Clinical Research in Cardiology最新文献

{"title":"The prognostic value of systemic inflammatory response index (SIRI) in acute coronary syndrome patients treated with primary percutaneous coronary intervention: a meta-analysis and systematic review.","authors":"Chenming Hu, Qianling Ye, Shunjie You, Si Li, Christopher Dostal, Matthias Ernst, Francesco Paneni, Peter Pokreisz, Gabor Tamas Szabo, Attila Kiss, Bruno K Podesser","doi":"10.1007/s00392-026-02889-4","DOIUrl":"https://doi.org/10.1007/s00392-026-02889-4","url":null,"abstract":"<p><strong>Background: </strong>The systemic inflammatory response index (SIRI)-an inflammatory index derived from neutrophil, monocyte, and lymphocyte counts-has shown potential in predicting cardiovascular risk. However, its prognostic value in patients with acute coronary syndrome (ACS) treated with primary percutaneous coronary intervention (pPCI) remains unclear. This study was aimed at evaluating the prognostic significance of SIRI in this specific high-risk population.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Embase, and The Cochrane Library up to June 2025 to identify all relevant studies about SIRI applied to patients with ACS after pPCI. The primary outcome was all-cause mortality. Among major adverse cardiovascular events (MACE), new-onset acute myocardial infarction (AMI), revascularization, and stroke were included as secondary outcomes. Risk estimates were pooled as odds ratios (OR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A total of nine studies involving 7679 patients were included. The pooled analysis demonstrated that an elevated SIRI was a significant predictor for both all-cause mortality (OR 3.32; 95% CI 1.29 to 8.54; p = 0.01), MACE (OR 2.45; 95% CI 1.74 to 3.45; p = 0.001), new-onset AMI (OR 1.86; 95% CI 1.25 to 2.77; p = 0.001), and myocardial revascularization (OR 1.64; 95% CI 1.35 to 1.98; p = 0.001).</p><p><strong>Conclusions: </strong>Our meta-analysis demonstrates that an elevated SIRI is a useful predictor of all-cause mortality, MACE, new-onset AMI, and revascularization in patients with ACS undergoing PCI. As a simple and cost-effective index, SIRI shows significant potential for early risk stratification and may help guide clinical management in this patient population.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to surgical bailout and mortality in complicated transcatheter aortic valve replacement.","authors":"Tobias Zeus, Ayse S Ceylan, Kathrin Klein, Christian Jung, Amin Polzin, Bedri Ramadani, Maximilian Scherner, Christina Ballazs, Dmytro Stadnik, Stephan Sixt, Peter Kienbaum, Artur Lichtenberg, Malte Kelm","doi":"10.1007/s00392-026-02851-4","DOIUrl":"https://doi.org/10.1007/s00392-026-02851-4","url":null,"abstract":"<p><strong>Background and aims: </strong>Surgical bailout during transcatheter aortic valve replacement (TAVR) is rare but highly critical. We evaluated the impact of hospital infrastructure, procedural setting, timing metrics, and haemodynamic stability on patients requiring emergent surgical bailout.</p><p><strong>Methods: </strong>A single-centre analysis was conducted on consecutive TAVR cases requiring emergent surgical bailout between 2009 and 2024. Two eras were compared: Era 1 (2009-2016), with procedures performed in a conventional catheterisation laboratory (CCL) requiring transfer to a distant operating room, and Era 2 (2017-2024), using a purpose-built hybrid operating room (HOR) with all disciplines on site. The primary endpoint was in-hospital mortality. Secondary endpoints included time to extracorporeal life support (ECLS) initiation and surgical incision.</p><p><strong>Results: </strong>Of 3039 TAVR procedures, 16 patients (0.53%) required surgical bailout (10 in Era 1, 6 in Era 2). In-hospital mortality was 100% in the CCL group versus 33.3% in the HOR group (P < 0.01). While time to ECLS was similar, time to surgical intervention was significantly shorter in the HOR group. All HOR patients received definitive surgical treatment, whereas 60% of CCL patients died before surgery could be initiated. Haemodynamic instability prior to conversion differed significantly between groups.</p><p><strong>Conclusions: </strong>Surgical bailout during TAVR is rare, but associated mortality remains high. Bailout performed in a HOR was associated with shorter delays to surgical incision and improved outcomes, with haemodynamic stability at the time of conversion emerging as an important factor associated with survival. These findings highlight the potential relevance of minimising time to surgery through optimised infrastructure, such as a HOR.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter mitral valve edge-to-edge repair for severe mitral regurgitation in patients with HFpEF phenotype.","authors":"Johannes Dohr, Clemens Metze, Maria Isabel Körber, Matthieu Schäfer, Stephan Nienaber, Jonathan Curio, Richard Nies, Stephan Baldus, Roman Pfister, Christos Iliadis","doi":"10.1007/s00392-026-02882-x","DOIUrl":"https://doi.org/10.1007/s00392-026-02882-x","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of heart failure with preserved ejection fraction (HFpEF) is often accompanied by mitral regurgitation (MR). Transcatheter edge-to-edge repair (M-TEER) is established for treating MR in heart failure with reduced ejection fraction (HFrEF), but its impact in patients with HFpEF phenotype is unclear.</p><p><strong>Aim: </strong>To investigate the effect of M-TEER in patients with HFpEF phenotype and concomitant MR based on diagnostic criteria according to current ESC guidelines and established HFpEF scores.</p><p><strong>Methods: </strong>181 patients with severe MR underwent M-TEER at our center with HFpEF phenotype. Echocardiography, symptom burden (NYHA class), quality of life (MLWHFQ, SF-PCS, and functional capacity (6MWD) were assessed before and 30 days after M-TEER. Survival and rehospitalisation rates were assessed at long-term follow-up.</p><p><strong>Results: </strong>M-TEER in patients with HFpEF phenotype significantly reduced MR grade and improved symptom burden, quality of life, and exercise capacity. Patients with either primary or secondary MR experienced clinically relevant symptomatic improvement for MLWHFQ (69%) and SF-PCS (60%) as well clinically relevant increase (44%) of the 6MWD. The clinical outcome between patients with primary or secondary MR was comparable. Severe tricuspid regurgitation (TR) complicating HFpEF was independently linked to an increased mortality risk (HR 3.66, 95%CI 1.32-10.15, p = 0.013).</p><p><strong>Conclusion: </strong>M-TEER is an effective treatment for both severe primary and secondary MR in patients with HFpEF phenotype, significantly reducing MR and improving symptoms. The independent association of severe TR with increased all-cause mortality highlights the importance of timely intervention to prevent right heart failure and worse outcomes.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel sirolimus-coated balloon versus a paclitaxel-coated balloon for coronary artery disease: the SELSEQ registry.","authors":"Francesco Tartaglia, Pier Pasquale Leone, Mauro Gitto, Alessandro Gabrielli, Gianmaria Calamita, Leon Gramss, Ottavia F Cozzi, Valentina Bernardini, Marco Luciano Rossi, Gabriele Gasparini, Bernhard Reimers, Damiano Regazzoli, Giulio G Stefanini, Antonio Mangieri, Azeem Latib, Antonio Colombo","doi":"10.1007/s00392-026-02887-6","DOIUrl":"https://doi.org/10.1007/s00392-026-02887-6","url":null,"abstract":"<p><strong>Background: </strong>SELUTION Sustained Limus Release (SEL, Cordis, Miami, Florida, USA) is a novel biodegradable polymer microsphere sirolimus-coated balloon (SCB) characterized by sustained coronary drug retention. A head-to-head comparison to currently available paclitaxel-coated balloons (PCB) is lacking.</p><p><strong>Objective: </strong>To compare clinical outcomes after percutaneous coronary intervention (PCI) with SEL SCB and iopromide-based SeQuent Please/NEO (SEQ, B. Braun, Melsungen, Germany) PCB.</p><p><strong>Methods: </strong>Consecutive all-comer patients undergoing PCI with SEL SCB or SEQ PCB for both de novo lesions and in-stent restenosis between January 2021 and December 2024 at two Italian centers were included in this observational, retrospective, cohort study. The primary endpoint was target lesion failure (TLF), defined as the composite of cardiac death, target vessel myocardial infarction (MI), and target lesion revascularization (TLR) at 12-month follow-up. Inverse probability of treatment weighting was applied to adjust for baseline differences.</p><p><strong>Results: </strong>A total of 487 patients (589 lesions) were included: 250 patients (302 lesions) treated with SEL SCB and 237 patients (287 lesions) with SEQ PCB. At a median follow-up of 403 [223-617] days, the 12-month rate of TLF was similar between SEL SCB and SEQ PCB (4.3% vs. 4.0%; adjusted hazard ratio [aHR]: 0.97; 95% confidence interval [CI]: 0.37-2.52). No significant differences were observed in cardiac death, target vessel MI, or TLR (aHR: 1.23; 95% CI: 0.21-7.19). Results were consistent across prespecified subgroups and sensitivity analyses.</p><p><strong>Conclusions: </strong>The SELSEQ study suggests comparable outcomes at 12-month follow-up among patients undergoing PCI with the biodegradable polymer microsphere SEL SCB and the iopromide-based SEQ PCB.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of renal dysfunction on immediate versus staged revascularization of non-culprit lesions in patients with ST segment elevation myocardial infarction: a pre-specified subgroup analysis of the randomized MULTISTARS AMI trial.","authors":"Miklos Rohla, Kurt Huber, Ferdinando Varbella, Axel Linke, Bettina Schwarz, Stephan B Felix, Moritz Seiffert, Rahel Kesterke, Peter Nordbeck, Bernhard Witzenbichler, Irene M Lang, Mirjam Kessler, Christian Valina, Alban Dibra, Philipp Jakob, Marco Moccetti, Matteo Vercellino, Luise Gaede, Lorenz Bott-Flügel, Julia Stehli, Alessandro Candreva, Francesco Paneni, Christian Templin, Matthias Schindler, Manfred Wischnewsky, Greca Zanda, Giorgio Quadri, Norman Mangner, Aurel Toma, Giulia Magnani, Peter Clemmensen, Thomas F Lüscher, Thomas Münzel, P Christian Schulze, Karl-Ludwig Laugitz, Wolfgang Rottbauer, Franz-Josef Neumann, Steffen Schneider, Thomas Riemer, Franz Weidinger, Stephan Achenbach, Gert Richardt, Adnan Kastrati, Ian Ford, Frank Ruschitzka, Barbara E Stähli","doi":"10.1007/s00392-026-02875-w","DOIUrl":"https://doi.org/10.1007/s00392-026-02875-w","url":null,"abstract":"<p><strong>Background: </strong>Renal dysfunction might affect outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MVD) undergoing percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>In MULTISTARS AMI, patients with STEMI and MVD were randomized to immediate or staged PCI of non-culprit lesions. In this pre-specified analysis, patients were stratified according to the presence of renal dysfunction at baseline, defined at an estimated glomerular filtration rate (eGFR) of 60 ml/min/1.73 m². Patients with an eGFR < 30 ml/min/1.73 m² were excluded from the trial. The primary endpoint was a composite of death, non-fatal myocardial infarction, stroke, unplanned revascularization, or hospitalization for heart failure at 1 year.</p><p><strong>Results: </strong>In MULTISTARS AMI, 108 (13%) of 832 patients had renal dysfunction. The primary endpoint occurred more frequently in patients with renal dysfunction (19.4% vs. 11.2%, unadjusted HR 1.82, 95% CI 1.13-2.94), primarily driven by higher rates of death. Among patients with renal dysfunction, the rates of the primary end point were 14.5% and 24.5% in the immediate and staged PCI groups (unadjusted HR 0.55, 95% CI 0.23-1.33). There was no interaction between renal dysfunction and the randomized treatment assignment with respect to the primary end point (adjusted HR 1.30, 95% CI 0.8-2.20, p_int 0.82). The occurrence of acute renal insufficiency was statistically similar in patients with renal dysfunction who underwent immediate and staged PCI (10.9% vs. 18.9%, unadjusted HR 0.61, 95% CI 0.22-1.72, p_int 0.09). Renal dysfunction at baseline emerged as a strong risk factor for the development of acute renal insufficiency (adjusted HR 5.0, 95% CI 2.30-10.70, p < 0.01).</p><p><strong>Conclusions: </strong>Outcomes with immediate compared to staged multivessel PCI did not appear significantly altered by the presence of renal dysfunction at baseline. (Supported by Boston Scientific; MULTISTARS AMI ClinicalTrials.gov number, NCT03135275).</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of SGLT2 inhibitors in patients with Fabry disease.","authors":"Malte Lenders, Sima Canaan-Kühl, Christine Kurschat, Albina Nowak, Constantin Gatterer, Victoria Sokalski, Fabian Braun, Markus Cybulla, Gere Sunder-Plassmann, Peter Nordbeck, Christoph Wanner, Eva Brand","doi":"10.1007/s00392-026-02886-7","DOIUrl":"https://doi.org/10.1007/s00392-026-02886-7","url":null,"abstract":"<p><strong>Aims: </strong>Fabry disease (FD) is a multisystemic disease affecting the heart and the kidneys of affected patients. In addition to FD-specific treatment, patients require concomitant medication for cardio- and nephroprotection. Sodium-dependent glucose transporter 2 inhibitors (SGLT2i) are recommended for patients with heart failure and/or kidney disease, but efficacy data for FD are scarce.</p><p><strong>Methods and results: </strong>In this multicenter study (n = 8), the effects of SGLT2i therapy after 12 months of treatment in 48 patients (12 females) on FD-specific therapy were examined. Patients were retrospectively analyzed at three time points (before SGLT2i: T_-1; SGLT2i start: T₀; and end of observation: T₊₁). Patients showed advanced cardiac manifestations with a high frequency of left ventricular hypertrophy (LVH) (females: 81.8% and males: 90.0%) at T₀. Males presented with a significantly lower left ventricular ejection fraction LVEF (56 [29-73]% versus 65 [38-78]%; p = 0.0113). There were no treatment-related adverse events or Fabry-associated clinical events (FACEs) between T₀ and T₊₁. Females showed a stable disease course independent of the concomitant treatment with SGLT2i. Males showed an eGFR decrease of 3.7 ml/min/1.73 m² per year (p = 0.0018) before and an ameliorated decrease of 2.7 ml/min/1.73 m² per year (p = 0.0182) after SGLT2i initiation. Importantly, a slight but significant improvement of LVEF by 0.6% per year (p = 0.0319) was observed, which was more prominent in males with a reduced LVEF (< 50%) at baseline.</p><p><strong>Conclusion: </strong>Treatment with SGLT2i of FD patients was safe and patients presented with stable disease courses. Especially males with reduced LVEF might benefit from SGLT2i treatment.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and tolerability of pharmacologic stress with the selective A_2A adenosine receptor agonist regadenoson for the assessment of myocardial ischemia: results from 5780 consecutive patients in a cardiology practice.","authors":"Sigmund Silber, Miriam Keller, Manuela Rippel","doi":"10.1007/s00392-026-02871-0","DOIUrl":"10.1007/s00392-026-02871-0","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the safety and tolerability of regadenoson for pharmacologic stress testing in the context of myocardial scintigraphy under routine clinical conditions in a cardiology practice in 5780 consecutive patients.</p><p><strong>Background: </strong>The drug regadenoson was approved in Germany in 2010 for pharmacological stress testing in myocardial scintigraphy for patients who are unable to undergo adequate physical exercise. Previously, only dipyridamole or adenosine were available for diagnostic pharmacological vasodilation, but they were not approved for this indication.</p><p><strong>Methods: </strong>Data on safety and tolerability were prospectively collected from consecutive patients referred for the assessment of myocardial ischemia using myocardial scintigraphy. Data were immediately entered into a dedicated computer program.</p><p><strong>Results: </strong>After injection of regadenoson, there was a significant mean increase in heart rate from 70.2 ± 12.3 to a maximum of 94.6 ± 17.3 bpm. Systolic blood pressure dropped from 128.9 ± 16.2 to a minimum of 123.3 ± 20.3 mmHg. 86% of patients experienced any adverse effects, with the most frequent being dyspnea (64.2%), followed by headaches (20.7%), a sensation of warmth (20.2%), and numerous other, less frequent sensations. Bronchospasms were not observed, notably not in the 508 patients with COPD/ bronchial asthma. Asystole of > 6 s occurred in 2 patients (0.03%), which were both successfully terminated immediately with theophylline and atropine. There were no fatalities.</p><p><strong>Conclusion: </strong>Overall, regadenoson demonstrated very good tolerability. The development of the selective A_2A adenosine receptor agonist regadenoson, compared to classical non-selective adenosine, represents a significant advancement in non-invasive imaging diagnostics of myocardial ischemia, using myocardial scintigraphy and other modalities such as MRI. Since adenosine is contraindicated in patients with bronchial asthma/COPD, regadenoson has become the diagnostic agent of choice in these cases, although it must be considered that very rare instances (< 0.1%) of life-threatening events can occur, necessitating that antidotes such as theophylline and atropine be readily available.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebuttal to: \"Comment on the CORRECT RADIAL trial: considerations on methodology and interpretation.\" (CRCD-D-26-00099).","authors":"Karsten Schenke, Rostislav Prog, Gerian Grönefeld","doi":"10.1007/s00392-026-02885-8","DOIUrl":"https://doi.org/10.1007/s00392-026-02885-8","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collagen type I degradation peptide as a predictive biomarker for mortality in ST-elevated myocardial infarction.","authors":"Emily M Martin, Elisavet Angeli, Federica Genovese, Martin Frydland, Morten A Karsdal, Jacob Eifer Møller, Christian Hassager","doi":"10.1007/s00392-026-02883-w","DOIUrl":"https://doi.org/10.1007/s00392-026-02883-w","url":null,"abstract":"<p><strong>Background and aims: </strong>Tissue remodelling and extracellular matrix (ECM) changes are primary consequences of ST-elevated myocardial infarction (STEMI), leading to an increased risk of developing heart failure and mortality. Collagen type I is the top constituent of the cardiac ECM and is rapidly degraded at sites of tissue injury occurring in STEMI. We aimed to investigate the prognostic potential of a novel biomarker of a collagen type I-derived signalling peptide (C1SIG) shown to be involved in left ventricular remodelling after MI and compare this against another collagen type I fragment quantified by the established C1M assay in a large STEMI cohort.</p><p><strong>Methods: </strong>Plasma C1SIG and C1M were quantified using specific enzyme-linked immunosorbent assays in 1616 individuals upon admittance to hospital with STEMI. Patients were then followed up for all-cause mortality over 1 year, and survival analyses were performed.</p><p><strong>Results: </strong>Short-term biomarker changes assessed in a subgroup (n = 140) showed increased circulating C1M and C1SIG in the short period from admission with STEMI up to 12 h post-admission (both, p < 0.0001). High C1M levels, defined by the highest quartile, and high C1SIG levels, defined by the median, were associated with reduced survival probability at 1 year (both, p < 0.0001) post-admission. The association was further supported in univariate and maintained for C1M only in multivariate Cox proportional hazard regression models adjusted for multiple confounders (HR [95% CI] 1.46 [1.15-1.85]). Added value analysis determined the additional predictive value of C1M to the clinically used GRACE risk score for cardiovascular event prediction (p = 0.0002).</p><p><strong>Conclusion: </strong>C1M and C1SIG are dynamic biomarkers of collagen type I degradation, where C1SIG is also suspected to be a collagen signal. C1M is an independent predictor of all-cause mortality within a year of a MI.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for morbidity and mortality in Ebstein's anomaly: a registry-based study of 398 patients.","authors":"Stephan Neumann, Luisa K Heneka, Michael Jerosch-Herold, Gerhard Schön, Ulrike M M Bauer, Michael Hübler, Daniel Biermann, Götz Müller, Ines Kowalewski, Martin Munz, Rainer Kozlik-Feldmann, Christoph Sinning, Elvin Zengin, Carsten Rickers","doi":"10.1007/s00392-026-02874-x","DOIUrl":"https://doi.org/10.1007/s00392-026-02874-x","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the long-term outcomes and risk factors for morbidity and mortality in patients with Ebstein's anomaly, including the effects of type and timing of valve surgery.</p><p><strong>Methods: </strong>For this retrospective, record-based study, all patients with Ebstein's anomaly enrolled in the German National Register for Congenital Heart Defects up to June 2021 were eligible for inclusion.</p><p><strong>Results: </strong>Non-surgical patients (n = 194/49% of 398 patients) had less tricuspid valve regurgitation (p < 0.001) and heart failure symptoms (p < 0.001) than surgical patients (n = 204/51%). Postoperative survival at 10, 20, and 30 years was 97%, 93%, and 80%. Eighty-one (40%) patients underwent multiple surgeries. Re-operation rates were lowest in patients with first valve surgery during adolescence (p = 0.0076). Postoperative NYHA class > I was more frequent with surgery delayed to older age (p < 0.001). Initial corrective surgery was complicated by complete atrioventricular block (CAVB) in 17 (9%) of patients. CAVB was more likely with older age (p = 0.001), and tricuspid valve replacement compared to reconstruction (p = 0.029). CAVB was associated with all-cause death (p < 0.001). Cone reconstruction reduced the risk of CAVB (p = 0.008) and tricuspid valve regurgitation (p < 0.001) compared to monocusp reconstruction.</p><p><strong>Conclusions: </strong>This registry-based study of Ebstein's anomaly corroborates good surgical long-term results, while re-operation rates remain high. Patients operated before adolescence were at the highest risk of re-operation, while older age at the time of the first surgery increased the risk of CAVB. The cone reconstruction was associated with improved tricuspid valve function and a lower risk of CAVB compared to monocusp reconstructions. Choosing an optimal time window for surgery and use of the cone reconstruction may therefore further improve outcomes.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}