Journal of cardiology最新文献

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Optimal management of high bleeding risk patients undergoing percutaneous coronary interventions: Where do we stand? 对接受经皮冠状动脉介入治疗的高出血风险患者进行优化管理:我们的现状如何?
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-10 DOI: 10.1016/j.jjcc.2024.08.002
Kyriakos Dimitriadis, Nikolaos Pyrpyris, Panagiotis Iliakis, Panagiotis Kanatas, Panagiotis Theofilis, Athanasios Sakalidis, Anastasios Apostolos, Panagiotis Tsioufis, Aggelos Papanikolaou, Konstantinos Aznaouridis, Konstantina Aggeli, Konstantinos Tsioufis
{"title":"Optimal management of high bleeding risk patients undergoing percutaneous coronary interventions: Where do we stand?","authors":"Kyriakos Dimitriadis, Nikolaos Pyrpyris, Panagiotis Iliakis, Panagiotis Kanatas, Panagiotis Theofilis, Athanasios Sakalidis, Anastasios Apostolos, Panagiotis Tsioufis, Aggelos Papanikolaou, Konstantinos Aznaouridis, Konstantina Aggeli, Konstantinos Tsioufis","doi":"10.1016/j.jjcc.2024.08.002","DOIUrl":"10.1016/j.jjcc.2024.08.002","url":null,"abstract":"<p><p>Percutaneous coronary interventions (PCI) are the mainstay of treating obstructive coronary artery disease. However, procedural planning and individualization of the procedure is necessary for different patient phenotypes to optimize outcomes. Specifically, post-PCI pharmacotherapy with antiplatelets complicates the management of patients at high bleeding risk due to comorbidities, such as atrial fibrillation. Aiming to limit post-procedural adverse events and reduce the procedure-related bleeding risk, several novel technologies and hypotheses have been tested in clinical practice. Such frontiers include limiting the duration of dual antiplatelet therapy or even prescribing single regimens, using drug-coated balloons for performing the intervention and the effect of imaging-guided PCI in optimizing stent expansion. Furthermore, specific instruction in different patient phenotypes, such as atrial fibrillation and chronic kidney disease, are emerging, as despite both pathologies being considered at high bleeding risk, one size does not fit all. Thus, our review will provide all the recent updates on the field as well as algorithms and expert opinions on how to manage this, particularly common, phenotype of patient.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971194","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}
引用次数: 0
Coronary Bioresorbable metallic stents:Advancements and future perspectives. 冠状动脉生物可吸收金属支架:进展与未来展望。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-10 DOI: 10.1016/j.jjcc.2024.08.003
Junyan Zhang, Zhongxiu Chen, Li Rao, Yong He
{"title":"Coronary Bioresorbable metallic stents:Advancements and future perspectives.","authors":"Junyan Zhang, Zhongxiu Chen, Li Rao, Yong He","doi":"10.1016/j.jjcc.2024.08.003","DOIUrl":"https://doi.org/10.1016/j.jjcc.2024.08.003","url":null,"abstract":"<p><p>Percutaneous coronary intervention is a critical treatment for coronary artery disease, particularly myocardial infarction, and is highly recommended in clinical guidelines. Traditional metallic stents, although initially effective, remain permanently in the artery and can lead to complications such as in-stent restenosis, late thrombosis, and chronic inflammation. Given the temporary need for stenting and the potential for late complications, bioresorbable stents have emerged as a promising alternative. However, bioresorbable polymeric stents have encountered significant clinical challenges due to their low mechanical strength and ductility, which increase the risks of thrombosis and local inflammation. Consequently, bioresorbable metals are being considered as a superior option for coronary stents. This review examines the progress of bioresorbable metallic stents from both preclinical and clinical perspectives, aiming to provide a theoretical foundation for future research. Iron, zinc, and magnesium are the primary materials used for these stents. Zinc-based bioresorbable stents have shown promise in preclinical studies due to their biocompatibility and vascular protective properties, although human clinical studies are still limited. Magnesium-based stents have demonstrated positive clinical outcomes, being fully absorbed within 12 months and showing low rates of late lumen loss and target lesion failure at 6- and 12-months post-implantation. Initial trials of iron-based stents have indicated favorable mid-term safety and efficacy, with complete absorption by the body within three years and consistent luminal expansion beyond six months post-implantation. Despite these advancements, further trials are needed for comprehensive validation. In conclusion, while current materials do not fully meet the ideal requirements, ongoing research should focus on developing bioresorbable stents with enhanced performance characteristics to better meet clinical needs.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971163","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}
引用次数: 0
Echocardiographic factors associated with thromboembolic events in patients with cardiac amyloidosis without atrial fibrillation. 与无心房颤动的心脏淀粉样变性患者血栓栓塞事件相关的超声心动图因素。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-09 DOI: 10.1016/j.jjcc.2024.08.001
Cristhian Espinoza Romero, Natalia Melo Pereira, Kevin De Paula Morales, Bruno V Kerges Bueno, Georgina J Luzuriaga, Vitor E Egypto Rosa, Joao Henrique Rissato, Viviane T Hotta, Fabio Fernandes
{"title":"Echocardiographic factors associated with thromboembolic events in patients with cardiac amyloidosis without atrial fibrillation.","authors":"Cristhian Espinoza Romero, Natalia Melo Pereira, Kevin De Paula Morales, Bruno V Kerges Bueno, Georgina J Luzuriaga, Vitor E Egypto Rosa, Joao Henrique Rissato, Viviane T Hotta, Fabio Fernandes","doi":"10.1016/j.jjcc.2024.08.001","DOIUrl":"10.1016/j.jjcc.2024.08.001","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac amyloidosis (CA) is associated with various complications, and one of them are thromboembolic events (TEEs), which can significantly impact patients' quality of life. Predicting and managing the risk of these TEEs in patients without atrial fibrillation (AF) pose significant challenges, as many occur independently of AF presence. Several predictors, particularly echocardiographic ones, have been linked to an increased risk, but there is no consensus on stratification or preventive treatment. The main objective was to determine the prevalence of TEEs in a cohort of CA patients without AF and identify echocardiographic predictors.</p><p><strong>Methods: </strong>A retrospective, single-center study including confirmed CA patients. A prespecified list of variables was defined, and only patients with at least 70 % of these variables were included. Risk rates were analyzed through binary logistic regression, with a significance level set at p < 0.05.</p><p><strong>Results: </strong>75 patients were included. Baseline characteristics are depicted in Fig. 1. Fifteen TEEs (20 %) were described, with 80 % being ischemic strokes. While diastolic dysfunction and pulmonary systolic arterial pressure (PSAP) were predictors in univariate analysis, the multivariate backward LR model identified interventricular septum diameter (IVSD) as the sole predictor, OR 1.280 (1.061-1.543), p = 0.010. It is also interesting to mention that analyzing the increase of every 3 mm in SIV, the chance of developing ETES was: OR = 2.095 (1.195-3.671), p = 0.010.</p><p><strong>Conclusions: </strong>An IVSD evaluated by echocardiography demonstrated good performance capacity as a factor associated with TEEs in this cohort of patients with AC without AF. For every 3 mm increase in IVSD, the risk of developing TEEs doubles.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912848","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}
引用次数: 0
A risk model of mortality rate in dialysis patients following transcatheter aortic valve replacement. 经导管主动脉瓣置换术后透析患者死亡率风险模型。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-02 DOI: 10.1016/j.jjcc.2024.07.009
Kizuku Yamashita, Koichi Maeda, Kyongsun Pak, Kazuo Shimamura, Ai Kawamura, Isamu Mizote, Masaki Taira, Daisuke Yoshioka, Shigeru Miyagawa
{"title":"A risk model of mortality rate in dialysis patients following transcatheter aortic valve replacement.","authors":"Kizuku Yamashita, Koichi Maeda, Kyongsun Pak, Kazuo Shimamura, Ai Kawamura, Isamu Mizote, Masaki Taira, Daisuke Yoshioka, Shigeru Miyagawa","doi":"10.1016/j.jjcc.2024.07.009","DOIUrl":"10.1016/j.jjcc.2024.07.009","url":null,"abstract":"<p><strong>Background: </strong>Dialysis patients undergoing transcatheter aortic valve replacement (TAVR) generally have poor prognosis compared with non-dialysis patients. Furthermore, there are few reliable risk models in this clinical setting. Therefore, we aimed to establish a risk model in dialysis patients undergoing TAVR that would be informative for their prognosis and the decision-making process of TAVR.</p><p><strong>Methods: </strong>A total 118 dialysis patients (full cohort) with severe aortic stenosis underwent TAVR in our institute between 2012 and 2022. The patients of the full cohort were randomly assigned to two groups in a 2:1 ratio to form derivation and validation cohorts. Risk factors contributing to deaths were analyzed from the preoperative variables and a risk model was established from Cox proportional hazard model.</p><p><strong>Results: </strong>There were 69 deaths following TAVR derived from infectious disease (43.5 %), cardiovascular-related disease (11.6 %), cerebral stroke or hemorrhage (2.9 %), cancer (1.4 %), unknown origin (18.8 %), and others (21.7 %) during the observational period (811 ± 719 days). The cumulative overall survival rates using the Kaplan-Meier method at 1 year, 3 years, and 5 years in the full cohort were 82.8 %, 41.9 %, and 24.2 %, respectively. An optimal risk model composed of five contributors: peripheral vascular disease, serum albumin, left ventricular ejection fraction < 40 %, operative age, and hemoglobin level, was established. The estimated C index for the developed models were 0.748 (95 % CI: 0.672-0.824) in derivation cohort and 0.705 (95 % CI: 0.578-0.832) in validation cohort. The prediction model showed good calibration [intraclass correlation coefficient = 0.937 (95%CI: 0.806-0.981)] between actual and predicted survival.</p><p><strong>Conclusions: </strong>The risk model was a good indicator to estimate the prognosis in dialysis patients undergoing TAVR.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889373","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}
引用次数: 0
Impact of right ventricular and pulmonary vascular characteristics on Impella hemodynamic support in biventricular heart failure: A simulation study. 右心室和肺血管特征对双心室心力衰竭患者 Impella 血流动力学支持的影响:模拟研究。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-02 DOI: 10.1016/j.jjcc.2024.07.008
Hiroki Matsushita, Keita Saku, Takuya Nishikawa, Takashi Unoki, Shohei Yokota, Kei Sato, Hidetaka Morita, Yuki Yoshida, Masafumi Fukumitsu, Kazunori Uemura, Toru Kawada, Atsushi Kikuchi, Ken Yamaura
{"title":"Impact of right ventricular and pulmonary vascular characteristics on Impella hemodynamic support in biventricular heart failure: A simulation study.","authors":"Hiroki Matsushita, Keita Saku, Takuya Nishikawa, Takashi Unoki, Shohei Yokota, Kei Sato, Hidetaka Morita, Yuki Yoshida, Masafumi Fukumitsu, Kazunori Uemura, Toru Kawada, Atsushi Kikuchi, Ken Yamaura","doi":"10.1016/j.jjcc.2024.07.008","DOIUrl":"10.1016/j.jjcc.2024.07.008","url":null,"abstract":"<p><strong>Background: </strong>Impella (Abiomed, Danvers, MA, USA) is a percutaneous ventricular assist device commonly used in cardiogenic shock, providing robust hemodynamic support, improving the systemic circulation, and relieving pulmonary congestion. Maintaining adequate left ventricular (LV) filling is essential for optimal hemodynamic support by Impella. This study aimed to investigate the impact of pulmonary vascular resistance (PVR) and right ventricular (RV) function on Impella-supported hemodynamics in severe biventricular failure using cardiovascular simulation.</p><p><strong>Methods: </strong>We used Simulink® (Mathworks, Inc., Natick, MA, USA) for the simulation, incorporating pump performance of Impella CP determined using a mock circulatory loop. Both systemic and pulmonary circulation were modeled using a 5-element resistance-capacitance network. The four cardiac chambers were represented by time-varying elastance with unidirectional valves. In the scenario of severe LV dysfunction (LV end-systolic elastance set at a low level of 0.4 mmHg/mL), we compared the changes in right (RAP) and left atrial pressures (LAP), total systemic flow, and pressure-volume loop relationship at varying degrees of RV function, PVR, and Impella flow rate.</p><p><strong>Results: </strong>The simulation results showed that under low PVR conditions, an increase in Impella flow rate slightly reduced RAP and LAP and increased total systemic flow, regardless of RV function. Under moderate RV dysfunction and high PVR conditions, an increase in Impella flow rate elevated RAP and excessively reduced LAP to induce LV suction, which limited the increase in total systemic flow.</p><p><strong>Conclusions: </strong>PVR is the primary determinant of stable and effective Impella hemodynamic support in patients with severe biventricular failure.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889375","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}
引用次数: 0
JCS/JSCVS/JCC/CVIT 2023 guideline focused update on indication and operation of PCPS/ECMO/IMPELLA JCS/JSCVS/JCC/CVIT 2023 指南重点更新了 PCPS/ECMO/IMPELLA 的适应症和操作。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-02 DOI: 10.1016/j.jjcc.2024.04.006
{"title":"JCS/JSCVS/JCC/CVIT 2023 guideline focused update on indication and operation of PCPS/ECMO/IMPELLA","authors":"","doi":"10.1016/j.jjcc.2024.04.006","DOIUrl":"10.1016/j.jjcc.2024.04.006","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0914508724000790/pdfft?md5=78dca824b6f3826f6b58981518fe5e1d&pid=1-s2.0-S0914508724000790-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of clinical outcomes between proximal and non-proximal right coronary artery occlusion in patients with inferior ST-segment elevation myocardial infarction. 下ST段抬高型心肌梗死患者近端右冠状动脉闭塞与非近端右冠状动脉闭塞的临床疗效比较。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-08-02 DOI: 10.1016/j.jjcc.2024.07.007
Koudai Hamaguchi, Kenichi Sakakura, Hiroyuki Jinnouchi, Yousuke Taniguchi, Kei Yamamoto, Takunori Tsukui, Masashi Hatori, Taku Kasahara, Yusuke Watanabe, Shun Ishibashi, Masaru Seguchi, Hideo Fujita
{"title":"Comparison of clinical outcomes between proximal and non-proximal right coronary artery occlusion in patients with inferior ST-segment elevation myocardial infarction.","authors":"Koudai Hamaguchi, Kenichi Sakakura, Hiroyuki Jinnouchi, Yousuke Taniguchi, Kei Yamamoto, Takunori Tsukui, Masashi Hatori, Taku Kasahara, Yusuke Watanabe, Shun Ishibashi, Masaru Seguchi, Hideo Fujita","doi":"10.1016/j.jjcc.2024.07.007","DOIUrl":"10.1016/j.jjcc.2024.07.007","url":null,"abstract":"<p><strong>Background: </strong>The clinical outcomes of ST-segment elevation myocardial infarction (STEMI) due to the occlusion of left coronary artery are worse in patients with proximal occlusion than in those with non-proximal occlusion. However, there are few reports that focus on the comparison of clinical outcomes in patients with STEMI between proximal and non-proximal right coronary artery (RCA) occlusions.</p><p><strong>Methods: </strong>We included 356 patients with STEMI whose infarct-related artery is RCA and divided them into the proximal group (n = 129) and the non-proximal group (n = 227). We defined segment 1 of RCA as proximal, and segments 2, 3, and 4 as non-proximal according to the reporting system of the American Heart Association. The primary endpoint was major cardiovascular events (MACE), which was defined as the composite of all-cause death, non-fatal myocardial infarction, readmission for heart failure, and ischemia-driven target vessel revascularization.</p><p><strong>Results: </strong>Incidence of shock at admission, requirement for catecholamine during percutaneous coronary intervention (PCI), or mechanical support during PCI tended to be higher in the proximal group (42.6 %) than in the non-proximal group (33.5 %) (p = 0.088). Although the incidence of right ventricular infarction tended to be higher in the proximal group (17.8 %) than in the non-proximal group (10.6 %) without reaching statistical significance (p = 0.072), the incidence of in-hospital death was similar between the 2 groups (1.6 % versus 1.8 %, p = 1.000). The MACE-free survival curves were not different between the 2 groups (p = 0.400). Multivariate Cox hazard analysis revealed that proximal RCA occlusion was not associated with MACE (HR 1.095, 95%CI 0.691-1.737, p = 0.699).</p><p><strong>Conclusions: </strong>Although the acute phase conditions such as shock or right ventricular infarction tended to be more severe in patients with proximal occlusion, overall clinical outcomes including long-term outcomes were comparable between the proximal and distal RCA occlusions. Furthermore, multivariate analysis showed that the proximal RCA occlusion was not associated with MACE after hospital discharge.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889374","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}
引用次数: 0
Left atrium as key player and essential biomarker in heart failure. 左心房是心力衰竭的关键因素和重要生物标志物。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-07-29 DOI: 10.1016/j.jjcc.2024.07.006
Katsuji Inoue, Otto A Smiseth
{"title":"Left atrium as key player and essential biomarker in heart failure.","authors":"Katsuji Inoue, Otto A Smiseth","doi":"10.1016/j.jjcc.2024.07.006","DOIUrl":"10.1016/j.jjcc.2024.07.006","url":null,"abstract":"<p><p>This article reviews roles of the left atrium as regulator of left ventricular filling, as compensatory reserve in left ventricular dysfunction and as diagnostic marker in patients with cardiovascular disorders. Application of novel imaging tools to assess left atrial function and their integration with conventional clinical methods are discussed. This includes a review of clinical applications of left atrial strain as a method to quantify the reservoir and booster pump components of left atrial function. Emerging methods for assessing left atrial wall stiffness and active work by pressure-strain loop analysis are discussed. Recommendations for how to apply left atrial strain in clinical routine to diagnose elevated left ventricular filling pressure are provided. Furthermore, a role for left atrial strain in the diagnostic work-up in patients suspected of pre-capillary pulmonary hypertension is proposed. The article also reviews how to implement parameters of atrial structure and function in clinical routine as recommended by recent international guidelines for imaging of heart failure.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859863","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}
引用次数: 0
BP classification using the 2017 ACC/AHA BP guidelines with risk of cardiovascular events in older individuals. 使用 2017 ACC/AHA 指南进行血压分类与老年人心血管事件风险的关系。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-07-26 DOI: 10.1016/j.jjcc.2024.07.005
Yuta Suzuki, Hidehiro Kaneko, Akira Okada, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Yuichiro Yano, Akira Nishiyama, Koichi Node, Hideo Yasunaga, Issei Komuro
{"title":"BP classification using the 2017 ACC/AHA BP guidelines with risk of cardiovascular events in older individuals.","authors":"Yuta Suzuki, Hidehiro Kaneko, Akira Okada, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Yuichiro Yano, Akira Nishiyama, Koichi Node, Hideo Yasunaga, Issei Komuro","doi":"10.1016/j.jjcc.2024.07.005","DOIUrl":"10.1016/j.jjcc.2024.07.005","url":null,"abstract":"<p><strong>Background: </strong>The association between stage 1 hypertension and the risk of cardiovascular disease (CVD) has not been established in older adults. Furthermore, little is known about whether lowering blood pressure (BP) is beneficial in older adults with stage 1 hypertension.</p><p><strong>Methods: </strong>This cohort study analyzed nationwide data collected from the Japanese DeSC database, including 476,654 individuals aged ≥60 years. Individuals were categorized into four groups according to the 2017 ACC/AHA BP guidelines: normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension. The primary outcome was a composite CVD event, including myocardial infarction, angina pectoris, stroke, and heart failure.</p><p><strong>Results: </strong>During a mean follow-up of 3.1 years, 53,946 composite CVD events were recorded. Hazard ratios of stage 1 hypertension for composite CVD events, myocardial infarction, angina pectoris, stroke, and heart failure were 1.10 (95 % CI, 1.07-1.13), 1.16 (95 % CI, 1.03-1.31), 1.06 (95 % CI, 1.01-1.10), 1.13 (95 % CI, 1.08-1.18), and 1.13 (95 % CI, 1.09-1.16), respectively. Individuals with a ≥5 mmHg decrease in systolic BP over one year had a lower risk of stroke among individuals with stage 1 hypertension. The positive association between stage 1 hypertension and composite CVD events was attenuated in individuals aged ≥75 years.</p><p><strong>Conclusions: </strong>Stage 1 hypertension is associated with a higher risk of developing CVD events among older adults. The 2017 ACC/AHA BP guidelines could be applied to older populations; however, the applicability of these guidelines to older adults aged ≥75 years requires further investigations.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788157","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}
引用次数: 0
Long-term clinical outcomes following percutaneous coronary intervention in patients aged 90 years and older. 90 岁及以上患者经皮冠状动脉介入治疗后的长期临床疗效。
IF 2.5 3区 医学
Journal of cardiology Pub Date : 2024-07-20 DOI: 10.1016/j.jjcc.2024.07.004
Kotaro Tokuda, Akihito Tanaka, Yusuke Uemura, Naoki Shibata, Makoto Iwama, Teruhiro Sakaguchi, Ruka Yoshida, Yosuke Negishi, Hiroshi Tashiro, Miho Tanaka, Yosuke Tatami, Shogo Yamaguchi, Naoki Yoshioka, Norio Umemoto, Taiki Ohashi, Yasunobu Takada, Hiroshi Asano, Yukihiko Yoshida, Toshikazu Tanaka, Toshiyuki Noda, Itsuro Morishima, Hideki Ishii, Toyoaki Murohara
{"title":"Long-term clinical outcomes following percutaneous coronary intervention in patients aged 90 years and older.","authors":"Kotaro Tokuda, Akihito Tanaka, Yusuke Uemura, Naoki Shibata, Makoto Iwama, Teruhiro Sakaguchi, Ruka Yoshida, Yosuke Negishi, Hiroshi Tashiro, Miho Tanaka, Yosuke Tatami, Shogo Yamaguchi, Naoki Yoshioka, Norio Umemoto, Taiki Ohashi, Yasunobu Takada, Hiroshi Asano, Yukihiko Yoshida, Toshikazu Tanaka, Toshiyuki Noda, Itsuro Morishima, Hideki Ishii, Toyoaki Murohara","doi":"10.1016/j.jjcc.2024.07.004","DOIUrl":"10.1016/j.jjcc.2024.07.004","url":null,"abstract":"<p><strong>Background: </strong>In an aging society, percutaneous coronary intervention (PCI) for super-elderly patients is commonly performed in clinical practice. However, data are scarce regarding the clinical features and outcomes of this population.</p><p><strong>Methods: </strong>This multicenter observational study enrolled patients aged over 90 years who underwent PCI across 10 hospitals between 2011 and 2020. The study included patients presenting with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The occurrence of all-cause and cardiac deaths during hospitalization and after discharge was investigated.</p><p><strong>Results: </strong>In total, 402 patients (91.9 ± 2.0 years, 48.3 % male) participated in the study, of whom 77.9 % presented with ACS. The rate of in-hospital death was significantly higher in patients with ACS compared to patients with CCS (15.3 % vs. 2.2 %, p < 0.001). The estimated cumulative incidence rates of all-cause death were 24.3 %, 39.5 %, and 60.4 % at 1, 3, and 5 years, respectively. No significant difference was observed in the occurrence of all-cause death between patients with ACS and CCS. Regarding causes of death after discharge, non-cardiac deaths accounted for just over half of the cases.</p><p><strong>Conclusion: </strong>This study highlights the clinical features and long-term clinical course of patients aged over 90 years who underwent PCI in a real-world setting. Patients presenting with ACS exhibited a higher rate of in-hospital mortality compared to those with CCS. Following discharge, both ACS and CCS patients experienced comparable and substantial increases in the incidence rates of both cardiac and non-cardiac mortality over time, and a more holistic management approach is warranted.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734160","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}
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