JRSM Cardiovascular Disease最新文献

{"title":"Aortopathy in pregnancy: Unanswered questions.","authors":"Stephanie L Curtis","doi":"10.1177/20480040251351398","DOIUrl":"https://doi.org/10.1177/20480040251351398","url":null,"abstract":"<p><p>Aortic dissection in pregnancy has a high mortality rate for mother and fetus. Women at risk are largely those with hereditary thoracic aortic disease, that is typically undiagnosed. Existing literature has focussed on characterising the phenotype of these women, but many questions remain about the causes of dissection in pregnancy and how to best manage women antenatally and postnatally. The widespread uptake of genetic testing has allowed us to refine the genotype and we need to use this to better individualise risk. We do not know how often to screen women during pregnancy and postpartum, nor do we know whether beta-blockers affect event rates. We have very little data on the outcomes of women who have undergone aortic surgery who embark on a pregnancy, including those who have residual dissection. Passive vaginal delivery is advised for delivery, but we do not know if this is safer than elective caesarean section and there is a paucity of evidence on the effectiveness of neuraxial anaesthesia in these women. Dissection postpartum can occur days or weeks after delivery. There is little evidence on the postnatal care or blood pressure control of women who have dissected postpartum and no guidelines on best postpartum care. Lastly, we know little of the birth experience of these women and whether birth plans were successful. This paper aims to discuss some of these unanswered questions in the hope that with further research and discussion of best practice we can collectively reduce this devastating event in young women.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251351398"},"PeriodicalIF":1.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327034","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 case of hemorrhagic pleural effusion postprimary PCI-rare event of postcardiac injury syndrome.","authors":"Prempassan Krishnamurthy, Panneer Selvam Ganesan, Manikandan Rajendran","doi":"10.1177/20480040251350187","DOIUrl":"10.1177/20480040251350187","url":null,"abstract":"<p><strong>Background: </strong>Postcardiac injury syndrome (PCIS) includes pleuropericardial inflammation and effusion syndromes after traumatic mesothelial cell injury to the pericardium or pleural cavity. Several triggers have been identified, that can cause PCIS including percutaneous coronary intervention (PCI), cardiac implantable electronic device (CIED) implantation, and cardiac surgical procedures. Though most common form occurs postcardiac surgeries, there are reports of PCIS occurring after PCI.</p><p><strong>Case summary: </strong>We present one such rare event of right-sided pleural effusion occurring after primary PCI, diagnosed based on ESC guidelines on PCIS, after exclusion of other possible causes.</p><p><strong>Discussion: </strong>PCIS is a diagnosis of exclusion, typically presenting as new onset pericardial effusion. Although rare, pleural effusion can occur as a part of PCIS with reports of both left- and right-sided pleural effusion. Management being conservative seems relatively simpler, but given the possibility of recurrence, long-term follow up becomes important, which necessitates making the diagnosis of PCIS, though rare. This case is one of the rare events occurring during a commonly performed procedure worldwide. PCIS in diagnosis of unexplained pleural/pericardial effusion occurring after PCI should always be considered. This may be an insight for taking into account, such uncommon events after a common intervention.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251350187"},"PeriodicalIF":1.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303083","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":"Normal and adverse pulmonary arterial flow patterns after the Fontan procedure and correlation with invasive CMR (iCMR) hemodynamics: A retrospective observational study.","authors":"Sanja Dzelebdzic, Surendrenath V Reddy, Daniel Young, Tarique Hussain","doi":"10.1177/20480040251344344","DOIUrl":"10.1177/20480040251344344","url":null,"abstract":"<p><strong>Background: </strong>Branch pulmonary artery flow patterns in the Fontan circulation manifest oscillations reflecting venous pressure changes. The clinical importance of variation in branch pulmonary artery flow patterns and the relationship with the single ventricle performance is not understood. We describe insights gained from simultaneous hemodynamic and phase contrast magnetic resonance using interventional CMR (iCMR) in these patients.</p><p><strong>Method: </strong>Twenty-seven patients with Fontan circulation referred for iCMR were studied using phase-contrast velocity mapping. The isovolumetric relaxation period (IVRT) was assessed using standard or velocity-encoded cine imaging of the atrioventricular valve (AVV) and aortic valve. We qualitatively assessed branch pulmonary artery flows considering four patterns: IVRT flow reversal, IVRT flow reaching baseline, and normal - phasic flow or continuous flow. We further collected comprehensive left and right heart iCMR hemodynamic and flow data, including pressures, aortopulmonary collateral (APC) burden, and degree of AVV regurgitation.</p><p><strong>Results: </strong>Most patients underwent extracardiac Fontan palliation and did not have significant APC burden. Cardiac cycle analysis demonstrated that flow reversal and flow reaching baseline correlated with IVRT (v-wave timing on SVC pressure). Further analysis showed statistically significant difference in pulmonary capillary wedge pressure (PCWp) v-wave (<i>P</i> = .008) among the described groups. Notably, patients with IVRT flow reversal pattern had higher PCWp v-wave and most had severe AVV regurgitation.</p><p><strong>Conclusion: </strong>Branch pulmonary artery IVRT flow reversal and IVRT baseline patterns in patients with Fontan circulation may represent indirect signs of single ventricle poor performance and severe AVV regurgitation.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251344344"},"PeriodicalIF":1.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200246","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":"Higher cortisol level and reduced circulating triiodothyronine in patients with cardiovascular diseases: A case-control study.","authors":"Muhammad Javid, Safir Ullah Khan, Maleeha Akram, Rodolfo Daniel Cervantes-Villagrana, Muhammad Rafi, Muhammad Fiaz Khan, Syed Shakeel Raza Rizvi","doi":"10.1177/20480040251340609","DOIUrl":"10.1177/20480040251340609","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormone plays a key role in cardiovascular diseases (CVDs), and stress may impact this relationship by affecting cortisol and triiodothyronine (T3) levels. This study explored the association between stress, indicated by cortisol levels, and thyroid function in cardiovascular patients, particularly those with hypertension.</p><p><strong>Methods: </strong>A cohort of 87 cardiovascular patients (37 females, 50 males) and 60 healthy controls (28 females, 32 males) was analyzed. Patients included those with coronary artery disease, acute myocardial infarction, and a high proportion with anterior wall myocardial infarction (AWMI, 52%). Anthropometric data and blood samples were collected, and cortisol and T3 levels were measured using the radioimmunoassay method. Blood pressure measurements were also recorded to assess associations with cortisol, thyroid function, and hypertension.</p><p><strong>Results: </strong>Cardiovascular patients had significantly higher cortisol levels (1065.99 ± 700.54 ng/mL vs 768.35 ± 563.10 ng/mL, <i>p</i> < .001) and lower T3 levels (1.25 ± 0.48 ng/mL vs 1.33 ± 0.46 ng/mL) compared to controls. The prevalence of AWMI was 52%. Blood pressure was significantly higher in cardiovascular patients of both sexes (<i>p</i> < .0007). Additionally, 39% of cardiovascular patients had elevated cortisol, and 38% had reduced T3. No sex-based differences in cortisol levels were observed.</p><p><strong>Conclusion: </strong>This study found significant associations between elevated cortisol and reduced T3 levels in cardiovascular patients, particularly those with hypertension. Although stress-induced thyroid dysfunction remains a hypothesis, these findings suggest a potential link between cortisol, T3, and CVD. Further longitudinal research is needed to explore causal mechanisms.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251340609"},"PeriodicalIF":1.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095080","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":"Comparison of prognostic value of triglyceride-glucose index and atherogenic index of plasma in patients with acute coronary syndrome: A retrospective study.","authors":"Shiru Bai, Tianlei Chen, Yanru Li, Xinning Li, Rongpin Du","doi":"10.1177/20480040251341155","DOIUrl":"https://doi.org/10.1177/20480040251341155","url":null,"abstract":"<p><strong>Objective: </strong>Few studies have compared the prognostic value of the triglyceride glucose (TyG) index and atherogenic index of plasma (AIP) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). We aimed to compare the prognostic value of the TyG index, AIP, and combined diagnosis in patients with ACS undergoing PCI.</p><p><strong>Methods: </strong>Patients with ACS who underwent PCI were enrolled and divided into two groups according to major adverse cardiovascular and cerebrovascular events (MACCEs). Univariate and multivariate Cox proportional hazard regressions were performed to determine independent risk factors for MACCEs. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic value of the TyG index, AIP, and combined prediction.</p><p><strong>Results: </strong>The study included 114 patients. Multivariate Cox regression revealed that the TyG index and AIP were independent predictors of MACCEs. The AUC of the TyG index and AIP were 0.710 (95% confidence interval [CI]: 0.618-0.791) and 0.626 (95% CI: 0.531-0.715), respectively, and the optimal cutoff points were 8.83 and 0.30, respectively. The difference between the TyG index and AIP was not significant. The AUC of the combined diagnosis was 0.706 (95% CI: 0.614-0.788), with no significant improvement compared with the TyG index or AIP.</p><p><strong>Conclusion: </strong>Both the TyG index and AIP were independent predictors of MACCEs in ACS patients undergoing PCI. The TyG index and AIP had similar predictive values for MACCEs, but the combined prediction did not improve significantly.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251341155"},"PeriodicalIF":1.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080960","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":"Isolated left ventricular apical hypoplasia: A case report.","authors":"Shu-Yi Hu, Chen Meng, Lei-Zhi Ku, Hua Yan, Yan-Fei Lu, Li Wang, Han-Dong Zhu","doi":"10.1177/20480040251325379","DOIUrl":"10.1177/20480040251325379","url":null,"abstract":"<p><p>Isolated left ventricular apical hypoplasia (ILVAH) is a rare, unclassified cardiomyopathy with typical imaging findings. Cardiac magnetic resonance (CMR) is valuable for identifying heart structural anomalies. This case report describes the detection of significant anatomical abnormalities in the left ventricle (LV) with CMR in a 32-year-old man who presented with sudden dyspnea at authors' institution. This case demonstrates the characteristics of ILVAH under multimodal imaging: A truncated spherical shape of the LV, encircling of the distal LV by the right ventricle, the presence of fat replacement at the apex, and without abnormality in the mitral valve or aorta.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251325379"},"PeriodicalIF":1.4,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796606","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":"Non-alcoholic fatty liver disease (NAFLD) and its association to cardiovascular disease: A comprehensive meta-analysis.","authors":"Irina Lubomirova Mladenova, Eu Fon Tan, Jing Yong Ng, Pankaj Sharma","doi":"10.1177/20480040251325929","DOIUrl":"10.1177/20480040251325929","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) affects up to nearly a third of the Western population and has been inconsistently associated with cardiovascular diseases (CVDs). Therefore, we conducted a comprehensive meta-analysis to quantify the correlation of NAFLD with all major vascular diseases, acute coronary syndrome (ACS), subclinical atherosclerosis and endothelial dysfunction.</p><p><strong>Methods: </strong>We searched PubMed and Embase for studies looking at the relationship between NAFLD and cardiovascular diseases published through September 2023. The parameters we used to assess cardiovascular diseases include acute coronary syndrome, brachial flow-mediated dilatation (FMD), serum asymmetric dimethylarginine (ADMA), carotid intima-media thickness (CIMT), and carotid stenosis (>50%). Data from these studies were then collected and meta-analysis was performed using the random effects model. RevMan v5.4 was used for statistical analysis.</p><p><strong>Results: </strong>We interrogated a total of 114 publications which met our inclusion criteria. NAFLD patients showed statistically significant reduction in FMD% [MD: -4.83 (95% CI: -5.84 to 3.81, <i>p <</i> .00001)] and increased serum ADMA [MD: 0.08 (95% CI: 0.05-0.11, <i>p <</i> .00001)]. Mean CIMT was also increased in NAFLD patients [MD 0.13 (95% CI: 0.12-0.14, <i>p <</i> .00001)]. NAFLD showed a higher prevalence of pathological CIMT [MD: 0.11 (95% CI: 0.10-0.12, <i>p <</i> .00001)] and increased carotid plaques [OR: 2.08 (95% CI: 1.52-2.86, <i>p <</i> .00001)]. Furthermore, we demonstrated statistically significant increase in cardiovascular diseases among NAFLD patients compared to controls [OR: 1.92 (95% CI: 1.53-2.41, <i>p <</i> .00001)].</p><p><strong>Conclusion: </strong>NAFLD is a strong predictor for endothelial dysfunction, subclinical atherosclerosis and cardiovascular disease. Further studies are required to determine whether incidental findings of fatty liver on abdominal ultrasonography should prompt the need for detailed assessment of other CVD risk factors.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251325929"},"PeriodicalIF":1.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693694","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":"Effect of glycaemic control on coronary artery bypass grafting outcomes - a United Kingdom centre experience.","authors":"Manoraj Navaratnarajah, Fadi Ibrahim Al-Zubaidi, Hassan Kattach, Clifford Barlow, Geoff Tsang, Sunil Ohri","doi":"10.1177/20480040251325918","DOIUrl":"10.1177/20480040251325918","url":null,"abstract":"<p><strong>Objectives: </strong>Assess whether pre-operative HbA_1c demonstrates positive predictive value relating to outcomes following coronary artery bypass grafting (CABG) in diabetes patients.</p><p><strong>Methods: </strong>Retrospective analysis of outcomes and mortality following CABG; examining the effects of diabetes and HbA_1c.</p><p><strong>Results: </strong>Post-operative length of stay (LOS) was prolonged in elective and urgent diabetes patients;7.3 ± 2.1 versus 6.4 ± 1.6 days and 9.0 ± 1.9 versus 7.6 ± 1.8 days, respectively; (<i>p</i> < 0.001). Sternal and leg wound infection rate was higher in elective diabetes group compared to no-diabetes group; 7% versus 3% (<i>p</i> < 0.01) and 3% versus 1% (<i>p</i> < 0.05), respectively. Pneumonia rate increased in elective and urgent diabetes patients; 19% versus 8% (<i>p</i> < 0.001) and 21% versus 15% (<i>p</i> < 0.05), respectively. Diabetes increased new-onset atrial fibrillation; 26% versus 14% (<i>p</i> < 0.001), and doubled blood transfusion rate; 28% versus 14% (<i>p</i> < 0.001) in elective patients; with similar findings in urgent patients. Long-term mortality was higher with diabetes compared to no-diabetes in elective patients; 15% versus 5%, (<i>p</i> < 0.001), and urgent patients; 10% versus 2%, (<i>p</i> < 0.001). Elevated HbA_1c showed significant positive predictive value relating to long-term mortality, and rates of pneumonia, blood transfusion, wound infection in elective and urgent diabetes patients; (<i>p</i> < 0.001). Elevated HbA_1c was an independent predictor of long-term mortality (hazard ratio:5.27, 95% CI:2.53-10.99; <i>p</i> < 0.001), superficial wound infection (odds ratio (OR):18.23, <i>p</i> < 0.001) and delayed discharge (OR:8.15, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Diabetes patients have prolonged LOS and increased morbidity following CABG. HbA_1c is predictive of morbidity and long-term mortality in diabetes patients, and pre-operative HbA_1c screening is justified in all surgical patients.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251325918"},"PeriodicalIF":1.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664625","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":"The association of troponin I with the incidence of atrial fibrillation (AF) after coronary artery bypass graft surgery (CABG): A prospective cohort.","authors":"Azadeh Izadi-Moud, Hamid Reza Mashreghi Moghadam, Navid Rabiee, Mahmoud Zardast, Sara Afshar, Hossein Ghazaee, Mahmood Hossinzadeh Maleki","doi":"10.1177/20480040251326241","DOIUrl":"10.1177/20480040251326241","url":null,"abstract":"<p><strong>Objectives: </strong>Atrial fibrillation (AF) occurs in 15-45% of patients who underwent coronary artery bypass graft (CABG) surgery. Inflammation, myocardial ischemia, and sympathetic activity are the main contributing factors to postoperative atrial fibrillation (POAF) occurrence. POAF causes increased mortality, morbidity, and healthcare costs. Cardiac troponin I (c-TnI) is a sensitive and exclusive biomarker for myocardial injury. We investigated if c-TnI serum level had any correlation with POAF after CABG.</p><p><strong>Method: </strong>We enrolled 100 stable patients undergoing elective on-pump CABG surgery. We measured c-TnI serum levels preoperative, postoperative, and 72-h post-CABG. All patients were evaluated with 12-lead ECG and continuous cardiac monitoring for 5 days to detect arrhythmias.</p><p><strong>Result: </strong>Twelve (12%) patients developed AF after the operation. Although the AF group's age and BMI were slightly higher, there was no notable clinical, laboratory, or surgical difference between the groups. In addition, the preoperative, postoperative, and 72-h post-CABG c-TnI levels didn't show a significant difference between the groups. In contrast, the post-operation c-TnI rise was significantly higher in the AF group (<i>p</i> < 0.05). We determined a 1.9 ng/ml cutoff for post-operation c-TnI rise using the ROC curve with 100% sensitivity and 33% specificity.</p><p><strong>Conclusion: </strong>We discover that post-operation c-TnI rise could be used as a predictive parameter for POAF with full sensitivity.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251326241"},"PeriodicalIF":1.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651151","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 of incident acute limb ischemia after contemporary femoropopliteal endovascular revascularization from a multicenter registry: A retrospective observational study.","authors":"Kazunori Horie, Mitsuyoshi Takahara, Tatsuya Nakama, Akiko Tanaka, Kazuki Tobita, Naoki Hayakawa, Shinsuke Mori, Yo Iwata, Kenji Suzuki","doi":"10.1177/20480040251325412","DOIUrl":"https://doi.org/10.1177/20480040251325412","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence of acute limb ischemia (ALI) among patients with femoropopliteal (FP) lesions treated with contemporary endovascular therapy (EVT) and to identify risk factors for ALI after FP-EVT.</p><p><strong>Methods: </strong>In this retrospective multicenter registry, we analyzed patients with lower extremity artery disease having FP lesions who underwent EVT between 2017 and 2021. We investigated the incident ALI related to the index EVT and its risk factors. We also assessed the prognosis after the incident ALI.</p><p><strong>Results: </strong>During a median follow-up of 35.3 months, incident ALI was observed in 72 of 3102 patients (2.3%). The Rutherford classification I/IIa/IIb/III was 50.0%, 30.5%, 18.1%, and 1.4%, respectively. Variables independently associated with the incident ALI were chronic limb-threatening ischemia (CLTI; hazard ratio, 1.83; <i>p</i> = 0.015), reference vessel diameter < 6 mm (2.39; <i>p</i> = 0.011), lesion length >25 cm (3.35; <i>p</i> = 0.005) with its time interaction (0.72 per 1 year; <i>p</i> = 0.042), P2/3 segment involvement (2.73; <i>p</i> < 0.001), chronic total occlusion (CTO; 3.40; <i>p</i> < 0.001), and in-stent restenosis/occlusion (3.21; <i>p</i> < 0.001). During a median follow-up of 12.8 months after the ALI event, all-cause mortality was 27.8% and the rate of major amputation was 6.9%.</p><p><strong>Conclusions: </strong>The FP-EVT showed that the occurrence of ALI was 2.3% during a median follow-up of 35.3 months. The independent predictors of the ALI event were CLTI, small vessels, long lesions, CTO, and in-stent restenosis; however, the impact of lesion length was attenuated over time after the index EVT.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040251325412"},"PeriodicalIF":1.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651121","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}