JRSM Cardiovascular Disease最新文献

{"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}

{"title":"Genetic background and clinical phenotype in a Vietnamese cohort with Brugada syndrome: A whole exome sequencing study.","authors":"Viet Tuan Tran, Hung Manh Pham, Phong Dinh Phan, Thinh Huy Tran, Van Khanh Tran","doi":"10.1177/20480040241310748","DOIUrl":"10.1177/20480040241310748","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to report the spectrum of genetic variations and clinical phenotype in a Vietnamese cohort with confirmed Brugada syndrome (BrS) using the whole exome sequencing (WES).</p><p><strong>Methods: </strong>Fifty patients with confirmed BrS were included in this study. Genomic DNA samples were extracted from peripheral blood and conducted for WES. The variants were annotated using ANNOVAR. The variants in the 13 reported genes associated with BrS were filtered, predicted the functional impact using eight computational tools, and classified according to the 2015 ACMG guidelines.</p><p><strong>Results: </strong>Arrhythmic events were documented in one-fifth of the participants. Twenty-four probands were identified to carry 36 variants in 13 genes. Majority of the variants in our study was <i>SCN5A</i> variants (9/36 variants, 25%), followed by <i>KCNH2</i> variants (5/36 variants, 14%). The prevalence of <i>SCN5A</i> carriers was 16%; while the prevalence of minor gene carriers was less than 10%. Nine novel missense variants were identified, including four missense <i>SCN5A</i> variants (p.E901D, p.F853L, p.L377F, and p.H184R), two missense <i>ANK2</i> variants (p.S2845L and V1497L), one missense <i>CACNA1C</i> variant (M1126V), one missense <i>DSP</i> variant (p.K478N), and one intron splicing JUP variant (c.1498-5G>C).</p><p><strong>Conclusion: </strong>Our study underscores the primary significance of the <i>SCN5A</i> gene in BrS, as indicated by variant prevalence, carrier rates, pathogenicity per ACMG classification, in silico predictions, and its correlation with clinical phenotypes. Longitudinal study with larger sample size, pedigree, Sanger sequence confirmation, and functional analysis is recommended.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"14 ","pages":"20480040241310748"},"PeriodicalIF":1.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081196","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":"Biplane 3D overlay guidance for congenital heart disease to assist cardiac catheterization interventions-A pilot study.","authors":"Ravi V Vegulla, Gerald Greil, Surendranath V Reddy, Luis Zabala, Vivian Dimas, Yousef Arar, Antonia Pontiki, Kawal Rhode, Tarique Hussain","doi":"10.1177/20480040241274521","DOIUrl":"10.1177/20480040241274521","url":null,"abstract":"<p><p>Cardiac catheterization for congenital heart disease (CHD) performed under fluoroscopic guidance still lacks definition and requires exposure to ionizing radiation and contrast agents, with most patients needing multiple procedures through their lifetime, leading to cumulative radiation risks. While fusion overlay techniques have been employed in the past to aid, these have been limited to a single plane, while interventions are traditionally performed under biplane fluoroscopy. We describe our initial experience performing cardiac catheterizations guided by an enhanced biplane GuideCCI system^© (Siemens Healthcare, Germany) augmented by 3D magnetic resonance imaging and computed tomography modeling. Twenty-one children and young adults with CHD undergoing catheterization procedures between October 2019 and May 2021 were chosen based on their degree of complexity of cardiac anatomy. 3D stereolithography models were generated, overlayed, and displayed in real time, alongside angiographs in both planes on the screen during these procedures. We report successful implementation of this novel technology for performance of 26 interventions including stent placements, balloon dilations, vessel occlusion and percutaneous valve and transvenous pacemaker implantation all in patients with various complex cardiac anatomies. A statistically significant reduction in radiation and contrast use was noted for coarctation of the aorta stent angioplasty and transcatheter pulmonary valve replacement when compared with national benchmarks and local institutional metrics (with and without single plane overlay). No complications were encountered with the use of this technology. Use of a tracheal registration technique provided very good correlation in most cases. Operators preferred using biplane augmented catheterization over traditional fluoroscopy in patients with complex cardiac anatomy undergoing interventions.</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"13 ","pages":"20480040241274521"},"PeriodicalIF":1.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308680","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":"Impact of the completeness of revascularization and high bleeding risk status in acute coronary syndrome patients with multi-vessel disease: A retrospective analysis.","authors":"Tanawat Attachaipanich, Phasakorn Putchagarn, Tasalak Thonghong, Krit Leemasawat, Panupong Pota, Aekapat Phoksiri, Srun Kuanprasert, Pannipa Suwannasom","doi":"10.1177/20480040241283152","DOIUrl":"https://doi.org/10.1177/20480040241283152","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the long-term mortality of acute coronary syndrome (ACS) patients with multivessel disease according to the level of completeness of revascularization (CR) and high-bleeding risk (HBR) status.</p><p><strong>Design setting and participants: </strong>This retrospective study collected the data of ACS patients with multivessel disease who underwent percutaneous coronary intervention between May 2018 and February 2019. Complete to reasonable revascularization (CR) was defined by the residual Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score (RSS) of 0 to ≤8. The HBR was defined by the PRECISE-DAPT score ≥25.</p><p><strong>Main outcome measures: </strong>The all-cause death at 36 months according to the CR and HBR status.</p><p><strong>Results: </strong>A total of 209 patients with 743 lesions were included in the analysis. The median follow-up was 3.6 years. Patients with CR had lower event rates than ICR (4.5 vs. 11.5 per 100 patient-year, HR 0.39, 95% CI 0.22-0.70), p = 0.002). Similar observations were noted when compared between non-HBR and HBR (3.9 vs. 11.1 per 100 patient-year, HR 0.35, 95% CI 0.18-0.64, p < 0.001). Kaplan-Meier analysis revealed that all-cause death was highest among those in the ICR/HBR (40.5%) followed by ICR/non-HBR (28.6%), CR/non-HBR (28.3%) and the lowest among the CR/HBR group (7.1%), log-rank p = <0.001. No significant interaction was observed between the two factors regarding all-cause death (p = 0.10 for interaction).</p><p><strong>Conclusions: </strong>In ACS patients with MVD, the achievement of CR was associated with reducing mortality rates and consistency irrespective of the HBR status. (Trial Registration: TCTR20211222003).</p>","PeriodicalId":30457,"journal":{"name":"JRSM Cardiovascular Disease","volume":"13 ","pages":"20480040241283152"},"PeriodicalIF":1.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355477","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}