Clinical Research in Cardiology最新文献

{"title":"Cardiac implantable electronic device carriers undergoing transcatheter tricuspid valve annuloplasty: real-world insights.","authors":"Jan M Wrobel, Johannes Kirchner, Kai Friedrichs, Thorsten Gietzen, Jan Althoff, Caroline Hasse, Philipp von Stein, Jonas Wörmann, Jennifer von Stein, Jonathan Curio, Felix Rudolph, Maria Ivannikova, Christos Iliadis, Daniel Steven, Stephan Baldus, Volker Rudolph, Roman Pfister, Muhammed Gerçek, Maria I Koerber","doi":"10.1007/s00392-025-02616-5","DOIUrl":"10.1007/s00392-025-02616-5","url":null,"abstract":"<p><strong>Background: </strong>Transtricuspid cardiac implantable electronic devices (CIEDs) complicate the management of tricuspid regurgitation (TR). Transcatheter tricuspid valve annuloplasty (TTVA) offers a promising approach due to minimal interaction with leaflets and transvalvular CIEDs, though real-world evidence is limited.</p><p><strong>Methods: </strong>This bi-center, retrospective study includes 204 consecutive patients who underwent TTVA with the Cardioband (Edwards Lifesciences) for severe symptomatic TR. Patients were divided into CIED carriers and non-CIED carriers. CIED carriers were further classified into those with lead-associated TR (LTR-A) and those with TR unrelated to CIED leads (LTR-B).</p><p><strong>Results: </strong>Among the 204 patients, 41 (20%) were CIED carriers. Of these, 24% had mixed TR etiology (functional and LTR-A), while 76% had predominantly functional TR (LTR-B). Compared to non-CIED-carriers, CIED carriers were more symptomatic (NYHA-FC > II; 93% vs. 89%; p = 0.026) with comparable TR severity at baseline. Intraprocedural success according to the Tricuspid Valve Academic Research Consortium was 68% in CIED carriers and 70% in non-CIED carriers (p = 0.851). LTR-A was associated with poorer TR reduction immediately after TTVA (p = 0.022). Overall safety was comparable, with right ventricular lead dislodgement occurring in one patient. Beyond that, CIED function remained unimpaired. At 30 days, echocardiographic follow-up showed comparable TR reduction (TR ≤ II: 56% vs. 68%; p = 0.219) and NYHA-FU ≤ II (63% vs. 70%; p = 0.524) in CIED-and non-CIED carriers, respectively.</p><p><strong>Conclusions: </strong>TTVA achieves significant TR reduction, providing a safe and effective therapeutic option for TR treatment in CIED carriers. WHAT IS KNOWN?: TTVA using the Cardioband has been approved for severe, symptomatic TR patients, however data on the safety and efficacy in CIED carriers is lacking. WHAT THE STUDY ADDS?: Intraprocedural success and safety were comparable in CIED and non-CIED carriers treated with TTVA. Subgroup analyses showed a trend towards worse outcome and efficiency of TTVA in patients with LTR-A. Postinterventional CIED interrogations did not show critical technical issues.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"878-891"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the editor: \"cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel disease\" (CRCD-D-24-01694).","authors":"Maximilian Fenski, Jeanette Schulz-Menger","doi":"10.1007/s00392-025-02600-z","DOIUrl":"10.1007/s00392-025-02600-z","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"942"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of GDMT on outcomes after mitral valve edge-to-edge repair stratified by SMR proportionality.","authors":"Lukas Stolz, Daniel Kalbacher, Benedikt Koell, Nicole Karam, Tania Puscas, Marco Metra, Marianna Adamo, Maximilian Spieker, Patrick Horn, Holger Thiele, Tobias Kister, Ralph-Stephan von Bardeleben, Philipp Lurz, Karl-Patrik Kresoja, Christos Iliadis, Roman Pfister, Mohammad Kassar, Fabien Praz, Bruno Melica, Teresa Trenkwalder, Erion Xhepa, Michael Neuss, Christian Butter, Paul Grayburn, Jörg Hausleiter","doi":"10.1007/s00392-025-02599-3","DOIUrl":"10.1007/s00392-025-02599-3","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"939-941"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of a smaller spacer in the PASCAL Ace on residual mitral valve orifice area.","authors":"Michael Paukovitsch, Dominik Felbel, Marijana Tadic, Mirjam Keßler, Jinny Scheffler, Matthias Gröger, Sinisa Markovic, Wolfgang Rottbauer, Leonhard Moritz Schneider","doi":"10.1007/s00392-023-02368-0","DOIUrl":"10.1007/s00392-023-02368-0","url":null,"abstract":"<p><strong>Background: </strong>Mitral transcatheter edge-to-edge repair (M-TEER) is an established treatment for functional mitral regurgitation (FMR) associated with a risk of creating iatrogenic stenosis.</p><p><strong>Objectives: </strong>To investigate the impact of the P10 and its larger spacer compared to the narrower Ace and its smaller spacer on reduction of mitral valve orifice area (MVOA) during M-TEER.</p><p><strong>Methods: </strong>Consecutive patients undergoing M-TEER for treatment of severe FMR were screened retrospectively. Patients with a single PASCAL device implantation within the central segments of the MV leaflets, non-complex anatomy, and baseline MVOA ≥ 3.5cm² were selected. Intraprocedural transesophageal echocardiography was used to compare MVOA reduction with 3D multiplanar reconstruction and direct planimetry. Device selection did not follow a prespecified MVOA threshold.</p><p><strong>Results: </strong>Seventy-two patients (81.0 years, IQR {74.3-85.0}) were included. In 32 patients, the P10 was implanted (44.4%). MR severity (p = 0.66), MR reduction (p = 0.73), and body surface area (p = 0.56) were comparable. Baseline MVOA tended to be smaller in P10 patients with the larger spacer (5.0 ± 1.1 vs. 5.4 ± 1.3cm², p = 0.18), however, residual MVOA was larger in these patients (2.7 ± 0.7 vs. 2.3 ± 0.6cm², p = 0.03). Accordingly, relative MVOA reduction was significantly less in P10 patients (- 45.9 ± 7.6 vs. - 56.3 ± 7.0%, p < 0.01). Indirect annuloplasty was more pronounced in Ace patients whereas mean transmitral gradients were similar.</p><p><strong>Conclusion: </strong>In FMR patients with non-complex anatomy, the larger spacer of the P10 maintains greater MVOA with similar MR reduction. Hence, the use of the PASCAL Ace device in patients with small MVOAs might correlate with a risk of both clinically relevant orifice reduction and even iatrogenic stenosis.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"809-817"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139544940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty, periinterventional complications and outcome in patients undergoing percutaneous mitral and tricuspid valve repair.","authors":"Matthieu Schäfer, Hannah Nöth, Clemens Metze, Christos Iliadis, Maria Isabel Körber, Marcel Halbach, Stephan Baldus, Roman Pfister","doi":"10.1007/s00392-024-02397-3","DOIUrl":"10.1007/s00392-024-02397-3","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common in elderly and multimorbid patients and associated with increased vulnerability to stressors.</p><p><strong>Methods: </strong>In a single centre study frailty according to Fried criteria was assessed in consecutive patients before transcatheter mitral and tricuspid valve repair. Postprocedural infections, blood transfusion and bleeding and renal failure were retrospectively assessed from records. Median follow-up time for survival was 560 days (IQR: 363 to 730 days).</p><p><strong>Results: </strong>90% of 626 patients underwent mitral valve repair, 5% tricuspid valve repair, and 5% simultaneous mitral and tricuspid valve repair. 47% were classified as frail. Frailty was associated with a significantly increased frequency of bleeding (16 vs 10%; p = 0.016), blood transfusions (9 vs 3%; p =  < 0.001) and infections (18 vs 10%; p = 0.006), but not with acute kidney injury (20 vs 20%; p = 1.00). Bleeding and infections were associated with longer hospital stays, with a more pronounced effect in frail patients (interaction test p < 0.05, additional 3.2 and 4.1 days in frail patients, respectively). Adjustment for the occurrence of complications did not attenuate the increased risk of mortality associated with frailty (HR 2.24 [95% CI 1.62-3.10]; p < 0.001).</p><p><strong>Conclusions: </strong>Bleeding complications and infections were more frequent in frail patients undergoing transcatheter mitral and tricuspid valve repair and partly explained the longer hospital stay. Albeit some of the complications were associated with higher long-term mortality, this did not explain the strong association between frailty and mortality. Further research is warranted to explore interventions targeting periprocedural complications to improve outcomes in this vulnerable population.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"827-835"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139734593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair.","authors":"Isabel A Hoerbrand, Martin J Kraus, Martin Gruber, Nicolas A Geis, Philipp Schlegel, Norbert Frey, Mathias H Konstandin","doi":"10.1007/s00392-024-02517-z","DOIUrl":"10.1007/s00392-024-02517-z","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter edge-to-edge repair for severe tricuspid regurgitation (TR) is a new treatment option (t-TEER). Data on optimal antithrombotic therapy after t-TEER in patients with an indication for anticoagulation are scarce and evidence-based guideline recommendations are lacking. We sought to investigate efficacy and safety of novel oral anticoagulation (NOAC) and vitamin-K-antagonists (VKA) in patients undergoing t-TEER.</p><p><strong>Methods: </strong>Among 78 consecutive patients with t-TEER of severe TR, 69 patients were identified with concomitant indication for oral anticoagulation. Outcomes of these patients treated with NOAC or VKA were compared over a median follow-up period of 327 (177-460) days.</p><p><strong>Results: </strong>Despite elevated thromboembolic and bleeding risk scores (CHA₂DS₂-VASc 4.2 ± 1.1, HEMORR₂HAGES 3.0 ± 1.0 and HAS-BLED 2.1 ± 0.8), only one major bleeding incidence occurred under NOAC therapy. The risk for overall (NOAC 8% vs. VKA group 26%, p = 0.044) and major bleeding events (NOAC 2% vs. VKA 21%, p = 0.010) was significantly lower in the NOAC compared to the VKA group. No significant difference was found between NOAC and VKA treatment in terms of mortality (NOAC 18% vs. VKA 16%, p = 0.865) or the combined endpoint of death, heart failure hospitalization, stroke, embolism, thrombosis, myocardial infarction, and severe bleeding (NOAC 48% vs. VKA 42%, p = 0.801). A comparison between apixaban (n = 27) and rivaroxaban (n = 16) treated patients revealed no significant differences between NOAC substances (all bleeding events apixaban 7% vs. rivaroxaban 13%, p = 0.638).</p><p><strong>Conclusion: </strong>Results of this study indicate that NOACs may offer a favorable risk-benefit profile for patients with concomitant indication for anticoagulation therapy following t-TEER.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"846-855"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve unit instead of intensive or intermediate care unit admission following transcatheter edge-to-edge mitral valve repair is safe and reduces postprocedural complications.","authors":"Matthias Gröger, Dominik Felbel, Michael Paukovitsch, Leonhard Moritz Schneider, Sinisa Markovic, Wolfgang Rottbauer, Mirjam Keßler","doi":"10.1007/s00392-024-02384-8","DOIUrl":"10.1007/s00392-024-02384-8","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter edge-to-edge mitral valve repair (M-TEER) is often performed in general anesthesia, and postprocedural monitoring is usually warranted on an intensive or intermediate care unit (ICU/IMC). We evaluated the implications of a dedicated valve unit (VU) instead of an ICU/IMC for monitoring after M-TEER.</p><p><strong>Methods and results: </strong>In total, 624 patients were retrospectively analyzed. A total of 312 patients were primarily transferred to either ICU or IMC following M-TEER, and 312 patients were scheduled for the VU in the absence of indications for ICU/IMC treatment. Hospital stay was significantly shorter in VU patients (median 6.0 days (interquartile range (IQR) 5.0 - 8.0) vs. 7.0 days (IQR 6.0 - 10.0), p < 0.001) and their risk for infections (2.9 vs. 7.7%, p = 0.008) and delirium (0.6 vs. 2.6%, p = 0.056) was substantially lower compared to ICU/IMC patients. In-hospital mortality was similar in both groups (0.6% vs. 1.3%, p = 0.41). Fifty patients (16.0%) in the VU group had to cross over to unplanned ICU/IMC admission. The most frequent indication was prolonged need for catecholamines (52.0%). Patients with ICU/IMC crossover had more advanced stages of heart failure (LV-EF < 30% in 36.0 vs. 16.0%, p = 0.001; severe concomitant tricuspid regurgitation in 48.0 vs. 27.8%, p = 0.005) and an LV-EF < 30% was independently associated with unplanned ICU/IMC admission.</p><p><strong>Conclusions: </strong>Following M-TEER postprocedural monitoring on a VU instead of an ICU/IMC is safe, reduces complications, and spares ICU capacities. Patients with advanced heart failure have a higher risk for unplanned ICU/IMC treatment after M-TEER.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"818-826"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of disease-related complications in asymptomatic mitral regurgitation: a health insurance claims analysis.","authors":"L Acar, C A Behrendt, S Baldus, V Falk, N Smetak, M Mboulla Nzomo, U Marschall, E Girdauskas","doi":"10.1007/s00392-024-02532-0","DOIUrl":"10.1007/s00392-024-02532-0","url":null,"abstract":"<p><strong>Background and aims: </strong>The impact of mitral regurgitation (MR) in asymptomatic patients is not well defined. We aimed to determine the prevalence of MR-related complications and their association with 10-year survival in a large unselected asymptomatic MR cohort.</p><p><strong>Methods: </strong>Health insurance claims data from Germany's second largest health insurance fund, BARMER, which maintains longitudinal data on 8.7 million German residents, were retrospectively analyzed. All patients with an outpatient diagnosis of MR in a minimum of two quarters during a calendar year and first recorded diagnosis between 2008 and 2011 were included. Patients with any complication attributable to MR or mitral valve intervention at index were excluded. Outcomes were compared between study group and age- and sex-matched controls (i.e., without known cardiac disease). MR-related complications of interest were new congestive heart failure, new-onset atrial fibrillation, pulmonary hypertension, or cardiac decompensation.</p><p><strong>Results: </strong>A total of 56,577 individuals (median age 68 years, 67% female) with asymptomatic MR were identified. At 10 years, MR-related complications were more frequent in the study group vs. control group (46.5% vs. 20.8%, OR 3.31, P < 0.0001). Furthermore, MR-related complications were more common in male vs. female patients with an asymptomatic MR (OR 2.65, P < 0.0001). The occurrence of at least one MR-related complication was associated with a reduced 10-year survival (OR 1.80, P < 0.0001).</p><p><strong>Conclusions: </strong>Almost half of patients with asymptomatic MR experience complications during a 10 year follow-up which result in impaired survival. These results imply the necessity of long-term disease management program. Furthermore, decision-making process and timing for mitral valve intervention in asymptomatic patients should be reevaluated.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"856-866"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: \"Cardiovascular magnetic resonance reveals myocardial involvement in patients with active stage of inflammatory bowel disease\".","authors":"Syeda Rabika, Syeda Sidra Mudassir, Muhammad Maaz, Syed Hussain","doi":"10.1007/s00392-025-02605-8","DOIUrl":"10.1007/s00392-025-02605-8","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"943-944"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188548","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":"C-reactive protein-to-albumin ratio is associated with mortality after transcatheter tricuspid valve repair.","authors":"Karl Finke, Laura Marx, Jan Althoff, Thorsten Gietzen, Matthieu Schäfer, Jan Wrobel, Philipp von Stein, Jennifer von Stein, Maria Isabel Körber, Stephan Baldus, Roman Pfister, Christos Iliadis","doi":"10.1007/s00392-025-02641-4","DOIUrl":"10.1007/s00392-025-02641-4","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter tricuspid valve repair (TTVr) is a treatment option for tricuspid regurgitation (TR) in patients with high surgical risk. Given the heterogeneity in clinical benefit, there is a need for markers to assess mortality risk in patients undergoing TTVr. The C-reactive protein (CRP)/albumin ratio (CAR) is a marker of systemic inflammation and reduced nutritional status, which can both occur in TR.</p><p><strong>Methods: </strong>Consecutive patients undergoing TTVr at a tertiary care center were retrospectively analyzed. Serum CRP and albumin were collected at baseline. Intraprocedural success (IS) was defined according to TVARC criteria. The primary outcome of all-cause mortality was assessed up to 2 years after TTVr.</p><p><strong>Results: </strong>A total of 215 patients (69% females, median age 80 years) were identified. IS was achieved in 61% of patients. AUC of CAR for 2-year mortality was 0.695, with an optimal threshold of 1.2945 (Youden index) dividing patients in high CAR (n = 93) and low CAR (n = 122) groups. In the high CAR group, the primary endpoint occurred more frequently (43% vs 15%, p < 0.001) and significantly higher right atrial pressure, worse renal function, and less IS during TTVr were observed. High CAR was independently associated with an increased mortality risk even when adjusted for renal and liver function, right-ventricular function, and procedural failure (HR 2.188; 95%CI 1.2-3.9; p = 0.011).</p><p><strong>Conclusion: </strong>Higher CAR reflects patients with advanced right-heart failure and extracardiac organ damage and is associated with mortality after TTVr. CAR is derived from readily available parameters and may be useful additive to established risk scores.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":"892-903"},"PeriodicalIF":3.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}