European Heart Journal最新文献_第10页

Recommendations for statin management in primary prevention: disparities among international risk scores. 一级预防中他汀类药物管理的建议：国际风险评分之间的差异。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad539

G B John Mancini, Arnold Ryomoto, Eunice Yeoh, Liam R Brunham, Robert A Hegele

{"title":"Recommendations for statin management in primary prevention: disparities among international risk scores.","authors":"G B John Mancini, Arnold Ryomoto, Eunice Yeoh, Liam R Brunham, Robert A Hegele","doi":"10.1093/eurheartj/ehad539","DOIUrl":"10.1093/eurheartj/ehad539","url":null,"abstract":"Background and aims: Statin recommendations in primary prevention depend upon risk algorithms. Moreover, with intermediate risk, risk enhancers and de-enhancers are advocated to aid decisions. The aim of this study was to compare algorithms used in North America and Europe for the identification of patients warranting statin or consideration of risk enhancers and de-enhancers.Methods: A simulated population (n = 7680) equal in males and females, with/without smoking, aged 45-70 years, total cholesterol 3.5-7.0 mmol/L, high-density lipoprotein cholesterol 0.6-2.2 mmol/L, and systolic blood pressure 100-170 mmHg, was evaluated. High, intermediate, and low risks were determined using the Framingham Risk Score (FRS), Pooled Cohort Equation (PCE), four versions of Systematic Coronary Risk Evaluation 2 (SCORE2), and Multi-Ethnic Study of Atherosclerosis (MESA) algorithm (0-1000 Agatston Units).Results: Concordance for the three levels of risk varied from 19% to 85%. Both sexes might be considered to have low, intermediate, or high risk depending on the algorithm applied, even with the same burden of risk factors. Only SCORE2 (High Risk and Very High Risk versions) identified equal proportions of males and females with high risk. Excluding MESA, the proportion with moderate risk was 25% (SCORE2, Very High Risk Region), 32% (FRS), 39% (PCE), and 45% (SCORE2, Low Risk Region).Conclusion: Risk algorithms differ substantially in their estimation of risk, recommendations for statin treatment, and use of ancillary testing, even in identical patients. These results highlight the limitations of currently used risk-based approaches for addressing lipid-specific risk in primary prevention.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"117-128"},"PeriodicalIF":39.3,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10082363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Concern regarding missed non-ST-segment elevation myocardial infarctions when applying a single, pre-hospital cardiac troponin measurement. 在应用单一的院前心肌肌钙蛋白测量时，对遗漏的非ST段抬高型心肌梗死的担忧。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad642

Jonas Glaeser, Pedro Lopez-Ayala, Christian Mueller

引用次数: 1

Adapting cardiovascular risk prediction models to different populations: the need for recalibration. 使心血管风险预测模型适应不同人群:需要重新校准。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad748

Lisa Pennells, Stephen Kaptoge, Emanuele Di Angelantonio

引用次数: 0

Less concern about missing NSTEMIs, more prospective randomized controlled trials warranted. 对NSTEM缺失的担忧减少，有必要进行更多前瞻性随机对照试验。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad646

Cyril Camaro, Goaris W A Aarts, Niels van Royen

引用次数: 0

Resistant hypertension: cardiorenal protection with mineralocorticoid receptor blockade. 耐药性高血压：矿物质皮质激素受体阻断剂的心肾保护作用。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad299

Bertram Pitt, George L Bakris

引用次数: 0

Inflammation in acute myocardial infarction: the good, the bad and the ugly. 急性心肌梗死的炎症：好的、坏的和丑陋的。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad486

Michael A Matter, Francesco Paneni, Peter Libby, Stefan Frantz, Barbara E Stähli, Christian Templin, Alessandro Mengozzi, Yu-Jen Wang, Thomas M Kündig, Lorenz Räber, Frank Ruschitzka, Christian M Matter

{"title":"Inflammation in acute myocardial infarction: the good, the bad and the ugly.","authors":"Michael A Matter, Francesco Paneni, Peter Libby, Stefan Frantz, Barbara E Stähli, Christian Templin, Alessandro Mengozzi, Yu-Jen Wang, Thomas M Kündig, Lorenz Räber, Frank Ruschitzka, Christian M Matter","doi":"10.1093/eurheartj/ehad486","DOIUrl":"10.1093/eurheartj/ehad486","url":null,"abstract":"Convergent experimental and clinical evidence have established the pathophysiological importance of pro-inflammatory pathways in coronary artery disease. Notably, the interest in treating inflammation in patients suffering acute myocardial infarction (AMI) is now expanding from its chronic aspects to the acute setting. Few large outcome trials have proven the benefits of anti-inflammatory therapies on cardiovascular outcomes by targeting the residual inflammatory risk (RIR), i.e. the smouldering ember of low-grade inflammation persisting in the late phase after AMI. However, these studies have also taught us about potential risks of anti-inflammatory therapy after AMI, particularly related to impaired host defence. Recently, numerous smaller-scale trials have addressed the concept of targeting a deleterious flare of excessive inflammation in the early phase after AMI. Targeting different pathways and implementing various treatment regimens, those trials have met with varied degrees of success. Promising results have come from those studies intervening early on the interleukin-1 and -6 pathways. Taking lessons from such past research may inform an optimized approach to target post-AMI inflammation, tailored to spare 'The Good' (repair and defence) while treating 'The Bad' (smouldering RIR) and capturing 'The Ugly' (flaming early burst of excess inflammation in the acute phase). Key constituents of such a strategy may read as follows: select patients with large pro-inflammatory burden (i.e. large AMI); initiate treatment early (e.g. ≤12 h post-AMI); implement a precisely targeted anti-inflammatory agent; follow through with a tapering treatment regimen. This approach warrants testing in rigorous clinical trials.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"89-103"},"PeriodicalIF":39.3,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10005009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The European Society of Cardiology working group on atherosclerosis and vascular biology. 欧洲心脏病学会动脉粥样硬化和血管生物学工作组。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad536

Esther Lutgens, Elena Osto, Marie-Luce Bochaton-Piallat

引用次数: 0

More on aldosterone biosynthesis inhibition and resistant hypertension: a Phase-2 study with lorundrostat. 关于醛固酮生物合成抑制和耐药性高血压的更多信息：洛undrostat的2期研究。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad756

Massimo Volpe, Leonarda Galiuto

引用次数: 0

Reports from 2023 Great Wall International Congress of Cardiology in China. 2023年中国长城国际心脏病学大会报告。

IF 39.3 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad737

Feng Cao, Yabin Wang, Yongjian Wu, Changsheng Ma

引用次数: 0

Stroke risk in women with atrial fibrillation. 心房颤动女性的中风风险。

IF 37.6 1区医学

European Heart Journal Pub Date : 2024-01-07 DOI: 10.1093/eurheartj/ehad508

Hifza Buhari, Jiming Fang, Lu Han, Peter C Austin, Paul Dorian, Cynthia A Jackevicius, Amy Y X Yu, Moira K Kapral, Sheldon M Singh, Karen Tu, Dennis T Ko, Clare L Atzema, Emelia J Benjamin, Douglas S Lee, Husam Abdel-Qadir

{"title":"Stroke risk in women with atrial fibrillation.","authors":"Hifza Buhari, Jiming Fang, Lu Han, Peter C Austin, Paul Dorian, Cynthia A Jackevicius, Amy Y X Yu, Moira K Kapral, Sheldon M Singh, Karen Tu, Dennis T Ko, Clare L Atzema, Emelia J Benjamin, Douglas S Lee, Husam Abdel-Qadir","doi":"10.1093/eurheartj/ehad508","DOIUrl":"10.1093/eurheartj/ehad508","url":null,"abstract":"Background and aims: Female sex is associated with higher rates of stroke in atrial fibrillation (AF) after adjustment for other CHA2DS2-VASc factors. This study aimed to describe sex differences in age and cardiovascular care to examine their relationship with stroke hazard in AF.Methods: Population-based cohort study using administrative datasets of people aged ≥66 years diagnosed with AF in Ontario between 2007 and 2019. Cause-specific hazard regression was used to estimate the adjusted hazard ratio (HR) for stroke associated with female sex over a 2-year follow-up. Model 1 included CHA2DS2-VASc factors, with age modelled as 66-74 vs. ≥ 75 years. Model 2 treated age as a continuous variable and included an age-sex interaction term. Model 3 further accounted for multimorbidity and markers of cardiovascular care.Results: The cohort consisted of 354 254 individuals with AF (median age 78 years, 49.2% female). Females were more likely to be diagnosed in emergency departments and less likely to receive cardiologist assessments, statins, or LDL-C testing, with higher LDL-C levels among females than males. In Model 1, the adjusted HR for stroke associated with female sex was 1.27 (95% confidence interval 1.21-1.32). Model 2 revealed a significant age-sex interaction, such that female sex was only associated with increased stroke hazard at age >70 years. Adjusting for markers of cardiovascular care and multimorbidity further decreased the HR, so that female sex was not associated with increased stroke hazard at age ≤80 years.Conclusion: Older age and inequities in cardiovascular care may partly explain higher stroke rates in females with AF.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"104-113"},"PeriodicalIF":37.6,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10771362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0