European Heart Journal Open最新文献

{"title":"High prevalence of pre-eclampsia in women with coarctation of the aorta.","authors":"Lasse Gronningsaeter,&nbsp;Eldrid Langesaeter,&nbsp;Ingvil Krarup Sørbye,&nbsp;Alessia Quattrone,&nbsp;Vibeke Marie Almaas,&nbsp;Helge Skulstad,&nbsp;Mette-Elise Estensen","doi":"10.1093/ehjopen/oead072","DOIUrl":"https://doi.org/10.1093/ehjopen/oead072","url":null,"abstract":"<p><strong>Aims: </strong>The aim was to study pregnancy outcomes in women with coarctation of the aorta (CoA) and associations to hypertensive disorders of pregnancy. Maternal morbidity and mortality are higher in women with heart disease and pre-eclampsia. Chronic hypertension, frequently encountered in CoA, is a risk factor for pre-eclampsia.</p><p><strong>Methods and results: </strong>Clinical data from the National Unit for Pregnancy and Heart Disease database was reviewed for pregnant women with CoA from 2008 to 2021. The primary outcome was hypertensive pregnancy disorders. The secondary outcomes were other cardiovascular, obstetric, and foetal complications. Seventy-six patients were included, with a total of 87 pregnancies. Seventeen (20%) patients were treated for chronic hypertension before pregnancy. Fifteen (20%) patients developed pre-eclampsia, and 5 (7%) had pregnancy-induced hypertension. Major adverse cardiac events developed in four (5%) patients, with no maternal or foetal mortality. Maternal age at first pregnancy [odds ratio (OR) 1.37], body mass index before first pregnancy (OR 1.77), and using acetylsalicylic acid from the first trimester (OR 0.22) were statistically significantly associated with pre-eclampsia. At follow-up (median) 8 years after pregnancy, 29 (38%) patients had anti-hypertensive treatment, an increase of 16% compared to pre-pregnancy. Five (7%) patients had progression of aorta ascendens dilatation to >40 mm, seven (9%) had an upper to lower systolic blood pressure gradient >20 mmHg, and six (8%) had received CoA re-intervention.</p><p><strong>Conclusion: </strong>Pre-eclampsia occurred in 20% of women with CoA in their first pregnancy. All pre-eclamptic patients received adequate anti-hypertensive treatment. All CoA patients were provided multi-disciplinary management, including cardiologic follow-up, to optimize maternal-foetal outcomes.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead072"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/ac/oead072.PMC10407978.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10667039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to treat atrial fibrillation in patients with cardiac amyloidosis.","authors":"Yu Nomoto,&nbsp;Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1093/ehjopen/oead071","DOIUrl":"https://doi.org/10.1093/ehjopen/oead071","url":null,"abstract":"* Corresponding author. Tel: +81 76 434 2281, Fax: +81 76 434 5026, Email: teimamu@med.u-toyama.ac.jp © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com To the Editor Patients with cardiac amyloidosis have a worse prognosis if they have concomitant atrial fibrillation (AF). However, clinical outcomes after AF catheter ablation in such a cohort remain uncertain. Using a nationwide database, Ullah et al. demonstrated that AF ablation in patients with cardiac amyloidosis was associated with higher inhospital all-cause mortality and net adverse clinical events both during the index hospitalization and at 30-day follow-up as compared with background-matched heart failure patients without cardiac amyloidosis. Several concerns are raised. The authors attempted to match baseline characteristics between the patients with cardiac amyloidosis + heart failure and those with heart failure alone. Heart failure is commonly stratified into those with reduced ejection fraction and those with preserved ejection fraction. The diagnosis of heart failure with preserved ejection fraction can be challenging. In particular, the symptom of AF is similar to heart failure. Thus, in their study, the patients with AF who did not have heart failure may also have been included in the control group. Such patients have a relatively better prognosis because they do not have true heart failure, and their results may have been overestimated. It may have been advisable to add the left ventricular ejection fraction as a matching variable. Cardiac amyloidosis has a variety of comorbidities, including aortic stenosis, left ventricular hypertrophy, and bradycardia, all of which have a negative prognostic impact. However, they were not statistically matched between the two groups. Thus, their findings may again have been overestimated. It may be of great interest to investigate whether these comorbidities are associated with worse prognosis in patients with cardiac amyloidosis. Thus, it is unclear how we should recommend AF catheter ablation in patients with cardiac amyloidosis. If comorbidities described above are dominantly associated with a worse prognosis, other interventions may be required in addition to AF catheter ablation, including left atrial appendage occlusion to prevent major bleeding and aortic valve replacement to treat severe aortic stenosis.","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead071"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/87/oead071.PMC10351497.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9839804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life expectancy and end-of-life communication in adult patients with congenital heart disease, 40-53 years after surgery.","authors":"Chiara Pelosi,&nbsp;Robert M Kauling,&nbsp;Judith A A E Cuypers,&nbsp;Elisabeth M W J Utens,&nbsp;Annemien E van den Bosch,&nbsp;Agnes van der Heide,&nbsp;Jeroen S Legerstee,&nbsp;Jolien W Roos-Hesselink","doi":"10.1093/ehjopen/oead067","DOIUrl":"https://doi.org/10.1093/ehjopen/oead067","url":null,"abstract":"<p><strong>Aims: </strong>Although survival of patients with congenital heart disease (CHD) improved significantly over time, life expectancy is still not normal. We aimed to investigate how adult patients, their partners, and treating cardiologists estimated the individual life expectancy of CHD patients. Furthermore, preferences regarding end-of-life (EOL) communication were investigated.</p><p><strong>Methods and results: </strong>In this study, we included 202 patients (age: 50 ± 5) who were operated in childhood (<15 years old) between 1968 and 1980 for one of the following diagnoses: atrial septal defect, ventricular septal defect, pulmonary stenosis, tetralogy of Fallot, or transposition of the great arteries. A specific questionnaire was administered to both the patients and their partners, exploring their perceived life expectancy and EOL wishes. Two cardiologists independently assessed the life expectancy of each patient. Most adults with CHD believed their life expectancy to be normal. However, significant differences were found between estimated life expectancy by the cardiologist and patients (female: <i>P</i> = 0.001, male: <i>P</i> = 0.002) with moderate/severe defects, as well as for males with mild defects (<i>P</i> = 0.011). Regarding EOL communication, 85.1% of the patients reported that they never discussed EOL with a healthcare professional. Compared with patients with mild CHD, significantly more patients with moderate/severe defect discussed EOL with a physician (<i>P</i> = 0.011). The wish to discuss EOL with the cardiologist was reported by 49.3% of the patients and 41.7% of their partners.</p><p><strong>Conclusion: </strong>Adult patients, especially with moderate/severe CHD, perceived their life expectancy as normal, whereas cardiologists had a more pessimistic view than their patients. Increased attention is warranted for discussions on life expectancy and EOL to improve patient-tailored care.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead067"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/da/e8/oead067.PMC10342419.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10202758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcome of patients with combined post- and pre-capillary pulmonary hypertension.","authors":"Anna Titz,&nbsp;Laura Mayer,&nbsp;Paula Appenzeller,&nbsp;Julian Müller,&nbsp;Simon R Schneider,&nbsp;Michael Tamm,&nbsp;Andrei M Darie,&nbsp;Sabina A Guler,&nbsp;John-David Aubert,&nbsp;Frédéric Lador,&nbsp;Hans Stricker,&nbsp;Jean-Marc Fellrath,&nbsp;Susanne Pohle,&nbsp;Mona Lichtblau,&nbsp;Silvia Ulrich","doi":"10.1093/ehjopen/oead069","DOIUrl":"https://doi.org/10.1093/ehjopen/oead069","url":null,"abstract":"<p><strong>Aims: </strong>Pulmonary hypertension (PH) is a complex clinical condition, and left heart disease is the leading cause. Little is known about the epidemiology and prognosis of combined post- and pre-capillary PH (CpcPH).</p><p><strong>Methods and results: </strong>This retrospective analysis of the Swiss PH Registry included incident patients with CpcPH registered from January 2001 to June 2019 at 13 Swiss hospitals. Patient baseline characteristics [age, sex, mean pulmonary artery pressure (mPAP), pulmonary artery wedge pressure (PAWP), pulmonary vascular resistance (PVR), and risk factors, including World Health Organization (WHO)-functional class (FC), 6 min walk distance (6MWD), and N-terminal pro-brain natriuretic peptide (NT-proBNP), treatment, days of follow-up, and events (death or loss to follow-up) at last visit] were analysed by Kaplan-Meier and Cox regression analyses. Two hundred and thirty-one patients (59.3% women, age 65 ± 12 years, mPAP 48 ± 11 mmHg, PAWP 21 ± 5 mmHg, PVR 7.2 ± 4.8 WU) were included. Survival analyses showed a significantly longer survival for women [hazard ratio (HR) 0.58 (0.38-0.89); <i>P</i> = 0.01] and a higher mortality risk for mPAP > 46 mmHg [HR 1.58 (1.03-2.43); <i>P</i> = 0.04] but no association with age or PVR. Patients stratified to high risk according to four-strata risk assessment had an increased mortality risk compared with patients stratified to low-intermediate risk [HR 2.44 (1.23-4.84); <i>P</i> = 0.01]. A total of 46.8% of CpcPH patients received PH-targeted pharmacotherapy; however, PH-targeted medication was not associated with longer survival.</p><p><strong>Conclusion: </strong>Among patients with CpcPH, women and patients with an mPAP ≤46 mmHg survived longer. Furthermore, risk stratification by using non-invasively assessed risk factors, such as WHO-FC, 6MWD, and NT-proBNP, as proposed for pulmonary arterial hypertension, stratified survival in CpcPH, and might be helpful in the management of these patients.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead069"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e5/7b/oead069.PMC10387509.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9980112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exaggerated myocardial torsion may contribute to dynamic left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.","authors":"Ada K C Lo,&nbsp;Thomas Mew,&nbsp;Christina Mew,&nbsp;Kristyan Guppy-Coles,&nbsp;Arun Dahiya,&nbsp;Arnold Ng,&nbsp;Sandhir Prasad,&nbsp;John J Atherton","doi":"10.1093/ehjopen/oead043","DOIUrl":"https://doi.org/10.1093/ehjopen/oead043","url":null,"abstract":"<p><strong>Aims: </strong>Dynamic left ventricular (LV) outflow tract obstruction (LVOTO) is associated with symptoms and increased risk of developing heart failure in hypertrophic cardiomyopathy (HCM). The association of LVOTO and LV twist mechanics has not been well studied in HCM. The aim of the study was to compare the pattern of LV twist in patients with HCM associated with asymmetrical septal hypertrophy with and without LVOTO.</p><p><strong>Methods and results: </strong>Echocardiography (including speckle tracking) was performed in 212 patients with HCM, divided according to the absence (<i>n</i> = 130) or presence (<i>n</i> = 82) of LVOTO (defined as peak pressure gradient ≥30 mmHg either at rest and/or with Valsalva manoeuvre). Patients with LVOTO were older, had smaller LV dimensions, a higher LV ejection fraction (LVEF), a longer anterior mitral valve leaflet length, and a higher early transmitral pulsed wave to septal tissue Doppler velocity ratio (<i>E</i>/<i>E</i>'). A univariate analysis showed that peak twist was significantly higher in patients with LVOTO compared with patients without LVOTO (19.7 ± 7.3 vs. 15.7 ± 6.0, <i>P</i> = 0.00015). Peak twist was similarly enhanced in patients with LVOTO, manifesting only during Valsalva (19.2 ± 5.6, <i>P</i> = 0.007) and patients with resting LVOTO (19.9 ± 8.0, <i>P</i> = 0.00004) compared with patients without LVOTO (15.7 ± 6.0). A stepwise forward logistic regression analysis showed that LVEF, LV end-systolic dimension indexed to body surface area, anterior mitral valve leaflet length, <i>E</i>/<i>E</i>', and peak twist were all independently associated with LVOTO.</p><p><strong>Conclusion: </strong>This study demonstrates that increased peak LV twist is independently associated with LVOTO in patients with HCM. Peak twist was similarly exaggerated in patients with only latent LVOTO, suggesting that it may play a contributory role to LVOTO in HCM.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead043"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/75/oead043.PMC10442061.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10060902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac device-related infective endocarditis need for lead extraction whatever the device according to the ESC EORP EURO-ENDO registry.","authors":"Erwan Donal,&nbsp;Christophe Tribouilloy,&nbsp;Anita Sadeghpour,&nbsp;Cécile Laroche,&nbsp;Ana Clara Tude Rodrigues,&nbsp;Maria do Carmo Pereira Nunes,&nbsp;Duk-Hyun Kang,&nbsp;Marta Hernadez-Meneses,&nbsp;Zhanna Kobalava,&nbsp;Michele De Bonis,&nbsp;Rafal Dworakowski,&nbsp;Branislava Ivanovic,&nbsp;Maria Holicka,&nbsp;Takeshi Kitai,&nbsp;Ines Cruz,&nbsp;Olivier Huttin,&nbsp;Paolo Colonna,&nbsp;Patrizio Lancellotti,&nbsp;Gilbert Habib","doi":"10.1093/ehjopen/oead064","DOIUrl":"https://doi.org/10.1093/ehjopen/oead064","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac device-related infective endocarditis (CDRIE) is a severe complication of cardiac device (CD) implantation and is usually treated by antibiotic therapy and percutaneous device extraction. Few studies report the management and prognosis of CDRIE in real life. In particular, the rate of device extraction in clinical practice and the management of patients with left heart infective endocarditis (LHIE) and an apparently non-infected CD (LHIE+CDRIE-) are not well described.</p><p><strong>Methods and results: </strong>We sought to study in EURO-ENDO, the characteristics, prognosis, and management of 483 patients with a CD included in the European Society of Cardiology EurObservational Research Programme EURO-ENDO registry. Three populations were compared: 280 isolated CDRIE (66.7 ± 14.3 years), 157 patients with LHIE and an apparently non-infected CD (LHIE+CDRIE-) (71.1 ± 13.6), and 46 patients with both LHIE and CDRIE (LHIE+CDRIE+) (70.2 ± 10.1). Echocardiography was not always transoesophageal echography (TOE); it was transthoracic echography (TTE) for isolated CDRIE in 88.4% (TOE = 67.6%), for LHIE+CDRIE- TTE = 93.0% (TOE = 58.6%), and for CDRIE+LHIE+ TTE = 87.0% (TOE = 63.0%). Nuclear imaging was performed in 135 patients (positive for 75.6%). In-hospital mortality was lower in isolated CDRIE 13.2% vs. 22.3% and 30.4% for LHIE+CDRIE- and LHIE+CDRIE+ (<i>P</i> = 0004). Device extraction was performed in 62.1% patients with isolated CDRIE, 10.2% of LHIE+CDRIE- patients, and 45.7% of CDRIE+LHIE+ patients. Device extraction was associated with a better prognosis [hazard ratio 0.59 (0.40-0.87), <i>P</i> = 0.0068] even in the LHIE+CDRIE- group (<i>P</i> = 0.047).</p><p><strong>Conclusion: </strong>Prognosis of endocarditis in patients with a CD remains poor, particularly in the presence of an associated LHIE. Although recommended by guidelines, device extraction is not always performed. Device removal was associated with better prognosis, even in the LHIE+CDRIE- group.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead064"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/60/oead064.PMC10351571.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9834147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circadian variation in acute myocardial infarction and modification by coronary artery disease: a prospective observational study.","authors":"Bernard Chan,&nbsp;Thomas Buckley,&nbsp;Peter Hansen,&nbsp;Elizabeth Shaw,&nbsp;Geoffrey H Tofler","doi":"10.1093/ehjopen/oead068","DOIUrl":"https://doi.org/10.1093/ehjopen/oead068","url":null,"abstract":"* Corresponding author. Tel: (61) 2 94631514, Fax: (61) 2 94632053, Email: Geoffrey.Tofler@health.nsw.gov.au © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Introduction","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead068"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/52/oead068.PMC10351570.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9839807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular disease risk in women with hyperandrogenism, oligomenorrhea/menstrual irregularity or polycystic ovaries (components of polycystic ovary syndrome): a systematic review and meta-analysis.","authors":"Andre C Q Lo,&nbsp;Charmaine Chu Wen Lo,&nbsp;Clare Oliver-Williams","doi":"10.1093/ehjopen/oead061","DOIUrl":"https://doi.org/10.1093/ehjopen/oead061","url":null,"abstract":"<p><strong>Aims: </strong>Prior meta-analyses indicate polycystic ovary syndrome (PCOS) is associated with cardiovascular diseases (CVDs), but have high statistical heterogeneity, likely because PCOS is a heterogenous syndrome diagnosed by having any two of the three components: hyperandrogenism, oligomenorrhea/menstrual irregularity or polycystic ovaries. Several studies report higher risk of CVDs from individual PCOS components, but a comprehensive assessment of how each component contributes to CVD risk is lacking. This study aims to assess CVD risk for women with one of the PCOS components.</p><p><strong>Methods and results: </strong>A systematic review and meta-analysis of observational studies was conducted. PubMed, Scopus, and Web of Science were searched without restrictions in July 2022. Studies meeting inclusion criteria examined the association between PCOS components and risk of a CVD. Two reviewers independently assessed abstracts and full-text articles, and extracted data from eligible studies. Where appropriate, relative risk (RR) and 95% confidence interval (CI) were estimated by random-effects meta-analysis. Statistical heterogeneity was assessed using the <i>I</i>² statistic. Twenty-three studies, including 346 486 women, were identified. Oligo-amenorrhea/menstrual irregularity was associated with overall CVD (RR = 1.29, 95%CI = 1.09-1.53), coronary heart disease (CHD) (RR = 1.22, 95%CI = 1.06-1.41), and myocardial infarction (MI) (RR = 1.37, 95%CI = 1.01-1.88) but not cerebrovascular disease. These results were broadly consistent even after further adjustment for obesity. There was mixed evidence for the role of hyperandrogenism in CVDs. No studies examined polycystic ovaries as an independent exposure for CVD risk.</p><p><strong>Conclusion: </strong>Oligo-amenorrhea/menstrual irregularity is associated with greater risk of overall CVD, CHD, and MI. More research is needed to assess the risks associated with hyperandrogenism or polycystic ovaries.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead061"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/9e/oead061.PMC10317290.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to: Is electrical neuromodulation able to affect the extent and stability of coronary atheromatous plaques?","authors":"","doi":"10.1093/ehjopen/oead081","DOIUrl":"https://doi.org/10.1093/ehjopen/oead081","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjopen/oead063.].</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead081"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468010/pdf/oead081.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10119824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular outcomes in patients with coronary artery disease and elevated lipoprotein(a): implications for the OCEAN(a)-outcomes trial population.","authors":"Arthur Shiyovich,&nbsp;Adam N Berman,&nbsp;Stephanie A Besser,&nbsp;David W Biery,&nbsp;Daniel M Huck,&nbsp;Brittany Weber,&nbsp;Christopher Cannon,&nbsp;James L Januzzi,&nbsp;John N Booth,&nbsp;Khurram Nasir,&nbsp;Marcelo F Di Carli,&nbsp;J Antonio G López,&nbsp;Shia T Kent,&nbsp;Deepak L Bhatt,&nbsp;Ron Blankstein","doi":"10.1093/ehjopen/oead077","DOIUrl":"https://doi.org/10.1093/ehjopen/oead077","url":null,"abstract":"<p><strong>Aims: </strong>The ongoing Olpasiran Trials of Cardiovascular Events and Lipoprotein(a) Reduction [OCEAN(a)]-Outcomes trial is evaluating whether Lp(a) lowering can reduce the incidence of cardiovascular events among patients with prior myocardial infarction (MI) or percutaneous coronary intervention (PCI) and elevated Lp(a) (≥200 nmol/L). The purpose of this study is to evaluate the association of elevated Lp(a) with cardiovascular outcomes in an observational cohort resembling the OCEAN(a)-Outcomes trial main enrolment criteria.</p><p><strong>Methods and results: </strong>This study included patients aged 18-85 years with Lp(a) measured as part of their clinical care between 2000 and 2019. While patients were required to have a history of MI, or PCI, those with severe kidney dysfunction or a malignant neoplasm were excluded. Elevated Lp(a) was defined as ≥200 nmol/L consistent with the OCEAN(a)-Outcomes trial. The primary outcome was a composite of coronary heart disease death, MI, or coronary revascularization. Natural language processing algorithms, billing and ICD codes, and laboratory data were employed to identify outcomes and covariates. A total of 3142 patients met the eligibility criteria, the median age was 61 (IQR: 52-73) years, 28.6% were women, and 12.3% had elevated Lp(a). Over a median follow-up of 12.2 years (IQR: 6.2-14.3), the primary composite outcome occurred more frequently in patients with versus without elevated Lp(a) [46.0 vs. 38.0%, unadjHR = 1.30 (95% CI: 1.09-1.53), <i>P</i> = 0.003]. Following adjustment for measured confounders, elevated Lp(a) remained independently associated with the primary outcome [adjHR = 1.33 (95% CI: 1.12-1.58), <i>P</i> = 0.001].</p><p><strong>Conclusion: </strong>In an observational cohort resembling the main OCEAN(a)-Outcomes Trial enrolment criteria, patients with an Lp(a) ≥200 nmol/L had a higher risk of cardiovascular outcomes.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":"3 4","pages":"oead077"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/d4/oead077.PMC10460541.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}