International journal of cardiology最新文献

{"title":"Subcutaneous ICD sports safety registry (SISS registry)","authors":"Martina Nesti ,&nbsp;Pasquale Notarstefano ,&nbsp;Luca Segreti ,&nbsp;Marzia Giaccardi ,&nbsp;Vincenzo Russo ,&nbsp;Gianluca Solarino ,&nbsp;Francesca Menichetti ,&nbsp;Zefferino Palamà ,&nbsp;Alessandro Paoletti Perini ,&nbsp;Chiara Bartoli ,&nbsp;Andrea Rossi ,&nbsp;Federico Landra ,&nbsp;Antonio Scarà ,&nbsp;Luigi Sciarra","doi":"10.1016/j.ijcard.2025.133945","DOIUrl":"10.1016/j.ijcard.2025.133945","url":null,"abstract":"<div><h3>Background</h3><div>Exercise has a positive impact on physical function and quality of life. However, individuals with an implantable cardioverter-defibrillator (ICD) may experience adverse events during sports activities. To date, scientific data on the safety of sports participation in patients with subcutaneous ICDs (S-ICDs) are lacking. This study aims to analyze the occurrence of appropriate and inappropriate arrhythmic events related to sports activity in a population of S-ICD patients.</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent S-ICD implantation were enrolled. Baseline clinical data, as well as information on sports activity and arrhythmic events, were collected.</div></div><div><h3>Results</h3><div>Among 280 patients (median age 46 [32–55] years; 72 % male) included in the registry, 205 (73 %) engaged in sports activities. During a follow-up period of 38 ± 13 months, 27 patients (13 %) experienced appropriate shocks. Of these, 20 (74.1 %) occurred at rest and 7 (25.9 %) during peak performance in sports. All patients who received appropriate shocks were implanted for secondary prevention.</div><div>Additionally, 27 patients (13.1 %) experienced inappropriate shocks, with 15 (55.6 %) occurring at rest and 12 (44.4 %) during peak physical activity, primarily due to T-wave oversensing. No significant differences were observed in type or intensity of sports activity between patients who experienced shocks and those who did not.</div></div><div><h3>Conclusion</h3><div>In S-ICD patients, both appropriate and inappropriate shocks occur more frequently during peak physical performance but are not associated with the type or intensity of sports activity. Appropriate shocks were most common in patients with arrhythmogenic or ischemic cardiomyopathy, while inappropriate shocks were mainly due to T-wave oversensing.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133945"},"PeriodicalIF":3.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD163-positive macrophage enrichment in cardiogenic thrombi from atrial fibrillation than in atherosclerotic thrombi from sinus rhythm","authors":"Tomomi Koizumi ,&nbsp;Noriyuki Kato ,&nbsp;Yukinori Inadome ,&nbsp;Fumimasa Tabata ,&nbsp;Tomosato Yamazaki ,&nbsp;Masao Ono ,&nbsp;MITO Study Investigators","doi":"10.1016/j.ijcard.2025.133941","DOIUrl":"10.1016/j.ijcard.2025.133941","url":null,"abstract":"<div><h3>Background</h3><div>Differentiating between atherosclerotic and cardiogenic thrombi remains a clinical challenge and complicates the optimal selection of antithrombotic therapy for secondary prevention.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate histopathological differences between thrombi presumed to be of atherosclerotic (sinus rhythm, SR) and cardiogenic (atrial fibrillation, AF) origin.</div></div><div><h3>Methods</h3><div>The Macrophage in Thrombus (MITO) study is a prospective observational study of patients with ST-elevation myocardial infarction (STEMI) or embolic stroke (ES), in whom solid thrombi were retrieved from infarct-related arteries. Patients were categorized into two groups: Group SR (presumed atherosclerotic thrombi) and Group AF (presumed cardiogenic thrombi). Thrombi were immunohistochemically stained for CD163-positive macrophages, scored on a three-point scale, score 1: no CD163-positive cell detectable at ×400; score 2: the cell detectable at ×400 but not ×100; score 3: easy to detect the cell in ×100 in the thrombus. Also, soluble CD163 was measured in plasma samples.</div></div><div><h3>Results</h3><div>The scores of Group SR were significantly lower than those of Group AF (<em>p</em> &lt; 0.01). Plasma level of soluble CD163 (ng/mL) in Group SR was significantly lower than in Group AF [487 (275, 636) vs. 630 (472,780), <em>p</em> = 0.04].</div></div><div><h3>Conclusion</h3><div>The distribution of CD163-positive cells differed between thrombi from Group SR and Group AF patients. These findings suggest a role for CD163-positive macrophages in the pathogenesis of cardiogenic thrombi and raise the possibility of CD163 as a biomarker for thrombus etiology.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133941"},"PeriodicalIF":3.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of myocardial bridging and LAD length with Takotsubo syndrome: A MINOCA cross-sectional study","authors":"Oscar Winnberg ,&nbsp;Jens Jensen ,&nbsp;Shams Y-Hassan ,&nbsp;Loghman Henareh ,&nbsp;Peder Sörensson ,&nbsp;Olov Collste ,&nbsp;Christina Ekenbäck ,&nbsp;Magnus Lundin ,&nbsp;Kenneth Caidahl ,&nbsp;Stefan Agewall ,&nbsp;Kerstin Cederlund ,&nbsp;Jannike Nickander ,&nbsp;Martin G. Sundqvist ,&nbsp;Claes Hofman-Bang ,&nbsp;Patrik Lyngå ,&nbsp;Eva Maret ,&nbsp;Nondita Sarkar ,&nbsp;Jonas Spaak ,&nbsp;Martin Ugander ,&nbsp;Irene Santos-Pardo ,&nbsp;Elin Brolin","doi":"10.1016/j.ijcard.2025.133950","DOIUrl":"10.1016/j.ijcard.2025.133950","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo syndrome (TTS) is an acute cardiac condition triggered by emotional or physical stress, characterized by a catecholamine surge and transient left ventricular dysfunction.</div><div>Although myocardial bridging (MB) and left anterior descending artery (LAD) length have been proposed as contributing factors, their roles in TTS remain uncertain. This study aimed to assess whether TTS is associated with MB or LAD length in a well-characterized myocardial infarction with non-obstructive coronary arteries (MINOCA) cohort.</div></div><div><h3>Methods</h3><div>We analyzed 183 participants from the prospective Stockholm Myocardial Infarction with Normal Coronaries (SMINC) 1 and 2 studies, which focused on MINOCA. All participants underwent coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA). MB was assessed with CCTA, and LAD length was measured using ICA. TTS patients (<em>n</em> = 60) were compared with MINOCA controls without TTS (<em>n</em> = 123).</div></div><div><h3>Results</h3><div>MB was present in 37 % of TTS patients and 42 % of controls, with no significant association observed (<em>p</em> = 0.523), including when stratified by partial or full encasement. LAD length did not differ significantly between groups (<em>p</em> = 0.088).</div></div><div><h3>Conclusion</h3><div>This study found no significant association between MB or LAD length and the occurrence of TTS. These results suggest that structural variations in the LAD are unlikely to play a major role in the development of TTS, underscoring the importance of exploring alternative pathophysiological mechanisms beyond coronary anatomy.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133950"},"PeriodicalIF":3.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of direct anticoagulants in chronic thromboembolic pulmonary hypertension: An anatomopathological study of endarterectomy material","authors":"William Salibe-Filho ,&nbsp;Yally Priscila Pessôa Nascimento ,&nbsp;Luiza Sarmento Tatagiba ,&nbsp;Vera Demarchi Aiello ,&nbsp;Jose Leonidas Alves-Junior ,&nbsp;Caio Julio Cesar Fernandes ,&nbsp;Carlos Viana Poyares Jardim ,&nbsp;Orival Freitas-Filho ,&nbsp;Fabio Biscegli Jatene ,&nbsp;Mario Terra-Filho ,&nbsp;Rogério Souza","doi":"10.1016/j.ijcard.2025.133951","DOIUrl":"10.1016/j.ijcard.2025.133951","url":null,"abstract":"<div><h3>Objetive</h3><div>Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable cause of pulmonary hypertension, characterized by persistent organized thrombi and micro vasculopathy leading to increased pulmonary vascular resistance and right heart failure. Pulmonary endarterectomy (PEA) remains the treatment of choice for operable patients. Although vitamin K antagonists (VKAs) are traditionally used for lifelong anticoagulation, direct oral anticoagulants (DOACs) have gained popularity despite limited evidence supporting their use in CTEPH. Histopathological assessment may provide new insights into anticoagulation effectiveness. This study aimed to evaluate the presence of recent thrombi in PEA specimens from patients using DOACs versus VKAs and to correlate these findings with surgical and hemodynamic outcomes.</div></div><div><h3>Methods</h3><div>Retrospective cohort study included 115 patients with CTEPH who underwent PEA at a national referral center for the treatment of CTEPH between 2018 and 2023. Patients were categorized based on anticoagulant type (DOAC or VKA). All surgical specimens underwent histopathological evaluation. Pre- and postoperative hemodynamic and clinical data were analyzed. Statistical comparisons were performed using appropriate parametric and non-parametric tests.</div></div><div><h3>Results</h3><div>Recent thrombi were identified in 26.2 % of patients on DOACs and 9.2 % of those on VKAs (<em>p</em> &lt; 0.05). Despite the higher prevalence of thrombi in the DOAC group, no significant differences were observed in extracorporeal circulation time, cardiac arrest duration, or postoperative hemodynamic parameters between groups. Microscopic evaluation proved to be more sensitive than macroscopic analysis for detecting thrombi.</div></div><div><h3>Conclusion</h3><div>Our findings demonstrate the presence of recent thrombi in patients with CTEPH undergoing PEA. This observation raises questions regarding the use of DOACs in patients with CTEPH.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133951"},"PeriodicalIF":3.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of particulate embolic agents versus alcohol in percutaneous transluminal septal myocardial ablation","authors":"Yunshu Li ,&nbsp;Yuanjing Li ,&nbsp;Zhu Li,&nbsp;Bi Huang,&nbsp;Qian Dong,&nbsp;Suxin Luo,&nbsp;Yintao Chen","doi":"10.1016/j.ijcard.2025.133952","DOIUrl":"10.1016/j.ijcard.2025.133952","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous transluminal septal myocardial ablation (PTSMA) is a widely used therapy for drug-refractory obstructive hypertrophic cardiomyopathy (oHCM), but alcohol ablation's non-target retrograde flow (due to high fluidity/permeability) raises complication risks, driving research into particulate embolic alternatives</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed 132 patients with oHCM admitted to the first affiliated Hospital of Chongqing Medical University between January 2018 and July 2024. Of these, 45 patients who underwent PTSMA at our hospital were further divided into the particulate group (<em>n</em> = 13) and the alcohol group (<em>n</em> = 32) based on the type of interventional material. The analysis focused on comparing short-term clinical outcomes and post-discharge transthoracic echocardiography (TTE) results among oHCM patients undergoing PTSMA with different ablation agents</div></div><div><h3>Results</h3><div>The particulate group demonstrated a significantly lower incidence of intraoperative complications compared with the alcohol group (<em>p</em> &lt; 0.05).The particulate group also demonstrated lower postoperative absolute cardiac troponin I(cTnI) levels (<em>p</em> &lt; 0.001). The post-discharge TTE revealed a significantly higher proportion of patients with left ventricular outflow tract gradient (LVOTG) &lt;50 mmHg in the alcohol group compared to the control group(p &lt; 0.05)</div></div><div><h3>Conclusion</h3><div>Particulate embolic agents can reduce the incidence of periprocedural complications in PTSMA and may hold potential clinical utility in high-risk patients. However, the higher reintervention risk of particulate embolic agents indicates that alcohol remains the preferred embolic agent for PTSMA. Future large-scale prospective studies are needed to validate the long-term safety and efficacy of particulate embolic agents</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133952"},"PeriodicalIF":3.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Alpha-1-microglobulin (A1M) and calcific aortic valve stenosis.","authors":"Xiu-Mei Zeng, Qiang Su, Li-Rong Mo","doi":"10.1016/j.ijcard.2025.133953","DOIUrl":"10.1016/j.ijcard.2025.133953","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":" ","pages":"133953"},"PeriodicalIF":3.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors of emergency medical services call delay and its impact on prognosis in STEMI patients: Findings from the CCA database-chest pain center registry","authors":"Qiang Xu ,&nbsp;Yiling Liu ,&nbsp;Hao Li ,&nbsp;Zhenzhen Lu ,&nbsp;Mengyao Wang ,&nbsp;Lihong Huang ,&nbsp;Li Shen ,&nbsp;Junbo Ge","doi":"10.1016/j.ijcard.2025.133944","DOIUrl":"10.1016/j.ijcard.2025.133944","url":null,"abstract":"<div><h3>Background</h3><div>A delay in calls to emergency medical services (EMS) accounts for a substantial portion of prehospital delay, which may affect the prognosis of patients with ST-elevation myocardial infarction (STEMI).The objective of this study was to identify factors contributing to EMS call delay in patients with STEMI and evaluate the association between EMS call delay and in-hospital mortality.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted between January 2020 and December 2023 from the China Chest Pain Center database. EMS call delays were described according to STEMI patients characteristics, and multivariable linear regression analysis was performed to explore independent factors related to EMS call delays. Locally weighted regression (LOESS) was used to fit the trend of mortality with EMS call delays. Logistic regression was used to analyze the relationship between EMS call delay and in-hospital mortality.</div></div><div><h3>Results</h3><div>This study included a total of 115,113 STEMI patients. The median EMS call delay time was 46 min. Subgroup analysis revealed that characteristics associated with an EMS call time exceedi ng 60 min included age ≥ 65 years, female sex, non-persistent chest pain/tightness, and nighttime symptom onset. Cardiovascular mortality, in-hospital mortality, and the incidence of in-hospital complications all exhibited a linear positive correlation with EMS call delay time. The independent risk factors for EMS call delay were age, female sex, non-persistent chest pain/tightness, and nighttime symptom onset.</div></div><div><h3>Conclusions</h3><div>Public health initiatives should focus on older adults, females, and individuals with nighttime symptom onset or nonpersistent chest pain to promote timely EMS activation and reduce mortality.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133944"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and clinical impact of transvalvular gradient following surgical repair of degenerative mitral regurgitation","authors":"Samuel M. Burton ,&nbsp;Martin Nelson ,&nbsp;Gui Rigo ,&nbsp;Massimo Caputo ,&nbsp;Gianni D. Angelini ,&nbsp;Hunaid A. Vohra","doi":"10.1016/j.ijcard.2025.133929","DOIUrl":"10.1016/j.ijcard.2025.133929","url":null,"abstract":"<div><h3>Objective</h3><div>Functional mitral stenosis (FMS) following mitral regurgitation (MR) repair is poorly understood. We aim to assess risk factors of FMS and its clinical impact in patients following the surgical repair of degenerative MR.</div></div><div><h3>Methods</h3><div>Patients who underwent surgical repair of degenerative MR between January 2016 and March 2023 were included. FMS was considered in patients with a pre-discharge mitral valve gradient ≥5 mmHg. Patients were 1:1 propensity score matched (PSM) by baseline characteristics. Multivariate logistic regression was employed to identify risk factors for developing FMS. Time-to-event data were analysed via the Kaplan-Meier method and multivariate Cox regression. The primary outcomes of our study were mortality and recurrence of MR.</div></div><div><h3>Results</h3><div>The cohort comprised of 510 patients (FMS <em>n</em> = 99, no-FMS <em>n</em> = 411). Mean clinical follow-up was 51.6 months. The FMS study group demonstrated a lower preoperative ejection fraction than the no-FMS group (53.7 ± 7.4 versus 55.5 ± 7.4, <em>p</em> = 0.04). Multivariate regression reported annuloplasty flexibility (<em>p</em> = 0.001), smaller ring size (<em>p</em> &lt; 0.001), edge-to-edge repair (<em>p</em> = 0.003), and increased cardiopulmonary bypass time (<em>p</em> = 0.03) as risk factors for developing FMS. The PSM cohort (groups <em>n</em> = 99) demonstrated FMS development is associated with recurrence of ≥MR2+ (<em>p</em> = 0.04); however, was not significant following multivariate regression (<em>p</em> = 0.21). A survival benefit trend was observed in the raw no-FMS group (16.2 % versus 10.7 %); however, this did not reach statistical significance (<em>p</em> = 0.22).</div></div><div><h3>Conclusions</h3><div>This study has identified surgical factors significantly affecting FMS development after degenerative mitral valve repair. FMS was associated with postoperative MR. Further research is required to understand how repair techniques affect postoperative MR and FMS.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133929"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant coronary artery disease in those undergoing TAVR for severe aortic stenosis: A benign finding?","authors":"Edward T. Ha,&nbsp;Asa Phichaphop,&nbsp;Brian C. Case","doi":"10.1016/j.ijcard.2025.133948","DOIUrl":"10.1016/j.ijcard.2025.133948","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133948"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of microaxial flow pump and VA-ECMO in infarct-related cardiogenic shock: Insights from the Netherlands heart registration","authors":"Alexander Griffioen ,&nbsp;Margriet Bogerd ,&nbsp;Jeroen Bunge ,&nbsp;Sanne ten Berg ,&nbsp;Elma Peters ,&nbsp;Luuk Otterspoor ,&nbsp;Gabe Bleeker ,&nbsp;Adriaan Kraaijeveld ,&nbsp;José Montero Cabezas ,&nbsp;Erik Lipsic ,&nbsp;Martijn Meuwissen ,&nbsp;Eric Dubois ,&nbsp;Marijke Timmermans ,&nbsp;José Henriques ,&nbsp;Robert Jan van Geuns","doi":"10.1016/j.ijcard.2025.133949","DOIUrl":"10.1016/j.ijcard.2025.133949","url":null,"abstract":"<div><h3>Background</h3><div>Active mechanical circulatory support (MCS) is associated with high complication rates. Reducing device-related complications may improve outcomes in patients with infarct-related cardiogenic shock (AMI-CS). This study aims to provide in-depth insight in the occurrence, specification and timing of complications in patients receiving active MCS, providing valuable starting points for clinical practice and future studies to reduce complications.</div></div><div><h3>Methods</h3><div>This real-world, multicentre study, using data from the Netherlands Heart Registration PCI-Registry, describes AMI-CS patients that underwent PCI and received MCS between 2017 and 2021 across 9 Dutch hospitals.</div></div><div><h3>Results</h3><div>This registry included 241 patients with a mean age of 59.7 years and predominantly male (78.0 %). Microaxial flow pump (MFP), VA-ECMO and MFP + VA-ECMO were used in 93 (38.6 %), 121 (50.2 %) and 27 (11.2 %) patients. MFP + VA-ECMO was associated with highest complication rates, particularly bleeding events (67 % vs. MFP: 33 % vs. VA-ECMO: 40 %). Differences in bleeding events persisted while accounting for competing risk of death (subdistribution hazard ratio (SHR) MFP + VA-ECMO vs. MFP: 2.33 [1.33–4.07]; SHR MFP + VA-ECMO vs. VA-ECMO: 2.00 [1.19–3.36]). SHR for VA-ECMO vs. MFP was 1.18 [0.74–1.90]). Bleeding events were observed within the first days of support, but also on the day of explant and thereafter. Access-site related bleeding events accounted for 51 % of all bleeding events.</div></div><div><h3>Conclusions</h3><div>Combined use of MFP and VA-ECMO was associated with higher complication rates, particularly bleeding events, compared to single device use. Complication rates between MFP and VA-ECMO were not significantly different. Importantly, patients are still at risk for bleeding events during and after explant of MCS devices.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"443 ","pages":"Article 133949"},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}