European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Long-term outcomes among out-of-hospital cardiac arrest survivors with reversible vs. non-reversible causes.","authors":"Carlo Alberto Barcella, Brian E Grunau, Meijiao Guan, Nathaniel M Hawkins, Marc W Deyell, Jason G Andrade, Jennie S Helmer, Graham C Wong, Kristian H Kragholm, Karin H Humphries, Jim Christenson, Christopher B Fordyce","doi":"10.1093/ehjacc/zuae097","DOIUrl":"10.1093/ehjacc/zuae097","url":null,"abstract":"<p><strong>Aims: </strong>A reversible cause of out-of-hospital cardiac arrest (OHCA) is vaguely defined in international guidelines as an identifiable transient or potentially correctable condition. However, studies evaluating long-term outcomes of patients experiencing OHCA due to reversible and non-reversible causes are lacking. We aimed to determine differences in long-term outcomes in OHCA survivors according to different aetiology.</p><p><strong>Methods and results: </strong>From the British Columbia Cardiac Arrest registry, adults with non-traumatic OHCA (2009-2016) surviving to hospital discharge were identified. Patients were categorized by OHCA aetiology combining reversibility and underlying ischaemic aetiology. The primary outcome was a composite of all-cause mortality, recurrent OHCA, or re-hospitalization for sudden cardiac arrest or ventricular arrhythmias. Using the Kaplan-Meier method and multivariable Cox regression models, we compared the risk of the composite outcome according to different OHCA aetiology. Of 1325 OHCA hospital-discharge survivors (median age 62.8 years, 77.9% male), 431 (32.5%) had reversible ischaemic, 415 (31.3%), non-reversible ischaemic, 99 (7.5%), reversible non-ischaemic, and 380 (28.7%), non-reversible non-ischaemic aetiologies. At 3 years post discharge, the Kaplan-Meier event-free rate was highest in patients with a reversible ischaemic aetiology [91%, 95% confidence interval (CI) 87-94%], and lowest in those with a reversible non-ischaemic aetiology (62%, 95% CI 51-72%). In multivariate analyses, compared with non-reversible non-ischaemic cause, reversible ischaemic cause was associated with a significantly lower hazard ratio (HR; 0.52, 95% CI 0.33-0.81), reversible non-ischaemic cause with a significantly higher HR (1.53, 95% CI 1.03-2.32), and non-reversible ischaemic cause with a non-significant HR (0.92, 95% CI 0.64-1.33) for the composite outcome.</p><p><strong>Conclusion: </strong>Compared to other aetiologies, the presence of a reversible ischaemic cause is associated with improved long-term OHCA outcomes.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"715-725"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105608","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":"Resilience and renewal: charting the future of cardiovascular care in a changing world.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuae107","DOIUrl":"10.1093/ehjacc/zuae107","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"683-684"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282332","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: Connecting the dots: a rare cause for refractory hypoxaemia.","authors":"Andrea Nájera-Rojas, Eder González-Macedo, Diego Araiza-Garaygordobil","doi":"10.1093/ehjacc/zuae063","DOIUrl":"10.1093/ehjacc/zuae063","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"749-750"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344001","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":"Epidemiology of cardiogenic shock using the Shock Academic Research Consortium (SHARC) consensus definitions.","authors":"David D Berg, Erin A Bohula, Siddharth M Patel, Carlos E Alfonso, Carlos L Alviar, Vivian M Baird-Zars, Christopher F Barnett, Gregory W Barsness, Courtney E Bennett, Sunit-Preet Chaudhry, Christopher B Fordyce, Shahab Ghafghazi, Umesh K Gidwani, Michael J Goldfarb, Jason N Katz, Venu Menon, P Elliott Miller, L Kristin Newby, Alexander I Papolos, Jeong-Gun Park, Matthew J Pierce, Alastair G Proudfoot, Shashank S Sinha, Lakshmi Sridharan, Andrea D Thompson, Sean van Diepen, David A Morrow","doi":"10.1093/ehjacc/zuae098","DOIUrl":"10.1093/ehjacc/zuae098","url":null,"abstract":"<p><strong>Aims: </strong>The Shock Academic Research Consortium (SHARC) recently proposed pragmatic consensus definitions to standardize classification of cardiogenic shock (CS) in registries and clinical trials. We aimed to describe contemporary CS epidemiology using the SHARC definitions in a cardiac intensive care unit (CICU) population.</p><p><strong>Methods and results: </strong>The Critical Care Cardiology Trials Network (CCCTN) is a multinational research network of advanced CICUs coordinated by the TIMI Study Group (Boston, MA). Cardiogenic shock was defined as a cardiac disorder resulting in SBP < 90 mmHg for ≥30 min [or the need for vasopressors, inotropes, or mechanical circulatory support (MCS) to maintain SBP ≥ 90 mmHg] with evidence of hypoperfusion. Primary aetiologic categories included acute myocardial infarction-related CS (AMI-CS), heart failure-related CS (HF-CS), and non-myocardial (secondary) CS. Post-cardiotomy CS was not included. Heart failure-related CS was further subcategorized as de novo vs. acute-on-chronic HF-CS. Patients with both cardiogenic and non-cardiogenic components of shock were classified separately as mixed CS. Of 8974 patients meeting shock criteria (2017-23), 65% had isolated CS and 17% had mixed shock. Among patients with CS (n = 5869), 27% had AMI-CS (65% STEMI), 59% HF-CS (72% acute-on-chronic, 28% de novo), and 14% secondary CS. Patients with AMI-CS and de novo HF-CS were most likely to have had concomitant cardiac arrest (P < 0.001). Patients with AMI-CS and mixed CS were most likely to present in more severe shock stages (SCAI D or E; P < 0.001). Temporary MCS use was highest in AMI-CS (59%). In-hospital mortality was highest in mixed CS (48%), followed by AMI-CS (41%), similar in de novo HF-CS (31%) and secondary CS (31%), and lowest in acute-on-chronic HF-CS (25%; P < 0.001).</p><p><strong>Conclusion: </strong>SHARC consensus definitions for CS classification can be pragmatically applied in contemporary registries and reveal discrete subpopulations of CS with distinct phenotypes and outcomes that may be relevant to clinical practice and future research.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"709-714"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105607","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":"Challenges posed by climate hazards to cardiovascular health and cardiac intensive care: implications for mitigation and adaptation.","authors":"Thomas Münzel, Haitham Khraishah, Alexandra Schneider, Jos Lelieveld, Andreas Daiber, Sanjay Rajagopalan","doi":"10.1093/ehjacc/zuae113","DOIUrl":"10.1093/ehjacc/zuae113","url":null,"abstract":"<p><p>Global warming, driven by increased greenhouse gas emissions, has led to unprecedented extreme weather events, contributing to higher morbidity and mortality rates from a variety of health conditions, including cardiovascular disease (CVD). The disruption of multiple planetary boundaries has increased the probability of connected, cascading, and catastrophic disasters with magnified health impacts on vulnerable populations. While the impact of climate change can be manifold, non-optimal air temperatures (NOTs) pose significant health risks from cardiovascular events. Vulnerable populations, especially those with pre-existing CVD, face increased risks of acute cardiovascular events during NOT. Factors such as age, socio-economic status, minority populations, and environmental conditions (especially air pollution) amplify these risks. With rising global surface temperatures, the frequency and intensity of heatwaves and cold spells are expected to increase, emphasizing the need to address their health impacts. The World Health Organization recommends implementing heat-health action plans, which include early warning systems, public education on recognizing heat-related symptoms, and guidelines for adjusting medications during heatwaves. Additionally, intensive care units must be prepared to handle increased patient loads and the specific challenges posed by extreme heat. Comprehensive and proactive adaptation and mitigation strategies with health as a primary consideration and measures to enhance resilience are essential to protect vulnerable populations and reduce the health burden associated with NOTs. The current educational review will explore the impact on cardiovascular events, future health projections, pathophysiology, drug interactions, and intensive care challenges and recommend actions for effective patient care.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":"13 10","pages":"731-744"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11518858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521434","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":"Question: Connecting the dots: a rare cause for refractory hypoxaemia.","authors":"Andrea Nájera-Rojas, Eder González-Macedo, Diego Araiza-Garaygordobil","doi":"10.1093/ehjacc/zuae062","DOIUrl":"10.1093/ehjacc/zuae062","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"747-748"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307445","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":"Trans-catheter aortic valve implantation is the standard for most patients with aortic stenosis and cardiogenic shock.","authors":"Rutger-Jan Nuis, Nicolas M Van Mieghem","doi":"10.1093/ehjacc/zuae111","DOIUrl":"10.1093/ehjacc/zuae111","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"699-700"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307446","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":"Extension studies in revascularization for left main coronary artery disease: considerations for good statistical practice and clinical guidance.","authors":"Dylan Taylor, Warren A Skoza, Xavier Rossello","doi":"10.1093/ehjacc/zuae110","DOIUrl":"10.1093/ehjacc/zuae110","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"745-746"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307444","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":"Sudden cardiac death after early-onset myocardial infarction: a multicentre longitudinal cohort study with a 20-year follow-up.","authors":"Serena Bricoli, Giulia Magnani, Maddalena Ardissino, Giuseppe Maglietta, Patrizia Celli, Maurizio Ferrario, Umberto Canosi, Carlo Cernetti, Francesco Negri, Piera Angelica Merlini, Marco Tubaro, Carlo Berzuini, Chiara Manzalini, Luigi Moschini, Elisabetta Ponte, Roberto Pozzi, Silvia Buratti, Andrea Botti, Federico Barocelli, Andrea Biagi, Rosario Bonura, Luca Bearzot, Tiziano Moccetti, Antonio Crocamo, Maria Francesca Notarangelo, Elisabetta Moscarella, Paolo Calabrò, Giampaolo Niccoli, Diego Ardissino","doi":"10.1093/ehjacc/zuae089","DOIUrl":"10.1093/ehjacc/zuae089","url":null,"abstract":"<p><strong>Aims: </strong>Sudden cardiac death (SCD) is a serious consequence of a myocardial infarction (MI), but identifying patients at risk of developing SCD remains a major clinical challenge, especially in the case of juvenile MI. The aim of this study is to identify predictors of SCD after early-onset MI using long-term follow-up data relating to a large nationwide patient cohort.</p><p><strong>Methods and results: </strong>The Italian Genetic Study on Early-onset MI enrolled 2000 patients experiencing a first MI before the age of 45 years, who were followed up for a median of 19.9 years. Fine-Gray proportional hazard models were used to assess the associations between their clinical, demographic, and index event data and the occurrence of SCD. Sudden cardiac death occurred in 195 patients, who were more frequently males, were hypertensive and/or diabetic, had a history of previous thrombo-embolic events with a greater atherosclerotic burden, and had a lower left ventricular ejection fraction (LVEF) after the index event. A multivariable analysis showed that the independent predictors of SCD were diabetes, hypertension, previous thrombo-embolic events, a higher SYNTAX score, and a lower LVEF. There was no clear evidence of the clustering of SCD events during the follow-up. Sudden cardiac death was the first post-MI clinical event in 101 patients; the remaining 94 experienced SCD after a non-fatal MI or hospitalization for coronary revascularization.</p><p><strong>Conclusion: </strong>Sudden cardiac death frequently occurs during the 20 years after early-onset MI. The nature of the identified predictors and the absence of clustering suggest that the pathophysiological basis of SCD may be related to progressive coronary atherosclerosis.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"726-730"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897084","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":"Embracing the Olympic spirit: pioneering cardiac care insights from the 2024 European Society of Cardiology scientific meeting and more!","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuae099","DOIUrl":"10.1093/ehjacc/zuae099","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"645"},"PeriodicalIF":3.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139643","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}