Open Heart最新文献

{"title":"Cardiac MRI-derived mean right atrial pressure and its prognostic importance.","authors":"Tom Alexander Howard Newman, Gareth Matthews, Hosamadin Assadi, Rui Li, Ciaran Grafton-Clarke, Zia Mehmood, Bahman Kasmai, Chris Sawh, Liang Zhong, Samer Alabed, Joao L Cavalcante, Ross J Thomson, Nay Aung, Rob J van der Geest, Andrew J Swift, Pankaj Garg","doi":"10.1136/openhrt-2025-003216","DOIUrl":"10.1136/openhrt-2025-003216","url":null,"abstract":"<p><strong>Background: </strong>Right atrial pressure (RAP) is a key variable that cardiac MRI (CMR) cannot currently measure. We aimed to develop a model to estimate mean RAP (mRAP) using CMR and assess the prognostic value of CMR-derived mRAP in an independent patient cohort.</p><p><strong>Methods: </strong>The derivation cohort consisted of patients investigated for heart failure symptoms with right heart catheterisation and CMR. Right atrial and ventricular CMR measurements were correlated with invasive mRAP to inform multivariable linear regression models incorporating patient characteristics. CMR-derived mRAP was tested as a predictor for clinical outcomes (lower-limb oedema, heart failure hospitalisation and all-cause mortality) on an independent cohort of patients receiving CMR. Both cohorts were derived from hospital registries.</p><p><strong>Results: </strong>In the derivation cohort (n=672), invasive mRAP was >8 mm Hg in 56% of patients. Right atrial end-systolic volume (RAESV) had the strongest correlation with invasive mRAP (Pearson's coefficient 0.58, p<0.01). RAESV was as accurate as more complex models for mRAP prediction (p>0.05). CMR-derived mRAP ≥10 mm Hg was better associated with outcomes than mRAP ≥8 mm Hg in the clinical cohort (n=101) with diagnostic power for peripheral oedema (area under the curve (AUC) 0.75, p=0.02) and heart failure hospitalisation (AUC 0.93, p<0.01). Kaplan-Meier analysis demonstrated elevated CMR-derived mRAP (≥10 mm Hg) was associated with reduced survival compared with mRAP <10 mm Hg (χ²=5, p=0.02) over a mean follow-up of 6.8 years.</p><p><strong>Conclusion: </strong>mRAP can be estimated by CMR. Raised CMR-derived mRAP is predictive of lower-limb oedema, heart failure hospitalisation and all-cause mortality.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476210","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":"Need for a permanent pacemaker after transcatheter aortic valve implantation in Spain: a retrospective analysis of the national Minimum Basic Dataset from 2017 to 2022.","authors":"Manuel Carnero-Alcázar, Ivan Javier Nuñez-Gil, Isidre Vilacosta, Lourdes Montero, Gregorio Cuerpo, Jose Lopez-Menendez, Gisela Feltes-Guzman, Rosa Beltrao-Sial, Daniel Pérez-Camargo, Álvaro Vicedo-López, Juan Miranda-Torrón, María Belén Solís-Chávez, Javier Cobiella, Luis Maroto","doi":"10.1136/openhrt-2025-003396","DOIUrl":"10.1136/openhrt-2025-003396","url":null,"abstract":"<p><strong>Background: </strong>There is no available information on the risk of permanent pacemaker implantation following transcatheter aortic valve implantation (TAVI) in Spain. Our objective was to investigate the incidence, temporal trends, and factors associated with this complication between 2017 and 2022, using data from the Spanish National Hospital Discharge Database (CMBD).</p><p><strong>Methods: </strong>This retrospective study was based on CMBD data of patients who underwent TAVI between 2017 and 2022. Patients under 60 years of age and those with a prior pacemaker or valve prosthesis were excluded. Demographic variables, comorbidities, hospital procedural volume and pacemaker incidence were analysed. A multivariable analysis was performed to evaluate changes in risk over time, adjusted for age, sex and Charlson Comorbidity Index.</p><p><strong>Results: </strong>A total of 20 826 procedures were included. The overall incidence of pacemaker implantation was 16.8%, increasing from 15.2% in 2017 to 18.2% in 2022 (p<0.001). This increase was independent of age, sex and Charlson index. No modifying effect of hospital procedural volume on the rising pacemaker risk was identified.</p><p><strong>Conclusions: </strong>The risk of permanent pacemaker implantation after TAVI has increased in Spain between 2017 and 2022. This increase was independent of demographic factors, comorbidities or hospital procedural volume. These findings highlight the need to optimise patient selection and improve TAVI implantation strategies to reduce this complication.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326469","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":"Cardiac magnetic resonance comparison of non-dilated and dilated cardiomyopathy: imaging features and prognostic predictors in non-dilated left ventricular cardiomyopathy.","authors":"Baiyan Zhuang, Shuang Li, Hongkai Zhang, Zhonghua Sun, Hui Wang, Lei Xu","doi":"10.1136/openhrt-2025-003441","DOIUrl":"10.1136/openhrt-2025-003441","url":null,"abstract":"<p><strong>Objectives: </strong>Non-dilated left ventricular cardiomyopathy (NDLVC) is a novel cardiomyopathy characterised by normal LV size and non-ischaemic myocardial scarring or fatty tissue replacement. This study aimed to explore the clinical and cardiac magnetic resonance (CMR) characteristics of NDLVC compared with dilated cardiomyopathy (DCM) and event rates of patients with NDLVC and reduced LV ejection fraction (NDLVC-REF).</p><p><strong>Materials and methods: </strong>A retrospective cohort study of 396 patients, including 210 with NDLVC (135 classified as NDLVC-REF) and 186 with DCM, who underwent CMR imaging between 2015 and 2017, was conducted. Follow-up lasted until May 2024, with a composite endpoint of major adverse cardiovascular events (only NDLVC patients were followed).</p><p><strong>Results: </strong>NDLVC patients exhibited better cardiac function than those with DCM, with higher LVEF (40.1%±15.8% vs 23.3%±8.8%, p<0.001). Compared with DCM, the presence of late gadolinium enhancement (LGE) was lower in the NDLVC group (77.4% vs 64.8%, p<0.001). NDLVC-REF showed a comparable prevalence of LGE presence with DCM (70.4% vs 77.4%, p=0.06) but lower LGE mass (4.8 (0, 9.9) g vs 6.8 (4.0, 11.0) g, p=0.01). Over a median follow-up of 83 months, 62 patients with NDLVC (29.5%) reached the composite endpoint. Multivariable analyses (forward logistic regression) identified right ventricular ejection fraction (RVEF) (0.98 (0.96, 0.99), p=0.01, Harrell's C-index=0.65) as the significant predictor of adverse outcomes in NDLVC. The presence of epicardium-involved LGE, left atrial volume index, LVEF, global radial strain and global circumferential strain was also associated with adverse events in NDLVC. In NDLVC-REF, RVEF <40% independently predicted major adverse cardiovascular events (2.19 (1.14-4.20), p=0.01).</p><p><strong>Conclusion: </strong>The clinical baseline and CMR parameters of NDLVC were different from those of DCM. RVEF was a powerful predictor of adverse events in NDLVC and NDLVC-REF.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326468","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":"Transcatheter bicuspid versus tricuspid aortic valve replacement in patients with a small aortic annulus: an observational study.","authors":"Wenjing Sheng, Jiaqi Fan, Jun Chen, Chongzhou Zheng, Dao Zhou, Hanyi Dai, Qiong Liu, Junhui Xue, Xian-Bao Liu","doi":"10.1136/openhrt-2025-003357","DOIUrl":"10.1136/openhrt-2025-003357","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcomes and haemodynamic performance following transcatheter aortic valve replacement (TAVR) in patients with severe bicuspid versus tricuspid aortic stenosis (AS) and small annuli.</p><p><strong>Design: </strong>Retrospective analysis based on a prospective observational cohort.</p><p><strong>Setting: </strong>Single-centre registry of patients undergoing TAVR between 2016 and 2023.</p><p><strong>Participants: </strong>A total of 427 patients (193 bicuspid (BAV) and 234 tricuspid (TAV) aortic valve) with symptomatic severe AS and small annuli (median area 381.5 mm² (IQR 348.0-406.4)), all undergoing preprocedural multidetector CT and standardised follow-up echocardiography.</p><p><strong>Main outcomes measure: </strong>Baseline characteristics, technical success, procedural complications, haemodynamic performance and bioprosthetic-valve dysfunction (BVD) were compared between groups. The primary clinical outcome was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause mortality, stroke and rehospitalisation for heart failure.Cox regression was used to adjust for confounders.</p><p><strong>Results: </strong>Compared with TAV patients, BAV recipients experienced higher technical failure rates (11.4% vs 6.0%, p=0.045) but lower permanent pacemaker implantation (4.7% vs 12%, p=0.008) at discharge. The 1-year MACCE rate was similar between groups (14.5% vs 9.8%, log-rank p=0.719), and Cox regression analyses adjusting for confounders revealed no significant difference (HR 1.408 (95% CI 0.622 to 3.191), p=0.412). Both groups demonstrated significant improvements in valve haemodynamics, with comparable rates of BVD (11.4% vs 9.2%, p=0.502) and structural valve dysfunction. Multivariate analysis demonstrated equivalent long-term survivals (HR 0.950 (95% CI 0.526 to 1.714), p=0.864) between groups.</p><p><strong>Conclusion: </strong>TAVR provides comparable clinical and haemodynamic outcomes for bicuspid and tricuspid AS with a small aortic annulus, despite greater procedural complexity in BAV cases. These findings support cautious expansion of TAVR to select BAV patients when performed with meticulous procedural planning.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294197","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":"Continuing evaluation of atrial fibrillation detection after cryptogenic stroke: 2-year findings from a multicentre study with Confirm Rx ICM.","authors":"Fabio Quartieri, Yong-Soo Baek, Jong-Sung Park, Tae-Hoon Kim, Kazunari Honma, Masafumi Morimoto, Ki-Woon Kang, Lin Feng, Kwangdeok Lee, Andrea Grammatico, Lukas Kaiser","doi":"10.1136/openhrt-2025-003242","DOIUrl":"10.1136/openhrt-2025-003242","url":null,"abstract":"<p><strong>Background: </strong>The detection of atrial fibrillation (AF) after a cryptogenic stroke (CS) carries important therapeutic implications. In this study, we aimed to accurately assess the incidence of AF among CS subjects by using an insertable cardiac monitor (ICM).</p><p><strong>Methods: </strong>A prospective, single-arm, multicentre registry was conducted to identify AF in 155 CS subjects using the Confirm Rx ICM (Abbott, California, USA) across 20 global sites. Inclusion criteria comprised participants aged 40 years or older who had experienced CS within a 90-day window. At each follow-up visit, expert electrophysiologists reviewed and adjudicated ICM detected AF episodes. The primary endpoint was the cumulative incidence of true device-detected AF (lasting more than 30 s) at 6 months, evaluated with Kaplan-Meier methods.</p><p><strong>Results: </strong>AF incidence was 21.3% (95% CI 15.3% to 29.1%) at 6 months, increasing to 48.8% (95% CI 34.7% to 64.9%) at 24 months. Subjects with AF detection experienced an average of 50.9 true AF episodes per subject per year. The median time from implantation to AF detection (>30 s) was 72 days (IQR 7-261). Among subjects with 30 s AF detection, anticoagulation therapy was initiated in 65.2% (30/46) of subjects. Oral anticoagulation medication was prescribed in 8.3% (9/109) of subjects without AF. Recurrent ischaemic stroke or transient ischaemic attack occurred in 5 subjects (3.2%, 5/155).</p><p><strong>Conclusion: </strong>These results show that ICM-driven long-term continuous AF monitoring is associated with high diagnostic yield in CS subjects.</p><p><strong>Trial registration number: </strong>NCT03505801.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294196","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":"Cardiac myosin inhibitors: a silver lining for an old disease.","authors":"Satyavir Yadav, Sourabh Agstam, Sandeep Singh","doi":"10.1136/openhrt-2025-003358","DOIUrl":"10.1136/openhrt-2025-003358","url":null,"abstract":"","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12161426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275454","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":"Dual impact of anaemia and chronic kidney disease on postpercutaneous coronary intervention outcomes: insights from the Japanese nationwide registry.","authors":"Ryoma Fukuoka, Kyohei Yamaji, Shun Kohsaka, Hideki Ishii, Yuichiro Mori, Yohei Numasawa, Tetsu Watanabe, Takashi Nakayama, Koichiro Sugimura, Yoshihide Fujimoto, Masaki Ieda, Akio Kawamura, Tetsuya Amano, Ken Kozuma","doi":"10.1136/openhrt-2024-003146","DOIUrl":"10.1136/openhrt-2024-003146","url":null,"abstract":"<p><strong>Background: </strong>Anaemia and chronic kidney disease (CKD) are both established risk factors for bleeding events after percutaneous coronary intervention (PCI). These conditions often coexist; however, previous assessments of these factors individually may have led to an underestimation of their impact on clinical outcomes.</p><p><strong>Methods: </strong>We analysed the data of 77 482 patients who underwent PCI between 2017 and 2020 in the Japanese nationwide PCI registry. Based on preprocedural anaemia (haemoglobin: <13 g/dL in men; <12 g/dL in women) and CKD (estimated glomerular filtration rate, <60 mL/min/1.73 m²) statuses, the patients were categorised into 'neither anaemia nor CKD' (n=36 629; 47.3%), 'CKD alone' (n=17 120; 22.1%), 'anaemia alone' (n=10 136; 13.1%) and 'both anaemia and CKD' (n=13 597; 17.5%) groups. The study endpoints included bleeding (fatal or non-fatal major bleeding) and ischaemic (cardiovascular death, non-fatal acute coronary syndrome or non-fatal ischaemic stroke) events.</p><p><strong>Results: </strong>The 1-year incidence of bleeding and ischaemic events was highest in the 'both anaemia and CKD' group and lowest in the 'neither anaemia nor CKD' group. After adjustment, 'anaemia alone' (HR 1.52; 95% CI 1.29 to 1.79; p<0.001) and 'both anaemia and CKD' (HR 1.39; 95% CI 1.18 to 1.63; p<0.001), but not 'CKD alone' (HR 1.00; 95% CI 0.85 to 1.17; p=0.97), were significantly associated with high risks of bleeding events compared with 'neither anaemia nor CKD'. All three groups had higher ischaemic risk compared with 'neither anaemia nor CKD' ('CKD alone': HR 1.29; 95% CI 1.16 to 1.45; p<0.001, 'anaemia alone': HR 1.40; 95% CI 1.22 to 1.60; p<0.001, 'both anaemia and CKD': HR 1.61; 95% CI 1.43 to 1.81; p<0.001).</p><p><strong>Conclusions: </strong>Anaemia increased bleeding risk regardless of CKD status, whereas 'CKD alone' did not. In addition, patients with anaemia and/or CKD were at a higher risk of ischaemic events. Clinicians should routinely perform initial risk assessments stratified by anaemia and CKD for patients undergoing PCI.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216492","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":"Predicting death or readmission following heart failure hospitalisation: the VancOuver CoastAL Acute Heart Failure (VOCAL-AHF) registry.","authors":"Samaneh Salimian, Nathaniel Mark Hawkins, Nandini Dendukuri, Negareh Mousavi, James Brophy","doi":"10.1136/openhrt-2025-003210","DOIUrl":"10.1136/openhrt-2025-003210","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) readmission and mortality rates remain high among HF patients. Improved and robust risk prediction models for better monitoring, informed decision-making, targeted interventions and improved patient outcomes are required. We developed and validated a patient-centric model to predict long-term outcomes of death or a repeat HF-hospitalisation using a modern model selection approach.</p><p><strong>Methods: </strong>We used data from a contemporary registry of patients discharged alive from an HF-hospitalisation between 1 April 2015 and 31 March 2019. An integrated and multifaceted selection approach (combining backward selection, least absolute shrinkage and selection operator and expert opinion) to Cox-proportional hazard models was used for model development. To account for model uncertainty and improve generalisability, bootstrap-Bayesian Model Averaging was used to derive the final risk model.</p><p><strong>Results: </strong>The cohort included 1842 patients with a median follow-up time of 529 days (range 2-1459 days). 790 (43%) patients experienced the outcome, with 68 (8.6%) having the outcome within 30 days. The final risk model included 12 variables, of which 8 were identified as being dominant. The top predictors with >99% probability for model inclusion were increasing age (HR 1.07, 95% CI 1.00 to 1.11/5 years), prior HF-diagnoses (1.47, 95% CI 1.13 to 1.71) and lower discharge haemoglobin (1.10, 95% CI 1.05 to 1.15/10 g/L). Other predictors (~>60% model-selection probability) included lower admitting systolic blood pressure, higher loop-diuretic discharge requirements, persistent smoking, an admitting non-sinus rhythm and absence of discharge angiotensin-converting enzyme inhibitor, angiotensin receptor blocker or angiotensin receptor-neprilysin inhibitor prescription. The 3-year cross-validated c-statistic was 0.63 (95% CI 0.61 to 0.65).</p><p><strong>Conclusions: </strong>A clinically oriented prognostic model with moderate discrimination, to predict adverse events postdischarge for HF, has been developed and internally validated. This model, leveraging an integrated approach to selection, shows promise in personalising discharge planning. Future external validation is necessary to confirm its applicability and potential impact on clinical practice.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216493","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":"Asymptomatic carotid artery stenosis and stroke risk in patients undergoing CABG.","authors":"Leo Pölzl, Ronja Lohmann, Christian Sutter, Clemens Engler, Michael Graber, Felix Nägele, Jakob Hirsch, Jonas Eder, Maria Ioannou-Nikolaidou, Antonia Lutz, Franziska Hübner, Maria Noflatscher, Rudolf Kirchmair, Elfriede Ruttmann, Sebastian Reinstadler, Michael Knoflach, Michael Grimm, Axel Bauer, Nikolaos Bonaros, Johannes Holfeld, C Gollmann-Tepeköylü, Markus Theurl","doi":"10.1136/openhrt-2025-003311","DOIUrl":"10.1136/openhrt-2025-003311","url":null,"abstract":"<p><strong>Objective: </strong>Perioperative stroke associated with coronary artery bypass grafting (CABG) is a catastrophic event. Identification of patients at risk and reduction of its incidence remains of high importance. The aim of this study was to analyse the association of different degrees of asymptomatic carotid artery stenosis (CAS) with the perioperative outcome in a consecutive series of CABG patients and to identify predictors for CABG associated ischaemic stroke.</p><p><strong>Methods: </strong>In total, 2727 patients undergoing isolated CABG procedure at the Medical University of Innsbruck between 2010 and 2020 were included in this study. Sonography data included the severity of carotid stenosis for left and right internal carotid artery individually. The primary outcome was the 30-day stroke and mortality rate, and the secondary outcome was 5-year mortality. A Cox regression model was performed after adjustment for EuroSCORE II.</p><p><strong>Results: </strong>Left CAS>50% was present in 177 patients (7%) and right CAS>50% in 197 patients (7.8%). In total, 1.6% (40 patients) of the patients died within 30 days after surgery, and 1.0% (24 patients) experienced a postoperative stroke within 30 days. Patients with a carotid stenosis>90% had a higher 30-day mortality (p<0.001) and higher incidence of postoperative stroke within 30 days (p=0.005). Patients with a history of a prior stroke were at higher risk of experiencing another stroke within 30-days after surgery, with an HR of 6.829 (2.811-16.589) (p<0.001).</p><p><strong>Conclusions: </strong>Asymptomatic CAS>90% and history of stroke are both independent risk factors for perioperative stroke and 30-day mortality.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216491","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":"Neighbourhood deprivation and cardiometabolic outcomes in the UK Biobank: differences by sex and ethnicity.","authors":"Kosuke Tamura, Yangyang Deng, Breanna Rogers, Mohammad Moniruzzaman, Ram Jagannathan, Lu Hu, Katsuyuki Miura, Véronique L Roger, Leonardo Mariño-Ramírez","doi":"10.1136/openhrt-2025-003225","DOIUrl":"10.1136/openhrt-2025-003225","url":null,"abstract":"<p><strong>Objective: </strong>To examine the associations of deprived neighbourhoods with all-cause mortality and incident cardiovascular disease (CVD) and to investigate whether these associations were independently and concurrently stratified by sex and ethnicity.</p><p><strong>Methods: </strong>Data came from the UK Biobank, a prospective cohort study of over 500 000 participants aged 22-69 across the UK between 2006 and 2010. The follow-up time was calculated from each participant's enrolment at baseline until the first occurrence of a diagnosis of each death, incident or the censor date (31 December 2020). All-cause mortality, incident total CVD, ischaemic heart disease (IHD) and cerebrovascular disease (CeVD) were the outcomes defined based on the International Classification of Diseases. Deprived neighbourhoods were categorised into four groups: least deprived (referent), somewhat deprived, deprived, and most deprived neighbourhoods. Cox proportional hazards models were used to examine associations of deprived neighbourhoods with each outcome. Analyses were stratified by sex and ethnicity separately and simultaneously.</p><p><strong>Results: </strong>A total of 261 954 participants were included. Participants had a mean follow-up of 14.3 years for all-cause mortality (3 745 307 person-years, 9933 deaths) and 12.7 years for total CVD incidence (3 321 619 person-years, 64 748 events). Those in the most deprived neighbourhoods (compared with the least) had a 31%, 13%, 15% and 34% greater risk of all-cause mortality, incident total CVD, IHD and CeVD, respectively. Patterns of associations were somewhat similar by sex, yet varied by ethnicity. The overall results were consistent with the white cohort but not for the other cohorts.</p><p><strong>Conclusions: </strong>This study indicated that individuals living in highly deprived neighbourhoods may have an elevated risk of all-cause mortality and incident CVD, particularly among the white cohort but not other cohorts. Future research should focus on efforts to invest in deprived areas to alleviate the burden of all-cause mortality and CVD incidence.</p>","PeriodicalId":19505,"journal":{"name":"Open Heart","volume":"12 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173915","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}