Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2023-002591
Sara Jonsson, Inger Sundström-Poromaa, Bengt Johansson, Jenny Alenius Dahlqvist, Christina Christersson, Mikael Dellborg, Alexandra Trzebiatowska-Krzynska, Peder Sörensson, Ulf Thilén, Anna-Karin Wikström, Annika Bay
{"title":"Time to childbirth and assisted reproductive treatment in women with congenital heart disease","authors":"Sara Jonsson, Inger Sundström-Poromaa, Bengt Johansson, Jenny Alenius Dahlqvist, Christina Christersson, Mikael Dellborg, Alexandra Trzebiatowska-Krzynska, Peder Sörensson, Ulf Thilén, Anna-Karin Wikström, Annika Bay","doi":"10.1136/openhrt-2023-002591","DOIUrl":"https://doi.org/10.1136/openhrt-2023-002591","url":null,"abstract":"Objective To investigate the time to first childbirth and to compare the prevalence of assisted reproductive treatment (ART) in women with congenital heart disease (CHD) compared with women without CHD. Methods All women in the national register for CHD who had a registered first childbirth in the Swedish Pregnancy Register between 2014 and 2019 were identified. These individuals (cases) were matched by birth year and municipality to women without CHD (controls) in a 1:5 ratio. The time from the 18th birthday to the first childbirth and the prevalence of ART was compared between cases and controls. Results 830 first childbirths in cases were identified and compared with 4137 controls. Cases were slightly older at the time for first childbirth (28.9 vs 28.5 years, p=0.04) and ART was more common (6.1% vs 4.0%, p<0.01) compared with controls. There were no differences in ART when stratifying for the complexity of CHD. For all women, higher age was associated with ART treatment (OR 1.24, 95% CI 1.20 to 1.28). Conclusions Women with and without CHD who gave birth to a first child did so at similar ages. ART was more common in women with CHD, but disease severity did not influence the need for ART. Age was an important risk factor for ART also in women with CHD and should be considered in consultations with these patients. Data are available upon reasonable request.","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"1 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140129947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2024-002620
Sameer Kurmani, Bhavik Modi, Aditya Mukherjee, David Adlam, Amerjeet Banning, Andrew Ladwiniec, Raj Rajendra, Julia Baron, Elved Roberts, Andre Ng, Iain Squire, Gerald McCann, Nilesh J Samani, Jan Kovac
{"title":"Coronary artery disease and outcomes following transcatheter aortic valve implantation","authors":"Sameer Kurmani, Bhavik Modi, Aditya Mukherjee, David Adlam, Amerjeet Banning, Andrew Ladwiniec, Raj Rajendra, Julia Baron, Elved Roberts, Andre Ng, Iain Squire, Gerald McCann, Nilesh J Samani, Jan Kovac","doi":"10.1136/openhrt-2024-002620","DOIUrl":"https://doi.org/10.1136/openhrt-2024-002620","url":null,"abstract":"Background Aortic stenosis is a life-limiting condition for which transcatheter aortic valve implantation (TAVI) is an established therapy. Coronary artery disease (CAD) is frequently found in this patient group and optimal management in these patients remains uncertain. Objectives We sought to examine the association of coexistent CAD on mortality and hospital readmission in patients undergoing TAVI. Methods In this observational cohort study, we examined patients who underwent TAVI and segregated them by the presence of obstructive epicardial CAD. The primary outcome was 3-year mortality with secondary outcomes being readmission for (1) all-causes, (2) a MACE (Major Adverse Cardiovascular Event) composite endpoint and (3) acute coronary syndrome. Subsidiary outcomes included patient angina and breathlessness scores. Results 898 patients underwent TAVI, of which 488 (54.3%) had unobstructed coronary arteries and 410 (45.7%) had obstructive CAD. Overall, n=298 (33.2%) patients experienced the primary mortality endpoint with no significant difference when stratified according to CAD (n=160 (32.9%) vs n=136 (33.2%), HR 0.98, CI 0.78 to 1.24). After multivariate analysis, the presence of CAD had no effect on the primary outcome (HR 0.98, CI 0.68 to 1.40). There was no significant difference in readmission for any cause (n=181, 37.1% (CAD) vs n=169, 41.2% (no CAD), p=0.23), including no significant difference on readmission for MACE (n=48, 9.8% (CAD) vs n=45, 11.0% (no CAD), p=0.11). CAD at the time of TAVI also did not alter breathlessness or angina scores before/after TAVI (p>0.05). Conclusion Coexistent CAD had no significant association with mortality, any-cause readmission or symptoms for patients undergoing TAVI in our cohort. Data are available upon reasonable request. Data Sharing Statement: The data is stored on an NHS database within the University Hospitals of Leicester and contains patient-identifiable information. Access may be granted upon reasonable request through [fermeen.admani@uhl-tr.nhs.uk][1]. [1]: http://fermeen.admani@uhl-tr.nhs.uk","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"34 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140325191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2024-002641
Michelle Lobeek, Melissa E Middeldorp, Isabelle C Van Gelder, Michiel Rienstra
{"title":"Multimorbidity in patients with atrial fibrillation","authors":"Michelle Lobeek, Melissa E Middeldorp, Isabelle C Van Gelder, Michiel Rienstra","doi":"10.1136/openhrt-2024-002641","DOIUrl":"https://doi.org/10.1136/openhrt-2024-002641","url":null,"abstract":"There is an escalating trend in both the incidence and prevalence of atrial fibrillation (AF). AF is linked to numerous other comorbidities, contributing to the emergence of multimorbidity. The sustained rise in multimorbidity and AF prevalences exerts a significant strain on healthcare systems globally. The understanding of the relation between multimorbidity and AF is essential to determine effective healthcare strategies, improve patient outcomes to adequately address the burden of AF. It not only begins with the accurate identification of comorbidities in the setting of AF. There is also the need to understand the pathophysiology of the different comorbidities and their common interactions, and how multimorbidity influences AF perpetuation. To manage the challenges that rise from the increasing incidence and prevalence of both multimorbidity and AF, such as adverse events and hospitalisations, the treatment of comorbidities in AF has already gained importance and will need to be a primary focus in the forthcoming years. There are numerous challenges to overcome in the treatment of multimorbidity in AF, whereby the identification of comorbidities is essential. Integrated care strategies focused on a comprehensive multimorbidity management with an individual-centred approach need to be determined to improve healthcare strategies and reduce the AF-related risk of frailty, cardiovascular diseases and improve patient outcomes. No data are available.","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140168839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2023-002544
Juliane Frydenlund, Jan Brink Valentin, Marie Norredam, Lars Frost, Sam Riahi, Kristian Hay Kragholm, Henrik Bøggild, Gregory Y H Lip, Søren Paaske Johnsen
{"title":"Oral anticoagulation therapy initiation in patients with atrial fibrillation in relation to world region of origin: a register-based nationwide study","authors":"Juliane Frydenlund, Jan Brink Valentin, Marie Norredam, Lars Frost, Sam Riahi, Kristian Hay Kragholm, Henrik Bøggild, Gregory Y H Lip, Søren Paaske Johnsen","doi":"10.1136/openhrt-2023-002544","DOIUrl":"https://doi.org/10.1136/openhrt-2023-002544","url":null,"abstract":"Background Atrial fibrillation (AF) is the most common sustained arrhythmia and results in a high risk of stroke. The number of immigrants is increasing globally, but little is known about potential differences in AF care across migrant populations. Aim To investigate if initiation of oral anticoagulation therapy (OAC) differs for patients with incident AF in relation to country of origin. Methods A nationwide register-based study covering 1999–2017. AF was defined as a first-time diagnosis of AF and a high risk of stroke. Stroke risk was defined according to guidelines from the European Society of Cardiology (ESC). Poisson regression adjusted for sex, age, socioeconomic position and comorbidity was made to compute incidence rate ratios (IRR) for initiation of OAC. Results The AF population included 254 586 individuals of Danish origin, 6673 of Western origin and 3757 of non-Western origin. Overall, OAC was initiated within −30/+90 days relative to the AF diagnosis in 50.3% of individuals of Danish origin initiated OAC, 49.6% of Western origin and 44.5% of non-Western origin. Immigrants from non-Western countries had significantly lower adjusted IRR of initiating OAC according to all ESC guidelines compared with patients of Danish origin. The adjusted IRRs ranged from 0.73 (95% CI: 0.66 to 0.80) following the launch of the 2010 ESC guideline to 0.89 (95% CI: 0.82 to 0.97) following the launch of the 2001 ESC guideline. Conclusion Patients with AF with a high risk of stroke of non-Western origin have persistently experienced a lower chance of initiating OAC compared with patients of Danish origin during the last decades. Data are available upon reasonable request. The data are available from Statistics Denmark, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Statistics Denmark.","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"24 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140324932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2023-002555
Astrid Fritz Hansson, Angelo Modica, Henrik Renlund, Christina Christersson, Claes Held, Gorav Batra
{"title":"Major bleeding in patients with atrial fibrillation treated with apixaban versus warfarin in combination with amiodarone: nationwide cohort study.","authors":"Astrid Fritz Hansson, Angelo Modica, Henrik Renlund, Christina Christersson, Claes Held, Gorav Batra","doi":"10.1136/openhrt-2023-002555","DOIUrl":"10.1136/openhrt-2023-002555","url":null,"abstract":"<p><strong>Background: </strong>Amiodarone is an established treatment for atrial fibrillation (AF) but might interfere with the metabolism of apixaban or warfarin. Therefore, the aim was to investigate the occurrence of major bleeding among patients with AF treated with amiodarone in combination with apixaban or warfarin.</p><p><strong>Methods: </strong>Retrospective observational study using Swedish health registers. All patients with AF in the National Patient Register and the National Dispensed Drug Register with concomitant use of amiodarone and warfarin or apixaban between 1 June 2013 and 31 December 2018 were included. Propensity score matching was performed, and matched cohorts were compared using Cox proportional HRs. The primary outcome was major bleeding resulting in hospitalisation based on International Classification of Diseases (ICD)-10 codes. Secondary outcomes included intracranial bleeding, gastrointestinal bleeding and other bleeding. Exploratory outcomes included ischaemic stroke/systemic embolism and all-cause/cardiovascular (CV) mortality.</p><p><strong>Results: </strong>A total of 12 103 patients met the inclusion criteria and 8686 patients were included after propensity score matching. Rates of major bleeding were similar in the apixaban (4.3/100 patient-years) and warfarin cohort (4.5/100 patient-years) (HR: 1.03; 95% CI: 0.76 to 1.39) during median follow-up of 4.4 months. Similar findings were observed for secondary outcomes including gastrointestinal bleeding and other bleeding, and exploratory outcomes including ischaemic stroke/systemic embolism and all-cause/CV mortality.</p><p><strong>Conclusions: </strong>Among patients treated with amiodarone in combination with apixaban or warfarin, major bleeding and thromboembolic events were rare and with no significant difference between the treatment groups.</p><p><strong>Eupas registry number: </strong>EUPAS43681.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2024-002607
Liam Steven Couch, James W Garrard, John A Henry, Rafail A Kotronias, Bashir Alaour, Giovanni Luigi De Maria, Keith M Channon, Adrian P Banning, Alexander Richard Lyon, Michael Marber, Thomas Edward Kaier
{"title":"Comparison of troponin and natriuretic peptides in Takotsubo syndrome and acute coronary syndrome: a meta-analysis","authors":"Liam Steven Couch, James W Garrard, John A Henry, Rafail A Kotronias, Bashir Alaour, Giovanni Luigi De Maria, Keith M Channon, Adrian P Banning, Alexander Richard Lyon, Michael Marber, Thomas Edward Kaier","doi":"10.1136/openhrt-2024-002607","DOIUrl":"https://doi.org/10.1136/openhrt-2024-002607","url":null,"abstract":"Objective Takotsubo syndrome (TTS) is an acute heart failure syndrome which resembles acute coronary syndrome (ACS) at presentation. Differentiation requires coronary angiography, but where this does not occur immediately, cardiac biomarkers may provide additional utility. We performed a meta-analysis to compare troponin and natriuretic peptides (NPs) in TTS and ACS to determine if differences in biomarker profile can aid diagnosis. Methods We searched five literature databases for studies reporting NPs (Brain NP (BNP)/NT-pro-BNP) or troponin I/T in TTS and ACS, identifying 28 studies for troponin/NPs (5618 and 1145 patients, respectively). Results Troponin was significantly lower in TTS than ACS (standardised mean difference (SMD) −0.86; 95% CI, −1.08 to −0.64; p<0.00001), with an absolute difference of 75 times the upper limit of normal (×ULN) higher in ACS than TTS. Conversely, NPs were significantly higher in TTS (SMD 0.62; 95% CI, 0.44 to 0.80; p<0.00001) and 5.8×ULN greater absolutely. Area under the curve (AUC) for troponin in ACS versus TTS was 0.82 (95% CI, 0.70 to 0.93), and 0.92 (95% CI, 0.80 to 1.00) for ST-segment elevation myocardial infarction versus TTS. For NPs, AUC was 0.69 (95% CI, 0.48 to 0.89). Combination of troponin and NPs with logistic regression did not improve AUC. Recursive Partitioning and Regression Tree analysis calculated a troponin threshold ≥26×ULN that identified 95% cases as ACS where and specificity for ACS were 85.71% and 53.57%, respectively, with 94.32% positive predictive value and 29.40% negative predictive value. Conclusions Troponin is lower and NPs higher in TTS versus ACS. Troponin had greater power than NPs at discriminating TTS and ACS, and with troponin ≥26×ULN patients are far more likely to have ACS. Data are available upon reasonable request.","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"52 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140168771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2023-002535
Linsay McCallum, Stefanie Lip, Maggie Rostron, Rebecca Hanna, Nukman Bin Pg Md Salimin, Sarah Nichol, Sandosh Padmanabhan
{"title":"OPTIMA-BP: empOwering PaTients in MAnaging Blood Pressure - protocol for a randomised parallel group study comparing use of Kvatchii web-based patient education portal as an addition to home blood pressure monitoring.","authors":"Linsay McCallum, Stefanie Lip, Maggie Rostron, Rebecca Hanna, Nukman Bin Pg Md Salimin, Sarah Nichol, Sandosh Padmanabhan","doi":"10.1136/openhrt-2023-002535","DOIUrl":"10.1136/openhrt-2023-002535","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is the leading modifiable risk factor for cardiovascular disease and is implicated in half of all strokes and myocardial infarctions. One-third of the adults in Scotland have hypertension yet only a quarter of them have their blood pressure (BP) controlled to target (<140/90 mm Hg). Empowering patients to have a better understanding of their condition and becoming actively involved in the monitoring and management of hypertension may lead to improved patient satisfaction, improved BP control and health outcomes and reduction in the use of primary/secondary care hypertension clinics.</p><p><strong>Methods and analysis: </strong>OPTIMA-BP is a randomised parallel group pilot study comparing the use of home BP monitoring accompanied by access to the web-based cardiovascular educational portal (Kvatchii) and home BP monitoring (HBPM) alone in 200 patients with hypertension attending the Glasgow Blood Pressure Clinic, Queen Elizabeth University Hospital, Glasgow. Consented participants will be asked to complete surveys on lifestyle factors, medication adherence, quality of life and hypertension knowledge, understanding and home monitoring. The intervention group will be asked to complete a survey to help evaluate the Kvatchii portal. At 6 and 12 months, the surveys will be repeated via the CASTOR EDC. Both groups will input their HBPM results at 2-month intervals into a CASTOR-EDC survey. OPTIMA-BP will follow-up with participants over 12 months with the study running over 24 months. The primary outcome is HBPM systolic BP area under the curve between baseline and 6 months ETHICS AND DISSEMINATION: OPTIMA-BP was approved by the North of Scotland Research Ethics Committee 2 (22/NS/0095). Current protocol version 1.2 date 6 June 2023. Written informed consent will be provided by all study participants. Study findings will be submitted to international peer-reviewed journals and will be presented at national and international scientific meetings.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov: NCT05575453. Registered 12 October 2022. https://clinicaltrials.gov/ct2/show/NCT05575453.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-03-01DOI: 10.1136/openhrt-2023-002397
Shruti Hegde, Mina Shnoda, Yasser Alkhadra, Adhiraj Bhattacharya, Maria Nikolaeva, Michael Maysky
{"title":"Prevalence of abnormal left ventricular global longitudinal strain by speckle tracking echocardiography and its prognostic value in patients with COVID-19","authors":"Shruti Hegde, Mina Shnoda, Yasser Alkhadra, Adhiraj Bhattacharya, Maria Nikolaeva, Michael Maysky","doi":"10.1136/openhrt-2023-002397","DOIUrl":"https://doi.org/10.1136/openhrt-2023-002397","url":null,"abstract":"Importance Although cardiac injury is a known complication of COVID-19 infection, there is no established tool to predict cardiac involvement and in-hospital mortality in this patient population. Objective To assess if left ventricular global longitudinal strain (LV-GLS) can detect cardiac involvement and be used as a risk-stratifying parameter for hospitalised patients with COVID-19. Main outcomes and measures In-hospital mortality. Results We found a statistically significant association between LV-GLS and in-hospital mortality (adjusted OR (aOR)=1.09; 95% CI 1.0 to 1.19, p=0.050). Furthermore, right ventricular fractional area change was significantly associated with in-hospital mortality (aOR=1.04; 95% CI 1.0 to 1.08, p=0.043). Troponin level had no statistically significant association with in-hospital mortality (aOR=3.43; 95% CI 0.78 to 15.03, p=0.101). Conclusion and relevance LV-GLS can be a useful parameter for cardiovascular risk assessment in hospitalised patients with COVID-19 infection. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"2020 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140126918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Midterm outcomes of transcatheter aortic valve replacement in patients with active cancer.","authors":"Masahiko Noguchi, Minoru Tabata, Joji Ito, Nahoko Kato, Kotaro Obunai, Hiroyuki Watanabe, Fumiaki Yashima, Yusuke Watanabe, Toru Naganuma, Masahiro Yamawaki, Futoshi Yamanaka, Shinichi Shirai, Hiroshi Ueno, Norio Tada, Masanori Yamamoto, Kentaro Hayashida","doi":"10.1136/openhrt-2023-002573","DOIUrl":"10.1136/openhrt-2023-002573","url":null,"abstract":"<p><strong>Objectives: </strong>The clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) and concomitant active cancer remain insufficiently explored. This study aimed to assess the midterm outcomes of TAVR in patients diagnosed with AS and active cancer.</p><p><strong>Methods: </strong>Data from the OCEAN-TAVI, a prospective Japanese registry of TAVR procedures, was analysed to compare prognoses and clinical outcomes in patients with and without active cancer at the time of TAVR.</p><p><strong>Results: </strong>Of the 2336 patients who underwent TAVR from October 2013 to July 2017, 89 patients (3.8%) had active cancer, whereas 2247 did not. Among patients with active cancer, 49 had limited-stage cancer (stage 1 or 2). The prevalent cancers identified before TAVR were colon (21%), prostate (18%), lung (15%), liver (11%) and breast (9%). Although the periprocedural complications and 30-day mortality rates were comparable between the groups, the 3-year survival rate after TAVR was notably lower in patients with active cancer (64.7%) than in those without active cancer (74.7%; p=0.016). Nevertheless, the 3-year survival rate of patients with limited-stage cancer (stage 1 or 2) did not significantly differ from those without cancer (70.6% vs 74.7%, p=0.50).</p><p><strong>Conclusions: </strong>The patients with active cancer exhibited significantly reduced midterm survival rates. However, no distinct disparity existed in those with limited-stage cancer (stage 1 or 2). Although TAVR is a viable treatment in patients with AS with active cancer, the type and stage of cancer and prognosis should be carefully weighed in the decision-making process.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10900309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Open HeartPub Date : 2024-02-08DOI: 10.1136/openhrt-2023-002465corr1
{"title":"Correction: <i>Contemporary use and outcome of Cabrol shunt in type A aortic dissection surgery: insight from China 5A study</i>.","authors":"","doi":"10.1136/openhrt-2023-002465corr1","DOIUrl":"10.1136/openhrt-2023-002465corr1","url":null,"abstract":"","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"11 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11145635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139707481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}