Angiology最新文献

Research has explored the relationship between inflammatory biomarkers and cardiovascular diseases, highlighting the potential prognostic significance of the high-sensitivity C-reactive protein (hs-CRP)/albumin (ALB) ratio. However, it remains unclear whether this ratio is associated with adverse prognosis in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). This retrospective cohort study included 752 STEMI patients undergoing PCI at Tianjin Chest Hospital between January 2017 and December 2018. During a median follow-up of 52 months, 183 cases (24.0%) experienced major adverse cardiovascular events (MACE) events and 75 cases (10.0%) died. Cox regression analysis demonstrated that hs-CRP/ALB was independently associated with MACE as both a continuous (hazard ratio [HR] 1.152, 95% CI 1.097-1.210, P < .001) and categorical variable (HR 1.257, 95% CI 1.084-1.458, P = .027). Similar findings were observed for all-cause mortality (HR 1.119, 95% CI 1.058-1.183, P < .001; HR 2.228, 95% CI 1.009-4.920, P = .032). The receiver operating characteristic (ROC) curve indicated that hs-CRP/ALB levels have predictive capability for overall mortality in patients (the area under the curve [AUC] = 0.68). hs-CRP/ALB levels independently correlate with poor long-term prognosis in STEMI patients with prior PCI.

We aimed to investigate the association between systemic inflammation and the left ventricular global function index (LVGFI) and evaluate the diagnostic performance of LVGFI for MACEs across the acute coronary syndrome (ACS) spectrum. A total of 1697 patients (794 with ST-segment elevation myocardial infarction [STEMI] and 903 with non-STEMI [NSTEMI]) were evaluated. The LVGFI was calculated using echocardiography. Inflammatory status was assessed with C-reactive protein (CRP) and the systemic immune inflammation index (SII). MACEs were defined as non-fatal re-infarction, repeated revascularization of the target vessel, and all-cause mortality at a 3-year follow-up. While the STEMI group exhibited lower LVGFI values compared with the NSTEMI group (P < .001), it had a higher SII level (P < .001) and CRP level (P = .021). The association between higher LVGFI quartiles and lower levels of systemic inflammation was more pronounced in the STEMI group. The threshold value of LVGFI to predict MACEs was <21.8% (Sensitivity = 79.2%, Specificity = 68.7%) for STEMI, while it was <25.4% (Sensitivity = 77.4%, Specificity = 70.8%) for NSTEMI. Considering both the inflammatory status and ACS spectrum when evaluating LVGFI could provide a more comprehensive assessment of cardiac function and prognosis in ACS patients.

Trimethylamine-N-oxide (TMAO), a metabolite produced by gut microbiota, has been linked to cardiovascular disease; however, its role in acute decompensated heart failure (ADHF) remains unclear. In this prospective observational study involving 102 ADHF and 60 stable heart failure (SHF) patients, plasma TMAO levels were correlated with clinical, echocardiographic, and laboratory parameters. TMAO levels were higher in ADHF compared with SHF (median 452.9 vs 372.4 ng/mL; P < .001), showing a positive correlation with B-type natriuretic peptide (BNP) and creatinine, and an inverse correlation with left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), hemoglobin, and high-density lipoprotein (HDL) cholesterol. TMAO demonstrated fair diagnostic ability for identifying ADHF (area under the curve [AUC] = 0.751), although weaker (P = .006) than BNP (AUC = 0.875). Multivariate analysis identified both TMAO and BNP as important discriminators. Additionally, TMAO levels were higher in ischemic than in non-ischemic heart failure (P = .047). These findings suggest that elevated TMAO is associated with ADHF and markers of disease severity. Because TMAO levels are influenced by renal function and anemia, it may be a context-dependent adjunct to natriuretic peptides rather than a standalone diagnostic marker. Further studies are needed to determine any additional value for diagnosis and risk stratification.

Peripheral artery disease (PAD) is a major public health concern worldwide, associated with high risk of mortality and morbidity related to cardiovascular and adverse limb events. Despite significant advances in both medical and interventional therapies, PAD often remains under-diagnosed, and the prognosis of patients can be difficult to predict. Artificial intelligence (AI) has brought a wide range of opportunities to improve the management of cardiovascular diseases, from advanced imaging analysis to machine-learning (ML)-based predictive models, and medical data management using natural language processing (NLP). The aim of this review is to summarize and discuss current techniques based on AI that have been proposed for the diagnosis and the evaluation of the prognosis in patients with PAD. The review focused on clinical studies that proposed AI-methods for the detection and the classification of PAD as well as studies that used AI-models to predict outcomes of patients. Through evaluation of study design, we discuss model choices including variability in dataset inputs, model complexity, interpretability, and challenges linked to performance metrics used. In the light of the results, we discuss potential interest for clinical decision support and highlight future directions for research and clinical practice.

The optimal post-stent antithrombotic regimen for acute iliofemoral deep vein thrombosis (DVT) in the setting of iliac vein compression syndrome is debated, with uncertainty surrounding the trade-off between preventing thrombotic events and minimizing bleeding risk. This single-center retrospective study compared rivaroxaban monotherapy (n = 84) versus combined rivaroxaban and aspirin therapy (n = 84) in 168 patients undergoing iliac vein stenting for acute iliofemoral DVT. Over a 1-year follow-up, combined therapy was associated with significantly lower rates of thrombus recurrence (7.1% vs 18.1%, P = .035) and in-stent thrombosis (2.4% vs 13.3%, P = .008) compared with anticoagulation alone. Clinically relevant bleeding events were infrequent and comparable between both groups. The reduction in thrombotic outcomes with dual therapy remained significant after propensity score matching adjusted for baseline characteristics. These results suggest that a strategy combining anticoagulant and antiplatelet therapy after iliac vein stenting may more effectively prevent thrombus recurrence and stent-related thrombosis without a significant increase in bleeding risk, offering a potential tailored approach for this patient population.