European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Question: Recurrent syncope: understanding the hidden menace.","authors":"Sharath Nagesh, Saikiran Kakarla","doi":"10.1093/ehjacc/zuaf045","DOIUrl":"10.1093/ehjacc/zuaf045","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"571-572"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947568","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":"In perspective: slow is safe, fast is final-timing matters in fractional flow reserve-guided complete revascularization for ST-segment elevation myocardial infarction with multivessel disease.","authors":"Marco Valgimigli, David A Morrow","doi":"10.1093/ehjacc/zuaf115","DOIUrl":"10.1093/ehjacc/zuaf115","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"565-567"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991808","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":"Diabetes in resuscitated comatose out-of-hospital cardiac arrest patients: a substudy of the randomized BOX trial.","authors":"Jakob Josiassen, Jacob E Møller, Henrik Schmidt, Rasmus P Beske, Johannes Grand, Jesper Kjaergaard, Christian Hassager","doi":"10.1093/ehjacc/zuaf073","DOIUrl":"10.1093/ehjacc/zuaf073","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to assess mortality rates in resuscitated comatose out-of-hospital cardiac arrest (OHCA) patients with and without diabetes randomized to targets of blood pressure, oxygen, and duration of fever prevention.</p><p><strong>Methods and results: </strong>Diabetic and non-diabetic patients from the BOX trial were compared. The BOX trial was a randomized, controlled, multicentre study comparing two mean arterial blood pressure targets (63 vs. 77 mmHg) in a double-blinded intervention and two open-labelled targets including a liberal and restrictive oxygenation (9-10 vs. 13-14 kPa) target and two regimes for length of fever control (36 vs. 72 h). The primary outcome for this substudy is 365-day survival. Multiple logistic regression models were used to adjust for factors known to be associated with outcome including age, sex, witnessed arrest (y/n), and time to return of spontaneous circulation (min). A total of 110 (14%) patients had pre-existing diabetes. Compared with the non-diabetic group, the patients with diabetes were older [median years (IQR) 67 (59; 73) vs. 63 (53; 72)] and had more comorbidities. The diabetic patients had an overall increased 365-day all-cause mortality (45% vs. 34%, P = 0.02). The logistic regression model adjusting for age and sex, witnessed arrest (y/n), and place of arrest gave an estimated adjusted odds ratio of 1.47 (0.93-2.30) (P = 0.10). No significant interactions were observed among interventions and outcomes related to diabetes status, P ranging from 0.10 to 0.80.</p><p><strong>Conclusion: </strong>Pre-existing diabetes was associated with an increased crude 365-day mortality. No differences in outcome were observed among diabetic OHCA patients depending on the assessed blood pressure targets, oxygen levels, and durations of fever control.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"531-539"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985811","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":"External validation of the simple NULL-PLEASE clinical score in predicting outcomes in men and women with out-of-hospital cardiac arrest: a nationwide registry-based study.","authors":"Christina Byrne, Carlo A Barcella, Maria Lukacs Krogager, Manan Pareek, Kristian Bundgaard Ringgren, Mads Wissenberg, Fredrik Folke, Gunnar Gislason, Lars Køber, Jesper Kjærgaard, Christian Hassager, Christian Torp-Pedersen, Gregory Y H Lip, Kristian Kragholm","doi":"10.1093/ehjacc/zuaf069","DOIUrl":"10.1093/ehjacc/zuaf069","url":null,"abstract":"<p><strong>Aims: </strong>The NULL-PLEASE score (Non-shockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood pH <7.2, Lactate >7.0 mmol/L, End-stage renal disease on dialysis, Age ≥85 years, Still resuscitation, and Extracardiac cause) was developed to predict survival in out-of-hospital cardiac arrest (OHCA) patients. Because survival differs between sexes, we aimed to validate NULL-PLEASE separately in men and women.</p><p><strong>Methods and results: </strong>Men and women with return of spontaneous circulation (ROSC) or ongoing cardiopulmonary resuscitation at hospital arrival from 2001 to 2019 were identified using Danish nationwide registries. The primary outcome was 1-day mortality. Secondary outcomes were defined as 30-day mortality and the combination of 1-year mortality or anoxic brain damage. Logistic regression was used for outcome risk estimation (reference: NULL-PLEASE = 0). Interaction analyses were performed between the NULL-PLEASE score and sex. The predictive ability was assessed using area under the receiver operating characteristics (AUCROC) curves. We included 2599 men and 1280 women. One-day mortality for men and women was 36% and 50%; 30-day mortality was 56% and 71%; and 63% and 78% experienced the combined 1-year outcome. AUCROC values for 1-day mortality were for men: 0.828 (95% CI: 0.813-0.844); and for women: 0.754 (95% CI: 0.728-0.780). Results were similar for secondary outcomes. We found significant interaction between the NULL-PLEASE score and sex: 1-day mortality: P < 0.001, 30-day mortality: P = 0.04, combined outcome: P = 0.09.</p><p><strong>Conclusion: </strong>In a nationwide OHCA-cohort, the predictive ability of the NULL-PLEASE score was higher in men than in women.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"522-530"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990483","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":"Savouring the latest in acute cardiovascular care: fresh from Madrid.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuaf105","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf105","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":"14 9","pages":"509-510"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237833","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":"Monitoring cardiogenic shock: echodynamics vs. pulmonary artery catheter Viewpoints from two leading experts.","authors":"Paolo Boretto, Jacob Jentzer, Simone Frea, Janine Pöss, Alessandro Galluzzo","doi":"10.1093/ehjacc/zuaf100","DOIUrl":"10.1093/ehjacc/zuaf100","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"576-578"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783819","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":"Quality of life after out-of-hospital cardiac arrest: a TOMAHAWK sub-study.","authors":"Michelle Rossberg, Anne Freund, Tharusan Thevathasan, Carsten Skurk, Inke R Koenig, Maren Vens, Hanna Grube, Frank Sandig, Kathrin Klinge, Ibrahim Akin, Georg Fuernau, Christian Hassager, Uwe Zeymer, Michael R Preusch, Tobias Graf, Alexander Jobs, Suzanne de Waha, Holger Thiele, Janine Poess, Steffen Desch","doi":"10.1093/ehjacc/zuaf093","DOIUrl":"10.1093/ehjacc/zuaf093","url":null,"abstract":"<p><strong>Aims: </strong>The TOMAHAWK trial compared immediate coronary angiography with a delayed/selective strategy in 554 resuscitated patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations. Mortality did not differ significantly between the two groups. In addition to survival, health-related quality of life (HRQoL) is a key outcome parameter for OHCA patients.</p><p><strong>Methods and results: </strong>The analysis included 169 survivors from the TOMAHAWK trial who completed both the 6-month and 12-month follow-up (6M-FU/12M-FU). HRQoL was assessed using a questionnaire based on the EuroQoL-5D-3L. This tool includes a visual analogue scale (EQ-VAS) ranging from 0 to 100 (worst to best imaginable subjective health) and a descriptive system with five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. No relevant differences were found between patients in the immediate angiography group and those in the delayed/selective angiography group regarding EQ-VAS scores at 6M-FU (70 ± 21 vs. 74 ± 18) and 12M-FU (72 ± 19 vs. 74 ± 17). Patients reported the most problems with usual activities (33% and 38%, respectively), and the fewest limitations in self-care (18% and 17%, respectively) at 6M-FU. Women reported more problems than men in all five dimensions. Elderly patients (≥65 years) were more likely than younger OHCA survivors to indicate limitations in mobility, self-care, usual activities, and pain/discomfort.</p><p><strong>Conclusion: </strong>OHCA survivors of the TOMAHAWK trial rated their HRQoL 6 and 12 months after the event as relatively good, but there were notable differences between women and men and between younger and elderly patients. The angiography strategy did not affect HRQoL.</p><p><strong>Trial registration: </strong>www.ClinicalTrials.gov: NCT02750462.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"511-519"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483679","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 NEO-MINDSET trial: immediate aspirin withdrawal after percutaneous coronary intervention for acute coronary syndrome-remains a therapeutic no-man's land.","authors":"Pascal Vranckx, Marin Pavlov, Sigrun Halvorsen","doi":"10.1093/ehjacc/zuaf116","DOIUrl":"10.1093/ehjacc/zuaf116","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"568-570"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091311","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: Recurrent syncope: understanding the hidden menace.","authors":"Sharath Nagesh, Saikiran Kakarla","doi":"10.1093/ehjacc/zuaf046","DOIUrl":"10.1093/ehjacc/zuaf046","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"573-575"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947555","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":"Comparison of cardiac troponin assays reveals assay-specific sensitivities in a clinical model of very acute myocardial injury.","authors":"Julius Obergassel, Marc D Lemoine, Laura C Sommerfeld, Jan L Rieß, Salah Al-Aqili, Sandro J Jäckle, Laura Rottner, Andreas Rillig, Andreas Metzner, Nils A Sörensen, Larissa Fabritz, Thomas Renné, Raphael Twerenbold, Stefan Blankenberg, Tanja Zeller, Paulus Kirchhof, Johannes T Neumann","doi":"10.1093/ehjacc/zuaf064","DOIUrl":"10.1093/ehjacc/zuaf064","url":null,"abstract":"<p><strong>Aims: </strong>High-sensitivity cardiac troponin (hs-cTn) assays indicating myocardial injury are critical for the diagnosis of acute myocardial infarction (AMI), but their use to differentiate between acute and chronic myocardial injury is limited. This study aimed to assess the differential utility of three hs-cTn assays, targeting different troponin epitopes (proximal and/or central), to detect myocardial injury in a clinical model of acute myocardial injury by left-atrial ablation.</p><p><strong>Methods and results: </strong>First, pre- and post-procedural serum samples were prospectively collected from 158 patients undergoing pulmonary vein isolation in a standardised setting. cTn-concentrations were measured using the high-sensitive Architect-cardiac troponin I (cTnI)-, Atellica-IM-cTnI-, and Elecsys-cTnT assays. Cardiac troponin I/T-concentrations and -ratios were compared, also to established AMI rule-in-thresholds. Second, 48 patients in which hs-cTn measurements were performed in clinical routine after ablation with a clinical indication were assessed for correlations between hs-cTn-levels, symptoms and electrocardiogram changes. The Atellica-assessed cTnI showed a doubled relative pre-to-post-procedural concentration increase compared to Architect-cTnI (39.6-fold vs. 20.5-fold; P = 0.0036). The Atellica-hs-cTnI/T-ratio had a 2.5 (95% confidence intervals (CI) 1.1,5.2) relative increase, while the Architect-cTnI-to-Elecsys-cTnT-ratio showed a 6.9 (95% CI 2.3,11.8) relative increase (P < 0.0001). In 78% of patients, at least one post-procedural cTn-concentration exceeded AMI rule-in-thresholds. Chronic kidney disease predicted higher pre-to-post-increases. In retrospectively analysed routine cTn-assessments after ablation, cTn-levels after ablation did not correlate with neither symptoms, electrocardiogram changes nor angiography findings.</p><p><strong>Conclusion: </strong>The Atellica assay demonstrated enhanced sensitivity for very acute myocardial injury, likely via its additional recognition of the proximally located cTnI epitope. This suggests its potential to improve differentiation of acute from chronic myocardial injury, warranting further investigation to confirm its clinical utility in that setting.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"552-561"},"PeriodicalIF":4.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987498","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}