European Journal of Clinical Investigation最新文献

{"title":"Correction to 'Lung damage in SARS-CoV-2 patients: An autopsy study in the era of vaccination'.","authors":"","doi":"10.1111/eci.70037","DOIUrl":"https://doi.org/10.1111/eci.70037","url":null,"abstract":"","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70037"},"PeriodicalIF":4.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700009","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":"New approach to specific Alzheimer's disease diagnosis based on plasma biomarkers in a cognitive disorder cohort.","authors":"Lourdes Álvarez-Sánchez, Laura Ferré-González, Carmen Peña-Bautista, Ángel Balaguer, Julián Luis Amengual, Miguel Baquero, Laura Cubas, Bonaventura Casanova, Consuelo Cháfer-Pericás","doi":"10.1111/eci.70034","DOIUrl":"https://doi.org/10.1111/eci.70034","url":null,"abstract":"<p><strong>Background: </strong>The validation of a combination of plasma biomarkers and demographic variables is required to establish reliable cut-offs for Alzheimer's disease diagnosis (AD).</p><p><strong>Methods: </strong>Plasma biomarkers (Aβ42/Aβ40, p-Tau181, t-Tau, NfL, GFAP), ApoE genotype, and demographic variables were obtained from a retrospective clinical cohort of cognitive disorders (n = 478). These patients were diagnosed as AD (n = 254) or non-AD (n = 224) according to cerebrospinal fluid (CSF) Aβ42/Aβ40 levels. An analysis using a Ridge logistic regression model was performed to predict the occurrence of AD. The predictive performance of the model was assessed using the observations from a training set (70% of the sample) and validated using a test set (30% of the sample) in each group. Optimum cutoffs for the model were evaluated.</p><p><strong>Results: </strong>The model including plasma Aβ42/Aβ40, p-Tau181, GFAP, ApoE genotype and age was optimal for predicting CSF Aβ42/Aβ40 positivity (AUC .91, sensitivity .86, specificity .82). The model including only plasma biomarkers (Aβ42/Aβ40, p-Tau181, GFAP) provided reliable results (AUC .88, sensitivity .83, specificity .78). Also, GFAP, individually, showed the best performance in discriminating between AD and non-AD groups (AUC .859). The established cut-offs in a three-range strategy performed satisfactorily for the validated predictive model (probability) and individual plasma GFAP (concentration).</p><p><strong>Conclusions: </strong>The plasma GFAP levels and the validated predictive model based on plasma biomarkers represent a relevant step toward the development of a potential clinical approach for AD diagnosis, which should be assessed in further research.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70034"},"PeriodicalIF":4.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676683","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":"Changes in ghrelin isoforms after sleeve gastrectomy or gastric plication and their association with adiposity and metabolic profile.","authors":"Carlota Tuero, Sara Becerril, Beatriz Ramirez, Victoria Catalán, Javier A Cienfuegos, María A Burrell, Victor Valenti, Rafael Moncada, Javier Gomez-Ambrosi, Amaia Rodriguez, Gema Frühbeck","doi":"10.1111/eci.70031","DOIUrl":"https://doi.org/10.1111/eci.70031","url":null,"abstract":"<p><strong>Background & aims: </strong>Sleeve gastrectomy (SG) and gastric plication (GP) are two widely performed bariatric techniques reducing the size of the stomach. The improvements observed following these procedures are not fully explained only by caloric restriction. Thus, we aimed at the analysis of adiposity and metabolism modifications in diet-induced obesity (DIO) rats submitted to SG or GP and correlate the changes with total ghrelin concentrations and its two different ghrelin isoforms.</p><p><strong>Materials and methods: </strong>Adiposity, lipolysis and circulating ghrelin isoforms were determined in 191 male Wistar rats submitted to surgery: sham (SO), SG, or GP. Results were compared with pair-fed (PF) controls fed either a normal diet (ND) or a high-fat diet (HFD).</p><p><strong>Results: </strong>DIO rats submitted to SG had significantly lower (p < .05) levels of desacyl ghrelin (DAG) and total ghrelin compared with SO and PF ones. Furthermore, they achieved a greater weight loss, adiposity and improvement in glucose and lipid metabolism, as well as brown adipose tissue mitochondrial morphology. No decrease in ghrelin concentrations was observed in GP.</p><p><strong>Conclusions: </strong>The differential effect on circulating ghrelin concentrations of SG and GP, despite both procedures reducing actual stomach size, probably underlies the better outcomes on weight control and lipolysis of the SG due to the fundus removal, the main site of ghrelin-producing cells.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70031"},"PeriodicalIF":4.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669359","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":"Anti-neutrophil cytoplasmic antibodies associated interstitial pneumonia: A possible new clinical entity.","authors":"Claudia Iannone, Maria Rosa Pellico, Antonella Caminati, Maurizio Zompatori, Lisa Tescaro, Francesca Luisi, Davide Elia, Maria Rosa Mirenda, Matteo Colleoni, Roberto Cassandro, Sergio Harari, Roberto Felice Caporali","doi":"10.1111/eci.70025","DOIUrl":"https://doi.org/10.1111/eci.70025","url":null,"abstract":"<p><strong>Background: </strong>Anti-neutrophil cytoplasmic antibodies (ANCA), a hallmark of systemic vasculitis (SV), have been reported in patients with idiopathic interstitial pneumonia (IIP). However, the clinical significance of ANCA in IIP remains unclear.</p><p><strong>Methods: </strong>We retrospectively studied 101 IP patients diagnosed by pneumologists as idiopathic interstitial pneumonia (IIP,64) and IP with autoimmune features (IPAF,37). ANCA, anti-myeloperoxidase and anti-proteinase-3 were tested by immunofluorescence and ELISA. Chest HRCT patterns, pulmonary function tests (PFTs) and the evolution to SV during a 12-month follow-up were assessed. Multivariable regression analysis was performed to assess the association of baseline covariates with SV. The proximity of patients with close characteristics was investigated by cluster analysis.</p><p><strong>Results: </strong>Twenty-one patients (20.8%) were ANCA+, similarly distributed between IPAF and IIP. ANCA+ patients were more likely to have NSIP (p = .02) and bronchiectasis (p = .02) on HRCT, less impaired 6MWD (p = .02), higher CRP (p = .02) and more arthralgias (p < .001) than ANCA- patients. During follow-up, 9 (43%) p-ANCA+ patients, but no ANCA- patients, developed SV (p = .001). p-ANCA+ IP had 26.3 OR (95% CI 3.20-36.8) to evolve to SV within 12 months (p < .0001). Cluster analysis identified one group of 25 patients with significantly higher baseline NSIP (88%), p-ANCA+ (48%), arthralgias (32%), and SV (24%) at 12 months. Nevertheless, 12 p-ANCA+ IP patients never developed SV.</p><p><strong>Conclusions: </strong>ANCA+ IP patients had a high risk of developing SV and need close monitoring and prompt immunotherapy. ANCA+ IP patients not evolving to SV had a diagnosis of IIP or IPAF. These patients need longer observational studies to investigate if they represent a distinct ILD entity.</p>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":" ","pages":"e70025"},"PeriodicalIF":4.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663114","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":"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,&nbsp;Monica Nannipieri,&nbsp;Silvia Armenia,&nbsp;Anna Solini,&nbsp;Rosa Maria Bruno","doi":"10.1111/eci.70026","DOIUrl":"10.1111/eci.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-five individuals with a BMI &gt;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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Bariatric surgery significantly improved BMI, FMD (<i>p</i> &lt; .001) and eGFRcys (<i>p</i> = .042). Before surgery, eGFRcys was positively correlated with FMD (<i>r</i> = .30, <i>p</i> = .011) and inversely correlated with cf-PWV (<i>r</i> = −.26, <i>p</i> = .020), while eGFRcr showed weaker or non-significant associations with vascular variables. eGFRcys increased post-surgery, correlating positively with improvements in FMD (traditional: <i>r</i> = .26, <i>p</i> = .038; allometric: CI [.19, .82], <i>p</i> = .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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":12013,"journal":{"name":"European Journal of Clinical Investigation","volume":"55 5","pages":""},"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}