险估计。然而，使用prevention代替pce对风险分类和他汀类药物资格的影响仍不清楚。这项回顾性队列研究分析了261303名英国生物银行参与者，年龄在40至69岁之间，无心血管疾病且未接受他汀类药物治疗。pce和基本prevention方程用于估计10年ASCVD风险，对风险水平进行分类，并根据7.5%的共同风险阈值确定他汀类药物的资格。使用pce的10年ASCVD风险中位数为5.2%(2.2%,10.6%)，使用prevention方程的中位数为3.5%（1.8%,5.8%）。prevention方程将14.0%的参与者分类为高风险（ASCVD风险>7.5%），而pce分类为36.9%。在被pce分类为中度风险的参与者中，75.3%的人被prevention重新分类为低风险。符合他汀类药物使用标准的个体比例为19.9%，符合pce标准的个体比例为40.7%。相应的差异为20.8% （95% CI: 20.6%-20.9%）。男性（33.0% [95% CI: 32.7%-33.3%]）比女性（11.5% [95% CI: 11.3%-11.7%]）多，老年组（60-69岁：34.0% [95% CI: 34.3%-33.7%]）比年轻组（40-49岁：3.5% [95% CI: 3.3%-3.6%]）不推荐使用他汀类药物。总之，基于7.5%的共同风险阈值，用基本预防方程代替pce将使英国生物银行参与者的他汀类药物资格降低约20%，特别是在男性和老年人中。

{"title":"Differences in Statin Eligibility With the Use of Predicting Risk of Cardiovascular Disease EVENTs Versus Pooled Cohort Equations in the UK Biobank","authors":"Jasninder S. Dhaliwal MD , Mokshad Gaonkar MS , Nirav Patel MD, MSPH , Naman S. Shetty MD , Peng Li PhD , Nehal Vekariya MS , Rajat Kalra MBChB , Garima Arora MD , Pankaj Arora MD","doi":"10.1016/j.amjcard.2024.12.034","DOIUrl":"10.1016/j.amjcard.2024.12.034","url":null,"abstract":"<div><div>The Pooled Cohort Equations (PCEs), developed by the American Heart Association (AHA) and American College of Cardiology, have been widely used since 2013 to estimate 10-year atherosclerotic cardiovascular disease (ASCVD) risk and guide statin therapy. Recently, the AHA introduced the Predicting Risk of CVD EVENTs (PREVENT) equations to improve ASCVD risk estimation. However, the effect of using PREVENT instead of PCEs on risk classification and statin eligibility remains unclear. This retrospective cohort study analyzed 261,303 UK Biobank participants, aged 40 to 69 years, who were free from cardiovascular disease and not on statin therapy. The PCEs and the base PREVENT equations were used to estimate 10-year ASCVD risk, categorize risk levels, and determine statin eligibility based on a common risk threshold of 7.5%. The median 10-year ASCVD risk was 5.2% (2.2%, 10.6%) using the PCEs and 3.5% (1.8%, 5.8%) with the PREVENT equations. The PREVENT equations classified 14.0% of participants as high-risk (ASCVD risk >7.5%), compared to 36.9% classified by PCEs. Among participants classified as intermediate-risk by PCEs, 75.3% were reclassified as low-risk by PREVENT. The proportion of individuals eligible for statin use by the PREVENT equation was 19.9%, and by the PCEs was 40.7%. The corresponding difference was 20.8% (95% confidence intervals [CI]: 20.6% to 20.9%). More men (33.0% [95% CI: 32.7% to 33.3%]) than women (11.5% [95% CI: 11.3% to 11.7%]) and more individuals in the older age group (60 to 69 years: 34.0% [95% CI: 33.7% to34.3%]) than in the younger age group (40 to 49 years: 3.5% [95% CI: 3.3% to 3.6%]) would not be recommended for statin consideration with the PREVENT equations. In conclusion, based on the common risk threshold of 7.5%, replacing the PCEs with the base PREVENT equation would reduce statin eligibility in the UK Biobank participants by ∼20%, especially among men and older adults.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"241 ","pages":"Pages 43-51"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930565","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

Hospital Volume and Long-Term Survival Among Medicare Beneficiaries Undergoing Surgical Repair of Acute Type A Aortic Dissection 急性A型主动脉夹层手术修复的医疗保险受益人的住院数量和长期生存率。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-03 DOI: 10.1016/j.amjcard.2024.12.035

Cody W. Dorton DO , Kyle A. McCullough MD , Taylor Pickering DO , Jasjit K. Banwait PhD , Sarah Hale CCRC , J. Michael DiMaio MD , Justin M. Schaffer MD

Despite guideline recommendations, transfer rates to high-volume aortic centers (high-VACs) for acute type A aortic dissections (TAAD) remain suboptimal. This may be because the benefit of undergoing surgical repair of TAAD at high-VACs remains poorly quantified. Medicare beneficiaries undergoing surgical repair of TAAD from 1999-2019 were identified. Hospital and surgeon annual aortic case volumes in Medicare beneficiaries were determined. Long-term survival after surgical repair of TAAD at low-volume aortic centers (low-VACs; <6 annual aortic cases), intermediate-volume aortic centers (intermediate-VACs; 6-27 annual aortic cases), and high-VACs (>27 annual aortic cases) was compared. Overlap propensity score weighting adjusted for measured confounding variables. 15,375 Medicare beneficiaries underwent surgical repair of TAAD from 1999-2019: 4119 (26.8%) at low-VACs, 7193 (46.8%) at intermediate-VACs, and 4063 (26.4%) at high-VACs. Over the study duration, the percentage of patients transferred from an outside medical facility for TAAD increased from 33% in 1999 to 50% in 2019 (Cochran-Armitage p<0.001). Transferred patients comprised 19% of cases performed at low-VACs, 43% at intermediate-VACs, and 64% at high-VACs. Risk-adjusted median survival at high-VACs was 6.6[6.3-7.1] years compared to 4.1[3.6-4.6] years at low-VACs, an advantage of 2.5[1.8-3.0] years. Risk-adjusted median survival at high-VACs was 6.7[6.4-7.1] years compared to 5.2[4.9-5.5] years at intermediate-VACs, an advantage of 1.5[0.9-1.9] years. Survival after surgical repair of TAAD is substantially improved at high-VACs compared to both low-VACs and intermediate-VACs. Although the prevalence of transfer for TAAD has increased since 1999, policy measures aimed at improving transfer rates have the potential to further enhance outcomes in TAAD.

尽管有指南建议，但急性 A 型主动脉夹层（TAAD）转入大容量主动脉中心（high-VACs）的比例仍未达到最佳水平；这可能是因为在大容量主动脉中心接受 TAAD 手术修复的益处仍未得到充分量化。我们对 1999-2019 年期间接受 TAAD 手术修复的医疗保险受益人进行了鉴定。确定了医疗保险受益人中医院和外科医生的年度主动脉病例量。比较了低病例量主动脉中心（low-VACs；每年 27 例主动脉病例）进行 TAAD 手术修复后的长期存活率。重叠倾向评分加权调整了测量的混杂变量。1999-2019年间，15375名医疗保险受益人接受了TAAD手术修复：4119人（26.8%）在低VAC接受了手术，7193人（46.8%）在中VAC接受了手术，4063人（26.4%）在高VAC接受了手术。在研究期间，因 TAAD 而从外部医疗机构转院的患者比例从 1999 年的 33% 增加到 2019 年的 50%（Cochran-Armitage p

{"title":"Hospital Volume and Long-Term Survival Among Medicare Beneficiaries Undergoing Surgical Repair of Acute Type A Aortic Dissection","authors":"Cody W. Dorton DO , Kyle A. McCullough MD , Taylor Pickering DO , Jasjit K. Banwait PhD , Sarah Hale CCRC , J. Michael DiMaio MD , Justin M. Schaffer MD","doi":"10.1016/j.amjcard.2024.12.035","DOIUrl":"10.1016/j.amjcard.2024.12.035","url":null,"abstract":"<div><div>Despite guideline recommendations, transfer rates to high-volume aortic centers (high-VACs) for acute type A aortic dissections (TAAD) remain suboptimal. This may be because the benefit of undergoing surgical repair of TAAD at high-VACs remains poorly quantified. Medicare beneficiaries undergoing surgical repair of TAAD from 1999-2019 were identified. Hospital and surgeon annual aortic case volumes in Medicare beneficiaries were determined. Long-term survival after surgical repair of TAAD at low-volume aortic centers (low-VACs; <6 annual aortic cases), intermediate-volume aortic centers (intermediate-VACs; 6-27 annual aortic cases), and high-VACs (>27 annual aortic cases) was compared. Overlap propensity score weighting adjusted for measured confounding variables. 15,375 Medicare beneficiaries underwent surgical repair of TAAD from 1999-2019: 4119 (26.8%) at low-VACs, 7193 (46.8%) at intermediate-VACs, and 4063 (26.4%) at high-VACs. Over the study duration, the percentage of patients transferred from an outside medical facility for TAAD increased from 33% in 1999 to 50% in 2019 (Cochran-Armitage p<0.001). Transferred patients comprised 19% of cases performed at low-VACs, 43% at intermediate-VACs, and 64% at high-VACs. Risk-adjusted median survival at high-VACs was 6.6[6.3-7.1] years compared to 4.1[3.6-4.6] years at low-VACs, an advantage of 2.5[1.8-3.0] years. Risk-adjusted median survival at high-VACs was 6.7[6.4-7.1] years compared to 5.2[4.9-5.5] years at intermediate-VACs, an advantage of 1.5[0.9-1.9] years. Survival after surgical repair of TAAD is substantially improved at high-VACs compared to both low-VACs and intermediate-VACs. Although the prevalence of transfer for TAAD has increased since 1999, policy measures aimed at improving transfer rates have the potential to further enhance outcomes in TAAD.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"237 ","pages":"Pages 86-92"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930607","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

Immediate Versus Staged Complete Revascularization in ST-Segment Elevation Myocardial Infarction: Beyond the Question of Time. STEMI的立即vs分期完全血运重建术：超越时间问题。

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology

Pub Date : 2025-01-03 DOI: 10.1016/j.amjcard.2024.12.032

Oliver Maier, Dragos-Andrei Duse, Malte Kelm

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

American Journal of Cardiology

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀