Clinical Research in Cardiology最新文献

{"title":"Percutaneous left atrial appendage closure for stroke prevention: current challenges and future perspectives.","authors":"Carla Rochira, Alessandro Mazzapicchi, Salvatore Davide Tomasello, Salvatore Adriano Azzarelli, Alessandro Di Giorgio, Francesco Scardaci, Vincenzo Argentino, Francesco Amico","doi":"10.1007/s00392-025-02624-5","DOIUrl":"https://doi.org/10.1007/s00392-025-02624-5","url":null,"abstract":"<p><p>Stroke accounts for significant morbidity and mortality worldwide. Accordingly, appropriate prevention is crucial to reduce the global burden of stroke. Percutaneous left atrial appendage closure (LAAC) is a viable approach for preventing cardioembolic stroke in patients with non-valvular atrial fibrillation who have a contraindication to long-term oral anticoagulation due to a non-reversible cause. In the last 2 decades, percutaneous LAAC has become a rapidly evolving field, with multiple devices approved or under clinical development. However, several issues remain, including limited high-quality evidence, late adverse events, and unclear post-procedural antithrombotic therapy. This review offers an up-to-date perspective on percutaneous LAAC, concentrating on current challenges and unmet needs.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514877","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":"Clinical outcomes after complex and high-risk percutaneous coronary intervention according to baseline chronic kidney disease.","authors":"Francesca Maria Di Muro, Samantha Sartori, Birgit Vogel, Yihan Feng, Mauro Gitto, Angelo Oliva, Prakash Krishnan, Benjamin Bay, Joseph Sweeny, Pedro Moreno, Parasuram Krishnamoorthy, George Dangas, Annapoorna Kini, Samin Sharma, Roxana Mehran","doi":"10.1007/s00392-025-02618-3","DOIUrl":"https://doi.org/10.1007/s00392-025-02618-3","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is associated with unfavorable outcomes in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). However, its prognostic role in patients undergoing complex high-risk PCI (CHIP) remains unexplored, prompting our investigation.</p><p><strong>Methods: </strong>Consecutive CHIP patients treated at a tertiary care center from 2012 to 2022 were included in the current analysis. CHIP was identified by the presence of at least one patient and one procedural criterion from a validated score. Patients were stratified by CKD status, with CKD defined as eGFR < 60 ml/min/1.73m². The primary endpoint was one-year incidence of major adverse cardiovascular events (MACE), including all-cause mortality, spontaneous myocardial infarction (MI), and stroke. A multivariable Cox regression model was computed adjusted for relevant baseline risk factors and comorbidities.</p><p><strong>Results: </strong>Among 4855 CHIP patients, 39.6% (n = 1925) had CKD at baseline. CKD patients were older, with more comorbidities, and complex CAD. After multivariable adjustment, CKD was associated with increased 1-year risks of MACE (primarily driven by all-cause mortality and MI rates), and bleeding. In-hospital adjusted hazards for ischemic and bleeding events were similar between the two cohorts, while CA-AKI occurred twice as often in CKD patients compared to non-CKD ones.</p><p><strong>Conclusions: </strong>In CHIP patients, CKD is a strong predictor of ischemic and bleeding events at one-year follow-up and doubles the risk of post-procedural CA-AKI, underscoring the need for tailored risk assessment and management of this vulnerable population.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490463","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":"Sex-related hormonal variances and clinical outcomes in TAVR patients.","authors":"Mustafa Mousa Basha, Baravan Al-Kassou, Marcel Weber, Thomas Beiert, Farhad Bakhtiary, Sebastian Zimmer, Georg Nickenig, Philip Roger Goody, Jasmin Shamekhi","doi":"10.1007/s00392-025-02623-6","DOIUrl":"https://doi.org/10.1007/s00392-025-02623-6","url":null,"abstract":"<p><strong>Background: </strong>Sex-related differences play a pivotal role in disease manifestation and outcome in patients with cardiovascular disease, including aortic valve stenosis (AS). However, data regarding sex-related hormonal differences in AS patients undergoing transcatheter aortic valve replacement (TAVR) is lacking.</p><p><strong>Objectives: </strong>We aimed to assess sex-related hormonal variances in patients with severe symptomatic AS and to evaluate the impact of these hormonal differences on the clinical outcomes after TAVR.</p><p><strong>Methods: </strong>In a total of 361 TAVR patients, we assessed the hormonal status, including cortisol, parathormone (PTH), insulin-like growth factor 1 (IGF-1), dehydroepiandrosterone sulfate (DHEAs), estradiol, progesterone and testosterone prior to TAVR. We compared baseline characteristics and outcome data according to sex and hormonal parameters. The primary endpoint was 1-year all-cause mortality according to sex; secondary endpoints included the risk of 1-year all-cause mortality in conjunction with hormone levels, with pre-specified cut-off values.</p><p><strong>Results: </strong>Rates of 1-year all-cause mortality were comparable between the sexes (p = 0.285). Cox regression analysis revealed significant associations between 1-year mortality and levels of cortisol (HR 2.30; p = 0.007), PTH (HR 2.09; p = 0.019), DHEA-S (HR 0.47; p = 0.016), and IGF-1 (HR 0.42; p = 0.004) in the overall cohort. Elevated cortisol levels (p = 0.011), decreased DHEA-S levels (p = 0.007), and lower IGF-1 levels (p = 0.017) were significantly associated with higher rates of 1-year all-cause mortality in males. Conversely, higher PTH levels were significantly associated with an increased risk of 1-year mortality in females (p = 0.012).</p><p><strong>Conclusion: </strong>Sex-specific hormonal differences significantly impact the prognosis of severe AS patients undergoing TAVR. Elevated cortisol levels and decreased DHEA-S and IGF-1 levels in males, as well as higher levels of PTH in females, were associated with an increased mortality risk.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482395","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":"The association of heart rate with adverse outcomes and recurrent heart failure hospitalization in peripartum cardiomyopathy.","authors":"Julia Berkowitz, Emilija Sagaityte, Mahnoor Khalid, Diana Lopez, Donya Mohebali, Natalie Bello, Zoltan Arany, Katharine French, Athena Poppas, Marwa Sabe, Wen-Chih Wu, Jacob Joseph, Luc Djousse, Gaurav Choudhary, Tasnim F Imran","doi":"10.1007/s00392-025-02615-6","DOIUrl":"https://doi.org/10.1007/s00392-025-02615-6","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding predictors of adverse outcomes in patients with peripartum cardiomyopathy (PPCM) is essential for risk stratification and prognosis. The aim of this study is to examine the relationship between heart rate (HR) at diagnosis and adverse outcomes in PPCM.</p><p><strong>Methods: </strong>We conducted a multi-center cohort study to identify patients with PPCM (1993-2017) who met the inclusion criteria: left ventricular ejection fraction (LVEF) <40%, development of heart failure within the last month of pregnancy or within 5 months of delivery, and no other identifiable cause of heart failure with reduced ejection fraction. The primary composite outcome of major adverse events included recurrent heart failure hospitalization, need for extra-corporeal membrane oxygenation, left ventricular assist device, orthotopic heart transplant, or all-cause death. Using Cox proportional hazards models, we examined the relationship between categories of HR at diagnosis and adverse outcomes.</p><p><strong>Results: </strong>A total of 177 women met criteria (81 with HR <100 bpm, 54 with HR 100-119 bpm, 42 with HR ≥120 bpm) with a mean age of 32 ± 7 years and median follow-up 3.6 years (IQR 1.1-8.2); 48 (27%) experienced the composite outcome. In a multivariable model adjusting for age, race, preeclampsia and hypertension, women with HR ≥ 120 bpm were four times more likely to experience major adverse events compared to women with HR < 100 bpm (HR 4.1, 95% CI 1.6-10.4) at the time of diagnosis. In a second multivariable model adjusting for the above covariates plus LVEF < 30%, QTc, and systolic blood pressure, those with HR ≥ 120 bpm were more likely to experience major adverse events compared to those with HR < 100 bpm (HR 3.31 (1.01-10.9), p = 0.049). Patients with HR <100 bpm were significantly more likely to have survival free from adverse events in survival analysis (p = 0.03).</p><p><strong>Conclusion: </strong>Sinus tachycardia at diagnosis was associated with lower LVEF on presentation and higher rates of major adverse events in PPCM. Tachycardia may be an early prognostic indicator of outcomes in PPCM and could help identify high-risk patients for closer follow-up and earlier intervention.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482396","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":"Tinnitus is not associated with cardiovascular risk factors or mortality in the Gutenberg Health Study.","authors":"Omar Hahad, Berit Hackenberg, Julia Döge, Katharina Bahr-Hamm, Jasmin Ghaemi Kerahrodi, Oliver Tüscher, Matthias Michal, Konstantin Kontohow-Beckers, Alexander K Schuster, Irene Schmidtmann, Karl J Lackner, Jörn M Schattenberg, Stavros Konstantinides, Philipp S Wild, Thomas Münzel","doi":"10.1007/s00392-025-02601-y","DOIUrl":"https://doi.org/10.1007/s00392-025-02601-y","url":null,"abstract":"<p><strong>Background and aims: </strong>Tinnitus, characterized by the conscious perception of sound without external acoustic stimulation, presents a multifaceted challenge. Recent research suggests a potential association between tinnitus and cardiovascular health. To elucidate these associations further, we examined the prevalence of tinnitus alongside its distress levels and their associations with cardiovascular risk factors, diseases, and risk of death within a general population cohort.</p><p><strong>Methods and results: </strong>This study analyzed data from the prospective Gutenberg Health Study (GHS), a population-based cohort of 15,010 individuals aged 35-74, who underwent baseline assessments from 2007 to 2012. We focused on the 10-year follow-up (2017-2020) of the GHS, including otologic testing with 8539 subjects, of whom 2387 (28%) reported tinnitus, allowing for a comprehensive cross-sectional and prospective analysis. Participants completed a questionnaire on hearing-related symptoms, including tinnitus presence (\"Do you suffer from ringing in the ears (tinnitus)?\" yes/no) and distress (\"How much do you feel bothered by it?\"), rated on a six-point scale from 0 (\"not bothersome\") to 5 (\"very bothersome\"). Outcomes were assessed based on observed prevalent cardiovascular conditions (i.e., cardiovascular risk factors and diseases) and deaths. Additionally, calculated cardiovascular risk was assessed using the SCORE2 algorithm. Significant differences in baseline characteristics emerged between participants with and without tinnitus, with the former exhibiting advanced age, male predominance, and a higher prevalence of cardiovascular risk factors and diseases. Tinnitus displayed associations with various prevalent cardiovascular diseases including atrial fibrillation (odds ratio 1.48, 95% confidence interval 1.11-1.96), peripheral artery disease (1.43, 1.05-1.95), coronary artery disease (1.49, 1.09-2.04), and any cardiovascular disease (1.31, 1.11-1.56), persisting even after adjustments for demographic, socioeconomic, and cardiovascular risk factors. While crude associations with several prevalent cardiovascular risk factors were observed, these associations diminished upon comprehensive adjustment. Tinnitus presence was associated with elevated 10-year cardiovascular disease risk (incidence rate ratio 1.11, 1.09-1.13), as indicated by higher SCORE 2 values, yet did not predict all-cause mortality risk.</p><p><strong>Conclusions: </strong>In the present study, tinnitus was associated with prevalent cardiovascular disease. However, no association with cardiovascular risk factors and mortality was found.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448507","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":"Quantitative perfusion by cardiac magnetic resonance imaging reveals compromised myocardial perfusion in patients with angina with non-obstructive coronary artery disease.","authors":"Caitlin E M Vink, Sonia Borodzicz-Jazdzyk, Elize A M de Jong, Janneke Woudstra, Tim P van de Hoef, Steven A J Chamuleau, Etto C Eringa, Marco J W Götte, Yolande Appelman","doi":"10.1007/s00392-025-02606-7","DOIUrl":"https://doi.org/10.1007/s00392-025-02606-7","url":null,"abstract":"<p><strong>Introduction: </strong>Stress perfusion cardiac magnetic resonance (CMR) effectively detects myocardial ischemia. In angina with non-obstructive coronary arteries (ANOCA), visually assessed first-pass perfusion often appears normal. Automated quantitative perfusion (QP) might benefit ANOCA diagnosis, offering absolute quantification of myocardial blood flow (MBF) and myocardial perfusion reserve (MPR).</p><p><strong>Aim: </strong>We aimed to evaluate the efficacy of QP in detecting ANOCA.</p><p><strong>Methods: </strong>This study compared fully automated QP CMR in ANOCA patients with age- and sex-matched healthy controls. Participants underwent adenosine stress perfusion CMR, including visual assessment and quantification of MBF and MPR. ANOCA patients underwent coronary function testing to identify vasospasm and/or coronary microvascular dysfunction.</p><p><strong>Results: </strong>Twenty-four ANOCA patients (83% women, 57 ± 9 years) and 25 healthy controls (80% women, 56 ± 7 years) were included. Visual perfusion assessment did not differ between groups (p = 0.54). Additionally, no differences in resting MBF were observed. However, ANOCA patients had significantly lower global MBF during stress (2.43 ± 0.72 vs 2.99 ± 0.65 ml/g/min, p < 0.01) and a significantly lower global MPR (2.24 ± 0.79 vs 2.68 ± 0.64, p = 0.04) compared to healthy controls. MPR was significantly reduced in the RCA territory in ANOCA patients (2.16 ± 0.71 vs 2.69 ± 0.69, p = 0.01), with no significant differences in other coronary territories. MPR did not significantly differ between ANOCA endotypes.</p><p><strong>Conclusions: </strong>ANOCA patients display reduced global MPR, suggesting compromised perfusion. Variation in MPR across coronary territories highlights the importance of assessing perfusion in all teritories. These findings are promising and support the use of QP for non-invasive detection of vasomotor dysfunction in ANOCA patients.</p><p><strong>Pre-registered clinical trial number: </strong>The pre-registered clinical trial number is NL-OMON23861.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448504","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":"Hyperkalemia-induced Brugada phenocopy: a systematic review of case reports.","authors":"Asmaa Zakria Alnajjar, Afnan Ismail Ibrahim, Mohamed Ellebedy","doi":"10.1007/s00392-025-02607-6","DOIUrl":"https://doi.org/10.1007/s00392-025-02607-6","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia-induced Brugada phenocopy is a transient electrocardiographic pattern that mimics the features of Brugada syndrome but is triggered by an elevation in serum levels of potassium. The objective of conducting this systematic review of case reports on hyperkalemia-induced BrP was to combine cases and increase the understanding base driving the clinical practice.</p><p><strong>Methods: </strong>We conducted a literature search in PubMed, WOS, Cochrane, and Scopus up to July 2024 for case reports of BrP induced by hyperkalemia. We considered case reports of patients with hyperkalemia and Brugada-like changes on ECG that resolved with the correction of hyperkalemia for inclusion. Extracted data included patient demographics, clinical presentation, ECG findings, potassium levels, management, and the outcomes.</p><p><strong>Results: </strong>Thirty-one case reports fit our inclusion criteria. Their ages ranged from 12 to 89years, with 60% being male. Most of the patients presented with symptoms of hyperkalemia such as weakness, palpitations, and chest pain. The ECG changes were typical of BrP and included the coved-type ST-segment elevation in leads V1-V3. The potassium levels at presentation varied from 6.1mmol/L to 9.5 mmol/L. The management strategies principally involved correction of hyperkalemia using intravenous calcium, insulin with glucose, and diuretics. In all patients, normalization of the potassium level was associated with resolution of the Brugada-like ECG pattern.</p><p><strong>Conclusion: </strong>Systemic hyperkalemia may induce BrP, a condition frequently mimicked on the ECG by Brugada syndrome and which resolves by properly treating the hyperkalemia. Such awareness will facilitate the making of an accurate diagnosis and management of this condition, avoiding unnecessary interventions based on Brugada syndrome. Further studies should aim at explaining the underlying pathophysiological mechanisms and the legislation of diagnostic criteria for hyperkalemia-induced BrP.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440199","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":"Association between potassium fluctuation and in-hospital mortality in acute myocardial infarction patients: a retrospective analysis of the MIMIC-IV database.","authors":"Ying Zhou, Yang Chen, Shangyan Liang, Yanling Li, Changlin Zhao, Zhen Wu","doi":"10.1007/s00392-025-02613-8","DOIUrl":"https://doi.org/10.1007/s00392-025-02613-8","url":null,"abstract":"<p><strong>Background: </strong>Serum potassium levels are recognized for their prognostic significance in patients presenting with acute myocardial infarction (AMI). However, the correlation between potassium level fluctuations and mortality rates among AMI patients remains unclear.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the MIMIC-IV database, including deidentified data from patients admitted to the Beth Israel Deaconess Medical Center from 2008 to 2022. Potassium fluctuation was assessed using parameters including mean postadmission serum potassium levels (K⁺[mean]), first measurable value upon admission (K⁺[admission]), minimum (K⁺[min]) and maximum (K⁺[max]) measurable values, and coefficient of variation (K⁺[CV]). The primary outcome was all-cause in-hospital mortality; secondary outcomes included ventricular tachycardia or fibrillation (VT/VF) and cardiac arrest. Restricted cubic spline models and logistic regression models were used to assess the associations between potassium fluctuation and clinical outcomes.</p><p><strong>Results: </strong>A J-shaped correlation between serum potassium levels and the risk of in-hospital mortality was identified. Both high and low potassium levels were significantly associated with increased mortality. Specifically, K⁺[mean] levels below 3.5 mmol/L and above 4.5 mmol/L were associated with higher mortality. Elevated K⁺[CV] values were also associated with higher in-hospital mortality in both univariate and multivariate analyses. Increased potassium variability was correlated with elevated risks of both VT/VF and cardiac arrest.</p><p><strong>Conclusions: </strong>Serum potassium fluctuation is an independent predictive factor for in-hospital mortality among AMI patients. These findings underscore the importance of maintaining potassium homeostasis in the management of AMI, suggesting that monitoring and stabilizing potassium levels are crucial for reducing in-hospital mortality.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406126","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 call for high-intensity lipid-lowering treatment of ASCVD patients diagnosed by coronary computed tomography angiography: lessons from the multi-center LOCATE study.","authors":"Franz Haertel, Ulf Teichgräber, P Christian Schulze, Oliver Weingärtner","doi":"10.1007/s00392-025-02604-9","DOIUrl":"https://doi.org/10.1007/s00392-025-02604-9","url":null,"abstract":"","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390294","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":"Dual pathway inhibition in patients with coronary artery disease (CAD) in clinical practice in Germany: results from the German CAD subgroup of the XATOA Registry.","authors":"Uwe Zeymer, Rupert M Bauersachs, Nikolaos Dagkonakis, E Sebastian Debus, Joerg Herold, Sonia S Anand, Keith A A Fox, Victor Aboyans, Ursula Rauch-Kröhnert","doi":"10.1007/s00392-025-02603-w","DOIUrl":"https://doi.org/10.1007/s00392-025-02603-w","url":null,"abstract":"<p><strong>Aims: </strong>To determine characteristics and clinical outcomes of German patients with coronary artery disease (CAD) with or without peripheral artery disease (PAD) who initiated dual pathway inhibition (DPI) using rivaroxaban 2.5 mg twice daily plus aspirin 100 mg once daily in clinical practice in Germany and to compare those with the results for CAD patients of the COMPASS trial.</p><p><strong>Methods and results: </strong>XATOA was an international prospective registry with a mean follow-up period of 15 months. There were 1641 German CAD patients included, of which 747 patients (45.5%) had CAD only and 894 patients (54.5%) had both CAD and PAD. Baseline characteristics (age, sex, medical history, prior medications) were similar between the subgroups of German CAD patients and comparable to CAD patients of COMPASS. The incidence of major adverse cardiovascular events (MACE) was comparable between CAD patient subgroups of XATOA Germany (only CAD patients: 3.7%, CAD + PAD patients: 3.9%) and was similar to the incidence for CAD patients overall in XATOA and in COMPASS (All CAD patients XATOA: 3.8% vs. 4.2% COMPASS CAD). Incidence for major bleeding was markedly lower in CAD patients of XATOA Germany compared to COMPASS CAD patients (All CAD patients XATOA: 1.1% vs. 3.2% in COMPASS CAD).</p><p><strong>Conclusion: </strong>In this real world experience among German patients with CAD enrolled in XATOA, DPI with rivaroxaban and aspirin was associated with low incidence of MACE and major bleeding.</p>","PeriodicalId":10474,"journal":{"name":"Clinical Research in Cardiology","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390323","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}