European Heart Journal: Acute Cardiovascular Care最新文献

{"title":"European Society of Cardiology quality indicators for the management of acute coronary syndrome.","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":"https://doi.org/10.1093/ehjacc/zuaf014","url":null,"abstract":"<p><strong>Background: </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: </strong>A Working Group of experts including members of the ESC Clinical Practice Guidelines Task Force for ACS, Acute CardioVascular Care Association 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).</p><p><strong>Results: </strong>Five domains of care for the diagnosis and management of ACS were identified: (1) structural framework and logistics, (2) in-hospital non-invasive care, (3) invasive strategy and periprocedural management, (4) secondary prevention interventions, and (5) outcomes. In total, 21 main QIs were selected, covering all five domains of care for the diagnosis and management of ACS.</p><p><strong>Conclusions: </strong>This document defines 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":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-28","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}

{"title":"Question: A mysterious cause of myocardial infarction: look beyond his coronary vessels.","authors":"Grace H T Kwok, Kevin K H Kam","doi":"10.1093/ehjacc/zuae117","DOIUrl":"https://doi.org/10.1093/ehjacc/zuae117","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046056","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":"Association between Air Pollutants and Out-of-Hospital Cardiac Arrest: A 5-Year Time Series Analysis.","authors":"Jingjing Wang, Qiang Zhou, Song Ni, Jie Li, Chongzhen Qin, Wangsheng Deng, Zhe Deng","doi":"10.1093/ehjacc/zuaf013","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf013","url":null,"abstract":"<p><strong>Background: </strong>We aimed to analyze the yet unclear correlation between air pollutant concentrations (AP) and out-of-hospital cardiac arrest (OHCA) in Shenzhen, China.</p><p><strong>Methods: </strong>A 5-year time series analysis of all OHCA events reported to the Shenzhen Emergency Center was conducted. Quasi-Poisson regression, controlling for meteorological variables (daily mean relative temperature and humidity) with multivariable fractional polynomial and using Fourier series to adjust for long-term trends and account for periodic patterns, was used to assess the association among particulate matter of 2.5 μm (PM2.5), ozone (O3), particulate matter of ≥10 μm (PM10), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and OHCA.</p><p><strong>Results: </strong>Data from 16,769 patients who experienced OHCA were analyzed. An increase of 10 μg/m3 in PM2.5 was associated with a higher risk of OHCA (relative risk (RR): 1.026 [95% confidence interval [CI]: 1.001-1.053]) on lag day 1. A similar increase in PM10 was linked to an immediate risk of OHCA on the onset day (RR: 1.02 [95% CI: 1.005-1.036]) and a cumulative risk on lag day 1 (RR: 1.021 [95% CI: 1.003-1.039]). An increased risk of OHCA was associated with NO2 and O3 exposure, while a reduced risk of OHCA was associated with SO2 and CO exposure in the subsequent 5 days. The relationship between PM2.5 and OHCA varied by gender and arrest rhythm. A reduction in the average daily PM2.5 concentration by 1 µg/m³ could decrease the incidence of OHCA attributable to PM2.5 exposure by 4.60%, while a reduction by 3 µg/m³ could decrease it by 18.41% on lag day 1. PM2.5 was significantly associated with the occurrence of OHCA on lag day 1. This association was modulated by gender and arrest rhythm.</p><p><strong>Conclusion: </strong>Improving the levels of PM2.5, NO2, and O3 could decrease the risk of OHCA and the demand for emergency medical service related to PM2.5 exposure.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022624","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 ECPR - 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":"https://doi.org/10.1093/ehjacc/zuaf012","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-22","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":"End-of-life issues in the ITU - 10 important points to remember.","authors":"Jean-Louis Vincent","doi":"10.1093/ehjacc/zuaf011","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf011","url":null,"abstract":"<p><p>End-of-life (EOL) issues have become increasingly common in intensive therapy units (ITUs), largely due to advances in critical care that enable patients to be kept alive for extended periods. Death in the ITU now generally follows an EOL decision, which can pose ethical, emotional, and practical challenges. Our approach to such issues should be based on adherence to the four bioethical principles -autonomy, beneficence, nonmaleficence, and distributive justice- as well as the concept of proportionate care, and requires careful and effective communication with the whole ITU team, including the patient and their family. In this article, we discuss 10 key considerations related to EOL care in the ITU, in an attempt to highlight some critical aspects of EOL decision-making for intensivists navigating this sensitive and multifaceted area of practice.</p>","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002573","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":"https://doi.org/10.1093/ehjacc/zuaf002","url":null,"abstract":"<p><strong>Aim: </strong>The diagnostic criteria for type 2 myocardial infarction identify a heterogenous 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: </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 (a) spontaneous myocardial infarction due to acute coronary pathology, (b) 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 (c) no myocardial infarction in the absence of obstructive disease or new myocardial abnormality.</p><p><strong>Results: </strong>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 to patients without myocardial infarction, those with secondary myocardial infarction were older, had more risk factors, and 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 to those without myocardial infarction (55% [17/31] versus 16% [7/44], P<0.001).</p><p><strong>Conclusions: </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":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemia with Non-Obstructive Coronary Arteries (INOCA) in the 2024 European Society of Cardiology (ESC) Guidelines for the management of chronic coronary syndromes.","authors":"Harmony Reynolds, Nathaniel Smilowitz","doi":"10.1093/ehjacc/zuaf005","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf005","url":null,"abstract":"<p><strong>Background: </strong>Chronic coronary syndromes (CCS) occur commonly in the absence of flow-limiting epicardial coronary stenoses. Ischemia or angina with no 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 & 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 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-centered, mechanism-based approach to medical treatment of INOCA/ANOCA to improve symptoms and quality of life.</p><p><strong>Conclusions: </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":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-16","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":"Current State in Acute Aortic Syndromes: Year in Review 2024.","authors":"David A Morrow, Milica Aleksic","doi":"10.1093/ehjacc/zuaf008","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf008","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002571","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":"EHJ ACVC where translational science meets care.","authors":"Pascal Vranckx, David Morrow, Sean van Diepen, Frederik H Verbrugge","doi":"10.1093/ehjacc/zuaf006","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf006","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964272","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 Toward Patient-Centric Outcomes.","authors":"Johan Verbeeck, Mickaël De Backer, Marc Buyse","doi":"10.1093/ehjacc/zuaf004","DOIUrl":"https://doi.org/10.1093/ehjacc/zuaf004","url":null,"abstract":"","PeriodicalId":11861,"journal":{"name":"European Heart Journal: Acute Cardiovascular Care","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-01-11","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}