European Heart Journal Open最新文献

{"title":"Myocardial perfusion imaging by ¹⁵O-H₂O positron emission tomography predicts clinical revascularization procedures in symptomatic patients with previous coronary artery bypass graft.","authors":"Mazen Vester,&nbsp;Simon Madsen,&nbsp;Mette Louise Gram Kjærulff,&nbsp;Lars Poulsen Tolbod,&nbsp;Bent Roni Ranghøj Nielsen,&nbsp;Steen Dalby Kristensen,&nbsp;Evald Høj Christiansen,&nbsp;Per Hostrup Nielsen,&nbsp;Jens Sörensen,&nbsp;Lars Christian Gormsen","doi":"10.1093/ehjopen/oead044","DOIUrl":"https://doi.org/10.1093/ehjopen/oead044","url":null,"abstract":"<p><strong>Aims: </strong>We wanted to assess if ¹⁵O-H₂O myocardial perfusion imaging (MPI) in a clinical setting can predict referral to coronary artery catheterization [coronary angiography (CAG)], execution of percutaneous coronary intervention (PCI), and post-PCI angina relief for patients with angina and previous coronary artery bypass graft (CABG).</p><p><strong>Methods and results: </strong>We analysed 172 symptomatic CABG patients referred for ¹⁵O-H₂O positron emission tomography (PET) MPI at Aarhus University Hospital Department of Nuclear Medicine & PET Centre, of which five did not complete the scan. In total, 145 (87%) enrolled patients had an abnormal MPI. Of these, 86/145 (59%) underwent CAG within 3 months; however, no PET parameters predicted referral to CAG. During the CAG, 25/86 (29%) patients were revascularized by PCI. Relative flow reserve (RFR) (0.49 vs. 0.54 <i>P</i> = 0.03), vessel-specific myocardial blood flow (MBF) (1.53 vs. 1.88 mL/g/min, <i>P</i> < 0.01), and vessel-specific myocardial flow reserve (MFR) (1.73 vs. 2.13, <i>P</i> < 0.01) were significantly lower in patients revascularized by PCI. Receiver operating characteristic analysis of the vessel-specific parameters yielded optimal cutoffs of 1.36 mL/g/min (MBF) and 1.28 (MFR) to predict PCI. Angina relief was experienced by 18/24 (75%) of the patients who underwent PCI. Myocardial blood flow was an excellent predictor of angina relief on both a global [area under the curve (AUC) = 0.85, <i>P</i> < 0.01] and vessel-specific (AUC = 0.90, <i>P</i> < 0.01) level with optimal cutoff levels of 1.99 mL/g/min and 1.85 mL/g/min, respectively.</p><p><strong>Conclusion: </strong>For CABG patients, RFR, vessel-specific MBF, and vessel-specific MFR measured by ¹⁵O-H₂O PET MPI predict whether subsequent CAG will result in PCI. Additionally, global and vessel-specific MBF values predict post-PCI angina relief.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/37/oead044.PMC10191278.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9499833","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":"Guideline-directed medical therapies for comorbidities among patients with atrial fibrillation: results from GARFIELD-AF.","authors":"Alan John Camm,&nbsp;Jan Steffel,&nbsp;Saverio Virdone,&nbsp;Jean-Pierre Bassand,&nbsp;Keith A A Fox,&nbsp;Samuel Z Goldhaber,&nbsp;Shinya Goto,&nbsp;Sylvia Haas,&nbsp;Alexander G G Turpie,&nbsp;Freek W A Verheugt,&nbsp;Frank Misselwitz,&nbsp;Ramón Corbalán Herreros,&nbsp;Gloria Kayani,&nbsp;Karen S Pieper,&nbsp;Ajay K Kakkar","doi":"10.1093/ehjopen/oead051","DOIUrl":"https://doi.org/10.1093/ehjopen/oead051","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to identify relationships in recently diagnosed atrial fibrillation (AF) patients with respect to anticoagulation status, use of guideline-directed medical therapy (GDMT) for comorbid cardiovascular conditions (co-GDMT), and clinical outcomes. The Global Anticoagulant Registry in the FIELD (GARFIELD)-AF is a prospective, international registry of patients with recently diagnosed non-valvular AF at risk of stroke (NCT01090362).</p><p><strong>Methods and results: </strong>Guideline-directed medical therapy was defined according to the European Society of Cardiology guidelines. This study explored co-GDMT use in patients enrolled in GARFIELD-AF (March 2013-August 2016) with CHA₂DS₂-VASc ≥ 2 (excluding sex) and ≥1 of five comorbidities-coronary artery disease, diabetes mellitus, heart failure, hypertension, and peripheral vascular disease (<i>n</i> = 23 165). Association between co-GDMT and outcome events was evaluated with Cox proportional hazards models, with stratification by all possible combinations of the five comorbidities. Most patients (73.8%) received oral anticoagulants (OACs) as recommended; 15.0% received no recommended co-GDMT, 40.4% received some, and 44.5% received all co-GDMT. At 2 years, comprehensive co-GDMT was associated with a lower risk of all-cause mortality [hazard ratio (HR) 0.89 (0.81-0.99)] and non-cardiovascular mortality [HR 0.85 (0.73-0.99)] compared with inadequate/no GDMT, but cardiovascular mortality was not significantly reduced. Treatment with OACs was beneficial for all-cause mortality and non-cardiovascular mortality, irrespective of co-GDMT use; only in patients receiving all co-GDMT was OAC associated with a lower risk of non-haemorrhagic stroke/systemic embolism.</p><p><strong>Conclusion: </strong>In this large prospective, international registry on AF, comprehensive co-GDMT was associated with a lower risk of mortality in patients with AF and CHA₂DS₂-VASc ≥ 2 (excluding sex); OAC therapy was associated with reduced all-cause mortality and non-cardiovascular mortality, irrespective of co-GDMT use.</p><p><strong>Clinical trial registration: </strong>Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d0/8e/oead051.PMC10246824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298903","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":"Circulating proteins and peripheral artery disease risk: observational and Mendelian randomization analyses.","authors":"Shuai Yuan,&nbsp;Olga E Titova,&nbsp;Ke Zhang,&nbsp;Jie Chen,&nbsp;Xue Li,&nbsp;Derek Klarin,&nbsp;Agneta Åkesson,&nbsp;Scott M Damrauer,&nbsp;Susanna C Larsson","doi":"10.1093/ehjopen/oead056","DOIUrl":"https://doi.org/10.1093/ehjopen/oead056","url":null,"abstract":"<p><strong>Aims: </strong>We conducted observational and Mendelian randomization (MR) analyses to explore the associations between blood proteins and risk of peripheral artery disease (PAD).</p><p><strong>Methods and results: </strong>The observational cohort analyses included data on 257 proteins estimated in fasting blood samples from 12 136 Swedish adults aged 55-94 years who were followed up for incident PAD via the Swedish Patient Register. Mendelian randomization analyses were undertaken using <i>cis</i>-genetic variants strongly associated with the proteins as instrumental variables and genetic association summary statistic data for PAD from the FinnGen study (11 924 cases and 288 638 controls) and the Million Veteran Program (31 307 cases and 211 753 controls). The observational analysis, including 86 individuals diagnosed with incident PAD during a median follow-up of 6.6-year, identified 13 proteins [trefoil factor two, matrix metalloproteinase-12 (MMP-12), growth differentiation factor 15, V-set and immunoglobulin domain-containing protein two, N-terminal prohormone brain natriuretic peptide, renin, natriuretic peptides B, phosphoprotein associated with glycosphingolipid-enriched microdomains one, C-C motif chemokine 15, P-selectin, urokinase plasminogen activator surface receptor, angiopoietin-2, and C-type lectin domain family five member A] associated with the risk of PAD after multiple testing correction. Mendelian randomization analysis found associations of T-cell surface glycoprotein CD4, MMP-12, secretoglobin family 3A member 2, and ADM with PAD risk. The observational and MR associations for T-cell surface glycoprotein CD4 and MMP-12 were in opposite directions.</p><p><strong>Conclusion: </strong>This study identified many circulating proteins in relation to the development of incident PAD. Future studies are needed to verify our findings and assess the predictive and therapeutic values of these proteins in PAD.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/4a/oead056.PMC10267302.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9652841","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":"Physical exercise volume, type, and intensity and risk of all-cause mortality and cardiovascular events in patients with cardiovascular disease: a mediation analysis.","authors":"Nadia E Bonekamp,&nbsp;Anne M May,&nbsp;Martin Halle,&nbsp;Jannick A N Dorresteijn,&nbsp;Manon G van der Meer,&nbsp;Ynte M Ruigrok,&nbsp;Gert J de Borst,&nbsp;Johanna M Geleijnse,&nbsp;Frank L J Visseren,&nbsp;Charlotte Koopal","doi":"10.1093/ehjopen/oead057","DOIUrl":"https://doi.org/10.1093/ehjopen/oead057","url":null,"abstract":"Abstract Aims To estimate the relation between physical exercise volume, type, and intensity with all-cause mortality and recurrent vascular events in patients with cardiovascular disease (CVD) and to quantify to what extent traditional cardiovascular risk factors mediate these relations. Methods and results In the prospective UCC-SMART cohort (N = 8660), the associations of clinical endpoints and physical exercise volume (metabolic equivalent of task hours per week, METh/wk), type (endurance vs. endurance + resistance), and intensity (moderate vs. vigorous) were estimated using multivariable-adjusted Cox models. The proportion mediated effect (PME) through body mass index, systolic blood pressure, low-density lipoprotein cholesterol, insulin sensitivity, and systemic inflammation was assessed using structural equation models. Sixty-one percent of patients (73% male, age 61 ± 10 years, >70% receiving lipid-lowering and blood pressure–lowering medications) reported that they did not exercise. Over a median follow-up of 9.5 years [interquartile range (IQR) 5.1–14.0], 2256 deaths and 1828 recurrent vascular events occurred. The association between exercise volume had a reverse J-shape with a nadir at 29 (95% CI 24–29) METh/wk, corresponding with a HR 0.56 (95% CI 0.48–0.64) for all-cause mortality and HR 0.63 (95% CI 0.55–0.73) for recurrent vascular events compared with no exercise. Up to 38% (95% CI 24–61) of the association was mediated through the assessed risk factors of which insulin sensitivity (PME up to 12%, 95% CI 5–25) and systemic inflammation (PME up to 18%, 95% CI 9–37) were the most important. Conclusion Regular physical exercise is significantly related with reduced risks of all-cause mortality and recurrent vascular events in patients with CVD. In this population with high rates of lipid-lowering and blood pressure–lowering medication use, exercise benefits were mainly mediated through systemic inflammation and insulin resistance.","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/40/oead057.PMC10284340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9712360","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":"Epicardial adipose tissue and obstructive coronary artery disease in acute chest pain: the EPIC-ACS study.","authors":"Stefanie Jehn,&nbsp;Anja Roggel,&nbsp;Iryna Dykun,&nbsp;Bastian Balcer,&nbsp;Fadi Al-Rashid,&nbsp;Matthias Totzeck,&nbsp;Joachim Risse,&nbsp;Clemens Kill,&nbsp;Tienush Rassaf,&nbsp;Amir A Mahabadi","doi":"10.1093/ehjopen/oead041","DOIUrl":"https://doi.org/10.1093/ehjopen/oead041","url":null,"abstract":"<p><strong>Aims: </strong>We tested the hypothesis that epicardial adipose tissue (EAT) quantification improves the prediction of the presence of obstructive coronary artery disease (CAD) in patients presenting with acute chest pain to the emergency department.</p><p><strong>Methods and results: </strong>Within this prospective observational cohort study, we included 657 consecutive patients (mean age 58.06 ± 18.04 years, 53% male) presenting to the emergency department with acute chest pain suggestive of acute coronary syndrome between December 2018 and August 2020. Patients with ST-elevation myocardial infarction, haemodynamic instability, or known CAD were excluded. As part of the initial workup, we performed bedside echocardiography for quantification of EAT thickness by a dedicated study physician, blinded to all patient characteristics. Treating physicians remained unaware of the results of the EAT assessment. The primary endpoint was defined as the presence of obstructive CAD, as detected in subsequent invasive coronary angiography. Patients reaching the primary endpoint had significantly more EAT than patients without obstructive CAD (7.90 ± 2.56 mm vs. 3.96 ± 1.91 mm, <i>P</i> < 0.0001). In a multivariable regression analysis, a 1 mm increase in EAT thickness was associated with a nearby two-fold increased odds of the presence of obstructive CAD [1.87 (1.64-2.12), <i>P</i> < 0.0001]. Adding EAT to a multivariable model of the GRACE score, cardiac biomarkers and traditional risk factors significantly improved the area under the receiver operating characteristic curve (0.759-0.901, <i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Epicardial adipose tissue strongly and independently predicts the presence of obstructive CAD in patients presenting with acute chest pain to the emergency department. Our results suggest that the assessment of EAT may improve diagnostic algorithms of patients with acute chest pain.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/58/oead041.PMC10152391.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9414613","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":"Cardio-ankle vascular index predicts postoperative atrial fibrillation after cardiac surgery.","authors":"Oscar Plunde,&nbsp;David Hupin,&nbsp;Anders Franco-Cereceda,&nbsp;Magnus Bäck","doi":"10.1093/ehjopen/oead042","DOIUrl":"https://doi.org/10.1093/ehjopen/oead042","url":null,"abstract":"Approximately 50% of patients undergoing surgical aortic valve replacement (SAVR) develop postoperative atrial fibrillation (POAF) which is associated with poor outcome. 1 Postoperative atrial fibrillation is multi-factorial and results from the interaction","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/88/oead042.PMC10230281.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940019","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":"SAIL study of stroke, systemic embolism and bleeding outcomes with warfarin anticoagulation in non-valvular atrial fibrillation (S⁴-BOW-AF).","authors":"Daniel E Harris, Fatemeh Torabi, Daniel Mallory, Ashley Akbari, Daniel Thayer, Ting Wang, Sarah Grundy, Mike Gravenor, Raza Alikhan, Steven Lister, Julian Halcox","doi":"10.1093/ehjopen/oead037","DOIUrl":"10.1093/ehjopen/oead037","url":null,"abstract":"<p><strong>Aims: </strong>In patients with non-valvular atrial fibrillation (NVAF) prescribed warfarin, the association between guideline defined international normalised ratio (INR) control and adverse outcomes in unknown. We aimed to (i) determine stroke and systemic embolism (SSE) and bleeding events in NVAF patients prescribed warfarin; and (ii) estimate the increased risk of these adverse events associated with poor INR control in this population.</p><p><strong>Methods and results: </strong>Individual-level population-scale linked patient data were used to investigate the association between INR control and both SSE and bleeding events using (i) the National Institute for Health and Care Excellence (NICE) criteria of poor INR control [time in therapeutic range (TTR) <65%, two INRs <1.5 or two INRs >5 in a 6-month period or any INR >8]. A total of 35 891 patients were included for SSE and 35 035 for bleeding outcome analyses. Mean CHA₂DS₂-VASc score was 3.5 (SD = 1.7), and the mean follow up was 4.3 years for both analyses. Mean TTR was 71.9%, with 34% of time spent in poor INR control according to NICE criteria.SSE and bleeding event rates (per 100 patient years) were 1.01 (95%CI 0.95-1.08) and 3.4 (95%CI 3.3-3.5), respectively, during adequate INR control, rising to 1.82 (95%CI 1.70-1.94) and 4.8 (95% CI 4.6-5.0) during poor INR control.Poor INR control was independently associated with increased risk of both SSE [HR = 1.69 (95%CI = 1.54-1.86), <i>P</i> < 0.001] and bleeding [HR = 1.40 (95%CI 1.33-1.48), <i>P</i> < 0.001] in Cox-multivariable models.</p><p><strong>Conclusion: </strong>Guideline-defined poor INR control is associated with significantly higher SSE and bleeding event rates, independent of recognised risk factors for stroke or bleeding.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9420531","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":"Heterogeneous plaque-lumen geometry is associated with major adverse cardiovascular events.","authors":"Sophie Z Gu, Yuan Huang, Charis Costopoulos, Benn Jessney, Christos Bourantas, Zhongzhao Teng, Sylvain Losdat, Akiko Maehara, Lorenz Räber, Gregg W Stone, Martin R Bennett","doi":"10.1093/ehjopen/oead038","DOIUrl":"10.1093/ehjopen/oead038","url":null,"abstract":"<p><strong>Aims: </strong>Prospective studies show that only a minority of plaques with higher risk features develop future major adverse cardiovascular events (MACE), indicating the need for more predictive markers. Biomechanical estimates such as plaque structural stress (PSS) improve risk prediction but require expert analysis. In contrast, complex and asymmetric coronary geometry is associated with both unstable presentation and high PSS, and can be estimated quickly from imaging. We examined whether plaque-lumen geometric heterogeneity evaluated from intravascular ultrasound affects MACE and incorporating geometric parameters enhances plaque risk stratification.</p><p><strong>Methods and results: </strong>We examined plaque-lumen curvature, irregularity, lumen aspect ratio (LAR), roughness, PSS, and their heterogeneity indices (HIs) in 44 non-culprit lesions (NCLs) associated with MACE and 84 propensity-matched no-MACE-NCLs from the PROSPECT study. Plaque geometry HI were increased in MACE-NCLs vs. no-MACE-NCLs across whole plaque and peri-minimal luminal area (MLA) segments (HI curvature: adjusted <i>P</i> = 0.024; HI irregularity: adjusted <i>P</i> = 0.002; HI LAR: adjusted <i>P</i> = 0.002; HI roughness: adjusted <i>P</i> = 0.004). Peri-MLA HI roughness was an independent predictor of MACE (hazard ratio: 3.21, <i>P</i> < 0.001). Inclusion of HI roughness significantly improved the identification of MACE-NCLs in thin-cap fibroatheromas (TCFA, <i>P</i> < 0.001), or with MLA ≤ 4 mm² (<i>P</i> < 0.001), or plaque burden (PB) ≥ 70% (<i>P</i> < 0.001), and further improved the ability of PSS to identify MACE-NCLs in TCFA (<i>P</i> = 0.008), or with MLA ≤ 4 mm² (<i>P</i> = 0.047), and PB ≥ 70% (<i>P</i> = 0.003) lesions.</p><p><strong>Conclusion: </strong>Plaque-lumen geometric heterogeneity is increased in MACE vs. no-MACE-NCLs, and inclusion of geometric heterogeneity improves the ability of imaging to predict MACE. Assessment of geometric parameters may provide a simple method of plaque risk stratification.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9b/b0/oead038.PMC10152392.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9420533","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":"Randomized evaluation of routine beta-blocker therapy after myocardial infarction quality of life (RQoL): design and rationale of a multicentre, prospective, randomized, open, blinded endpoint study.","authors":"Sophia Humphries, Katarina Mars, Robin Hofmann, Claes Held, Erik M G Olsson","doi":"10.1093/ehjopen/oead036","DOIUrl":"10.1093/ehjopen/oead036","url":null,"abstract":"<p><strong>Aims: </strong>Most cases of acute myocardial infarction (MI) in Sweden are treated with long-term β-blocker therapy as secondary prevention. Case studies and patient reports have indicated negative effects of β-blockers including symptoms of depression, fatigue, sexual dysfunction, and general low mood, all related to reduced quality of life (QoL). To date, no recent large-scale, randomized trial has explored the effects of β-blockers on these factors.</p><p><strong>Methods and results: </strong>The ongoing Randomized Evaluation of Decreased Usage of beta-bloCkErs after myocardial infarction (REDUCE): quality of life (RQoL) study is a multicentre, prospective, randomized pre-specified substudy aiming to evaluate the effects of β-blockers on self-reported measures of QoL. Following randomized allocation to long-term β-blocker or no β-blocker treatment, patients complete a total of six baseline measures pertaining to QoL, sexual functioning, and perceived side effects. Data collection is optionally carried out online through a unique and secure portal and repeated again at two follow-up time points. Recruitment began in July 2018. Data from the first 100 patients showed that at the first follow-up, 93% had completed the questionnaires, which decreased to 81% at the second follow-up. The method of digital data collection was utilized by over half of the patients recruited so far.</p><p><strong>Conclusion: </strong>Data from the first 100 patients indicate success in terms of study design and recruitment. The RQoL substudy investigates the effects of β-blockers on self-reported measures of QoL in MI patients and will potentially contribute to the limited knowledge of QoL-related side effects reported in conjunction with β-blocker use.</p><p><strong>Clinical trial registration: </strong>Eudra CT number, 2017-002336-17; Clinical trial.gov identifier, NCT03278509.</p>","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/ee/oead036.PMC10230287.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940018","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":"Atrial fibrillation in patients with cardiac amyloidosis and heart failure: a desperate cause?","authors":"Jean-Marc Sellal, Christian de Chillou","doi":"10.1093/ehjopen/oead027","DOIUrl":"10.1093/ehjopen/oead027","url":null,"abstract":"","PeriodicalId":11973,"journal":{"name":"European Heart Journal Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/cf/oead027.PMC10098253.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9322884","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}