Cardiology journal最新文献

Background: This study aimed to employ Mendelian randomization (MR) analysis to investigate the causal relationship between sodium-glucose cotransporter 2 (SGLT2) inhibition and atrial fibrillation (AF), as well as assess the potential mediating role of inflammatory proteins in this association.

Methods: A two-sample MR analysis was conducted using summary-level data from the genome-wide association study (GWAS) were used to evaluate the genetic prediction of SGLT2 inhibition and AF. Additionally, a two-step MR approach was applied to explore the causal mediation effects of inflammatory proteins in the SGLT2-AF pathway.

Results: Genetically predicted SGLT2 inhibition was associated with a significantly lower risk of AF (odds ratio [OR] 0.51; 95% confidence interval [CI]: 0.27-0.97; p = 0.039). Mendelian randomization analysis further identified FGF-23 (OR 0.88; 95% CI: 0.79, 0.98; p = 0.024) and PD-L1 (OR 0.90; 95% CI: 0.82, 0.96; p = 0.023) as significant mediators, accounting for 21.28% and 17.69% of the total effect, respectively.

Conclusions: These findings provide potential protective role of SGLT2 inhibition against AF, mediated by inflammatory proteins. Further mechanistic and clinical investigations are warranted to elucidate the underlying pathways and therapeutic implications.

Background: Studies of animal and human aortic tissue samples showed that sirtuins may protect against aortic aneurysm (AA). However, to date, no studies have assessed plasma or serum sirtuin levels in humans. Therefore, the aim of this study was to evaluate associations between plasma sirtuin 1 (SIRT1) and sirtuin 2 (SIRT2) levels and the presence of ascending AA.

Methods: Plasma SIRT1 and SIRT2 levels were assessed in patients with and without ascending AA using an enzyme-linked immunosorbent assay.

Results: The study included 32 patients with ascending AA (median age: 67 years) and 37 controls without AA (median age: 68 years). Plasma SIRT1 and SIRT2 levels did not differ between groups (p > 0.05). However, slightly higher sirtuin levels were observed in patients with ascending AA than in controls, particularly for SIRT1 in the subgroups of patients without coronary artery disease, atrial fibrillation, and chronic obstructive pulmonary disease (COPD). Among patients with ascending AA, higher SIRT2 levels were noted for those without COPD vs. those with COPD (p = 0.04).

Conclusions: The study showed no significant differences in SIRT1 and SIRT2 levels between patients with and without ascending AA. However, there was a trend towards higher SIRT1 levels in patients with AA, especially in those without comorbidities.

Background: To ascertain the diagnostic value of radiomic features of pericoronary adipose tissue (PCAT) and other coronary computed tomography angiography (CCTA) parameters for differentiating non-ST-segment-elevation myocardial infarction (NSTEMI) from unstable angina (UA).

Methods: This study included NSTEMI and UA patients (n = 102 each). The radiomic features of PCAT were selected according to the intraclass correlation coefficient, Pearson's coefficient, the t test, and least absolute shrinkage and selection operator. Six classifiers-random forest, support vector machine, naive Bayes, K-nearest neighbors, extreme gradient boosting, and light gradient boosting machine (LightGBM)-were used to build radiomics models, and the best were selected. Four CCTA parameter models, encapsulating plaque parameters (model 1), plaque parameters + fatty attenuation index (FAI) (model 2), plaque parameters + CT fractional flow reserve (CT-FFR) (model 3), and plaque parameters + CT-FFR + FAI (model 4), were constructed. Finally, we established a fusion model (nomogram) with all CCTA parameters and radiomics model scores. All models were compared regarding their performance.

Results: The LightGBM radiomics model achieved the highest AUC. Among CCTA parameter models, only model 4 achieved a predictive performance similar to that of the radiomics model in the training and test cohorts (AUC = 0.904 vs. 0.898 and 0.860 vs. 0.877). The combined model (nomogram) showed greater predictive efficacy (AUC = 0.963, 0.910) than model 4 or the radiomics model.

Conclusion: The PCAT-based radiomics model accurately distinguishes between NSTEMI and UA, with similar diagnostic performance as the model that combined all the significant CCTA parameters. The nomogram integrating CCTA parameters and the radiomic score has good clinical application prospects.

The 2024 guidelines of the European Society of Cardiology (ESC) refer to four very important therapeutic areas: arterial hypertension, atrial fibrillation, chronic coronary syndromes and peripheral artery disease. The ESC countries and their institutional members share a common goal of reducing the burden of cardiovascular diseases, which remain the leading cause of death worldwide. Experts from these six countries - three from Europe and three from Asia - gathered at the annual meeting to briefly present the epidemiological situation regarding selected issues addressed in the 2024 ESC guidelines, and to create a document highlighting the significant progress in pharmacotherapy. The new guidelines allow us to identify particularly important therapeutic areas and unmet pharmaceutical needs within the four treatment guidelines developed by the ESC in 2024. While discussing each of these four documents, 10 subjectively selected points were chosen to highlight what should be kept in mind in daily clinical practice. Altogether, a range of all-risk categories are represented, and the observations made in this position paper are of a universal nature.

Background: Heart failure (HF) nurses play an important role in heart failure management. This study aimed to assess the knowledge of HF nurses in Poland regarding HF management.

Methods: 97 nurses from Poland provided their consent and completed an online questionnaire comprised of 20 questions. The study was conducted from January 2023 to May 2023. The questionnaire was divided into three parts: general information, practical issues, and the impact of the Polish online educational platform on clinical practice. The inclusion criteria were: a registered nursing license, age under 60, and participation in the Association of Heart Failure of Polish Cardiac Society's online learning platform course for HF nurses. The study group was divided into two subgroups: cardiovascular (CV) nurses (n = 37) and non-CV nurses (n = 60). Statistical analysis was performed using STATISTICA software, with p < 0.05 considered statistically significant.

Results: CV nurses showed a higher initial level of education and greater involvement in hospital settings and patient education in comparison to non-CV nurses. Knowledge levels regarding HF management were similar in both groups. Significant differences were found in the work settings and engagement in patient education between CV and non-CV nurses.

Conclusions: The study highlights the importance of the HF nurse educational program in Poland, emphasizing the role of CV nurses and the impact of an online educational platform. Findings contribute to ongoing efforts to enhance HF management and improve the quality of care for patients with heart failure.

Background: There is limited data on the impact of body mass index (BMI) on distal radial access (DRA). Using a large-scale prospective registry, the influence of obesity on DRA outcomes was evaluated, including cannulation and complications.

Methods: Using data from the prospective, multicenter KODRA (Korean Prospective Registry for Evaluating the Safety and Efficacy of Distal Radial Approach) registry data, 4,638 patients who planned palpation-guided distal radial artery puncture were enrolled into two groups, both with body mass index (BMI) information available: obese (n = 2,205; BMI ≥ 25 kg/m²) and non-obese (n = 2,433). The primary endpoint was the success rate of distal radial artery cannulation. Secondary endpoints included cannulation time, crossover rate, and DRA-related complications.

Results: The mean age was 66.6 ± 11.7 years and 67.2% were men. No significant difference existed in the success rate of distal radial artery cannulation between the two groups (94.5% in the obese group vs. 94.3% in the non-obese group, p = 0.787). This tendency in cannulation success rate was consistently observed in multiple sensitivity analyses, including multivariable and propensity score-matched analyses. Crossover rate (6.6% vs. 6.7%, p = 0.962) and DRA-related complications (4.3% vs. 4.6%, p = 0.630) were not significantly different between groups. However, cannulation time was significantly longer in the obese group compared to the non-obese group [105 (101-109) sec vs. 100 (97-103) sec, p = 0.046].

Conclusions: In this subgroup analysis of the KODRA registry, obesity was not associated with the success rate for palpation-guided distal radial artery cannulation, crossover rate, and DRA-related complications.

Background: The aim of this study was to investigate whether serum uric acid to serum creatinine ratio (SUA/SCr) predicts the early major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with ST elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVCAD).

Methods: This study was designed retrospectively and included 572 patients with a mean age of 61.9 ± 12.3 years who presented with STEMI and had MVCAD. The patients were divided into 2 groups as those with and without MACCEs, taking into account the 30-day follow-up period. Serum uric acid, and serum creatinine were obtained at admission. The SUA/SCr of all patients were calculated and evaluated the relationship of SUA/SCr with the 30-day MACCEs.

Results: During the mean 27.0 ± 7.7 day follow-up period, 58 (10.1%) patients died, and 84 patients (14.7%) suffered MACCEs. According to multivariable cox regression analysis, advanced age (HR: 1.020, p = 0.028), smoking (HR: 2.513, p = 0.001), lower left ventricular ejection fraction (HR: 0.962, p = 0.001), TIMI < 3 flow (HR: 0.425, p < 0.001), higher syntax score (HR: 1.067, p < 0.001), and higher SUA/SCr (HR: 1.1029, p = 0.011) independently predicted the 30-day MACCEs. The area under the curve for SUA/SCr was 0.606 with a p value of 0.002. The Kaplan Meier curves represented that high-risk patients with SUA/SCr greater than 4.58 had significantly higher MACCEs than low-risk group during the follow up period after index hospitalization (p = 0.001).

Conclusions: Newly defined promising oxidative and inflammatory biomarker, SUA/SCr can be a potential predictor of MACCEs within 30 days and decision-making treatment in STEMI and MVCAD patients.