Open Heart最新文献

{"title":"Effect of sodium-glucose cotransporter 2 inhibitors on ventricular function in systemic right ventricular failure.","authors":"Ralph Ml Neijenhuis, Madelien V Regeer, Niki L Walker, Bart Ja Mertens, Amanda Hunter, Philippine Kiès, Lorna Swan, Hubert W Vliegen, Simon T MacDonald, Filip Zemrak, Ali N Zaidi, Ari M Cedars, Monique Rm Jongbloed, J Wouter Jukema, Gruschen R Veldtman, Anastasia D Egorova","doi":"10.1136/openhrt-2025-003445","DOIUrl":"10.1136/openhrt-2025-003445","url":null,"abstract":"<p><strong>Background: </strong>Systemic right ventricle (sRV) patients are at an increased risk of developing heart failure. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) could be a valuable treatment option. This study investigated the changes in ventricular function in sRV failure patients in the first year after starting SGLT2i.</p><p><strong>Methods: </strong>Adult sRV patients from the international, real-world ACHIEVE-SGLT2i registry were included if they had a clinical diagnosis of sRV failure, a transthoracic echocardiogram before starting SGLT2i, and at least one in the first year after starting available for analysis. The primary outcomes were changes in sRV global longitudinal strain (GLS) and fractional area change (FAC). Longitudinal changes were evaluated using linear mixed models.</p><p><strong>Results: </strong>Thirty-nine sRV failure patients (46±9.3 years old, 41% female) were included. Twenty-five (64%) had transposition of the great arteries after an atrial switch procedure and 14 (36%) had congenitally corrected transposition. sRV GLS improved significantly in the first 50 days (-1.4%-point per month, p<0.001) and stabilised afterwards (<0.1%-point per month, p=0.520). Though age had a significant overall negative effect on sRV GLS (0.1%-point per year of age, p=0.049), it did not influence the longitudinal changes after starting SGLT2i. sRV FAC also improved in the first 50 days (3.2%-point per month, p=0.002), after which sRV FAC deteriorated in patients with subpulmonary left ventricular pacing (-0.9%-point per month, p=0.012) while it stabilised in patients without pacing (0.1%-point per month, p=0.573). In the first 50 days, tricuspid annular plane systolic excursion also improved significantly in all patients (1.2 mm per month, p=0.006), and stabilised afterwards (p=0.721).</p><p><strong>Conclusions: </strong>SGLT2i therapy is associated with improvements in systolic ventricular function in sRV failure patients. Despite early improvement in sRV FAC, there was a negative longer term correlation with subpulmonary left ventricular pacing, potentially reflecting adverse effects of subpulmonary ventricular pacing on sRV function.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691145","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}

{"title":"Artificial intelligence in coronary angiography: benchmarking the diagnostic accuracy of ChatGPT-4o against interventional cardiologists.","authors":"John Michael Hoppe, Antonia Kellnar, David Esser, Kathrin Diegruber, Christopher Stremmel","doi":"10.1136/openhrt-2025-003316","DOIUrl":"10.1136/openhrt-2025-003316","url":null,"abstract":"<p><strong>Background: </strong>The integration of artificial intelligence (AI) into medical diagnostics has significantly impacted cardiology by enhancing diagnostic precision and therapeutic strategies. Coronary artery disease continues to be a leading cause of global morbidity and mortality, with coronary angiography being the diagnostic gold standard. However, the subjective nature of angiographic interpretation can lead to inconsistent assessment. AI aims to provide automated, objective assessments to mitigate these challenges.</p><p><strong>Methods: </strong>This study evaluated ChatGPT with Generative Pre-trained Transformer (GPT)-4o (OpenAI, USA), for automated coronary angiogram interpretation. Due to its inability to process video data, we extracted maximum contrast frames from diagnostic angiogram views. These anonymised images were analysed by GPT-4o. Its diagnostic findings and stent recommendations were compared with expert cardiologist assessments.</p><p><strong>Results: </strong>We included 100 patients who underwent coronary interventions between January and April 2024. GPT-4o accurately identified coronary vessels in 98% of images. The overall sensitivity for detecting lesions requiring intervention was 71.6%, with a specificity of 57.2% (F1 score 0.652). Performance varied by vessel with best results for left anterior descending artery (sensitivity 81.0%; specificity 69.3%) and right coronary artery (sensitivity 86.5%; specificity 61.4%). Identification of the target vessel based solely on imaging was 47%, which improved to 87% with additional clinical information.</p><p><strong>Conclusions: </strong>GPT-4o shows potential as a supportive tool in coronary angiography interpretation. Its diagnostic performance improves significantly when contextual clinical information is included. However, its accuracy based on static images alone remains below the threshold required for reliable diagnostic and therapeutic support. The lack of cine-loop data as an essential element in real-world angiographic interpretation is a key limitation. Future developments should focus on enhancing AI capabilities for analysing complex anatomical structures and integrating dynamic imaging data to augment clinical utility.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675341","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}

{"title":"'Vaccination' against myocardial infarction: the hidden long-term effect of coronary artery bypass grafting.","authors":"Hristo Kirov, Mathias W Pletz, Tulio Caldonazo, Torsten Doenst","doi":"10.1136/openhrt-2025-003163","DOIUrl":"10.1136/openhrt-2025-003163","url":null,"abstract":"","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668039","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}

{"title":"Improved diagnosis of COVID-19 vaccine-associated myocarditis with cardiac scarring identified by cardiac magnetic resonance imaging.","authors":"Josephine Warren, Daryl Cheng, Nigel Crawford, Bryn Jones, Rui Lun Ng, Annette Alafaci, Dion Stub, Philip Lew, Andrew J Taylor","doi":"10.1136/openhrt-2025-003333","DOIUrl":"10.1136/openhrt-2025-003333","url":null,"abstract":"<p><strong>Background: </strong>Myocarditis is a rare but potentially serious complication of COVID-19 vaccination. Cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) imaging can identify cardiac scar, which may improve diagnostic accuracy and prognostication. We sought to define the incidence of long-term LGE post COVID-19 vaccine-associated myocarditis (C-VAM) and to establish the additive role of CMR in the diagnostic workup of this condition.</p><p><strong>Methods: </strong>Patients with Brighton Collaboration Criteria Level 1 (definite) or Level 2 (probable) C-VAM were prospectively recruited from the Surveillance of Adverse Events Following Vaccination In the Community database to undergo CMR at least 6 months after diagnosis. As there were limited patients with access to baseline CMR, prior CMR results were not included in the initial case definition. The presence of LGE at follow-up CMR was then integrated into the diagnostic algorithm, and the reclassification rate (definite vs probable) was calculated.</p><p><strong>Results: </strong>67 patients with C-VAM (mean age 30±13 years, 72% male) underwent CMR evaluation. The median time from vaccination to CMR was 548 (range 398-603) days. 20 patients (30%) had LGE. At diagnosis, nine patients (13%) were classified as definite and 58 (87%) as probable myocarditis. With the integration of CMR-LGE data, 16 patients (28%) were reclassified from probable to definite myocarditis.</p><p><strong>Conclusion: </strong>LGE on CMR occurred in one-third of patients with C-VAM. Without CMR at the time of diagnosis, almost one-third of patients are misclassified as probable rather than definite myocarditis, indicating a diagnostic strategy using echocardiography alone is insufficient.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668038","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}

{"title":"Age-stratified differences in coronary artery plaque phenotypes in women and men with non-obstructive coronary artery disease.","authors":"Caroline Annette Berge Hondros, Silja Hanseth, Margrete Solvik, Eva Kristine Ringdal Pedersen, Ingela Khan, Siren Hovland, Terje Hjalmar Larsen, Mai Tone Lønnebakken","doi":"10.1136/openhrt-2025-003371","DOIUrl":"10.1136/openhrt-2025-003371","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) progression and risk of cardiac events differ between women and men during the lifespan. Accordingly, we aimed to explore the impact of sex and age on plaque phenotype in non-obstructive CAD.</p><p><strong>Method: </strong>We included 1189 patients with non-obstructive CAD (48% women) from the Norwegian Registry of Invasive Cardiology and quantitatively assessed each patient's plaque phenotype by coronary CT angiography. Plaque subtypes included calcified (>350 Hounsfield units [HU]), fibrous (131 to 350 HU), fibrofatty (76 to 130 HU) and necrotic core plaques (-30 to 75 HU). The impact of sex on plaque phenotype was assessed after age stratification (≤50, 51-64 and ≥65 years).</p><p><strong>Results: </strong>Total plaque burden adjusted for vessel volume was higher in middle-aged and older women compared with men (all p<0.05). Women had lower proportions of fibrofatty plaques compared with men across all age groups, while middle-aged and older women had higher proportions of calcified and fibrous plaques compared with men. Middle-aged and older men had higher proportions of necrotic core plaques compared with women (all p<0.05). After adjusting for cardiovascular risk factors, female sex remained independently associated with total plaque burden (β=1.0 [0.5 to 1.5], p<0.001), and younger age and male sex with fibrofatty plaque burden (β=-2.8 [-4.4 to -1.2], p<0.001, and β=-3.8 [-4.9 to -2.8], p<0.001, respectively).</p><p><strong>Conclusion: </strong>In non-obstructive CAD, female sex was associated with a higher total plaque burden, whereas male sex and younger age were associated with a higher proportion of vulnerable fibrofatty plaques. Our results highlight important sex differences in plaque phenotypes among patients with non-obstructive CAD during the lifespan, which may impact risk-stratification.</p><p><strong>Trial registration number: </strong>NCT04009421.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619708","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}

{"title":"Evaluating an alert-based multiparametric algorithm for predicting heart failure hospitalisations in patients with implantable cardioverter-defibrillators: a meta-cohort study.","authors":"Alan Bulava, João De Sousa, Laurence Guédon-Moreau, Morio Shoda, Tobias Timmel, Sally Thompson Hilpert, Antonio D'Onofrio","doi":"10.1136/openhrt-2025-003474","DOIUrl":"10.1136/openhrt-2025-003474","url":null,"abstract":"<p><strong>Background: </strong>The alert-based HeartInsight algorithm predicts risk of worsening heart failure hospitalisations (WHFHs) by evaluating temporal trends of seven physiologic parameters obtained through automatic daily remote monitoring of implantable cardioverter-defibrillators. The aim of the present study was to evaluate the predictive performance of HeartInsight in a larger and more heterogeneous meta-cohort of patients, incorporating newer device generations and including patients managed with the most recent guideline-directed medical therapy (GDMT).</p><p><strong>Methods: </strong>The HeartInsight algorithm was retrospectively applied to data from four clinical trials in which WHFH events were adjudicated by independent external boards and remote monitoring was activated to provide relevant parameter trends. The analysis comprised 1352 patients with New York Heart Association (NYHA) class II/III, and no long-standing atrial fibrillation.</p><p><strong>Results: </strong>During a median follow-up of 599 days, 110 patients (median age 68 years (IQR, 61-75), 75.7% male) had a total of 165 WHFHs. The estimated sensitivity of WHFH prediction, as determined by generalised estimating equations, was 51.5% (95% CI 43.0% to 59.9%). The false alert rate was 0.85 per patient-year, the median alerting time was 34 days (IQR, 16-78) and the specificity was 81.4% (95% CI 80.4 to 82.4%). The results were verified in the multivariable analysis with two adjusting covariates (newer/older device generation and quadruple/other GDMT) and in the univariable analysis of prespecified patient subgroups according to NYHA class, aetiology and sex, showing no significant differences.</p><p><strong>Conclusions: </strong>Study results underscore the robustness of the predictive algorithm in a heterogeneous and contemporarily managed heart failure population.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591893","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}

{"title":"Effectiveness of semaglutide on survival outcomes in patients with type 2 diabetes and chronic kidney disease.","authors":"Takefumi Kishimori, Takao Kato, Atsuyuki Wada, Akira Tani, Ryosuke Yamaji, Jumpei Koike, Yoshihiro Iwasaki, Takehiro Matsumoto, Takafumi Yagi, Masaharu Okada","doi":"10.1136/openhrt-2025-003382","DOIUrl":"10.1136/openhrt-2025-003382","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes (T2D) and chronic kidney disease (CKD) significantly increase the risk of cardiovascular events, including death and heart failure (HF). The FLOW trial demonstrated that semaglutide reduces all-cause death, cardiovascular events and HF risk in patients with T2D and CKD. Since there is a difference in patient characteristics between clinical trials and real-world data, this study aims to investigate the association of semaglutide and all-cause death, acute HF or cardiovascular outcomes in patients with T2D and CKD using the data platform.</p><p><strong>Methods: </strong>This multicentre retrospective observational study using TriNetX, a global healthcare data platform. We identified 1 151 750 patients aged ≥18 years with T2D and CKD diagnosed before 31 December 2020. Among these, 14 511 patients initiated semaglutide and 69 700 initiated sitagliptin between 1 January 2018 and 31 December 2020. After propensity score matching, 13 703 patients were included in each group. The primary outcome was the 3-year incidence of all-cause death. Secondary outcomes included acute HF, acute myocardial infarction and stroke.</p><p><strong>Results: </strong>The 3-year risk of all-cause death in the semaglutide group relative to the sitagliptin group was significantly lower (7.2% (943/13 703) vs 9.5% (1196/13 703); p<0.001; HR, 0.76; 95% CI, 0.70 to 0.83). Similarly, the semaglutide group was less likely to have acute HF (12.1% vs 13.1%; HR, 0.92; 95% CI, 0.86 to 0.98). However, the risks of acute myocardial infarction and stroke in the semaglutide group relative to the sitagliptin group were not significant (9.6% vs 9.5%; HR, 1.01; 95% CI, 0.93 to 1.09 in acute myocardial infarction, and 9.2% vs 9.0%; HR, 1.02; 95% CI, 0.94 to 1.10 in stroke).</p><p><strong>Conclusions: </strong>In patients with T2D and CKD, semaglutide was associated with a lower 3-year risk of all-cause death compared with sitagliptin.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591892","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}

{"title":"Radiomic features of peri-left atrial epicardial adipose tissue and atrial fibrillation recurrence after ablation.","authors":"Yifan Hu, Longzhe Gao, Qiangrong Wang, Jin Chen, Shanshan Jiang, Genqing Zhou, Jiayin Zhang","doi":"10.1136/openhrt-2025-003364","DOIUrl":"10.1136/openhrt-2025-003364","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to establish a prediction model that incorporates the radiomic features of epicardial adipose tissue (EAT) to predict atrial fibrillation (AF) recurrence after ablation.</p><p><strong>Methods: </strong>We prospectively enrolled patients with AF who underwent pulmonary CT venography before ablation therapy at two hospitals (470 patients in the internal cohort and 81 in the external cohort) between June 2018 and December 2019. Stepwise regression was used to identify clinically relevant factors, including quantitative EAT and left atrial (LA)-EAT measurements (model 1). The random forest algorithm was used to select the radiomic features of EAT and LA-EAT. A radiomics model predicting AF recurrence within 1 year after ablation was developed using these features (model 2). Subsequently, logistic regression was used to integrate radiomic features with clinical data (model 3).</p><p><strong>Results: </strong>In total, 551 patients were enrolled (median age: 66 years, IQR: 60-72 years; 340 men), with 145 experiencing AF recurrence within 1 year. Model 2, based on LA-EAT radiomic features, demonstrated significantly better performance than model 1 (clinical predictive factors and LA-EAT volume) for predicting AF recurrence (areas under the curve (AUC): 0.737 vs 0.584 in the external validation cohort). Model 3 exhibited the highest performance (AUC=0.790 in the external validation cohort, sensitivity value=0.800). Additionally, the combined model provided the highest net clinical benefit within a threshold probability range of 0.2-0.4.</p><p><strong>Conclusions: </strong>The LA-EAT radiomics model along with LA-EAT volume and clinical risk factors exhibited the highest predictive performance for AF recurrence following ablation therapy.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591894","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}

{"title":"Contemporary study of acute myocarditis in South Africa: CAMISA.","authors":"Karim Hassan, Anton Doubell, Charles Kyriakakis, Lloyd Joubert, Dan Zaharie, Gert Van Zyl, Rory Leisegang, Philip Herbst","doi":"10.1136/openhrt-2024-002845","DOIUrl":"10.1136/openhrt-2024-002845","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to determine the clinical presentations, aetiologies and outcomes of patients presenting with acute myocarditis (AM) in South Africa.</p><p><strong>Methods: </strong>This is a prospective cohort study. Consecutive patients presenting to Tygerberg Hospital, Cape Town, South Africa, between August 2017 and November 2021 who fulfilled the European Society of Cardiology diagnostic criteria for clinically suspected myocarditis undergoing all recommended investigations, including cardiac MRI (CMR) and endomyocardial biopsy (EMB), were included.</p><p><strong>Results: </strong>111 cases (mean age 41.2 years, 66.3% male) of clinically suspected myocarditis were recruited. AM was confirmed in 89: 44 (49.4%) on CMR only, 16 (18.0%) on EMB only and 29 (32.6%) on both CMR and EMB. 46 (51.7%) presented with infarct-like symptoms, 31 (34.8%) presented with heart failure (HF), 8 (9.0%) with sustained ventricular tachycardia (VT) and 4 (4.5%) with complete heart block (CHB). Viral pathogens were detected in 52 (58.4%) patients with AM, with Parvovirus B19 the most frequent in 39 (75.0%) as monoinfection and as coinfection in 4 (3 (5.8%) with Epstein-Barr virus (EBV) and 1 (1.9%) with EBV and human herpesvirus 6. The prespecified adverse outcome, defined as the occurrence of major adverse clinical events, including cardiac death, documented sustained VT, recurrence of AM and HF hospitalisation, occurred in 30.3%. Initial presentation with sustained VT (HR 5.36, 95% CI 1.76 to 16.33, p=0.003) or CHB (HR 5.67, 95% CI 1.38 to 23.26, p=0.016) was a significant predictor of adverse outcome on multivariate analysis.</p><p><strong>Conclusion: </strong>We report data from the largest cohort of patients with AM outside of the developed world. It provides insight into the clinical presentation, aetiology, viral pathogens and outcomes of patients with AM locally. The findings in this cohort from Africa appear similar to the developed world.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584388","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}

{"title":"Survival, adverse events and management of silent in-hospital coronary bypass graft occlusion.","authors":"Islam Salikhanov, Luca Koechlin, Brigitta Gahl, Luise Voehringer, Oliver Reuthebuch, Daniel Dimanski, Brian M Mawad, Denis Berdajs","doi":"10.1136/openhrt-2025-003368","DOIUrl":"10.1136/openhrt-2025-003368","url":null,"abstract":"<p><strong>Objectives: </strong>To assess mid-term outcomes in patients with early silent coronary bypass occlusion.</p><p><strong>Methods: </strong>292 consecutive patients who underwent isolated coronary artery bypass grafting (CABG) between July 2021 and December 2023 were included in this prospective cohort study. Silent CABG occlusion was defined as a bypass occlusion detected by coronary CT before discharge and without clinical suspicion of perioperative myocardial infarction. The primary endpoint was the incidence of angina-related rehospitalisation and coronary revascularisation during the follow-up. The secondary endpoint was the incidence of major adverse cardiovascular and cerebrovascular events, defined as a composite of all-cause mortality, myocardial infarction and stroke.</p><p><strong>Results: </strong>The mean age was 67±9.5 years, with 85.3% (n=249) being male. Early silent occlusion was identified in 25 patients (8.5%). The median hospital stay was longer in the occlusion group with 10 days (IQR 8.0-12.0), versus 8.0 days (IQR 7.0-9.0) in the non-occlusion group (p<0.001). The median follow-up duration was 14.5 (IQR 13.3-16.5) months. The incidence of angina-related rehospitalisation and revascularisation was significantly higher in patients with graft occlusion (p<0.01). Cox proportional hazards regression identified graft occlusion as a strong predictor of rehospitalisation (HR=8.55, 95% CI: 3.23 to 22.64; p<0.001) and reintervention (HR=15.12, 95% CI: 4.89 to 46.74; p<0.001), indicating nearly a 9-fold higher risk of rehospitalisation and a 15-fold increased hazard of reintervention.</p><p><strong>Conclusion: </strong>In-hospital silent graft occlusion following CABG is associated with a higher incidence of angina-related rehospitalisation and revascularisation during mid-term follow-up.</p><p><strong>Trial registration number: </strong>NCT04595630.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 2","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584459","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}