Syed Bukhari, Marie D Gerhard-Herman, Behnood Bikdeli
{"title":"COVID-19 and vascular ageing: an accelerated yet partially reversible clock?","authors":"Syed Bukhari, Marie D Gerhard-Herman, Behnood Bikdeli","doi":"10.1093/eurheartj/ehaf590","DOIUrl":"10.1093/eurheartj/ehaf590","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3919-3921"},"PeriodicalIF":35.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabio Mangiacapra, Luca Paolucci, Bernard De Bruyne, Gilles Rioufol, Joo-Yong Hahn, Shao-Liang Chen, Bon-Kwon Koo, Pim A L Tonino, Marcel van 't Veer, Pascal Motreff, Denis Angoulvant, Joo Myung Lee, Doyeon Hwang, Seokhun Yang, Nico H J Pijls, Emanuele Barbato
{"title":"Fractional flow reserve vs angiography to guide percutaneous coronary intervention: an individual patient data meta-analysis.","authors":"Fabio Mangiacapra, Luca Paolucci, Bernard De Bruyne, Gilles Rioufol, Joo-Yong Hahn, Shao-Liang Chen, Bon-Kwon Koo, Pim A L Tonino, Marcel van 't Veer, Pascal Motreff, Denis Angoulvant, Joo Myung Lee, Doyeon Hwang, Seokhun Yang, Nico H J Pijls, Emanuele Barbato","doi":"10.1093/eurheartj/ehaf504","DOIUrl":"10.1093/eurheartj/ehaf504","url":null,"abstract":"<p><strong>Background and aims: </strong>Several randomized controlled trials (RCTs) have compared fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) with angiography-guided PCI in different clinical settings, yielding mixed results. This individual patient data meta-analysis focused on trials where FFR was used to assess intermediate coronary lesions in chronic coronary syndrome (CCS) or non-culprit vessels in non-ST-elevation acute coronary syndromes (NSTE-ACS).</p><p><strong>Methods: </strong>Randomized controlled trials comparing FFR- vs angiography-guided PCI with a minimum follow-up of 1 year were searched. Studies lacking angiographic inclusion criteria or using FFR for culprit arteries in NSTE-ACS were excluded. Studies including patients with ST-elevation myocardial infarction (MI) or undergoing surgical revascularization could be included after censoring these two subgroups. The primary outcome was the 1-year rate of major adverse cardiac events (MACE), defined as a composite of all-cause death, MI, and repeat revascularization. The secondary outcomes were a composite of all-cause death and MI, the individual components of the primary outcome, cardiac death, spontaneous MI, and procedural MI. The present study is registered with PROSPERO (CRD42024553676).</p><p><strong>Results: </strong>Five RCTs were selected, including 2493 patients: 1241 in the angiography arm and 1252 in the FFR arm. More vessels underwent PCI in the angiography group (45.1% vs 30.2%, P < .001), with more stents implanted per patient [2.0 (2.0-3.0) vs 1.5 (1.0-2.0), P < .001]. One-year MACE occurred in 14.7% of patients in the angiography group and 12.1% in the FFR group [hazard ratio (HR) .80, 95% confidence interval (CI) .64-.99; P = .046]. The risk of MI was significantly reduced in the FFR-guided group (HR .71, 95% CI .53-.96; P = .031). These outcomes were driven by a reduction in peri-procedural MI with FFR guidance, with no significant difference between groups in non-procedural MI, MACE between 30 days and 1 year, and secondary outcomes.</p><p><strong>Conclusions: </strong>Fractional flow reserve-guided PCI was associated with reduced major adverse events in patients with CCS and NSTE-ACS due mainly to fewer peri-procedural MIs, with no differences in mortality or MACE beyond 30 days.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3851-3859"},"PeriodicalIF":35.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Telemonitoring for heart failure: a meta-analysis.","authors":"","doi":"10.1093/eurheartj/ehaf509","DOIUrl":"10.1093/eurheartj/ehaf509","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3935-3937"},"PeriodicalIF":35.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12517741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947730","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}
Riccardo Liga, Alessia Gimelli, Tomaž Podlesnikar, Marta Cvijić, Gianluca Pontone, Marcelo Haertel Miglioranza, Andrea Igoren Guaricci, Sara Seitun, Alberto Clemente, Alexey Sumin, João Vitola, Antti Saraste, Christian Paunonen, Ching-Hui Sia, Filipp Paleev, Leyla Elif Sade, Jose Luis Zamorano, Natallia Maroz-Vadalazhskaya, Mirjana Sredojević, Constantinos Anagnostopoulos, Filipe Macedo, Juhani Knuuti, Thor Edvardsen, Bernard Cosyns, Steffen E Petersen, Julien Magne, Cecile Laroche, Bogdan A Popescu, Victoria Delgado, Danilo Neglia
{"title":"Treatment and outcomes of chronic coronary syndromes: the EORP EURECA imaging registry.","authors":"Riccardo Liga, Alessia Gimelli, Tomaž Podlesnikar, Marta Cvijić, Gianluca Pontone, Marcelo Haertel Miglioranza, Andrea Igoren Guaricci, Sara Seitun, Alberto Clemente, Alexey Sumin, João Vitola, Antti Saraste, Christian Paunonen, Ching-Hui Sia, Filipp Paleev, Leyla Elif Sade, Jose Luis Zamorano, Natallia Maroz-Vadalazhskaya, Mirjana Sredojević, Constantinos Anagnostopoulos, Filipe Macedo, Juhani Knuuti, Thor Edvardsen, Bernard Cosyns, Steffen E Petersen, Julien Magne, Cecile Laroche, Bogdan A Popescu, Victoria Delgado, Danilo Neglia","doi":"10.1093/eurheartj/ehaf594","DOIUrl":"10.1093/eurheartj/ehaf594","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3922-3927"},"PeriodicalIF":35.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144872100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lessons from coronary physiology: primum non nocere.","authors":"Adrian P Banning","doi":"10.1093/eurheartj/ehaf429","DOIUrl":"10.1093/eurheartj/ehaf429","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":"3860-3862"},"PeriodicalIF":35.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"DanGer shock criteria and outcomes in acute myocardial infarction-related cardiogenic shock treated with Impella: the J-PVAD registry.","authors":"Riku Arai,Keisuke Kojima,Daisuke Fukamachi,Yasuo Okumura","doi":"10.1093/eurheartj/ehaf787","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf787","url":null,"abstract":"BACKGROUND AND AIMSThe DanGer shock trial showed a survival benefit of Impella in highly selected patients with ST-elevation myocardial infarction-related cardiogenic shock (STEMI-CS). In real-world settings, however, Impella is often used in broader populations not meeting trial criteria. This study aimed to assess the distribution and outcomes of DanGer shock-eligible and -ineligible acute myocardial infarction-related cardiogenic shock (AMI-CS) patients in a nationwide Japanese registry.METHODSA total of 3975 AMI-CS patients treated with Impella between 2020 and 2023 were identified from the J-PVAD registry. Patients were stratified into five groups: eligible STEMI-CS, non-eligible STEMI-CS, out-of-hospital cardiac arrest (OHCA), mechanical complications (MCs), and non-STEMI-CS (NSTEMI-CS). Eligible STEMI-CS was defined as STEMI-CS fulfilling all of the following: lactate ≥ 2.5 mmol/L, systolic blood pressure <100 mmHg or catecholamine use, left ventricular ejection fraction <45%, and shock onset to first Impella support ≤24 h. Thirty-day mortality, associated risk factors, and complications were examined across the five groups.RESULTSEligible STEMI-CS accounted for 35.6% of all AMI-CS cases, with a 30-day mortality of 37.6%. Non-eligible STEMI-CS patients had lower mortality (27.6%), but it increased significantly with advanced age, renal dysfunction, veno-arterial extracorporeal membrane oxygenation use, ventricular arrhythmia, or sepsis. Thirty-day mortality was 51.3% in OHCA (63.4% without return of spontaneous circulation), 39.8% in MC, and 33.3% in NSTEMI-CS groups.CONCLUSIONSIn this nationwide registry, one-third of AMI-CS patients treated with Impella met DanGer shock criteria. Outcomes in non-eligible subgroups were heterogeneous, highlighting the importance of individualized risk assessment in guiding Impella use in real-world practice.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"50 2 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The management of heart failure: a brief look into the future.","authors":"Eugene Braunwald","doi":"10.1093/eurheartj/ehaf720","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf720","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"57 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145277251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}