Reviews in cardiovascular medicine最新文献

{"title":"Efficacy and Safety of New Oral Anticoagulants versus Warfarin in the Resolution of Atrial Fibrillation with Left Atrial/Left Atrial Appendage Thrombus: A Systematic Review and Meta-Analysis.","authors":"Guan-Lian Mo, Jing Wen, Yu-Yu Ye, Yong-Qi Lu, Tian-Ming Gan, Ying-Jie Yang, Jin-Yi Li","doi":"10.31083/RCM26055","DOIUrl":"10.31083/RCM26055","url":null,"abstract":"<p><strong>Background: </strong>To compare the efficacy and safety of novel oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in nonvalvular atrial fibrillation (NVAF) patients with left atrial/left atrial thrombosis through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>The CBM (China Biology Medicine disc), CNKI (China National Knowledge Infrastructure), VIP (Chinese Technology Periodical Database), Wanfang, PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant studies from their inception to June 30, 2022.</p><p><strong>Results: </strong>Twelve articles (eight cohort studies and four randomized controlled trials) involving 982 patients were included. Meta-analysis showed that NOACs had a significantly higher thrombolysis rate than VKAs (78.0% vs. 63.5%, odds ratio (OR) = 2.32, 95% confidence interval (CI) 1.71 to 3.15, <i>p</i> < 0.0001). Subgroup analysis revealed rivaroxaban to be more effective than VKAs, whereas there was no significant difference between dabigatran and apixaban. There were no significant differences in embolic events, bleeding, or all-cause mortality. Thrombus resolution analysis showed higher left ventricular end-diastolic diameter and smaller left atrial diameter in the effective group than in the ineffective group.</p><p><strong>Conclusions: </strong>NOACs are more effective in thrombolysis than VKAs in NVAF patients with left atrial thrombosis, and there is no increased risk of adverse events compared with VKAs.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"26055"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Cardiomyopathy: From Diagnosis to Treatment.","authors":"Zheyu Liu, Tao Liu, Gang Wu","doi":"10.31083/RCM25124","DOIUrl":"10.31083/RCM25124","url":null,"abstract":"<p><p>With a better understanding of the susceptibility to atrial fibrillation (AF) and the thrombogenicity of the left atrium, the concept of atrial cardiomyopathy (ACM) has emerged. The conventional viewpoint holds that AF-associated hemodynamic disturbances and thrombus formation in the left atrial appendage are the primary causes of cardiogenic embolism events. However, substantial evidence suggests that the relationship between cardiogenic embolism and AF is not so absolute, and that ACM may be an important, underestimated contributor to cardiogenic embolism events. Chronic inflammation, oxidative stress response, lipid accumulation, and fibrosis leading to ACM form the foundation for AF. Furthermore, persistent AF can exacerbate structural and electrical remodeling, as well as mechanical dysfunction of the atria, creating a vicious cycle. To date, the relationship between ACM, AF, and cardiogenic embolism remains unclear. Additionally, many clinicians still lack a comprehensive understanding of the concept of ACM. In this review, we first appraise the definition of ACM and subsequently summarize the noninvasive and feasible diagnostic techniques and criteria for clinical practice. These include imaging modalities such as echocardiography and cardiac magnetic resonance imaging, as well as electrocardiograms, serum biomarkers, and existing practical diagnostic criteria. Finally, we discuss management strategies for ACM, encompassing \"upstream therapy\" targeting risk factors, identifying and providing appropriate anticoagulation for patients at high risk of stroke/systemic embolism events, and controlling heart rhythm along with potential atrial substrate improvements.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"25124"},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Nomogram for Predicting Long-Term Net Adverse Clinical Events in High Bleeding Risk Patients Undergoing Percutaneous Coronary Intervention.","authors":"Junyan Zhang, Zhongxiu Chen, Ran Liu, Yuxiao Li, Hongsen Zhao, Yanning Li, Minggang Zhou, Hua Wang, Chen Li, Li Rao, Yong He","doi":"10.31083/RCM25352","DOIUrl":"10.31083/RCM25352","url":null,"abstract":"<p><strong>Background: </strong>Patients with a high risk of bleeding undergoing percutaneous coronary intervention (PCI-HBR) were provided consensus-based criteria by the Academic Research Consortium for High Bleeding Risk (ARC-HBR). However, the prognostic predictors in this group of patients have yet to be fully explored. Thus, an effective prognostic prediction model for PCI-HBR patients is required.</p><p><strong>Methods: </strong>We prospectively enrolled PCI-HBR patients from May 2022 to April 2024 at West China Hospital of Sichuan University. The cohort was randomly divided into training and internal validation sets in a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) regression algorithm was employed to select variables in the training set. Subsequently, a prediction model for 1-year net adverse clinical events (NACEs)-free survival was developed using a multivariable Cox regression model, and a nomogram was constructed. The outcome of the NACEs is defined as a composite endpoint that includes death, myocardial infarction, ischemic stroke, and Bleeding Academic Research Consortium (BARC) grade 3-5 major bleeding. Validation was conducted exclusively using the internal validation cohort, assessing the discrimination, calibration, and clinical utility of the nomogram.</p><p><strong>Results: </strong>This study included 1512 patients with PCI-HBR, including 1058 in the derivation cohort and 454 in the validation cohort. We revealed five risk factors after LASSO regression, Cox regression, and clinical significance screening. These were then utilized to construct a prognostic prediction nomogram, including chronic kidney disease, left main stem lesion, multivessel disease, triglycerides (TG), and creatine kinase-myocardial band (CK-MB). The nomogram exhibited strong predictive ability (the area under the curve (AUC) to predict 1-year NACE-free survival was 0.728), displaying favorable levels of accuracy, discrimination, and clinical usefulness in the internal validation cohort.</p><p><strong>Conclusions: </strong>This study presents a nomogram to predict 1-year NACE outcomes in PCI-HBR patients. Internal validation showed strong predictive capability and clinical utility. Future research should validate the nomogram in diverse populations and explore new predictors for improved accuracy.</p><p><strong>Clinical trial registration: </strong>The data for this study were obtained from the PPP-PCI registry, NCT05369442 (https://clinicaltrials.gov/study/NCT05369442).</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"25352"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Implant Global Longitudinal Strain as a Predictor of Pacing-Induced Cardiomyopathy in Patients with Preserved Ejection Fraction Undergoing Pacemaker Placement.","authors":"Sung Soo Kim, Hyung Wook Park, Hyung Ki Jeong","doi":"10.31083/RCM26173","DOIUrl":"10.31083/RCM26173","url":null,"abstract":"<p><strong>Background: </strong>Right ventricular (RV) pacing exacerbates heart failure and increases cardiac mortality in patients with reduced ejection fraction (EF). However, its impact on left ventricular dysfunction in patients with preserved EF remains inconclusive. This study investigates the relationship between RV pacing, global longitudinal strain (GLS), and EF in patients with preserved EF.</p><p><strong>Methods: </strong>This prospective registry study included patients with preserved EF (≥50%) undergoing de novo permanent pacemaker (PPM) implantation for atrioventricular block at Chosun University Hospital, South Korea, from 2018 to 2022. Echocardiographic evaluations were performed pre-implant, post-implant, and at 12 months, with follow-up visits every 3-6 months. Composite outcomes included cardiac death, heart failure hospitalization, pacing-induced cardiomyopathy (PICM), and biventricular pacing (BVP) upgrade.</p><p><strong>Results: </strong>A total of 71 patients (28 males, mean age 73.1 years) were included. Following PPM implantation, significant declines in both EF and GLS were noted, especially in those with PICM. Over three years, 2 patients died, 6 were hospitalized, 7 developed PICM, and 3 underwent a BVP upgrade. Reduced post-implant GLS was an independent predictor of PICM (hazard ratios (HR) 1.715, 95% CI 1.174-2.504; <i>p</i> = 0.005). Receiver operating characteristic (ROC) analysis showed an area under curve (AUC) of 0.92 for GLS, with a GLS <-15.0 having 100% sensitivity and 80.9% specificity for predicting PICM.</p><p><strong>Conclusions: </strong>Post-implant GLS is a reliable predictor of PICM in patients with preserved EF. Regular GLS monitoring can guide timely interventions, including guideline-directed medical therapy or BVP upgrades, to prevent deterioration and improve outcomes.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"26173"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction between 24 h Urinary Free Cortisol and Obesity in Hypertension-Mediated Organ Damage in Patients with Untreated Hypertension.","authors":"Gao-Zhen Cao, Jia-Yi Huang, Qing-Shan Lin, Cong Chen, Min Wu, Run Wang, Ming-Yen Ng, Kai-Hang Yiu, Jian-Cheng Xiu","doi":"10.31083/RCM25598","DOIUrl":"10.31083/RCM25598","url":null,"abstract":"<p><strong>Background: </strong>Given the close relationship between excessive cortisol secretion and obesity, as well as their intimate associations with cardiometabolic sequelae, this study aimed to evaluate whether elevated cortisol levels and obesity are independently and potentially interactively related to hypertension-mediated organ damage (HMOD) in patients with untreated hypertension.</p><p><strong>Methods: </strong>A total of 936 untreated hypertensive patients were recruited. Body mass index (BMI), 24-hour urinary free cortisol (24 h UFC), and HMOD indicators, including left ventricular hypertrophy (LVH), carotid intima-media thickness (CIMT), and albuminuria, were assessed. Multivariate logistic regression was conducted to evaluate the associations of HMOD indicators with 24 h UFC and obesity. Generalized linear models were used to test for the interaction effects of obesity in the associations between log 24 h UFC levels and HMOD indicators.</p><p><strong>Results: </strong>Compared to non-obese patients, those who were obese had a greater left ventricular mass index (LVMI), greater CIMT, a higher level of 24-hour urinary albumin (24 h UALB) and more frequent albuminuria (all <i>p</i> < 0.05). In the obese group, elevated 24 h UFC was significantly associated with LVH (odds ratio (OR) = 2.53; 95% CI: 1.02-6.31, <i>p</i> = 0.044) and albuminuria (OR = 3.13; 95% CI: 1.31-7.43, <i>p</i> = 0.01), after multivariate adjusting. There was a significant interactive effect of obesity on the association between 24 h UFC and LVH and albuminuria (all <i>p</i> for interaction <0.05). A significant correlation was observed between 24 h UFC and LVMI in obese and non-obese patients. Conversely, the correlations of 24 h UFC and log 24 h UALB were found only in obese patients but not in non-obese patients.</p><p><strong>Conclusions: </strong>Elevated 24 h UFC levels were associated with higher severity of HMOD, including more frequent LVH, albuminuria, and greater CIMT. Additionally, obesity modified the effects of 24 h UFC on both LVH and albuminuria.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"25598"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins-Their Effect on Lipoprotein(a) Levels.","authors":"Marcin Mateusz Granat","doi":"10.31083/RCM26162","DOIUrl":"10.31083/RCM26162","url":null,"abstract":"<p><p>Lipoprotein(a) (Lp(a)) serum concentration plays a crucial role as a risk factor in cardiovascular diseases and is gaining more and more attention. Patients with elevated lipoprotein(a) levels are often prescribed statins as they also have high concentrations of low-density lipoprotein cholesterol (LDL-C). Statins are drugs that successfully decrease LDL-C, but their effectiveness in Lp(a) levels reduction is uncertain. The aim of this study was to evaluate if statin therapy can affect Lp(a) concentration. A literature search on databases like PubMed, Oxford Academic, ScienceDirect, Embase, The Cochrane Library, Scopus, and Springer Link was conducted from 1 May to 10 August 2024 with the aim of finding studies concerning the effect of statins on Lp(a) levels. Only randomised control studies and studies with a placebo/comparator arm were included. For calculations, SPSS Statistics software version 29 was used. The risk of bias for this study was assessed using the revised Cochrane risk-of-bias tool for randomised trials. Overall, 43 studies (13,264 participants in study arms and 11,676 in control arms) were included in the analysis. The mean difference of absolute change in Lp(a) concentration for all 43 studies equaled 0.22 mg/dL and was not clinically significant. Egger's regression-based test resulted in no risk of bias in this study (<i>p</i> = 0.404). In conclusion, statin therapy does not significantly affect Lp(a) levels. Results of this work suggest that people with high Lp(a) levels will not change their Lp(a)-associated cardiovascular (CV) risk by statin administration.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"26162"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Coronary Artery Disease on the Prognosis of Hypertrophic Cardiomyopathy: A Multi-Center Cohort Study.","authors":"Guoqing Hou, Qian Liao, Huihui Ma, Yan Shu, Shengzhi Zeng, Yongmei Zhou, Liangjun Luo, Gang Zhao, Tao He, Mingjiang Liu, Jianhong Tao, Wei Hua, Xiaoping Li","doi":"10.31083/RCM25045","DOIUrl":"10.31083/RCM25045","url":null,"abstract":"<p><strong>Background: </strong>There is a shortage of patients with hypertrophic cardiomyopathy (HCM) with concurrent coronary artery disease (CAD), and the influence of CAD on the prognosis of patients with HCM is uncertain. This real-world cohort study was conducted to evaluate the prognosis of patients with patients with CAD.</p><p><strong>Methods: </strong>This cohort study of patients with HCM was conducted from May 2003 to September 2021. The total number of patients enrolled was 2167, and the mean follow-up period was 6.4 years (interquartile range 2.8-9.5 years). Sudden cardiac death (SCD), cardiovascular death, and all-cause mortality were assessed as outcomes. Using logistic regression, nine indicators were selected for 1:1 propensity score matching (PSM). Additionally, Kaplan-Meier survival curves and Cox proportional hazards regression analyses were used to assess the impact of CAD on the prognosis of patients with HCM.</p><p><strong>Results: </strong>During an average of 6.4 years of follow-up, of the 2167 patients enrolled, 446 (20.6%) died. The patients were classified into two groups: CAD (n = 480) and non-CAD (n = 1,687). After imputation of missing values using the mean and 1:1 propensity score matching, there was no difference in SCD (log-rank χ² = 0.4, <i>p</i> = 0.540), cardiovascular death (log-rank χ² = 0.1, <i>p</i> = 0.995) and all-cause mortality (log-rank χ² = 0.1, <i>p</i> = 0.776) between the CAD and non-CAD groups. After imputation of missing values using the median and 1:1 propensity score matching, patients with and without CAD were not significantly different in terms of SCD (log-rank χ² = 0.1, <i>p</i> = 0.948), cardiovascular death (log-rank χ² = 0.1, <i>p</i> = 0.811), and all-cause mortality (log-rank χ² = 0.5, <i>p</i> = 0.499). In the Cox analysis, CAD was not a significant independent predictor of SCD, cardiovascular death, or all-cause mortality in patients with HCM.</p><p><strong>Conclusions: </strong>In this study, it was observed that there was no statistically significant disparity in mortality rates between patients diagnosed with HCM who concurrently had CAD and those who did not exhibit CAD. This finding underscores the notion that the presence of CAD did not exert a notable influence on the incidence of SCD, cardiovascular death, or all-cause mortality, thereby emphasizing the complexity and multifaceted nature of mortality risk factors in HCM patients.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"25045"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Machine Learning to Predict Coronary Artery Disease Severity in Patients with Premature Myocardial Infarction.","authors":"Yu-Hang Wang, Chang-Ping Li, Jing-Xian Wang, Zhuang Cui, Yu Zhou, An-Ran Jing, Miao-Miao Liang, Yin Liu, Jing Gao","doi":"10.31083/RCM26102","DOIUrl":"10.31083/RCM26102","url":null,"abstract":"<p><strong>Background: </strong>Studies using machine learning to identify the target characteristics and develop predictive models for coronary artery disease severity in patients with premature myocardial infarction (PMI) are limited.</p><p><strong>Methods: </strong>In this observational study, 1111 PMI patients (≤55 years) at Tianjin Chest Hospital from 2017 to 2022 were selected and divided according to their SYNTAX scores into a low-risk group (≤22) and medium-high-risk group (>22). These groups were further randomly assigned to a training or test set in a ratio of 7:3. Lasso-logistic was initially used to screen out target factors. Subsequently, Lasso-logistic, random forest (RF), k-nearest neighbor (KNN), support vector machine (SVM), and eXtreme Gradient Boosting (XGBoost) were used to establish prediction models based on the training set. After comparing prediction performance, the best model was chosen to build a prediction system for coronary artery severity in PMI patients.</p><p><strong>Results: </strong>Glycosylated hemoglobin (HbA1c), angina, apolipoprotein B (ApoB), total bile acid (TBA), B-type natriuretic peptide (BNP), D-dimer, and fibrinogen (Fg) were associated with the severity of lesions. In the test set, the area under the curve (AUC) of Lasso-logistic, RF, KNN, SVM, and XGBoost were 0.792, 0.775, 0.739, 0.656, and 0.800, respectively. XGBoost showed the best prediction performance according to the AUC, accuracy, F1 score, and Brier score. In addition, we used decision curve analysis (DCA) to assess the clinical validity of the XGBoost prediction model. Finally, an online calculator based on the XGBoost was established to measure the severity of coronary artery lesions in PMI patients.</p><p><strong>Conclusions: </strong>In summary, we established a novel and convenient prediction system for the severity of lesions in PMI patients. This system can swiftly identify PMI patients who also have severe coronary artery lesions before the coronary intervention, thus offering valuable guidance for clinical decision-making.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"26102"},"PeriodicalIF":1.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Obstructive Sleep Apnea on In-Stent Restenosis in Coronary Heart Disease Patients after Elective Drug-Eluting Stenting.","authors":"Wenjie Yang, Zhuoshan Huang, Ke Yang, Dinghui Liu, Junpeng Xiao, Zhen Wu, Ling Jiang, Shan Cao, Xujing Xie, Shujie Yu","doi":"10.31083/RCM25814","DOIUrl":"10.31083/RCM25814","url":null,"abstract":"<p><strong>Background: </strong>Extensive research has established obstructive sleep apnea (OSA) as a contributing factor to numerous cardiovascular and cerebrovascular diseases. However, whether OSA affects in-stent restenosis (ISR) after elective drug-eluting stenting is unclear. Therefore, the objective of this study was to examine the impact of OSA on ISR in patients with coronary heart disease (CHD) who underwent successful elective drug-eluting stent (DES) implantation.</p><p><strong>Methods: </strong>This study retrospectively analyzed CHD patients who successfully underwent elective coronary stent implantation and overnight sleep breathing monitoring and were readmitted for coronary angiography due to symptoms of CHD at 12 to 26 months after percutaneous coronary intervention (PCI). OSA was diagnosed when the apnea-hypopnea index (AHI) was ≥5 events/hour. ISR was defined as >50% restenosis of the vessel diameter in which the DES was implanted. To explore the association between OSA and ISR among patients with CHD, multivariate logistic regression models were developed and utilized.</p><p><strong>Results: </strong>This study enrolled 206 individuals who were diagnosed with CHD, with a mean age of 62.01 ± 10.27 years, and males constituted 76.2% of the patient population. After a median follow-up period of 15 months following DES implantation, there was a significant increase in the incidence of ISR among patients with moderate to severe OSA, increasing from 10.9% to 31.3% (<i>p</i> < 0.001). According to the fully adjusted model, the occurrence of ISR was found to be independently associated with the presence of OSA (OR: 3.247, 95% CI: 1.373-7.677, <i>p</i> = 0.007).</p><p><strong>Conclusions: </strong>In individuals who underwent elective drug-eluting stenting, OSA is an independent risk factor for ISR.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"25814"},"PeriodicalIF":1.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Tricuspid Valve Replacement: Current Options and Future Perspectives.","authors":"Guido Del Monaco, Gianluca Mincione, Alessandro Sticchi, Bernhard Reimers, Antonio Colombo, Antonio Mangieri","doi":"10.31083/RCM25712","DOIUrl":"10.31083/RCM25712","url":null,"abstract":"<p><p>Tricuspid regurgitation (TR) is a potentially lethal condition and represents a significant clinical challenge both for clinical and interventional cardiologists. Traditionally managed medically and surgically, transcatheter therapies are now an emerging option, especially in patients with prohibitive surgical risk due to age or comorbidities. Transcatheter tricuspid valve replacement (TTVR) is emerging as a potential solution for patients suffering from TR with positive clinical data supporting its use in a wide range of anatomies and clinical settings. However, the adoption of TTVR introduces new challenges, including a scarcity of long-term clinical risks of valve thrombosis, questions regarding the durability of implanted valves, and the potential higher risk for post-procedural pacemaker (PM) implantation.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 1","pages":"25712"},"PeriodicalIF":1.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}