Circulation最新文献

{"title":"Response by Jaber et al to Letter Regarding Article, \"Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial\".","authors":"Wissam A Jaber,Carin F Gonsalves,Stefan Stortecky,Jay Giri,C Michael Gibson","doi":"10.1161/circulationaha.125.075457","DOIUrl":"https://doi.org/10.1161/circulationaha.125.075457","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"199 1","pages":"e271-e272"},"PeriodicalIF":37.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter by White et al Regarding Article, \"Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial\".","authors":"R James White,Dominick Roto,Daniel Lachant","doi":"10.1161/circulationaha.124.073132","DOIUrl":"https://doi.org/10.1161/circulationaha.124.073132","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"199 1","pages":"e269-e270"},"PeriodicalIF":37.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidance for Incorporating FDA Processes into the ACC/AHA Clinical Practice Guideline Methodology: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.","authors":"Hani Jneid,Abdul R Abdullah,Victor A Ferrari,Richard J Kovacs,Debabrata Mukherjee,Daichi Shimbo","doi":"10.1161/cir.0000000000001357","DOIUrl":"https://doi.org/10.1161/cir.0000000000001357","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"11 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening-Detected Atrial Fibrillation and Cardiovascular Outcomes in Working-Age Adults.","authors":"Yuichiro Mori,Mitsuaki Sawano,Shun Kohsaka,Yusuke Tsugawa,Motoko Yanagita,Shingo Fukuma","doi":"10.1161/circulationaha.125.074433","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074433","url":null,"abstract":"BACKGROUNDEarly detection of atrial fibrillation (AF) is essential for preventing ischemic stroke and other cardiovascular complications. However, the incidence and prognosis of AF in the general middle-aged population remain unclear. In Japan, annual health screenings for employees include mandatory ECGs, offering a unique opportunity to fill this evidence gap.METHODSThis retrospective cohort study aimed to evaluate the incidence and subsequent cardiovascular outcomes of screening-detected AF in the general working population in Japan, using the Japan Health Insurance Association database, which covers one-quarter of the working-age population of that country. From individuals 35 to 59 years of age who underwent annual health screenings between April 2015 and March 2020, excluding those with a history of cardiovascular disease, those with initial AF detection upon screening ECGs were identified. The primary outcome was hospitalization for ischemic stroke. The secondary outcomes were all-cause death and hospitalization for heart failure. The association between screening-detected AF and outcomes was evaluated using adjusted subdistribution hazard models compared with matched controls.RESULTSAmong 9.5 million individuals included in our study, 11 790 initial AF cases (42.4 of 100 000 person-years [95% CI, 41.6-43.1]) were detected. Individuals with AF were older (mean age, 50.9 versus 46.3 years) and more likely to be male (91.6% versus 63.6%) compared with non-AF cases. Among these individuals with screening-detected AF, the 3-year incidences of ischemic stroke, all-cause death, and heart failure were 1.83% (95% CI, 1.57-2.09), 0.78% (95% CI, 0.61-0.95), and 3.87% (95% CI, 3.50-4.24), respectively. Compared with age- and sex-matched controls, individuals with AF had a higher risk of incident ischemic stroke (hazard ratio, 5.38 [95% CI, 4.51-6.42]), all-cause death (hazard ratio, 1.98 [95% CI, 1.66-2.36]), and heart failure (hazard ratio, 18.35 [95% CI, 15.10-22.31]).CONCLUSIONSAF was detected in one out of 2400 screening ECGs among the middle-aged population in Japan, with higher relative risks of ischemic stroke and heart failure, compared with those without AF. These findings highlight the association of screening-detected AF with stroke and heart failure, warranting further study into AF as an early sign of heart failure and optimal cardiovascular risk reduction strategies after AF detection in the general middle-aged population.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"17 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 ACC/AHA Clinical Practice Guidelines Core Principles and Development Process: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.","authors":"Catherine M Otto,Abdul R Abdullah,Leslie L Davis,Victor A Ferrari,Stephen Fremes,Debabrata Mukherjee,Lauren Prestera,Boback Ziaeian","doi":"10.1161/cir.0000000000001383","DOIUrl":"https://doi.org/10.1161/cir.0000000000001383","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"41 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Prognostic Significance of Anomalous Origin of a Coronary Artery in Adults.","authors":"Francesco Gentile,Eliana Carapellucci,Vincenzo Uggenti,Valentina Lorenzoni,Francesco Arsì,Giulia Fulceri,Michele Coceani,Angelo Monteleone,Dante Chiappino,Claudio Passino,Alberto Giannoni,Sergio Berti,Michele Emdin,Alberto Clemente","doi":"10.1161/circulationaha.125.074198","DOIUrl":"https://doi.org/10.1161/circulationaha.125.074198","url":null,"abstract":"BACKGROUNDThe clinical significance and outcome predictors of anomalous aortic origin of a coronary artery (AAOCA) in adults remains unclear. Therefore, the aim of this study was to analyze the clinical and prognostic implications of AAOCA in a large cohort of patients undergoing coronary computed tomography angiography (CCTA) in an Italian tertiary referral center.METHODSConsecutive adults with AAOCA identified through CCTA from September 2004 to September 2024 were included. Data on clinical indications of CCTA, AAOCA subtypes, evidence of inducible myocardial ischemia, and concomitant coronary atherosclerotic disease were collected. Patients were followed up for the end points of all-cause mortality and major adverse cardiac events (nonfatal acute coronary syndromes, revascularization procedures, and heart failure hospitalization). Outcomes were compared with matched controls with normal coronary artery anatomy.RESULTSAmong 17 454 CCTAs performed over a span of 20 years, AAOCA was detected in 173 patients (62±15 years of age, n=58 women [34%]). Chest pain (34%) was the most common indication of CCTA. Obstructive coronary atherosclerotic disease was present in 36 patients (21%), and myocardial ischemia was detected in 60% of those (n=62) who underwent functional imaging testing. AAOCA repair was performed in 10 patients (6%), whereas the majority of patients were treated conservatively. After a median 37-month follow-up (17 to 69 months), mortality (P=0.321) and major adverse cardiac events (P=0.392) were similar between patients with AAOCA and controls. Only obstructive coronary atherosclerotic disease was associated with a higher event rate during follow-up, whereas AAOCA subtype and ischemia were not.CONCLUSIONSIn adults with AAOCA, concomitant obstructive coronary atherosclerotic disease is the primary determinant of adverse events. Given the low prevalence of AAOCA and event rates, multicenter registries are needed to refine risk stratification and management of these patients.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"57 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 AHA/ACC Statement on Cost/Value Methodology in Clinical Practice Guidelines (Update From 2014 Statement): A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.","authors":"Dhruv S Kazi,Abdul R Abdullah,Suzanne V Arnold,Anirban Basu,Brandon K Bellows,Khadijah Breathett,Derek S Chew,David J Cohen,Colette DeJong,Paul A Heidenreich,Susan Hennessy,Inmaculada Hernandez,Nicolas Isaza,Karen E Joynt Maddox,Ann Marie Navar,Ankur Pandya,Kendra D Sims,Merilyn S Varghese,Liesl Zühlke","doi":"10.1161/cir.0000000000001377","DOIUrl":"https://doi.org/10.1161/cir.0000000000001377","url":null,"abstract":"AIMThe \"2025 AHA/ACC Statement on Cost/Value Methodology in Clinical Practice Guidelines (Update From 2014 Statement)\" describes a systematic approach for consistent implementation of \"economic value statements\" across ACC/AHA guidelines. It updates the cost-effectiveness threshold and proposes a new level of certainty framework that summarizes the strength of the available evidence. Additionally, it describes how cost-effectiveness analyses (CEAs) can help advance equity in population cardiovascular health.METHODSA focused literature search was conducted from January 9, 2024, to February 2, 2024, encompassing English-language publications related to CEA methodology in PubMed, EMBASE, and the Cochrane Library, with publication dates ranging from 1973 to the present. Additional relevant studies published during the writing process (through June 25, 2024) were also considered by the writing committee.STRUCTUREThis Cost/Value Methodology Statement updates prior guidance regarding the incorporation of evidence from published CEAs into clinical guidelines. It provides guidance for identifying and synthesizing relevant high-quality evidence, developing economic value statements, and communicating level of certainty in such statements. It defines the US cost-effectiveness threshold as $120 000 per quality-adjusted life year gained, highlights special considerations related to cardiovascular drugs and devices, emphasizes health equity considerations when interpreting CEAs, and defines a reference case for future CEAs.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"38 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PYGM Protects Against Myocardial Infarction by Enhancing Glycogenolysis and Facilitating Autophagic Flux.","authors":"Jing Gan,Ruyi Zhao,Dong Zheng,Yue Peng,Maolan Wu,Feifan Sun,Ruike An,Aimin Xu,Maohua Chen,Yulin Li,Wei Lei,Zhuofeng Lin,Fan Wu","doi":"10.1161/circulationaha.124.072312","DOIUrl":"https://doi.org/10.1161/circulationaha.124.072312","url":null,"abstract":"BACKGROUNDPYGM (muscle glycogen phosphorylase), the rate-limiting enzyme in glycogenolysis, plays an indispensable role in maintaining cardiac energy metabolism. However, the role of PYGM in the pathogenesis of myocardial infarction (MI) remains unclear.METHODSThe expression profiles of PYGM in cardiac tissues and plasma samples from subjects with MI were assessed using immunoblotting. The role of PYGM in MI was determined by evaluating the effects of PYGM deficiency and its replenishment through adeno-associated virus-mediated PYGM expression in mice with MI.RESULTSWe found that circulating PYGM levels and their cardiac contents were significantly decreased in patients with MI, which was associated with impaired cardiac function. Loss of PYGM significantly exacerbated MI-induced cardiac dysfunction and damage in mice, and replenishment of PYGM profoundly reversed these adverse effects. Mechanistically, PYGM enhanced glycogenolysis by activating glycolysis and the pentose phosphate pathway, thereby improving cardiac energy homeostasis and mitigating oxidative stress. In addition, PYGM improved MI-induced autophagic flux obstacles and alleviated MI-induced cardiac damage by suppressing the expression of Thbs1 (thrombospondin-1). Moreover, genetic deficiency or pharmacological blockage of autophagy attenuated the protective effects of PYGM against MI-induced cardiac injury, and cardiac-specific knockdown of Thbs1 substantially improved the adverse impact of MI on cardiac dysfunction and damage in PYGM-null mice.CONCLUSIONSPYGM safeguards against MI-induced myocardial injury by stimulating glycogenolysis and promoting autophagic flux, thus preserving myocardial energy homeostasis.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"156 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145127141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longer Shelf Life, Shorter Human Life.","authors":"Dean Ornish","doi":"10.1161/CIRCULATIONAHA.125.076896","DOIUrl":"10.1161/CIRCULATIONAHA.125.076896","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":"843-845"},"PeriodicalIF":38.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Ultraprocessed Foods and Their Association With Cardiometabolic Health: Evidence, Gaps, and Opportunities: A Science Advisory From the American Heart Association.","authors":"Maya K Vadiveloo, Christopher D Gardner, Sara N Bleich, Neha Khandpur, Alice H Lichtenstein, Jennifer J Otten, Casey M Rebholz, Chelsea R Singleton, Miriam B Vos, Selina Wang","doi":"10.1161/CIR.0000000000001384","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001384","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"152 12","pages":"e264"},"PeriodicalIF":38.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}