其他最新文献

{"title":"Aetiology of chronic liver disease is a valuable factor for stratifying adverse outcomes of acute decompensation: prospective observational study.","authors":"Jung Hee Kim, Sung-Eun Kim, Do Seon Song, Hee Yeon Kim, Eileen L Yoon, Ji Won Park, Tae Hyung Kim, Young-Kul Jung, Ki Tae Suk, Hyung Joon Yim, Jung Hyun Kwon, Sung Won Lee, Seong Hee Kang, Moon Young Kim, Soung Won Jeong, Jae-Young Jang, Jeong Ju Yoo, Sang Gyune Kim, Young-Joo Jin, Gab Jin Cheon, Byung Seok Kim, Yeon Seok Seo, Hyoungsu Kim, Dong Hyun Sinn, Woo Jin Chung, Hwi Young Kim, Han Ah Lee, Seung Woo Nam, In Hee Kim, Ji Hoon Kim, Hee Bok Chae, Joo Hyun Sohn, Ju Yeon Cho, Yoon Jun Kim, Jin Mo Yang, Jung Gil Park, Won Kim, Hyun Chin Cho, Dong Joon Kim","doi":"10.1080/07853890.2024.2428431","DOIUrl":"10.1080/07853890.2024.2428431","url":null,"abstract":"<p><strong>Background/aims: </strong>Acute decompensation (AD) is defined as the development of complications related to portal hypertension and liver dysfunction that affect the progression of chronic liver disease (CLD) or liver cirrhosis (LC). Variations exist in patient demographics and prognostic outcomes of AD based on the aetiology of CLD, encompassing LC. However, limited research has been conducted to analyse these discrepancies across aetiologies.</p><p><strong>Methods: </strong>The prospective Korean Acute-on-Chronic Liver Failure (KACLiF) cohort consisted of 1,501 patients who were hospitalized with AD of CLD from July 2015 to August 2018. In this study, we assess the clinical attributes and prognostic implications of AD with CLD/LC stratified by the aetiology.</p><p><strong>Results: </strong>Among 1,501 patients, the mean age was 54.7 years old and 1,118 patients (74.5%) were men. The common events of AD were GI bleeding (35.3%) and jaundice (35.0%). There was a median follow-up of 8.0 months (1.0-16.0 months). The most common aetiology of CLD was alcohol (<i>n</i> = 1021), followed by viral hepatitis (<i>n</i> = 206), viral hepatitis with alcohol-related (<i>n</i> = 129), cryptogenic (<i>n</i> = 108) and autoimmune (<i>n</i> = 37). Viral hepatitis with alcohol-related CLD showed a poor liver function profile and a high frequency of acute-on-chronic liver failure (ACLF) [22.1% vs. 19.6% (alcohol CLD), 8.1% (viral CLD), 5.6% (autoimmune related CLD and 16.0% (cryptogenic CLD)] with worse adverse outcomes (mortality or liver transplantation) than other aetiologies. The difference in aetiology was a significant factor for 28-day adverse outcomes in multivariate analysis even in a high MELD score (≥15), which indicated poor baseline liver function and prognosis (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The aetiology of CLD constitutes a pivotal determinant influencing both short- and long-term adverse outcomes of AD in CLD, even among individuals presenting with elevated MELD scores. Notably, patients afflicted with viral hepatitis should exercise caution even in the consumption of modest quantities of alcohol that induced the exacerbations in the adverse outcomes associated with AD.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2428431"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The comparison of fractional CO₂ laser and focused ultrasound for vulvar lichen sclerosus: a retrospective study.","authors":"Maoyu Liu, Xuerui Zhang, Linlin Xiao, Jing Liang, Dan Cheng, Yue Zhu, Shufang Chang","doi":"10.1080/02656736.2025.2507958","DOIUrl":"10.1080/02656736.2025.2507958","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy of fractional carbon dioxide laser (FxCO₂) and focused ultrasound (FUS) in treating vulvar lichen sclerosus (VLS).</p><p><strong>Methods: </strong>This single-center retrospective study included biopsy-proven VLS patients who did not respond to first-line topical corticosteroids and were treated with FxCO₂ or FUS as an alternative between January 2020 and October 2022. The efficacy was evaluated using the Cattaneo score and clinical scoring system (CSS). A subgroup analysis was conducted to compare efficacy based on VLS severity.</p><p><strong>Results: </strong>At the 3-month follow-up, the total effective rates were similar between FxCO₂ (91.18%, 31/34) and FUS (88.57%, 31/35) (<i>p</i> > 0.05). At the 6-month follow-up, the total effective rates for FxCO₂ decreased to 85.29% (29/34), while FUS remained at 88.57% (31/35) (<i>p</i> > 0.05). Recurrence rates were 14.7% (5/34) for FxCO₂ and 11.4% (4/35) for FUS (<i>p</i> > 0.05) at the 6-month follow-up. Although there was no significant difference in total CSS scores and clinician-administered sign scores between FxCO₂ and FUS at both follow-ups (<i>p</i> > 0.05), FxCO₂ suggested superior patient-administered symptom improvement at 3-month (median: FxCO₂ 3 vs. FUS 5, <i>p</i> < 0.05) and 6-month follow-ups (median: FxCO₂ 3 vs. FUS 5, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>FxCO₂ and FUS show similar efficacy in treating VLS, with FxCO₂ suggesting a trend toward greater symptom relief. Further studies are needed to validate these preliminary observations.</p>","PeriodicalId":520653,"journal":{"name":"International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group","volume":"42 1","pages":"2507958"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145323","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}

{"title":"Cardiovascular safety of Janus kinase inhibitors in inflammatory bowel disease: a systematic review and network meta-analysis.","authors":"Huibin Yang, Ting An, Yuxuan Zhao, Xiaojing Shi, Bangmao Wang, Qingyu Zhang","doi":"10.1080/07853890.2025.2455536","DOIUrl":"10.1080/07853890.2025.2455536","url":null,"abstract":"<p><strong>Background and objective: </strong>Janus kinase (JAK) inhibitors (JAKinibs) are effective for inflammatory bowel disease (IBD), but their cardiovascular safety is inconclusive. We aim to assess the cardiovascular risks associated with JAKinibs in IBD patients.</p><p><strong>Patients and methods: </strong>Systematic searches of seven databases and ClinicalTrials.gov from inception to February 2024 were conducted. Outcomes included major adverse cardiovascular events (MACE), venous thromboembolism events (VTE) and cardiovascular events (CVE), which were separately evaluated based on whether or not the dose was considered. P-score was applied to rank interventions.</p><p><strong>Results: </strong>A total of 26 trials involving 10,537 IBD patients were included, and results showed no significantly increased risk of MACE, VTE and CVE was associated with JAKinibs. However, when the dose was considered, Tofacitinib 5 mg BID (versus placebo) showed a trend towards an increased risk of MACE [odds ratio (OR)=1.05, 95% confidence interval (CI): 0.23-4.82], as well as Upadacitinib 30 mg QD (versus placebo) showed a trend towards increased risks of VTE (OR=1.36, 95% CI: 0.23-8.03) and CVE (OR=1.08, 95% CI: 0.24-4.85), and ranked higher than placebo for the risk of VTE [P-score=0.766 (versus 0.722)]. Notably, Deucravacitinib ranked lowest for all cardiovascular risks, and significantly decreased the risks of VTE (OR=0.03, 95% CI: 0.00-0.87) and CVE (OR=0.03, 95% CI: 0.00-0.87) compared with placebo.</p><p><strong>Conclusions: </strong>Although a trend of increased cardiovascular risks was found considering dose, no significantly increased cardiovascular risk was associated with JAKinibs in IBD patients, and Deucravacitinib significantly decreased the risks of VTE and CVE.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2455536"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of sperm retrieval success in first-time and repeated Micro-TESE for nonobstructive azoospermia.","authors":"Sulieman Alriyalat, Mohammad Ghassab Deameh, Hamzeh Farraj, Jad Khaled Alsmadi, Baha' Aldeen Bani Irshid, Hammam Abu Rahmeh, Ahmad Khaled Awawdeh, Mohammad Ahmad Mubarak, Ali Fawzey Ababneh, Wa'el Ahmad Bani Amer, Mohammad Al-Zubi","doi":"10.1080/20565623.2025.2511449","DOIUrl":"10.1080/20565623.2025.2511449","url":null,"abstract":"<p><strong>Introduction: </strong>Microdissection testicular sperm extraction (micro-TESE) is the preferred sperm retrieval method, although success rates vary based on factors such as age and hormone levels. We evaluate sperm retrieval outcomes in first-time and repeated micro-TESE, identifying predictors of success to guide clinical management.</p><p><strong>Material and methods: </strong>Retrospective study analyzed 152 men with nonobstructive azoospermia (NOA) who underwent micro-TESE between 2020 and 2022. Patients were grouped based on sperm retrieval outcomes, and clinical, demographic and hormonal factors were assessed. Comparisons were made between first-time and repeat micro-TESE cases.</p><p><strong>Results: </strong>Sperm retrieval rate was higher for first-time TESE cases (64.6%) than repeated TESE cases (28.8%, <i>p</i> < 0.01). Repeated TESE cases were older, had higher smoking rates, and exhibited significantly elevated follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels, with lower total testosterone (<i>p</i> < 0.01). In repeated TESE cases, no significant differences in age, smoking status or hormone levels were found between successful and failed attempts.</p><p><strong>Conclusion: </strong>First-time micro-TESE users had a significantly higher sperm retrieval rate than those undergoing repeated attempts. Repeated TESE was associated with older age, higher smoking rates and adverse hormonal profiles. Larger studies are needed to validate these findings and optimize patient selection for repeated micro-TESE.</p>","PeriodicalId":12568,"journal":{"name":"Future Science OA","volume":"11 1","pages":"2511449"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TiO₂ nanomaterial promotes plant growth and disease resistance.","authors":"Xiaotong Gai, Xiaofeng Xu, Ning Jiang, Dingli Zhang, Yongjun Zhang, YongWn Kim, YuanHu Xuan, Dandan Li","doi":"10.1080/15592324.2025.2512943","DOIUrl":"10.1080/15592324.2025.2512943","url":null,"abstract":"<p><p>TiO₂ nanomaterials can promote plant growth and enhance disease resistance. However, the underlying mechanism remains unclear. This study applied TiO₂ to promote the growth of wheat, soybean, tobacco, cucumber, and corn. Genetic analysis using macro-element transporter rice mutants in rice revealed that growth promotion induced by TiO₂ was dependent on <i>potassium transporter</i> (<i>AKT1</i>), <i>nitrate transporter 1.1B</i> (<i>NRT1.1B</i>), <i>ammonium transporter 1</i> (<i>AMT1</i>), and <i>phosphate transporter 8</i> (<i>PT8</i>). TiO₂ also enhanced chlorophyll accumulation, and growth promotion was inhibited in the chlorophyll biosynthesis rice mutants, <i>yellow-green leaf 8</i> (<i>ygl8</i>) and <i>divinyl reductase</i> (<i>dvr</i>), indicating that TiO₂ promoted growth through chlorophyll biosynthesis. In addition to photosynthesis, TiO₂ affected light signaling by inhibiting the translocation of Phytochrome B (<i>PhyB</i>) from the cytosol to the nucleus, thereby improving resistance to rice sheath blight (ShB). TiO₂ application also enhanced resistance to wheat stem rust, tobacco wildfire, angular spot disease, and rice ShB by inhibiting the growth of bacterial and fungal pathogens, suggesting that TiO₂ regulates plant defense signaling and has antibacterial and antifungal effects. Field experiments with wheat, soybeans, and rice confirmed that TiO₂ treatment significantly increased the crop yield. These findings suggest that TiO₂ is a promising nanomaterial for the simultaneous enhancement of plant growth and disease resistance.</p>","PeriodicalId":94172,"journal":{"name":"Plant signaling & behavior","volume":"20 1","pages":"2512943"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating augmented reality technology into physical therapy in the school setting: a feasibility study.","authors":"Elise Baron, Amy Pratt, Betsy Donahoe-Fillmore","doi":"10.1080/07853890.2025.2499022","DOIUrl":"10.1080/07853890.2025.2499022","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the feasibility of using an immersive augmented-reality technology (AT) in conjunction with physical therapy (PT) for in-school therapy, while determining whether this technology would be as engaging and motivating as standard PT.</p><p><strong>Methods: </strong>Participants included Fifteen students (6-8 y/o) receiving once-weekly PT. The therapist was instructed to engage students in AT and standard PT for one academic year, alternating sessions. Before each session, students were informed of therapy modality and rated their excitement using a Smiley Face Likert scale with associated text. To assess feasibility, the number and order of each session type, as well as student refusal rate, were investigated. To assess engagement, the therapist recorded time-on-task and number of times redirection was needed. Feasibility was reported as descriptive statistics, and Wilcoxon signed-rank tests were used to compare average scores on excitement and engagement between AT and standard PT.</p><p><strong>Results: </strong>60% of students (9/15) reaching the intended goal of 50% of therapy sessions as AT, as well as 60% (9/15) of students 'roughly alternating' (no more than three same session types in a row) their sessions throughout the duration of the study. The student refusal rate of AT was 0%. When using AT, students were 23% (<i>p</i>= <.0001) more excited, 4.4% (<i>p</i>=.004) more on task and needed 61% (<i>p</i>= <.0001) less refocusing compared to standard PT.</p><p><strong>Conclusion: </strong>Integrating AT alongside standard PT proved to be moderately feasible in a school setting. Additionally, students demonstrated increased excitement, increased time on tasks and decreased refocusing during a session using AT. A flexible-use approach will make AT a motivating addition to school-based therapy.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2499022"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PCSK9 is upregulated and correlated with more severe disease condition but fails to predict treatment outcomes in psoriasis patients.","authors":"Xuwen Yin, Lei Shi, Ni Zhang, Heng Li, Jianwen Long, Xinjian Yu","doi":"10.1080/09546634.2025.2482867","DOIUrl":"https://doi.org/10.1080/09546634.2025.2482867","url":null,"abstract":"<p><strong>Background: </strong>Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) not only regulates cholesterol metabolism and cardiovascular disorder but also modifies inflammatory response and autoimmunity.</p><p><strong>Objective: </strong>This study investigated the relation of PCSK9 to clinical features and treatment outcomes in psoriasis patients.</p><p><strong>Methods: </strong>One hundred and five psoriasis patients who initiated systemic treatment due to moderate-to-severe disease condition were enrolled. Baseline characteristics and treatment response after 12-week treatment were collected. Their serum samples before treatment initiation were collected and sent to PCSK9 detection by enzyme-linked immunosorbent assay. Serum PCSK9 was also detected in 30 healthy subjects.</p><p><strong>Results: </strong>PCSK9 level was 2-fold times in psoriasis patients <i>vs.</i> healthy subjects. PCSK9 could predict psoriasis risk with AUC of 0.777. By optimum cutoff value of 179 ng/ml, PCSK9 had the best predictive potential for psoriasis risk. PCSK9 quartile was positively correlated with BMI, hyperlipemia history, PASI, and sPGA. However, PCSK9 quartile was not correlated with PASI 75 response, PASI 90 response, or sPGA 0/1 response at week 12.</p><p><strong>Conclusion: </strong>PCSK9 is upregulated and correlated with severe disease condition, but fails to predict treatment outcomes in psoriasis patients.</p>","PeriodicalId":94235,"journal":{"name":"The Journal of dermatological treatment","volume":"36 1","pages":"2482867"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218009","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}

{"title":"Erector spinae plane block spread patterns and its analgesic effects after computed tomography-guided hepatic tumour ablation: a randomized double-blind trial.","authors":"Wei-Han Chou, Wen-Yun Niu, Po-Chin Liang, Shih-Han Lin, Jen-Ting Yang, Chih-Peng Lin, Ming-Shiang Wu, Chun-Yu Wu","doi":"10.1080/07853890.2025.2480255","DOIUrl":"10.1080/07853890.2025.2480255","url":null,"abstract":"<p><strong>Introduction: </strong>Spread patterns of the erector spinae plane block (ESPB) in a larger cohort of living subjects remain inadequately understood. This study investigated the spread of local anaesthetics or saline with contrast in patients undergoing computed tomography-guided radiofrequency ablation of hepatic tumours.</p><p><strong>Patients and methods: </strong>Thirty patients participated in a double-blinded randomized controlled trial, 14 April 2021 and 18 January 2023. These patients were randomized into two groups: the ESPB group, which received local anaesthetic with contrast, and the sham group, which received saline with contrast. The spread of the drug was assessed regarding vertebral levels and its correlation with the patient characteristics. Pain intensity and morphine consumption were also evaluated.</p><p><strong>Results: </strong>The ESPB consistently spread cranio-caudally to the dorsal erector spinae muscle in all patients, with a median (IQR) spread of 9 (8-11) vertebral levels, and to the intercostal space with a median (IQR) spread of 4 (3-6) vertebral levels. Paravertebral spread occurred in 90% of patients (27 out of 30) with a median (IQR) spread of 3 (2-5) vertebral levels, while epidural spread was observed in 36.7% of patients (11 out of 30) with a median (IQR) spread of 0 (0-2) vertebral levels. Cranio-caudal spread negatively correlated with back muscle thickness (<i>r</i>= -0.4; <i>p</i> = 0.035), and females exhibited significantly more intercostal spread levels than males (5.8 ± 1.0 vs. 4.3 ± 1.6 levels in females and males, respectively; <i>p</i> = 0.021). However, no significant difference was found in pain intensity and morphine consumption between the two study groups.</p><p><strong>Conclusion: </strong>This study provides insights into the drug spread patterns of ESPB in living subjects. However, a unilateral ESPB did not yield sufficient analgesic effects for radiofrequency ablation of hepatic tumours.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2480255"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in the clinical application of heliox.","authors":"Hao Ke","doi":"10.4103/mgr.MEDGASRES-D-25-00026","DOIUrl":"10.4103/mgr.MEDGASRES-D-25-00026","url":null,"abstract":"","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"15 4","pages":"546-547"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12124710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of stroke following percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis.","authors":"Andriany Qanitha, Abdul Hakim Alkatiri, Nurul Qalby, Gita Vita Soraya, Muhammad Azka Alatsari, Nabilah Puteri Larassaphira, Rif'at Hanifah, Peter Kabo, Muzakkir Amir","doi":"10.1080/07853890.2025.2506481","DOIUrl":"10.1080/07853890.2025.2506481","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in the field, no systematic review has thoroughly documented the occurrence of stroke following Percutaneous Coronary Intervention (PCI) in patients with Acute Coronary Syndrome (ACS). This study aimed to investigate the factors contributing to stroke occurrence post-PCI in ACS patients.</p><p><strong>Methods: </strong>A systematic search of PubMed and EMBASE identified 2,369 articles. After full-text screening, 109 articles were included in the systematic review, with 55 articles selected for meta-analysis.</p><p><strong>Results: </strong>Data from 18,466,823 patients across 109 studies were analyzed. Among these, 202,999 patients (1.1%) experienced post-PCI stroke. The participants' ages ranged from 49.0 to 87.6 years (mean 64.3 ± 6.2 years). The incidence of early post-PCI stroke within 30 days was 1.1%, while the incidence of stroke occurring >30 days post-PCI was 1.8%, predominantly ischemic strokes. Predictors of stroke following PCI in ACS patients included traditional risk factors (i.e. female sex, older age, diabetes mellitus, hypertension, prior stroke or transient ischemic attack); comorbidities (i.e. chronic kidney disease, atrial fibrillation, anemia, high bleeding risk); and procedural factors (i.e. thrombus aspiration and Clopidogrel use).</p><p><strong>Conclusions: </strong>This study highlights the relatively low prevalence of stroke following PCI, estimated at approximately 1% of the studied population. These findings emphasize the critical need for continued vigilance in identifying and managing risk factors associated with post-PCI stroke in ACS patients. Future research should prioritize refining risk prediction models, developing innovative preventive strategies, and optimizing post-PCI care pathways to effectively reduce the incidence of stroke in this population.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2506481"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}