Journal of Cardiovascular Medicine最新文献

{"title":"Proprotein convertase subtilisin/kexin type 9 inhibitors: are we ready to replace injectable with oral drugs?","authors":"Giuseppe Patti, Leonardo Grisafi","doi":"10.2459/JCM.0000000000001932","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001932","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"702-705"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011994","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":"Dose-stratified lipid-lowering efficacy and safety of oral PCSK9 inhibitors: a systematic review and meta-analysis.","authors":"Marcello Marchetta, Lucio Giuseppe Granata, Mila Kovacevic, Simona Giubilato, Giuseppe Andò, Giuseppe Massimo Sangiorgi","doi":"10.2459/JCM.0000000000001931","DOIUrl":"10.2459/JCM.0000000000001931","url":null,"abstract":"<p><strong>Background: </strong>Oral PCSK9 inhibitors are investigational agents that may broaden therapeutic choice beyond injectable PCSK9-targeting therapies, but their efficacy and short-term safety across evaluated dose strata remain incompletely characterized.</p><p><strong>Objectives: </strong>To assess lipid-lowering efficacy and short-term safety across the lowest and highest evaluated dose strata in randomized trials.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and CENTRAL from inception to November 2025 and included randomized, placebo-controlled trials of oral PCSK9 inhibitors reporting lipid or safety outcomes. Primary efficacy analyses evaluated percentage change in LDL-C separately for the lowest and highest evaluated dose strata. Secondary outcomes included ApoB, non-HDL-C, and Lp(a). Safety outcomes included any adverse event, serious adverse events (SAEs), and selected individual adverse events. Random-effects pairwise meta-analyses were performed separately for the two prespecified dose strata, with exploratory tests for subgroup differences. Sensitivity analyses excluded the HeFH trial. Certainty of evidence was graded using GRADE.</p><p><strong>Results: </strong>Four trials (949 participants) met inclusion criteria. Both dose strata significantly reduced LDL-C, ApoB, non-HDL-C, and Lp(a), with larger pooled reductions generally observed in the highest evaluated stratum. Available short-term safety analyses did not detect statistically significant increases in overall, serious, or selected individual adverse events in either stratum. Sensitivity analyses yielded consistent estimates. Certainty of evidence for all primary efficacy outcomes was moderate.</p><p><strong>Conclusion: </strong>Oral PCSK9 inhibitors substantially reduced atherogenic lipoproteins across the evaluated dose strata. These findings demonstrate pharmacodynamic lipid-lowering efficacy but do not establish a class-wide dose-response relationship, cardiovascular outcome benefit, or clinical equivalence to outcome-proven PCSK9 monoclonal antibodies. Longer-term safety and dedicated cardiovascular outcome trials are required.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"688-701"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012541","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":"What does 48-h estimated glomerular filtration rate really capture in cardiogenic shock?","authors":"Mauro Riccardi, Matteo Pagnesi","doi":"10.2459/JCM.0000000000001938","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001938","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"736-737"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012022","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":"Multimodality imaging characterization of an infarct-like cardiomyopathy.","authors":"Stefano Frittella, Rocco Mollace, Matteo Brusamolino, Giorgio Agati, Erika Bertella","doi":"10.2459/JCM.0000000000001935","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001935","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"738-739"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012458","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":"Minimalist LAAO in contemporary practice: is conscious sedation ready for prime time?","authors":"Antonio Rapacciuolo, Lucio Addeo, Carlo Di Nardo","doi":"10.2459/JCM.0000000000001933","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001933","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"685-687"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012490","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":"Interpreting the prognostic significance of 48-h estimated glomerular filtration rate in cardiogenic shock.","authors":"Salih Topal, Burak Sezenöz","doi":"10.2459/JCM.0000000000001937","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001937","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"735-736"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012479","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":"Cangrelor in elderly patients undergoing percutaneous coronary intervention: findings from the ICARUS Registry.","authors":"Stefano Benenati, Felice Gragnano, Sebastiano Stratoti, Riccardo Scalamera, Vincenzo De Sio, Antonio Capolongo, Arturo Cesaro, Gianmarco Annibali, Salvatore Campagnuolo, Angelo Silverio, Michele Bellino, Matteo Schettino, Edoardo Bertero, Letizia Carelli, Giorgio Caretta, Marco Rezzaghi, Francesco Veneziano, Gennaro De Rosa, Mario Centore, Davide De Nardo, Rocco Vergallo, Leonardo De Luca, Gennaro Galasso, Alberto Menozzi, Giuseppe Musumeci, Plinio Cirillo, Paolo Calabrò, Italo Porto","doi":"10.2459/JCM.0000000000001939","DOIUrl":"10.2459/JCM.0000000000001939","url":null,"abstract":"<p><strong>Background/objectives: </strong>We aimed to assess the clinical characteristics and in-hospital outcomes of elderly vs. nonelderly patients treated with cangrelor during percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>Patients undergoing PCI with cangrelor between January 2019 and May 2023 in seven Italian institutions were retrospectively enrolled. Patients aged ≥75 years at the time of PCI were classified as elderly. The primary endpoint was net adverse clinical events (NACE), a composite of cardiovascular death, myocardial infarction, stroke, definite or probable stent thrombosis, and Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding, evaluated at 48 h post-PCI. The impact of advanced age (≥75 years) on clinical outcomes was assessed using multivariable logistic regression (LR), inverse probability of treatment weighting (IPTW), and doubly robust (DR) models.</p><p><strong>Results: </strong>A total of 1071 patients were included, of whom 340 (32%) were elderly. At 48 h, elderly patients had higher odds of NACE [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.12-3.97, P = 0.021 by multivariable LR; OR 1.98, 95% CI 1.45-2.27, P < 0.001 with IPTW; and OR 2.09, 95% CI 1.51-2.93, P < 0.001 by DR estimation]. These results were driven by an increased risk of both ischemic and bleeding events, the latter including access-site and nonaccess-site hemorrhages of both minor and major severity.</p><p><strong>Conclusions: </strong>In this real-world study of patients undergoing PCI with cangrelor, elderly individuals accounted for one-third of the population. Elderly patients were at higher risk of NACE, driven by both ischemic and bleeding events.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"726-734"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012353","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":"Conscious sedation versus general anesthesia for transesophageal echocardiography guidance of percutaneous left atrial appendage occlusion.","authors":"Giulia Laterra, Giorgio Sacchetta, Giampiero Vizzari, Giombatista Barrano, Paolo Mazzone, Giovanni Ruscica, Silvia Motta, Maria Sanfilippo, Carmelo Grasso, Salvatore Geraci, Gerlando Pilato, Marco Barbanti, Marco Contarini","doi":"10.2459/JCM.0000000000001898","DOIUrl":"10.2459/JCM.0000000000001898","url":null,"abstract":"<p><strong>Objectives: </strong>This study sought to compare the transesophageal echocardiography (TEE)-guided left atrial appendage occlusion (LAAO) procedures under general anesthesia with conscious sedation.</p><p><strong>Background: </strong>In the expanding field of LAAO procedures, developing minimalistic approaches that eliminate the need for general anesthesia is crucial. Conscious sedation is spreading as an alternative for performing TEE-monitored LAAO procedures.</p><p><strong>Methods: </strong>For this study, patients enrolled in the registry who underwent LAAO under conscious sedation were compared with those who received general anesthesia. One-to-one propensity score matching was used to balance baseline characteristics between groups. Outcomes assessed included technical success, procedural success, and clinical follow-up.</p><p><strong>Results: </strong>A total of 231 patients were included. After adjustment, 99 patched pairs treated with LAAO using general anesthesia and conscious sedation were compared. The technical success did not differ between general anesthesia and conscious sedation patients [98 versus 99%; P  = 0.612; hazard ratio 1.68; 95% confidence interval (CI): 0.22-18.64]. The procedural success, defined as technical success in the absence of in-hospital device or procedure-related clinical events, was comparable between the two groups (95 versus 97%; P  = 0721; hazard ratio 1.70; 95% CI: 0.32-11.24). No statistically significant differences were found for all procedural complications assessed, including death, neurological events, pericardial effusion, device embolization, systemic arteria embolization, and major bleeding. Also, clinical adverse events during follow-up were comparable between general anesthesia and conscious sedation procedures.</p><p><strong>Conclusion: </strong>This study shows that LAAO can be performed with equivalent outcomes under either general anesthesia or conscious sedation.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"678-684"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329730","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":"Newer-generation balloon-expandable vs. self-expanding transcatheter aortic valves: a propensity score matched analysis.","authors":"Massimo Baudo, Serge Sicouri, Dimitrios E Magouliotis, Fadi Hage, Rahi Wissam, Scott M Goldman, Eric M Gnall, William A Gray, Sandro Gelsomino, Basel Ramlawi","doi":"10.2459/JCM.0000000000001934","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001934","url":null,"abstract":"<p><strong>Aims: </strong>Balloon-expandable valve (BEV) and self-expanding valve (SEV) platforms have undergone significant technological advancements. This study aimed to compare postoperative outcomes in patients with severe aortic stenosis (AS) treated with transcatheter aortic valve implantation (TAVI) using newer-generation BEV and SEV devices.</p><p><strong>Methods: </strong>We retrospectively analyzed all patients who underwent TAVI for severe native AS at a single center between January 2018 and December 2023. Exclusion criteria included emergency procedures, active endocarditis, prior aortic valve interventions, bicuspid valves, primary aortic regurgitation, non-transfemoral access, concomitant coronary procedures, and use of retracted valves. Bioprosthetic valve dysfunction (BVD) was assessed according to modified Valve Academic Research Consortium 3 (VARC-3) definitions.</p><p><strong>Results: </strong>Propensity score matching was used to create 354 well balanced pairs. Periprocedural outcomes, including mortality, were comparable between the matched BEV and SEV groups. However, echocardiographic evaluation at discharge revealed significantly higher mean transvalvular gradients (P < 0.001) and peak velocities (P < 0.001) in the BEV group. During follow-up, the SEV group showed a significantly lower incidence of BVD [hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.45-0.91; P = 0.013], particularly regarding higher rates of severe prosthesis-patient mismatch (P = 0.001) and at least moderate structural valve deterioration (P = 0.006). No significant differences were observed in all-cause (HR: 1.18, 95% CI: 0.90-1.56, P = 0.235), or cardiac-related mortality (HR: 1.29, 95% CI: 0.91-1.83, P = 0.157).</p><p><strong>Conclusion: </strong>Among patients treated with newer-generation transcatheter valves, SEV demonstrated more favorable hemodynamic performance compared with BEV. However, short- and mid-term mortality rates remained similar between the two groups. Longer-term follow-up of randomized trials is needed to confirm these findings.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"706-715"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012507","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":"Highlights from the issue.","authors":"Ciro Indolfi","doi":"10.2459/JCM.0000000000001940","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001940","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 9","pages":"675-677"},"PeriodicalIF":2.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012497","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}