Journal of cardiology最新文献

{"title":"Effects of repeated periods of high-intensity interval training on myocardial function in patients with metabolic syndrome: A 16-month follow-up.","authors":"Juan F Ortega, Eva García-Camacho, Alejandro Gadella-Fernández, Félix A Morales-Palomo, Alfonso Moreno-Cabañas, Laura Álvarez-Jiménez, Ricardo Mora-Rodriguez, Manuel Gallango-Brejano","doi":"10.1016/j.jjcc.2026.04.007","DOIUrl":"https://doi.org/10.1016/j.jjcc.2026.04.007","url":null,"abstract":"<p><strong>Background: </strong>One program of exercise training is useful to improve myocardial function in patients with cardiovascular disease (CVD) but not in patients with CVD risk factors. However, it is unknown whether repeated periods of high-intensity interval training (HIIT) can reverse the progressive myocardial dysfunction observed in patients with metabolic syndrome (MetS). We aimed to follow MetS patients for 16 months and determine the effect of two periods of HIIT, separated by a year, on their myocardial function.</p><p><strong>Methods: </strong>Eighty-eight middle-aged volunteers with MetS and without heart failure were randomized in one of two groups: HIIT: Two periods of HIIT separated by a year (16 weeks, 3 sessions/week) or, CONTROL: standard medical treatment. Myocardial function, assessed by the left ventricle (LV) global longitudinal strain (GLS), and routine echocardiographic parameters, maximal oxygen consumption (VO_2max), and MetS components were assessed at baseline, after the first HIIT period (4 months), and one year later, after the second HIIT period. Variables were analyzed following the intention-to-treat analysis principle using linear mixed model.</p><p><strong>Results: </strong>At baseline, 29% of participants from HIIT, and 24% from CONTROL had an impaired LV-GLS. However, none had diastolic dysfunction. Fifty-three participants (29 from HIIT and 24 from CONTROL) completed the follow-up. LV-GLS and LV-early rapid filling (e' wave velocity and E/e' ratio) improved progressively after the two periods of HIIT in comparison to CONTROL (group*time p = 0.002, p = 0.028, and p = 0.002, respectively). VO_2max improved only in the HIIT group (group*time p = 0.002), while ejection fraction and MetS z-score changes were not different between groups (group*time p = 0.964 and p = 0.419, respectively).</p><p><strong>Conclusions: </strong>Among middle-aged adults receiving medical treatment for MetS, the addition of two HIIT periods, spaced one year apart, led to significant improvements in myocardial function, that were not observed in the control group receiving medical treatment alone.</p><p><strong>Clinical trials number: </strong>NCT06262256.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of global longitudinal strain in predicting fatal arrhythmic events in hypertrophic cardiomyopathy: An up-to-date systematic review and Meta-analysis.","authors":"George Bazoukis, Haipeng Liu, Rim Copti, Athanasios Saplaouras, Truong Nhat Minh Nguyen, Sharen Lee, Tereza Michael, Tong Liu, Gary Tse, Konstantinos P Letsas, Michael Efremidis","doi":"10.1016/j.jjcc.2026.04.006","DOIUrl":"10.1016/j.jjcc.2026.04.006","url":null,"abstract":"<p><strong>Background: </strong>Sudden cardiac death (SCD) remains a leading cause of mortality in patients with hypertrophic cardiomyopathy (HCM). Accurate identification of individuals at high risk is essential for guiding implantable cardioverter-defibrillator (ICD) therapy. Global longitudinal strain (GLS), an echocardiographic parameter derived from speckle-tracking imaging, reflects subclinical left ventricular systolic dysfunction and may serve as an adjunctive risk marker for fatal ventricular arrhythmias (VAs).</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed and the Cochrane Library were searched from inception to April 2025 for studies assessing the association between GLS and SCD and/or fatal VAs in HCM.</p><p><strong>Results: </strong>Out of 1050 identified records, seven studies comprising 2167 patients (mean age 54.7 years) met inclusion criteria. All included studies were of moderate-to-high quality (Newcastle-Ottawa Scale ≥6). In the pooled quantitative synthesis of three studies, patients with reduced GLS (<15%) had a significantly higher risk of fatal VAs [hazard ratio/odds ratio (HR/OR): 1.10, 95% (confidence interval) CI 1.04-1.17]. On the other hand, 1% worsening of GLS was not associated with SCD and/or fatal VAs (HR/OR: 1.09, 95% CI 0.89-1.33). A combined meta-analysis using data from seven studies showed a significant association between GLS and SCD and/or fatal VAs in patients with HCM (HR/OR: 1.10, 95% CI 1.03-1.18).</p><p><strong>Conclusions: </strong>GLS is associated with risk of fatal arrhythmic events in HCM and may help identify higher-risk patients, but evidence from observational studies does not prove causality and may be confounded. GLS could aid shared decision-making about ICDs in borderline cases when combined with established risk factors, but should not be used alone. Prospective multicenter studies with standardized imaging are needed to validate thresholds, confirm added prognostic value, and show impact on outcomes.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between high platelet reactivity with Prasugrel and clinical events after percutaneous coronary intervention in patients with diabetes mellitus: A PENDULUM registry substudy","authors":"Daiki Yoshiura MD ,&nbsp;Masanori Taniwaki MD ,&nbsp;Yoshihisa Nakagawa MD, PhD ,&nbsp;Ken Kozuma MD, PhD, FJCC ,&nbsp;Raisuke Iijima MD, PhD ,&nbsp;Anna Tsutsui PhD ,&nbsp;Yoshitaka Murakami PhD ,&nbsp;Masayuki Fukuzawa ,&nbsp;Satoru Abe ,&nbsp;Go Kato ,&nbsp;Masato Nakamura MD, PhD, FJCC ,&nbsp;Kengo Tanabe MD, PhD","doi":"10.1016/j.jjcc.2025.11.016","DOIUrl":"10.1016/j.jjcc.2025.11.016","url":null,"abstract":"<div><h3>Background</h3><div>Patients with diabetes mellitus (DM) have a high risk of ischemic events after percutaneous coronary intervention (PCI). However, the relationship between high platelet reactivity (HPR) with prasugrel and clinical events in patients with DM remains unclear. This post-hoc analysis of the PENDULUM registry examined the relationships of HPR with major adverse cardiac and cerebrovascular events (MACCE) and major bleeding in patients with DM on prasugrel.</div></div><div><h3>Methods</h3><div>Based on P2Y12 reaction unit (PRU) levels, patients were stratified into high platelet reactivity (HPR; PRU &gt; 208) and no-HPR (PRU ≤ 208) groups. Clinical events were assessed up to 30 months after the index PCI. A total of 3652 patients who received prasugrel at a dose of 3.75 mg once daily were enrolled: 1522 patients with DM (HPR, <em>n</em> = 454; no-HPR, <em>n</em> = 1068), and 2130 patients without DM (HPR, <em>n</em> = 547; no-HPR, <em>n</em> = 1583).</div></div><div><h3>Results</h3><div>Patients with DM had MACCE significantly more frequently than patients without DM (HR: 1.64; 95 % CI: 1.30–2.06; <em>p</em> &lt; 0.001). Patients without DM in the HPR subgroup had MACCE more frequently, but not significantly (HR: 1.43; 95 % CI: 1.00–2.05; <em>p</em> = 0.053). In contrast, in patients with DM, no significant association between HPR and MACCE was found (HR: 1.25; 95 % CI: 0.90–1.75; <em>p</em> = 0.18). Major bleeding occurred in 4.2 % of the HPR group and 3.5 % of the no-HPR group in patients with DM, with no significant difference between the two groups (HR: 1.22; 95 % CI: 0.70–2.12; <em>p</em> = 0.49).</div></div><div><h3>Conclusions</h3><div>In patients with DM, HPR with prasugrel was not associated with MACCE or major bleeding, whereas MACCE tended to be increased in those without DM.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 406-413"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The RFR-FFR gradient: A novel predictor of preprocedural microvascular dysfunction and mortality","authors":"Takahiro Watanabe MD ,&nbsp;Yoshihisa Kanaji MD, PhD ,&nbsp;Eisuke Usui MD, PhD ,&nbsp;Masahiro Hada MD, PhD ,&nbsp;Hiroki Ueno MD ,&nbsp;Mirei Setoguchi MD ,&nbsp;Kodai Sayama MD ,&nbsp;Takumi Watanabe MD ,&nbsp;Riko Murakami MD ,&nbsp;Kaisei Hosokawa MD ,&nbsp;Taishi Yonetsu MD, PhD ,&nbsp;Tetsuo Sasano MD, PhD, FJCC ,&nbsp;Tsunekazu Kakuta MD, PhD","doi":"10.1016/j.jjcc.2025.12.003","DOIUrl":"10.1016/j.jjcc.2025.12.003","url":null,"abstract":"<div><h3>Background</h3><div>While fractional flow reserve (FFR) is the gold standard for assessing coronary stenosis, non-hyperemic pressure ratios (NHPRs) such as the resting full-cycle ratio (RFR) are used as less invasive alternatives. However, NHPR-guided percutaneous coronary intervention (PCI) has been reported to be associated with poorer outcomes. We hypothesized that the difference between RFR and FFR (RFR-FFR) carries important clinical information.</div></div><div><h3>Methods</h3><div>This retrospective study included 460 patients with chronic coronary syndrome who underwent FFR-guided elective PCI following functional assessment of the left anterior descending artery (LAD) with both RFR and FFR. Patients were stratified into tertiles based on their RFR-FFR value. The primary endpoint was all-cause death.</div></div><div><h3>Results</h3><div>Patients in the lowest RFR-FFR tertile presented with a higher-risk clinical profile including older age, female sex, and greater comorbidity burden such as elevated N-terminal pro-B-type natriuretic peptide and lower renal function, and evidence of microvascular dysfunction such as lower coronary flow reserve and microvascular resistance reserve. During a median follow-up of 5.2 years, lower RFR-FFR patients showed higher rate of all-cause death. Multivariable analysis identified age and baseline heart rate as independent predictors of a low RFR-FFR value. Crucially, a multivariable Cox regression analysis revealed that a low RFR-FFR value was an independent predictor of all-cause death.</div></div><div><h3>Conclusions</h3><div>A lower RFR-FFR value is a marker of increased comorbidities and microvascular dysfunction, correlating with poorer long-term clinical outcomes. This pre-PCI novel metric holds potential utility for risk stratification and personalizing treatment strategies in patients with chronic coronary artery disease undergoing LAD PCI.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 414-421"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply: Comparing BREATH2 with HFA-PEFF and H2FPEF: Room for integration or redundancy?","authors":"Yuki Saito MD, PhD, FJCC ,&nbsp;Masaru Obokata MD, PhD","doi":"10.1016/j.jjcc.2026.02.009","DOIUrl":"10.1016/j.jjcc.2026.02.009","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 473-474"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological impact of lipid-rich plaque on coronary microvascular dysfunction: Evaluation using near-infrared spectroscopy intravascular ultrasound and angiography-derived index of microcirculatory resistance after percutaneous coronary intervention","authors":"Nobuhiro Yamada MD,&nbsp;Masafumi Ueno PhD,&nbsp;Kyohei Onishi PhD,&nbsp;Kazuyoshi Kakehi PhD,&nbsp;Kosuke Fujita PhD,&nbsp;Takayuki Kawamura PhD,&nbsp;Koichiro Matsumura PhD,&nbsp;Gaku Nakazawa PhD","doi":"10.1016/j.jjcc.2025.12.014","DOIUrl":"10.1016/j.jjcc.2025.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Coronary microvascular dysfunction (CMD) after percutaneous coronary intervention (PCI) is associated with poor prognosis, including periprocedural myocardial infarction, and is often attributed to distal embolization of lipid-rich plaque components. However, whether preprocedural lipid quantification using near-infrared spectroscopy–intravascular ultrasonography (NIRS-IVUS) can predict CMD remains unclear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 147 coronary lesions in 121 patients with coronary artery disease (excluding ST-segment elevation myocardial infarction) who underwent NIRS-IVUS-guided PCI. CMD was defined as an angiography-based index of microcirculatory resistance (angio-IMR) ≥25. Two NIRS-derived lipid parameters were assessed: maximum lipid core burden index &gt;4 mm (maxLCBI_4mm) and a novel index, lipid burden in the stent (LBS = stent diameter × length × LCBI), which was determined by the operator based on the planned stent diameter, planned stent length, and the LCBI within the planned stent implantation segment.</div></div><div><h3>Results</h3><div>CMD occurred in 36.7 % of lesions and was associated with significantly higher values of both indices (<em>p</em> &lt; 0.01). A stepwise trend between lipid burden and microvascular dysfunction was also observed. Optimal cut-offs were identified as maxLCBI_4mm ≥ 579 and LBS ≥20,384. Both indices independently predicted CMD (odds ratios = 7.253 and 3.181), and CMD risk was highest in lesions exceeding both thresholds.</div></div><div><h3>Conclusions</h3><div>Higher pre-PCI maxLCBI_4mm and LBS values were independently associated with CMD development after PCI. Further studies are warranted to validate their clinical relevance in optimizing PCI strategies.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 451-458"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply: An evidence-based tool for screening for heart failure with preserved ejection fraction in primary care: The BREATH2 score: Discussion from a statistical perspective","authors":"Yuki Saito MD, PhD, FJCC ,&nbsp;Masaru Obokata MD, PhD","doi":"10.1016/j.jjcc.2026.02.010","DOIUrl":"10.1016/j.jjcc.2026.02.010","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 477-478"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardio-ankle vascular index as a screening tool for coronary artery disease in patients with metabolic dysfunction-associated steatotic liver disease","authors":"Mitsutaka Nakashima MD, PhD ,&nbsp;Toru Miyoshi MD, PhD, FJCC ,&nbsp;Yuta Ueki MD ,&nbsp;Takahiro Nishihara MD, PhD ,&nbsp;Takashi Miki MD, PhD ,&nbsp;Shohei Hara MD ,&nbsp;Keishi Ichikawa MD, PhD ,&nbsp;Kazuhiro Osawa MD, PhD ,&nbsp;Shinsuke Yuasa MD, PhD, FJCC","doi":"10.1016/j.jjcc.2025.12.006","DOIUrl":"10.1016/j.jjcc.2025.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common hepatic disorder that significantly increases cardiovascular risk. However, no established screening method exists for detecting subclinical coronary artery disease (CAD) in this high-risk population. The cardio-ankle vascular index (CAVI), a blood pressure–independent measure of arterial stiffness, may offer a non-invasive tool for early detection of coronary atherosclerosis.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 295 patients with MASLD who underwent both CAVI measurement and coronary computed tomography angiography at a single center. Significant CAD was defined as ≥50 % luminal stenosis. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic performance. Multivariable logistic regression was performed to identify independent associations between elevated CAVI and CAD. The incremental predictive value of CAVI was assessed using net reclassification improvement (NRI).</div></div><div><h3>Results</h3><div>Of the 295 patients, 110 (37.3 %) had significant CAD. Patients with CAD had significantly higher CAVI values (9.0 vs. 8.7, <em>p</em> = 0.007). The area under the ROC curve for CAVI predicting CAD was 0.614. A CAVI cut-off of 8.6 provided a sensitivity of 66.4 % and a specificity of 56.8 %. CAVI ≥8.0 was independently associated with CAD (OR 3.44, 95 % CI: 1.06–11.2, <em>p</em> = 0.040). Adding CAVI to a conventional risk model improved risk reclassification (NRI 0.4236, <em>p</em> &lt; 0.001), although the C-statistic change was not significant (from 0.724 to 0.725, <em>p</em> = 0.835).</div></div><div><h3>Conclusions</h3><div>CAVI is independently associated with significant coronary stenosis in MASLD patients and may serve as a non-invasive screening tool to enhance cardiovascular risk stratification. Its moderate diagnostic accuracy suggests utility as a component of a multifactorial risk assessment strategy.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 429-433"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic ultrasound for acute myocardial infarction: Mechanisms, preclinical evidence, and clinical perspectives","authors":"Yosuke Katayama MD, PhD ,&nbsp;Koya Ozawa MD, PhD ,&nbsp;Tomoko Negishi MD ,&nbsp;Robert Gerber BSc, MB BS, PhD ,&nbsp;Kazuaki Negishi MD, PhD, MSc","doi":"10.1016/j.jjcc.2026.01.005","DOIUrl":"10.1016/j.jjcc.2026.01.005","url":null,"abstract":"<div><div>ST-segment elevation myocardial infarction remains a leading cause of mortality. Despite the success of primary percutaneous coronary intervention (PCI), outcomes have plateaued, largely due to reperfusion injury and subsequent microvascular obstruction. This review examines the evolving landscape of microbubble-enhanced ultrasound therapy (aka sonothrombolysis/ sonoperfusion), which is a novel strategy aimed at mitigating reperfusion injury and improving myocardial salvage. We summarize the fundamental mechanisms and critically appraise the clinical trial evidence, from early feasibility studies to pivotal randomized controlled trials. The clinical application of this therapy has progressed significantly. While early trials without microbubbles or with suboptimal ultrasound parameters yielded neutral or even negative results, recent studies have demonstrated clear benefits. A critical determinant of success has emerged: the timing of the intervention. Compelling evidence from recent randomized trials indicates that therapy initiated before PCI significantly improves myocardial salvage and reduces infarct size. In contrast, post-PCI application alone appears to offer limited therapeutic benefit once significant microvascular injury is established. Microbubble-enhanced ultrasound therapy, particularly when administered pre-PCI, represents a promising adjunctive treatment to address the persistent challenge of reperfusion injury. Its potential for pre-hospital application could make it a crucial bridging strategy, capable of initiating myocardial salvage at the earliest possible moment. Further research should focus on technological refinement and validating its efficacy in a pre-hospital setting.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 459-467"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simplified bedside model for prediction of acute kidney injury after percutaneous coronary intervention: CRASH score","authors":"Dinu V. Balanescu MD,&nbsp;Kaniz Fatema MBBS, PhD,&nbsp;Brad R. Lewis MS,&nbsp;Patricia J.M. Best MD,&nbsp;Rajiv Gulati MD, PhD,&nbsp;Joerg Herrmann MD","doi":"10.1016/j.jjcc.2025.12.012","DOIUrl":"10.1016/j.jjcc.2025.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Acute kidney injury (AKI) following percutaneous coronary intervention (PCI) is associated with poor outcomes. The National Cardiovascular Data Registry (NCDR) AKI prediction model includes a relatively high number of complex clinical variables. We propose a simplified bedside score including 5 pre-procedural variables from the NCDR model as an effective tool for AKI prediction after PCI.</div></div><div><h3>Methods</h3><div>The Mayo Clinic Rochester cardiac catheterization laboratory registry, which follows NCDR criteria, was analyzed between Q2 2022 and Q1 2023. Inclusion/exclusion criteria, definitions, and outcome data were based on the NCDR model. Logistic regression models were built to predict AKI, including a simplified integer score comprised of 5 pre-procedural variables: Cardiac arrest, Reduced glomerular filtration rate &lt; 30 ml/min/1.73 m2, Anemia (Hb &lt;10 mg/dl), Shock, and Heart failure history. Model calibration and discrimination were tested.</div></div><div><h3>Results</h3><div>We identified 840 patients with a mean age of 70 (IQR 61–79), of which 593 (70.6 %) were men. AKI developed in 107 (12.7 %) patients. There was no significant difference between the groups in gender, vascular access, PCI indication, or contrast volume used (median: 150; IQR: 110–200 ml in the non-AKI group and median: 170 IQR: 123–213 ml in the AKI group; <em>p</em> = 0.14). The CRASH score demonstrated a c-statistic of 0.77 (0.60–0.88) and calibration intercept of 0.31 (−0.07–0.69) and slope of 1.03 (0.66–1.39) in the validation data, similar to the NCDR score.</div></div><div><h3>Conclusions</h3><div>A simplified integer score using 5 pre-procedural variables was an effective tool for risk prediction of post-PCI AKI, with performance similar to the more complex NCDR model.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"87 5","pages":"Pages 440-444"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}