Vascular Health and Risk Management最新文献

{"title":"Association of the Hemoglobin, Albumin, Lymphocyte, and Platelet Score with Contrast-Associated Acute Kidney Injury and Mortality in Patients Underwent Coronary Angiography: A Multicenter Retrospective Cohort Study.","authors":"Xi Yang, Junfeng Zhu, Zhifei Chen, Dehua Huang, Jieyi Chen, Guanghui Zhang, Zeliang Li, Xiaoyu Huang","doi":"10.2147/VHRM.S634088","DOIUrl":"10.2147/VHRM.S634088","url":null,"abstract":"<p><strong>Purpose: </strong>Contrast-associated acute kidney injury (CA-AKI) is a frequent complication in patients undergoing coronary angiography (CAG), which can cause deterioration of renal function and adverse clinical outcomes. This study aimed to explore the relationships between the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and CA-AKI risk, as well as all-cause and cardiovascular mortality in patients undergoing CAG.</p><p><strong>Patients and methods: </strong>This retrospective observational study enrolled patients undergoing CAG, including those receiving concomitant percutaneous coronary intervention (PCI), and stratified them according to the quartiles of the HALP score. Multivariate Logistic regression analysis was used to assess the association between HALP score and CA-AKI, and the Cox regression model was adopted to evaluate the relationship between HALP score and mortality.</p><p><strong>Results: </strong>This study included 42554 patients undergoing CAG. Among these, 5130 patients (12.1%) experienced CA-AKI. HALP score showed a significant inverse association with CA-AKI, with lower HALP score linked to higher CA-AKI risk. After adjusting for all the potential confounding variables, participants in the highest quartile of HALP score had the lowest risk of CA-AKI (OR = 0.81, 95% CI: 0.73-0.90, p < 0.001). In Cox regression models, patients undergoing CAG with the highest HALP score exhibited the lowest risks of all-cause mortality (HR=0.65, 95% CI: 0.60-0.70, p < 0.001) and cardiovascular mortality. (HR=0.65, 95% CI: 0.58-0.73, p < 0.001).</p><p><strong>Conclusion: </strong>The HALP score was independently associated with CA-AKI, all-cause mortality, and cardiovascular mortality among patients undergoing CAG.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"634088"},"PeriodicalIF":3.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216818","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":"Doppler Ultrasound-Derived Blood Flow Parameters Associated with Significant Arteriovenous Fistula Stenosis in a Large Vietnamese Hemodialysis Cohort.","authors":"Hien Van Pham, Nhat Van Tran, Huong Thi Bich Tran, Truc Thanh Thai","doi":"10.2147/VHRM.S624013","DOIUrl":"https://doi.org/10.2147/VHRM.S624013","url":null,"abstract":"<p><strong>Purpose: </strong>Arteriovenous fistula (AVF) stenosis is a major cause of vascular access dysfunction in hemodialysis patients. This study evaluated the associations between Doppler ultrasound-derived blood flow parameters measured at different AVF sites and Doppler-defined significant AVF stenosis.</p><p><strong>Methods: </strong>This retrospective cohort study included adult hemodialysis patients with native AVFs who underwent Doppler ultrasound evaluation at Cho Ray Hospital, Vietnam. Blood flow parameters were measured at the brachial artery, anastomosis, 5 cm from the anastomosis, and 10 cm from the anastomosis. Doppler-defined significant stenosis was defined as ≥50% luminal narrowing compared with the adjacent normal vessel segment. Univariable and multivariable logistic regression analyses were performed to evaluate associations between Doppler flow parameters and significant stenosis.</p><p><strong>Results: </strong>Among 1,541 patients, 585 (38.0%) had Doppler-defined significant AVF stenosis. Patients with significant stenosis had lower blood flow values at all evaluated sites, including Qmin and Qmean (all p<0.001). After adjustment for demographic and AVF characteristics, higher blood flow values remained associated with lower odds of significant stenosis. The adjusted odds ratios (95% confidence intervals) per 500 mL/min increase were 0.73 (0.67-0.79) for brachial artery flow, 0.76 (0.71-0.83) for anastomosis flow, 0.83 (0.78-0.89) for flow measured 5 cm from the anastomosis, 0.81 (0.75-0.87) for flow measured 10 cm from the anastomosis, 0.63 (0.56-0.71) for Qmin, and 0.76 (0.70-0.82) for Qmean. Significant stenosis was still observed in some patients with relatively high flow values.</p><p><strong>Conclusion: </strong>Lower Doppler ultrasound-derived blood flow values at multiple AVF sites were associated with Doppler-defined significant AVF stenosis and may support comprehensive vascular access assessment. Further prospective studies using independent reference standards and clinically relevant outcomes are needed before these parameters can be used as validated predictive tools.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"624013"},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169630","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":"A New Chapter for <i>Vascular Health and Risk Management</i>: Continuing Excellence and Impact in Vascular Medicine.","authors":"Mirna N Chahine","doi":"10.2147/VHRM.S657119","DOIUrl":"https://doi.org/10.2147/VHRM.S657119","url":null,"abstract":"","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"657119"},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169635","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":"Refining the Stroke Risk Screening Scales (SRSS) Through Two-Round Cognitive Interviews with Stroke Survivors and Healthcare Providers in Thailand.","authors":"Suebsarn Ruksakulpiwat, Thitipong Tankumpuan, Ruttanaporn Kongkar, Sumana Srisoongnern, Rachadaporn Saenmueang, Joachim G Voss","doi":"10.2147/VHRM.S618512","DOIUrl":"10.2147/VHRM.S618512","url":null,"abstract":"<p><strong>Background: </strong>Accurate stroke risk screening requires instruments that are both clinically valid and easily understood by end users. Although the Stroke Risk Screening Scales (SRSS) demonstrated strong content validity, challenges related to item interpretation and response processes may compromise measurement accuracy. This study aimed to examine these barriers and identify strategies to enhance the clarity, accuracy, and usability of the SRSS.</p><p><strong>Methods: </strong>A qualitative cognitive interviewing approach was conducted with 30 purposively sampled participants, including 15 individuals with stroke and 15 healthcare providers. Each participant completed two interview rounds, with the same 30 participants re-interviewed in Round 2 (conducted within one month of Round 1) to confirm whether revisions made after Round 1 addressed the barriers identified, yielding a total of 60 interviews. Data were collected using a semi-structured verbal probing guide to explore participants' understanding, reasoning, and response processes across 30 SRSS items. Interviews were audio-recorded, transcribed verbatim, and analyzed using inductive thematic analysis based on Braun and Clarke's framework. Rigor was ensured through independent coding, iterative codebook development, triangulation, and maintenance of an audit trail.</p><p><strong>Results: </strong>Two overarching themes emerged: (1) interpretation and response barriers, including technical terminology, ambiguous measurement units, recall difficulties, misaligned response options, lack of skip logic, and cultural mismatches; and (2) evidence-based refinement strategies to improve usability. Participants recommended simplifying terminology, incorporating descriptive examples, aligning question stems with response options, implementing skip logic, and standardizing measurement units and thresholds. These findings highlighted critical gaps between clinical terminology and lay understanding that may affect response accuracy.</p><p><strong>Conclusion: </strong>Cognitive interviewing identified key interpretive and structural limitations in the SRSS and provided actionable, user-informed strategies for refinement. These findings offer preliminary response-process evidence supporting the interpretability and usability of the SRSS among stroke survivors and healthcare providers, and highlight the importance of user-centered pre-testing in the development of screening tools for diverse populations. Further psychometric evaluation in larger and more diverse samples is needed to establish the instrument's reliability, validity, and clinical applicability.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"618512"},"PeriodicalIF":3.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082166","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":"Development and Temporal Validation of a Logistic Regression-Based Risk Score for Identifying Life-Threatening Chest Pain at Emergency Department Triage: A Retrospective Cohort Study.","authors":"Dongsheng Xu, Ping Gao, Qiang Xu, Huanhuan Nie","doi":"10.2147/VHRM.S623118","DOIUrl":"10.2147/VHRM.S623118","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chest pain is a frequent emergency department (ED) presentation with highly time-dependent outcomes. Widely used risk tools such as HEART and GRACE incorporate laboratory results that are unavailable at first nurse contact, limiting their value for immediate triage. In mainland China, acuity assignment follows the Chinese Emergency Triage Scale (CETS), yet nurse triage accuracy remains variable, particularly among less experienced staff.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To develop and temporally validate a simplified, non-laboratory clinical risk score that identifies life-threatening conditions (LTCs)-defined as final physician-assigned CETS Level I or II-among adults presenting to the ED with chest pain, and to map score thresholds onto the four-level CETS framework for nurse-facing decision support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a single-centre retrospective observational cohort study, reported in accordance with TRIPOD+AI, at an ED of a large tertiary academic hospital in Hefei, Anhui Province, China. The cohort was split by calendar time into an internal development cohort (n = 2,005; July 2020-February 2021) and a temporal validation cohort (n = 501; February-March 2021). The internal cohort was randomly divided into a training set (n = 1,391) and a test set (n = 614). Candidate predictors were restricted to information routinely available at nurse triage. Least absolute shrinkage and selection operator (LASSO) regression identified parsimonious predictors, which were entered into a multivariable logistic regression (LR) model. Six machine-learning (ML) algorithms were trained as benchmarks. Discrimination (AUC, AUPRC), calibration (calibration curves, Brier score), clinical utility (decision-curve analysis, standardised net benefit), and DeLong tests for AUC differences were evaluated. An integer risk score was derived from LR coefficients. Feature contributions were examined with SHAP values based on the LR model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;LTC prevalence was 44.8% (899/2,005) in the internal cohort and ED mortality was 1.7% (34/2,005). LASSO retained 13 predictors: age, sex, mode of arrival, symptom onset time, cardiogenic chest pain (CCP), chest tightness, hypertension, diabetes, coronary artery disease (CAD), chronic kidney disease (CKD), cerebrovascular disease (CVD), shock index (SI), and Modified Early Warning Score (MEWS). The LR model showed stable discrimination-AUC 0.864 (95% CI 0.844-0.883) in training, 0.876 (0.849-0.904) in the test set, and 0.860 (0.825-0.896) in temporal validation-without statistically significant AUC superiority of more complex ML models on the test or validation sets (DeLong P &gt; 0.05). In the test set, LR achieved the highest AUPRC (0.858), F1 score (0.792), and standardised net benefit (0.690), with the lowest Brier score (0.142). The integer score ranged from -3 to 49. At the Youden-optimal cut-off of 18.8, four CETS-aligned tiers were defined: Level IV ","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"623118"},"PeriodicalIF":3.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075898","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":"MiR-375 Targeting PDK1 Regulates the Wnt/β-Catenin Pathway in Lower Extremity Arteriosclerosis Obliterans.","authors":"Zongrong Liu, Zhujun Yue, Ruirui Yang, Safwan Muhammad, Jingquan Chen","doi":"10.2147/VHRM.S594540","DOIUrl":"10.2147/VHRM.S594540","url":null,"abstract":"<p><strong>Background: </strong>Lower extremity arteriosclerosis obliterans (LEASO) is a severe peripheral arterial disease characterized by chronic inflammation, lipid deposition, and vascular remodeling. MicroRNA-375 (miR-375) has emerged as a regulatory molecule in vascular pathology, but its role in LEASO remains unclear.</p><p><strong>Objective: </strong>This study investigated whether miR-375 regulates the Wnt/β-catenin signaling pathway by targeting pyruvate dehydrogenase kinase 1 (PDK1), and its impact on LEASO progression.</p><p><strong>Methods: </strong>Clinical samples (arterial tissues and blood) were collected from 10 LEASO patients and 10 trauma-related amputation controls. Histology, qPCR, Western blot, and ELISA were used to evaluate molecular and inflammatory markers. Animal models of atherosclerosis (LDLR-/- mice) and LEASO (SD rats) were established, with Wnt/β-catenin pathway inhibition as intervention. In vitro, vascular smooth muscle cells (VSMCs) were transfected with miR-375 mimics/inhibitors, and functional assays were performed. Dual-luciferase reporter assays confirmed the interaction between miR-375 and PDK1.</p><p><strong>Results: </strong>Compared with the control group, miR-375 expression was markedly downregulated in LEASO tissues, reaching only 50.3% of the control level (P=0.008). By contrast, the mRNA and protein expression levels of PDK1, Wnt3a and β-catenin were significantly increased. A strong positive correlation was observed between PDK1 expression and Wnt signaling activity (r=0.91, P=0.012). Dual-luciferase reporter assay verified that miR-375 directly bound to the 3'-untranslated region (3'-UTR) of PDK1 mRNA, and suppressed PDK1 expression by 78% (P<0.001).In vascular smooth muscle cells (VSMCs), miR-375 overexpression suppressed cell proliferation and migration by 41.5% and 17.3%, respectively. Nevertheless, simultaneous PDK1 overexpression reversed these inhibitory biological effects. Notably, miR-375 upregulation inhibited the PDK1-Wnt/β-catenin signaling cascade and alleviated pathological phenotypes both in vitro and in vivo. However, endogenous miR-375 reduction was accompanied by compensatory and nonlinear alterations of molecular profiles under certain in vitro conditions, such as oxidized low-density lipoprotein (ox-LDL)-stimulated VSMCs.In vivo experiments demonstrated that restored miR-375 expression reduced atherosclerotic plaque area by 41.5%, decreased the secretion of pro-inflammatory cytokines including interleukin-6 (IL-6) and interleukin-1β (IL-1β), and enhanced plaque stability. Conversely, miR-375 knockdown aggravated intracellular lipid deposition and systemic inflammatory responses.</p><p><strong>Conclusion: </strong>miR-375 suppresses LEASO progression by targeting PDK1 and downregulating Wnt/β-catenin signaling. Restoring miR-375 expression represents a promising therapeutic strategy for LEASO.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"594540"},"PeriodicalIF":3.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026016","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":"Short-Term 24-h Systolic Blood Pressure Variability and Subclinical Target-Organ Damage in White-Coat Hypertension: A Retrospective Cross-Sectional Study.","authors":"Jing Huang, Zien Huang, Feng Huang","doi":"10.2147/VHRM.S626042","DOIUrl":"10.2147/VHRM.S626042","url":null,"abstract":"<p><strong>Objective: </strong>To compare subclinical target-organ damage (TOD) across normotension (NT), white-coat hypertension (WCH), and mild-to-moderate hypertension (HT), and examine the association of 24-h systolic blood pressure (SBP) variability with concurrent TOD in untreated WCH.</p><p><strong>Methods: </strong>This single-center retrospective cross-sectional study included 267 hospitalized participants who underwent ambulatory blood pressure monitoring between 2012 and 2021 (91 NT, 93 WCH, 83 HT). TOD markers were compared across groups. Within WCH, multivariable models assessed 24-h SBP variability in relation to any TOD, left ventricular hypertrophy (LVH), left ventricular mass index (LVMI), and microalbuminuria (MA), adjusting for age, sex, body mass index, and 24-h mean SBP.</p><p><strong>Results: </strong>Any TOD occurred in 26.4%, 52.7%, and 71.1% of NT, WCH, and HT participants, respectively (P<0.001). Within WCH, any TOD occurred in 35.5%, 64.5%, and 58.1% across increasing variability tertiles; the unadjusted between-tertile comparison was not statistically significant (P=0.056). Continuous 24-h SBP variability was associated with any TOD (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.05-1.52), LVH (OR 1.30, 95% CI 1.08-1.60), LVMI (β=2.23 g/m², 95% CI 0.33-4.12), and log-transformed MA (β=0.105, 95% CI 0.052-0.157). The area under the receiver operating characteristic curve was 0.613 for the base model and 0.678 after adding 24-h SBP variability, with better overall fit of the extended model (likelihood-ratio P=0.009).</p><p><strong>Conclusion: </strong>WCH showed an intermediate prevalence of any TOD between NT and mild-to-moderate HT. Within WCH, higher 24-h SBP variability was associated with concurrent TOD after accounting for 24-h mean SBP and basic clinical factors, and may provide Supplementary Information when interpreted alongside mean ambulatory blood pressure. These single-center cross-sectional findings do not establish temporal or causal relationships and require confirmation in prospective multicenter studies.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"626042"},"PeriodicalIF":3.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012991","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":"Temporal Changes in Hospital-Captured 90-Day Care After Venous Thromboembolism: A 16-Year Electronic Health Record Cohort Study.","authors":"Yonghui Wang, Yan Wang, Xuemin Zhang, Wei Li, Weihao Li, Tao Zhang","doi":"10.2147/VHRM.S637373","DOIUrl":"10.2147/VHRM.S637373","url":null,"abstract":"<p><strong>Background: </strong>Direct oral anticoagulants (DOACs) have simplified treatment for venous thromboembolism (VTE), but fewer mandatory monitoring visits may reduce opportunities for structured reassessment. We evaluated temporal changes in hospital-captured documentation of post-VTE care processes during the transition to DOAC-based treatment, including initial anticoagulation, clinical follow-up, laboratory monitoring, and selective imaging reassessment.</p><p><strong>Methods: </strong>We conducted a single-center retrospective electronic health record cohort study using routinely collected vascular surgery outpatient and inpatient records from Peking University People's Hospital between 2009 and 2024. Patients with VTE-related evidence and a definable hospital-captured index date were included. Treatment eras were prespecified as 2009-2014, 2015-2019, and 2020-2024. The study-defined documentation measure comprised therapeutic anticoagulation within 14 days and clinical follow-up, laboratory monitoring, and selective VTE-related ultrasound or imaging reassessment within 15-90 days.</p><p><strong>Results: </strong>Among 5998 patients with a definable hospital-captured index VTE-related event, the median age was 64.0 years, and 55.3% were female. Documented anticoagulation within 14 days increased from 34.1% in 2009-2014 to 58.0% in 2020-2024. Within 15-90 days, clinical follow-up was documented in 1483 patients (24.7%), laboratory monitoring in 366 (6.1%), and VTE-related ultrasound or imaging reassessment in 578 (9.6%). All four prespecified domains were documented in 149 patients (2.5%) overall and in 3.2% during 2020-2024. In multivariable analysis, the 2020-2024 era, pulmonary embolism presentation, and upper-extremity or catheter-related VTE were associated with higher odds of four-domain documentation completion.</p><p><strong>Conclusion: </strong>In this 16-year electronic health record cohort, hospital-captured documentation of early anticoagulation increased, whereas documentation of 90-day follow-up processes remained infrequent; incomplete documentation or care delivered outside the hospital system may have contributed. These findings highlight opportunities to strengthen continuity and traceability of post-VTE management through timely clinical review and individualized decisions regarding treatment duration, safety monitoring, and selective imaging when clinically indicated.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"637373"},"PeriodicalIF":3.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009212","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":"Sex as a Modifier of Health-Related Quality of Life, Illness Acceptance, and Psychological Distress in Patients After Aortic Aneurysm Repair: A 2-Year Prospective Study.","authors":"Aneta Maria Kubisa, Sara Daria Janczak, Izabella Uchmanowicz, Ercole Vellone, Gianluca Pucciarelli, Dariusz Janczak, Aleksandra Kołtuniuk","doi":"10.2147/VHRM.S626089","DOIUrl":"10.2147/VHRM.S626089","url":null,"abstract":"<p><strong>Introduction: </strong>Women constitute a minority of patients undergoing aortic aneurysm repair, yet available data suggest a worse quality of life and a higher burden of perioperative anxiety in this group. Prospective, multi-timepoint data comparing the sexes in Polish clinical centres are virtually absent. We assessed whether sex modifies quality of life, illness acceptance, and psychological distress over 2 years following aortic aneurysm repair.</p><p><strong>Material and methods: </strong>In this prospective, single-centre cohort study, 150 consecutive patients (113 men, 37 women; mean age 69.9, SD 8.1 years) treated for aortic aneurysm between 2021 and 2024 completed the WHOQOL-Bref, the Acceptance of Illness Scale (AIS) and the Hospital Anxiety and Depression Scale, Polish modified version (HADS-M), immediately after surgery and at 6 months, 1 year and 2 years. The cohort was unrestricted with respect to aneurysm extent and repair modality. The primary analysis used generalised estimating equations including sex, time and the sex-by-time interaction, adjusted for age, repair modality, urgency of admission, ischaemic heart disease and partnered status. A prespecified sensitivity analysis was restricted to infrarenal aneurysms treated by standard endovascular repair (n=94).</p><p><strong>Results: </strong>Immediately after surgery, women scored lower than men in all four WHOQOL-Bref domains: physical 52.7 vs 60.2 (p=0.013), psychological 58.4 vs 68.1 (p=0.001), social relationships 59.0 vs 69.6 (p<0.001) and environmental 62.8 vs 67.5 (p=0.037); anxiety was higher in women (8.7 vs 7.1; p=0.035). After adjustment, the early deficit remained significant for the psychological domain (adjusted difference -9.26, 95% CI -15.54 to -2.98; p=0.004) and the social relationships domain (-9.85, 95% CI -15.95 to -3.74; p=0.002) but not for the physical or environmental domains, and the crude anxiety difference did not survive adjustment (p=0.253). Significant sex-by-time interactions indicated convergence in all domains except social relationships, for which the adjusted female deficit persisted across follow-up (-6.86, 95% CI -12.27 to -1.44; p=0.013). At 2 years no woman remained in the low illness-acceptance category compared with 20.5% of men (p=0.037); this categorical comparison rests on small and unstable cell counts and is presented as descriptive only. The sensitivity analysis reproduced and strengthened these findings.</p><p><strong>Conclusion: </strong>Women undergoing aortic aneurysm repair report a lower quality of life in the early postoperative period, and the deficit in the social relationships domain is the one that persists over 2 years after adjustment. In the absence of a preoperative baseline and with a small female subgroup, these observations are hypothesis-generating and support the routine, sex-stratified capture of patient-reported outcome measures in aortic practice.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"626089"},"PeriodicalIF":3.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009167","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":"Risk Factors and Clinical Outcomes for Patients with Venous Thromboembolism in Kenya: Findings from the HEART Registry.","authors":"Soud Seif, Jasmit Shah, Mohamed Jeilan, Anders Barasa, Harun A Otieno, Felix Ayub Barasa, Bernard Gitura, Mzee Ngunga","doi":"10.2147/VHRM.S586399","DOIUrl":"10.2147/VHRM.S586399","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE) poses a significant burden despite advances in diagnostic and therapeutic options. The risk factors and clinical outcomes of VTE are dynamic, highlighting the need for more comprehensive studies, especially in sub-saharan Africa. This study aimed to identify risk factors and clinical outcomes in three major tertiary centers in Kenya.</p><p><strong>Methodology: </strong>The HEART Registry was developed in 2021 and recruited patients with VTE prospectively over three years from three facilities in Kenya. Patients' demographics, risk factors for VTE, hospital course, and clinical outcomes over six months were obtained. Descriptive statistics were used to summarize the data, presenting the findings as frequencies, percentages, medians, and interquartile ranges. No pre-specified inferential or comparative analyses were planned, consistent with the descriptive registry design.</p><p><strong>Results: </strong>A total of 422 patients with VTE were prospectively enrolled. The median age was 46.5 years notably younger than typically reported in Western populations. DVT was the most common presentation (54%) followed by PE (38.4%). A substantial proportion of patients (49.5%) did not have any identifiable risk factors (unprovoked VTE). The most common acute-phase treatment was low molecular weight heparin (57.5%), followed by warfarin (28.6%). Direct oral anticoagulants recommended as first line therapy by current international guidelines were available but underutilized reflecting access constraints. Only 1.7% of participants received thrombolytic therapy. The median length of hospital stay was eight days. In the acute phase, 10.4% (n=31) of admitted participants died. At six-month follow-up, death occurred in an additional 39 patients.</p><p><strong>Conclusion: </strong>A substantial proportion of VTE patients in Kenya had no identifiable risk factors which is a pattern consistent with global data on unprovoked VTE. This highlights the need for caution in attributing VTE solely to preventable causes. VTE associated acute and six month mortality was high, driven predominantly by underlying comorbidities. Preventing VTE in acute medical conditions remains a major area of concern and future prospective studies are needed to identify novel population specific risk factors and optimize outcomes in this setting.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"586399"},"PeriodicalIF":3.2,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921093","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}