JAMA cardiology最新文献

{"title":"Progressive Kidney Dysfunction After Left Atrial Appendage Closure.","authors":"Shuaishuai Yuan, Chao Tao, Peijun Li","doi":"10.1001/jamacardio.2025.0258","DOIUrl":"10.1001/jamacardio.2025.0258","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"512"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Pregnancy Outcomes and N-Terminal Pro-Brain Natriuretic Peptide Levels 2 to 7 Years After Delivery: The nuMoM2b Heart Health Study.","authors":"Priya M Freaney, Xiaoning Huang, Lucia C Petito, William A Grobman, Janet Catov, Alisse Hauspurg, C Noel Bairey Merz, Natalie Bello, Jin Kyung Kim, Abbi Lane, David M Haas, Lisa D Levine, Rebecca B McNeil, Eliza Miller, George Saade, Lauren Theilen, Lynn M Yee, Jasmina Varagic, Brian Mercer, Uma Reddy, Donald M Lloyd-Jones, Philip Greenland, Sadiya S Khan","doi":"10.1001/jamacardio.2025.0325","DOIUrl":"10.1001/jamacardio.2025.0325","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"514-516"},"PeriodicalIF":14.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peak Oxygen Uptake vs Ventilatory Efficiency.","authors":"Jiawei Du, Jinghua Hou","doi":"10.1001/jamacardio.2025.0216","DOIUrl":"10.1001/jamacardio.2025.0216","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"516-517"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Aspirin vs Clopidogrel After Coronary Stenting by Bleeding Risk and Procedural Complexity.","authors":"Jeehoon Kang, Jaewook Chung, Kyung Woo Park, Jang-Whan Bae, Huijin Lee, Doyeon Hwang, Han-Mo Yang, Kyoo-Rok Han, Keon-Woong Moon, Ung Kim, Moo-Yong Rhee, Doo-Il Kim, Song-Yi Kim, Sung-Yun Lee, Seung Uk Lee, Sang-Wook Kim, Seok Yeon Kim, Jung-Kyu Han, Eun-Seok Shin, Bon-Kwon Koo, Hyo-Soo Kim","doi":"10.1001/jamacardio.2024.4030","DOIUrl":"10.1001/jamacardio.2024.4030","url":null,"abstract":"<p><strong>Importance: </strong>Antiplatelet monotherapy in the chronic maintenance period for patients with high bleeding risk (HBR) and those who have undergone complex percutaneous coronary intervention (PCI) has not yet been explored.</p><p><strong>Objective: </strong>To compare clopidogrel vs aspirin monotherapy in patients with HBR and/or PCI complexity.</p><p><strong>Design, setting, and participants: </strong>This post hoc analysis of the multicenter HOST-EXAM Extended study, an open-label trial conducted across 37 sites in South Korea, enrolled patients from 2014 to 2018 with up to 5.9 years of follow-up. The analysis was conducted from February to November 2023. Patients who maintained dual antiplatelet therapy (DAPT) event-free for 6 to 18 months following PCI were included.</p><p><strong>Interventions: </strong>Patients were randomized to receive either clopidogrel or aspirin in a 1:1 ratio. Those with sufficient data to assess HBR or complex PCI were analyzed.</p><p><strong>Main outcomes and measures: </strong>Coprimary end points were thrombotic composite end point (cardiovascular death, nonfatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and definite/probable stent thrombosis) and any bleeding (Bleeding Academic Research Consortium type 2 to 5).</p><p><strong>Results: </strong>Of 3974 patients included (mean [SD] age, 63.4 [10.7] years; 2976 male [74.9%]), 866 had HBR (21.8%), and 849 underwent complex PCI (21.4%). Clopidogrel as compared with aspirin was associated with lower rates of thrombotic and bleeding events regardless of HBR and/or PCI complexity. For the thrombotic composite end point, the hazard ratio (HR) was 0.75 (95% CI, 0.53-1.04) among HBR vs 0.62 (95% CI, 0.48-0.80) among patients without HBR (P for interaction = 0.38) and 0.49 (95% CI, 0.32-0.77) among patients with complex PCI vs 0.74 (95% CI, 0.59-0.92) among patients with noncomplex PCI (P for interaction = 0.12). The reduction in bleeding by clopidogrel compared with aspirin was consistent among both patients with HBR (HR, 0.82; 95% CI, 0.56-1.21) and patients without HBR (HR, 0.58; 95% CI, 0.40-0.85; P for interaction = 0.20) and among patients undergoing complex PCI (HR, 0.79; 95% CI, 0.47-1.33) vs noncomplex PCI (HR, 0.68; 95% CI, 0.50-0.93; P for interaction = 0.62).</p><p><strong>Conclusions and relevance: </strong>In this study, in patients who experienced PCI and were event-free during 6 to 18 months of DAPT, the beneficial impact of clopidogrel monotherapy over aspirin monotherapy was consistent, regardless of bleeding risk and/or PCI complexity.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02044250.</p>","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"427-436"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Calcium Testing-Too Early, Too Late, Too Often.","authors":"Alexander R Zheutlin, Anuj K Chokshi, John T Wilkins, Neil J Stone","doi":"10.1001/jamacardio.2024.5644","DOIUrl":"10.1001/jamacardio.2024.5644","url":null,"abstract":"<p><strong>Importance: </strong>Traditional risk factors, enhancing factors, and risk scores help clinicians assess atherosclerotic cardiovascular disease (ASCVD) risk for primary prevention. The latest cholesterol guidelines suggest measuring coronary artery calcium (CAC) score by computed tomography (CT) in those at intermediate risk when there is uncertainty about statin initiation for primary prevention. CAC testing can improve both risk estimation and adherence to cardiovascular risk-reducing behaviors.</p><p><strong>Observations: </strong>As measuring CAC score has become more widely available, this article focuses on 3 situations where CAC testing may be omitted or deferred until a time when CAC testing can provide clinically useful information. Three clinical scenarios to facilitate the clinician-patient risk discussion are as follows: (1) when CAC testing is too early, (2) when CAC testing is too late, and (3) when CAC testing is repeated too often. The timing of CAC testing sits within the decision point of lipid-lowering therapy use. High-risk young adults may face an elevated lifetime risk of cardiovascular disease despite a CAC level of 0, whereas older adults may not see an expected benefit over a short time horizon or may already be taking lipid-lowering therapy, rendering a CAC score less valuable. Integrating a CAC score into the decision to initiate lipid-lowering therapy requires understanding of a patient's risk factors, including age, as well as the natural history of atherosclerosis and related events.</p><p><strong>Conclusions and relevance: </strong>These clinical scenarios reflect when consideration of CAC score is of use and when it is not. Although CAC testing is becoming more widely available and sought after by clinicians and patients alike, it is only as useful as the clinical context. Understanding when assessing CAC score is too early to effectively rule out risk, too late to influence decisions, or too often to yield clinically relevant information provides important insights that optimize the clinical utility of this potentially valuable prognostic tool.</p>","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"503-509"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Filling the Evidence Gaps Toward a Coronary Artery Calcium-Guided Primary Prevention Strategy.","authors":"Michael J Blaha","doi":"10.1001/jamacardio.2025.0410","DOIUrl":"10.1001/jamacardio.2025.0410","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"411-413"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Man in His 30s With Ponytail Coronary Artery Anomaly.","authors":"Leizhi Ku, Xiaojing Ma","doi":"10.1001/jamacardio.2025.0124","DOIUrl":"10.1001/jamacardio.2025.0124","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"513"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JAMA Cardiology-The Year in Review 2024.","authors":"Robert O Bonow","doi":"10.1001/jamacardio.2025.0478","DOIUrl":"10.1001/jamacardio.2025.0478","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"409-411"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing Declines in Cardiovascular Health From Childhood: Never Too Early for Heart Health.","authors":"Natalie A Cameron, Norrina B Allen","doi":"10.1001/jamacardio.2024.4019","DOIUrl":"10.1001/jamacardio.2024.4019","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"414-416"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peak Oxygen Uptake Vs Ventilatory Efficiency-In Reply.","authors":"Matthew M Y Lee, Gregory D Lewis","doi":"10.1001/jamacardio.2025.0219","DOIUrl":"10.1001/jamacardio.2025.0219","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"517"},"PeriodicalIF":14.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}