Journal of Cardiovascular Medicine最新文献

{"title":"Multidisciplinary approach and combination pharmacotherapy for the management of cardiometabolic patients.","authors":"Giuseppe M C Rosano, Cristiana Vitale, Ilaria Spoletini, Kamlesh Khunti, Kostantinos Tsioufis, Sarah Onida, Marisa Papaluca, Alberto Zambon","doi":"10.2459/JCM.0000000000001734","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001734","url":null,"abstract":"<p><p>Cardiometabolic disorders such as hypertension, coronary artery disease, dyslipidaemia, heart failure, and diabetes often cluster together, resulting in patients affected by multiple, related disorders. Therefore, there is a clear need for a multidisciplinary approach when managing these complex patients. Also, therapeutic measures targeting cardiometabolic disorders are expected to influence their common pathogenic mechanisms, such as inflammation and oxidative stress. These were key highlights from a recent forum on cardiometabolic health including various experts across cardiology, endocrinology, and primary care. This consensus document highlights the importance of a combined treatment approach rather than siloed specialties.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 6","pages":"297-302"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234264","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":"Predictive value of scores for all-cause mortality in patients with cardiogenic shock.","authors":"Domenico Simone Castiello, Alberto Polimeni, Antonio Curcio","doi":"10.2459/JCM.0000000000001728","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001728","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 6","pages":"280-283"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234268","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":"Single vs. dual antithrombotic therapy in patients with oral anticoagulation and stabilized coronary artery disease: a systematic review and meta-analysis of randomized-controlled trials.","authors":"Giuseppe Gargiulo, Raffaele Piccolo, Duk-Woo Park, Gi-Byoung Nam, Yasuo Okumura, Giovanni Esposito, Marco Valgimigli","doi":"10.2459/JCM.0000000000001723","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001723","url":null,"abstract":"<p><strong>Aims: </strong>Despite consistent recommendations from clinical guidelines, data from randomized trials on a long-term antithrombotic treatment strategy for patients with oral anticoagulation (OAC) and stabilized coronary artery disease (CAD) are still limited and underpowered for ischaemic events. Therefore, we investigated the safety and efficacy of single vs. dual antithrombotic therapy (SAT vs. DAT) in patients with OAC and stabilized CAD.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was performed using PubMed to search for randomized clinical trials comparing SAT vs. DAT in patients with OAC and stabilized CAD.</p><p><strong>Results: </strong>Five trials encompassing 5758 patients (SAT = 2897 vs. DAT = 2861) were included. The predominant indication of OAC was atrial fibrillation (n = 5495, 95.4%). Most of the patients had prior percutaneous coronary intervention (PCI) (81.1%). The primary safety outcome (trial-defined major bleeding) was lower with SAT compared with DAT [hazard ratio 0.58, 95% confidence interval (95% CI) 0.40-0.83; P < 0.001; I2 = 65.9%] as was the composite of major bleeding or clinically relevant nonmajor (CRNM) bleeding (hazard ratio 0.62, 95% CI 0.400.96; P = 0.03; I2 = 54.6%). There were no differences between the groups in terms of all-cause death, myocardial infarction, stroke, and the trial-defined composite of major adverse cardiovascular events. These findings were consistent among sensitivity analyses.</p><p><strong>Conclusion: </strong>In OAC patients with stabilized CAD, largely due to atrial fibrillation and prior (6-12 months) PCI, SAT is associated with lower major bleeding without increased risk of ischaemic complications compared with DAT.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 6","pages":"258-265"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234269","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":"Oral anticoagulation alone in atrial fibrillation and stable coronary artery disease: evidence silences doubt.","authors":"Felice Gragnano, Vincenzo De Sio, Dominick J Angiolillo, Paolo Calabrò","doi":"10.2459/JCM.0000000000001732","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001732","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 6","pages":"266-268"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234266","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":"Bridging antiplatelet therapies in patients undergoing surgery: a meta-analysis.","authors":"Riccardo Scalamera, Stefano Benenati, Rocco Vergallo, Italo Porto","doi":"10.2459/JCM.0000000000001739","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001739","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325885","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":"Dual antiplatelet therapy de-escalation by discontinuation in patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis.","authors":"Marco Spagnolo, Claudio Laudani, Antonino Imbesi, Giacinto Di Leo, Nicola Ammirabile, Simone Finocchiaro, Maria Sara Mauro, Placido Maria Mazzone, Antonio Greco, Daniele Giacoppo, Davide Capodanno","doi":"10.2459/JCM.0000000000001737","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001737","url":null,"abstract":"<p><strong>Background: </strong>De-escalation of dual antiplatelet therapy (DAPT) by early discontinuation of one antiplatelet agent has been proposed as an alternative to 12-month DAPT to balance ischemic and bleeding risks in patients with acute coronary syndrome (ACS). However, the efficacy and safety of abbreviated DAPT regimens in ST-elevation myocardial infarction (STEMI) - a subset of ACS with distinct clinical and risk profiles - remain uncertain.</p><p><strong>Methods: </strong>Randomized trials and sub-analyses of randomized trials comparing DAPT de-escalation by early discontinuation versus 12-month DAPT in patients with STEMI treated with primary angioplasty were included. Co-primary endpoints were major bleeding and major adverse cardiovascular events (MACE). Secondary endpoints included net adverse clinical events (NACE), individual ischemic outcomes, and clinically relevant bleeding. Trial sequential analysis (TSA) and sensitivity analyses were prespecified (CRD42024608709).</p><p><strong>Results: </strong>Eight randomized trials encompassing 10,216 patients were included. Short DAPT regimens significantly reduced major bleeding [hazard ratio, 0.50; 95% confidence interval (CI), 0.30-0.85; P = 0.011] compared with standard DAPT. No significant differences were observed in MACE (hazard ratio, 1.21; 95% CI, 0.91-1.64; P = 0.193) or NACE (hazard ratio, 0.94; 95% CI, 0.80-1.10; P = 0.427). The results of TSA reinforced these findings. Other secondary outcomes showed no significant differences, but interpretation was limited by the small number of studies reporting these events.</p><p><strong>Conclusion: </strong>Abbreviated DAPT significantly reduces major bleeding risk in patients with STEMI compared with standard 12-month DAPT, without apparently compromising ischemic protection. However, further research is needed to clarify net clinical outcomes in this high-risk ACS subset.</p><p><strong>Protocol registration identifier: </strong>CRD42024608709.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325887","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 the Killip class of heart failure on treatment times and intrahospital mortality among STEMI patients.","authors":"Konstantinos Avranas, Marcus Mittag, Kerstin Schadow, Kerstin Eck, Ralf Lehmann","doi":"10.2459/JCM.0000000000001719","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001719","url":null,"abstract":"<p><strong>Aims: </strong>While timely reperfusion is known to reduce mortality, the extent to which the severity of heart failure, as classified by the Killip system, influences treatment delays remains unclear. Our study aims to address the existing gap in evidence regarding the relationship between Killip classification at presentation and treatment times in ST-elevation myocardial infarction (STEMI) patients.</p><p><strong>Methods: </strong>We conducted a correlative analysis using data from patients treated in our hospital and enrolled in the FITT-STEMI Register from 2009 to 2022. We focused on the relation of treatment times allocating patients into the four Killip classes and used an ANOVA test (significance level: P  < 0.05). Killip class and intrahospital mortality were studied via binary logistic regression.</p><p><strong>Results: </strong>In total, 1264 patients were identified. Door-to-balloon time among Killip I patients was 54 (±35) min (mean ± SD) and 53 (±26) min among Killip II and prolonged up to 77.5 (±46) min for class III and 79.7 (±45) min for class IV (overall P -value < 0.001). This remained statistically significant even after the exclusion of patients with out-of-hospital cardiac arrest (OHCA) (overall P -value: <0.001).Post hoc analysis showed a significant difference between Killip II and III classes for both all-comers ( P  = 0.014) as well as after the exclusion of OHCA patients ( P  = 0.012).Intrahospital mortality increased from <5% for classes I and II up to 10.3% for class III and 35.4% for class IV.</p><p><strong>Conclusion: </strong>The severity of heart failure among STEMI patients significantly affects the duration of treatment times. Patients presenting with Killip class III and IV demonstrate high intrahospital mortality rates.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 5","pages":"240-247"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020567","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":"Use of vericiguat in a heart transplant recipient with biventricular dysfunction.","authors":"Daniele Masarone, Luigi Falco, Dario Catapano, Cristiano Amarelli, Claudio Marra, Emilio di Lorenzo","doi":"10.2459/JCM.0000000000001722","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001722","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 5","pages":"253-254"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016588","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":"Diagnostic accuracy of ECG and N-terminal pro B-type natriuretic peptide for cardiac dysfunction among asymptomatic long-term breast cancer survivors.","authors":"Rachel Knol, Laurine T van der Wal, Jozine M Ter Maaten, Geertruida H de Bock, Saskia W M C Maass, Daan Brandenbarg","doi":"10.2459/JCM.0000000000001710","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001710","url":null,"abstract":"<p><strong>Background: </strong>With a growing population of breast cancer survivors, it is important to acknowledge long-term consequences of breast cancer treatment, including left ventricular systolic dysfunction (LVSD). Although echocardiography is a reliable technique to diagnose LVSD, its limited accessibility in primary care poses challenges.</p><p><strong>Methods: </strong>A cross-sectional diagnostic accuracy study among 350 long-term breast cancer survivors, at least 5 years after breast cancer diagnosis, comparing the diagnostic performance of index tests ECG and N-terminal pro B-type natriuretic peptide (NT-proBNP) to the reference test echocardiography. LVSD was defined as left ventricular ejection fraction (LVEF) less than 54% or LVEF less than 50% on echocardiography.</p><p><strong>Results: </strong>The median age at time of investigation was 63 years (IQR 57-68), with a median follow-up duration since breast cancer diagnosis of 10 years (IQR 7-14). An abnormal ECG demonstrated a sensitivity of 63.0% (IQR 48.7-75.7), a corresponding specificity of 51.7 (IQR 45.8-57.6) and a negative likelihood ratio of 0.7 (IQR 0.5-1.0) for detecting a LVEF less than 54%. An abnormal ECG showed a sensitivity of 75.0 (IQR 47.6-92.7), a corresponding specificity of 50.6 (IQR 45.1-56.2) and a negative likelihood ratio of 0.5 (0.2-1.2) for detecting LVSD defined as LVEF less than 50%. The area under the curve for NT-proBNP was 0.59 (95% confidence interval: 0.50-0.68) for detecting LVEF less than 54% and 0.56 (95% confidence interval: 0.39-0.74) for detecting LVEF less than 50%.</p><p><strong>Discussion: </strong>ECG and NT-proBNP are inadequate diagnostic tools to screen for LVSD among asymptomatic long-term breast cancer survivors.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 5","pages":"216-223"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967456","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}

{"title":"Expert consensus document on artificial intelligence of the Italian Society of Cardiology.","authors":"Ciro Indolfi, Piergiuseppe Agostoni, Francesco Barillà, Andrea Barison, Stefano Benenati, Grzegorz Bilo, Giuseppe Boriani, Natale Daniele Brunetti, Paolo Calabrò, Stefano Carugo, Michela Casella, Michele Ciccarelli, Marco Matteo Ciccone, Gaetano Maria De Ferrari, Gianluigi Greco, Giovanni Esposito, Emanuela T Locati, Andrea Mariani, Marco Merlo, Saverio Muscoli, Savina Nodari, Iacopo Olivotto, Stefania Paolillo, Alberto Polimeni, Aldostefano Porcari, Italo Porto, Carmen Spaccarotella, Carmine Dario Vizza, Nicola Leone, Gianfranco Sinagra, Pasquale Perrone Filardi, Antonio Curcio","doi":"10.2459/JCM.0000000000001716","DOIUrl":"10.2459/JCM.0000000000001716","url":null,"abstract":"<p><p>Artificial intelligence (AI), a branch of computer science focused on developing algorithms that replicate intelligent behaviour, has recently been used in patients management by enhancing diagnostic and prognostic capabilities of various resources such as hospital datasets, electrocardiograms and echocardiographic acquisitions. Machine learning (ML) and deep learning (DL) models, both key subsets of AI, have demonstrated robust applications across several cardiovascular diseases, from the most diffuse like hypertension and ischemic heart disease to the rare infiltrative cardiomyopathies, as well as to estimation of LDL cholesterol which can be achieved with better accuracy through AI. Additional emerging applications are encountered when unsupervised ML methodology shows promising results in identifying distinct clusters or phenotypes of patients with atrial fibrillation that may have different risks of stroke and response to therapy. Interestingly, since ML techniques do not analyse the possibility that a specific pathology can occur but rather the trajectory of each subject and the chain of events that lead to the occurrence of various cardiovascular pathologies, it has been considered that DL, by resembling the complexity of human brain and using artificial neural networks, might support clinical management through the processing of large amounts of complex information; however, external validity of algorithms cannot be taken for granted, while interpretability of the results may be an issue, also known as a \"black box\" problem. Notwithstanding these considerations, facilities and governments are willing to unlock the potential of AI in order to reach the final step of healthcare advancements while ensuring that patient safety and equity are preserved.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"26 5","pages":"200-215"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020207","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}