International journal of cardiology最新文献

{"title":"Corrigendum to “Prevalence of obesity among adult patients with congenital heart disease: A population-based study” [International Journal of Cardiology Volume 425, 15 April 2025, 133032]","authors":"Mathilde S.K. Vangedal , Jani Thuraiaiyah , Troels Hoejsgaard Joergensen , Anette Solis , Anne Langsted , Børge G. Nordestgaard , Caroline Kistorp , Jakob Raunsoe , Søren Schoett Schmiegelow , Mark Aplin , Morten Dahl , Chee Woon Lim , Annette S. Jensen","doi":"10.1016/j.ijcard.2025.133247","DOIUrl":"10.1016/j.ijcard.2025.133247","url":null,"abstract":"","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"431 ","pages":"Article 133247"},"PeriodicalIF":3.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820679","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":"Gender disparities in cangrelor usage for the treatment of patients with acute coronary syndrome undergoing percutaneous coronary intervention","authors":"Waiel Abusnina,&nbsp;Abhishek Chaturvedi,&nbsp;Kalyan R. Chitturi,&nbsp;Lior Lupu,&nbsp;Dan Haberman,&nbsp;Matteo Cellamare,&nbsp;Vaishnavi Sawant,&nbsp;Cheng Zhang,&nbsp;Itsik Ben-Dor,&nbsp;Lowell F. Satler,&nbsp;Hayder D. Hashim,&nbsp;Brian C. Case,&nbsp;Ron Waksman","doi":"10.1016/j.ijcard.2025.133280","DOIUrl":"10.1016/j.ijcard.2025.133280","url":null,"abstract":"<div><h3>Background</h3><div>Cangrelor is a rapid, potent intravenous P2Y12 inhibitor that reduces thrombotic and ischemic events in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI). This study aimed to investigate gender disparities in Cangrelor usage, efficacy, and safety across gender in patients presenting with acute coronary syndrome (ACS) undergoing PCI.</div></div><div><h3>Methods</h3><div>This is an observational retrospective analysis included patients presented with ACS who underwent PCI and received Cangrelor at MedStar Washington Hospital Center (2018–2023). Access to Cangrelor across gender was recorded. The primary safety outcome was in-hospital thrombolysis in myocardial infarction (TIMI) major bleeding, while the primary efficacy outcome was in-hospital major adverse cardiac events (MACE): defined as the composite of in-hospital cardiac death, MI, and stroke. A control group was investigated gender disparities in patients with ACS who did not receive Cangrelor.</div></div><div><h3>Results</h3><div>A total of 2859 patients with ACS underwent PCI (991 women and 1868 men). Among these patients, women were less likely to receive Cangrelor during PCI compared to men (40.2 % vs. 48 %; <em>P</em> &lt; 0.001). The Cangrelor cohort consisted of 1295 patients (398 women, 897 men), and among those, women had significantly higher rates of in-hospital TIMI major bleeding (3.5 % vs. 0.6 %; <em>P</em> &lt; 0.001) and higher in-hospital MACE (5.0 % vs. 1.3 %; P &lt; 0.001) compared to men. Multivariate modeling after adjusting for differences in baseline characteristics showed that women were associated with increased TIMI major bleeding (OR 4.02, 95 %CI 1.09–14.79; P 0.037), but not in-hospital MACE (OR 2.11, 95 %CI 0.88–5.07; P 0.096). In the non-Cangrelor cohort, there were no significant difference between women and men in TIMI major bleeding (0.8 % vs. 0.9 %, <em>P</em> = 0.865) and MACE (1.5 % vs. 1.6, <em>P</em> = 0.842).</div></div><div><h3>Conclusion</h3><div>In patients presenting with ACS, women who received cangrelor had higher rates of TIMI major bleeding, without an impact on MACE. This may partially explain why women with ACS undergoing PCI receive less cangrelor compared to men. Therefore, increased bleeding events in women receiving cangrelor warrant further investigation.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"432 ","pages":"Article 133280"},"PeriodicalIF":3.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842718","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":"A novel open-vascular single-branched stent graft in total arch repair of type a aortic dissection one-year results of a prospective multicenter randomized controlled study","authors":"Jiawei Gu ,&nbsp;Weize Zhang ,&nbsp;Le Kang ,&nbsp;Yongxin Sun,&nbsp;Jun Li,&nbsp;Yulin Wang,&nbsp;Qiang Ji,&nbsp;Shuyang Lu,&nbsp;Junyu Zhai,&nbsp;Ben Huang,&nbsp;Kai Zhu,&nbsp;Dingqian Liu,&nbsp;Hao Lai,&nbsp;Chunsheng Wang","doi":"10.1016/j.ijcard.2025.133268","DOIUrl":"10.1016/j.ijcard.2025.133268","url":null,"abstract":"<div><h3>Background</h3><div>Acute type A aortic dissection (TAAD) is a life-threatening condition requiring timely surgery. Modifications in TAAD arch reconstruction are needed to improve surgical manipulation and reduce complications. This study evaluates a novel single-branched stent graft for arch reconstruction.</div></div><div><h3>Methods and results</h3><div>We randomly enrolled 156 patients with acute Type A Aortic Dissection (TAAD) from 8 Chinese hospitals to receive either the Fontus branched stent graft (75 patients) or the Cronus straight stent graft (81 patients) for frozen elephant trunk (FET) surgery. In the analysis of the primary endpoint, 30-day mortality was 10.7 % (8/75) in the Fontus group and 11.1 % (9/81) in the Cronus group, with a mortality difference of 0.44 % (95 % CI, −9.34 % to 10.22 %; non-inferiority threshold −14 %). At 12 months, all-cause mortality was 16.0 % in the Fontus group compared to 13.6 % in the Cronus group (<em>p</em> = 0.670). The rates of false lumen (FL) obliteration and freedom from secondary interventions for target lesions were 90.5 % and 98.4 % in the Fontus group, and 92.7 % and 98.6 % in the Cronus group. Instrumental adverse events occurred in 5 patients in the Fontus group, while no such events occurred in the Cronus group (<em>p</em> = 0.024). At 1 month, dissection-associated mortality was 10.7 % (8/75) in the Fontus group and 11.1 % (9/81) in the Cronus group.</div></div><div><h3>Conclusions</h3><div>This first randomized clinical study on FET repair for acute TAAD shows that the Fontus single-branched stent graft is safe, effective and non-inferior to the conventional straight stent graft in 1-year survival and adverse event rates.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"431 ","pages":"Article 133268"},"PeriodicalIF":3.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834294","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":"Predicting prolonged length of in-hospital stay in patients with non-ST elevation myocardial infarction (NSTEMI) using artificial intelligence","authors":"Seyed Reza Razavi ,&nbsp;Tyler Szun ,&nbsp;Alexander C. Zaremba ,&nbsp;Seth Cheung ,&nbsp;Ashish H. Shah ,&nbsp;Zahra Moussavi","doi":"10.1016/j.ijcard.2025.133267","DOIUrl":"10.1016/j.ijcard.2025.133267","url":null,"abstract":"<div><h3>Background</h3><div>Patients presenting with non-ST elevation myocardial infarction (NSTEMI) are typically evaluated using coronary angiography and managed through coronary revascularization. Numerous studies have demonstrated the benefits of expedited discharge following revascularization in this patient population. However, individuals with concomitant heart failure, hemodynamic instability, or arrhythmias often necessitate prolonged hospitalization. Using aortic pressure (AP) wave assessment, we aim to predict a prolonged length of stay (&gt; 4 days, PLoS) in patients with NSTEMI treated with percutaneous coronary intervention (PCI).</div></div><div><h3>Methods</h3><div>In this single-center, retrospective cohort study, we included 497 patients with NSTEMI [66.3 ± 12.9 years, 37.6 % (187) females]. We developed a predictive model for PLoS using features primarily extracted from the AP signal recorded throughout PCI. We performed feature selection using recursive feature elimination (RFE) with cross-validation and built a machine learning (ML) model using the CatBoost tree-based classifier. The decision-making process of the ML model was analyzed using SHapley Additive exPlanations (SHAP).</div></div><div><h3>Results</h3><div>We achieved average accuracy, specificity, sensitivity, precision, and receiver operating characteristic curve area under the curve (AUC) values of 77 %, 78 %, 76 %, 67 %, and 77 %, respectively. Using SHAP, we identified the ejection systolic period, ejection systolic time, the difference between systolic blood pressure and dicrotic notch pressure (DesP), the age modified shock index (mSI_age) and mean arterial pressure (MAP) as the most characteristic features extracted from the AP signal.</div></div><div><h3>Conclusions</h3><div>In conclusion, this study demonstrates the potential of using ML and features extracted from the AP signal to predict PLoS in patients with NSTEMI.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"432 ","pages":"Article 133267"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834594","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":"Clinical outcomes associated with Insertable cardiac monitor implantation in Korea: A Nationwide claims data analysis","authors":"Ji Hyun Lee ,&nbsp;So-Ryoung Lee ,&nbsp;Youngjin Cho ,&nbsp;Il-Young Oh ,&nbsp;Sol Kwon ,&nbsp;JinKyung Jeon ,&nbsp;So-Jeong You ,&nbsp;Seil Oh ,&nbsp;Eue-Keun Choi","doi":"10.1016/j.ijcard.2025.133265","DOIUrl":"10.1016/j.ijcard.2025.133265","url":null,"abstract":"<div><h3>Background</h3><div>Insertable cardiac monitors (ICMs) are valuable diagnostic tools for detecting cardiac arrhythmias, yet their nationwide implications remain underreported. We aimed to assess comprehensive outcome data for the Korean population receiving ICM insertions.</div></div><div><h3>Methods</h3><div>Using a Korean nationwide claims database, patients who underwent ICM insertion from 2010 to 2021 (<em>N</em> = 3152) were selected. The subjects were divided into three groups based on the indication of the procedure: recurrent syncope (<em>n</em> = 1389), palpitation (<em>n</em> = 146), cryptogenic stroke (<em>n</em> = 994) and unidentifiable (<em>n</em> = 623). The clinical outcomes, including new diagnoses of arrhythmias and therapeutic interventions following ICM insertion, were evaluated in each group.</div></div><div><h3>Results</h3><div>Median follow-up duration was 18.5 months (interquartile range: 7.3–33.7). In the syncope group, pacemaker and implantable cardioverter defibrillator were implanted in 396 (28.5 %) and 27 (1.9 %) patients following ICM insertion. Age (≥70 vs. &lt;60, Hazard ratio [HR]: 2.090, <em>p</em> &lt; 0.001) and prevalent atrial fibrillation (AF) or flutter (AFL)(HR: 1.891, p &lt; 0.001) were independent risk factors for the cardiac device therapy. In the palpitation group, various arrhythmias, including AF/AFL (<em>n</em> = 7), supraventricular tachycardia (<em>n</em> = 2), and other arrhythmias (<em>n</em> = 13), were identified in 19 (13.6 %) patients. In the cryptogenic stroke group, new-onset AF/AFLs occurred in 91 (9.7 %) patients. The initiation of direct oral anticoagulants was noted in 8.9 % of anticoagulation-naïve cryptogenic stroke patients during follow-up.</div></div><div><h3>Conclusions</h3><div>ICM insertion led to significant diagnostic and therapeutic interventions across all indication groups, with notable rates of device implantation and arrhythmia detection. These findings underscore the clinical value of ICMs in guiding patient management and improving outcomes across various cardiac conditions.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"432 ","pages":"Article 133265"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834592","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":"A hybrid machine learning approach using particle swarm optimization for cardiac arrhythmia classification","authors":"Sanjay Dhanka,&nbsp;Surita Maini","doi":"10.1016/j.ijcard.2025.133266","DOIUrl":"10.1016/j.ijcard.2025.133266","url":null,"abstract":"<div><h3>Background</h3><div>Precise and rapid identification of cardiac arrhythmias is paramount for delivering optimal patient care. Machine learning (ML) techniques hold significant promise for classifying arrhythmias, yet achieving peak performance often necessitates refined hyperparameter tuning.</div></div><div><h3>Methods</h3><div>This investigation presents a novel, multi-faceted strategy for cardiac arrhythmia classification, employing a synergistic model that combines Particle Swarm Optimization (PSO) with a range of ML algorithms, i.e., Logistic Regression, Linear Discriminant Analysis, Gaussian Naive Bayes, Decision Tree, and XGBoost Classifier to enhance their predictive capabilities. The models are implemented on the UCI cardiac arrhythmia dataset and validated by Stratify K-Fold.</div></div><div><h3>Results</h3><div>The hybrid models developed in this study exhibited a marked improvement over their unoptimized counterparts, demonstrating superior overall performance across a spectrum of metrics. Notably, Model 5, integrating PSO with the XGBoost Classifier, achieved exceptional results, including a 95.24 % accuracy, 94.81 % balanced accuracy, 96.3 % sensitivity, 93.3 % specificity, 96.3 % precision, 96.3 % F1 Score, 93.33 % NPV, 89.63 % MCC, 4.76 % CE, 14.44 LR+, 0.04 LR-, and a DOR of 364, surpassing the performance of previously reported methods. Furthermore, the models exhibited low computational cost and complexity, making them feasible for real-time applications.</div></div><div><h3>Conclusions</h3><div>This research underscores the effectiveness of PSO-optimized hybrid models for the accurate and efficient classification of cardiac arrhythmias. The proposed approach demonstrates a significant advancement over existing methodologies in terms of diagnostic performance, presenting a valuable resource for clinical decision-making. Future studies could explore the application of these models to diverse clinical problems and investigate their interpretability to enhance trust and adoption.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"432 ","pages":"Article 133266"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834593","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":"Early aortic valve replacement versus conservative management in asymptomatic severe aortic stenosis: Meta-analysis of time-to-event data of randomized controlled trials","authors":"Xander Jacquemyn ,&nbsp;Michel Pompeu Sá ,&nbsp;Mateo Marín-Cuartas ,&nbsp;Jeroen J. Bax ,&nbsp;Michael A. Borger ,&nbsp;Marie-Annick Clavel ,&nbsp;Philippe Pibarot ,&nbsp;Philippe Généreux ,&nbsp;Ibrahim Sultan","doi":"10.1016/j.ijcard.2025.133269","DOIUrl":"10.1016/j.ijcard.2025.133269","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines recommend aortic valve replacement (AVR) for symptomatic patients with severe aortic stenosis (AS), but the optimal timing for intervention in asymptomatic patients is still debated. Recent randomized controlled trials (RCTs) have offered new insights, prompting a reevaluation of the potential benefits of early AVR.</div></div><div><h3>Methods</h3><div>A systematic review and pooled meta-analysis of Kaplan–Meier-derived reconstructed time-to-event data of RCTs published by November 2024 was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Outcomes were derived from the primary endpoints of the included studies, with the main analysis focusing on all-cause mortality, cardiovascular mortality, and heart failure hospitalization.</div></div><div><h3>Results</h3><div>Four randomized controlled trials, involving 1427 patients, were included. The early AVR group demonstrated a significant reduction in all-cause mortality (hazard ratio [HR] = 0.72, 95 % confidence interval [CI] 0.53-0.97, <em>p</em> = 0.031), cardiovascular mortality (HR = 0.56, 95 % CI 0.36-0.89, <em>p</em> = 0.014), and heart failure hospitalization (HR = 0.31, 95 % CI 0.18-0.53, <em>p</em> &lt; 0.001). No significant interaction effects between surgical AVR and transcatheter AVR were observed. Additionally, in the conservative management group, the conversion to AVR was substantial, with a median time to conversion of 13.4 months. The cumulative conversion rates were 42.8 % (95 % CI 38.6 %–46.7 %) at 1 year, 82.3 % (95 % CI 78.6 %–85.3 %) at 3 years, and 94.9 % (95 % CI 91.4 %–96.9 %) at 5 years.</div></div><div><h3>Conclusion</h3><div>Early AVR in asymptomatic patients with severe AS is associated with a significant reduction in all-cause mortality, cardiovascular mortality, and heart failure hospitalization compared to conservative management.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"432 ","pages":"Article 133269"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838787","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":"Long term prognosis in cardiac sarcoidosis under FDG-PET guided immunosuppressive therapy","authors":"Yasutaka Imamura ,&nbsp;Mitsuru Momose ,&nbsp;Atsushi Yamamoto ,&nbsp;Atsushi Suzuki ,&nbsp;Naoki Serizawa ,&nbsp;Kenta Uto ,&nbsp;Eri Watanabe ,&nbsp;Michinobu Nagao ,&nbsp;Shuji Sakai ,&nbsp;Junichi Yamaguchi","doi":"10.1016/j.ijcard.2025.133273","DOIUrl":"10.1016/j.ijcard.2025.133273","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac sarcoidosis (CS) is a granulomatous disease that can lead to heart failure and fatal arrhythmias. While ¹⁸F-fluorodeoxyglucose–positron emission tomography (FDG–PET) is useful in assessing active inflammation, its role in guiding immunosuppressive therapy and predicting long-term prognosis remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 36 CS patients who underwent FDG–PET-guided immunosuppressive therapy between 2012 and 2017. FDG uptake was quantitatively evaluated before treatment, at 6 and 12 months, and annually thereafter. Prognostic outcomes, including major adverse cardiac events (MACE) and mortality, were assessed.</div></div><div><h3>Results</h3><div>Over a median follow-up of 8.2 years, 11 patients experienced MACE, and 7 died. SUVmax at 6 months (six-M SUVmax) and 1 year (one-y SUVmax) significantly correlated with prognosis. Patients with one-y SUVmax &gt;4.5 had a higher risk of adverse events (<em>p</em> &lt; 0.0001), while patients with six-M SUVmax &gt;3.5 had a higher risk of adverse events (<em>p</em> = 0.035). Lower left ventricular ejection fraction (LVEF &lt;40 %) was also associated with worse outcomes. Those requiring a final prednisolone (PSL) dose ≥10 mg had increased mortality (<em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>FDG–PET-derived SUVmax at 1 year is a critical prognostic indicator in CS patients undergoing immunosuppressive therapy. Poor response to PSL, indicated by persistent FDG uptake, correlates with worse outcomes. Regular FDG–PET monitoring and personalized treatment strategies are essential to optimizing long-term management.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"432 ","pages":"Article 133273"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842976","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":"Independent effect of influenza vaccination on all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study from the MIMIC-IV database","authors":"Jian Lei ,&nbsp;Ling-Zhao Zheng ,&nbsp;Ke-Yuan Chen ,&nbsp;Xi Yang ,&nbsp;Yue Tian ,&nbsp;Zhi-Huang Qiu ,&nbsp;Liang-Wan Chen","doi":"10.1016/j.ijcard.2025.133246","DOIUrl":"10.1016/j.ijcard.2025.133246","url":null,"abstract":"<div><h3>Objective</h3><div>Atrial fibrillation (AF) is common in critically ill patients and associated with higher mortality. The impact of influenza vaccination on all-cause mortality in this population is unclear. This study evaluates the effect of influenza vaccination on mortality in critically ill AF patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted using the MIMIC-IV database. The effect of influenza vaccination on mortality was assessed using Kaplan-Meier survival curves and Cox proportional hazards models, adjusted for confounders. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to minimize selection bias. Subgroup analyses examined clinical characteristics among AF patients in the intensive care unit (ICU).</div></div><div><h3>Results</h3><div>Among 12,137 ICU AF patients, 6554 (54.0 %) received the influenza vaccine. Vaccination was associated with reduced all-cause mortality (28-day hazard ratio [HR] = 0.79, 90-day HR = 0.83, 365-day HR = 0.84; all <em>p</em>-values &lt;0.001). After PSM and covariate adjustment, influenza vaccination remained an independent predictor of better outcomes (28-day HR = 0.83, 90-day HR = 0.82, 365-day HR = 0.84; all p-values &lt;0.001). These findings were consistent in IPTW analyses. Subgroup analyses showed greater benefits in elderly, hypertensive, and non-paroxysmal AF patients.</div></div><div><h3>Conclusion</h3><div>Influenza vaccination is associated with improved survival in critically ill AF patients. These findings support vaccination as a crucial protective measure for high-risk AF patients in the ICU.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"433 ","pages":"Article 133246"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864204","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":"Additional genetic variants in cardiomyopathy patients with the pathogenic PLN p.(Arg14del) founder variant","authors":"E. van Drie ,&nbsp;J.D.H. Jongbloed ,&nbsp;E. Hoorntje ,&nbsp;P.A. van der Zwaag ,&nbsp;M.G.P.J. Cox ,&nbsp;R.H. Lekanne Deprez ,&nbsp;A.C. Houweling ,&nbsp;V.P. Proost ,&nbsp;A.A.M. Wilde ,&nbsp;D. Dooijes ,&nbsp;A.F. Baas ,&nbsp;A.S.J.M. te Riele ,&nbsp;K.Y. van Spaendonck-Zwarts ,&nbsp;E.M. Lodder ,&nbsp;J.P. van Tintelen","doi":"10.1016/j.ijcard.2025.133264","DOIUrl":"10.1016/j.ijcard.2025.133264","url":null,"abstract":"<div><h3>Aims</h3><div>To evaluate the prevalence and clinical consequences of additional rare genetic variants in cardiomyopathy- and/or channelopathy-related genes in PLN p.(Arg14del) patients.</div></div><div><h3>Methods</h3><div>In PLN p.(Arg14del) index patients (<em>n</em> = 160), additional rare genetic variants in cardiomyopathy- or channelopathy-related genes were collected. These variants were (re)classified as either variants of uncertain significance (VUS) or (likely) pathogenic ((L)P). VUS were further subcategorized in low, mid or high suspicion VUS. Cascade genetic testing results were studied in families with an additional (L)P variant. The occurrence and onset of malignant ventricular arrhythmias (MVA) or severe heart failure (HF)-related events in PLN index patients with and without additional (L)P variants were compared. In addition, extended genetic testing was performed in PLN relatives (<em>n</em> = 8) with major cardiac events &lt;45 year.</div></div><div><h3>Results</h3><div>In 6 % (6/106) of PLN index patients in whom targeted gene panel analysis was performed, an additional (L)P variant was identified. These patients showed a non-significant trend towards earlier onset of MVA or a severe HF-related event versus those without an additional variant. Incorporating VUS subclassification did not alter either of these trends. Two out of 8 PLN relatives with a major cardiac event &lt;45 year had an additional P variant.</div></div><div><h3>Conclusion</h3><div>Additional (L)P variants in established cardiomyopathy- or channelopathy-related genes were found in 6 % of PLN p.(Arg14del) index patients, which is higher than in control populations. These patients showed a trend towards earlier onset of MVA or HF-related symptoms.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"432 ","pages":"Article 133264"},"PeriodicalIF":3.2,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870634","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}