Clinical Medicine Insights. Cardiology最新文献

{"title":"Best Practices and Key Barriers for Amyloidosis Patient Care at US Specialized Amyloidosis Centers: An Analysis by ARC-ASPIRE.","authors":"Jose Nativi-Nicolau, Johana Fajardo, Alyssa Galloway, Sami Khella, Nisith Kumar, Michaela Liedtke, Isabelle Lousada, Tiffany Patrick, Colleen Moffitt, Lori Klein, Gabriela Tamariz, Karthikeyan Veeraraghavalu, Alexandra Haddad-Angulo","doi":"10.1177/11795468261444669","DOIUrl":"https://doi.org/10.1177/11795468261444669","url":null,"abstract":"<p><strong>Objectives: </strong>Amyloidosis is a group of rare diseases that often manifest in multi-organ symptoms requiring an effective multidisciplinary team of care providers to manage. This study aimed to identify the best practices and key barriers to patient-centric care at US specialized amyloidosis centers (SACs) which have emerged as central hubs for multidisciplinary amyloidosis care.</p><p><strong>Methods: </strong>We conducted and analyzed interviews with 77 stakeholders of amyloidosis diseases, including specialist physicians from 17 SACs across the US, patients, patient advocacy group representatives, and referring physicians.</p><p><strong>Results: </strong>The most commonly mentioned best practices were patient-centric multidisciplinary care, timely intake of new high-risk patients, and responsiveness to patient questions. Expanding local physician education was noted as critical to earlier diagnosis. Fifteen out of 17 SACs are actively involved in clinical trials for amyloidosis treatments. Key barriers to care identified were patient distance to SACs, limited medical records and data sharing, and insurance hurdles. Most SACs keep track of metrics, such as patient volume, patient demographics, time to first appointment, as part of internal or in external registries to measure progress.</p><p><strong>Conclusion: </strong>These findings offer practical insights for optimizing amyloidosis care and highlight the structural and informational gaps that must be addressed to improve access and outcomes.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"20 ","pages":"11795468261444669"},"PeriodicalIF":3.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811734","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":"Comparing Efficacy and Safety of Different Aldosterone Synthase Inhibitors for Hypertension: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Areeba Shoaib, Hafsa Arshad Azam Raja, Pawan Kumar Thada, Ameer Haider Cheema","doi":"10.1177/11795468261436180","DOIUrl":"https://doi.org/10.1177/11795468261436180","url":null,"abstract":"<p><strong>Background: </strong>Hypertension affects over 1.3 billion globally, many remain uncontrolled, and aldosterone synthase inhibitors (ASIs) are emerging as a treatment. This network meta-analysis compared the effectiveness and safety of ASI regimens in hypertensive patients.</p><p><strong>Methods: </strong>PubMed, Cochrane Central, and ScienceDirect were searched till December 2025. We conducted a frequentist network meta-analysis using RStudio version 4.3.3 with the \"meta\" and \"netmeta\" packages. <i>P</i>-scores were used for treatment ranking.</p><p><strong>Results: </strong>Ten randomized controlled trials were included in the analysis. Baxdrostat 1 mg, 2 mg, lorundrostat 100 mg once daily, 12.5 mg twice daily, 25 mg twice daily, 50 mg once daily, 50 mg and escalation to 100 mg, osilodrostat 0.25, 0.5, and 1.0 mg once daily, vicadrostat 10, 20, and 3 mg plus empagliflozin, and 20 mg significantly reduced the systolic blood pressure (SBP), where the baxdrostat 2 mg (<i>P</i>-score = 0.89) was ranked best. Lorundrostat 50 mg once daily, Baxdrostat 1 and 2 mg significantly reduced the diastolic blood pressure (DBP) with Lorundrostat 50 mg once daily ranked best (<i>P</i>-score = 0.84). Adverse events were increased with lorundrostat regimens, but serious adverse events were similar across regimens. Hyperkalemia was more frequent with Baxdrostat 1 and 2 mg and all lorundrostat regimens. Symptomatic hypotension occurred mainly with lorundrostat 50 mg daily.</p><p><strong>Conclusion: </strong>The SBP and DBP were significantly reduced with the baxdrostat and lorundrostat regimens, although the risk of hyperkalemia increased. Adverse events were also higher in the lorundrostat regimens, whereas serious adverse events were comparable.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"20 ","pages":"11795468261436180"},"PeriodicalIF":3.3,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698018","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 Artificial Intelligence Into Digital Health-Optimized Therapeutics for the Remote Cardiac Rehabilitation.","authors":"Xueqi Wan, Limeng Ge, Jinfan Tian, Guanshou Ding, Bingyu Gao, Haoci Geng, Changjiang Ge, Xiantao Song","doi":"10.1177/11795468261421344","DOIUrl":"https://doi.org/10.1177/11795468261421344","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs), which have high morbidity and mortality, have become one of the world's largest public health concerns. Although primary hospitalization can partially relieve symptoms, many patients continue to have poor prognoses and lowered quality of life after discharge. Cardiac rehabilitation (CR) is an important recommendation for patients undergoing cardiac surgery, as well as those who suffer from severe cardiovascular events or chronic cardiac disease. However, standard, center-based CR options tend to be ineffective and hard to access, leading to low compliance. The development of digital health technologies (DHTs), especially wearables-which can be combined with mobile applications-has enabled home-based CR, that is, remote CR. This model has substantially enhanced CR efficiency and patient adherence. With advancements in artificial intelligence (AI), including machine learning (ML) algorithms and deep learning, large-scale data from wearables and other DHTs can be effectively retrieved and interpreted. Further incorporation of AI into DHTs may provide real-time fitness telemonitoring, accurate risk recognition and prediction, individualized exercise recommendations, and improved patient adherence. In this review, we succinctly highlight several applications of both AI and wearables in remote CR, and evaluate their collective roles in patient CR execution from several perspectives. We hope our review will help advance further integration of AI and DHT into home-based CR, and plan to direct future research toward refining the use of AI in new-era digital CR.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"20 ","pages":"11795468261421344"},"PeriodicalIF":3.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442945","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":"Efficacy and Safety of Clopidogrel Versus Aspirin Monotherapy After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.","authors":"Ameer Haider Cheema, Muhammad Hassan Waseem, Zain Ul Abideen, Muhammad Zubair Tahir, Fahad Saleem, Amna Nadeem, Urvah Tauseef, Tahreem Qasim, Sania Aimen, Muhammad Bilal Zahid, Pawan Kumar Thada","doi":"10.1177/11795468251414841","DOIUrl":"10.1177/11795468251414841","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is the leading cause of death worldwide. After percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) is recommended to reduce thrombotic events. This meta-analysis assesses the effectiveness of clopidogrel compared to aspirin monotherapy following DAPT post-PCI.</p><p><strong>Methods: </strong>From inception to April 2025, an exhaustive literature search was conducted across electronic databases, including PubMed, Cochrane Library, ScienceDirect, EMBASE, and Web of Science. Risk ratios (RRs) along with 95% confidence intervals (CIs) were pooled using the random-effects model in Review Manager. Leave-one-out sensitivity analysis and funnel plots were used to evaluate heterogeneity and publication bias, respectively.</p><p><strong>Results: </strong>Six studies, including 3 RCTs and 3 observational studies, spanning over 19 494 patients, were included in our analysis. Clopidogrel significantly reduced major adverse cardiovascular events (MACE) (RR = 0.78; 95% CI: [0.69, 0.89]; <i>P</i> = .0002; <i>I</i> ² = 0%) and myocardial infarction (MI) (RR = 0.73; 95% CI: [0.56, 0.94]; <i>P</i> = .02; <i>I</i> ² = 21%) compared to aspirin. Likewise, the clopidogrel group demonstrated a substantial advantage in reducing the incidence of any stroke (RR = 0.66; 95% CI: [0.49, 0.89]; <i>P</i> = .006; <i>I</i> ² = 14%), including ischemic stroke (RR = 0.69; 95% CI: [0.49, 0.97]; <i>P</i> = .04; <i>I</i> ² = 0%). All other endpoints, including hemorrhagic stroke, all-cause mortality, cardiac death, major bleeding, stent thrombosis, repeat, and target vessel revascularization, were comparable between the 2 arms.</p><p><strong>Conclusion: </strong>Clopidogrel significantly reduced the incidence of MACE, MI, and stroke after DAPT following PCI compared to aspirin, indicating greater effectiveness. However, the main conclusion of this meta-analysis depends primarily on the estimates from RCTs. Additional randomized studies are necessary to confirm these results and support clinical decision-making.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"20 ","pages":"11795468251414841"},"PeriodicalIF":3.3,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12813258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009178","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":"Protecting the Heart in Motion: The Role of Physical Activity and Cardiorespiratory Fitness in Preventing Sudden Cardiac Death.","authors":"Setor K Kunutsor, Khushmanjot Kaur, Jari A Laukkanen","doi":"10.1177/11795468251391010","DOIUrl":"10.1177/11795468251391010","url":null,"abstract":"<p><p>Sudden cardiac death (SCD) remains one of the most devastating manifestations of cardiovascular disease. While traditional risk stratification has focused on structural heart disease and electrophysiological markers, growing evidence suggests that modifiable lifestyle factors-particularly physical activity (PA) and cardiorespiratory fitness (CRF)-play a critical role in mitigating the risk of SCD. This narrative review synthesizes evidence on the associations between PA, CRF, and SCD risk. It explores potential biological mechanisms underlying these relationships, identifies key gaps in the literature, and discusses the clinical and public health implications. A substantial body of prospective cohort studies and meta-analyses demonstrates a strong, inverse, and dose-dependent association between both PA and CRF and the risk of SCD. Engaging in ⩾4 hours/week of moderate-to-vigorous PA or achieving CRF levels of ⩾8 to 10 METs is associated with 40% to 50% reductions in SCD risk. CRF also modifies the risk conferred by traditional cardiovascular risk factors such as hypertension, diabetes, and systemic inflammation. Proposed mechanisms include favorable modulation of cardiovascular risk profiles, improved autonomic regulation, anti-arrhythmic and anti-ischemic effects, and enhanced myocardial function. However, evidence gaps persist regarding causal inference (absence of Mendelian randomization studies), optimal PA and CRF thresholds, sex- and age-specific effects, and interactions with other risk factors. PA and CRF are powerful, modifiable predictors of SCD and should be integrated into preventive strategies and routine clinical assessments. Targeted interventions to increase PA and improve CRF, especially among underrepresented and high-risk groups, offer an important opportunity to reduce the burden of SCD globally.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"19 ","pages":"11795468251391010"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145803075","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":"Congenital Heart Defects and Skeletal Malformations Syndrome (CHDSKM) Associated with the <i>ABL1</i> Gene in a Peruvian patient: Case Report.","authors":"Daniel Arauco-Lázaro, Nelson D Purizaca-Rosillo, Miguel A Rojas-Huillca, Salomón Vásquez-Villanueva, Ericson L Gutierrez","doi":"10.1177/11795468251406974","DOIUrl":"10.1177/11795468251406974","url":null,"abstract":"<p><p>We present the clinical case of a 20-year-old male patient who presented recurrent pneumothorax on 5 occasions; in addition, he revealed a history of skeletal malformations in the hands and joint hypermobility. A genetic panel for connective tissue disorders was performed, in which a heterozygous variant in the gene was detected <i>ABL1</i>: (NM_007313.2): c.199T>C (p.Trp67Arg), which was classified as probably pathogenic, which is why the diagnosis of Heart Defects and Skeletal Malformations Syndrome was confirmed (CHDSKM).</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"19 ","pages":"11795468251406974"},"PeriodicalIF":3.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12708980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780625","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":"Agreement Between Cardiovascular Risk Assessment Models (SCORE2, Framingham, ASCVD-2013, and SCORE2-OP) in Adults Aged 70 Years or Older: A Population-Based Study.","authors":"Cristian Orlando Porras Bueno, Hector Henry Lindarte Vargas, Maria Paula Ravagli Baquero, Fabian Gil, Oscar Mauricio Muñoz Velandia, Ángel Alberto García Peña","doi":"10.1177/11795468251406976","DOIUrl":"10.1177/11795468251406976","url":null,"abstract":"<p><strong>Background: </strong>Despite several prediction models to estimate cardiovascular risk (CVR) being available, most have been developed and validated in populations under 70 years of age. To improve this estimation in older adults aged 70 years or older, the SCORE2-OP model was developed; however, its application outside Europe may under- or overestimate true CVR.</p><p><strong>Objective: </strong>To assess the concordance between the CVR measured by 4 widely used CVR tools (Framingham, ASCVD-2013, SCORE2) and the SCORE2-OP in older adults aged ⩾ 70 years.</p><p><strong>Methods: </strong>Secondary analysis of adults aged ⩾ 70 years from the SABE Colombia study, which was conducted between April and September 2015. The concordance between the 4 different CVR prediction models and SCORE2-OP was assessed via Cohen's quadratically weighted kappa coefficient and Lin's concordance correlation coefficient.</p><p><strong>Results: </strong>Among the 23 694 participants in the SABE Colombia study, 23 108 were excluded due to insufficient data to estimate the CVR for any of the tools evaluated. 586 individuals met the inclusion criteria and were analyzed. The concordance between the ASCVD-2013 (weighted kappa 0.24; 95% CI 0.22-0.26) and Framingham algorithms (0.22; 95% CI 0.20-0.24) calibrated to the Colombian population and SCORE2-OP were both classified as fair. In contrast, agreement between SCORE2 calibrated for Colombia and SCORE2-OP reached a moderate level (0.43; 95% CI 0.40-0.46). Higher values were observed compared with the SCORE2-OP model developed for intermediate-risk regions.</p><p><strong>Conclusions: </strong>Our results suggest that, among adults aged ⩾ 70 years, there is variable agreement between widely used CVR prediction models and SCORE2-OP, with the latter overestimating CVR compared to nationally validated CVR scores. This highlights the need for region-specific validation to ensure accurate estimation of CVR in this population.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"19 ","pages":"11795468251406976"},"PeriodicalIF":3.3,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773822","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":"Coronary Revascularization in the Era of TAVR: Timing, Strategy, and Outcomes.","authors":"Avery Love, Chandler O'Leary, Shahman Shahab","doi":"10.1177/11795468251395832","DOIUrl":"10.1177/11795468251395832","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is prevalent among patients undergoing transcatheter aortic valve replacement (TAVR), complicating clinical decision-making regarding optimal timing of percutaneous coronary intervention (PCI). Despite widespread clinical experience, there is ongoing controversy and limited consensus regarding when PCI, before, during, or after TAVR, offers the best risk-benefit balance.</p><p><strong>Objective: </strong>To synthesize and critically evaluate the current evidence on different PCI timing strategies in patients undergoing TAVR and to identify areas of uncertainty and clinical complexity.</p><p><strong>Review: </strong>Randomized trials, including ACTIVATION and NOTION-3, have yielded mixed findings, highlighting a modest reduction in ischemic events with pre-TAVR PCI but increased procedural bleeding risks. Observational registries (REVASC-TAVI and the National Readmissions Database) have similarly shown that pre- and peri-TAVR PCI strategies carry heightened risks of complications without clear long-term mortality benefits. Recent meta-analyses reinforce these findings, indicating that no PCI timing strategy conclusively outperforms others in reducing long-term mortality. Key considerations such as anatomical complexity, frailty, bleeding risk, and valve type significantly influence optimal PCI timing.</p><p><strong>Conclusion: </strong>Current evidence supports a personalized, patient-centered approach to PCI timing in TAVR candidates, emphasizing careful consideration of individual anatomical and clinical factors rather than a standardized timing protocol. Further research exploring advanced risk stratification, imaging modalities, and long-term clinical outcomes is essential to refine current guidelines and practice.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"19 ","pages":"11795468251395832"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12669480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667232","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 Rule of 7\": A Case of an Ambitious Master Duatlonist Who Experienced a Sudden Cardiac Arrest.","authors":"Łukasz Małek, Mariusz Kłopotowski","doi":"10.1177/11795468251396709","DOIUrl":"10.1177/11795468251396709","url":null,"abstract":"<p><p>One of the solutions to decrease the frequency of sudden cardiac arrest (SCA) in athletes is cardiovascular screening in the form of pre-participation tests (PPT). It is especially frustrating when SCA affects an athlete who has recently undergone PPT without any alarming findings. In our case, a 44-year-old ambitious amateur duathlete who underwent PPT within a year experienced SCA at home after an intensive weekend of training. It was related to a coincidence of new disease and other risk factors. PPT cannot be viewed as an unconditional green light for training and competition.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"19 ","pages":"11795468251396709"},"PeriodicalIF":3.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596004","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":"Prothrombin Complex Concentrate Versus Fresh Frozen Plasma in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Ameer Haider Cheema, Areeba Shoaib, Aiman Waheed, Muhammad Mukhlis, Barka Sajid, Sania Aimen, Pawan Kumar Thada","doi":"10.1177/11795468251391024","DOIUrl":"10.1177/11795468251391024","url":null,"abstract":"<p><strong>Background: </strong>Excessive bleeding and coagulopathy frequently occur after cardiac surgery, and Fresh Frozen Plasma (FFP) remains the standard treatment. Prothrombin Complex Concentrates (PCC) present a potential alternative; however, their effectiveness and safety compared to FFP remain uncertain.</p><p><strong>Methods: </strong>Electronic databases, including PubMed, Cochrane Central, and ScienceDirect, were searched from inception till April 2025. The risk ratios (RR) and mean differences (MD) were pooled using the random-effects model in Review Manager software for the dichotomous and continuous outcomes, respectively. Leave-one-out sensitivity analysis and GRADE assessment were performed to evaluate the cause of heterogeneity and assess the certainty of evidence, respectively. Publication bias was evaluated visually through funnel plots and statistically through Egger's regression test.</p><p><strong>Results: </strong>This meta-analysis included 9 studies-comprising 4 randomized controlled trials and 5 observational studies-covering a total of 1920 patients. PCC is associated with a significant reduction in chest tube drainage output within 24 hours compared to FFP (MD -170.05, 95% CI, -253.54 to -86.56; <i>P</i> < .0001; <i>I</i> ² = 38%). Similarly, the number of RBC units transfused (MD -1.06, 95% CI, -1.57 to -0.55, <i>P</i> < .0001; <i>I</i> ² = 45%) and number of patients requiring RBC transfusion (RR 0.84, 95% CI, 0.77-0.92; <i>P</i> < .0001; <i>I</i> ² = 47%) within first 24 hours are both reduced significantly in the PCC arm. Other outcomes including stroke (RR 1.03, 95% CI, 0.63-1.69; <i>P</i> = .90; <i>I</i> ² = 0%), thromboembolic events (RR 1.11, 95% CI, 0.76-1.64; <i>P</i> = .59; <i>I</i> ² = 0%), and all-cause mortality within 30 days (RR 1.03, 95% CI 0.73-1.45; <i>P</i> = .87; <i>I</i> ² = 0%) were comparable between both groups.</p><p><strong>Conclusion: </strong>PCC significantly reduced the chest tube drainage output along with the number of RBC units transfused and the number of patients requiring RBC transfusion within the first 24 hours. In contrast, stroke, other thromboembolic events, and all-cause mortality were comparable between the 2 groups.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"19 ","pages":"11795468251391024"},"PeriodicalIF":3.3,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12639227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585973","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}