Vascular Health and Risk Management最新文献

{"title":"The Association of Lipoprotein(a) Levels with Atherosclerotic Cardiovascular Disease in Thailand: A Cross-Sectional Study.","authors":"Lukana Preechasuk, Tanawan Kongmalai, Varisara Lapinee, Busadee Pratumvinit, Nuntakorn Thongtang","doi":"10.2147/VHRM.S544693","DOIUrl":"10.2147/VHRM.S544693","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal plasma lipoprotein(a) [Lp(a)] cutoff level for predicting atherosclerotic cardiovascular disease (ASCVD) in Southeast Asian populations remains limited. Therefore, our study aimed to identify the optimal plasma Lp(a) cutoff for predicting ASCVD in Thai patients.</p><p><strong>Patients and methods: </strong>We conducted a retrospective analysis of patients who underwent Lp(a) measurement at Siriraj Hospital between January 2019 and August 2024. Inclusion criteria included Thai ethnicity and age ≥15 years. Baseline characteristics, comorbidities, laboratory data, and Lp(a) levels were extracted from medical records. Lp(a) levels were compared between ASCVD and non-ASCVD groups. Odds ratios (OR) for ASCVD and coronary artery disease (CAD) were calculated using Lp(a)<25 nmol/L as the reference.</p><p><strong>Results: </strong>A total of 2341 patients (age 54.4±17.7 years, 42.0% male) were included. Among them, 413 (17.6%) had ASCVD, 254 (10.9%) had CAD, 186 (7.9%) had ischemic stroke, 21 (0.9%) had peripheral arterial disease (PAD), and 14 (0.6%) had abdominal aortic aneurysm. Median Lp(a) levels (nmol/L) were significantly higher in patients with ASCVD [37.2 vs 24.4, p<0.001], CAD [43.8 vs 24.5, p<0.001], and AS [51.6 vs 25.3, p=0.002] compared to those without diseases. After adjusting for other risk factors, Lp(a)≥40 nmol/L was associated with increased risks of ASCVD [OR 1.538 (1.203-1.958)] and CAD [OR 1.877 (1.407-2.505)]. A multivariate model incorporating Lp(a)≥40 nmol/L with other risk factors demonstrated 70-80% sensitivity and specificity for predicting ASCVD and CAD.</p><p><strong>Conclusion: </strong>Elevated plasma Lp(a) levels are significantly associated with ASCVD and CAD. An Lp(a) cutoff of≥40 nmol/L predicted ASCVD and CAD risk in Thai.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"813-822"},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186920","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":"Postoperative Acute Refractory Hypoxemia After Acute Type A Aortic Dissection Surgery: Supporting the Two-Hit Mechanism of Transfusion-Related Acute Lung Injury. A Retrospective Cohort Study.","authors":"Mariam Omotolani Afolabi, Jiannan Li, Jian Wang, Mashud Akinfemi Junior Abass, AiLing Lin, Asta Debora, Tinotenda Blessing Madzikatire, Jue Wang","doi":"10.2147/VHRM.S544999","DOIUrl":"10.2147/VHRM.S544999","url":null,"abstract":"<p><strong>Background: </strong>Acute type A aortic dissection (ATAAD) surgery is often complicated by postoperative acute refractory hypoxemia (ARH). Multiple risk factors contribute to ARH, and perioperative blood transfusion is a potential risk factor. This study investigates the association between perioperative blood product transfusion and ARH in ATAAD surgical patients.</p><p><strong>Methods: </strong>This retrospective cohort study included 282 patients who underwent surgical repair of ATAAD between 2015 and 2020. Perioperative blood product transfusion volumes, postoperative oxygenation indices, laboratory and radiological findings were analyzed. The primary outcome, ARH, was defined as moderate-to-severe hypoxemia (P/F ≤ 200 mmHg) within 72 hours postoperatively. Multivariate logistic regression was used to identify risk factors for ARH, confounders were adjusted for, and platelet transfusion association was further evaluated.</p><p><strong>Results: </strong>Acute refractory hypoxemia occurred in 35.8% of the total patient cohort. At baseline, ARH patients had significantly higher BMI and a high prevalence of hypertension and coronary artery disease. Marfan syndrome was significantly more prevalent in the non-ARH group. Platelet transfusion was administered in 81.2% of patients, and a significantly higher frequency of ARH patients received platelet transfusion [p=0.013; Adjusted OR 95% CI; 3.43 (1.54-7.63)]. A synergistic effect was observed between high preoperative C-reactive protein (CRP) and platelet transfusion in the resulting ARH [<i>p</i> < 0.001; adjusted OR 95% CI: 16.06 (3.02-85.50)]. After multivariate logistic regression analysis, platelet transfusion, high CRP, brachiocephalic trunk involvement, and prolonged hypothermic circulatory arrest time were independent risk factors for postoperative ARH after ATAAD surgery. ARH patients required a significantly longer duration of mechanical ventilation.</p><p><strong>Conclusion: </strong>Platelet transfusion was independently associated with risk of postoperative ARH, supporting a potential TRALI-like mechanism. Findings suggest that in high-risk ATAAD surgery, the synergistic effect of preoperative systemic inflammation and platelet transfusion may contribute to lung injury compatible with the \"two-hit\" model. This potential pathway requires further investigation.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"797-811"},"PeriodicalIF":2.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114271","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":"Fasting Blood Glucose on Prognosis After Acute Large Vessel Occlusion Reperfusion- A Multi-Center Study Based on Propensity Score Matching.","authors":"Bin Luo, Yi Xiang, Yueming Pan, Fanlei Meng, Juanjuan Zhang, Zhiguang Liu, Peixian Lin, Long Zhang, Yubo Wang, Hecheng Ren, Lin Ma, Ying Huang","doi":"10.2147/VHRM.S530356","DOIUrl":"10.2147/VHRM.S530356","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the impact of 24-hour post-reperfusion glycemic control on 90-day functional outcomes in acute large vessel occlusion (ALVO) patients after successful recanalization.</p><p><strong>Materials and methods: </strong>This multi-center retrospective study analyzed 2056 ALVO patients (male: 1488; female: 568) from three cerebrovascular centers achieving successful reperfusion via mechanical thrombectomy with/without bridging thrombolysis. Using 1:1 propensity score matching (covariates: gender, age, Diabetes mellitus, hypertension, hyperlipidemia, cardiac disease, smoking status, glucose measurement timing, baseline NIHSS, and preoperative mRS), 194 matched pairs (mean age 63[IQR 55-71] years; male: 278) were stratified by 90-day modified Rankin Scale (mRS) outcomes into favorable (mRS 0-2) and poor prognosis (mRS 3-6) cohorts.</p><p><strong>Results: </strong>The poor prognosis cohort demonstrated significantly elevated mean fasting blood glucose (MFBG) levels (7.22 mmol/L [6.66-8.50] vs 6.86 mmol/L [6.28-7.58], P<0.001). Multivariable logistic regression adjusted for sex, age, vascular risk profile, and baseline NIHSS (adjusted OR=0.819, 95% CI 0.714-0.940, P=0.004) confirmed MFBG elevation as an independent risk factor for unfavorable outcomes.</p><p><strong>Conclusion: </strong>Sustained hyperglycemia during the initial 24-hour post-recanalization period independently predicts impaired 90-day functional recovery in ALVO patients. These findings highlight the imperative for standardized glucose monitoring protocols during the hyperacute post-thrombectomy phase, while optimal glycemic targets (<7.0 mmol/L vs individualized thresholds) and therapeutic windows for neuroprotection warrant validation through prospective multicenter RCTs.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"785-795"},"PeriodicalIF":2.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Safety of Radiofrequency Catheter Ablation Using Three-Dimensional Electroanatomic Mapping Systems in Treating Ventricular Arrhythmias: A Single-Center Prospective Cohort Study in Vietnam.","authors":"Le Uyen Phuong Tran, Ngoc Dung Kieu, Cao Dat Tran, Tri-Thuc Nguyen, Van Sy Hoang, Truc Thanh Thai","doi":"10.2147/VHRM.S549819","DOIUrl":"10.2147/VHRM.S549819","url":null,"abstract":"<p><strong>Purpose: </strong>Advanced catheter ablation using three-dimensional electroanatomic mapping (EAM) has shown favorable outcomes in high-income countries, but real-world evidence from low- and middle-income settings is scarce. This study aimed to assess the clinical characteristics, procedural features, and outcomes of radiofrequency ablation using EAM in patients with ventricular tachycardia (VT) or premature ventricular contractions (PVCs) at a tertiary cardiac center in Vietnam.</p><p><strong>Methods: </strong>We analyzed 233 patients who underwent VT and PVC ablation at Cho Ray Hospital from March 2021 to December 2023. Patients were categorized into two groups based on left ventricular ejection fraction (LVEF) with the cut-off value of 50%: reduced (LVEF < 50%, n = 39) and preserved (LVEF ≥ 50%, n = 194). Data on demographics, arrhythmia burden, ablation protocol, and follow-up outcomes were collected and compared.</p><p><strong>Results: </strong>Patients with reduced LVEF more frequently presented with ventricular tachycardia (23.1% vs 6.7%, p < 0.001), ischemic heart disease (23.1% vs 7.7%, p = 0.008), and were more likely to require irrigated catheters (46.2% vs 20.1%, p = 0.001). The PVC burden prior to ablation was significantly different between groups (36.3% ± 17.2 vs 27.8% ± 12.2, p = 0.014) and patients with reduced LVEF exhibited remarkable recovery after ablation, with LVEF improving from 33.7 ± 8.1 to 55.2 ± 9.1 (<i>p</i> < 0.001). The acute ablation success rate was 100% in both groups. The procedure demonstrated high levels of safety, with a non-severe complication rate of 4.7% (n = 11) and low radiation exposure (median 16 mGy [inter-quartile range: 11-26]).</p><p><strong>Conclusion: </strong>Catheter ablation is highly effective and safe in treating ventricular arrhythmias across different LVEF, especially in ventricular arrhythmia-induced cardiomyopathy group, leading to rapid recovery of left ventricular function and reduction in arrhythmia burden. These findings provide important real-world evidence from a resource limited setting, providing multiple use of catheters and skin patches.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"773-784"},"PeriodicalIF":2.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12430247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065865","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":"Relationship Between Electrolyte Levels and Dipping Blood Pressure Pattern in Hypertensive Patients: A Single Center Cross-Sectional Study in Shanghai.","authors":"Jia-Ying Huang, Wang Zheng, Xin-Di Feng, Si-Yu Qiao, Jing-Yi Tang, Zi-Lin Ma, Feng Wang, Yi-Hong Wei","doi":"10.2147/VHRM.S540403","DOIUrl":"10.2147/VHRM.S540403","url":null,"abstract":"<p><strong>Background: </strong>Few studies have explored the link between body fluid ion levels (sodium, calcium, magnesium, phosphorus) and blood pressure circadian rhythm. This study investigates these ions' relationship with the dipping blood pressure pattern in hypertensive patients, highlighting their potential for monitoring electrolyte levels in hypertension management.</p><p><strong>Methods: </strong>According to 2018 Chinese guidelines for hypertension management, hypertensive patients were classified into dipping/super-dipping and non-dipping/reverse-dipping groups based on nocturnal blood pressure decline. Clinical data and serum/24-hour urine electrolyte levels were then collected from these patients. Logistic regression and advanced statistical modeling were used to identify influencing factors.</p><p><strong>Results: </strong>Age and alpha-blockers negatively correlate with the likelihood of dipping blood pressure in hypertensive patients (P<0.05). Highest chance of dipping occurs at age 54 years, with serum sodium at 139.55 mmol/L and 24-hour urinary calcium at 5.34 mmol (P<0.05). The lowest likelihood is at a 24-hour urinary calcium level of 1.65 mmol (P<0.05). The largest nocturnal systolic drop is at age 57 years, serum calcium at 2.41 mmol/L, and 24-hour urinary calcium at 5.34 mmol (P<0.05). The largest diastolic drop is at age 54 years, with serum sodium at 139.03 mmol/L, serum calcium at 2.42 mmol/L, and serum magnesium at 0.95 mmol/L (P<0.05). A serum calcium level over 2.20 mmol/L significantly boosts the chance of dipping and nocturnal diastolic drop (P<0.05).</p><p><strong>Conclusion: </strong>In hypertensive patients, the chance of a dipping blood pressure pattern declines with age, possibly peaking between 54-57 years. Optimal serum sodium for dipping is 139 mmol/L, and higher serum calcium (peaking at 2.41 mmol/L) increases this likelihood. Alpha-blockers may negatively affect the dipping blood pressure pattern.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"759-771"},"PeriodicalIF":2.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12420775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041408","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":"Identification of Proactive Health Behavior Clusters in Atrial Fibrillation-Related Ischemic Stroke Patients: A Multi-Center Latent Class Analysis.","authors":"Lina Guo, Yuying Guo, Jed Montayre, Wenjing Ning, Genoosha Namassevayam, Mengyu Zhang, Yuying Xie, Xinxin Zhou, Peng Zhao, Juanjuan Wang, Ruiqing Di","doi":"10.2147/VHRM.S534357","DOIUrl":"10.2147/VHRM.S534357","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to identify latent classes of proactive health behavior and to explore the predictive factors associated with various clusters of proactive health behavior among patients with atrial fibrillation-related ischemic stroke.</p><p><strong>Methods: </strong>A multi-center cross-sectional study was conducted, recruiting a total of 1,250 participants through cluster random sampling from January 2023 to May 2024. Latent class analysis was performed to identify classes of proactive health behavior within the sample of atrial fibrillation-related ischemic stroke patients. Additionally, multinomial regression analyses were utilized to investigate the predictive factors associated with the different latent classes identified. This study adhered to the STROBE checklist.</p><p><strong>Results: </strong>Out of the 1,250 participants, 1,196 (91.6%) completed the survey, including 809 males and 387 females, with 71% of them reporting moderate or lower levels of proactive health behavior. The findings revealed three latent classes: (1) low proactive health behavior with health responsibility deficiency (n=426, 35.6%); (2) moderate proactive health behavior with stress and coping disorder (n=464, 38.7%); and (3) high proactive health behavior with light physical activity (n=306, 25.5%). Factors correlated with the latent classes of proactive health behavior were identified. Protective factors included a high level of stroke knowledge, strong awareness of health beliefs, and better environmental and social support (all p < 0.05). Conversely, risk factors for the latent classes of proactive health behavior included low education, being unmarried, lack of thrombolysis, and low household income (all p < 0.05).</p><p><strong>Conclusion: </strong>This study successfully identified three different latent classes of proactive health behaviors and their related predictors in Chinese atrial fibrillation-related ischemic stroke patients. These findings provide theoretical guidance and practical insights for the development of targeted intervention programs aimed at improving proactive health behaviors in patients with atrial fibrillation-related ischemic stroke patients.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"749-758"},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041405","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":"Investigating the Role of Gene Polymorphisms in Hypertension: Evidence from the Jordanian Population.","authors":"Ola Al-Sanabra, Laith Al-Eitan, Maryam Alasmar, Islam Bani Khalid","doi":"10.2147/VHRM.S536434","DOIUrl":"10.2147/VHRM.S536434","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertension (HTN) is a complex disorder regulated by multiple physiological systems. Each individual's underlying genetic architecture strongly influences inter-individual variability in therapeutic responses to HTN. Consequently, identifying candidate genes that contribute to the genetic basis of HTN remains a significant challenge. This study aims to investigate the association between eleven polymorphisms across eight candidate genes and HTN in the Jordanian population.</p><p><strong>Patients and methods: </strong>This study included 200 patients with hypertension from Jordan and 224 healthy controls. Whole blood samples were collected from each participant, followed by the extraction of genomic DNA. The distribution of polymorphisms in the genes VEGFA, NAT2, TANC2, NR3C2, PROX1, PTGER3, TLE1, and PRKCA was investigated. Haplotype, genotype, and allele frequencies were analyzed using the SNPStats web tool.</p><p><strong>Results: </strong>In the Jordanian population, significant differences were observed in the frequency of the A/A genotype of rs699947 in VEGFA and the G/A genotype of rs2429427 in TANC2 (P = 0.006 and 0.042, respectively) between healthy individuals and those with hypertension. No significant associations were detected for the other SNPs analyzed with hypertension incidence. Additionally, significant differences were noted in the codominant and recessive models of VEGFA rs699947, the recessive model of NAT2 rs1041983, the dominant and overdominant models of TANC2 rs2429427, and the overdominant model of NR3C2 rs5522 between the groups. Overall, the genotype distributions of the VEGFA and TANC2 genes differed significantly between healthy individuals and those with hypertension.</p><p><strong>Conclusion: </strong>These findings highlight the potential of incorporating genetic profiling into clinical practice to enable more precise, genotype-guided hypertension management, paving the way for personalized therapeutic strategies in affected populations.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"705-717"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024229","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":"Vascular Endothelium in Health and Disease: Structure, Function, Assessment and Role in Metabolic Disorders.","authors":"Waldemar Pluta, Anna Lubkowska, Wioleta Dudzińska","doi":"10.2147/VHRM.S519426","DOIUrl":"10.2147/VHRM.S519426","url":null,"abstract":"<p><p>The vascular endothelium is responsible for regulating vascular tone, maintaining fluid homeo-stasis, and preventing platelet aggregation, exhibits regulatory properties in vasorelaxation and vasoconstriction - it produces, among others, nitric oxide and endothelin. The imbalance of vasoactive molecules leads to the loss of their function, known as endothelial dysfunction. Impaired endothelial function is observed in people with metabolic disorders, often preceding the onset of the disease by several years. Endothelial function assessment can be performed using invasive (eg coronary angiography) and non-invasive (flow-dependent dilation, biochemical markers) techniques. Among metabolic abnormalities, increasing scientific interest has focused on metabolic obesity in normal-weight individuals. People with this type of obesity, despite having a normal body mass index, exhibit both metabolic abnormalities typical of obesity (including hypertension and type 2 diabetes) and endothelial dysfunction. This comprehensive review summarizes the current knowledge of the structure and function of the vascular endothelium, methodologies for assessment, and pathophysiological mechanisms of endothelial dysfunction in metabolic disorders, with particular emphasis on diagnostic approaches and clinical implications for cardiovascular risk stratification.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"729-747"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030363","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":"Association Between Revascularization and 30-Day Survival of Ischemic Cardiomyopathy Patients in Dr. Hasan Sadikin General Hospital.","authors":"Pradana Pratomo Raharjo, Adrian Sebastian Suhendro, Achmad Fauzi Yahya, Triwedya Indra Dewi","doi":"10.2147/VHRM.S524863","DOIUrl":"10.2147/VHRM.S524863","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic cardiomyopathy is the leading cause of heart failure and associated with increased morbidity and mortality. The role of percutaneous coronary intervention (PCI) in term of increasing survival and cardiovascular outcomes in ischemic cardiomyopathy remains unclear.</p><p><strong>Purpose: </strong>To evaluate whether revascularization is associated with 30-day survival in ischemic cardiomyopathy in Dr. Hasan Sadikin General Hospital.</p><p><strong>Patients and methods: </strong>This was a single center, observational, retrospective cohort study. Subject data was taken from the CABG and PCI database of Cardiology and Vascular Medicine Department, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital from January 2021 to December 2022. Study outcome was 30-day survival after revascularization procedure. Survival analysis was done using Kaplan-Meier analysis then bivariate analysis with log rank test and cox regression analysis. Cox regression analysis was also done for multivariate analysis of confounding factors.</p><p><strong>Results: </strong>A total of 67 ischemic cardiomyopathy patients were included in the final analysis of this study with balance proportion except for age, complete revascularization, and chronic total occlusion (CTO) variables. CABG group tends to be younger with more proportion in age ≤65 years old compared with PCI group (92.6% vs. 65%. p = 0.01). Complete revascularization had reached dominantly in the CABG group compared with PCI group (85.2% vs. 15%. p < 0.001). In coronary anatomy characteristic, CTO was found more in the CABG group (81.5% vs. 52.5%. p = 0.02). In 30-day follow up, overall survival rate was 91% with 81.5% in the CABG group compared with 97.5% in the PCI group (p = 0.03). Multivariate analysis was done to exclude confounding factors with adjusted hazard ratio of revascularization was 4.02 (CI95% 0.27-60.3. p = 0.31).</p><p><strong>Conclusion: </strong>There is no association between revascularization and 30-day survival in ischemic cardiomyopathy in Dr. Hasan Sadikin General Hospital. However, wide confidence intervals highlight uncertainty.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"719-728"},"PeriodicalIF":2.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024296","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":"Deep Learning-Based Detection of Arrhythmia Using ECG Signals - A Comprehensive Review.","authors":"Aquib Irteza Reshad, Valentina Nino, Maria Valero","doi":"10.2147/VHRM.S508620","DOIUrl":"10.2147/VHRM.S508620","url":null,"abstract":"<p><p>Cardiac arrhythmias are a major health concern around the world, causing morbidity and mortality in a wide range of people. The timely and accurate diagnosis of arrhythmias is critical for optimal clinical management and intervention. Deep learning techniques have developed as powerful tools for detecting arrhythmias in recent years, taking advantage of advances in signal processing and machine learning. This review investigates the use of deep learning approaches to detect arrhythmias via electrocardiogram (ECG) readings. The study includes an in-depth evaluation of 30 papers retrieved from three distinct databases using a structured method. The result indicates that deep learning models can achieve high accuracy like 99.93% as well as high F1 scores such as 99.57%. Furthermore, the study examines current research trends, approaches, and developments in deep learning-based arrhythmia detection, including convolutional neural networks (CNNs), and hybrid architectures that includes RNN and CNN algorithms. Additionally, the paper investigates the strengths and limits of existing techniques, focusing on critical issues such as dataset heterogeneity, model interpretability, and real-time implementation. Future research and development directions in arrhythmia detection using deep learning are also mentioned. This study seeks to give significant insights for physicians, researchers, and policymakers involved in the development and implementation of sophisticated arrhythmia detection systems, with the ultimate goal of improving patient outcomes and cardiac healthcare.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"21 ","pages":"685-703"},"PeriodicalIF":2.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001160","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}