Current vascular pharmacology最新文献

{"title":"Impact of Statin Therapy on Mortality and Rehospitalization in Acute Heart Failure Patients Stratified by Ejection Fraction: Insights from the Gulf CARE Registry.","authors":"Mohammed Al-Jarallah, Rajesh Rajan, Raja Dashti, Bassam Bulbanat, Mustafa Ridha, Kadhim Sulaiman, Ibrahim Al-Zakwani, Alawi A Alsheikh-Ali, Prashanth Panduranga, Khalid F Alhabib, Jassim Al Suwaidi, Wael Almahmeed, Hussam Al Faleh, Abdelfatah Elasfar, Ahmed Al-Motarreb, Nooshin Bazargani, Nidal Asaad, Haitham Amin, Zhanna Kobalava, Peter A Brady, Georgiana Luisa Baca, Parul Setiya, Ahmad R Alsaber, Ghazaal Alavi Tabatabaei, Joud Al Balool, Keanu Razzaghi","doi":"10.2174/0115701611311671250416054455","DOIUrl":"https://doi.org/10.2174/0115701611311671250416054455","url":null,"abstract":"<p><strong>Background: </strong>The prevalence and clinical outcomes of statin therapy in patients with acute heart failure [AHF] stratified by left ventricular ejection fraction [EF] in the Middle East are unknown.</p><p><strong>Methods: </strong>We analysed 5005 patients admitted to 47 hospitals in seven Middle Eastern countries [Saudi Arabia, Oman, Yemen, Kuwait, United Arab Emirates, Qatar, and Bahrain] with AHF from February to November 2012 with AHF who were enrolled in Gulf CARE, a multinational registry of patients with heart failure [HF]. AHF patients were stratified into three groups: HF patients with reduced [EF] [HFrEF] [<40%], HF with mildly reduced EF [HFmrEF] [40-49%], and HF patients with preserved EF [HFpEF] [≥50%].</p><p><strong>Results: </strong>The mean age of the cohort was 59.3±14.9 years, 62.6% [n=3131.0] of the patients were males. A total of 2555 [51%] AHF patients had used statins prior to hospital admission. The mean EF was 36.9±14%. HFrEF was observed in 2683 patients [53%], whereas 961 patients [19.2%] had HFmrEF, and 932 patients [18.6%] had HFpEF. Multivariate logistic regression analysis revealed that prior statin use was significantly associated with reduced in-hospital mortality risk [OR=1.43, 95% CI: 1.10-1.86, p=0.007] and hospitalization rates for heart failure [OR=0.71, 95% CI: 0.60-0.83, p<0.001]. However, when examining rates of survival, there were no significant disparities between the two groups; at 3 months follow-up: aOR, 1.22; 95% Cl: 0.95-1.57; P=0.111; and 12-months follow-up: aOR, 1.07; 95% Cl: 1.07 0.87-1.31; P=0.553. Regarding rehospitalization rates, no significant difference was observed at a 3- month follow-up: aOR, 1.22; 95% Cl: 1.03-1.42; P=0.015. Interestingly, patients admitted with statin therapy were significantly associated with higher odds of hospitalization during the 12-month follow-up period: aOR, 1.42; 95% Cl: 1.21-1.66; P<0.001.</p><p><strong>Conclusion: </strong>Prior statin use was associated with a lower risk of in-hospital mortality and rehospitalization. However, there were no significant differences in all-cause mortality between the two groups at both 3- and 12-month follow-ups. While rehospitalization rates at the 3-month follow-up showed higher odds of rehospitalization at the 12-month follow-up. Prior statin therapy appears to influence both in-hospital mortality and long-term rehospitalization outcomes in a Middle Eastern patient population.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Zwolle Risk Score in STEMI Patients Undergoing Primary PCI: Insights from the ISCAS-STEMI COVID-19 Registry.","authors":"Giuseppe De Luca, Magdy Algowhary, Berat Uguz, Dinaldo C Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, Gerard Roura I Ferrer, Alexandre Quadros, Marek Malewski, Fortunato Scotto Di Uccio, Clemens Von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carillo, Maurits T Dirksen, Victor Manuel Becerra-Munoz, Michael Kang-Yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Miličić, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Jose Moreu, Flavien Vincent, Enrico Fabris, Inigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Fores, Luigi Vignali, Hélder Pereira, Stephane Manzo-Silbermann, Santiago Ordonez, Alev Arat Ozkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, Joao Antonio Brum Silveira, Rodrigo Zoni, Ivan Bessonov, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopulos, Carlos E Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alexandro Gutierrez Barrios, Jaun Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint Joy, Gustavo Pessah, Giuliana Cortese, Guido Parodi, Mohammed Abed Burgadha, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia","doi":"10.2174/0115701611335913250408214530","DOIUrl":"https://doi.org/10.2174/0115701611335913250408214530","url":null,"abstract":"<p><strong>Background: </strong>Several scores have been developed to facilitate risk stratification and early discharge following primary angioplasty, particularly the Zwolle Risk Score (ZRS). However, validation in large-sized studies is still lacking. Therefore, the aim of the current study was to validate the use of the ZRS in a contemporary global population, including patients who were treated during the SARS-CoV-2 pandemic and enrolled in a large intercontinental observational study.</p><p><strong>Methods: </strong>The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving primary PCI centers from Europe, Latin America, South-East Asia, and NorthAfrica, including patients treated from March 1st until June 30th, in 2019 and 2020]. ZRS was calculated for each patient. The patients were additionally categorized according to the following values of the ZRS [≤3; 4-6; 7-9; ≥10]. Our study outcomes were in-hospital and 30-day mortality. The discriminatory capacity of the ZRS was assessed by the area under the ROC curve [c statistic] as an index of model performance.</p><p><strong>Results: </strong>Our population is represented by 16084 STEMI patients undergoing mechanical reperfusion enrolled in 109 centers. The score showed a very good performance in the predicting mortality both in-hospital [AUC=0.83 [0.82-0.85], p<0.0001] and at 30- day follow-up [AUC=0.82 [0.81-0.84, p<0.0001]. The results were confirmed when the ZRS was separately applied to patients treated in 2019 and 2020, with good stability across time. ZRS was able to identify a large cohort [n=10672, 66.3%] of low-risk patients [score ≤3] with a very low mortality rate at 2 days [1%] and between 3 and 10 days [0.7%], with a very good negative predictive value for in-hospital [98.3%] and 30-day mortality [97.7%], with similar results in 2019 and 2020.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate the good prognostic performance of the ZRS in a large-scale contemporary global multicenter validation set. Similar results were obtained both in the pre-pandemic and the COVID-19 era. ZRS ≤3 identified a very low-risk population that could be discharged early, even during the COVID-19 pandemic, with expected advantages in the availability of hospital beds and nursing staff, costs of medical care, and in-hospital risk of contagion.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saphenous Vein Coronary Artery Bypass Grafts: Why Invest in VEST?","authors":"Michael R Dashwood","doi":"10.2174/0115701611389800250407071205","DOIUrl":"https://doi.org/10.2174/0115701611389800250407071205","url":null,"abstract":"","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: TNF-α/TLR4/IL-6/NF-κB Signaling Pathway and ROS/NOX4/p38/MDA Signaling Pathway Cross-Talk Involved in the Development of Vertebral Artery Stenosis/Occlusion in Elderly Patients","authors":"Xia Li, Yongjuan Zhao, Hualan Zhou, Youdong Hu, Ying Chen, Dianxuan Guo","doi":"10.2174/0115701611312760250319050036","DOIUrl":"10.2174/0115701611312760250319050036","url":null,"abstract":"<p><p>As a conflict has arisen among the authors, the article has been withdrawn at the request of the authors of the journal Current Vascular Pharmacology.</p><p><p>The publisher sincerely apologizes to the readers of the journal for any inconvenience this may have caused.</p><p><p>The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/editorial-policies-main.php</p><p><strong>Bentham science disclaimer: </strong>It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultaneously submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submitting the article for publication the authors agree that the publishers have the legal right to take appropriate action against the authors, if plagiarism or fabricated information is discovered. By submitting a manuscript the authors agree that the copyright of their article is transferred to the publishers if and when the article is accepted for publication.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Disorders in Systemic Lupus Erythematosus.","authors":"Antonis A Manolis, Theodora A Manolis, Antonis S Manolis","doi":"10.2174/0115701611348352250319034731","DOIUrl":"https://doi.org/10.2174/0115701611348352250319034731","url":null,"abstract":"<p><p>Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with multiorgan and system involvement, including the Cardiovascular (CV) system. Cardiac involvement in these patients is frequent and most often asymptomatic, at least in the early stages. It includes accelerated atherosclerosis, premature Coronary Artery Disease (CAD), and a high risk of CV complications. The risk of developing CV Disease (CVD) in SLE is linked not only with classical CV risk factors but also with disease-specific factors, like the degree of activity, autoantibodies, organ damage, and type of therapy. Clinical presentation comprises several clinical manifestations ranging from angina to acute Myocardial Infarction (MI) and Sudden Cardiac Death (SCD). The leading cause of death in SLE patients is from CVD due to accelerated atherosclerosis, which often has a more rapid progression compared with the general population. The CV risk in SLE is greater when antiphospholipid antibodies are present. Regarding diagnosis, apart from relevant blood tests, the simplest and readily available diagnostic test, echocardiography, with its contemporary techniques that include global longitudinal strain, is needed to provide a more thorough cardiac evaluation and allow for early management. These aspects of the disease, together with issues regarding phenotypes, biomarkers, neonatal lupus, heart block, SLE-related CV ailments such as coronary artery disease, myocarditis, valvular heart disease, and the antiphospholipid syndrome, as well as diagnostic modalities, drug and interventional therapies, and current relevant guidelines are all thoroughly reviewed and discussed in this article.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Marital Status and Quality Risk Factors for Cardiovascular Diseases?","authors":"Roberto Manfredini, Gianluca Colussi, Filippo Pigazzani","doi":"10.2174/0115701611392019250313071507","DOIUrl":"https://doi.org/10.2174/0115701611392019250313071507","url":null,"abstract":"","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Statin use and Abdominal Aortic Calcification in Male, Non-diabetic Elderly.","authors":"Meng Wang, Changju Liu, Hongjian Shan","doi":"10.2174/0115701611304116250221104627","DOIUrl":"https://doi.org/10.2174/0115701611304116250221104627","url":null,"abstract":"<p><strong>Aims: </strong>Our study was to investigate the association between statin use and the prevalence of abdominal aortic calcification (AAC).</p><p><strong>Methods: </strong>The population was enrolled in the 2013-2014 cycle of the National Health and Nutrition Examination Survey (NHANES). The statin use was determined from the questionnaire inquiring the medications taken in the past month. The presence of AAC and severe AAC were assessed based on the AAC score measured by abdominal dual-energy X-ray absorptiometry (DXA). Logistic regression analysis was performed to evaluate the association between statin treatment and AAC after adjustment for potential confounders.</p><p><strong>Results: </strong>The study included a total of 2074 individuals; the average age 61.6±11.8 years old and 922 (44.5%) were male. AAC (AAC score >0) was present in 35.4% of the population and 12.0% had severe AAC. There were 836 (40.3%) statin users. After adjustment for demographics, lifestyles, comorbidities, and laboratory examinations, statin use was associated with higher odds of AAC (OR 1.28, 95%CI 1.02-1.62; P=0.034) and severe AAC (OR 1.78, 95%CI 1.24-2.55; P=0.002), respectively. Subgroup analysis revealed that the association was stronger in male, non-diabetic participants and those aged >60 years old.</p><p><strong>Conclusion: </strong>Stain use was associated with a greater presence of AAC and severe AAC. This association was stronger for male, non-diabetic participants and those aged >60 years.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors of Warfarin Response Among Patients with Atrial Fibrillation: Evidence from the Middle Eastern JoFib Study.","authors":"Nasr Alrabadi, Mohammed Al-Nusair, Razan Haddad, Lama Alburie, Nizar Mhaidat, Mohamad I Jarrah, Ayman Hammoudeh","doi":"10.2174/0115701611297687250221010411","DOIUrl":"https://doi.org/10.2174/0115701611297687250221010411","url":null,"abstract":"<p><strong>Objective: </strong>To describe clinical factors predictive of warfarin response in atrial fibrillation (AF) patients and to evaluate its association with adverse outcomes.</p><p><strong>Methods: </strong>Patients in the Middle Eastern JoFib study, a prospective, multicenter registry of AF patients, using warfarin with at least one international normalized ratio (INR) reading, were enrolled. We used the most recent INR as a measure of warfarin control.</p><p><strong>Results: </strong>Out of the total 2020 patients, 544 (26.9%) were using warfarin. Multivariable logistic regression analysis demonstrated that heart failure (adjusted OR 0.55, 95%CI 0.36-0.86) and increasing HAS-BLED score (adjusted OR 0.73, 95%CI 0.58-0.92) decreased the odds of having a therapeutic INR. Chronic kidney disease (adjusted OR 3.11, 95%CI 1.46-6.62), heart failure (adjusted OR 2.37, 95%CI 1.4-4.01), and cancer (adjusted OR 2.48, 95%CI 1.03-6.01) were independently predictive of having INR less than 2.0. The first episode of AF was independently predictive of having INR above 3.0 (adjusted OR 2.48, 95%CI 1.39-4.42). Multivariable Cox regression analysis demonstrated that INR below the therapeutic range (aHR 4.36, 95%CI 2.19-8.68) and INR above the therapeutic range (aHR 3.03, 95%CI 1.33-6.92) were predictive of all-cause mortality. Below-range INR also predicted cardiovascular mortality (aHR 3.69, 95%CI 1.66-8.16).</p><p><strong>Conclusion: </strong>Clinical factors predictive of sub-optimal INR in Middle Eastern AF patients using warfarin include chronic kidney disease, heart failure, cancer, high HAS-BLED score, and first episode of AF. Furthermore, sub-optimal INR is predictive of all-cause and cardiovascular mortality.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Fibrosis Predicts the Prognosis of Patients with Acute Ischemic Stroke Through the Mediation of Cardioembolism.","authors":"Mingyue Zhao, Jiexi Huang, Tian Zeng, Minyue Zhang, Jiaqi Huang, Yufan Gao, Haobo Xie, Shengqi Li, Yilin Chen, Jiahan Xu, Yanchu Wang, Shenyi Lin, Yiyun Weng, Guangyong Chen","doi":"10.2174/0115701611343296250218111614","DOIUrl":"https://doi.org/10.2174/0115701611343296250218111614","url":null,"abstract":"<p><strong>Background: </strong>Hepatic fibrosis, a chronic pathological condition, is associated with adverse outcomes in stroke patients. Cardioembolism (CE) is a common etiology of stroke, yet the association between hepatic fibrosis and CE remains understudied.</p><p><strong>Aim: </strong>This study aims to investigate the association between hepatic fibrosis and CE-induced stroke, as well as its impact on stroke patient prognosis.</p><p><strong>Methods: </strong>This retrospective study included 344 acute ischemic stroke (AIS) patients who underwent thrombolytic therapy. Hepatic fibrosis was assessed using the Fibrosis-4 (FIB-4) index and the Aspartate Aminotransferase-Platelet Ratio Index (APRI). Mediation analysis examined the role of CE in the association between hepatic fibrosis and 3-month functional outcomes.</p><p><strong>Results: </strong>Among 344 patients, 319 were classified using the Trial of Org 10172 in Acute Stroke Treatment criteria. Severe fibrosis (FIB-4 ≥ 2.01) was observed in 131 patients (38.08%), and CE was identified in 79 patients. FIB-4 was an independent predictor of CE (OR: 2.038, 95%CI: 1.507- 2.757, p < 0.001) and poor 3-month functional outcome (OR: 1.477, 95%CI: 1.103-1.978, p = 0.009) after adjusting for confounders. The effect of FIB-4 on poor 3-month functional outcomes was partially mediated by CE, with a mediation proportion of 30.63%.</p><p><strong>Conclusions: </strong>Hepatic fibrosis is a significant predictor of short-term functional outcomes in AIS, particularly cardioembolic stroke. The association between hepatic fibrosis and stroke outcomes is partially mediated through CE. These findings highlight the importance of assessing hepatic fibrosis in stroke patients, particularly those with CE etiology.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Clinical Outcomes between Newly Diagnosed and Pre-Existing Diabetes Mellitus Patients after Acute Coronary Syndrome.","authors":"Wei-Chieh Lee, Huang-Chung Chen, Chih-Yuan Fang, Yi-Hsuan Tsai, Yun-Yu Hsieh, Tien-Yu Chen, Yen-Nan Fang, Po-Jui Wu, Hsiu-Yu Fang, Ping-Yen Liu","doi":"10.2174/0115701611322555250219111038","DOIUrl":"https://doi.org/10.2174/0115701611322555250219111038","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate clinical outcomes, including recurrent acute coronary syndrome (ACS) and mortality, in ACS patients with varying HbA1c levels, addressing the controversy over optimal targets in those with newly diagnosed and pre-existing diabetes mellitus (DM).</p><p><strong>Methods: </strong>From January 2005 to December 2019, a total of 33,990 patients were identified with ACS in the Chang Gung Research Database based on their medical history. After excluding patients without DM and baseline or subsequent HbA1C data, a cohort of 11,870 DM patients was divided into two groups: one consisting of 6,089 patients with newly diagnosed DM and the other comprising 5,781 patients with pre-existing DM.</p><p><strong>Results: </strong>During the three-year follow-up, the pre-existing DM group experienced worse clinical outcomes, such as increased rates of re-ACS, major bleeding, cardiovascular (CV) events, and all-cause mortality. Optimal HbA1c levels for mitigating re-ACS and/or CV mortality and all-cause mortality appeared to differ between the two DM cohorts. Re-ACS and CV mortality reached their highest at an HbA1c of 6.8% for all DM patients, 6.6% for newly diagnosed, and 6.7% for pre-existing cases. The greatest all-cause mortality risk was at an HbA1c of 7.4% for all DM patients, 7.0% in newly diagnosed, and 8.2% in pre-existing patients.</p><p><strong>Conclusion: </strong>Upon comparing newly diagnosed DM patients with those with pre-existing DM, a poorer prognosis was observed in the latter group, attributed to older age and a higher burden of comorbidities. Throughout the follow-up period, maintaining consistently low HbA1c levels did not reduce the incidence of re-ACS nor enhance survival rates.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}