European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Inflammation in cardiogenic shock: a marker of outcome, not yet a treatment target.","authors":"Tomasz J Guzik","doi":"10.1093/ehjacc/zuag124","DOIUrl":"https://doi.org/10.1093/ehjacc/zuag124","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223587","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":"Reply to: Did prolonged high-level pump support precede acute kidney injury?","authors":"Takahiro Nakashima, Takashi Unoki, Kenichi Tsujita","doi":"10.1093/ehjacc/zuag122","DOIUrl":"https://doi.org/10.1093/ehjacc/zuag122","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105981","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":"Prognostic implications of complications during VA-ECMO for cardiogenic shock.","authors":"Aniket S Rali, Dhruv Sarma, Hui Li, Martin Urner, Philip Boonstra, Peta M A Alexander, Ryan P Barbaro, Carlos Alviar, Jacob C Jentzer, E William Grandin, Matthew D Bacchetta, Brian Lima, Zubair Shah, Peter Rycus, Joseph E Tonna","doi":"10.1093/ehjacc/zuag127","DOIUrl":"https://doi.org/10.1093/ehjacc/zuag127","url":null,"abstract":"<p><strong>Purpose: </strong>Veno-arterial extracorporeal oxygenation (VA-ECMO) provides comprehensive cardiopulmonary support in patients with cardiogenic shock (CS), but may result in complications. While complications rates are known, their impact on risk of death remains largely unknown.</p><p><strong>Methods: </strong>Using the Extracorporeal Life Support Organization (ELSO) Registry to identify adults with a diagnosis of CS treated with VA-ECMO (2017-2024), we analyzed the association between timing and type of complication and in-hospital mortality using three methodologies: 1) Cox proportional hazards analysis, treating complications as time-dependent covariates; 2) Multi-State Model (MSM) analysis, treating complications as transient states and estimating the differential mortality rate from each of these states; and 3) landmark Kaplan Meier survival analysis, estimating conditional survival curves, given survival to 3 weeks, based on count and timing of complications.</p><p><strong>Results: </strong>Among 22,547 patients (31.7% female), 12,094 (54%) died during index hospitalization. More non-survivors experienced complications than survivors (74% vs 54%), with all sub-types occurring more frequently. Neurologic complications increased the hazard of mortality by 3.6 (95% C.I 3.4 - 3.8). MSM analysis indicated that the absolute 30-day risk of mortality was greater if a patient had a complication, increasing from 48.6% (0 complications) to 93.1% with a neurologic complication. Landmark survival analysis demonstrated that patients without complications within the first 3 weeks had the highest conditional survival.</p><p><strong>Conclusion: </strong>Complications on VA-ECMO have a significant and cumulative effect on in-hospital mortality, with a higher number associated with increased risk of death. Neurologic and pulmonary complications were associated with the greatest mortality risk.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106004","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":"Answer: Acute chest pain in Duchenne muscular dystrophy.","authors":"Mónica Dias, Fernando Mané, Rui Files Flores","doi":"10.1093/ehjacc/zuag065","DOIUrl":"https://doi.org/10.1093/ehjacc/zuag065","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105983","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":"We didn't start the fire1.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuag123","DOIUrl":"https://doi.org/10.1093/ehjacc/zuag123","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105977","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":"Inflammation, Infarct Size and 10-Year Mortality in STEMI Patients Stratified by the ORBI Risk Score: A DANAMI-3 Sub-study.","authors":"Joakim Bo Kunkel, Jacob Lønborg, Martin Frydland, Burcu Tas Özbek, Lars Nepper-Christensen, Niels Vejlstrup, Kiril Ahtarovski, Lars Køber, Dan Eik Høfsten, Jasmine Melissa Marquard, Utsho Islam, Sarah Louise Duus Holle, Yan Zhou, Lene Holmvang, Christian Hassager, Thomas Engstrøm, Helle Søholm","doi":"10.1093/ehjacc/zuag126","DOIUrl":"https://doi.org/10.1093/ehjacc/zuag126","url":null,"abstract":"<p><strong>Background: </strong>The ORBI Risk Score predicts in-hospital cardiogenic shock after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Whether high-risk patients also have more systemic inflammation, larger infarcts and higher long-term mortality is not known.</p><p><strong>Methods: </strong>In a DANAMI-3 sub-study, 1,574 STEMI patients without cardiogenic shock were classified as high (ORBI ≥8, n = 273) or low risk (n = 1,301). Inflammation was assessed by routine C-reactive protein (CRP), leukocyte count and neutrophil-to-lymphocyte ratio (NLR) within 72 hours of PCI, and admission mid-regional pro-adrenomedullin (MR-proADM). Infarct size was measured by cardiac magnetic resonance. Ten-year all-cause mortality was obtained from the Danish Civil Registration System. Cox models were adjusted for age, sex, comorbidity, kidney function and randomised allocation.</p><p><strong>Results: </strong>High-risk patients had higher peak CRP (72 vs. 11 mg/L), leukocyte count (12.8 vs. 10.4 × 109/L), NLR (6.2 vs. 3.5) and MR-proADM (0.73 vs. 0.62 nmol/L; all p < 0.001), and larger infarcts (final infarct size 15.7% vs. 10.1% of left ventricular mass). Ten-year mortality was 41% vs. 20% (hazard ratio 2.56, 95% CI 2.05-3.20; adjusted 1.47, 1.16-1.85). The adjusted hazard ratio was 4.79 within 30 days and 1.27 after the first year. The score discriminated 10-year mortality less well than age alone (area under the curve 0.67 vs. 0.79).</p><p><strong>Conclusions: </strong>The ORBI Risk Score identifies STEMI patients with more inflammation, larger infarcts and higher mortality, especially in the first year. Beyond the first year the association was largely explained by age. Whether anti-inflammatory treatment benefits these patients is a question for randomised trials.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105928","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":"At what RATE are we bleeding? Rethinking anticoagulation during mechanical circulatory support.","authors":"Christophe Vandenbriele, Alessandro Galluzzo, Janine Pöss, Tharusan Thevathasan","doi":"10.1093/ehjacc/zuag125","DOIUrl":"https://doi.org/10.1093/ehjacc/zuag125","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":7.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080156","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":"Proximity where possible, concentration where needed.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuag105","DOIUrl":"10.1093/ehjacc/zuag105","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"657-659"},"PeriodicalIF":7.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879637","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":"Truncating tradition in the POET II trial: is a shorter course of antibiotics non-inferior to standard length therapy in left-sided endocarditis?","authors":"Frederik H Verbrugge, Sean van Diepen","doi":"10.1093/ehjacc/zuag120","DOIUrl":"10.1093/ehjacc/zuag120","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"712-714"},"PeriodicalIF":7.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900381","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":"Advanced reperfusion therapies for acute pulmonary embolism in pregnancy and postpartum.","authors":"Ioannis T Farmakis, Konstantinos C Christodoulou, Stefano Barco, Karsten Keller, Stavros V Konstantinides, Lukas Hobohm","doi":"10.1093/ehjacc/zuag047","DOIUrl":"10.1093/ehjacc/zuag047","url":null,"abstract":"<p><strong>Aims: </strong>Pulmonary embolism (PE) remains the leading preventable cause of maternal death in high-income countries. Data on the management of acute PE during pregnancy are limited because pregnant women are systematically excluded from interventional trials. We evaluated the use and outcomes of advanced reperfusion therapies in pregnancy-associated PE.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of the US Nationwide Inpatient Sample from 2016 through 2020. Pregnancy- and puerperium-related hospitalizations were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. High-risk PE was defined by shock, mechanical ventilation, cardiac arrest, cardiopulmonary resuscitation, or vasopressor support. Advanced reperfusion therapies included systemic thrombolysis (ST), catheter-directed therapy (CDT), surgical embolectomy, and venoarterial extracorporeal membrane oxygenation (VA-ECMO).</p><p><strong>Results: </strong>Among 19 741 880 pregnancy- or puerperium-related hospitalizations, 12 715 (0.06%) were complicated by PE, corresponding to 6.7 (95% CI, 6.6-6.8) hospitalizations per 10 000 live births. The overall in-hospital mortality rate was 0.86% (0.058 [95% CI, 0.048-0.070] deaths per 10 000 live births). Mortality was 0.2% among patients without haemodynamic instability and 29.1% among those with high-risk PE. Advanced reperfusion therapies were used in 3.4% of all pregnancy-associated PE cases and in 32.7% of high-risk cases. In-hospital mortality was 9.8% after ST, 10.7% after CDT, and 50% after VA-ECMO. Major bleeding occurred in 15.7%, 10.7%, and 50%, respectively.</p><p><strong>Conclusion: </strong>Pregnancy-associated PE is rare but associated with high mortality in high-risk presentations. Advanced reperfusion therapies are used infrequently, reflecting the limited evidence, highlighting the need for multidisciplinary management, and further research and guidance.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"701-705"},"PeriodicalIF":7.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580812","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}