Journal of cardiology最新文献

{"title":"The role of long-term fine particulate matter peaks in cardiovascular risk: an AIRCARD substudy.","authors":"Stephan Peronard Mayntz, Solveig Warncke, Lærke Groth Ladefoged, Roda Abdulkadir Mohamed, Anna Mejldal, Jes Sanddal Lindholt, Axel Cosmus Pyndt Diederichsen, Lise Marie Frohn, Jørgen Brandt, Matthias Ketzel, Jibran Khan, Jess Lambrechtsen","doi":"10.1016/j.jjcc.2025.04.012","DOIUrl":"10.1016/j.jjcc.2025.04.012","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease is a leading cause of mortality globally, with air pollution, particularly fine particulate matter (PM_2.5), recognized as a significant risk factor. While long-term accumulated exposure to PM_2.5 has been extensively studied, the impact of PM_2.5 peaks on cardiovascular events remains unexplored.</p><p><strong>Methods: </strong>This prospective cohort study analyzed data from 26,723 male participants aged 65 to 74 years from the Danish DANCAVAS and VIVA screening trials. We assessed the association between long-term cumulated repeated PM_2.5 peak exposure and major adverse cardiovascular events (MACE), including non-fatal acute myocardial infarction, non-fatal stroke, cardiovascular mortality, and revascularization procedures, using Cox proportional hazards models. PM_2.5 peak exposure was treated as a time-varying variable, and models were adjusted for potential confounders, including individual-level demographic, clinical, and socioeconomic factors. PM_2.5 peaks were defined as monthly average concentrations exceeding the long-term mean by more than two standard deviations.</p><p><strong>Results: </strong>The fully adjusted model showed no significant elevation in the risk of MACE associated with increased PM_2.5 peak exposure (HR = 0.9991, 95 % CI: 0.9974-1.0008). This lack of association was consistent across sensitivity analyses and different peak definitions, including shorter-term peaks in the five and one years preceding an event.</p><p><strong>Conclusions: </strong>Our findings suggest that PM_2.5 peak exposure does not significantly increase the risk of MACE in this Danish population. These results challenge the hypothesis that PM_2.5 peaks over a long period are a determinant of cardiovascular risk. Further research is warranted to explore these relationships in different populations and to investigate potential mechanisms underlying the effects of air pollution peaks on cardiovascular health.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001902","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":"Impact of malnutrition on in-hospital outcomes in patients with acute myocardial infarction and no standard modifiable cardiovascular risk factors.","authors":"Yuxiu Yang, Fei Gao, Tao Liu, Jianping Deng, Hong Qiu, Xiaoteng Ma, Lixia Yang, Zhijian Wang","doi":"10.1016/j.jjcc.2025.04.016","DOIUrl":"10.1016/j.jjcc.2025.04.016","url":null,"abstract":"<p><strong>Background: </strong>Individuals who present with acute myocardial infarction (AMI) in the absence of standard modifiable cardiovascular risk factors (i.e. SMuRF-less) seem to have a significantly increased risk of mortality; however, it remains unclear whether the 'SMuRF paradox' would be influenced by patients' baseline nutritional status.</p><p><strong>Methods: </strong>We consecutively included patients from a multi-center, prospective registry (NCT05337319) from January 2022 to October 2023. Malnutrition was defined via the Nutritional Risk Index. The primary outcome was in-hospital major adverse cardiovascular events (MACEs), which included mortality, cardiac shock, acute congestive heart failure, reinfarction, and stroke.</p><p><strong>Results: </strong>A total of 3753 patients with first-presentation AMI were included, of which 10 % were SMuRF-less and over 21 % were malnourished. SMuRF-less malnourished had the highest MACEs (16.1 %), followed by the SMuRF-less nourished (15.5 %), ≥1 SMuRFs malnourished (12.1 %), and ≥1 SMuRFs nourished (5.2 %, p < 0.001). With ≥1 SMuRFs nourished as the reference, SMuRF-less malnourished had the highest increase in MACEs [adjusted OR (95 % CI), 3.385 (2.163-5.298), p < 0.001], followed by SMuRF-less nourished group [adjusted OR (95 % CI), 2.460 (1.214-4.985), p = 0.012], but only a nonsignificant increase in MACEs was observed in the ≥1 SMuRFs malnourished [adjusted OR (95 % CI), 1.297 (0.880-1.911), p = 0.188]. SMuRF-less was not associated with MACEs in the subgroup of malnourished patients [adjusted OR (95 % CI), 1.931 (0.892-4.178), p = 0.095], with a nonsignificant result in interaction analysis (p for interaction = 0.148).</p><p><strong>Conclusion: </strong>Among patients with first-presentation AMI, malnutrition is prevalent, especially in those SMuRF-less. Compared with those with at least one SMuRF, SMuRF-less patients have a significantly higher risk of in-hospital MACEs irrespective of their nutritional status, while the outcome was the most favorable among ≥1 SMuRF and nourished patients.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968666","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":"Impact of sinus rhythm maintenance after repeat catheter ablation on clinical outcomes in heart failure with preserved ejection fraction.","authors":"Yasuyuki Egami, Noriyuki Kobayashi, Ayako Sugino, Masaru Abe, Mizuki Ohsuga, Hiroaki Nohara, Shodai Kawanami, Kohei Ukita, Akito Kawamura, Koji Yasumoto, Naotaka Okamoto, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino","doi":"10.1016/j.jjcc.2025.05.003","DOIUrl":"10.1016/j.jjcc.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) and heart failure (HF) with preserved ejection fraction (HFpEF) frequently coexist and significantly contribute to morbidity and mortality. Catheter ablation (CA) for AF in HFpEF patients can improve clinical outcomes compared to medical therapy. However, the impact of repeat (Re) CA for AF recurrence (AFR) in HFpEF patients on adverse events remains unclear. This study aimed to evaluate the impact of sinus rhythm maintenance (SRM) versus AFR after ReCA on clinical adverse outcomes and HFpEF improvement.</p><p><strong>Methods: </strong>This retrospective study included 79 patients with AFR and HFpEF who underwent ReCA. HFpEF was defined as an HFA-PEFF score of 5-6 and left ventricular ejection fraction ≥50 %. HFpEF improvement was defined as a reduction in the 12-month HFA-PEFF score to 0-4. Patients were divided into two groups based on rhythm status after ReCA: SRM (post-ReCA SRM, n = 54) and AFR (post-ReCA AFR, n = 25). The primary endpoint was a composite of all-cause mortality, HF hospitalizations, or stroke during a 3-year follow-up. Secondary endpoints included 12-month HFA-PEFF scores and the proportion of patients with HFpEF improvement (HFA-PEFF score 0-4).</p><p><strong>Results: </strong>The post-ReCA SRM group had a significantly lower incidence of the primary endpoint (7.4 % vs. 36 %, p = 0.002) and higher event-free survival (hazard ratio: 0.19, 95 % CI: 0.06-0.63, p = 0.006). The post-ReCA SRM group also showed lower 12-month HFA-PEFF scores [4 (3, 5) vs. 5 (4, 6), p = 0.045] and greater HFpEF improvement (48 % vs. 11 %, p = 0.005).</p><p><strong>Conclusions: </strong>In HFpEF patients with AFR after initial CA, SRM after ReCA is significantly associated with fewer adverse events, including all-cause mortality, hospitalizations for worsening HF, and strokes, during a 3-year follow-up period, and improved HFpEF status during a 3-year follow-up.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127388","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":"Prevalence and clinical outcomes of permanent conduction disturbances after transcatheter aortic valve replacement.","authors":"Takahiko Kai, Masaki Izumo, Masahiro Sekiguchi, Tetsu Tanaka, Taishi Okuno, Yukio Sato, Shingo Kuwata, Masashi Koga, Ikutaro Nakajima, Kenichi Sasaki, Yasuhiro Tanabe, Tomoo Harada, Yoshihiro J Akashi","doi":"10.1016/j.jjcc.2025.04.013","DOIUrl":"10.1016/j.jjcc.2025.04.013","url":null,"abstract":"<p><strong>Background: </strong>A new-onset conduction disturbance is a major concern in patients undergoing transcatheter aortic valve replacement (TAVR) but can resolve over time. This study aimed to evaluate the recovery in conduction disturbances post-TAVR and its association with clinical outcomes.</p><p><strong>Methods: </strong>This retrospective study included 780 TAVR patients at St. Marianna University between January 2016 and March 2023. Patients were stratified into four groups based on conduction status at six months post-TAVR: no conduction disturbance, recovered conduction disturbance [defined as a post-procedural pacemaker implantation with cumulative right ventricular pacing <40 % or complete left bundle branch block (CLBBB) at discharge but not at six months], permanent conduction disturbance (defined as pacemaker implantation with cumulative right ventricular pacing ≥40 % or CLBBB at both discharge and six months), and preprocedural conduction disturbance. The primary outcomes were all-cause mortality and heart failure hospitalization. The secondary outcome was the change in cardiac damage from pre-procedure to one-year post-TAVR.</p><p><strong>Results: </strong>Of 780 patients, 220 (28 %) had new-onset CLBBB or required a pacemaker implantation at discharge. Among these, 99 (45 %) had permanent conduction disturbances at six months. Over a median follow-up of 788 days, both permanent and preprocedural conduction disturbances were significantly associated with a higher incidence of heart failure hospitalization [hazard ratio (HR) 3.63; 95 % confidence interval (CI): 2.04-6.47, p < 0.01 and HR 2.50; 95 % CI: 1.27-4.90, p < 0.01), although no difference in all-cause mortality was observed. In contrast, the prognosis of patients with recovered conduction disturbance was comparable with those with no conduction disturbance. Patients with permanent and preprocedural conduction disturbances showed significant worsening cardiac damage.</p><p><strong>Conclusion: </strong>Permanent and preprocedural conduction disturbances after TAVR were associated with increased heart failure hospitalizations, while the prognostic impact of recovered conduction disturbance may be limited.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986274","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":"Helicobacter pylori Infection and Thoracic Aortic Aneurysm: Insights from Mendelian randomization.","authors":"Cheng-Zhi Zhang, Can-Ran Lv, Zhuo-Hang Cui, Jiao-Jiao Wang, Jing Zhang, Jian Yang","doi":"10.1016/j.jjcc.2025.05.001","DOIUrl":"10.1016/j.jjcc.2025.05.001","url":null,"abstract":"<p><p>The association between Helicobacter pylori (H. pylori) infection and the development of thoracic aortic aneurysm (TAA) remains inconclusive. Globally, approximately 58% of the population is infected with Helicobacter pylori. It is typically associated with chronic gastritis, peptic ulcers, and gastric cancer1. Mendall et al. were the first to report a serological correlation between H. pylori seropositivity and coronary heart disease2, a finding that has gradually spurred interest in the potential role of the bacterium in the pathogenesis of cardiovascular diseases. Previous studies have demonstrated an association between H. pylori-specific serotypes and acute ascending aortic dissection, particularly highlighting the chronic infection with the CagA-VacA s1m1 subtype, which is closely linked to an increased risk of aortic rupture3. Recent studies have suggested that the eradication of H. pylori is associated with a reduced incidence of abdominal aortic aneurysm in patients with peptic ulcer disease4. However, the causal relationship between H. pylori seropositivity and TAA remains unclear. In this study, we employed Mendelian randomization (MR) analysis to explore the potential causal link between H. pylori infection and TAA with the aim of providing further evidence supporting their association.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093746","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":"Causal relationship between circulating inflammatory proteins and atherosclerosis: a bidirectional Mendelian randomization study and meta-analysis.","authors":"Bin Xu, Qiyang Xu, Yi Wang, Dehai Lang, Zuodong Lin","doi":"10.1016/j.jjcc.2025.04.015","DOIUrl":"10.1016/j.jjcc.2025.04.015","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis (AS) is a chronic inflammatory disease that significantly contributes to cardiovascular morbidity and mortality. Despite extensive research efforts, the connections between circulating inflammatory proteins (CIPs) and different subtypes of AS remain poorly understood. This study aims to clarify these relationships through Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>We utilized summary statistics from genome-wide association studies (GWAS) that included 14,824 European participants to analyze inflammatory protein levels, alongside data from the IEU GWAS database for AS phenotypes. Our primary approach for MR analysis was the inverse variance weighted method. To ensure the validity and robustness of the causal relationships, we conducted tests for pleiotropy and heterogeneity, as well as reverse MR analysis to assess the possibility of reverse causality. Finally, we performed a meta-analysis to consolidate and interpret our findings comprehensively.</p><p><strong>Results: </strong>Our MR analysis identified several significant associations: elevated artemin [odds ratio (OR) = 1.195], glial cell line-derived neurotrophic factor (hGDNF) (OR = 1.173), and tumor necrosis factor (TNF) (OR = 1.179) levels increased peripheral atherosclerosis (PA) risk; higher CUB domain-containing protein 1 (OR = 0.534), interleukin (IL)-8 (OR = 0.274), monocyte chemoattractant protein-3 (OR = 0.373), transforming growth factor-alpha (OR = 0.306), and tumor necrosis factor receptor superfamily member 9 (OR = 0.423) levels decreased cerebral artery atherosclerosis risk; fibroblast growth factor 21 (FGF-21) (OR = 1.122), hGDNF (OR = 1.108), and IL-22 receptor subunit alpha-1 (IL-22RA1) (OR = 1.235) levels were positively associated with coronary artery atherosclerosis (COA) risk; while IL-13 (OR = 0.909) and TNF-beta levels (OR = 0.954) were negatively associated with COA risk. C-X-C motif chemokine 6 levels (CXCL6) (OR = 1.353) and hGDNF (OR = 1.161) were identified as risk factors for atherosclerosis, excluding cerebral, coronary, and peripheral arterial disease (AECCP). In contrast, IL-2 receptor subunit beta levels (OR = 0.801) and IL-6 levels (OR = 0.788) were found to be protective factors for AECCP. Additionally, CXCL6 (OR = 1.261), FGF-21 (OR = 1.090), IL-22RA1 (OR = 1.127), and hGDNF (OR = 1.134) exhibited a risk effect against overall AS risk, while IL-6 (OR = 0.834) exhibited a protective effect against overall AS risk.</p><p><strong>Conclusions: </strong>This study identifies specific CIPs that have significant causal effects on various forms of AS through MR analysis. The findings suggest potential biomarkers and treatment targets for preventing and managing different manifestations of AS in clinical practice.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009101","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":"Underweight increases the incidence of infective endocarditis in the Korean population: A nation-wide cohort study.","authors":"Koh Eun Shin, Gyu Bae Lee, Kyungdo Han, Ho-Sung Son, Jae-Seung Jung, Byoung Duck Han, Yang-Hyun Kim, Hee Jung Kim","doi":"10.1016/j.jjcc.2025.04.014","DOIUrl":"10.1016/j.jjcc.2025.04.014","url":null,"abstract":"<p><strong>Background: </strong>In general, obesity is associated with infectious diseases, however, the relationship between underweight and infectious disease is controversial. Moreover, the association between body mass index (BMI) and the incidence of infective endocarditis (IE) has not been studied to date. Therefore, we investigated the relationship between BMI and incidence of IE in the Korean population.</p><p><strong>Methods: </strong>We analyzed 4,080,331 participants (mean age 47.12 ± 14.13 years) from the National Health Insurance health checkup database. Hazard ratios (HRs) and 95 % confidence intervals (CIs) for IE incidence according to five BMI levels were calculated using multivariable Cox proportional hazards models with or without IE risk.</p><p><strong>Results: </strong>During the 9-year follow-up, the incidence rate of IE was 3.244 persons per 100,000 person-years in the underweight group, 2.023 in normal weight, 2.105 in overweight, 2.133 in obesity stage I, and 3.294 in obesity stage II. After adjusting for all covariates, overall HR for the incidence of IE increased among participants with IE risk in all BMI levels compared to subjects without IE risk when the normal weight group without IE risk was designated as the reference group. An increase in the HR for the incidence of IE was observed only in underweight subjects in both the total and no IE risk groups [HR: 2.01 (95 % CI, 1.46-2.77); HR: 2.01 (95 % CI, 1.45-2.78)].</p><p><strong>Conclusion: </strong>Underweight is associated with increased risk of developing IE, especially in subjects without IE risk. Considering increasing incidence of IE, clinicians should pay more attention to underweight patients with no IE risks.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020166","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":"Impact of diabetes mellitus on post-CABG outcomes in veterans: Insights from the REGROUP trial","authors":"Thais Faggion Vinholo MD, MSc ,&nbsp;Eileen Stock PhD ,&nbsp;Jordan Bloom MD, MPH ,&nbsp;Sameer Hirji MD, MPH ,&nbsp;Ellen DeMatt MA ,&nbsp;Kousick Biswas PhD ,&nbsp;Jacquelyn A. Quin MD, MPH ,&nbsp;Miguel Haime MD ,&nbsp;Marco A. Zenati MD","doi":"10.1016/j.jjcc.2024.09.007","DOIUrl":"10.1016/j.jjcc.2024.09.007","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 5","pages":"Pages 418-420"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307848","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":"Age-specific differences of Impella support in Japanese patients: The Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events","authors":"Akihiro Shirakabe MD, PhD ,&nbsp;Masato Matsushita MD, PhD ,&nbsp;Shota Shigihara MD ,&nbsp;Suguru Nishigoori MD ,&nbsp;Tomofumi Sawatani MD ,&nbsp;Kenichi Tani MD ,&nbsp;Masaki Morooka MD ,&nbsp;Kuniya Asai MD, PhD ,&nbsp;J-PVAD Investigators","doi":"10.1016/j.jjcc.2024.11.007","DOIUrl":"10.1016/j.jjcc.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>The association between the clinical significance and prognostic impact of catheter-based micro-axial ventricular assist device Impella (Abiomed, Danvers, MA, USA) support and age has not been sufficiently investigated.</div></div><div><h3>Methods and results</h3><div>A total of 5282 patients treated with Impella were analyzed from the Japanese registry for Percutaneous Ventricular Assist Device (J-PVAD). Patients were categorized into four age groups: &lt;50 years old (Group A, <em>n</em> = 670), 50–69 years old (Group B, <em>n</em> = 2009), 70–79 years old (Group C, <em>n</em> = 1716), and ≥80 years old (Group D, <em>n</em> = 887). Kaplan–Meier curve analysis demonstrated that the prognosis, including 30-day all-cause mortality, was significantly poorer in Group D compared to the other groups. A multivariate Cox regression model identified Group D as an independent predictor of 30-day all-cause death (HR: 2.173, 95 % CI: 1.699–2.779) relative to Group A. The multivariate logistic regression analysis indicated that estimated glomerular filtration rate, lactate levels, and systolic blood pressure were independently associated with 30-day mortality across all age categories. The presence of more than two major adverse events was independently associated with 30-day mortality specifically in the cohort aged ≥80 years (OR: 1.492, 95 % CI: 1.037–2.148, <em>p</em> = 0.031).</div></div><div><h3>Conclusion</h3><div>Increasing age was identified as a significant factor associated with higher 30-day mortality rates in J-PVAD. While the incidence of major adverse events did not differ significantly across age categories, the occurrence of two or more additional adverse events was linked to increased 30-day mortality among older individuals. Therefore, an appropriate mechanical support strategy may be necessary for elderly Japanese patients based on their age.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 5","pages":"Pages 343-351"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769313","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":"Impact of ECPELLA support on 1-year outcomes and myocardial damage in patients with acute myocardial infarction and refractory cardiogenic shock: A single-center retrospective observational study","authors":"Takashi Unoki MD ,&nbsp;Tomoko Nakayama MD ,&nbsp;Keita Saku MD, PhD ,&nbsp;Hiroki Matsushita MD ,&nbsp;Taiji Inamori MD ,&nbsp;Junya Matsuura MD ,&nbsp;Takaaki Toyofuku MD ,&nbsp;Tomohide Sato MD ,&nbsp;Yutaka Konami MD ,&nbsp;Hiroto Suzuyama MD ,&nbsp;Masayuki Inoue MD ,&nbsp;Eiji Horio MD, PhD ,&nbsp;Kazuhisa Kodama MD, PhD ,&nbsp;Eiji Taguchi MD ,&nbsp;Takuya Nishikawa MD, PhD ,&nbsp;Tadashi Sawamura MD ,&nbsp;Koichi Nakao MD, PhD, FJCC ,&nbsp;Tomohiro Sakamoto MD, PhD, FJCC ,&nbsp;Ken Okumura MD, PhD ,&nbsp;Junjiro Koyama MD, PhD","doi":"10.1016/j.jjcc.2024.12.003","DOIUrl":"10.1016/j.jjcc.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Venoarterial-extracorporeal membrane oxygenation (VA-ECMO) is a vital mechanical circulatory support for treating patients with refractory cardiogenic shock (CS). VA-ECMO can improve end-organ perfusion; however, it increases left ventricular (LV) afterload, resulting in further myocardial damage. ECPELLA, a combination of VA-ECMO and Impella (Abiomed Inc., Danvers, MA, USA) treatments, is an emerging modality to optimize end-organ perfusion and LV unloading. The impact of ECPELLA in refractory CS has not been established. We aimed to investigate the effects of ECPELLA on acute-phase LV damage and outcomes in patients with acute myocardial infarction (AMI) and refractory CS and compare them with those of VA-ECMO with an intra-aortic balloon pump (IABP).</div></div><div><h3>Methods</h3><div>This single-center retrospective observational study included 90 consecutive patients with AMI and refractory CS who received VA-ECMO between January 2012 and December 2022. Of these, 44 and 46 received ECPELLA and VA-ECMO with IABP, respectively. We assessed the serum creatine kinase myocardial band (CK-MB) levels and 1-year mortality.</div></div><div><h3>Results</h3><div>No significant differences were observed in the baseline characteristics and time from onset to reperfusion between the two groups. Compared with VA-ECMO with IABP, ECPELLA produced lower peak CK-MB levels (265 IU/L vs. 500 IU/L, <em>p</em> = 0.016) and a smaller area under the curve of CK-MB during the first 3 days (274 IU/L × d vs. 534 IU/L × d, <em>p</em> = 0.025). ECPELLA was associated with significantly lower 1-year mortality (64% vs 91%; <em>p</em> = 0.001). Cox proportional hazards analysis revealed that ECPELLA was inversely and independently associated with 1-year mortality (hazard ratio: 0.38, 95% confidence interval: 0.23–0.64; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that ECPELLA may offer myocardial protection and be associated with improved 1-year mortality in patients with AMI and refractory CS. Further prospective studies are needed to confirm these observations and better understand the potential benefits of ECPELLA in this population.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 5","pages":"Pages 352-359"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846679","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}