Minerva cardiology and angiology最新文献

{"title":"Optimal triage of patients with acute chest pain.","authors":"Francesco Caiazza, Pasquale Guarini, Pasquale Campana, Santo Dellegrottaglie, Francesco De Stefano, Dario Fabiani, Germano Jr Ferruzzi, Francesco Melillo, Alberto Morello, Roberto F Pedretti, Alessandra Scatteia, Angelo Silverio, Laura A Dalla Vecchia","doi":"10.23736/S2724-5683.24.06556-6","DOIUrl":"10.23736/S2724-5683.24.06556-6","url":null,"abstract":"<p><p>Acute chest pain (ACP) is one of the most common symptoms in patients admitted to emergency departments (ED). It can be related to several life-threatening cardiovascular conditions such as acute coronary syndrome (ACS), aortic dissection, and pulmonary embolism. The optimal triage of patients with ACP is a clinical and healthcare necessity given the large number of patients daily admitted to ED with this symptom. The first contact with the patient in ED includes the clinical appraisal of the characteristics of ACP and coexisting symptoms, and the assessment of the patient's medical history. Risk scores may help stratify a patient's likelihood of having cardiac chest pain. The ECG examination allows the identification of patients with ST-segment elevation, depression, or T-wave changes, but may be normal in patients with non-ST-segment elevation ACS. Rapid protocols based on serial high-sensitivity cardiac troponin assays within one or two hours are recommended for identifying candidates for early discharge. Due to the bedside feasibility, non-invasiveness, and wide availability, transthoracic echocardiography represents the first-line imaging modality for evaluating patients with ACP. In selected cases, computed tomography angiography may also be performed. A practical approach to ACP in ED should improve patient outcomes and reduce healthcare system costs. This review aimed to provide an overview of the characteristics of patients with ACP of cardiac origin and to describe the state of the art about their management in the ED.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"626-637"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance of RAC2 combined with CT-FFR parameters in coronary heart disease.","authors":"Zhanying Zhu, Jiani Xu, Haitao Wang, Wei Jin, Miao Liu","doi":"10.23736/S2724-5683.24.06618-3","DOIUrl":"10.23736/S2724-5683.24.06618-3","url":null,"abstract":"<p><strong>Background: </strong>The incidence and mortality of coronary heart disease (CHD) are high in the elderly population. CT fractional flow reserve (CT-FFR) is a potential diagnostic technique for cardiovascular diseases. In order to mine valuable biomarkers to combine CT-FFR parameters to improve the diagnostic accuracy of CHD.</p><p><strong>Methods: </strong>In this study, GEO database was used to screen the key genes of CHD. GraphPad software was used to construct receiver operating characteristic (ROC) curve, and SPSS software was used for logistic regression analysis. Inflammatory cell model was constructed by treating human cardiac microvascular endothelial cells (HMVEC-Cs) with TNF-α to explore the role of RAC2 in this process.</p><p><strong>Results: </strong>Real time quantitative PCR (RT-qPCR) results showed high-expression of RAC2 in CHD patients, which were reversed after nitric ester drug therapy. The analysis of ROC curves displayed that RAC2 combined with CT-FFR had a higher diagnostic value for CHD (AUC=0.971, 95% CI 0.950-0.992) compared to the single factor, and RAC2 was an independent risk factor for poor prognosis in CHD patients treated with nitric ester drugs (AUC=0.888, 95% CI 0.814-0.961, P<0.001). Overexpression of RAC2 further enhanced the elevated expression levels of NF-κB, NLRP3, IL-1β, and IL-6, induced by TNF-α, and its silence had the opposite effect.</p><p><strong>Conclusions: </strong>RAC2 promoted the inflammatory response of HMVEC-Cs and predicted a poor prognosis in CHD patients. The combination of RAC2 and CT-FFR parameters was a good classifier for diagnosing CHD.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"558-565"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective, randomized comparison of workhorse guidewires for bifurcation percutaneous coronary intervention.","authors":"Krista Schoff, Ziad Syed Ahmad, Sorabh Kothari, Kristina Gifft, Jinli Wang, Charles Donigian, Quang LE, Poorna R Karuparthi, Albert Chan, Chirag Bavishi, Arun Kumar, Taishi Hirai","doi":"10.23736/S2724-5683.25.06812-7","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06812-7","url":null,"abstract":"<p><strong>Background: </strong>Despite the significant improvement in guidewire technology, in-vivo comparison of workhorse guidewires is lacking. This study aims to assess the feasibility of randomized data collection regarding the wiring time and its variability among three guidewires: Sion Blue, Minamo, and Runthrough, and to identify key lesion characteristics for future guidewire research.</p><p><strong>Methods: </strong>45 patients were randomized between February of 2023 and May 2024. Patients undergoing elective percutaneous coronary intervention (PCI) to a bifurcation lesion requiring two guidewires were included. The wiring time was defined from when the tip of the guidewire at the end of the guide catheter until the advancement to the distal target vessel.</p><p><strong>Results: </strong>The mean wiring time was 55.3 seconds for side branch and 95.8 seconds for main branch. The wiring time was similar for both side-branch wiring (Sion Blue 65.9±79.5, Minamo 41.2±33.4, Runthrough 57.6±88, P=0.65) and the main branch wiring (Sion Blue 44.8±38.9, Minamo 123.8±189.4, Runthrough 119.1±183.6, P=0.3). Use of the torque device, guidewire reshaping, or switching to a second guidewire were uncommon. Lesions requiring longer wiring time had severe stenosis (>90%), severe calcification, or tortuosity. The median crossing time was longer when recrossing stent struts, especially during two-stent strategy (>130 seconds).</p><p><strong>Conclusions: </strong>Prospective data collection assessing the difference of wiring time as a clinical endpoint is feasible. Our study results can form a basis for future studies comparing different guidewires.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of vitamin D on postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting: a systematic review and meta-analysis.","authors":"Farwa Nisa, Hafiz M Nauman, Priyanka K Lal, Arfa A Assad, Mustafa Arain, Ramsha Ali, Hafiz M Saleem, Fakhra Shafiq, Asad U Farooq, Muhammad A Zeb, Hassan Ijaz, Fizza Laeeq, Muhammad Ibrahim, Muhammad S Arshad","doi":"10.23736/S2724-5683.25.06724-9","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06724-9","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this paper was to determine whether vitamin D supplementation reduces the incidence of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Evidence acquisition: </strong>PubMed and Cochrane Central Register of Controlled Trials were systematically searched from inception through May 2023 for randomized controlled trials (RCTs) assessing the effectiveness of Vitamin D in preventing atrial fibrillation among postoperative patients after CABG.</p><p><strong>Evidence synthesis: </strong>The primary outcome extracted was the incidence of atrial fibrillation after Vitamin D in CABG patients. Secondary outcome included the length of hospital stay. Data were pooled using a random-effect model. A total of 4 RCTs, involving 694 patients, were included in the final analysis. The results showed that Vitamin D supplementation significantly reduced the incidence of POAF in CABG patients (RR: 0.55; 95% CI: 0.40 to 0.76; P=0.0003; I²=1%). However, administration of Vitamin D did not lead to significant reduction in the length of hospital stay (WMD: -0.14; 95% CI: -0.82 to 0.53; P=0.68; I²=34%).</p><p><strong>Conclusions: </strong>Our updated pooled analysis concludes that vitamin D reduces the incidence of POAF in CABG patients. Future large-scale studies should focus on more diverse patient populations and explore a broader range of outcomes to better understand the full impact of Vitamin D supplementation in this context.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal of epidural catheter in a patient with postoperative acute coronary syndrome under dual antiplatelet therapy.","authors":"Daniela Ferraccioli, Diego Fiume, Gaetano Gioffrè, Claudia Cacace, Elisa DE Carolis, Giulia Liciani, Luigi DI Lallo, Michele Arciuolo, Stefano Coppa, Silvia Carlini, Simone Parrino, Lisa Befani, Alessandro M Martini, Mario Peverini, Massimo Galletti","doi":"10.23736/S2724-5683.25.07034-6","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.07034-6","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High incidence of adverse events in spontaneous coronary artery dissection patients during mid-term follow-up: a persistent challenge ahead.","authors":"Maria L Narducci, Francesco Flore, Chiara Simonini, Veronica Carmina, Rocco A Montone, Gaetano Pinnacchio, Gianluigi Bencardino, Francesco Perna, Francesco M Animati, Saverio Tremamunno, Gemma Pelargonio, Francesco Burzotta","doi":"10.23736/S2724-5683.25.06814-0","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06814-0","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous coronary artery dissection (SCAD) is an emerging cause of acute coronary syndrome (ACS), disproportionately affecting women. Data on the management and outcomes of these patients remain limited, especially regarding the overall risk of major adverse cardiovascular events (MACE) and arrhythmic complications. This study aimed to investigate the incidence and independent predictors of MACE in SCAD patients.</p><p><strong>Methods: </strong>In this single-center, prospective observational study, 76 patients with SCAD were enrolled. Clinical follow-up (mean duration: 4.03±3.4 years) was conducted through in-hospital visits and electronic database monitoring. The primary composite endpoint included MACE, defined as cardiovascular (CV) rehospitalization and death, the secondary endpoint included supraventricular and ventricular arrhythmias.</p><p><strong>Results: </strong>All the patients enrolled were characterized by their clinical presentation, underlying risk factors, and triggers for SCAD. Of the 76 patients, 45 (59.2%) received medical therapy alone, 27 (35.5%) underwent percutaneous coronary intervention (PCI), and four (5.2%) had coronary artery bypass grafting (CABG). During the follow-up period, the primary endpoint occurred in 34 patients (44.7%), with CV rehospitalization as the main cause of MACE (31 patients, 40.8%). Coronary revascularization emerged as the only independent predictor of MACE (HR=1.92, 95% CI 1.13-3.21, P=0.035). The secondary endpoint occurred in 13 patients (17.1%).</p><p><strong>Conclusions: </strong>Although SCAD is often considered a rare and relatively benign cause of ACS, our findings reveal a high rate of CV rehospitalization and mortality. Furthermore, mid-term follow-up indicates that SCAD is associated with supraventricular and non-sustained ventricular arrhythmias, with limited impact on prognosis and generally requiring pharmacological optimization.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular benefits of liraglutide in patients with type 2 diabetes: an in-depth exploration.","authors":"Amruth A Alluri, Avishek Mitra, Aamuktha Marepalli, Kshitij Raj, Nayan Gandhi, Yuliya Prystupa, Rajmohan Seetharaman","doi":"10.23736/S2724-5683.25.06846-2","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06846-2","url":null,"abstract":"<p><p>Liraglutide is a key therapeutic agent in managing type 2 diabetes mellitus (T2DM), with benefits extending beyond glycemic control to address cardiovascular and renal comorbidities. As T2DM prevalence rises globally, the need for medications that provide comprehensive health benefits becomes increasingly important. Liraglutide, a GLP-1 receptor agonist, has demonstrated effectiveness in reducing cardiovascular events, especially among patients with high cardiovascular risk, such as those with a prior history of myocardial infarction or stroke. It has shown significant reductions in major adverse cardiovascular events (MACE), including cardiovascular mortality and stroke risk, making it an essential component in secondary prevention for patients with established atherosclerotic cardiovascular disease (ASCVD). Moreover, liraglutide has a favorable safety profile, presenting a lower incidence of hypoglycemia compared to many other glucose-lowering agents, which is crucial for patient safety and adherence. Given these wide-ranging benefits, liraglutide serves as a valuable tool for optimizing health outcomes in diverse diabetic populations, particularly in those with complex comorbidities. To support this narrative review, a search in three electronic databases yielded 44 relevant journal articles and book chapters about liraglutide published from 2010 to 2022, providing a robust foundation for evaluating its cardiovascular impact and clinical utility in T2DM patients with concurrent cardiac conditions.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of patient satisfaction with percutaneous coronary angioplasty and clinical care experience: a qualitative study.","authors":"Francesco Germinal, Beatrice Miglietta, Federica Zilli, Eleonora Zinnari, Giulia D'Agostino, Amedeo Picciolo, Alessandro Mandurino-Mirizzi, Giuseppe Colonna","doi":"10.23736/S2724-5683.25.06910-8","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06910-8","url":null,"abstract":"<p><strong>Background: </strong>In the face of numerous studies concerning the technical advances of percutaneous coronary intervention [PCI] and clinical outcomes, only a few studies focus on patients' lived experiences after PCI. This study aims to explore patients' lived experiences after PCI, both in clinical terms and in terms of their perception of their health status, functional capacity, and autonomy at home.</p><p><strong>Methods: </strong>A qualitative phenomenological, individual, semi-structured survey was conducted on a sample of 18 patients undergoing PCI. Face-to-face interviews were conducted, interviews had a time duration of 7 to 10 minutes, and all conversations were recorded and transcribed. The study assessed the level of satisfaction, concerning the lived experience, in the pre/post-procedure period and the subsequent follow-up.</p><p><strong>Results: </strong>Patients emphasized the importance of four themes: post-PCI health conditions, activities of daily living, the relationship established with health care providers, and the relationship between patient and family members/caregivers. Patients emphasized the improvement of symptoms, particularly exertional dyspnea, exertional angina, and easy fatigability. As a result, patients reported increased confidence in performing normal daily activities. Patients stressed the importance of establishing a good relationship between patients and healthcare providers. About 72.2% (95% CI 49.1-87.5%) of patients reported that they needed the help of family in the recovery phase. Of this group, 84.6% (95% CI 57.7-95.7%) reported that they never felt like a burden to their loved ones.</p><p><strong>Conclusions: </strong>Post-PCI follow-up is generally characterized by improvement in the patient's functional capacity and autonomy. There are, however, cases in which at least part of the burden of home care falls on family members.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of asymptomatic severe aortic stenosis: a systematic review and meta-analysis of randomized controlled trials.","authors":"Nicholas Johnson, Shoomena Anil, Neil J Craig, Benoy N Shah, Liam Ring, Vasiliki Tsampasian, Vassilios S Vassiliou","doi":"10.23736/S2724-5683.25.06950-9","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06950-9","url":null,"abstract":"<p><strong>Introduction: </strong>Whilst aortic stenosis remains the most prevalent valvular abnormality, the management of asymptomatic severe aortic stenosis remains a clinical challenge. Recently, two randomised-controlled trials (RCTs) - EVOLVED (Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis and Myocardial Fibrosis) and Early TAVR (Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis) - have been published, alongside an extended follow-up from the AVATAR (Aortic Valve Replacement Versus Conservative Treatment in Asymptomatic Severe Aortic Stenosis) study.</p><p><strong>Evidence acquisition: </strong>In response, we conducted a systematic review of PubMed, Ovid, and Cochrane databases, identifying RCTs up to October 29, 2024, that compared early intervention with conventional management.</p><p><strong>Evidence synthesis: </strong>Four studies met the inclusion criteria, with a combined total of 1427 patients across the trials. Meta-analysis of the primary endpoints across these studies demonstrated a benefit with early intervention (HR=0.50, 95% CI: 0.35-0.73). However, we did not find mortality and cardiac mortality to show significant reductions (HR=0.68, 95% CI: 0.40-1.18 and HR=0.66, 95% CI: 0.33-1.29, respectively). Crucially, stroke outcomes were improved with early intervention (HR=0.60, 95% CI: 0.38-0.95), as were unplanned hospitalizations (HR=0.40, 95% CI: 0.30-0.53).</p><p><strong>Conclusions: </strong>These findings confirm the safety of early intervention and suggest a reduction in stroke incidence, although no significant benefits were observed in overall or cardiac mortality; results which can help to guide shared decision-making with patients and prevent adverse health outcomes.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Mass Index and outcomes following transcatheter aortic valve replacement: going beyond customs.","authors":"Andrea Marrone, Alfonso Ielasi","doi":"10.23736/S2724-5683.25.06844-9","DOIUrl":"10.23736/S2724-5683.25.06844-9","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"467-470"},"PeriodicalIF":1.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}