Carlos Diaz-Arocutipa, Rafael Salguero, Elena Puerto, Roberto Martín-Asenjo, Lourdes Vicent
{"title":"Sex and race/ethnicity disparities on in-hospital outcomes in patients with severe aortic stenosis undergoing TAVR.","authors":"Carlos Diaz-Arocutipa, Rafael Salguero, Elena Puerto, Roberto Martín-Asenjo, Lourdes Vicent","doi":"10.1080/14779072.2025.2528916","DOIUrl":"10.1080/14779072.2025.2528916","url":null,"abstract":"<p><strong>Background: </strong>We assessed the sex and racial/ethnic disparities on in-hospital outcomes in patients undergoing transcatheter aortic valve replacement (TAVR).</p><p><strong>Research design and methods: </strong>This retrospective study analyzed TAVR procedures performed during 2016-2019. Data from the National Inpatient Sample database identified 155,610 patients who underwent TAVR. Outcomes included in-hospital mortality, stroke, major bleeding, and other complications, assessed separately by sex and race/ethnicity (White, Black, and Hispanic). Logistic regression was used to estimate odds ratio (OR) with its 95% confidence interval (CI).</p><p><strong>Results: </strong>Women had higher odds of in-hospital mortality (OR 1.33, 95% CI 1.07-1.64), bleeding, and vascular complications, but lower odds of pacemaker implantation and renal replacement therapy compared with men. Hispanic patients had increased mortality (OR 1.86, 95% CI 1.26-2.75) and black patients had increased odds of stroke (OR 2.06, 95% CI 1.24-3.44). Subgroup analysis showed that Hispanic women had the highest mortality odds (OR 2.42, 95% CI 1.46-4.01).</p><p><strong>Conclusions: </strong>There are significant sex and racial/ethnic disparities in TAVR outcomes, particularly among minority women. Women had a higher odds of mortality, major bleeding, and vascular complications compared to men. Racial disparities were also seen, with Hispanic patients having an increased odds of mortality and black patients having an increased odds of stroke.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"357-366"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Electrocardiogram indicators of right ventricular dilation in repaired tetralogy of Fallot patients.","authors":"Uchina Hiya, Tomoyuki Kabutoya, Kenta Fujimura, Kana Kubota, Yasushi Imai, Akiko Yokomizo, Mitsuru Seki, Kazuomi Kario","doi":"10.1080/14779072.2025.2524566","DOIUrl":"10.1080/14779072.2025.2524566","url":null,"abstract":"<p><strong>Background: </strong>Patients with surgically repaired tetralogy of Fallot (rTOF) often develop chronic pulmonary regurgitation (PR), necessitating pulmonary valve replacement (PVR). While cardiac MRI is crucial for PVR timing, its availability is limited. This study evaluates electrocardiographic (ECG) findings - specifically the R-wave amplitude in lead V1 (V1R) and the sum of the R-wave amplitude in lead V1 and the deepest S-wave amplitude in lead V5 or V6 (V1R + V5S or V6S) - as predictors of cardiac MRI findings.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 35 rTOF patients (mean age 34 ± 9 years; 60% male) who underwent cardiac MRI from 2019 to 2022, assessing correlations between ECG parameters (V1R, V1R + V5S or V6S, and QRS duration) and MRI findings (RVESVI and RVEDVI).</p><p><strong>Results: </strong>V1R showed significant correlation with RVESVI (<i>r</i> = 0.486, <i>p</i> = 0.003) and was notably higher in patients with RVESVI ≥ 80 mL/m<sup>2</sup>. A V1R cutoff of 20 mm identified RVESVI ≥ 80 mL/m<sup>2</sup> with 67% sensitivity and 77% specificity.</p><p><strong>Conclusions: </strong>V1R on ECG may help predict the need for cardiac MRI, aiding in the timely PVR planning for rTOF patients.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"367-371"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evaluating the shared risk factors between atherosclerotic cardiovascular disease and cancer: how significant is the link?","authors":"Brett Deng, Shubh Desai, Leslie Ynalvez, Moez Karim Aziz, Cezar Iliescu","doi":"10.1080/14779072.2025.2527704","DOIUrl":"10.1080/14779072.2025.2527704","url":null,"abstract":"<p><strong>Introduction: </strong>Atherosclerotic cardiovascular disease (ASCVD) and cancer are the leading causes of death globally. While traditionally viewed as distinct, growing evidence reveals significant overlap in their risk factors and pathophysiology, suggesting a shared biological basis that warrants closer clinical and research attention.</p><p><strong>Areas covered: </strong>This review explores modifiable lifestyle and pathological risk factors that contribute to both ASCVD and cancer, including tobacco use, poor diet, physical inactivity, environmental toxins, hypertension, hyperlipidemia, obesity, insulin resistance, and sex hormone dysregulation. Mechanistically, these factors converge on common pathways such as chronic inflammation, oxidative stress, and hormonal imbalance, facilitating both atherogenesis and tumorigenesis. The paper also highlights how these shared mechanisms offer opportunities for unified prevention and treatment strategies.</p><p><strong>Expert opinion: </strong>Understanding these connections is critical for dual-risk stratification, prevention, and management strategies. Emerging approaches such as personalized medicine, leveraging genomic and biomarker data, and multidisciplinary care models that integrate cardiology and oncology expertise offer opportunities to optimize outcomes. Advances in multi-omics and targeted therapies promise to further elucidate the shared mechanisms, paving the way for innovative interventions. This comprehensive understanding highlights the need for integrated care to address the dual burden of ASCVD and cancer and improve patient outcomes.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"333-343"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaeshaelya Thiruchelvam, Jonathan Than Chun Xin, Win Kit Law, Lyn Feng Lee, Xuen Bei Liew, Jia Le Lim, Olivia Sim Hui Min, Zhi Qi Tan, Chia Siang Kow
{"title":"Bleeding risk assessment tools for patients with myocardial infarction: a comparative review and clinical implications.","authors":"Kaeshaelya Thiruchelvam, Jonathan Than Chun Xin, Win Kit Law, Lyn Feng Lee, Xuen Bei Liew, Jia Le Lim, Olivia Sim Hui Min, Zhi Qi Tan, Chia Siang Kow","doi":"10.1080/14779072.2025.2520827","DOIUrl":"10.1080/14779072.2025.2520827","url":null,"abstract":"<p><strong>Introduction: </strong>Bleeding risk stratification tools are essential for optimizing ischemic protection while minimizing bleeding complications in patients with myocardial infarction, particularly for those undergoing percutaneous coronary intervention (PCI) or dual antiplatelet therapy.</p><p><strong>Areas covered: </strong>A structured search of PubMed, Scopus, and Web of Science was conducted for studies published from January 2005 to December 2024. This review evaluates traditional and novel bleeding risk models in MI management. Established tools like CRUSADE, ACUITY-HORIZONS, ACTION, and PRECISE-DAPT aid in predicting in-hospital and early post-discharge bleeding but have limitations in long-term risk assessment and adapting to modern PCI techniques. Emerging models - SWEDEHEART, ARC-HBR, CREDO-KYOTO, and BleeMACS - offer enhanced risk stratification by incorporating broader clinical variables and long-term bleeding predictors, improving their applicability to contemporary MI management.</p><p><strong>Expert opinion: </strong>Despite advancements, current models exhibit moderate predictive accuracy (c-statistics 0.70-0.80) and rely on static baseline factors, limiting real-time applicability. They also fail to integrate ischemic risk assessment, creating challenges in balancing thrombotic and bleeding risks. Future research should focus on AI-driven dynamic risk models, broader validation across diverse populations, and integrating bleeding and ischemic risk stratification into a unified framework. Embedding these tools into electronic health records will enhance clinical decision-making and improve patient outcomes.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"287-301"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Determining major adverse cardiovascular event risk of beta-blocker discontinuation after acute coronary syndromes.","authors":"Nicolas Johner, Baris Gencer","doi":"10.1080/14779072.2025.2520828","DOIUrl":"10.1080/14779072.2025.2520828","url":null,"abstract":"<p><strong>Introduction: </strong>Beta-blocker therapy reduced mortality and cardiovascular events following acute coronary syndromes (ACS) in the pre-reperfusion era. In the contemporary era of early mechanical reperfusion and modern secondary prevention, the benefit of beta-blockers after ACS without reduced left ventricular ejection fraction (LVEF) has been questioned. This review was based on PubMed database searches from inception to January 2025.</p><p><strong>Areas covered: </strong>The recent REDUCE-AMI and ABYSS trials were the first adequately powered contemporary randomized trials evaluating beta-blockers after ACS without reduced LVEF. Contemporary observational evidence is also discussed. Implications for different LVEF categories (41-49% versus ≥ 50%), ACS subtypes, beta-blocker therapy duration, optimal dose, and interaction with other secondary prevention therapies are addressed.</p><p><strong>Expert opinion: </strong>We estimate that there is sufficient evidence to abandon routine beta-blocker prescription in post-ACS patients with preserved LVEF ≥ 50%. Beta-blocker prescription should be individualized with shared decision-making, balancing the risk of cardiovascular event against potential benefits of deprescription. Factors favoring beta-blocker discontinuation include adverse effects, polypharmacy, >1-3 years of stability post-ACS, and specific comorbidities (e.g. heart failure with preserved LVEF). Factors favoring beta-blocker prescription/continuation (besides established indications such as LVEF ≤ 40%, arrhythmias, angina, and refractory hypertension) include good tolerance, LVEF 41-49%, and non-adherence to other secondary prevention therapies.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"271-285"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eva Sinha, Simone Marschner, Anushriya Pant, Sarah Zaman
{"title":"Closing the prevention and diagnosis gap: how can we innovate early coronary heart disease identification in women with female-specific risk factors?","authors":"Eva Sinha, Simone Marschner, Anushriya Pant, Sarah Zaman","doi":"10.1080/14779072.2025.2523929","DOIUrl":"10.1080/14779072.2025.2523929","url":null,"abstract":"","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"263-265"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How can clinicians help to facilitate more equitable cardiovascular healthcare?","authors":"Itamar S Santos","doi":"10.1080/14779072.2025.2522219","DOIUrl":"10.1080/14779072.2025.2522219","url":null,"abstract":"","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"259-261"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenyfer María Fuentes-Mendoza, Roger Gonzales-Valdivieso, Marcio Concepción-Zavaleta, Maicol Augusto Cortez Sandoval
{"title":"The overlooked cardiovascular burden of type 1 diabetes: from atherosclerosis to myocardial infarction.","authors":"Jenyfer María Fuentes-Mendoza, Roger Gonzales-Valdivieso, Marcio Concepción-Zavaleta, Maicol Augusto Cortez Sandoval","doi":"10.1080/14779072.2025.2522223","DOIUrl":"10.1080/14779072.2025.2522223","url":null,"abstract":"","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"267-269"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chia Siang Kow, Feng Chen, Shawn Kai Jie Leong, Kai Yuan Tham, Li Ann Yeoh, Ze Ming Chew, Wen Jie Peh, Kaeshaelya Thiruchelvam
{"title":"Bleeding risk assessment tools in patients with atrial fibrillation taking anticoagulants: a comparative review and clinical implications.","authors":"Chia Siang Kow, Feng Chen, Shawn Kai Jie Leong, Kai Yuan Tham, Li Ann Yeoh, Ze Ming Chew, Wen Jie Peh, Kaeshaelya Thiruchelvam","doi":"10.1080/14779072.2025.2523920","DOIUrl":"10.1080/14779072.2025.2523920","url":null,"abstract":"<p><strong>Introduction: </strong>Bleeding risk assessment plays a critical role in the anticoagulation management for atrial fibrillation (AF), to balance stroke prevention with risk of major hemorrhage. Traditional bleeding risk models, such as HAS-BLED, ORBIT, and ATRIA, offer valuable insights but have limitations in predictive accuracy and clinical applicability. Recent advances in risk stratification have introduced novel models integrating biomarkers, genetic data, and artificial intelligence (AI)-driven algorithms to improve precision and individualized patient care.</p><p><strong>Areas covered: </strong>This review evaluates strengths and limitations of established bleeding risk assessment tools and explores emerging trends in predictive modeling. It discusses novel risk stratification models- DOAC Score, GARFIELD-AF, and HEMORR₂HAGES, which incorporate renal function markers, hematologic parameters, and genetic polymorphisms to enhance predictive accuracy. Integration of machine learning and digital health tools, such as the Universal Clinician Device (UCD) and the mAFA-II mobile application, was also examined for their role in improving anticoagulation safety and adherence.</p><p><strong>Expert opinion: </strong>The future of bleeding risk assessment lies in AI-driven, real-time risk prediction models adapting to dynamic patient profiles. Enhanced integration of digital health solutions and learning health systems will minimize adverse events while optimizing stroke prevention. Future research should prioritize the validation and standardization of these novel tools.</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"303-315"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Newly diagnosed versus previously diagnosed or no diabetes mellitus in patients with acute coronary syndrome: a systematic review and meta-analysis.","authors":"Donatos Tsamoulis, Michail Papapanou, Dimitrios Platis, Timoleon Giannakas, Nikolaos Ktenopoulos, Loukianos S Rallidis","doi":"10.1080/14779072.2025.2522225","DOIUrl":"10.1080/14779072.2025.2522225","url":null,"abstract":"<p><strong>Introduction: </strong>Νewly diagnosed diabetes mellitus (NDDM) among acute coronary syndrome (ACS) patients represents a distinct clinical entity, although available data remain inconclusive. This systematic review and meta-analysis compared ACS patients with NDDM to those without diabetes mellitus (DM) and those with previously diagnosed DM (PDDM).</p><p><strong>Methods: </strong>We searched PubMed, Scopus, and CENTRAL until 10 December 2024. We assessed myocardial necrosis, prognosis, coronary artery disease (CAD) extent, left ventricular ejection fraction (LVEF) at discharge, and cardiometabolic profiles. ROBINS-E and GRADE assessed bias risk and evidence certainty, respectively.</p><p><strong>Results: </strong>Out of 257,859 ACS patients from 34 studies, 5.2% had NDDM. NDDM patients had higher mean peak hs-cardiac troponin I levels compared to PDDM patients (MD 18,389.15 [95% CI 2975.96, 33802.34]) and intermediate post-discharge prognosis between PDDM and non-DM patients [5-MACE; RR 0.80 (95% CI 0.71, 0.91); RR 1.21 (95% CI 1.08, 1.37), respectively]. NDDM patients had similar discharge LVEF to PDDM patients but lower than non-DM patients (MD -2.06% [95% CI -2.93, -1.18]). Their cardiometabolic profile resembled PDDM.</p><p><strong>Conclusions: </strong>Although the evidence was mostly low-certainty, the high prevalence of NDDM and its potentially unfavorable outcomes compared to non-DM patients could stimulate further research on the effects of intensified DM screening and preventive measures in the community and among ACS patients.</p><p><strong>Registration: </strong>This systematic review and meta-analysis was registered with PROSPERO (CRD42024501412).</p>","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"317-326"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}