Expert Review of Cardiovascular Therapy最新文献_第6页

Advances in machine learning for cardiac event prediction: where can we still improve? 心脏事件预测的机器学习进展：我们还可以在哪里改进？

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-05-24 DOI: 10.1080/14779072.2026.2674710

Sasha-Ann East, Kameswari Maganti, Partho Sengupta

{"title":"Advances in machine learning for cardiac event prediction: where can we still improve?","authors":"Sasha-Ann East, Kameswari Maganti, Partho Sengupta","doi":"10.1080/14779072.2026.2674710","DOIUrl":"10.1080/14779072.2026.2674710","url":null,"abstract":"Introduction: Artificial intelligence (AI) is playing a transformative role in cardiovascular care by enabling more precise prediction of adverse clinical events across prevention, imaging, electrophysiology, and interventional practice. AI models integrate high-dimensional clinical data and imaging-derived phenotypes to improve risk stratification beyond traditional scoring systems, identifying patients who may benefit from earlier, targeted interventions.Areas covered: This review examines recent advances in AI-based cardiovascular event prediction, focusing on coronary artery disease, heart failure, cardiac arrhythmias, and valvular heart disease. In these domains, AI transcends conventional markers-such as ejection fraction and stenosis severity-to extract prognostically relevant insights from complex data streams. Despite this potential, clinical translation remains limited. Many models are retrospective, rely heavily on discrimination metrics, and lack consistent validation across diverse health systems and patient subgroups. Furthermore, risk estimates are rarely linked to explicit management pathways.Expert opinion: To facilitate adoption, we prioritize: rigorous external and prospective validation with a focus on calibration and fairness; coupling predictions with actionable care algorithms; and developing interpretable, workflow-integrated tools. Overcoming these barriers is essential to establishing AI-based risk prediction as a reliable clinical standard.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"449-461"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148014120","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}

引用次数: 0

Clinical identification of familial chylomicronemia syndrome and novel therapeutic options. 家族性乳糜微粒血症综合征的临床鉴定和新的治疗选择。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-20 DOI: 10.1080/14779072.2026.2661212

Shyann Hang, Robert A Hegele

{"title":"Clinical identification of familial chylomicronemia syndrome and novel therapeutic options.","authors":"Shyann Hang, Robert A Hegele","doi":"10.1080/14779072.2026.2661212","DOIUrl":"10.1080/14779072.2026.2661212","url":null,"abstract":"Introduction: Hypertriglyceridemia (HTG) is a heterogeneous metabolic disorder driven by both genetic susceptibility and secondary factors. Most patients with severe HTG (triglyceride [TG] >10 mmol/L [>885 mg/dL]) have multifactorial chylomicronemia syndrome (MCS) while only a few have familial chylomicronemia syndrome (FCS), a rare autosomal recessive condition.Areas covered: We summarize the pathophysiology of severe HTG, emphasizing impaired intravascular lipolysis of TG-rich lipoproteins and the regulatory role of apolipoproteins (apo), particularly apo C-III. We outline features that distinguish FCS from MCS and discuss diagnostic strategies, including clinical scoring systems and targeted genetic testing. Current management approaches, including responses to conventional TG-lowering therapies and emerging biologic therapies targeting apo C-III, are examined. We searched PubMed for all English language literature focusing on the search terms 'chylomicronemia,' 'familial chylomicronemia syndrome,' 'multifactorial chylomicronemia syndrome,' 'hypertriglyceridemia,' 'APOC3 inhibition,' 'antisense oligonucleotides,' and 'apolipoprotein C-III.'Expert opinion: Differentiating FCS from MCS is critical because RNA-based inhibition of apo C-III has transformed the therapeutic landscape for FCS patients. These agents provide substantial, durable TG lowering, and meaningful reductions in pancreatitis risk, although cardiovascular benefit remains uncertain. Future efforts should focus on optimizing diagnostic pathways, assessing cardiovascular outcomes, and determining long-term safety of these novel biologic therapies.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"397-407"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728557","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}

引用次数: 0

Medical therapies to prevent the development and progression of calcific aortic valve stenosis: a contemporary review. 预防钙化性主动脉瓣狭窄发生和发展的药物治疗：当代综述。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1080/14779072.2026.2652411

William A Courtney, Jarryd Walker, Aindreas Dorai-Raj, Samer Arnous, Cormac T O'Connor, David Playford, Abdul Ihdayhid, Carl J Schultz, Graham S Hillis, Thomas J Kiernan

{"title":"Medical therapies to prevent the development and progression of calcific aortic valve stenosis: a contemporary review.","authors":"William A Courtney, Jarryd Walker, Aindreas Dorai-Raj, Samer Arnous, Cormac T O'Connor, David Playford, Abdul Ihdayhid, Carl J Schultz, Graham S Hillis, Thomas J Kiernan","doi":"10.1080/14779072.2026.2652411","DOIUrl":"10.1080/14779072.2026.2652411","url":null,"abstract":"Introduction: Aortic stenosis (AS), the leading cause of valvular heart disease related mortality, affects 12% of individuals over 75 years and is set to expand as the population ages. Once symptoms develop, severe symptomatic AS carries an average survival of approximately two years. The only management currently available is aortic valve replacement (AVR), either surgically or via transcatheter aortic valve implantation, but this addresses only the end stage of the disease process which is often associated with irreversible myocardial remodeling. There are currently no pharmacotherapies proven to treat AS. The development of this condition is an active pathophysiological process which involves complex metabolic signaling cascades providing myriad potential therapeutic targets.Areas covered: This review looks at recent and ongoing clinical trials of novel pharmacotherapies for AS, including lipid lowering therapy, nitrous oxide pathway targeting, vitamin K supplementation, renin-angiotensin-aldosterone system blockade, repurposing diabetic pharmacotherapies, colchicine, and transthyretin stabilizers.Expert opinion: AS is an active, pathological disease which should be amenable to pharmacological modulation. A wide spectrum of pharmacotherapeutic agents are currently being investigated and the authors of this review are optimistic that we might be on the cusp of a breakthrough.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"339-351"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591017","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}

引用次数: 0

A 20-year UK multi-center experience of combined surgical aortic valve replacement and coronary artery bypass grafting. 20年英国多中心联合手术主动脉瓣置换术和冠状动脉搭桥术的经验。

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-16 DOI: 10.1080/14779072.2026.2661213

Abiodun Adigun, Marcus Taylor, Stuart W Grant, David Rose, Nnamdi Nwaejike, Mohamad N Bittar

{"title":"A 20-year UK multi-center experience of combined surgical aortic valve replacement and coronary artery bypass grafting.","authors":"Abiodun Adigun, Marcus Taylor, Stuart W Grant, David Rose, Nnamdi Nwaejike, Mohamad N Bittar","doi":"10.1080/14779072.2026.2661213","DOIUrl":"10.1080/14779072.2026.2661213","url":null,"abstract":"Background: Concomitant surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) generally carries a higher operative mortality than isolated SAVR or CABG but also conveys survival benefit. Our aim was to identify factors associated with adverse short and long-term outcomes in this patient group.Research design and methods: All consecutive patients undergoing first-time SAVR & CABG in two cardiac surgery centers between 2004 and 2024 were included. Primary outcomes were in-hospital & 1-year mortality and overall survival. Secondary outcomes were post-operative complications and post-operative length of stay (PLOS). Cox multivariable regression was used to identify variables independently associated with overall survival.Results: 2617 patients were included. Mean age was 73.5 years (±8.1) and 26.7% (n = 700) were female. In-hospital and 1-year mortality were 3.1% (n = 82) and 7.0% (n = 182), respectively. The incidence of post-operative stroke was 3.6% (n = 94). Median follow-up time was 82 months (49-119) and estimated median overall survival was 106 months (102-110). Despite higher early mortality, receiving a greater number of grafts was independently associated with improved long-term survival.Conclusions: Findings from this study suggest that SAVR & CABG remains a safe and effective treatment option for appropriately selected patients with acceptable peri-operative morbidity and reassuring long-term durability.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"487-492"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688991","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}

引用次数: 0

Retrograde type A aortic dissection following endovascular arch repair: what do clinicians need to be aware of? 血管内弓修复术后逆行a型主动脉夹层：临床医生需要注意什么？

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-07 DOI: 10.1080/14779072.2026.2652410

Dora Z Zatyko, Balazs C Lengyel, Alan B Lumsden

{"title":"Retrograde type A aortic dissection following endovascular arch repair: what do clinicians need to be aware of?","authors":"Dora Z Zatyko, Balazs C Lengyel, Alan B Lumsden","doi":"10.1080/14779072.2026.2652410","DOIUrl":"10.1080/14779072.2026.2652410","url":null,"abstract":"Introduction: Retrograde Type A aortic dissection (RTAD) is a life-threatening complication following thoracic endovascular aortic repair (TEVAR) or hybrid arch repair. Expanding use of endovascular arch interventions has heightened the need to better understand its mechanisms, risk factors, prevention strategies, and diagnostic challenges.Areas covered: This Special Report reviews current evidence regarding the mechanisms, risk factors, clinical presentation, and management of RTAD following TEVAR. A structured literature search was conducted using PubMed/MEDLINE, Embase, and Scopus to identify relevant studies published from database inception through February 2026. Device-related, procedural, anatomic, and hemodynamic contributors are discussed, with particular emphasis on optimal device sizing, deployment technique, and surveillance. Advanced imaging modalities, including dynamic computed tomography angiography and four-dimensional flow magnetic resonance imaging, are examined for their potential to identify hemodynamically significant flow disturbances and refine risk stratification beyond static morphologic assessment.Expert opinion: RTAD remains uncommon but catastrophic. Greater emphasis on patient selection, procedural planning, graft design optimization, and early multimodality imaging may reduce incidence. Future progress will depend on standardized reporting, improved computational and imaging-based risk predictors, and next-generation aortic devices engineered specifically for the arch.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"289-299"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581091","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}

引用次数: 0

Moving toward digital twins for precision cardiac electrophysiology: overcoming technical and clinical challenges. 向精确心脏电生理学的数字双胞胎迈进：克服技术和临床挑战。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-05-19 DOI: 10.1080/14779072.2026.2674735

Melania Buonocunto, Alexander Jung, Stefan Meier, Jordi Heijman

{"title":"Moving toward digital twins for precision cardiac electrophysiology: overcoming technical and clinical challenges.","authors":"Melania Buonocunto, Alexander Jung, Stefan Meier, Jordi Heijman","doi":"10.1080/14779072.2026.2674735","DOIUrl":"10.1080/14779072.2026.2674735","url":null,"abstract":"Introduction: Precision cardiac electrophysiology seeks to provide healthcare strategies tailored to the individual patient. The concept of digital twins is fundamental to this approach. Digital twins in cardiac electrophysiology are personalized computer models that replicate the electrical activity of patients' hearts. By integrating patient-specific data with mechanistic simulations, they can predict disease risk and help optimize therapy planning.Areas covered: This narrative review summarizes the state-of-the-art of cardiac digital twins, including advances in anatomical and functional twinning, as well as illustrative case studies. It then discusses key technical/clinical challenges, focusing on model development, data recording and integration, and pathways toward clinical implementation.Expert opinion: Fueled by growing data availability and advances in computational power, the vision of cardiac digital twins is moving from theoretical concept to potential clinical reality. For instance, digital twins could guide ablation in patients with persistent atrial fibrillation by identifying potential targets through computer simulations. However, given the potentially substantial costs, identifying patient groups and clinical applications in which digital twins provide the greatest value is essential. In parallel, artificial intelligence-based precision medicine may offer a more cost-effective and efficient alternative for certain scenarios, while digital twins likely remain most valuable when mechanistic insight is required.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"423-437"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147927955","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}

引用次数: 0

Efficacy and safety of CSL112 (apolipoprotein A-I) on modulation of HDL-related biomarkers and reverse cholesterol transport in atherosclerosis and myocardial infarction: a systematic review and meta-analysis. CSL112（载脂蛋白a- i）在动脉粥样硬化和心肌梗死中调节hdl相关生物标志物和逆转胆固醇转运的有效性和安全性：一项系统综述和荟萃分析

IF 2.1

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-05-12 DOI: 10.1080/14779072.2026.2665194

Umais Ahmed Shaikh, Asma Fatima, Syed Hassan Ali, Shanza Shakir, Yumna Noor, Maryam Abdul Rab, Rabia Ashraf, Muhammad Saad Khan, Umaimah Naeem, Kalpana Singh

{"title":"Efficacy and safety of CSL112 (apolipoprotein A-I) on modulation of HDL-related biomarkers and reverse cholesterol transport in atherosclerosis and myocardial infarction: a systematic review and meta-analysis.","authors":"Umais Ahmed Shaikh, Asma Fatima, Syed Hassan Ali, Shanza Shakir, Yumna Noor, Maryam Abdul Rab, Rabia Ashraf, Muhammad Saad Khan, Umaimah Naeem, Kalpana Singh","doi":"10.1080/14779072.2026.2665194","DOIUrl":"10.1080/14779072.2026.2665194","url":null,"abstract":"Background: Despite statin therapy, cardiovascular disease remains a leading cause of mortality. CSL112 enhances HDL function and reverses cholesterol transport, offering a novel strategy for atherosclerotic cardiovascular disease (CVD).Methods: Following PRISMA guidelines, databases including PubMed, the Cochrane Library, Scopus, Google Scholar, and EMBASE were searched from inception to May 2025 for studies evaluating efficacy and safety of CSL112 in adults at risk of atherosclerotic CVD. Data were analyzed using RevMan version 5.4 with a random-effects model.Results: Six trials (n = 1,824) showed that CSL112 significantly increased total cholesterol efflux capacity (CEC), most notably with the 6 g dose (MD 11.90; p < 0.00001), including ABCA1-dependent (MD 5.88; p < 0.00001) and ABCA1-independent CEC (MD 4.68; p < 0.0001) at 2 hr. HDL-C levels increased significantly (MD 6.89; p < 0.00001) without meaningful change in apolipoprotein A-I. Safety analyses showed no increased risk of serious adverse events (RR 1.05) or treatment-emergent adverse events (RR 0.88) versus placebo.Conclusion: CSL112 significantly enhances CEC and HDL-C levels with favorable safety profile with the 6 g dose at 2 hr, supporting its use as an adjunctive therapy for immediate cardiovascular protection. Large outcome-driven trials are warranted to define long-term clinical benefits.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"475-486"},"PeriodicalIF":2.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766628","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}

引用次数: 0

Getting ahead of sudden cardiac arrest in pediatric hypertrophic cardiomyopathy. 小儿肥厚性心肌病患者心脏骤停的预防。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-05-07 DOI: 10.1080/14779072.2026.2669536

Shuenn-Nan Chiu, Wei-Chieh Tseng, Jyh-Ming Jimmy Juang, Ni-Chung Lee, Wen-Pin Chen, Mei-Hwan Wu

{"title":"Getting ahead of sudden cardiac arrest in pediatric hypertrophic cardiomyopathy.","authors":"Shuenn-Nan Chiu, Wei-Chieh Tseng, Jyh-Ming Jimmy Juang, Ni-Chung Lee, Wen-Pin Chen, Mei-Hwan Wu","doi":"10.1080/14779072.2026.2669536","DOIUrl":"10.1080/14779072.2026.2669536","url":null,"abstract":"Introduction: Sudden cardiac arrest (SCA) remains one of the most devastating complications of pediatric hypertrophic cardiomyopathy (HCM). Despite major advances in genetic diagnostics, cardiac imaging, and risk stratification strategies, the prevention of sudden cardiac death (SCD) in children and adolescents with HCM remains an unresolved clinical challenge. Contemporary guideline-based approaches and pediatric-specific risk models have improved decision-making regarding implantable cardioverter-defibrillator (ICD) implantation in diagnosed patients; however, these strategies are inherently limited by their reliance on an established HCM phenotype. A substantial proportion of pediatric patients experience SCA as the initial clinical manifestation of disease, without any warning symptoms.Areas covered: In this expert review, we conducted a MEDLINE-based literature search using the keywords HCM, SCA, and pediatric to synthesize current evidence on the epidemiology, age-specific characteristics, and arrhythmogenic mechanisms of pediatric HCM, and also highlight the limitations of existing risk stratification models and prevention strategies. We discuss emerging insights into electrical vulnerability that may precede overt structural disease, as well as the evolving role of electrocardiography-based screening strategies.Expert opinion: By integrating clinical experience with recent advances-including artificial intelligence-enhanced electrocardiography-we propose a shift from post-diagnosis risk prediction toward upstream detection of vulnerable individuals.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"409-422"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812196","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}

引用次数: 0

Contemporary cost-effectiveness of endovascular versus open surgical repair of for elective infrarenal abdominal aortic aneurysms in the United Kingdom. 在英国，血管内与开放手术修复择期腹主动脉瘤的当代成本-效果。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-16 DOI: 10.1080/14779072.2026.2654745

Vladica M Veličković, Xiaoyang Du, Dawn M Cooper, Maxim Souter, Julie Lyon, Trevor Cleveland, Simon Neequaye, Daniel Carradice

{"title":"Contemporary cost-effectiveness of endovascular versus open surgical repair of for elective infrarenal abdominal aortic aneurysms in the United Kingdom.","authors":"Vladica M Veličković, Xiaoyang Du, Dawn M Cooper, Maxim Souter, Julie Lyon, Trevor Cleveland, Simon Neequaye, Daniel Carradice","doi":"10.1080/14779072.2026.2654745","DOIUrl":"10.1080/14779072.2026.2654745","url":null,"abstract":"Background: Endovascular aneurysm repair (EVAR) and open surgical repair (OSR) are both used for elective unruptured infrarenal abdominal aortic aneurysm (AAA), but their relative cost-effectiveness in the UK NHS remains uncertain.Research design and methods: A lifetime Markov cohort model compared EVAR and OSR, incorporatingwaiting-list and perioperative mortality, postoperative survival, reinterventions, and imaging surveillance. Time-varying mortality effects were derived from reconstructed individual-patient-data meta-analysis, with equal long-term mortality assumed in the base case. Costs and QALYs were discounted at 3.5%. Uncertainty was explored through deterministic, probabilistic (10,000 iterations), and scenario analyses using alternative survival models.Results: EVAR had higher lifetime costs (£17,710 vs £16,191) but greater QALYs (6.373 vs 6.219), yielding an ICER of £9,865/QALY. Probabilistic analysis produced a mean ICER of £9,793/QALY, with EVAR cost-effective in 56.1% and 62.2% of simulations at £20,000 and £30,000/QALY thresholds, respectively. Results were sensitive to survival modeling assumptions, EVAR device costs, perioperative mortality, and surveillance intensity.Conclusions: Under contemporary time-varying mortality assumptions, EVAR is likely cost-effective versus OSR at standard UK thresholds, though conclusions depend on long-term survival assumptions and surveillance intensity.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"493-501"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689104","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}

引用次数: 0

Percutaneous coronary intervention in high-bleeding risk patients: a review of contemporary management strategies. 经皮冠状动脉介入治疗高危出血患者：当代管理策略综述。

IF 2.5

Expert Review of Cardiovascular Therapy Pub Date : 2026-04-01 Epub Date: 2026-03-24 DOI: 10.1080/14779072.2026.2649156

Giuseppe Andò, Giulia Cavolina, Alessio Villari, Giulia Alagna, Francesca Campanella, Giovanni Taverna, Pierre Sabouret, Piera Capranzano

{"title":"Percutaneous coronary intervention in high-bleeding risk patients: a review of contemporary management strategies.","authors":"Giuseppe Andò, Giulia Cavolina, Alessio Villari, Giulia Alagna, Francesca Campanella, Giovanni Taverna, Pierre Sabouret, Piera Capranzano","doi":"10.1080/14779072.2026.2649156","DOIUrl":"10.1080/14779072.2026.2649156","url":null,"abstract":"Introduction: High bleeding risk (HBR) affects over one-third of patients undergoing percutaneous coronary intervention (PCI) and is associated with elevated mortality due to both hemorrhagic and ischemic complications. Optimizing the management of these patients remains a critical challenge in contemporary interventional cardiology.Areas covered: This review summarizes advances in bleeding risk assessment and management strategies in HBR patients. Literature was evaluated regarding validated risk tools (ARC-HBR, PRECISE-HBR), procedural approaches (radial access, intravascular imaging-guided PCI), device selection (contemporary drug-eluting and polymer-free stents, drug-eluting balloons), and pharmacologic optimization (shortened dual antiplatelet therapy, minimization of triple therapy, proton pump inhibitor prophylaxis). Emerging approaches, including artificial intelligence-enhanced risk prediction, biomarker-based phenotyping, and pharmacogenomic-guided antiplatelet selection, are also discussed. Dedicated HBR care pathways and multidisciplinary programs supporting best-practice implementation are highlighted.Expert opinion: Despite contemporary strategies reducing bleeding risk, HBR patients continue to experience disproportionate mortality. Precision medicine approaches, including continuous risk quantification, next-generation antithrombotics with improved safety, and standardized, data-driven HBR management frameworks, are needed to further optimize outcomes and guide future trials in this high-risk population.","PeriodicalId":12098,"journal":{"name":"Expert Review of Cardiovascular Therapy","volume":" ","pages":"309-322"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480346","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}

引用次数: 0