Journal of Cardiovascular Medicine最新文献

{"title":"Prognostic value of preoperative peak atrial longitudinal strain for patients undergoing mitral valve surgery.","authors":"Annalisa Pasquini, Andrea Pica, Maria Concetta Pastore, Gabriele Mazzenga, Maria Alma Iuliano, Monica Filice, Lorenzo Tanzi, Marta Focardi, Piergiorgio Bruno, Giovanni Alfonso Chiariello, Natalia Pavone, Maria Grandinetti, Francesco Burzotta, Hatem Soliman Aboumarie, Matteo Cameli, Massimo Massetti","doi":"10.2459/JCM.0000000000001895","DOIUrl":"10.2459/JCM.0000000000001895","url":null,"abstract":"<p><strong>Aims: </strong>In asymptomatic severe degenerative mitral regurgitation (MR), indications for surgery mainly rely on 2D echocardiographic criteria. Preoperative peak atrial longitudinal strain (PALS) has prognostic value for predicting clinical outcome after surgery for MR while Bernard demonstrated the prognostic value of an echocardiographic staging assessment of extra-valvular cardiac damage in patients with at least moderate MR.The primary aim was to assess the additive prognostic value of PALS to Bernard's staging classification in patients undergoing surgery for degenerative MR.</p><p><strong>Methods: </strong>Ambispective multicenter cohort study of patients with severe degenerative MR undergoing surgery. Patients were assigned to Bernard's stages based on pre-operative echocardiographic data, from which PALS values were obtained. Follow-up assessed the composite primary endpoint: all-cause mortality, hospitalization for heart failure, acute myocardial infarction, stroke, life-threatening bleeding or wound infections requiring re-intervention, failure requiring re-intervention.</p><p><strong>Results: </strong>Three hundred patients (mean age 63 ± 13 years; 65% men) were enrolled with a median follow-up of 24 months. Bernard's staging predicted outcomes in our population, as demonstrated by survival analysis with Kaplan-Meier curves (log-rank 13.3; P = 0.01) and Cox model (hazard ratio of 1.51; P < 0.001). Adding PALS improved prognostic performance (χ2 = 20.96 vs. 16.15), with an area under the curve of 0.70 vs. 0.64 at 24 months, a net reclassification improvement of 0.18 (P = 0.031), an integrated discrimination improvement of 0.02 (P = 0.020). We identified an optimal PALS cutoff of 18% associated with the primary endpoint.</p><p><strong>Conclusions: </strong>PALS has a potential additive role in estimating the prognosis of patients undergoing surgery for severe degenerative MR.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 6","pages":"484-492"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360878","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":"In-hospital outcomes of acute coronary syndrome in patients with cancer: a systematic review and meta-analysis.","authors":"Abdullah Ahmad, Abdul Rafeh Awan, Muhammad Hasnain Mankani, Bakhtawar Haseeb, Muhammad Daniyal, Meher Ayyazuddin, Kaitlyn Chenney, Puneet Bansal, Beren Berber, Amir Humza Sohail, Waqqas Haroon Chaudhary, Muhammad Ahmad Nadeem, Abu Baker Sheikh","doi":"10.2459/JCM.0000000000001894","DOIUrl":"10.2459/JCM.0000000000001894","url":null,"abstract":"<p><strong>Background: </strong>Patients with a history of malignancy are at elevated risk for acute coronary syndrome (ACS). This study evaluates in-hospital cardiovascular outcomes in ACS patients with and without a cancer history.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, Embase, and ClinicalTrials.gov (2000-2025) identified studies comparing in-hospital outcomes for ACS in patients with vs. without malignancy. Data were pooled and analyzed using RevMan 5.4, calculating risk ratios (RRs) under a random-effects model.</p><p><strong>Results: </strong>Fifteen studies were included. Among ACS patients, a history of cancer was associated with significantly worse in-hospital outcomes. Cancer history increased all-cause mortality by 44% [RR: 1.44; 95% confidence interval (CI): 1.21-1.71; P < 0.001], bleeding by 72% (RR: 1.72; 95% CI: 1.33-2.22; P < 0.001), major adverse cardiac events (MACE) by 18% (RR: 1.18; 95% CI: 1.17-1.19; P < 0.001), and stroke by 48% (RR: 1.48; 95% CI: 1.35-1.63; P < 0.001). No significant associations were observed for heart failure (RR: 1.24; 95% CI: 0.96-1.59; P = 0.10), re-infarction (RR: 1.17; 95% CI: 0.83-1.65; P = 0.36), or cardiogenic shock (RR: 1.22; 95% CI: 0.97-1.55; P = 0.09).</p><p><strong>Conclusion: </strong>Patients with a history of malignancy presenting with ACS face significantly higher in-hospital risks of mortality, bleeding, MACE, and stroke, while risks of heart failure, re-infarction, and shock show nonsignificant trends. These findings underscore the vulnerability of this population and highlight the need for multidisciplinary, individualized management strategies to improve outcomes.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 6","pages":"440-453"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360851","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":"From photoshop to artificial intelligence. Scientific integrity in the modern era of cardiovascular research: a call for action.","authors":"Ciro Indolfi","doi":"10.2459/JCM.0000000000001902","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001902","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 6","pages":"457-458"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360869","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":"When cancer meets acute coronary syndrome: moving beyond the 'cancer disadvantage'.","authors":"Cristina Madaudo, Daniela Di Lisi, Giuseppina Novo","doi":"10.2459/JCM.0000000000001903","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001903","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 6","pages":"454-456"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new milestone for the Journal of Cardiovascular Medicine.","authors":"","doi":"10.2459/JCM.0000000000001920","DOIUrl":"https://doi.org/10.2459/JCM.0000000000001920","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 6","pages":"v"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360843","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":"Spontaneous coronary artery dissection and sudden cardiac arrest: a reversible event or an indication for secondary prevention?","authors":"Giacomo Mugnai, Pietro Francia, Laura Perrotta, Donatella Ruggiero, Francesco Santoro, Giuseppe Sgarito, Davide Genovese","doi":"10.2459/JCM.0000000000001896","DOIUrl":"10.2459/JCM.0000000000001896","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome (ACS), particularly in young women. A high-risk subset of these patients presents with cardiac arrest (CA), creating a profound clinical management dilemma. Current guidelines for secondary prevention with an implantable cardioverter-defibrillator (ICD) offer limited guidance for life-threatening ventricular arrhythmias (VA) secondary to putatively 'reversible' causes such as SCAD. This review critically analyzes the evidence for and against ICD implantation. While the observed rate of appropriate ICD therapy in SCAD survivors is low, the risk of recurrent SCAD is significant (10-30%). Although the acute dissection may heal, the underlying systemic arteriopathy represents a persistent, nonreversible substrate. Therefore, for a selected, high-risk cohort of SCAD patients presenting with CA, the event might be considered a marker for a durable arrhythmic substrate. In these cases, an ICD implantation for secondary prevention should be considered after a comprehensive risk assessment and shared decision-making.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":" ","pages":"493-501"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329847","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":"Polygenic risk in early-onset coronary artery disease with low prevalence of traditional cardiovascular risk factors.","authors":"Maddalena Rossi, Andrea Conti, Giulia Gagno, Stefania Cappellani, Alessandro Altinier, Enrico Fabris, Maria Perotto, Annamaria De Bellis, Carla Indennidate, Alessia Paldino, Giulia Barbati, Gianfranco Sinagra, Matteo Dal Ferro, Adamo Pio d'Adamo","doi":"10.2459/JCM.0000000000001874","DOIUrl":"10.2459/JCM.0000000000001874","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to investigate the potential role of polygenic risk in early-onset coronary artery disease (CAD) and recurrence of major adverse coronary events (MACE) in patients with low prevalence of traditional cardiovascular risk factors (CVRFs).</p><p><strong>Methods: </strong>This was a prospective study enrolling a cohort of patients with early-onset CAD (<50 years) despite no/few traditional CVRFs. Baseline CAD risk was calculated according to Systematic Coronary Risk Evaluation 2 (SCORE2). The CAD-polygenic risk score (PGS) developed by Khera et al. was computed for the patients and compared with a local control population of unselected individuals. MACE were collected at long term follow-up.</p><p><strong>Results: </strong>We enrolled 42 patients [81% males; median age 44 years, interquartile range (IQR) 40-46] presenting with early-onset CAD from 2014 to 2021. The majority of them (72%) had ≤1 modifiable CVRF with a 3.9% mean risk of developing CV event at 10 years. The control population consisted of 1408 individuals (51% males; median age 39 years, IQR 29-49). We found a significant positive shift in CAD-PGS distribution among early-CAD patients compared with controls (P value < 0.0001). Over a median follow-up of 104 months, 40.5% of patients experienced a new MACE, with an annual incidence rate of 8 (IQR 5-13) per 100 persons/year.</p><p><strong>Conclusions: </strong>In patients with early-onset CAD despite low clinical risk score, we found CAD-PGS values significantly higher than in the general population and a high rate of recurrence of MACE. These findings highlight the potential of PGS in refining CAD risk stratification, properly tailoring prevention strategies.</p>","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 5","pages":"351-358"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030994","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":"Clopidogrel vs. aspirin: the overlooked role of complex PCI, CKD, and genotype.","authors":"Waqar Tahir, Aman Yadav","doi":"10.2459/JCM.0000000000001877","DOIUrl":"10.2459/JCM.0000000000001877","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 5","pages":"414-415"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031013","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":"When traditional risk fails: polygenic burden as the missing dimension in early coronary artery disease.","authors":"Annamaria Iorio, Giovanni Maria Severini","doi":"10.2459/JCM.0000000000001882","DOIUrl":"10.2459/JCM.0000000000001882","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 5","pages":"359-361"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031050","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":"Clopidogrel vs. aspirin after percutaneous coronary intervention: consistent evidence across high-risk subgroups.","authors":"Ahmed Ibrahim, Pierre Sabouret, Giuseppe Andò","doi":"10.2459/JCM.0000000000001878","DOIUrl":"10.2459/JCM.0000000000001878","url":null,"abstract":"","PeriodicalId":15228,"journal":{"name":"Journal of Cardiovascular Medicine","volume":"27 5","pages":"415-416"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148031073","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}