European Heart Journal: Acute Cardiovascular Care最新文献

Bleeding complications in patients with out-of-hospital cardiac arrest treated with cangrelor and oral P2Y12 inhibitors. 康奈洛联合口服P2Y12抑制剂治疗院外心脏骤停患者的出血并发症

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-06-06 DOI: 10.1093/ehjacc/zuaf082

Georg Gelbenegger, Alexandra Julia Lipa, Anselm Jorda, Robert Zilberszac, Gottfried Heinz, Thomas Staudinger, Christian Zauner, Michael Holzer, Guy Friedrich, Fabian Plank, Irene M Lang, Bernd Jilma, Jolanta M Siller-Matula

{"title":"Bleeding complications in patients with out-of-hospital cardiac arrest treated with cangrelor and oral P2Y12 inhibitors.","authors":"Georg Gelbenegger, Alexandra Julia Lipa, Anselm Jorda, Robert Zilberszac, Gottfried Heinz, Thomas Staudinger, Christian Zauner, Michael Holzer, Guy Friedrich, Fabian Plank, Irene M Lang, Bernd Jilma, Jolanta M Siller-Matula","doi":"10.1093/ehjacc/zuaf082","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf082","url":null,"abstract":"Background: Cangrelor is used to bridge the gap of insufficient platelet inhibition in patients with out-of-hospital cardiac arrest (OHCA) undergoing percutaneous coronary intervention (PCI).Methods: In a retrospective chart review study, we investigated the incidence of bleeding and stent thrombosis in patients with OHCA undergoing PCI who received either cangrelor and transition to an oral P2Y12 inhibitor or an oral P2Y12 inhibitor alone. Subgroups consisted of patients treated with conventional cardiopulmonary resuscitation (CPR) and extracorporeal CPR. The primary endpoint was BARC 3-5 bleeding at 30 days.Results: Between January 2016 and March 2025, 414 patients were included of which 267 received cangrelor and an oral P2Y12 inhibitor and 147 received an oral P2Y12 inhibitor alone. BARC 3-5 bleeding at 30 days occurred at a similar rate in the cangrelor group and the oral P2Y12 inhibitor group (18.4% versus 19.0%, respectively; adjusted OR, 0.79; 95%CI, 0.45-1.39). BARC 3-5 bleeding at 6, 24 and 48 hours was similar between the cangrelor group and the oral P2Y12 inhibitor group in patients treated with conventional and extracorporeal CPR. In patients treated with extracorporeal CPR, stent thrombosis occurred less frequently in the cangrelor group compared with the oral P2Y12 inhibitor group (2.1% versus 4.5%, respectively; adjusted OR, 0.32, 95% CI, 0.03-3.14), but without reaching statistical significance.Conclusion: In patients with OHCA undergoing PCI, BARC 3-5 bleeding occurred at a similar rate in patients receiving either cangrelor and transition to an oral P2Y12 inhibitor or an oral P2Y12 inhibitor alone.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247060","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}

引用次数: 0

Fifty shades of pediatric heart failure with systolic dysfunction. 小儿心力衰竭与收缩功能障碍的五十种不同程度。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-06-06 DOI: 10.1093/ehjacc/zuaf083

Thomas Salaets, Alexander Van De Bruaene, Bjorn Cools

引用次数: 0

Myocardial infarction secondary to coronary embolism: etiology, clinical characteristics, and prognosis. 继发于冠状动脉栓塞的心肌梗死：病因、临床特征和预后。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-06-04 DOI: 10.1093/ehjacc/zuaf081

Maria Calvo-Barceló, Èlia Rifé-Pardo, Laia Milà, Yassin Belahnech, Claudia Alvarez-Martin, Bruno García-Del-Blanco, Ignacio Ferreira-González, José A Barrabés

{"title":"Myocardial infarction secondary to coronary embolism: etiology, clinical characteristics, and prognosis.","authors":"Maria Calvo-Barceló, Èlia Rifé-Pardo, Laia Milà, Yassin Belahnech, Claudia Alvarez-Martin, Bruno García-Del-Blanco, Ignacio Ferreira-González, José A Barrabés","doi":"10.1093/ehjacc/zuaf081","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf081","url":null,"abstract":"Background: Limited data is available regarding etiology, clinical characteristics, and prognosis of coronary embolism (CE). This study aimed to describe the clinical features of embolic myocardial infarction (MI) and compare them with non-embolic MI.Methods: All admissions for acute MI in a single tertiary center between January 2010 and December 2023 were reviewed. CE was diagnosed by established criteria.Results: Among 8160 patients, 89 (1.1%) were diagnosed with CE. The most common attributable cause was atrial fibrillation (52.8%), followed by prosthetic valve thrombosis (11.2%) and endocarditis (7.9%). Compared with the remaining patients, those with CE were more frequently female, had a lower prevalence of cardiovascular risk factors, and presented more often with ST-segment elevation (79.8% vs. 58.6%, p<0.001). CE patients had a high frequency of unsuccessful reperfusion and higher rates of mechanical complications (5.6% vs. 2.2%, p=0.031) and strokes/transient ischemic attacks (6.7% vs. 1.3%, p<0.001) than those with non-CE MI, although in-hospital mortality was not statistically different (9.0% vs. 6.4%, respectively, p=0.321). In a propensity-matched analysis among hospital survivors (77 in each group), no differences were observed over a median follow-up of 59.6 months in overall mortality or thromboembolic events after discharge, although more patients in the CE group were admitted for heart failure.Conclusions: CE is mostly caused by atrial fibrillation, usually presents with ST-segment elevation, and is associated with higher rates of mechanical complications and in-hospital embolic events, but not of recurrent thromboembolism after discharge. No significant differences in mortality were observed between CE and non-CE MI.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215257","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}

引用次数: 0

The Pursuit of Precision in Cardiogenic Shock: Navigating Promise, Pitfalls, and a Path Forward. 心源性休克的精确追求：导航的希望，陷阱和前进的道路。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-06-03 DOI: 10.1093/ehjacc/zuaf080

Vanessa Blumer, Ajar Kochar, Shashank S Sinha

引用次数: 0

Answer: Silent stenosis to sudden shock: the unplanned culprit. 答案：无声的狭窄到突然的休克：意外的罪魁祸首。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-06-03 DOI: 10.1093/ehjacc/zuaf030

Narendran Dhanasekaran, Bharath Raj Kidambi, Yeriswamy Mogalahally Channabasappa

引用次数: 0

Surviving the Storm: Decoding the Intricacies of Sepsis Management and the Symphony of Cardiovascular Complications in Intensive Care. 在风暴中生存：解码败血症管理的复杂性和重症监护心血管并发症的交响乐。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-06-03 DOI: 10.1093/ehjacc/zuaf079

Maxwell A Hockstein, Rory J Spiegel

引用次数: 0

First Chapter of the 2025 ACVC Clinical Decision-Making Toolkit - Pulmonary Embolism. 2025年ACVC临床决策工具包第一章-肺栓塞。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-05-27 DOI: 10.1093/ehjacc/zuaf076

Alessandro Galluzzo, Janine Pöss

引用次数: 0

Repolarization Abnormalities and Outcomes Among Patients with Cardiac Arrest. 心脏骤停患者的复极异常和结果。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-05-27 DOI: 10.1093/ehjacc/zuaf077

Christopher Schenck, Soumya Banna, Noah Kim, Christine Nguyen, Emily J Gilmore, David M Greer, Rachel Beekman, P Elliott Miller

{"title":"Repolarization Abnormalities and Outcomes Among Patients with Cardiac Arrest.","authors":"Christopher Schenck, Soumya Banna, Noah Kim, Christine Nguyen, Emily J Gilmore, David M Greer, Rachel Beekman, P Elliott Miller","doi":"10.1093/ehjacc/zuaf077","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf077","url":null,"abstract":"Background: Changes in ventricular repolarization, observed as QTc prolongation, are frequently observed following cardiac arrest. The T-peak to T-end (TpTe) interval represents a period of increased susceptibility to ventricular arrhythmia. We posit that TpTe prolongation may be associated with adverse clinical outcomes in patients resuscitated from cardiac arrest.Methods: We included patients aged ≥18 years with both out-of-hospital and in-hospital cardiac arrest following return of spontaneous circulation (ROSC) who had an electrocardiogram (ECG) obtained within 24 hours following ROSC. The first ECG obtained was evaluated to determine the QTc and TpTe intervals. Hierarchical logistic regression was used to evaluate the association between prolongation of the QTc and TpTe intervals and clinical outcomes (in-hospital mortality and favorable neurologic outcome at hospital discharge).Results: We included 443 patients, with a median age of 61 years (IQR: 50-72 years), 60.5% male, 65.7% OHCA, and 29.8% with initial shockable rhythm. Overall, 310 patients had QTc prolongation (70.0%), and 284 had TpTe prolongation (64.1%). Patients with TpTe prolongation had a greater incidence of initial shockable rhythm (35.6% vs 19.5%, P<0.001) and higher initial lactate (8.6 vs 7.4 mmol/L, P=0.03). QTc prolongation was not associated with in-hospital mortality (odds ratio [OR]:1.27, 95% confidence interval [CI]: 0.75-2.14, P=0.37) or favorable neurologic outcome (OR:0.88, 95% CI: 0.50-1.54, P=0.65). TpTe prolongation was independently associated with in-hospital mortality (OR: 1.69, 95% CI: 1.01-2.85, P=0.05) but not favorable neurologic outcome (OR: 0.78, 95% CI: 0.45-1.37, P=0.39).Conclusions: TpTe interval prolongation, but not QTc interval prolongation, was associated with increased in-hospital mortality in patients resuscitated from cardiac arrest.","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157437","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}

引用次数: 0

Question: Silent stenosis to sudden shock: the unplanned culprit. 问题：无声狭窄到突然休克：意外的罪魁祸首。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-05-27 DOI: 10.1093/ehjacc/zuaf029

Narendran Dhanasekaran, Bharath Raj Kidambi, Yeriswamy Mogalahally Channabasappa

引用次数: 0

Lactate Dynamics and Metabolic Differences in Cardiogenic Shock Across Clinical Contexts. 不同临床背景下心源性休克的乳酸动力学和代谢差异。

IF 3.9 2区医学

European Heart Journal: Acute Cardiovascular Care Pub Date : 2025-05-19 DOI: 10.1093/ehjacc/zuaf074

Johannes Grand

引用次数: 0