Journal of atherosclerosis and thrombosis最新文献

{"title":"An Improved Prognosis in Subjects With Homozygous Familial Hypercholesterolemia Associated With Advances in LDL-Lowering Therapy.","authors":"Hayato Tada, Masayuki Takamura","doi":"10.5551/jat.ED302","DOIUrl":"10.5551/jat.ED302","url":null,"abstract":"","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"882-883"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Recurrence Patterns and Treatment Strategies for Reintervention after Paclitaxel-Coated Balloon Angioplasty in Femoropopliteal Artery Diseases: Results of the ASTRA Study.","authors":"Naoki Yoshioka, Takahiro Tokuda, Akiko Tanaka, Shunsuke Kojima, Kohei Yamaguchi, Takashi Yanagiuchi, Kenji Ogata, Tatsuro Takei, Yasuhiro Morita, Tatsuya Nakama, Itsuro Morishima","doi":"10.5551/jat.66102","DOIUrl":"10.5551/jat.66102","url":null,"abstract":"<p><strong>Aims: </strong>Data on recurrence and its patterns after paclitaxel-coated balloon (PCB) angioplasty for femoropopliteal artery disease are limited. We evaluated the incidence and predictors of re-recurrence according to the retreatment strategy (PCB or scaffold) and recurrence pattern (restenosis or reocclusion) in patients with recurrence after primary PCB therapy.</p><p><strong>Methods: </strong>This multicenter retrospective study included 276 limbs of 246 patients who underwent repeat endovascular therapy (EVT) using either PCB (PCB group, n = 217) or a scaffold (scaffold group, n = 59) for primary PCB recurrence. The primary endpoint was 1-year freedom from re-recurrence, and secondary analyses identified the predictors of re-recurrence.</p><p><strong>Results: </strong>In the PCB group, 174 restenotic and 43 reoccluded lesions were treated with PCBs. In the scaffold group, 32 restenotic and 27 reoccluded lesions were treated with scaffolds. In both groups, reoccluded lesions had significantly lower freedom from re-recurrence rates than restenotic lesions (PCB: 43.0% vs. 68.6%, p＜0.001; scaffold: 52.6% vs. 81.5%, p = 0.033). Freedom from re-reocclusion was also significantly lower in reoccluded lesions than in restenotic lesions (PCB: 48.5% vs. 88.6%, p＜0.001; scaffold: 65.8% vs. 93.2%, p = 0.033). The independent predictors of re-recurrence after PCB treatment were male sex (hazard ratio [HR] 2.01, p = 0.010), reoccluded lesions (HR 2.71, p = 0.001), poor BK run-off (HR 1.97, p = 0.020), use of first-generation low-dose PCB (HR 2.32, p = 0.017), and residual stenosis ＞30% (HR 2.60, p = 0.009). After scaffold treatment, reoccluded lesions were also identified as a significant predictor of re-recurrence (HR 2.99, p = 0.043).</p><p><strong>Conclusion: </strong>Reocclusion after PCB therapy was strongly associated with subsequent re-recurrence, including re-reocclusion, regardless of the retreatment strategy.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"946-957"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of T1-weighted MRI in Identifying Coronary Intraplaque Hemorrhage: CATCH the Truly High-Risk Plaque.","authors":"Hidenari Matsumoto","doi":"10.5551/jat.66089","DOIUrl":"10.5551/jat.66089","url":null,"abstract":"<p><p>Intraplaque hemorrhage (IPH) is a key feature of plaque vulnerability that contributes to atherothrombotic events. Non-invasive coronary plaque imaging has been challenging because of the small size of the coronary arteries and motion caused by cardiac contraction and respiration. Recent advances in magnetic resonance imaging (MRI) have enabled the non-invasive detection of coronary IPH. Compared with coronary computed tomography angiography and intravascular imaging modalities, MRI offers unique noninvasive tissue characterization based on intrinsic signal properties. Histopathological and intravascular imaging investigations have indicated that erythrocyte-derived materials, rather than lipid components, constitute the predominant substrate of coronary high-intensity plaques, reflecting recent IPH. This review summarizes the pathophysiological basis, imaging characteristics, and clinical implications of MRI-detected coronary IPH, in the context of other imaging modalities.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"871-881"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Ischemic Conditioning for Acute Ischemic Stroke: The RICAIS Randomized Clinical Trial.","authors":"Kazuo Kitagawa, Kentaro Ishizuka, Ryosuke Doijiri, Kenji Maruyama, Manabu Sakaguchi, Shuji Hino, Yutaka Honma, Yoko Kimura, Yasuyuki Iguchi, Teruyuki Hirano, Momoyo Oda, Kiyotaka Oi, Sono Toi, Takafumi Mizuno, Satoko Arai, Megumi Hosoya, Sho Wako, Shuntaro Takahashi, Moeko Saito, Kenichi Todo, Tomonari Saito, Kazumi Kimura, Tetsuro Ago, Takanari Kitazono, Yasuto Sato, Takao Hoshino","doi":"10.5551/jat.66105","DOIUrl":"10.5551/jat.66105","url":null,"abstract":"<p><strong>Aims: </strong>Preclinical studies have shown that remote ischemic conditioning (RIC) has a neuroprotective effect; however, the findings of clinical studies are inconsistent. This study aimed to show the effect of RIC on acute ischemic stroke while considering its severity at baseline.</p><p><strong>Methods: </strong>We enrolled 79 patients with ischemic stroke who had National Institute of Health Stroke Scale (NIHSS) scores of 5-20 within 48 h after stroke onset and randomized them into the RIC [n = 43] and control groups [n = 36]. The intervention was performed using an inflatable cuff on one lower extremity. In the RIC group, each treatment consisted of four cycles of 5 min cuff inflation and deflation. The treatment was repeated once daily for at least three days. Based on the NIHSS score, the patients were divided into three groups: mild (NIHSS 5-9), moderate (NIHSS 10-14), and severe (NIHSS 15-20). The primary outcome was a good functional outcome at 90 days, defined as a modified Rankin Scale score of 0-1 in the mild group, 0-2 in the moderate group, and 0-3 in the severe group.</p><p><strong>Results: </strong>Among the 79 patients (mean age, 65.0 years, 40 women), 7 (16.3%) in the RIC group and 8 (22.2%) in the control group had good functional outcomes (odds ratio, 0.73 [95% confidence interval, 0.29-1.82]; P = 0.502). The incidences of major adverse cardiovascular events, aspiration pneumonia, and serious adverse events were similar in both the groups.</p><p><strong>Conclusion: </strong>Although this study may have been underpowered, RIC initiated within 48 h of stroke onset did not seem to improve the functional outcomes in acute ischemic stroke.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"937-945"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of High-Intensity Statins and Low-Density Lipoprotein Cholesterol on the Outcomes of Coronary Intervention for Chronic Coronary Syndrome in Japan.","authors":"Yohei Yamauchi, Yumiko Kanzaki, Daisuke Shishikura, Kenta Sakaguchi, Shimpei Fujioka, Hirofumi Kusumoto, Kosuke Tsuda, Kazushi Sakane, Tomohiro Fujisaka, Masahito Michikura, Mariko Harada-Shiba, Hideaki Morita","doi":"10.5551/jat.66062","DOIUrl":"10.5551/jat.66062","url":null,"abstract":"<p><strong>Aim: </strong>The clinical effect of high-intensity statin therapy after percutaneous coronary intervention (PCI) in Japanese patients with chronic coronary syndrome (CCS) remains unclear. We investigated the association between high-intensity statin therapy and the cardiovascular outcomes following PCI in patients with CCS.</p><p><strong>Methods: </strong>We retrospectively evaluated 716 patients with CCS who underwent PCI and categorized them into high- or non-high-intensity statin groups, according to the Japan Atherosclerosis Society guidelines. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and revascularization, while the secondary outcome was all-cause death. The outcomes were further assessed according to the low-density lipoprotein cholesterol (LDL-C) levels (＜55 mg/dL, 55-69 mg/dL, and ≥ 70 mg/dL). The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox model.</p><p><strong>Results: </strong>Over a median follow-up of 2 years, high-intensity statin therapy reduced the incidence of the primary outcome (HR, 0.32; 95% CI, 0.17-0.61; P＜0.01) and all-cause death (HR, 0.18; 95% CI, 0.06-0.57; P＜0.01). This association with the primary composite outcome was consistently observed across the achieved LDL-C categories.</p><p><strong>Conclusions: </strong>High-intensity statin therapy was associated with a reduced risk of cardiovascular events after PCI in Japanese patients with CCS, independent of the achieved LDL-C levels.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"922-936"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Serum Fatty Acids and the Eicosapentaenoic Acid/Arachidonic Acid Ratio with Hypertriglyceridemia in a Japanese Population: A Cross-Sectional Study.","authors":"Yayoi Funakoshi, Koutatsu Maruyama, Tadahiro Kato, Isao Saito","doi":"10.5551/jat.66106","DOIUrl":"10.5551/jat.66106","url":null,"abstract":"<p><strong>Aim: </strong>The association between serum fatty acids and atherosclerotic disease remains unclear. In this cross-sectional study, we examined the association of serum fatty acids and the EPA/AA ratio with hypertriglyceridemia (HTG), a key metabolic factor underlying atherosclerosis.</p><p><strong>Methods: </strong>A total of 2,413 adults aged 40-74 years were randomly selected after excluding those with clinically validated myocardial infarction or stroke. We analyzed the serum fatty-acid composition and categorized saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), n-6 polyunsaturated fatty acids (PUFA), n-3 PUFA, and the EPA/AA ratio into quartiles, defined HTG at triglyceride levels ≥ 150 or ≥ 175 mg/dL in fasting or non-fasting samples, respectively, and calculated the adjusted odds ratios (AORs) and 95 % confidence intervals (CIs) using multivariable logistic regression.</p><p><strong>Results: </strong>After adjusting for age, sex, body mass index, social status, lifestyle, and the self-reported medical history of hypertension, diabetes, dyslipidemia, other cardiovascular diseases, and cerebrovascular conditions (excluding validated myocardial infarction or stroke), the odds of HTG were significantly higher in the highest quartile of SFA (AOR, 8.13; 95 % CI, 5.62-11.77) and MUFA (AOR, 64.7; 95 % CI, 31.4-133.2). In contrast, higher n-6 PUFA (AOR, 0.02; 95 % CI, 0.01-0.04) and n-3 PUFA (AOR, 0.36; 95 % CI, 0.26-0.50) levels, and a higher EPA/AA ratio (AOR, 0.64; 95 % CI, 0.46-0.88) were associated with lower odds of HTG.</p><p><strong>Conclusions: </strong>Higher serum SFA and MUFA were associated with increased odds, while higher n-6 PUFA, n-3 PUFA, and the EPA/AA ratio were associated with decreased odds of HTG.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"958-967"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Evinacumab in Japanese Patients with Homozygous Familial Hypercholesterolemia: Long-term Results from an Open-label, Single-arm, Phase 3 Trial.","authors":"Masahiro Koseki, Hisashi Makino, Yoshihiko Otsubo, Masa-Aki Kawashiri, Naohiko Fujii, Naoya Fujita, Yukiyo Yamamoto, Alpana Waldron, Robert Pordy, Shazia Ali, Serap Sankoh, Pinay Kainth, Hayato Tada, Kimimasa Tobita, Mariko Harada-Shiba","doi":"10.5551/jat.66077","DOIUrl":"https://doi.org/10.5551/jat.66077","url":null,"abstract":"<p><strong>Aim: </strong>This sub-group analysis evaluated the long-term efficacy and safety of evinacumab, an angiopoietin-like 3 inhibitor, in adolescent and adult Japanese patients with homozygous familial hypercholesterolemia (HoFH) who were enrolled in the open-label, single-arm, extension of the Phase 3 ELIPSE HoFH pivotal trial.</p><p><strong>Methods: </strong>Patients aged ≥ 12 years with HoFH on stable lipid-lowering therapies received intravenous evinacumab 15 mg/kg every 4 weeks and weekly/biweekly lipoprotein apheresis. Final results are reported.</p><p><strong>Results: </strong>Eleven patients were enrolled and received at least 1 dose of evinacumab at baseline, including 9 adults who participated in the evinacumab pivotal study (evinacumab-continue) and 2 newly enrolled adolescent patients (evinacumab-naïve). Mean (standard error) percent decrease in LDL-C from baseline to Week 24 was 42.9% (7.4) in the overall cohort (n = 9) and 37.1% (7.9) in the evinacumab-continue group (n = 7), with reductions in LDL-C observed as early as Week 8 and persisting through Week 168. Evinacumab treatment was also associated with reductions in other lipid parameters measured, including apolipoproteins A1 and B, non-high density lipoprotein cholesterol (HDL-C), HDL-C, total cholesterol, fasting triglycerides, and lipoprotein(a). Similar lipid-lowering results were seen in the evinacumab-naïve group (n = 2). Treatment-emergent adverse events (TEAEs) occurred in all 11 patients. Serious TEAEs occurred in 3 (27.3%) patients, and none were treatment related.</p><p><strong>Conclusions: </strong>Evinacumab treatment resulted in sustained reductions in LDL-C and other lipid parameters in Japanese patients ≥ 12 years with HoFH, including those undergoing lipoprotein apheresis, and was generally well tolerated.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368483","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":"Retinol-binding Protein 4 as a Predictor of Cardiovascular Events after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction.","authors":"Rongzhen Lu, Tianzi Li","doi":"10.5551/jat.65886","DOIUrl":"10.5551/jat.65886","url":null,"abstract":"<p><strong>Aim: </strong>This study explored the association between retinol-binding protein 4 (RBP4) and cardiovascular events in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>A total of 736 AMI patients who underwent successful PCI were prospectively enrolled between January 2020 and January 2022. The baseline RBP4 levels were measured by ELISA and categorized into quartiles. The incidence of major adverse cardiovascular events (MACEs), including all-cause mortality, recurrent myocardial infarction, revascularization, heart failure, and stroke, was assessed at the 1- and 3-year follow-up. Multivariate Cox proportional hazards models were used to evaluate the association between RBP4 and MACEs. A receiver operating characteristic (ROC) curve analysis was performed to determine the predictive efficiency of RBP4 for predicting the 1-year and 3-year MACEs.</p><p><strong>Results: </strong>During follow-up, 110 (14.95%) and 165 (22.42%) patients developed MACEs at one and three years, respectively. Elevated RBP4 (the fourth quartile vs. the first quartile) was associated with an increased risk of MACEs (HR = 2.18, 95%CI = 1.42~4.37, P = 0.007) and heart failure (HR = 3.89, 95%CI = 1.68~5.75, P＜0.001) at the 1-year follow-up. Additionally, the elevated RBP4 were associated with an increased risk of MACEs (HR = 4.41, 95%CI = 2.57~7.31, P＜0.001), revascularization (HR = 3.43, 95%CI = 1.82~4.87, P＜0.001) and heart failure (HR = 7.12, 95%CI = 3.78~11.92, P＜0.001) at 3-year follow-ups. An ROC curve analysis revealed that the serum RBP4 cutoff for predicting the 1-year MACEs was 46.3 ng/mL (AUC = 0.74, 95%CI = 0.69~0.78, P＜0.001), and for predicting the 3-year MACEs, it was 43.9 ng/mL (AUC = 0.81, 95%CI = 0.77~0.85, P＜0.001). A Stratified Cox regression analysis suggested that the renal function did not significantly modify the association between RBP4 and MACEs.</p><p><strong>Conclusion: </strong>Elevated RBP4 levels are independently associated with an increased risk of MACEs in patients with AMI post-PCI, thus highlighting its potential as a prognostic biomarker for risk stratification.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"911-921"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of the Estimated Small Dense Low-Density Lipoprotein Cholesterol Levels in Predicting the Incidence of Coronary Artery Disease: The Nagahama Study and Shizuoka Kokuho Database Study.","authors":"Yasuharu Tabara, Aya Shoji-Asahina, Yoko Sato, Takahisa Kawaguchi, Takeo Nakayama, Fumihiko Matsuda","doi":"10.5551/jat.65926","DOIUrl":"10.5551/jat.65926","url":null,"abstract":"<p><strong>Aims: </strong>Small dense low-density lipoprotein cholesterol (sdLDLC) has been suggested to be more harmful for cardiovascular outcomes than total LDLC. This study aimed to clarify the prognostic significance of the estimated sdLDLC for the incidence of coronary artery diseases (CAD).</p><p><strong>Methods: </strong>We analyzed the clinical information obtained at an annual health checkup of 365,083 adults aged 40-74 years enrolled in the National Health Insurance system in Japan. The incidence of CAD was determined using the health insurance claims data. Additionally, we calculated Japanese-specific coefficients of the sdLDLC estimation equation using general population data, where the measured sdLDLC value was available (n = 9,558).</p><p><strong>Results: </strong>The estimated sdLDLC level calculated from the total LDLC and triglyceride levels was correlated with the measured sdLDLC level (coefficient of determination = 0.768) and it was significantly associated with the CAD incidence (hazard ratio per 10 mg/dL = 1.21, p＜0.001). Although the total LDLC showed a similar association, the estimated sdLDLC ≥ 30 mg/dL (hazard ratio = 1.97, p = 0.016) and ≥ 40 mg/dL (hazard ratio = 2.57, p = 0.001) were significantly associated with CAD, even in participants with normal LDLC levels (＜120 mg/dL). The cross-sectional association of the measured sdLDLC with the pulse wave velocity of the large artery (β = 0.034, p＜0.001) was significant, while that of the estimated sdLDLC (β = 0.014, p = 0.057) was not.</p><p><strong>Conclusion: </strong>The estimated sdLDLC may be a straightforward and cost-effective marker for identifying individuals with normal LDLC levels at risk of CAD. However, the measured sdLDLC may be a more favorable marker than the estimated sdLDLC.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":"895-910"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147377672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of Atrial Cardiopathy in Patients with Embolic Stroke of an Undetermined Source.","authors":"Yuan Chai, Lulu Pei, Lu Zhao, Rui Zhang, Yuan Gao, Hui Fang, Haiman Hou, Kai Liu, Junzhe Yang, Yuying Wang, Xinsheng Han, Ferdinando S Buonanno, Mingming Ning, Xinyi Leng, Duolao Wang, Yuming Xu, Bo Song","doi":"10.5551/jat.65885","DOIUrl":"https://doi.org/10.5551/jat.65885","url":null,"abstract":"<p><strong>Aim: </strong>Atrial cardiomyopathy (AC) is associated with cardiovascular events, but the benefit of anticoagulation in embolic stroke of an undetermined source (ESUS) remains unclear. We aimed to prospectively evaluate the prognostic value of AC in patients with ESUS.</p><p><strong>Methods: </strong>We prospectively enrolled patients with ESUS who were hospitalized within 7 days of onset (January 2019 - December 2021). AC was defined as an N-terminal pro-B-type natriuretic peptide level ＞250 pg/ml, P-wave terminal force in lead V1 ＞5000 µV·ms, or enlarged left atrial diameter. Ischemic stroke/transient ischemic attack (TIA) recurrence was evaluated using Fine-Gray sub-distribution hazard models with death as a competing event. Cox proportional hazards models were used for supportive analyses and all-cause mortality.</p><p><strong>Results: </strong>Among the 345 patients (mean age 59.22±13.19 years; 69.0% men), 42.0% met the criteria for AC. During a median follow-up of 18.1 months, 36 patients experienced ischemic stroke, 2 had TIA, and 18 died. AC was strongly associated with ischemic stroke/TIA recurrence in competing risk analyses (adjusted subdistribution hazard ratio [aSHR] 3.36, 95% CI 1.65-6.86; P＜0.001). For all-cause mortality, AC was associated with a higher risk after adjusting for age and sex (adjusted hazard ratio 3.80, 95% CI 1.19-12.08; P = 0.024). Adding AC to conventional risk models significantly improved the NRI (ischemic stroke/transient ischemic attack: 72.45%, P＜0.001; mortality: 66.16%, P = 0.002) and IDI (4.52%, P＜0.001; 3.89%, P = 0.041).</p><p><strong>Conclusions: </strong>AC independently predicts recurrent ischemic stroke/TIA in ESUS and improves risk stratification, while its association with mortality requires cautious interpretation due to limited events.</p>","PeriodicalId":15128,"journal":{"name":"Journal of atherosclerosis and thrombosis","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345314","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}