European Journal of Clinical Investigation最新文献

{"title":"Impact of sirolimus on long-term adverse cardiovascular outcomes in kidney transplant recipients: A nationwide cohort study.","authors":"Jinhyun Park, Wonhui Choi, Jinseub Hwang, Ha Young Jang, Yun Kim, Young-Mi Ah, Jin-Won Kwon, Kyung Hee Choi, Yun-Kyoung Song","doi":"10.1111/eci.70027","DOIUrl":"https://doi.org/10.1111/eci.70027","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant recipients (KTRs) are at high risk for cardiovascular disease due to the long-term use of immunosuppressive therapy. This study aims to evaluate the long-term impact of sirolimus on cardiovascular outcomes in Korean KTRs.</p><p><strong>Methods: </strong>From a cohort of 7180 eligible KTRs identified from 2010 to 2021, 387 KTRs who received sirolimus were included. To control for confounding variables, propensity score matching was applied, and the landmark method was used to address immortal time bias. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of myocardial infarction, coronary revascularization, ischaemic stroke and all-cause mortality.</p><p><strong>Results: </strong>The analysis showed no significant difference in MACE between the sirolimus-treated and untreated groups (hazard ratio, 1.40; 95% confidence interval, .77-2.55), despite a higher incidence of dyslipidaemia in the sirolimus-treated group. However, subgroup analysis revealed an increased MACE risk in KTRs with pre-transplant congestive heart failure (CHF) who were treated with sirolimus (hazard ratio, 6.22; 95% confidence interval, 1.78-21.74), while no significant differences were found in other subgroups.</p><p><strong>Conclusions: </strong>These findings suggest that while sirolimus can be a viable option for immunosuppression, it should be used cautiously in those with pre-existing CHF.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70027"},"PeriodicalIF":4.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial perfusion imaging in advanced coronary artery disease.","authors":"Roel Hoek, Pepijn A van Diemen, Yvemarie B O Somsen, Ruben W de Winter, Ruurt A Jukema, Jorge E Dahdal, Pieter G Raijmakers, Roel S Driessen, Ibrahim Danad, Paul Knaapen","doi":"10.1111/eci.70024","DOIUrl":"https://doi.org/10.1111/eci.70024","url":null,"abstract":"<p><p>Myocardial perfusion imaging (MPI) is widely adapted as a noninvasive technique to assess the presence and extent of ischemia in patients with symptoms suggestive of obstructive coronary artery disease (CAD). However, as CAD advances, several factors can complicate the interpretation of MPI, subsequently impacting clinical decision-making. This review focuses on the utility of MPI by means of cardiac magnetic resonance (CMR) imaging, single-photon emission computed tomography (SPECT) and positron emission tomography (PET) in patients with advanced CAD-the latter characterized by documented CAD (i.e. prior myocardial infarction [MI] and/or percutaneous coronary intervention [PCI]), prior coronary artery bypass grafting (CABG) or the presence of a chronic total occlusion (CTO). It will discuss factors impacting the interpretation of MPI, the diagnostic performance for detecting obstructive CAD and coronary microvascular dysfunction (CMD), as well as the role of MPI in guiding revascularization.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70024"},"PeriodicalIF":4.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of hypoxic versus normoxic exercise on cardiovascular function in people without cardiovascular diseases: A systematic review and meta-analysis.","authors":"Rubén Fernández-Rodríguez, Vicente Martínez-Vizcaíno, Sara Reina-Gutiérrez, Bruno Bizzozero-Peroni, Francisco J Amaro-Gahete, Juan Fernando Ortega-Fonseca, Ana Torres-Costoso","doi":"10.1111/eci.70028","DOIUrl":"https://doi.org/10.1111/eci.70028","url":null,"abstract":"<p><strong>Background: </strong>Exercise is a well-known strategy for the prevention and treatment of cardiovascular diseases; however, the potential additional benefits of hypoxic exercise on cardiovascular function in comparison to normoxic exercise are still unknown. This study aimed to synthesize the hypoxic exercise protocols of application and to comparatively determine the effects of hypoxic versus normoxic exercise on cardiovascular function (i.e. haemoglobin concentrations, arterial oxygen saturation %, maximal heart rate, blood pressure at rest and blood lactate levels) in people without cardiovascular diseases.</p><p><strong>Methods: </strong>We systematically searched five databases, from inception to September 2023, and selected randomized controlled trials (RCTs) comparing the effects of chronic hypoxic exercise versus normoxic exercise on cardiovascular function in people without cardiovascular diseases. A random effects meta-analysis with both the Dersimonian-Laird and the Hartung-Knapp-Sidik-Jonkman methods was conducted to estimate the pooled standardized mean differences (SMDs) and their 95% confidence intervals (95% CIs) of the hypoxic exercise effectiveness on each of the included outcomes related to cardiovascular function. We performed meta-regression models-considering total sample size, age, BMI, length of intervention and FiO₂ percentages-to determine their influence on the estimated effect. Subgroup analyses based on age, gender, type of exercise and health status of participants were conducted.</p><p><strong>Results: </strong>A total of 31 RCTs involving 910 individuals were included. None of the pooled SMDs comparing hypoxic versus normoxic exercise were statistically significant. Subgroup analyses were only significant for lactate in people under 30 years of age and healthy and/or athletic individuals (.59; 95% CI .11, 1.06).</p><p><strong>Conclusions: </strong>Our data suggest that there were no additive benefits of performing hypoxic exercise on the cardiovascular function parameters explored for up to 7 weeks when compared to normoxic exercise in people without cardiovascular disease, except for a moderate increase in blood lactate levels in young healthy and/or athletic individuals.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70028"},"PeriodicalIF":4.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystatin C-estimated GFR correlates with endothelial function improvements following bariatric surgery.","authors":"Diego Moriconi, Monica Nannipieri, Silvia Armenia, Anna Solini, Rosa Maria Bruno","doi":"10.1111/eci.70026","DOIUrl":"https://doi.org/10.1111/eci.70026","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a critical risk factor for chronic kidney disease and cardiovascular disease. The study aimed to explore the relationship between endothelial function, assessed by flow-mediated dilation (FMD), and kidney function, estimated using cystatin C-based eGFR (eGFRcys), in individuals with severe obesity undergoing bariatric surgery.</p><p><strong>Methods: </strong>Sixty-five individuals with a BMI >35 kg/m² scheduled for bariatric surgery were assessed before and 1 year post-surgery. Vascular health was evaluated using FMD, pulse wave velocity and renal resistive index, while kidney function was measured using creatinine-based (eGFRcr) and cystatin C-based (eGFRcys) equations. FMD was calculated using both traditional and allometric scaling methods to account for variations in brachial arterial diameter.</p><p><strong>Results: </strong>Bariatric surgery significantly improved BMI, FMD (p < .001) and eGFRcys (p = .042). Before surgery, eGFRcys was positively correlated with FMD (r = .30, p = .011) and inversely correlated with cf-PWV (r = -.26, p = .020), while eGFRcr showed weaker or non-significant associations with vascular variables. eGFRcys increased post-surgery, correlating positively with improvements in FMD (traditional: r = .26, p = .038; allometric: CI [.19, .82], p = .003). Multivariable mixed models confirmed the robust association between eGFRcys and FMD calculated by allometric scaling, independent of BMI or blood pressure changes. In contrast, eGFRcr showed no significant association with FMD changes.</p><p><strong>Conclusions: </strong>Bariatric surgery enhances both renal and vascular health in individuals with severe obesity. Cystatin C-based eGFR correlates more strongly with endothelial function improvements than creatinine-based eGFR. These findings highlight the utility of cystatin C as an integrative marker for assessing renal and vascular risk in populations affected by obesity undergoing metabolic surgery.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70026"},"PeriodicalIF":4.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation in atherosclerotic cardiovascular disease: From diagnosis to treatment.","authors":"Natalie Arnold, Wolfgang Koenig","doi":"10.1111/eci.70020","DOIUrl":"https://doi.org/10.1111/eci.70020","url":null,"abstract":"<p><strong>Background: </strong>Targeting inflammation offers a unique possibility to address residual cardiovascular risk in almost two thirds of all patients with prevalent atherosclerotic cardiovascular disease (ASCVD). However, despite FDA approval and the ESC 2024 Guidelines for the Management of Chronic Coronary Syndrome recommendations to implement low-dose colchicine (0.5 mg daily) in the secondary prevention of ASCVD patients with residual inflammatory risk, its clinical adoption is still limited. In this regard, a simple screening for elevated high-sensitive C-reactive protein (hsCRP) on a routine basis might help to recognize low-grade inflammation as an important therapeutic target.</p><p><strong>Results: </strong>Within the present review, we first provide recently published epidemiologic evidence that hsCRP is at least as strong a predictor of future ASCVD events as traditional lipoproteins. Furthermore, we summarize our recent knowledge on currently available strategies to modulate an inflammatory process in ASCVD and critically discuss still open issues regarding the benefit of colchicine therapy in the acute coronary setting or for stroke prevention. In addition, we also briefly touch upon some specific issues of safety related to the long-term use of colchicine. Finally, we discuss the next diagnostic and therapeutic frontiers in targeting residual inflammatory risk, such as detection of vascular/coronary inflammation by pericoronary fat attenuation or the use of ziltivekimab, a human monoclonal antibody targeting interleukin-6.</p><p><strong>Conclusion: </strong>Thus, the integration of interventions aimed at lowering the inflammatory burden in combination with aggressive lipid-modifying therapy in secondary prevention may hold the potential to further reduce the still substantial burden of ASCVD.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70020"},"PeriodicalIF":4.4,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular benefits of early rhythm control and healthy lifestyle in young atrial fibrillation.","authors":"Kyung-Yeon Lee, So-Ryoung Lee, Eue-Keun Choi, JungMin Choi, Hyo-Jeong Ahn, Soonil Kwon, Kyung-Do Han, Seil Oh, Gregory Y H Lip","doi":"10.1111/eci.70018","DOIUrl":"https://doi.org/10.1111/eci.70018","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence exists regarding the consistent and synergistic benefits of early rhythm control (ERC) and healthy lifestyle (HLS) on major adverse cardiovascular events (MACEs) in young patients with atrial fibrillation (AF).</p><p><strong>Aims: </strong>To evaluate the individual and synergistic benefits of ERC and HLS on MACEs in young AF patients.</p><p><strong>Methods: </strong>In an observational cohort study using a Korean nationwide claims database, new-onset AF patients (age 20-<65 years) were included. ERC was defined as rhythm control treatment within 2 years of AF diagnosis, and HLS as having at least two healthy lifestyle behaviours (quitting smoking/abstaining from alcohol/regular exercise). Patients were grouped into: without ERC and HLS (n = 28,809); HLS alone (n = 41,827); ERC alone (n = 10,962); and both ERC and HLS (n = 16,594). The primary outcome was MACEs, and the secondary outcomes included ischaemic stroke, myocardial infarction, heart failure hospitalisation and all-cause death. Multivariable Cox regression analysis assessed HR for MACEs.</p><p><strong>Results: </strong>A total of 98,192 patients were analysed (mean age, 53.3 ± 9.0 years; 35.2% females; mean CHA₂DS₂-VASc score, 1.6 ± 1.3). The ERC and HLS groups were significantly associated with a lower risk of MACEs (ERC: HR .765; 95% CI .722-.810, p < .001 and HLS: HR .813, 95% CI .770-.860, p < .001) compared to those without ERC and HLS; both the ERC and HLS groups were associated with the lowest risk of MACEs (HR .616, 95% CI .569-.666, p < .001). Similar trends were observed for ischaemic stroke among secondary outcomes.</p><p><strong>Conclusions: </strong>ERC and HLS were individually and synergistically associated with a significantly lower risk of MACEs in young AF patients.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70018"},"PeriodicalIF":4.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-regional pro-adrenomedullin: A rapid sepsis biomarker for diagnosing spontaneous bacterial peritonitis in cirrhosis.","authors":"Abderrahim Oussalah, Vincent Haghnejad, Maël Silva Rodriguez, Anne-Sophie Lagneaux, Tom Alix, Pierre Filhine-Tresarrieu, Janina Ferrand, Jean Jung, Julien Broseus, Sylvain Salignac, Amandine Luc, Cédric Baumann, Philipp Schuetz, Alain Lozniewski, Katell Peoc'h, Hervé Puy, Jean-Louis Guéant, Jean-Pierre Bronowicki","doi":"10.1111/eci.70021","DOIUrl":"https://doi.org/10.1111/eci.70021","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous bacterial peritonitis (SBP) is a frequent and life-threatening complication of cirrhosis, contributing to considerable morbidity and mortality.</p><p><strong>Methods: </strong>A cross-sectional derivation study was conducted to assess the diagnostic accuracy of two sepsis-related calcitonin peptide family biomarkers, mid-regional pro-adrenomedullin (MR-pro-ADM) and procalcitonin, in ascitic fluid for identifying bacteriologically confirmed SBP (BC-SBP). In a subsequent validation study, the diagnostic performance of the 'SBP score' was evaluated in an independent patient cohort using an absolute polymorphonuclear (PMN) leukocyte count threshold of ≥250 cells/mm³ as the diagnostic benchmark for diagnosing SBP.</p><p><strong>Results: </strong>In the derivation study, the concentration of MR-pro-ADM in ascitic fluid was significantly higher in patients with BC-SBP compared to those without BC-SBP (3.14 nmol/L [IQR, 2.39-6.74] vs. 1.91 nmol/L [IQR, 1.33-2.80]; p = .0002). Bayesian ANOVA indicated that MR-pro-ADM was highly discriminative for diagnosing BC-SBP, with a substantial Bayes factor (BFM = 2505), whereas procalcitonin exhibited poor discriminatory performance. Receiver-operating characteristic (ROC) analysis identified an optimal MR-pro-ADM cut-off of ≥2.50 nmol/L for diagnosing BC-SBP, with an area under the ROC curve (AUROC) of 0.746 (95% CI, 0.685-0.801; p < .0001). Multivariable logistic regression identified three independent predictors of BC-SBP, which were subsequently incorporated into the 'SBP score' (MR-pro-ADM ≥2.5 nmol/L, absolute PMN count ≥250 cells/mm³ and Child-Pugh score). In the validation study, the 'SBP score' demonstrated an AUROC of 0.993 (95% CI, 0.929-1.000; p < .0001) for diagnosing SBP.</p><p><strong>Conclusion: </strong>MR-pro-ADM in ascitic fluid emerges as a promising biomarker for SBP diagnosis. Combining MR-pro-ADM with absolute PMN count and Child-Pugh score in the 'SBP score' greatly improves the diagnostic accuracy of SBP.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70021"},"PeriodicalIF":4.4,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiangiogenic effect of circulating extracellular vesicles in acute coronary syndrome: Role of miR-199a-3p and miR-125a-5p.","authors":"Joaquin Bobi, Francisco-Rafael Jimenez-Trinidad, Luis Ortega-Paz, Nuria Cortes-Serra, Iolanda Lazaro, Juan-Jose Rodriguez, Carmen Fernandez-Becerra, Ana García-Álvarez, Manel Sabate, Salvatore Brugaletta, Ana-Paula Dantas","doi":"10.1111/eci.70022","DOIUrl":"https://doi.org/10.1111/eci.70022","url":null,"abstract":"<p><strong>Objective: </strong>Circulating extracellular vesicles (EVs) have a great impact on human health as biomarkers and messengers in intercellular signalling. We aimed to determine how the miRNA profile of circulating EVs during an acute coronary event interferes with the vasculogenic potential of endothelial cells (EC).</p><p><strong>Approach and results: </strong>EVs were purified from the plasma of patients in the acute phase of non-ST segment elevation myocardial infarction (NSTEMI, n = 33) and from healthy donors (n = 19) used as a control group. Human ECs were treated with EV suspension (5 × 10⁷ particles/cm²) and tested for their vasculogenic potential and mRNA expression. The EV miRNA profile was determined by miRNA array. EV levels were markedly increased in the plasma of NSTEMI (2.3 × 10¹¹ ± 1.5 × 10¹⁰ particles/mL) versus control (1.2 × 10¹¹ ± 1.1 × 10¹⁰ particles/mL; p = .02). Treatment of ECs with control EVs increased migration, tube formation, and shaped more branched vessel-like structures in comparison to Sham-treated ECs. Nevertheless, EVs from NSTEMI lacked their vasculogenic potential. Network analysis of EV miRNA and EC mRNA expression revealed a correlation of increased miR-199a-3p and miR-125a-5p expression with a decrease in components involved in EC sprout and stabilization. Combined therapy with miR-199a-3p and miR-125a-5p decreased EC vasculogenic potential. Moreover, anti-miRNA therapy with a combination of anti-miR-125a-5p and anti-miR-199a-3p restored the vasculogenic potential impaired by NSTEMI EVs.</p><p><strong>Conclusions: </strong>Circulating EVs play an important role in the control of angiogenesis. However, in the acute phase of NSTEMI, intercellular communication via EV is modified and loses its ability to generate new blood vessels. The loss of angiogenic capacity of EVs during NSTEMI may be an important player in the disease progression and outcomes.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70022"},"PeriodicalIF":4.4,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving concepts of low-density lipoprotein: From structure to function.","authors":"Chu-Huang Chen, Tatsuya Sawamura, Alexander Akhmedov, Ming-Hsien Tsai, Omer Akyol, Akemi Kakino, Huan-Hsing Chiang, Simon Kraler, Thomas F Lüscher","doi":"10.1111/eci.70019","DOIUrl":"https://doi.org/10.1111/eci.70019","url":null,"abstract":"<p><strong>Background: </strong>Low-density lipoprotein (LDL) is a central player in atherogenesis and has long been referred to as 'bad cholesterol.' However, emerging evidence indicates that LDL functions in multifaceted ways beyond cholesterol transport that include roles in inflammation, immunity, and cellular signaling. Understanding LDL's structure, metabolism and function is essential for advancing cardiovascular disease research and therapeutic strategies.</p><p><strong>Methods: </strong>This narrative review examines the history, structural properties, metabolism and functions of LDL in cardiovascular health and disease. We analyze key milestones in LDL research, from its early identification to recent advancements in molecular biology and omics-based investigations. Structural and functional insights are explored through imaging, proteomic analyses and lipidomic profiling, providing a deeper understanding of LDL heterogeneity.</p><p><strong>Results: </strong>Low-density lipoprotein metabolism, from biosynthesis to receptor-mediated clearance, plays a crucial role in lipid homeostasis and atherogenesis. Beyond cholesterol transport, LDL contributes to plaque inflammation, modulates adaptive immunity and regulates cellular signaling pathways. Structural studies reveal its heterogeneous composition, which influences its pathogenic potential. Evolving perspectives on LDL redefine its clinical significance, affecting cardiovascular risk assessment and therapeutic interventions.</p><p><strong>Conclusions: </strong>A holistic understanding of LDL biology challenges traditional perspectives and underscores its complexity in cardiovascular health. Future research should focus on further elucidating LDL's structural and functional diversity to refine risk prediction models and therapeutic strategies, ultimately improving cardiovascular outcomes.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70019"},"PeriodicalIF":4.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of oral anticoagulation in patients with atrial fibrillation: The challenge remains open.","authors":"Giuseppe Boriani, Kevin Serafini, Jacopo Francesco Imberti","doi":"10.1111/eci.70023","DOIUrl":"https://doi.org/10.1111/eci.70023","url":null,"abstract":"","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70023"},"PeriodicalIF":4.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}