Journal of Clinical Medicine最新文献

{"title":"Successful Oral Immunotherapy (OIT) Due to Anti-IgE Protection.","authors":"Mehrak Yoosefi Moridani, Susanne Lau, Kirsten Beyer","doi":"10.3390/jcm14186612","DOIUrl":"10.3390/jcm14186612","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Oral immunotherapy with peanut protein powder is difficult to initiate in patients with a very low reactivity threshold to peanuts. For this specific group, an add-on treatment with omalizumab (anti-IgE monoclonal antibody) is helpful to tolerate the initial steps. <b>Methods</b>: After failed initiation in three children, an off-label approval from the individuals' insurance was necessary for the premedication with anti-IgE ahead of a second approach at our center. Currently, the European countries have no approval from the European Medicines Agency (EMA) for the treatment of food allergies with omalizumab. <b>Results</b>: Under anti-IgE protection, our patients have restarted the oral immunotherapy without anaphylactic reactions and have reached the maintenance dose within the treatment protocol. <b>Conclusions</b>: For a few patients with initial anaphylactic reactions due to doses below the first treatment step (3 mg peanut protein powder), a premedication with omalizumab is not only safe but also reduces side effects, in particular anaphylactic reactions, and the time to reach the hundredfold higher maintenance dose (300 mg peanut protein powder).</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175938","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":"Redo-Transcatheter Aortic Valve Replacement: Current Evidence and Procedural Considerations.","authors":"Raviteja R Guddeti, Hanad Bashir, Puvi Seshiah, Nadia El-Hangouche, Dean J Kereiakes, Santiago Garcia","doi":"10.3390/jcm14186608","DOIUrl":"10.3390/jcm14186608","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe aortic stenosis (AS), with indications expanding from high and intermediate- to low-surgical risk patients. However, the durability of transcatheter heart valves (THV) is still an ongoing concern, especially in younger, low-risk patients. Redo-TAVR (TAVR-in-TAVR) is feasible and is associated with favorable short-term outcomes in observational studies and registries. Understanding native aortic valve (AV) anatomy and the characteristics of the index THV is critical to the technical and procedural success of redo-TAVR. Cardiac computed tomography angiography (CTA) plays a central role in pre-procedure planning and aids in appropriate valve selection and procedural planning in addition to identifying patients at high risk for coronary occlusion during redo-TAVR. While evidence on redo-TAVR is limited to retrospective observational studies, prospective registries will shed light on the long-term clinical and hemodynamic outcomes.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175951","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":"Atrial Fibrillation Ablation After Three Decades: Mechanistic Insight or Just a Technological Race?","authors":"Giulia Spiriti, Antonio Scarà, Alessio Borrelli, Federico Zanin, Leonardo Pignalosa, Lorenzo Buzzelli, Zefferino Palamà, Antonio Gianluca Robles, Martina Nesti, Luigi Sciarra","doi":"10.3390/jcm14186601","DOIUrl":"10.3390/jcm14186601","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common sustained supraventricular arrhythmia, affecting 2-3% of the adult population and contributing significantly to morbidity, mortality, and healthcare burden. Catheter ablation has become a cornerstone in the treatment of symptomatic, drug-refractory AF, with pulmonary vein isolation (PVI) established as the standard approach, especially in paroxysmal AF. Over the past three decades, ablation technologies have evolved considerably-from radiofrequency and cryoballoon to the recent advent of pulsed field ablation-enhancing procedural safety, efficiency, and lesion durability. Despite these technological advancements, long-term outcomes have plateaued, suggesting that success may depend not just solely on the energy source used, but also on a more individualized, mechanism-based approach. The classification of AF based on duration alone fails to capture the complexity of its underlying pathophysiology. Tailored strategies that consider arrhythmic mechanisms, electrophysiological triggers, and patient-specific substrates-especially in persistent AF-are increasingly recognized as essential for durable results. Tools such as high-density mapping, autonomic modulation, and substrate-targeted ablation are expanding therapeutic horizons. Moreover, special populations, such as athletes, present unique arrhythmic profiles influenced by structural and autonomic remodeling, requiring nuanced management. The integration of lifestyle interventions, neuromodulation techniques, and emerging genetic and pharmacological insights further supports a comprehensive, personalized approach. In this paper, we explore whether future success in AF ablation lies more in refining technology or in advancing our understanding of arrhythmic mechanisms to guide patient-specific therapy.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175535","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":"Assessment of Gait Disorders in Cerebral Small Vessel Disease: Advantages of Different Clinical Scales.","authors":"Larisa A Dobrynina, Elina T Bitsieva, Kamila V Shamtieva, Maryam R Zabitova, Marina V Krotenkova","doi":"10.3390/jcm14186626","DOIUrl":"10.3390/jcm14186626","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Cerebral small vessel disease (cSVD) is one of the leading causes of gait disorders (GDs) in the elderly. Clinical diversity and lack of standardization in assessment of GDs in cSVD patients are associated with late diagnosis. The comparative value of clinical rating scales used for gait assessment in clinical studies of cSVD has not been previously clarified. The purpose of the study was to assess GDs in cSVD patients with different scales and evaluate the advantages of their usage in clinical practice. <b>Materials and methods:</b> The study included 124 cSVD patients (STRIVE, 2013) (average age 62.2 ± 7.9, women-53.2%) and 30 healthy volunteers (average age 59.77 ± 6.361, women-56.7%). Gait and balance function were assessed with the Tinetti test, \"6-m walk\" test, and the Clinical Scale for Assessing the Severity of Gait Disorders in SVD (RCN, 2019). <b>Results:</b> In total, 85 (68.5%) patients had gait disturbances. The \"6-MWT\" showed a general tendency to decrease gait speed, step length, and increase in base width. ROC analysis established their thresholds for GD diagnosis. Moderate- or high-risk of falls was found in 52 (41.9%) patients. Gait parameters assessed by two tests (Tinneti and 6-WMT) showed a high degree of intercorrelations. Comparative analysis of the quantitative parameters of Tinneti and 6-WMT tests revealed significant differences depending on the severity of the GD assessed by the Clinical Scale for Assessing the Severity of GDs in cSVD (RCN, 2019). <b>Conclusions:</b> GDs in cSVD are characterized by slowness, changes in step length, base width, and a high risk of falls. The Tinetti test and \"6-MWT\" have good reproducibility in cSVD, high correlations between the tests, as well as significant differences between the categories of GD severity, which justifies their use in cSVD patients. The advantage of the Tinetti test is the ability to perform a fall risk assessment, while \"6-MWT\" allows for the diagnosis of GD based on gait parameter thresholds, which is important in the early stages of the disease and in dynamic observation. The Clinical Scale for Assessing the Severity of Gait Disorders in cSVD is a convenient screening tool for assessing the severity of GDs in clinical practice.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175838","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":"Ex-Situ Dual Hypothermic Oxygenated Machine Perfusion in Full-Left-Full-Right Split Liver Transplantation for Two Adult Recipients.","authors":"Konrad Kobryń, Aleksandra Frankowska, Paweł Rykowski, Mateusz Bartkowiak, Andriej Zhylko, Marcin Morawski, Jan Stypułkowski, Łukasz Masior, Piotr Smoter, Waldemar Patkowski, Michał Grąt","doi":"10.3390/jcm14186596","DOIUrl":"10.3390/jcm14186596","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The shortage of liver grafts remains a major challenge in transplantation. Full-left-full-right (FLFR) split liver transplantation (SLT) expands the donor pool by providing two grafts for small adult recipients. However, prolonged cold ischemia time (CIT) and ischemia-reperfusion injury (IRI) limit its success. <b>Methods</b>: We report a case of FLFR SLT utilizing ex situ dual hypothermic oxygenated machine perfusion (DHOPE) to mitigate IRI and enhance graft viability. A brain-dead donor's liver was split under continuous DHOPE, followed by simultaneous transplantation into two adult recipients. <b>Results</b>: Both recipients exhibited stable graft function at one-year follow-up. DHOPE effectively reduced CIT and optimized postoperative recovery, with no major complications beyond Clavien-Dindo Grade IIIb. <b>Conclusions</b>: This is the first reported FLFR SLT using ex situ DHOPE for two adult recipients, demonstrating its feasibility in reducing CIT and improving outcomes. Machine perfusion may become a standard in FLFR SLT.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175689","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":"Hemodynamic Markers Predict Outcomes a Decade After Acute Coronary Syndrome.","authors":"Andrzej Minczykowski, Oskar Wojciech Wiśniewski, Tomasz Krauze, Adam Szczepanik, Agnieszka Banaszak, Przemysław Guzik, Andrzej Wykrętowicz","doi":"10.3390/jcm14186627","DOIUrl":"10.3390/jcm14186627","url":null,"abstract":"<p><p><b>Background:</b> Previous research from our group demonstrated that novel hemodynamic indices can predict 3-5-year mortality risk in myocardial infarction survivors. Building on these findings, we assessed the long-term prognostic value of these markers over a 10-year follow-up period. <b>Methods</b>: We conducted a prospective study involving 569 consecutive acute coronary syndrome (ACS) patients admitted within 12 h of symptom onset, all presenting with >50% coronary artery stenosis. Hemodynamic indices were assessed using echocardiography to measure ejection fraction (EF), global longitudinal peak systolic strain (GLPSS), and ventricular-arterial coupling (VA coupling). Excess aortic pressure (excess_PTI) was evaluated via radial tonometry, while local arterial stiffness was assessed by pulse wave velocity (PWV) through carotid ultrasonography. The primary outcome was all-cause mortality over a 10-year follow-up period. <b>Results</b>: Over a median follow-up of 3249 days, 172 patients reached the primary endpoint (death). Deceased individuals were older and exhibited lower EF, impaired VA coupling, higher excess_PTI, and a lower PWV/GLPSS index compared to survivors. In multivariate Cox proportional hazards analysis, EF, VA coupling, excess_PTI, and PWV/GLPSS index were independently associated with all-cause mortality over a 10-year follow-up period. <b>Conclusions</b>: This study highlights the significant long-term prognostic value of novel hemodynamic indices, including VA coupling, PWV/GLPSS index, and excess_PTI, in predicting 10-year all-cause mortality in ACS patients.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175923","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":"Is Periodontal Inflammation Associated with Liver Cirrhosis? A Cross-Sectional Study.","authors":"Goran Rinčić, Marija Roguljić, Nives Rinčić, Lucija Virović Jukić, Petar Gaćina, Darko Božić, Ana Badovinac","doi":"10.3390/jcm14186616","DOIUrl":"10.3390/jcm14186616","url":null,"abstract":"<p><p><b>Background</b>: Periodontitis is linked to a range of systemic non-communicable diseases, including hepatic diseases. The aim of this study was to investigate whether periodontal health status is associated with liver cirrhosis (LC). <b>Methods</b>: Patients were recruited from the Department of Internal Medicine at the University Clinical Hospital \"Sestre Milosrdnice\" and categorized into two groups. The case group comprised patients with LC, while age-matched individuals without LC served as controls. Systemic health status was evaluated through laboratory tests, medical history, and clinical parameters, and the Model for End-Stage Liver Disease (MELD) score was calculated for each participant. A comprehensive clinical periodontal assessment was conducted, measuring bleeding on probing (BoP), probing pocket depth (PPD), gingival recession (GR), clinical attachment level (CAL), and the Periodontal Inflamed Surface Area (PISA) score. Stepwise logistic regression was employed to assess possible predictors of LC, including periodontal status. <b>Results</b>: A total of 100 patients were included in the analysis, consisting of 50 cases with LC and 50 controls. The mean age was 56.79 years (SD = 11.16) of participants, and 58% were male. The majority of LC cases were attributed to alcohol abuse (41/50, 82%), and the median MELD score was 16 (IQR 6-33). Comparison of the two groups revealed significantly worse clinical periodontal parameters in the LC group and a higher prevalence of periodontitis (<i>p</i> = 0.012). Among the 50 LC patients, 46 (92%) exhibited severe forms of periodontitis (stages III and IV). Logistic regression analysis identified alcohol consumption and the PISA score as independent predictors of LC (OR = 23.81, 95% CI 4.48-126.47, <i>p</i> < 0.001; OR = 1.006, 95% CI 1.003-1.01, <i>p</i> < 0.001, respectively). <b>Conclusions</b>: Within the limits of the present study, the higher prevalence of periodontal disease in the LC group suggests an association between LC and periodontitis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175930","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":"Bronchoscopy in the Pediatric Cardiovascular Patient with Persistent Respiratory Pathology.","authors":"Ana-Belen Ariza-Jimenez, Delia Valverde Montoro, Pilar Caro Aguilera, Estela Perez Ruiz, Francisco Javier Perez Frias","doi":"10.3390/jcm14186606","DOIUrl":"10.3390/jcm14186606","url":null,"abstract":"<p><p><b>Background:</b> Patients with congenital heart disease can associate malformations. The most frequent complications are those related to the airways, which produce prolonged cardiovascular postoperative. <b>Objectives</b>: Describe pathology, bronchoscopy indications, and findings in patients with heart pathology and persistent breath failure to improve prognosis and determine an early treatment. <b>Methods</b>: Retrospective descriptive study of bronchoscopies performed during 24 years in pediatric patients with congenital heart disease with surgery indication and persistent respiratory symptomatology. <b>Results:</b> We performed 199 fibrobronchoscopies in 144 patients, with an average of 1.4 fibrobronchoscopies per patient. A total of 58% were male. The mean age was 27.5 months (5 days-13 years). Valvular disease was the most frequent congenital heart disease, followed by the transposition of large vessels. The most frequent indications were stridor (42.7%) and persistent atelectasis (24.6%), followed by extubation failure (12.4%) and pump output (6.2%). The majority of the findings were found in the upper airway (56%), with a clear predominance of malacias (32%), while in the lower airway, extrinsic compression was highlighted (42%). <b>Conclusions</b>: Flexible fiberoptic bronchoscopy is a useful and rapid method for the diagnosis of airway malformations associated with congenital heart diseases that may have a relevant role in its management and prognosis.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175732","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":"Clinical Characteristics and Management of Statin-Associated Anti-3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy.","authors":"Jiyeol Yoon, Seung Woo Kim, Se Hoon Kim, Jason Jungsik Song, Yong-Beom Park, Hee Jin Park, Ha Young Shin, Se Hee Park, Yumie Rhee","doi":"10.3390/jcm14186610","DOIUrl":"10.3390/jcm14186610","url":null,"abstract":"<p><p><b>Background</b>: Immune-mediated necrotizing myopathy (IMNM) associated with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibody is a rare but critical complication usually triggered by statin use. However, the comprehensive characterization and long-term outcomes of anti-HMGCR-positive IMNM remain underexplored. This study aimed to examine the clinical characteristics, diagnostic challenges, treatment responses, and long-term outcomes of patients with anti-HMGCR-positive IMNM. <b>Methods</b>: A retrospective review was conducted at a single institution between 2019 and 2025 to analyze the data of patients diagnosed with anti-HMGCR-positive IMNM. Diagnoses were confirmed by detecting anti-HMGCR antibodies and meeting the criteria for IMNM of the European Neuromuscular Center. The analyzed data included demographics, clinical presentation, laboratory findings, imaging results, muscle biopsy characteristics, treatment regimens, and follow-up outcomes. <b>Results</b>: Ten patients (six women and four men) with a median age of 58 (range, 33-86) years were included. Nine patients had a history of statin use for a median duration of two years. The average diagnostic delay was 233 days after the onset of symptoms. The initial creatine kinase (CK) levels ranged from 1438 to over 13,000 IU/L. Muscle biopsies revealed necrosis and regeneration of muscle fibers. CK levels fluctuated and trended downward over 180 days post-treatment. Treatment included corticosteroids, methotrexate, azathioprine, tacrolimus, mycophenolate, intravenous immunoglobulin, and rituximab. Delayed treatment initiation from symptom onset was correlated with prolonged treatment time until the first remission. <b>Conclusions</b>: The prognosis of anti-HMGCR-positive IMNM is less favorable when treatment is delayed after symptom onset. Further research is warranted to identify poor prognostic markers and develop relevant treatments.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175733","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":"Impairment of Kidney Function in Patients with Chronic Coronary Syndromes.","authors":"Katarzyna Charkiewicz-Szeremeta, Emilia Sawicka-Śmiarowska, Danuta Czarnecka, Marlena Dubatówka, Zbigniew Gąsior, Tomasz Hryszko, Piotr Jankowski, Małgorzata Knapp, Dariusz A Kosior, Aldona Kubica, Klaudia Mickiewicz, Andrzej Pająk, Marek Rajzer, Marek Styczkiewicz, Renata Wolfshaut-Wolak, Karol A Kamiński","doi":"10.3390/jcm14186607","DOIUrl":"10.3390/jcm14186607","url":null,"abstract":"<p><p><b>Background</b>: Kidney function is critical for cardiovascular health, and its appropriate assessment entails proper determination of prognosis in patients with chronic coronary syndromes (CCSs). However, assessment of the urinary spot albumin to creatinine ratio (uACR) is often overlooked, whereas it is crucial for determination of chronic kidney disease (CKD). This study assesses the prevalence of impaired kidney function in patients with CCS based on their eGFR and albuminuria. <b>Methods and results</b>: This study comprised a total of 1957 patients from seven regions in Poland, aged ≤ 80 years, who, 6-18 months earlier, were hospitalized for acute coronary syndrome or elective myocardial revascularization. Complete uACR and eGFR data were obtained from 1152 patients (median age was 67 years, and 71.23% of participants were male). The finding of albuminuria reclassified the CKD in 17% (200) patients, suggesting that a patient's risk cannot be ascertained only based on their eGFR result. CKD reclassification by albuminuria was observed in older (<i>p</i> < 0.001) patients with higher BPs (<i>p</i> = 0.008), BPd (<i>p</i> = 0.038), HR (<i>p</i> < 0.001), fasting glucose (<i>p</i> < 0.001), and HbA1c (<i>p</i> < 0.001) and decreased HDL concentration (<i>p</i> = 0.001); hence, this is the population where uACR assessment is particularly valuable. <b>Conclusions</b>: In a notable percentage of patients with CCS, their kidney function classification is changed based on their albuminuria. Therefore, it is important to include albuminuria in the routine assessment of patients with cardiovascular disease.</p>","PeriodicalId":15533,"journal":{"name":"Journal of Clinical Medicine","volume":"14 18","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175773","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}