Clinical Cardiology最新文献

{"title":"A Comparison Between Culprit Versus Complete Revascularization in Diabetic Patients With Acute Myocardial Infarction","authors":"Naser Aslanabadi,&nbsp;Sina Mashayekhi,&nbsp;Maziar Rezvani,&nbsp;Ali Abdollahzadeh,&nbsp;Amirhossein Hajialigol","doi":"10.1002/clc.70046","DOIUrl":"10.1002/clc.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The benefit of complete revascularization in diabetic patients with myocardial infarction remains unclear. this study aims to find the optimal strategy of total vascular repair for diabetic patients with acute myocardial infarction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In an analysis of a cohort, we assigned diabetic patients with myocardial infarction who were undergoing percutaneous coronary intervention (PCI) of the culprit lesion to receive either staged complete revascularization of nonculprit lesions or to receive no further revascularization in Madani Hospital (Tabriz, Iran). Functionally significant nonculprit lesions were identified either by angiography. The primary outcome was rates of readmission, cardiac deaths, nonfatal myocardial re-infarction, and overall mortality at 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In our center, a total of 1186 patients underwent primary-PCI treatment, among which 521 were diagnosed with diabetes. Ultimately, 393 patients were selected for inclusion in the study. Within this cohort, 271 individuals (68.9%) underwent repair of only the culprit vessels (group 1), while 122 individuals (31.1%) received a comprehensive staged restoration of the vessels (group 2). During this time, group 1 in comparison with group 2 experienced 204 (75.3%) versus 97 (79.5%) cases of readmission, 48 (17.7%) versus 8 (6.5%) instances of cardiac death, 22 (8.1%) versus 18 (14.7%) occurrences of nonfatal myocardial re-infarction. Notably, the incidence of cardiac death in group 2 were significantly lower than that in group 1 (<i>p</i> ≤ 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For individuals diagnosed with diabetes, staged complete revascularization demonstrated a lower frequency of readmission, cardiac deaths, nonfatal myocardial reinfarction, and overall mortality, in contrast to revascularization that targeted only the culprit lesion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 11","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615837","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}

{"title":"Precision Management of Complex Coronary Lesions: Drug-Coated Balloons and Computational Cardiology at the Forefront of Nanotechnology","authors":"Yashendra Sethi,&nbsp;Inderbir Padda,&nbsp;Sneha Annie Sebastian,&nbsp;Arsalan Moinuddin,&nbsp;Talha Bin Emran,&nbsp;Sunny Goel,&nbsp;Gurpreet Johal","doi":"10.1002/clc.70045","DOIUrl":"10.1002/clc.70045","url":null,"abstract":"&lt;p&gt;Complex coronary lesions present formidable challenges in interventional cardiology, necessitating innovative approaches for effective management. From myocardial bridging (MB) to ostial lesions and bifurcations, each poses unique anatomical and physiological hurdles. Despite advancements in coronary interventions, addressing these lesions remains a clinical conundrum owing to their diverse characteristics and associated complications. Traditionally, drug-eluting stents (DES) are the primary choice for treating coronary artery stenosis, including lesions with myocardial bridges; however, such stents may exacerbate potential risks, including major adverse cardiac events, in-stent restenosis, and postimplantation stent fracture; further compounded by prolonged dual antiplatelet therapy and its associated bleeding risks.&lt;/p&gt;&lt;p&gt;Stemmed from the theorized concept of “intervention without implantation” – drug-coated balloons (DCB)—provide a simple yet pivotal alternative to DES (Figure 1). Employing semi-compliant balloons loaded with antiproliferative drugs, DCBs penetrate into the local vessel wall, inhibiting intimal hyperplasia and promoting long-term vessel patency. Previous studies like those by Xu et al. and Jeger Rv et al. have demonstrated their safety and efficacy in various coronary artery conditions, such as in-stent restenosis, bifurcation lesions, small-sized vessels, considerable lesion lengths [&gt; 50 mm], high bleeding risk patients, de-novo lesions, and patients planned for major surgery, e.g., coronary artery bypass graft [&lt;span&gt;1, 2&lt;/span&gt;]. Table 1 summarizes the most recent (last 5 years) and relevant literature employing DCBs in complex coronary lesions. However, the considerations below are essential to understanding the underlying challenges and why their application has not gained traction.&lt;/p&gt;&lt;p&gt;Of late, MBs have garnered significant attention for their association with acute coronary syndromes, coronary artery spasms, ventricular arrhythmias, and sudden cardiac death. Typically, MB denotes a congenital variation wherein a segment of a coronary artery traverses through the myocardium rather than taking its classic epicardial route. Given they are commonly hitched with atherosclerosis of proximal coronary arteries, DCBs offer a promising avenue; however, their precise delivery and long-term efficacy are still to be determined [&lt;span&gt;2, 8&lt;/span&gt;]. Recent reports have indicated DCBs as a potential treatment for atherosclerosis in the myocardial bridging segment, highlighting the benefits of the “leave nothing behind” strategy [&lt;span&gt;10&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Ostial lesion analogs (OLAs): aorto-ostial lesions, non-aorto-ostial lesions, and branch-ostial lesions are typically found close to the ostium (≤ 3 mm) of the coronary artery. They are characterized by a rigid fibrotic texture (with pronounced sclerosis) which significantly enhances its propensity to recoil. Lesions at coronary ostia present unique challenges due to their anato","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 11","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603378","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}

{"title":"Obesity Paradox and the Effect of NT-proBNP on All-Cause and Cause-Specific Mortality","authors":"Rupinder Kaur Bahniwal,&nbsp;Nargiza Sadr,&nbsp;Colleen Schinderle,&nbsp;Cynthia J. Avila,&nbsp;Julie Sill,&nbsp;Rehan Qayyum","doi":"10.1002/clc.70044","DOIUrl":"10.1002/clc.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In heart failure patients, obesity is associated with better outcomes as compared to normal weight, a phenomenon called the obesity paradox.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine if obesity modifies the relationship between NT-proBNP and all-cause and cause-specific mortality in adults without coronary artery disease or heart failure history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2004 and linked it with mortality through December 31, 2019. Participants &gt; 18 years were categorized into normal weight (BMI ≤ 25 kg/m²), overweight (BMI &gt; 25–29.9 kg/m²) and obese (BMI &gt; 29.9 kg/m²). NT-proBNP levels were categorized as low (&lt; 126 pg/mL) or high (≥ 126 pg/mL). Using Cox proportional hazard models, we examined effect modification by obesity using interaction, without and with adjusting for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 12 621 participants, 2794 (22%) died during 202 859 person-years follow-up. In adjusted models, normal-weight participants with high NT-proBNP had 2 times higher all-cause mortality risk than those with low NT-proBNP (HR = 2.05; 95%CI = 1.74, 2.41; <i>p</i> &lt; 0.001); however, this mortality risk was 27% lower in obese participants (HR interaction = 0.73; 95%CI = 0.59, 0.92; <i>p</i> = 0.008). Similarly, in normal-weight participants, the difference in other-cause mortality risk between high and low NT-proBNP participants was significant in adjusted models (HR = 2.27; 95%CI = 1.81, 2.85; <i>p</i> &lt; 0.001) and obese participants had 48% lower other-cause mortality risk between those with high and low NT-proBNP (interaction HR = 0.52; 95%CI = 0.36, 0.77; <i>p</i> = 0.001). Conversely, obesity did not modify the relationship between NT-proBNP and cardiovascular or cancer mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients free of heart failure or coronary artery disease, obesity may be protective against mortality associated with high NT-proBNP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 11","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11546245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603361","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}

{"title":"A Comprehensive Nomogram Integrating Phonocardiogram and Echocardiogram Features for the Diagnosis of Heart Failure With Preserved Ejection Fraction","authors":"Linchun Cao,&nbsp;Xingming Guo,&nbsp;Kangla Liao,&nbsp;Jian Qin,&nbsp;Yineng Zheng","doi":"10.1002/clc.70022","DOIUrl":"10.1002/clc.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Heart failure with preserved ejection fraction (HFpEF) is associated with high hospitalization and mortality rates, representing a significant healthcare burden. This study aims to utilize various information including echocardiogram and phonocardiogram to construct and validate a nomogram, assisting in clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analyzed 204 patients (68 HFpEF and 136 non-HFpEF) from the First Affiliated Hospital of Chongqing Medical University. A total of 49 features were integrated and used, including phonocardiogram, echocardiogram features, and clinical parameters. The least absolute shrinkage and selection operator (LASSO) regression was used to select the optimal matching factors, and a stepwise logistic regression was employed to determine independent risk factors and develop a nomogram. Model performance was evaluated by the area under receiver operating characteristic (ROC) curve (AUC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The nomogram was constructed using five significant indicators, including NT-proBNP (OR = 4.689, <i>p</i> = 0.015), <i>E</i>/<i>e</i>′ (OR = 1.219, <i>p</i> = 0.032), LAVI (OR = 1.088, <i>p</i> &lt; 0.01), D/S (OR = 0.014, <i>p</i> &lt; 0.01), and QM1 (OR = 1.058, <i>p</i> &lt; 0.01), and showed a better AUC of 0.945 (95% CI = 0.908–0.982) in the training set and 0.933 (95% CI = 0.873–0.992) in the testing set compared to conventional nomogram without phonocardiogram features. The calibration curve and Hosmer–Lemeshow test demonstrated no statistical significance in the training and testing sets (<i>p</i> = 0.814 and <i>p</i> = 0.736), indicating the nomogram was well-calibrated. The DCA and CIC results confirmed favorable clinical usefulness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The nomogram, integrating phonocardiogram and echocardiogram features, enhances HFpEF diagnostic efficiency, offering a valuable tool for clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 11","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496157","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}

{"title":"Toluene Inhalant Addiction and Cardiac Functions in Young Adults: A Comparison of Electrocardiographic and Echocardiographic Parameters","authors":"Gürkan Karaca,&nbsp;Erdinç Hatipsoylu,&nbsp;Ahmet Ekmekci,&nbsp;Ömer Kamil Yazıcı,&nbsp;Ali Kimiaei,&nbsp;Seyedehtina Safaei,&nbsp;Ahmet Bilge Sözen","doi":"10.1002/clc.70037","DOIUrl":"10.1002/clc.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Volatile substance (thinner) addiction can cause serious cardiac events, such as malignant ventricular arrhythmias, acute coronary syndromes, sudden death syndrome, and dilated cardiomyopathy, as reported in many case studies. We aimed to find echocardiographic and electrocardiographic parameters that could foresee these adverse outcomes in clinical settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 32 healthy young adult patients with at least 1 year of thinner addiction and no cardiac symptoms. We also recruited a control group of 30 healthy individuals without any medical problems. Both groups received standard echocardiography and ECG tests. We analyzed the following echocardiographic parameters: LVEDd (left ventricular end-diastolic diameter), LVESd (left ventricular end-systolic diameter), mitral valve EF slope, E/A ratio, and aortic and pulmonary valve VTI (velocity time integral). We also measured the corrected (QTc), uncorrected QT intervals, and widest P-wave values in the ECG. We used the SPSS 13 software for statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The echocardiographic findings did not differ significantly between the groups. However, the ECG results showed that the thinner addicts had higher values of corrected (QTc), uncorrected QT intervals, and widest P-wave values than the control group, according to Mann–Whitney <i>U</i> and Student's <i>T</i> test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Corrected QT (QTc) and P-wave duration are increased in individuals with a thinner addiction. These findings may suggest a higher risk of sudden cardiac death, atrial, and ventricular dysrhythmias in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 11","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496160","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}

{"title":"Pacemaker Implantation for Low-Grade Conduction Abnormalities After Balloon-Expandable Transcatheter Aortic Valve Implantation","authors":"Julian Wolfes,&nbsp;Fernando de Torres Alba,&nbsp;Gerrit Kaleschke,&nbsp;Julia Vormbrock,&nbsp;Florian Reinke,&nbsp;Christian Ellermann,&nbsp;Helmut Baumgartner,&nbsp;Lars Eckardt,&nbsp;Gerrit Frommeyer","doi":"10.1002/clc.70028","DOIUrl":"10.1002/clc.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A frequent complication after TAVI are postinterventional conduction abnormalities requiring permanent pacemaker implantation. In this study, we analyzed the characteristics of borderline conduction abnormalities leading to pacemaker implantation and the resulting ventricular pacing amounts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>All patients who underwent balloon-expandable TAVI between 2014 and 2019 in our tertiary center were analyzed in a retrospective manner. One hundred and sixty-five patients of 1083 TAVI-patients developed postinterventional conduction abnormalities leading to pacemaker implantation. Of these 19 (11.5%) did not represent a clear indication for cardiac pacing according to current European guidelines. Patient characteristics, underlying conduction abnormalities, and the temporal change of ventricular pacing percentages at 24 h and 6 weeks after pacemaker implantation were analyzed.</p>\u0000 \u0000 <p>The dominating borderline conduction abnormalities leading to pacemaker implantation were new-onset persisting bundle-branch-blocks and new first-degree AV-blocks with progression of AV-delay.</p>\u0000 \u0000 <p>While pacemaker implantation was safe and without severe complications in all cases, only 6 of 19 patients had high pacing amounts (95%−100%) after 24 h while 11 patients had low to no pacing amounts (0%−5%). After 6 weeks, 8 patients showed decreasing pacing amounts, no patient had an increasing amount of ventricular pacing and all patients had an intrinsic ventricular rhythm &gt; 30/min.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our cohort of 1038 TAVI patients, 19 patients underwent PMI for borderline CAs (11.5% of all PMI). Of these, only 2 patients had high pacing amounts after 6 weeks. The risk of complete persisting heart block in these patients is very low. Furthermore, algorithms to reduce ventricular pacing are highly effective to avoid ventricular pacing whenever reasonable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 11","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496159","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}

{"title":"Enhancing Quality of Life in Symptomatic Paroxysmal Atrial Fibrillation Patients: A Systematic Analysis of Cognitive Behavioral Therapy Interventions","authors":"Pratik Agarwal,&nbsp;Yashendra Sethi,&nbsp;Avisham Goyal,&nbsp;Inderbir Padda,&nbsp;Daniel Fabian,&nbsp;Talha Bin Emran,&nbsp;Gurpreet Johal,&nbsp;Chinmaya Mareddy","doi":"10.1002/clc.70034","DOIUrl":"10.1002/clc.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Paroxysmal atrial fibrillation (PAF) significantly impacts patients' lives, contributing to morbidity, reduced quality of life (QoL), and psychological distress. Conventional treatment approaches primarily focus on rhythm control through pharmacologic therapy, often overlooking the patient's holistic well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>Cognitive behavioral therapy (CBT), a well-established intervention for modifying dysfunctional thoughts and behaviors, may provide a beneficial nonpharmacological approach to improving QoL in symptomatic PAF patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted in accordance with Cochrane methodology and PRISMA guidelines. A comprehensive search was performed using PubMed, Scopus, and Google Scholar to identify relevant studies on the effects of CBT on QoL in PAF patients. Various CBT interventions, including exposure-based, internet-delivered, and mindfulness-based approaches, were analyzed. Study quality was assessed using JBI and Cochrane tools to evaluate the risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review found that CBT interventions led to statistically significant improvements in several QoL domains, including physical and emotional well-being. Psychological well-being and self-management skills were notably enhanced, as CBT helped address maladaptive cognitive patterns and improved coping strategies. The studies reviewed consistently demonstrated a low risk of bias, indicating reliability in the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CBT shows promise as a holistic, nonpharmacological intervention for managing PAF, improving both psychological and physical QoL. However, future research is needed to establish standardized protocols, increase sample sizes, and conduct long-term follow-ups to further validate its effectiveness in this population. Incorporating CBT into PAF management could substantially enhance patient outcomes and well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 11","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496158","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}

{"title":"Association Between Family Income, Subclinical Myocardial Injury, and Cardiovascular Mortality in the General Population","authors":"Sneha Chebrolu,&nbsp;Richard Kazibwe,&nbsp;Elsayed Z. Soliman","doi":"10.1002/clc.70036","DOIUrl":"10.1002/clc.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Both low family income and subclinical myocardial injury (SCMI) are risk factors for cardiovascular disease (CVD) mortality. However, the impact of their joint association on CVD mortality is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This analysis from the third National Health and Nutrition Examination Survey included 6805 participants (age 59.1 ± 13.4 years, 52.3% women, and 49.8% White) free of CVD at baseline. Family income was assessed using the poverty-income ratio (PIR) and categorized into low (PIR &lt; 1), middle (PIR = 1–4), and high (PIR &gt; 4) income. A validated ECG-based cardiac infarction injury score (CIIS) ≥ 10 was considered positive for SCMI. CVD mortality was determined using the National Death Index. Cox-proportional hazard analysis was used to evaluate the associations of family income and SCMI, separately and jointly, with CVD mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1782 (26.2%) participants had SCMI at baseline. During a median follow-up of 18.2 years, 856 (12.6%) events of CVD mortality occurred. In separate multivariable Cox models, SCMI (vs. no SCMI) and middle- and low-income (vs. high-income) were each associated with a higher risk of CVD mortality (HR [95% CI]: 1.34 [1.16–1.54], 1.44 [1.16–1.78], and 1.59 [1.22–2.07], respectively). Compared to high-income participants without SCMI, those with low-income and SCMI had an increased risk of CVD mortality (HR [95% CI]: 2.17 [1.53–3.08]). The multiplicative interaction between PIR and SCMI was not significant (<i>p</i> = 0.054).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lower family income and SCMI are associated with CVD mortality, and their concomitant presence is associated with the highest risk. Family income and SCMI may help in the individualized assessment of CVD risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459374","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}

{"title":"LDL-C and hs-CRP Jointly Modify the Effect of Lp(a) on 5-Year Death in Patients With Percutaneous Coronary Intervention","authors":"Jiawen Li,&nbsp;Kailun Yan,&nbsp;Pei Zhu,&nbsp;Xiaofang Tang,&nbsp;Yuejin Yang,&nbsp;Runlin Gao,&nbsp;Jinqing Yuan,&nbsp;Xueyan Zhao","doi":"10.1002/clc.70025","DOIUrl":"10.1002/clc.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent studies have suggested that adverse events associated with lipoprotein(a) [Lp(a)] might be modified by low-density lipoprotein cholesterol (LDL-C) or high-sensitivity C-reactive protein (hs-CRP) levels, but whether LDL-C and hs-CRP jointly mediate the outcome of Lp(a) remains unknown in patients with coronary artery disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A prospective study was conducted, enrolling consecutive 10 724 patients with percutaneous coronary intervention (PCI) in 2013. The endpoint event was all-cause death. A total of 10 000 patients with complete baseline data were finally included. During a median follow-up of 5.1 years, Lp(a) ≥ 30 mg/dL was an independent risk factor of all-cause death in the overall population, LDL-C ≥ 70 mg/dL, and hs-CRP ≥ 2 mg/L population, respectively. According to concurrent LDL-C (70 mg/dL) and hs-CRP (2 mg/L) levels, further analysis revealed that when LDL-C &lt; 70 mg/dL regardless of hs-CRP levels, Lp(a) ≥ 30 mg/dL was not an independent predictor of all-cause death. However, when LDL-C ≥ 70 mg/dL, Lp(a) ≥ 30 mg/dL was independently associated with a higher risk of all-cause death in hs-CRP ≥ 2 mg/L (HR: 1.488, 95% CI: 1.059‒2.092), but not in hs-CRP &lt; 2 mg/L (HR: 1.303, 95% CI: 0.914‒1.856).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among PCI patients, Lp(a)-associated outcome was jointly affected by LDL-C and hs-CRP. As long as LDL-C is well controlled, the adverse effects of increased Lp(a) on cardiovascular risk seem to be weakened, and only when LDL-C and hs-CRP increase at the same time, elevated Lp(a) is associated with poorer long-term outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459376","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}

{"title":"Risk Factors of Postoperative Atrial Fibrillation After Isolated Coronary Artery Bypass Grafting Surgery in the Recent 10 Years: Clinical Analysis of 6229 Patients","authors":"Jia-Yi Zhou,&nbsp;Jian-Liang Zhang,&nbsp;Lei Xi,&nbsp;Zhi-Peng Guo,&nbsp;Xiao-Cheng Liu,&nbsp;Zhi-Gang Liu,&nbsp;Qin Yang,&nbsp;Guo-Wei He","doi":"10.1002/clc.24335","DOIUrl":"10.1002/clc.24335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG) that prolongs hospitalization and increases expenses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis</h3>\u0000 \u0000 <p>Perioperative risk factors may predict POAF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From March 2015 to January 2023, 6229 patients who underwent isolated CABG and were in sinus rhythm before CABG were included in this retrospective study. The preoperative and postoperative variants of patients were collected and analyzed by univariate analyses between the patients with and without POAF. Multivariate logistic regression analysis was then used to study the independent risk factors for POAF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of POAF in this group of patients was 30.94%. Univariate analyses demonstrated that age (<i>p</i> &lt; 0.001), hypertension (<i>p</i> &lt; 0.001), smoking (<i>p</i> &lt; 0.05), cardiopulmonary bypass (CPB) time (<i>p</i> &lt; 0.01), and ejection fraction (EF, <i>p</i> &lt; 0.01) were the risk factors for POAF. Multivariate logistic regression analysis determined the independent risk factors associated with POAF were old age (odds ratio [OR] = 1.062, <i>p</i> = 0.000) and low EF (OR = 0.980; <i>p</i> = 0.008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the current era, after isolated CABG surgery, there is still a quite high incidence of POAF (30.94% in this group of CABG patients). The main risk factors correlating to POAF include age, hypertension, smoking, CPB time, and EF. Among these factors, multivariate analysis identified old age and low EF as the independent risk factors associated with POAF. Particular care should be taken in the perioperative period for these patients in the prevention of POAF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 10","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459377","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}