Minerva cardiology and angiology最新文献

{"title":"Comparison of clinical characteristics and prognostic factors in patients with heart failure with preserved ejection fraction with and without renal dysfunction.","authors":"Kenichi Matsushita, Kazumasa Harada, Takashi Kohno, Hiroki Nakano, Daisuke Kitano, Junya Matsuda, Hideaki Yoshino, Takeshi Yamamoto, Ken Nagao, Morimasa Takayama","doi":"10.23736/S2724-5683.24.06510-4","DOIUrl":"10.23736/S2724-5683.24.06510-4","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) with renal dysfunction (RD) is considered to be a specific phenotype of HFpEF. This study aimed to compare the clinical characteristics and prognostic factors for in-hospital mortality between HFpEF-diagnosed patients with and without RD.</p><p><strong>Methods: </strong>This multicenter retrospective study included 5867 consecutive patients with acute HFpEF. RD was defined by an estimated glomerular filtration rate (eGFR) of <60 mL/min per 1.73 m². Kaplan-Meier survival curves and log-rank tests were used to compare the in-hospital mortality between the groups. Univariable and multivariable Cox regression analyses were performed to identify significant prognostic factors.</p><p><strong>Results: </strong>Across the study cohort, 68% of patients had RD. In-hospital mortality was significantly higher in HFpEF patients with RD than in those without RD. The comorbidities and laboratory data differed significantly between the groups. Independent prognostic factors for in-hospital mortality in the HFpEF patients with RD were age (hazard ratio [HR], 1.039), systolic blood pressure (HR, 0.991), eGFR (HR, 0.981), C-reactive protein (CRP; HR, 1.028), diuretics (HR, 0.374), angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACE-I/ARBs; HR, 0.680), and beta-blockers (HR, 0.662). In HFpEF patients without RD, age (HR, 1.039), systolic blood pressure (HR, 0.979), and ACE-I/ARBs (HR, 0.373) were independent prognostic factors.</p><p><strong>Conclusions: </strong>Significant differences in the clinical characteristics and prognostic factors, such as CRP and beta-blockers, were observed between the HFpEF patients with and without RD. These results have implications for future research and may help guide individualized patient management strategies.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"615-624"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088104","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":"Impacts of aspirin use on the prognosis of patients with myocardial infarction and pneumonia.","authors":"Jialun Ye, Jieqiong Chen, Sheng Chen","doi":"10.23736/S2724-5683.24.06467-6","DOIUrl":"10.23736/S2724-5683.24.06467-6","url":null,"abstract":"<p><strong>Background: </strong>We aimed to explore the impact of aspirin use on the risk of readmission and mortality in patients with myocardial infarction and pneumonia.</p><p><strong>Methods: </strong>This was a cohort study including 703 participants with severe pneumonia and myocardial infarction included in the Medical Information Mart for Intensive Care (MIMIC)-III and the MIMIC-IV. Kaplan-Meier survival analysis was used to show the readmission and survival probability of patients with or without aspirin. In addition, univariate and multivariable models were used to investigate the impact of aspirin on the risk of readmission or mortality of patients. Subgroup analyses were conducted in terms of age, gender, antibiotic use, vancomycin and ampicillin use.</p><p><strong>Results: </strong>Average follow-up was one year, 22% of patients experienced readmission, and 72% patients survived. After the confounders were adjusted for, a 0.46-fold decreased risk of readmission (hazard ratio [HR]=0.46, 95% confidence interval [CI]: 0.27-0.78) and a 0.58-fold decreased risk of one-year mortality (HR=0.56, 95%CI: 0.42-0.82) were observed favoring aspirin use. Subgroup analyses revealed that aspirin was, however, associated with an increased risk of mortality in patients not receiving vancomycin treatment (HR=1.79, 95%CI: 1.08-2.97).</p><p><strong>Conclusions: </strong>Our findings suggest that clinicians should consider using aspirin in patients with severe myocardial infarction and pneumonia was recommended.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":"607-614"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158038","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":"Clinical implications of residual shunt after patent foramen ovale closure.","authors":"Loredana Iannetta, Patrizia Presbitero, Eustaquio M Onorato, Fabio Ferrari, Bindo Missiroli","doi":"10.23736/S2724-5683.24.06456-1","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06456-1","url":null,"abstract":"<p><p>Residual shunt (RS) after percutaneous patent foramen ovale (PFO) closure has classically been a question of debate for controversial results about its association with increased risk of recurrent ischemic events. Different underlying processes of neural tissue injury have to be taken into account evaluating clinical impact of residual shunt after PFO closure: clotting mechanisms and non-clotting, vasoactive or oxidative mechanisms. Some biochemical studies demonstrated the importance of effective PFO closure aimed to obtain significant reduction of several molecules involved in PFO related strokes. Blood levels of serotonin and homocysteine seem to significantly decrease after percutaneous procedures. A recent study on a pro-thrombotic phenotype of migraineurs with aura and PFO demonstrated that PFO closure reduce activated platelets and thrombin at the value of healthy subjects, underlining the importance of the correct sealing of the defect. The aim of this review is to examine currently available literature studies. Different and discordant results have been obtained due to heterogeneity of study population, instrumental assessment of RS and follow-up methods and length. In the 2021 American Guidelines for the prevention of stroke, RS was definitely considered a predictor of recurrence of ischemic events. Management of this subset of patients is still an unresolved issue and more studies are encouraged.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750196","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":"Inflammation-related markers in COVID-19 infection and ST-segment elevation myocardial infarction.","authors":"Nart Z Baytuğan, Hasan C Kandemir, Aziz I Çelik, Tahir Bezgin","doi":"10.23736/S2724-5683.24.06639-0","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06639-0","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to investigate the association between inflammation-related markers in COVID-19 infection and ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>We conducted an observational, single-center, retrospective study between January 2020 and November 2022. A total of 149 patients aged between 34 and 90 years, 28.2% (N.=42) female and 71.8% (N.=107) male, were included in the study. Systemic immune-inflammation index (SII), systemic inflammation-response indexes (SIRI), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were calculated for each patient. The patients were divided into two groups based on their presence or absence of a confirmed SARS-CoV-2 infection.</p><p><strong>Results: </strong>During the in-hospital follow-up, mortality occurred in 12% (N.=20) of patients. Among the COVID-19 (+) and STEMI group, the mortality rate was 24.3% (N.=10), while it was 5.6% (N.=6) in the COVID-19 (-) and STEMI group (P=0.001). In multivariate logistic regression analysis, SII ([HR] = 7.198 [1.423-36.411], P=0.017) and PLR ([HR] = 5.762 [1.783-18.619], P=0.003) remained significant risk factor for mortality.</p><p><strong>Conclusions: </strong>The SII, SIRI, NLR, and PLR are relatively new, simple, and effective inflammation-related markers that determine mortality risk in STEMI patients.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750666","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":"Operator-dependent and operator-independent contrast media minimization strategies to prevent acute kidney injury after percutaneous coronary intervention.","authors":"Luca Paolucci, Valeria Cavaliere, Francesca DE Micco, Mario Scarpelli, Amelia Focaccio, Cristina Quintavalle, Carlo Briguori","doi":"10.23736/S2724-5683.24.06642-0","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06642-0","url":null,"abstract":"<p><p>Contrast associated acute kidney injury (CA-AKI) is a major complication of contrast media (CM) exposure following percutaneous coronary intervention (PCI), associated with high rates of morbidity and mortality in both early and late phases. During the past years, several CA-AKI prevention strategies based on CM sparing have been proposed, which differ significantly in terms of methodological features and efficacy. In this review, we propose a new classification of these techniques based on their dependency on operators' management. Following, we summarize current evidence on the effectiveness in terms of CA-AKI reduction of each one of the currently available operator-dependent and -independent CM minimization strategies.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750939","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 and renal benefits of sodium-glucose cotransporter-2 inhibitors: pathophysiologic mechanisms and clinical evidence.","authors":"Andre M Small, Stephen D Wiviott","doi":"10.23736/S2724-5683.24.06600-6","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06600-6","url":null,"abstract":"<p><p>Large-scale clinical outcome trials have demonstrated significant reductions in cardiovascular (CV) and renal outcomes with sodium-glucose cotransporter-2 inhibitors (SGLT2i). These benefits are sustained in patients with a range of left ventricular ejection fractions (LVEF), irrespective of diabetes status, and in a variety of clinical settings, prompting incorporation into clinical practice guidelines for patients with chronic kidney disease (CKD), heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD). The clinical benefits are mediated by an interplay of cardio-metabolic-renal mechanisms, and they have a favorable safety profile. We provide a review of the proposed mechanisms of cardiorenal protection and the evidence supporting the clinical benefits of SGLT2i in CKD, acute and chronic HF treatment and prevention , and ASCVD, highlighting the uses of SGLT2i in clinical practice guidelines.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676008","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":"Cardiac contractility modulation: from molecular patterns to tailored treatment in heart failure subgroups.","authors":"Nicola Pierucci, Andrea D'Amato, Francesca Fanisio, Raffaele M Bruti, Marco V Mariani, Silvia Prosperi, Aurora Labbro Francia, Domenico Filomena, Sara Trivigno, Vincenzo M LA Fazia, Agostino Piro, Roberto Badagliacca, Cristina Chimenti, Paolo Severino, Carlo Lavalle","doi":"10.23736/S2724-5683.24.06593-1","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06593-1","url":null,"abstract":"<p><p>Cardiac contractility modulation (CCM) signals are non-excitatory signals that are applied during the myocyte's absolute refractory period. These signals have been demonstrated to have an inotropic effect without increasing myocardial oxygen consumption. This has been observed in both preclinical animal studies and randomized clinical trials. CCM influences the expression of various genes that are abnormally expressed in heart failure: it reverses fetal myocyte gene programming associated with heart failure and regulates the expression of genes associated with calcium cycling and myocardial contractile machinery. Clinical investigations have primarily focused on patients with heart failure and normal QRS duration where CCM has demonstrated its safety and effectiveness in reducing heart failure-related hospitalizations, as well as improving symptoms, functional capacity, and overall quality of life. Currently, for individuals experiencing symptomatic heart failure with an ejection fraction ranging from 25% to 45% and a QRS duration of less than 130 ms, who are not suitable candidates for cardiac resynchronization therapy, CCM offers a viable treatment option. Even though promising results in specific HF subgroups have been published, further studies are needed to understand the role of CCM in tailored treatment for heart failure. Moreover, the role of multimodality imaging in lead placement and prognostic stratification in CCM patients should be further investigated. This review aims to summarize the main pathophysiological evidence related to the use of CCM and to highlight its role as a possible additional weapon in tailored treatment for specific subgroups of patients with heart failure.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676343","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":"Overexpression of long non-coding RNA cytoskeleton regulator RNA in patients with acute myocardial infarction with arrhythmia.","authors":"Huijun Ma, Fujing Tian, Dan Wang, Lili Fan, Lijie Wang, Jiawei Chen, Lu Song","doi":"10.23736/S2724-5683.24.06625-0","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06625-0","url":null,"abstract":"<p><strong>Background: </strong>Complications of arrhythmia often occur in patients with acute myocardial infarction (AMI). This study mainly explored the expression and diagnostic significance of long non-coding RNA CYTOR (lncRNA CYTOR) in patients with AMI with arrhythmia, and analyzed the effects of CYTOR on inflammation and oxidative stress responses of cardiomyocytes.</p><p><strong>Methods: </strong>CYTOR expression in serum samples from 119 cases of AMI with arrhythmia and 119 healthy subjects was determined by qRT-PCR. Receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic function of serum CYTOR in AMI with arrhythmia. AMI cell models were constructed by hypoxia/reoxygenation treatment. The pathological function of CYTOR in AMI was determined by the detection of inflammatory factors and oxidative stress indicators.</p><p><strong>Results: </strong>Serum CYTOR was upregulated in patients with AMI with arrhythmia, which has a certain ability to distinguish patients from healthy individuals (P<0.001, AUC=0.8963). The levels of interleukin-1beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and malondialdehyde (MDA) were increased in the AMI cell model, while superoxide dismutase (SOD) levels were decreased (P<0.001), which was alleviated by silencing CYTOR.</p><p><strong>Conclusions: </strong>Overexpression of CYTOR may aggravate the condition of AMI patients with arrhythmia, which promotes oxidative stress injury and inflammatory response of cardiomyocytes. CYTOR can be a reference factor for diagnostic biomarkers of AMI with arrhythmia.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676043","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":"Discovery of five diagnostic biomarkers associated with immune cell infiltration in cases of acute myocardial infarction.","authors":"Qiushi Suo, Pengfei Li, Zhiping Liu, Chuncheng Qu, Hanbing Song","doi":"10.23736/S2724-5683.24.06542-6","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06542-6","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) remains one of the leading causes of mortality and morbidity worldwide.</p><p><strong>Methods: </strong>GSE61144 and GSE66360 were the sources of microarray gene expression profiles for acute myocardial infarction patients and were acquired from the Gene Expression Omnibus (GEO) database (https://www.ncbi.nlm.nih.gov/geo/). After merging the datasets, genes that were differentially expressed were chosen.</p><p><strong>Results: </strong>A total of 234 genes were found to have different expression levels. Of these, 206 genes were upregulated, and 28 genes were downregulated. Five coexpression modules were identified by WGCNA, with the yellow module showing a high correlation with AMI (r=0.65, P=2.0e-15). Ninety-two hub genes were selected in the yellow module by setting a threshold of module membership (MM) greater than 0.8 and gene significance (GS) higher than 0.4. By overlapping these genes with the differentially expressed genes, 81 hub genes were obtained. Five key genes (C5AR1, CXCL1, CXCL2, FPR1, and P2RY13) were identified through PPI analysis. AMI patients exhibited elevated levels of immune cell infiltration, and immune scores in AMI samples were significantly positively correlated with all five key genes. Moreover, the expression levels of these five genes were higher in AMI patients. These five genes possessed area under the curve (AUC) values exceeding 0.8 for diagnosing AMI, thereby demonstrating their efficacy as diagnostic markers.</p><p><strong>Conclusions: </strong>C5AR1, CXCL1, CXCL2, FPR1, and P2RY13 have the potential to be useful biomarkers in diagnosing AMI and are linked to immune cell infiltration in AMI, opening up new avenues for future research into the pathogenesis of AMI.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566360","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":"Role of polypill in cardiovascular prevention and treatment.","authors":"Leonardo DE Luca, Simone P Crispino, Federico Andreoli, Stefania A DI Fusco, Alfonso Pannone, Annunziata Nusca, Furio Colivicchi, Francesco Grigioni, Domenico Gabrielli","doi":"10.23736/S2724-5683.24.06561-X","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06561-X","url":null,"abstract":"<p><p>Cardiovascular diseases (CVD) remain the leading cause of mortality globally and require innovative strategies for effective prevention and treatment. The polypill concept, which integrates multiple cardioprotective agents into a single dosage form, has emerged as a promising approach to improve adherence and simplify the management of cardiovascular risk factors. We review clinical trials and observational studies evaluating the impact of the polypill on reducing the incidence of major cardiovascular events (MACEs), its influence on medication adherence, and its potential to fill treatment gaps in diverse populations. Also of note are the pharmacoeconomic implications of the widespread use of the polypill, particularly in low- and middle-income countries where the burden of cardiovascular disease is increasing. Although the polypill demonstrates a favorable profile in improving therapeutic compliance and reducing cardiovascular risk factors, debates persist regarding its efficacy compared to individualized treatment regimens. This review summarizes the current evidence on the efficacy, safety, and cost-effectiveness of the polypill in CVD primary and secondary prevention. Furthermore, potential challenges in implementing the polypill strategy include tailoring the components to patient-specific risk profiles and the need for robust evidence from large-scale randomized controlled trials to substantiate its long-term benefits.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391820","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}