European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"Development and Validation of a Risk Score in Acute Myocardial Infarction related Cardiogenic Shock.","authors":"Elma J Peters, Joakim B Kunkel, Margriet Bogerd, Sanne Ten Berg, Marijke J C Timmermans, Ole K L Helgestad, Hanne B Ravn, Adriaan O Kraaijeveld, Luuk C Otterspoor, Krischan D Sjauw, Erik Lipšic, Annemarie E Engström, Alexander P J Vlaar, Christian Hassager, Jacob E Møller, José P S Henriques","doi":"10.1093/ehjacc/zuaf043","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf043","url":null,"abstract":"<p><strong>Background: </strong>Mortality in patients with acute myocardial infarction-related cardiogenic shock (AMICS) is high, but a widely accepted tool for individual risk assessment is lacking. A reliable prediction model could assist in clinical decision making, patient selection for clinical trials, and comparison of AMICS populations. Therefore, the aim of this study was to develop and externally validate a prediction model for 30-day mortality in AMICS patients.</p><p><strong>Methods: </strong>This retrospective cohort study included patients from 2017 to 2021(development cohort) and 2010-2017 (validation cohort). Patients with AMICS undergoing percutaneous coronary intervention in the Netherlands were identified using the Netherlands Heart Registration. International validation was performed in the Danish Retroshock registry. The main outcome was 30-day mortality.</p><p><strong>Results: </strong>Among 2261 patients, the median age was 67 years(IQR 58-75), and 1649(73%) were male. The mortality rate at 30 days was 39%(n=886). Significant predictors for mortality were: initial lactate, glucose, renal function, hemoglobin, age, blood pressure, heart rate, intubation prior to PCI, intervention in the left main coronary artery, and successful revascularization. The AUC of the initial model was 0.81(0.79-0.83). The external validation cohort included 1393 patients with 1050 (75%) male and a median age of 67 years(IQR 59-75). The 30-day mortality rate was 49%(n=680). The model showed good performance om the external validation with an AUC of 0.73(0.70-0.76).</p><p><strong>Conclusions: </strong>A prediction model was developed and externally validated using data from two large national registries. The model demonstrated good performance and is suitable for clinical decision-making and quality purposes in AMICS.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709224","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 legacy of extracorporeal cardiopulmonary resuscitation-bridging the past, shaping the present, defining the future.","authors":"Tharusan Thevathasan, Christian Hassager, Jason Bartos, Marcel van de Poll, Janine Pöss","doi":"10.1093/ehjacc/zuaf012","DOIUrl":"10.1093/ehjacc/zuaf012","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"195-197"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022628","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":"Antithrombotic therapy in patients with chronic coronary syndrome: a focus on the 2024 European Society of Cardiology guidelines.","authors":"Antonio Landi, Marco Valgimigli","doi":"10.1093/ehjacc/zuae134","DOIUrl":"10.1093/ehjacc/zuae134","url":null,"abstract":"<p><p>Antithrombotic therapy represents the mainstay of the pharmacological treatment in patients with chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI). The optimal choice, combination, and duration of antithrombotic therapy represent still a clinical conundrum requiring a critical assessment of patient comorbidities, clinical presentation, and PCI features. The 2024 European Society of Cardiology (ESC) guidelines for the management of patients with CCS have been recently published encompassing new and revised recommendations on antithrombotic therapy. The scope of this manuscript is to provide a focus on the key recommendations on antithrombotic therapy of the 2024 ESC guidelines. Furthermore, we will provide an overview of differences and similarities between the latest ESC recommendations and statements on oral antithrombotic regimens in CCS patients from a recent European expert consensus document.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"178-182"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827812","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":"Clinical derivation and data simulated validation of rule-out and rule-in algorithms for the Siemens Atellica IM high-sensitivity cardiac troponin I assay.","authors":"Ingar Ziad Restan, Ole-Thomas Steiro, John W Pickering, Hilde L Tjora, Jørund Langørgen, Torbjørn Omland, Paul Collinson, Rune Bjørneklett, Kjell Vikenes, Trude Steinsvik, Øyvind Skadberg, Øistein R Mjelva, Alf Inge Larsen, Vernon V S Bonarjee, Kristin M Aakre","doi":"10.1093/ehjacc/zuaf017","DOIUrl":"10.1093/ehjacc/zuaf017","url":null,"abstract":"<p><strong>Aims: </strong>This prospective, two-centre study derived and validated predictive algorithms for the Siemens Atellica IM high-sensitivity cardiac troponin I (hs-cTnI) assay in the emergency department (ED).</p><p><strong>Methods and results: </strong>Algorithms for predicting 30-day myocardial infarction (MI) Types 1 and 2 and death or non-ST-elevation MI (NSTEMI, Types 1 and 2) at index admission were developed from a derivation cohort of 1896 patients and validated using a synthetic data set with nearly 1 million patient cases. Performance was compared with the European Society of Cardiology algorithms for hs-cTnT (Roche Diagnostics) and hs-cTnI (Abbott Diagnostics). An admission hs-cTnI concentration < 5 ng/L had a negative predictive value (NPV) and sensitivity for 30-day MI or death of 99.5-99.7% and 98.1-98.8%, respectively, in the derivation cohort and validation data set. The NPV and sensitivity were ≥99.7% and ≥98.8% for ruling out index NSTEMI. A 0- to 1-h algorithm with baseline hs-cTnI concentration < 10 ng/L and Δ change < 3 ng/L had NPV of ≥99.5% and sensitivity ≥ 97.3% for predicting 30-day MI or death and a ≥99.5% sensitivity and NPV for index NSTEMI. Rule-in algorithms of either 0-h hs-cTnI ≥ 120 ng/L or 0- to 1-h Δ change ≥ 12 ng/L had positive predictive value ≥ 73% and specificity > 96% for 30-day MI or death and index NSTEMI. The results were comparable with established hs-cTn algorithms.</p><p><strong>Conclusion: </strong>This study presents Siemens Atellica hs-cTnI algorithms for diagnosis and risk prediction in the ED with performance comparable with established hs-cTnT (Roche) and hs-cTnI (Abbott) algorithms.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"155-168"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058469","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":"Ischaemia with non-obstructive coronary arteries in the 2024 European Society of Cardiology guidelines for the management of chronic coronary syndromes.","authors":"Harmony R Reynolds, Nathaniel R Smilowitz","doi":"10.1093/ehjacc/zuaf005","DOIUrl":"10.1093/ehjacc/zuaf005","url":null,"abstract":"<p><strong>Aims: </strong>Chronic coronary syndromes (CCS) occur commonly in the absence of flow-limiting epicardial coronary stenosis. Ischaemia or angina with non-obstructive coronary arteries (INOCA/ANOCA) may be caused by coronary microvascular disease, coronary artery spasm, myocardial bridging, diffuse atherosclerosis, or a combination of disorders.</p><p><strong>Methods and results: </strong>We highlight the new recommendations in the 2024 European Society of Cardiology (ESC) guidelines on CCS relevant to the diagnosis and management of INOCA/ANOCA. The guidelines place a new emphasis on consideration of INOCA/ANOCA early during cardiovascular risk stratification and the initial diagnostic workup for chest pain. There is a new Class I recommendation for the availability of invasive coronary function testing (CFT) at the time of initial coronary angiography, when the mechanisms of chest pain are uncertain after non-invasive testing, and in patients with established INOCA/ANOCA who have persistent symptoms and poor quality of life despite medical therapy. Once underlying disorders have been identified based on the results of invasive CFT, the ESC guidelines emphasize a patient-centred, mechanism-based approach to medical treatment of INOCA/ANOCA to improve the symptoms and quality of life.</p><p><strong>Conclusion: </strong>The 2024 ESC CCS guidelines provide a new vision for the diagnosis and management of ANOCA/INOCA, with an expanded role for invasive CFT and targeted medical therapy to improve symptoms and quality of life in patients with angina.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"173-177"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002577","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":"Implications of a new clinical classification of acute myocardial infarction.","authors":"Jasper Boeddinghaus, Anda Bularga, Caelan Taggart, Ryan Wereski, Michael McDermott, Alexander J F Thurston, Amy V Ferry, Michelle C Williams, Andrew H Baker, Marc R Dweck, David E Newby, Andrew R Chapman, Bertil Lindahl, Nicholas L Mills","doi":"10.1093/ehjacc/zuaf002","DOIUrl":"10.1093/ehjacc/zuaf002","url":null,"abstract":"<p><strong>Aims: </strong>The diagnostic criteria for Type 2 myocardial infarction identify a heterogeneous group of patients with variable outcomes and no clear treatment implications. We aimed to determine the implications of a new clinical classification for myocardial infarction with more objective diagnostic criteria using cardiac imaging.</p><p><strong>Methods and results: </strong>In a prospective cohort study, patients with Type 2 myocardial infarction underwent coronary angiography and cardiac magnetic resonance imaging or echocardiography. The new classification was applied to identify (i) spontaneous myocardial infarction due to acute coronary pathology, (ii) secondary myocardial infarction precipitated by acute illness in the presence of obstructive coronary artery disease, a new regional wall motion abnormality, or infarct-pattern scarring, and (iii) no myocardial infarction in the absence of obstructive disease or new myocardial abnormality. In 100 patients (65 years, 43% women) with Type 2 myocardial infarction, the new classification identified 25 and 31 patients with spontaneous and secondary myocardial infarction, respectively, and 44 without myocardial infarction. Compared with patients without myocardial infarction, those with secondary myocardial infarction were older, had more risk factors, and had higher troponin concentrations (P < 0.05 for all). During a median follow-up of 4.4 years, death, myocardial infarction, or heart failure hospitalization was more common in secondary myocardial infarction compared with those without myocardial infarction [55% (17/31) vs. 16% (7/44), P < 0.001].</p><p><strong>Conclusion: </strong>A new clinical classification of myocardial infarction informed by cardiac imaging would reduce the diagnosis of myocardial infarction in acute illness and identify those patients at highest risk who are most likely to benefit from treatment.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/ct2/show/NCT03338504.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"131-141"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002575","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":"This month: from groundbreaking insights to global conversations-we are just one step away from Florence! Join the leading edge of Acute Cardiovascular Care!","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuaf021","DOIUrl":"10.1093/ehjacc/zuaf021","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"129-130"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448592","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":"Question: an uncommon electrocardiogram pattern in a case of acute chest pain.","authors":"Gulbadin Mufti, Shahid H Shali, A Shaheer Ahmed","doi":"10.1093/ehjacc/zuaf019","DOIUrl":"10.1093/ehjacc/zuaf019","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"191-192"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630245","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":"From non-inferiority to superiority: the shift towards patient-centric outcomes.","authors":"Johan Verbeeck, Mickaël De Backer, Marc Buyse","doi":"10.1093/ehjacc/zuaf004","DOIUrl":"10.1093/ehjacc/zuaf004","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"189-190"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964273","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":"European Society of Cardiology quality indicators for the management of acute coronary syndromes: developed in collaboration with the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the ESC.","authors":"Xavier Rossello, Maribel Gonzalez-Del-Hoyo, Suleman Aktaa, Chris P Gale, Israel Barbash, Marc J Claeys, J J Coughlan, Joao Pedro Ferreira, Mary Galbraith, Margret Leosdottir, Francois Schiele, Sergio Raposeiras-Roubin, Maria Rubini Gimenez, Robert A Byrne, Borja Ibanez","doi":"10.1093/ehjacc/zuaf014","DOIUrl":"10.1093/ehjacc/zuaf014","url":null,"abstract":"<p><strong>Aims: </strong>Closing the evidence-practice gap for the treatment of acute coronary syndrome (ACS) is central to improving quality of care. Under the European Society of Cardiology (ESC) framework, we aimed to develop updated quality indicators (QIs) for the evaluation of quality of care and outcomes for patients with ACS.</p><p><strong>Methods and results: </strong>A Working Group of experts including members of the ESC Clinical Practice Guidelines Task Force for ACS, Association for Acute Cardiovascular Care, and European Association of Percutaneous Cardiovascular Interventions followed the ESC methodology for QI development. This methodology involved (i) the identification of the domains of ACS care for the diagnosis and management of ACS; (ii) the construction of candidate QIs through a systematic review of the literature; and (iii) the selection of the final set of QIs (using a modified Delphi method). Five domains of care for the diagnosis and management of ACS were identified: (i) structural framework and logistics, (ii) in-hospital non-invasive care, (iii) invasive strategy and periprocedural management, (iv) secondary prevention interventions, and (v) outcomes. In total, 21 main QIs were selected, covering all five domains of care for the diagnosis and management of ACS.</p><p><strong>Conclusion: </strong>This document defines the five domains of ACS care and provides 21 QIs for the diagnosis and management of ACS. The updated ESC QIs for ACS may be used for quality improvement initiatives.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":"145-154"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058481","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}