Reviews in cardiovascular medicine最新文献

{"title":"Management of Coronary Vulnerable Plaques: A Focus on Preventive Percutaneous Coronary Intervention.","authors":"Stefano Rigattieri, Marco Redivo, Matteo Casenghi, Marta Belmonte, Francesca Giovannelli, Antonella Tommasino, Emanuele Barbato, Andrea Berni","doi":"10.31083/RCM26712","DOIUrl":"https://doi.org/10.31083/RCM26712","url":null,"abstract":"<p><p>Vulnerable or high-risk coronary plaques are usually referred to as angiographically mild to moderate lesions characterized by a large plaque burden, positive vessel remodeling, thin fibrous cap, and large necrotic/lipid core. According to several pathology studies, these plaques represent the substrate of coronary thrombosis in about two-thirds of cases; therefore, there has been increasing interest in detecting and treating vulnerable plaques (VPs). Nowadays, VP detection is possible through noninvasive and invasive imaging techniques, such as coronary computed tomography, magnetic resonance imaging, intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy. Since VPs were shown to be associated with cardiovascular events in observational studies, pharmacological and non-pharmacological strategies have been investigated to achieve a regression and/or a passivation of these plaques. In addition to pharmacological therapies, mainly focused on lipid-lowering agents, there has been a recent growing interest in interventional therapies, including coronary scaffolds, stents, and drug-coated balloons. This led to the concept of preventive percutaneous coronary intervention, which, unlike the treatment of culprit lesions in acute coronary syndromes or of ischemia-inducing stenoses, as recommended by guidelines, implies the treatment of angiographically and functionally non-significant lesions based on one or more high-risk plaque characteristics as identified by noninvasive or intracoronary imaging. This article provides an updated review of key concepts in defining and detecting VPs; their prognostic value and available pharmacological and interventional management evidence will also be discussed.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26712"},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023582","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":"Age Differences in Aortic Stenosis.","authors":"Tomoyo Hamana, Teruo Sekimoto, Aloke V Finn, Renu Virmani","doi":"10.31083/RCM28185","DOIUrl":"https://doi.org/10.31083/RCM28185","url":null,"abstract":"<p><p>Aortic stenosis (AS) is a significant and growing concern, with a prevalence of 2-3% in individuals aged over 65 years. Moreover, with an aging global population, the prevalence is anticipated to double by 2050. Indeed, AS can arise from various etiologies, including calcific trileaflets, congenital valve abnormalities (e.g., bicuspid and unicuspid valves), and post-rheumatic, whereby each has a distinct influence that shapes the onset and progression of the disease. The normal aortic valve has a trilaminar structure comprising the fibrosa, spongiosa, and ventricularis, which work together to maintain its function. In calcific AS, the disease begins with early calcification starting in high mechanical stress areas of the valve and progresses slowly over decades, eventually leading to extensive calcification resulting in impaired valve function. This process involves mechanisms similar to atherosclerosis, including lipid deposition, chronic inflammation, and mineralization. The progression of calcific AS is strongly associated with aging, with additional risk factors including male gender, smoking, dyslipidemia, and metabolic syndrome exacerbating the condition. Conversely, congenital forms of AS, such as bicuspid and unicuspid aortic valves, result in an earlier disease onset, typically 10-20 years earlier than that observed in patients with a normal tricuspid aortic valve. Rheumatic AS, although less common in developed countries due to effective antibiotic treatments, also exhibits age-related characteristics, with an earlier onset in individuals who experienced rheumatic fever in their youth. The only curative therapies currently available are surgical and transcatheter aortic valve replacement (TAVR). However, these options are sometimes too invasive for older patients; thus, management of AS, particularly in older patients, requires a comprehensive approach that considers age, disease severity, comorbidities, frailty, and each patient's individual needs. Although the valves used in TAVR demonstrate promising midterm durability, long-term data are still required, especially when used in younger individuals, usually with low surgical risk. Moreover, understanding the causes and mechanisms of structural valve deterioration is crucial for appropriate treatment selections, including valve selection and pharmacological therapy, since this knowledge is essential for optimizing the lifelong management of AS.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"28185"},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993769","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":"Intravenous Iron Sucrose for Acute Decompensated Heart Failure Patients with Reduced Ejection Fraction and Iron Deficiency.","authors":"Hsiao-Ping Sung, Wei-Hsian Yin, Szu-Fu Chen, Chung-Lieh Hung, Kuan-Chia Lin, Hung-Yu Chang","doi":"10.31083/RCM28216","DOIUrl":"https://doi.org/10.31083/RCM28216","url":null,"abstract":"<p><strong>Background: </strong>The concurrent presence of iron deficiency (ID) and heart failure (HF) can worsen prognosis and reduce the quality of life for affected individuals. This study aimed to explore the effects of incorporating iron sucrose into standard HF treatments for patients with acute decompensated HF and ID.</p><p><strong>Methods: </strong>We prospectively enrolled 65 hospitalized HF patients, all with a left ventricular ejection fraction of ≤40% and ID, defined as ferritin levels below 100 ng/mL or ferritin levels between 100 and 299 ng/mL with transferrin saturation below 20%. Patients were randomized into two groups: the iron sucrose group, who received intravenous iron sucrose in addition to the standard HF treatment; a control group who received standard HF treatment alone serum ferritin, iron, transferrin saturation, and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores were measured at baseline and a 4-week follow-up.</p><p><strong>Results: </strong>Baseline characteristics, iron profiles, and KCCQ scores were comparable between the two groups. At 4 weeks, patients in the iron sucrose group possessed significantly higher serum ferritin levels than those in the control group (ferritin 485.3 ± 269.7 ng/mL vs. 225.5 ± 162.5 ng/mL, <i>p</i> < 0.001; Δferritin 382.2 ± 243.5 ng/mL vs. 97.4 ± 143.0 ng/mL, <i>p</i> < 0.001, respectively). Only 9.1% of patients in the iron sucrose group remained within the ID criteria, compared to 36.7% in the control group (<i>p</i> = 0.012). The ΔKCCQ score was 10.6 points higher (27.8 ± 19.5 vs. 17.1 ± 17.8 points, <i>p</i> = 0.031) in the iron sucrose group than in the control group.</p><p><strong>Conclusions: </strong>Post-discharge intravenous iron sucrose may improve iron levels and quality of life in HF patients with ID.</p><p><strong>Clinical trial registration: </strong>NCT06703411, https://clinicaltrials.gov/expert-search?term=NCT06703411.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"28216"},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009712","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":"Predictive Effect of GDF-15 on Adverse Outcomes After Cardiovascular Interventions: A Systematic Review and Meta-Analysis.","authors":"Xiaotong Jia, Junwei Gao, Zeyou Qi, Jun Ma","doi":"10.31083/RCM28279","DOIUrl":"https://doi.org/10.31083/RCM28279","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to evaluate the predictive effect of Growth Differentiation Factor-15 (GDF-15) on adverse outcomes in patients undergoing cardiovascular interventions.</p><p><strong>Method: </strong>A comprehensive literature search was performed across PubMed, EMBASE, Cochrane Library, and Web of Science databases. The meta-analysis used hazard ratios (HR) and odds ratios (OR) to compare outcomes such as all-cause mortality, cardiovascular death, postoperative atrial fibrillation (AF), acute kidney injury (AKI), and spontaneous myocardial infarction (MI) between high GDF-15 levels and control groups. Subgroup analyses were conducted based on study design and GDF-15 cutoff levels. Publication bias was evaluated using funnel plot and Egger's test.</p><p><strong>Results: </strong>A total of 13 studies were included in the meta-analysis. The study revealed a significant association between elevated GDF-15 levels and increased all-cause mortality. Subgroup analysis showed a significant association in retrospective studies but not in prospective studies. Higher GDF-15 cutoff levels (>2 ng/mL) were more strongly associated with increased mortality than lower cutoff levels (≤2 ng/mL). Elevated GDF-15 levels were found to be significantly associated with increased risks of cardiovascular death, AKI, and spontaneous MI. No significant difference was observed in the incidence of postoperative AF. The overall adverse outcomes analysis showed no significant difference. Subgroup analyses suggested significant associations primarily observed in studies with higher GDF-15 cutoffs.</p><p><strong>Conclusion: </strong>Elevated GDF-15 levels are associated with increased risks of all-cause mortality, cardiovascular death, AKI, and spontaneous MI in patients undergoing cardiovascular interventions. Due to the heterogeneity of the studies, including variations in surgical techniques, the conclusions should be interpreted with caution.</p><p><strong>The prospero registration: </strong>CRD42024582279, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024582279.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"28279"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042194","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":"Predictors of Coronary Collateral Circulation in Patients with Acute ST-segment Elevation Myocardial Infarction: A Nomogram-based Approach.","authors":"Hongxia Shao, Wenling Zhao, Zhao Li, Xingchen Song, Ruifeng Liu","doi":"10.31083/RCM26477","DOIUrl":"https://doi.org/10.31083/RCM26477","url":null,"abstract":"<p><strong>Background: </strong>Coronary collateral circulation (CCC) is a crucial protective mechanism in acute myocardial infarction. This study aimed to identify early predictors of CCC in patients with acute ST-segment elevation myocardial infarction (STEMI) and develop a nomogram for predicting its presence.</p><p><strong>Methods: </strong>We conducted a retrospective study of STEMI patients admitted to the Beijing Friendship Hospital from January 2015 to December 2023. Patients with CCC, as confirmed by coronary angiography, were matched 1:3 with those without CCC based on the date of admission. We compared baseline characteristics, laboratory parameters, coronary features, and in-hospital outcomes between the two groups. Variable selection was performed using least absolute shrinkage and selection operator (LASSO) regression analysis, followed by univariable and multivariable logistic regression analyses to identify independent predictors of CCC. A nomogram was constructed based on significant predictors and was validated through receiver operating characteristic (ROC) curve analysis, calibration curves, and decision curve analysis.</p><p><strong>Results: </strong>A total of 668 patients with STEMI were included in the study (501 without CCC and 167 with CCC). Patients with CCC had a higher prevalence of right coronary artery (RCA) closure and multi-vessel disease, as well as elevated inflammatory markers and altered coagulation parameters. Multivariable logistic regression analysis identified a history of coronary heart disease (CHD), osmolality, levels of fibrinogen, and left anterior descending (LAD) artery closure, left circumflex (LCX) artery closure, and RCA closures, as well as the Gensini score, were independent predictors of CCC. The nomogram incorporating these predictors demonstrated good discrimination and calibration, indicating an accurate prediction of the presence of CCC.</p><p><strong>Conclusions: </strong>History of CHD, osmolality, levels of fibrinogen, LAD, LCX, and RCA closures, as well as the Gensini score, are independent predictors of CCC in patients with STEMI. The developed nomogram offers a clinically useful tool for identifying patients likely to have CCC, potentially aiding in personalized treatment strategies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26477"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992119","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":"'One Stop' Therapy has a Satisfying Performance on AF Patients with Interatrial Communication: Evidence from Pooled Clinical Experience.","authors":"Zhi-Yuan Zhang, Feng Li, Chi Geng, Yu-Qi Chen, Si-Liang Peng, Yao-Ting Zhang, You Zhang, Xiao-Song Gu, Hui Li","doi":"10.31083/RCM26662","DOIUrl":"https://doi.org/10.31083/RCM26662","url":null,"abstract":"<p><strong>Background: </strong>Left atrial appendage closure (LAAC) has been reported to be a viable alternative to prevent thromboembolic events for atrial fibrillation (AF) patients. Interatrial communication closure, such as atrial septal defect (ASD) and patent foramen ovale (PFO) closure could significantly decrease the occurrence of stroke. For AF patients with interatrial communication, the success rate as well as the long-term outcomes of 'One stop' closure remain elusive.</p><p><strong>Methods: </strong>Studies were systematically screened using online databases (including PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure (CNKI) database, and WanFang database) from their establishment to 1st August 2024. We utilized a fixed-effect model to synthesize the success rate and the long-term outcomes. Subgroup analysis was performed to identify the potential confounders.</p><p><strong>Results: </strong>A total of 7 studies comprising 156 patients were included. ASD/PFO closure combined with LAAC showed a high degree of feasibility, with a success rate of 1.00 (95% CI: 0.99, 1.00; <i>p</i> < 0.001). Meanwhile, 'One stop' ASD/PFO closure combined with LAAC exhibited a high long-term safety and a low occurrence of complications. Moreover, subgroup analysis revealed that the bleeding event occurrence was relatively higher in the male proportion ≥50% subgroup and HAS-BLED score ≥3 subgroup, respectively.</p><p><strong>Conclusions: </strong>ASD/PFO closure combined with LAAC has a satisfying performance on AF patients with interatrial communication.</p><p><strong>The prospero registration: </strong>CRD42023462221, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023462221.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26662"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009910","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":"CRO-INSIGHT: Utilization of Implantable Cardioverter Defibrillators in Non-ischemic and Ischemic Cardiomyopathy in a Single Croatian Tertiary Hospital Centre.","authors":"Mislav Puljevic, Eugen Ciglenecki, Vedran Pasara, Ivan Prepolec, Mia Dubravcic Dosen, Pero Hrabac, Ana-Marija Brekalo, Martina Lovric Bencic, Miroslav Krpan, Richard Matasic, Borka Pezo-Nikolic, Davor Puljevic, Davor Milicic, Vedran Velagic","doi":"10.31083/RCM26349","DOIUrl":"https://doi.org/10.31083/RCM26349","url":null,"abstract":"<p><strong>Background: </strong>Implantable cardioverter defibrillators (ICDs) have significantly reduced the incidence of sudden cardiac death in patients with heart failure, particularly those with ischemic heart disease. However, the impact on overall mortality remains controversial, especially in non-ischemic heart failure patients. The Danish Study to Assess the Efficacy of ICDs in Patients with Non-Ischemic Systolic Heart Failure (DANISH) trial and subsequent studies have questioned the efficacy of ICDs in this population, particularly among older patients. The present study aimed to evaluate survival outcomes and predictors in a Croatian cohort of patients with an ICD or cardiac resynchronization therapy defibrillator (CRT-D) device.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed data from 614 patients who received an ICD or CRT-D device at KBC Zagreb between 2009 and 2018. Patient data, including demographic information, device indication, and clinical parameters, were collected at the time of implantation. Follow-up data were systematically recorded to assess device activation and survival outcomes. Statistical analyses included a detailed descriptive analysis, Kaplan-Meier survival estimates, and Cox regression models.</p><p><strong>Results: </strong>The cohort consisted predominantly of males (83.4%), with a mean age of 58.7 years. Most had reduced left ventricular ejection fraction (mean 31.4%) and were classified as New York Heart Association (NYHA) class II or III. Over a median follow-up of 48.4 months, 36.6% of patients died. Device activation occurred in 30.3% of patients, with appropriate activation observed in 88.2% of these cases. Cox regression identified age, non-sustained ventricular tachycardia (NSVT), and decompensation history as significant survival predictors.</p><p><strong>Conclusions: </strong>This study confirmed that appropriate device activation improved survival in patients with an ICD/CRT-D. Age, NSVT, and history of decompensation were key predictors of device activation and survival outcomes. These findings underscore the need for individualized patient assessment when considering inserting ICDs, particularly in non-ischemic heart failure patients. Further research is needed to refine clinical guidelines and optimize patient selection for ICD therapy.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26349"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042062","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":"Evaluation of the Aspartate Aminotransferase to Platelet Ratio Index for Predicting In-Hospital Mortality in Cardiogenic Shock Patients Admitted to the Intensive Care Unit.","authors":"Min Yang, Dandan Liu, Yu Liu","doi":"10.31083/RCM26590","DOIUrl":"https://doi.org/10.31083/RCM26590","url":null,"abstract":"<p><strong>Backgrounds: </strong>This study aimed to investigate the conceivable utility of the aspartate aminotransferase to platelet ratio index (APRI) in prognostic prediction for patients with cardiogenic shock (CS) hospitalized in the intensive care unit (ICU).</p><p><strong>Methods: </strong>Data for patients diagnosed with CS were obtained from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database and categorized into groups based on the APRI quartiles. The primary endpoint encompassed in-hospital and ICU mortality rates. The secondary outcomes included sepsis and acute kidney injury (AKI). Kaplan-Meier survival analysis was utilized to assess differences in main endpoints among groups categorized by their APRI.</p><p><strong>Results: </strong>This study collected data from 1808 patients diagnosed with CS. Multivariate Cox regression analysis indicated that an elevated APRI was independently correlated with a heightened risk of in-hospital mortality (hazard ratio (HR) 1.005 [95% confidence interval (CI) 1.003-1.007]; <i>p</i> < 0.001) and ICU mortality (HR 1.005 [95% CI 1.003-1.007]; <i>p</i> < 0.001). Multivariate logistic regression analysis demonstrated that APRI was independently correlated with a heightened risk of sepsis (odds ratio (OR) 1.106 [95% CI 1.070-1.144]; <i>p</i> < 0.001) and AKI (OR 1.054 [95% CI 1.035-1.073]; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>An increased APRI was linked to worse clinical outcomes in critically ill patients with cirrhosis. Nevertheless, further extensive prospective investigations are needed to validate these findings.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"26590"},"PeriodicalIF":1.9,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005951","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 Prediction Model for In-hospital Mortality in Patients with Cardiac Arrest: A Retrospective Study.","authors":"Peifeng Ni, Shurui Xu, Weidong Zhang, Chenxi Wu, Gensheng Zhang, Qiao Gu, Xin Hu, Ying Zhu, Wei Hu, Mengyuan Diao","doi":"10.31083/RCM33387","DOIUrl":"https://doi.org/10.31083/RCM33387","url":null,"abstract":"<p><strong>Background: </strong>Cardiac arrest (CA) is associated with high incidence and mortality rates. Hence, assessing the prognosis of CA patients is crucial for optimizing clinical treatment. This study aimed to develop and validate a clinically applicable nomogram for predicting the risk of in-hospital mortality in CA patients.</p><p><strong>Methods: </strong>We retrospectively collected the clinical data of CA patients admitted to two hospitals in Zhejiang Province between January 2018 and June 2024. These patients were randomly assigned to the training set (70%) and the internal validation set (30%). Variables of interest included demographics, comorbidities, CA-related characteristics, vital signs, and laboratory results, and the outcome was defined as in-hospital death. Variables were selected using least absolute shrinkage and selection operator (LASSO) regression, recursive feature elimination (RFE), and eXtremely Gradient Boosting (XGBoost). Meanwhile, multivariate regression analysis was used to identify independent risk factors. Subsequently, prediction models were developed in the training set and validated in the internal validation set. Receiver operating characteristic (ROC) curves were plotted and the area under these curves (AUC) was calculated to compare the discriminative ability of the models. The model with the highest performance was further validated in an independent external cohort and was subsequently represented as a nomogram for predicting the risk of in-hospital mortality in CA patients.</p><p><strong>Results: </strong>This study included 996 CA patients, with an in-hospital mortality rate of 49.9% (497/996). The LASSO regression model significantly outperformed the RFE and XGBoost models in predicting in-hospital mortality, with an AUC value of 0.81 (0.78, 0.84) in the training set and 0.85 (0.80, 0.89) in the internal validation set. The AUC values for these sets in the RFE model were 0.74 (0.70, 0.78) and 0.77 (0.72, 0.83), respectively, and those for the XGBoost model were 0.75 (0.71, 0.79) and 0.77 (0.72, 0.83), respectively. For the optimal prediction model, the AUC value of the LASSO regression model in the external validation set was 0.84 (0.78, 0.90). The LASSO regression model was represented as a nomogram incorporating several independent risk factors, namely age, hypertension, cause of arrest, initial heart rhythm, vasoactive drugs, continuous renal replacement therapy (CRRT), temperature, blood urea-nitrogen (BUN), lactate, and Sequential Organ Failure Assessment (SOFA) scores. Calibration and decision curves confirmed the predictive accuracy and clinical utility of the model.</p><p><strong>Conclusions: </strong>We developed a nomogram to predict the risk of in-hospital mortality in CA patients, using variables selected via LASSO regression. This nomogram demonstrated strong discriminative ability and clinical practicality.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"33387"},"PeriodicalIF":1.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036591","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":"Intracardiac Echocardiography to Guide Left Atrial Appendage Occlusion: An Update.","authors":"Milos Brankovic, Adamantios Tsangaris, Luka Petrovic, Abhishek Sharma","doi":"10.31083/RCM28189","DOIUrl":"https://doi.org/10.31083/RCM28189","url":null,"abstract":"<p><p>The left atrial appendage occlusion (LAAO) procedure is an important intervention for stroke prevention in patients with non-valvular atrial fibrillation who cannot tolerate anticoagulation. Accurate imaging is essential to guide and ensure optimal device deployment. Transesophageal echocardiography (TEE) has traditionally been the gold standard for procedural guidance, but intracardiac echocardiography (ICE) is emerging as an alternative owing to its unique advantages. This review examines the comparative effectiveness, procedural advantages, limitations, and clinical outcomes of ICE and TEE in LAAO closure, highlighting emerging trends and implications for future clinical practice.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 4","pages":"28189"},"PeriodicalIF":1.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992112","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}