Critical Pathways in Cardiology最新文献

筛选
英文 中文
Performance of High-Sensitivity Troponin T Risk Stratification Strategies for 90-day Cardiac Death or Myocardial Infarction. 高灵敏度肌钙蛋白T风险分层策略对90天内心脏性死亡或心肌梗死的影响
Critical Pathways in Cardiology Pub Date : 2025-07-10 DOI: 10.1097/HPC.0000000000000397
R Gentry Wilkerson, Nicklaus P Ashburn, Anna C Snavely, Brandon R Allen, Robert H Christenson, Michael Weaver, Xiaoxi Zhang, Troy E Madsen, Bryn E Mumma, Michael W Supples, Simon A Mahler
{"title":"Performance of High-Sensitivity Troponin T Risk Stratification Strategies for 90-day Cardiac Death or Myocardial Infarction.","authors":"R Gentry Wilkerson, Nicklaus P Ashburn, Anna C Snavely, Brandon R Allen, Robert H Christenson, Michael Weaver, Xiaoxi Zhang, Troy E Madsen, Bryn E Mumma, Michael W Supples, Simon A Mahler","doi":"10.1097/HPC.0000000000000397","DOIUrl":"https://doi.org/10.1097/HPC.0000000000000397","url":null,"abstract":"<p><strong>Background: </strong>Thirty-day performance of the high-sensitivity troponin T (hs-cTnT) European Society of Cardiology 0/1-hour (ESC 0/1-h) and \"one-and-done\" (hs-cTnT<limit of quantification [LoQ]) strategies are established. However, 90-day performance is unclear. Our objective was to evaluate the 90-day performance of these hs-cTnT strategies in a U.S. cohort.</p><p><strong>Methods: </strong>A pre-planned secondary analysis of a prospective multisite U.S. cohort was conducted. Adults with chest pain were enrolled from eight emergency departments (1/2017-9/2018). hs-cTnT measures (0- and 1-h) were used to classify patients by the ESC 0/1-h algorithm into rule-out, observation, and rule-in zones. Patients with 0-h measures <LoQ were considered ruled-out by the one-and-done strategy. The primary outcome was adjudicated 90-day cardiac death or MI. Negative predictive value (NPV) for the primary endpoint and efficacy (proportion ruled-out) were calculated for each strategy alone and in combination with the HEART score.</p><p><strong>Results: </strong>Among 1462 patients with a mean age of 57.6±12.9 years, 46.4% (678/1462) were female and 14.0% (205/1462) had cardiac death or MI at 90 days. One-and-done strategy efficacy was 32.8% (479/1462) and NPV was 99.0% (95%CI, 97.6-99.7). Adding the HEART score decreased efficacy to 20.1% (293/1462) and increased NPV to 99.7% (95%CI, 98.1-100). ESC 0/1-h efficacy was 57.8% (826/1430) and NPV was 98.3% (95%CI, 97.2-99.1). Combined with a HEART score NPV increased to 99.3% (95%CI, 98.0-99.9) but efficacy decreased to 30.8% (95%CI, 28.3-33.2).</p><p><strong>Conclusion: </strong>The one-and-done strategy and ESC 0/1-hour algorithm had modest rates of missed 90-day cardiac death or MI. Adding a HEART score improved safety but decreased efficacy.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating Outcomes of Over-Expanding Versus Conventional Sizing in transcatheter aortic valve replacement for Borderline Aortic Annulus: A Meta-Analysis. 评估边缘主动脉环经导管主动脉瓣置换术中过度扩张与常规大小的结果:一项meta分析。
Critical Pathways in Cardiology Pub Date : 2025-06-26 DOI: 10.1097/HPC.0000000000000392
Ahmad Mustafa, Ryan Kaple, Chapman Wei, Yuriy Dudiy, Sung-Han Yoon, Perry Wengrofsky, Vladimir Jelnin, George Batsides, Rachel Spallone, Elie Elman, Mark Anderson, David Landers, Craig Basman
{"title":"Evaluating Outcomes of Over-Expanding Versus Conventional Sizing in transcatheter aortic valve replacement for Borderline Aortic Annulus: A Meta-Analysis.","authors":"Ahmad Mustafa, Ryan Kaple, Chapman Wei, Yuriy Dudiy, Sung-Han Yoon, Perry Wengrofsky, Vladimir Jelnin, George Batsides, Rachel Spallone, Elie Elman, Mark Anderson, David Landers, Craig Basman","doi":"10.1097/HPC.0000000000000392","DOIUrl":"10.1097/HPC.0000000000000392","url":null,"abstract":"<p><p>Approximately 20-40% of patients that present for transcatheter aortic valve replacement (TAVR) with a balloon-expandable (BE) transcatheter heart valve (THV) fall into a borderline aortic annulus size (BAAS). There are potential benefits to over-expanding an under-sized THV (OE-THV) in such cases that include reduced electrical disturbances and annular injury at the expense of increased paravalvular leak (PVL). We conducted a meta-analysis of data comparing conventional sized vs OE-THV strategy for BAAS and review the literature for BE-THV in such cases. 9 non-randomized studies that compared a conventional strategy to OE-THV in patients with BAAS were included in our study. Our findings suggest that there is no difference in mortality, stroke, mean gradient or significant PVL. There was a trend towards less pacemakers in patients receiving an OE-THV. Borderline aortic annulus measurements are common in patients undergoing TAVR and there appears to be equipoise between conventional sizing vs OE-THV. Future detailed studies are required to evaluate short- and long-term outcomes amongst strategies.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The QRS Interval After Pacemaker Implant: An Independent Mortality Risk Factor. 心脏起搏器植入后QRS间期:一个独立的死亡危险因素?
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000385
Gabriel Vanerio
{"title":"The QRS Interval After Pacemaker Implant: An Independent Mortality Risk Factor.","authors":"Gabriel Vanerio","doi":"10.1097/HPC.0000000000000385","DOIUrl":"10.1097/HPC.0000000000000385","url":null,"abstract":"<p><strong>Background: </strong>We have been pacing the right ventricular apex, creating an artificial left bundle branch block (LBBB) for more than 4 decades. We learned that some patients would develop dys-synchronization and hence heart failure due to QRS widening. If the lead is implanted in the left bundle area and a narrow QRS is achieved, those patients with LBBB will improve after implant, but those with non-LBBB morphologies might not benefit from QRS narrowing. However, there is not enough information regarding patients with narrow or wide QRS with different types of atrioventricular block that could also benefit from QRS narrowing.</p><p><strong>Objectives: </strong>Demonstrate that a narrow-paced QRS is a significant determinant of mortality in patients receiving a permanent pacemaker despite the previous QRS morphology.</p><p><strong>Patients and methods: </strong>We analyzed 204 patients from our pacemaker database. We attempted to implant the lead in the septal area. In our lab, we utilized standard lead electrodes. The criteria for appropriate implant were an electrogram with injury potential, an acceptable lead positioning in the right anterior oblique and left anterior oblique, and a ventricular bipolar threshold less or equal to 1.0 V @ 0.5 ms. QRS duration was assessed according to the global QRS method (from the earliest onset of the QRS in any of the 12 simultaneously recorded standard leads). A QRS interval of 135 ms was determined as a cutoff point using a receiver operator curve (mortality).</p><p><strong>Results: </strong>The first implants were performed in March 2008 and ended in March 2024. A narrow QRS (<135 ms) was observed in 140 subjects (140/204, 68%). The primary endpoint (death from cardiovascular cause) was met in 10 (4.9%) patients. LBBB was present before implant in 29 patients and a QRS <135 ms was measured in 12/29 (41%). We did not observe more complications compared with the conventional technique. The survival curve using Kaplan-Meier analysis comparing the 2 groups was significantly different with a significant mortality reduction in the narrow QRS group.</p><p><strong>Conclusions: </strong>A narrow-paced QRS is an independent variable associated with increased survival rates.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0385"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management and Outcomes of Coronary Artery Aneurysms: A Patient-Level Systematic Review. 冠状动脉瘤的治疗和预后:一项患者水平的系统综述。
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000381
Daler Rahimov, Nayeem Nasher, Danial Ahmad, Rohinton J Morris, Anjali Upadhyaya, Colin Yost, Daniella Wong, Preeyal Patel, Alec Vishnevsky, Nicholas J Ruggiero, John W Entwistle, Vakhtang Tchantchaleishvili
{"title":"Management and Outcomes of Coronary Artery Aneurysms: A Patient-Level Systematic Review.","authors":"Daler Rahimov, Nayeem Nasher, Danial Ahmad, Rohinton J Morris, Anjali Upadhyaya, Colin Yost, Daniella Wong, Preeyal Patel, Alec Vishnevsky, Nicholas J Ruggiero, John W Entwistle, Vakhtang Tchantchaleishvili","doi":"10.1097/HPC.0000000000000381","DOIUrl":"10.1097/HPC.0000000000000381","url":null,"abstract":"<p><strong>Background: </strong>Data are lacking to guide standardized management of coronary artery aneurysms (CAAs). We sought to analyze the available evidence in a quantitative manner.</p><p><strong>Methods: </strong>An electronic search identified 431 case reports or case series on CAA, comprising 488 patients. Patient-level data were extracted. Subgroups of CAA with fistulous connections (CAAF) and CAA without fistulous connections (CAAO) were analyzed separately.</p><p><strong>Results: </strong>Fistulous connection was present in 24.0% (117/488) of patients with CAA. Angina was a presenting symptom in 64.7% (301/465), with higher preponderance in the CAAO group [CAAO: 71.1% (249/350) versus CAAF: 45.2% (52/115); P < 0.01]. The median largest aneurysm diameter was higher in the CAAF group [CAAO: 3.0 (1.5-5.0) cm versus CAAF: 5.0 (3.0-7.0) cm; P < 0.01], and rupture was more frequently observed in the CAAF group [CAAO: 3.1% (11/353) versus CAAF: 13.8% (16/116); P < 0.01]. For any given diameter, CAAF had a higher risk of rupture compared with CAAO. Surgery was the most common management strategy, particularly in patients with CAAF [CAAO: 50.9% (189/371) versus CAAF: 75.2% (88/117); P < 0.01]. The Kaplan-Meier analysis showed a trend toward more favorable survival in CAAF. The hazard of mortality was associated with aneurysm diameter in both subsets but was higher in the CAAO group independent of surgical versus interventional management.</p><p><strong>Conclusions: </strong>CAAF appears to have a higher risk of rupture but may be associated with better survival than CAAO. Management for patients with CAA differs based on the presence or absence of a fistula; however, both surgical and interventional modes of management result in similar survival.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0381"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of Embolic Protection in Percutaneous Coronary Intervention Without Saphenous Venous Graft Lesions in ST-Segment-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis: Erratum. st段抬高型心肌梗死经皮冠状动脉介入治疗无隐静脉移植物损害时栓塞保护的作用:一项系统回顾和荟萃分析:勘误。
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000389
Maisha Maliha, Vikyath Satish, Kuan Yu Chi, Diego Barzallo Zeas, Amrin Kharawala, Nishat Shama, Nathaniel Abittan, Sneha Nandy, Anita Osabutey, Nidhi Madan, Prabhjot Singh, Eleonora Gashi
{"title":"Role of Embolic Protection in Percutaneous Coronary Intervention Without Saphenous Venous Graft Lesions in ST-Segment-Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis: Erratum.","authors":"Maisha Maliha, Vikyath Satish, Kuan Yu Chi, Diego Barzallo Zeas, Amrin Kharawala, Nishat Shama, Nathaniel Abittan, Sneha Nandy, Anita Osabutey, Nidhi Madan, Prabhjot Singh, Eleonora Gashi","doi":"10.1097/HPC.0000000000000389","DOIUrl":"10.1097/HPC.0000000000000389","url":null,"abstract":"","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0376"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rewarding 20-Year Experience With Initial and Repeat EKG and Echocardiographic Screening for Prevention of Sudden Death in Detecting Abnormal Findings. 奖励二十年来在发现异常发现预防猝死方面进行初始和重复心电图和超声心动图筛查的经验。
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000382
Sharon Bates, Mohammad Reza Movahed
{"title":"Rewarding 20-Year Experience With Initial and Repeat EKG and Echocardiographic Screening for Prevention of Sudden Death in Detecting Abnormal Findings.","authors":"Sharon Bates, Mohammad Reza Movahed","doi":"10.1097/HPC.0000000000000382","DOIUrl":"10.1097/HPC.0000000000000382","url":null,"abstract":"<p><strong>Background: </strong>To further analyze the impacts, findings, and modalities of multiple cardiac screenings to answer the question, are multiple screens necessary and useful in youth?</p><p><strong>Methods: </strong>Over 20 years, the Anthony Bates Foundation (ABF) has offered free and low-cost cardiac screenings to youth and their families nationwide. The volunteer force has provided blood pressure and ultrasound tests to participants throughout the 20 years. After year 7, electrocardiograms were added to the screening.</p><p><strong>Results: </strong>Over the 20 years, ABF abnormal findings held steady between 10% and 13%, with potential life-threatening findings at 2.5%. The participants who have experienced multiple screening tests on average would repeat within 2.5 years and have abnormal findings at 31.84%, potential life-threatening at 11.43%, and total echocardiography-related abnormal findings at 16.82%. The variance between male and female attendance by age is also noted during the review of ABF repeat screened data. Male attendance was at 59.65% and female 40.35%. The abnormality rate of males for the first visit was 10.9% followed by the second visit of 18.80%. The abnormality rate of females for the first visit was 12.22% followed by the second visit of 17.09%. A detailed analysis of abnormal findings is presented in this article.</p><p><strong>Conclusions: </strong>Cardiac screening involving multiple repeated screenings appears to be effective in detecting increasing numbers of abnormal findings that can be lifesaving.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0382"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transcatheter Aortic Valve Implantation in Brazilian Public Health System: A Single-Center Experience. 经导管主动脉瓣植入在巴西公共卫生系统:单一中心的经验。
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000387
Guilherme Pinheiro Machado, Pedro Castilhos Crivelaro, Gustavo Neves de Araujo, Alan Pagnoncelli, Julia Carvalho da Silva, Camila Porto Cardoso, Wagner Tadeu Azeredo Azevedo, Rodrigo Petersen Saadi, Eduardo Keller Saadi, Orlando Wender, Marco Wainstein, Felipe Costa Fuchs
{"title":"Transcatheter Aortic Valve Implantation in Brazilian Public Health System: A Single-Center Experience.","authors":"Guilherme Pinheiro Machado, Pedro Castilhos Crivelaro, Gustavo Neves de Araujo, Alan Pagnoncelli, Julia Carvalho da Silva, Camila Porto Cardoso, Wagner Tadeu Azeredo Azevedo, Rodrigo Petersen Saadi, Eduardo Keller Saadi, Orlando Wender, Marco Wainstein, Felipe Costa Fuchs","doi":"10.1097/HPC.0000000000000387","DOIUrl":"10.1097/HPC.0000000000000387","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) has been established as the treatment of choice for severe aortic stenosis in high-risk patients as well as patients above 75 years old in all risk spectrums. Despite its worldwide adoption, implementation in lower-middle-income countries such as the Brazilian public health system (SUS, acronym in Portuguese) is incipient.</p><p><strong>Objectives: </strong>This study aimed to evaluate TAVI exclusively within SUS patients.</p><p><strong>Methods: </strong>This was a prospective cohort study in a public tertiary hospital in southern Brazil. All patients who underwent TAVI between 2018 and 2024 were included. The cohort was divided into 2 temporal periods: from July 2018 to December 2022 (n = 60) and January 2023 to October 2024 (n = 65). The clinical and procedural characteristics and in-hospital, as well as 1 year of outcomes, were evaluated according to Valve Academic Research Consortium-2 (VARC-2) criteria.</p><p><strong>Results: </strong>During the study period, 125 patients underwent TAVI. The average age was 80 years (± 10), and 49.6% were male. The mean aortic valve area was 0.76 cm² and the mean gradient was 45 (±13) mm Hg. The mean STS predicted risk of mortality (STS-PROM) score was 4.6% (±3.6). Device success was achieved in 119 patients (95.2%). In-hospital mortality was 2 (1.6%). A new permanent pacemaker was required in 16 (12.8%). Demographic and clinical characteristics between the first and the second periods were similar.</p><p><strong>Conclusions: </strong>The mortality and complications rate of TAVI performed within the scope of the Brazilian public health system were consistent with the clinical experience of other international registries.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0387"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Altered Anthropometrics and HbA1c Levels, but not Dyslipidemia, Are Associated With Elevated hs-CRP Levels in Middle-aged Adults: A Population-based Analysis. 人体测量学和 HA1c 水平的改变(而非血脂异常)与中年人 hs-CRP 水平的升高有关:基于人群的分析。
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000378
Laith Ashour, Layan Ayesh, Zeid Jarrar, Areen Mishleb, Danah Alenezi, Moath Fateh, Rawan Almejaibal, Nicola Hanna Madani, Muath Mohammad Dabas, Sama Samer Abu Monshar, Samar Hamdan
{"title":"Altered Anthropometrics and HbA1c Levels, but not Dyslipidemia, Are Associated With Elevated hs-CRP Levels in Middle-aged Adults: A Population-based Analysis.","authors":"Laith Ashour, Layan Ayesh, Zeid Jarrar, Areen Mishleb, Danah Alenezi, Moath Fateh, Rawan Almejaibal, Nicola Hanna Madani, Muath Mohammad Dabas, Sama Samer Abu Monshar, Samar Hamdan","doi":"10.1097/HPC.0000000000000378","DOIUrl":"10.1097/HPC.0000000000000378","url":null,"abstract":"<p><p>Population-based studies of cardiovascular disease markers, such as high-sensitivity C-reactive protein (hs-CRP), are crucial. However, studies exploring the effect of metabolic indices on hs-CRP while controlling for confounding variables adequately in middle-aged adults are limited. Using Wave 5 public-use biomarkers data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined the impact of various metabolic indices on hs-CRP in adults aged 32-42, controlling for eight allergic and infectious factors that may elevate hs-CRP levels. We used multiple linear regression analysis to determine which factors predict hs-CRP levels after the log transformation of the dependent variable. The total number of participants was N = 1839 (weighted N = 1,390,763), with a mean age of 38.1 (SD = 2.0) and 46.4% having obesity. Among the controlled variables, recent surgery was the only confounder to significantly predict increased hs-CRP levels [ P = 0.029; exponentiated estimate (EE) = 1.61; 95% confidence interval (Cl), 1.31-1.91]. Notably, current smoking and altered low-density lipoprotein levels did not show a significant association with hs-CRP levels ( P > 0.05). However, a significant increase in hs-CRP levels was observed in females compared with males ( P < 0.001; EE = 1.43; 95% Cl, 1.35-1.51). Similar findings were noted for diabetic HbA1c levels ( P = 0.001; EE = 1.6; 95% CI, 1.42-1.78), high waist circumference ( P = 0.015; EE = 1.25; 95% CI, 1.15-1.35), and stage 3 obesity ( P = 0.006; EE = 7.62; 95% CI, 2.86-12.38). Although not statistically significant, hs-CRP levels exhibited a gradual increase with rising body mass index after controlling for other variables. These findings will improve the clinical application of hs-CRP in predicting coronary artery disease, especially in younger adults.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0378"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476566","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}
引用次数: 0
Role of the Presence of Interatrial Block as a Prediction Pathway of Atrial Fibrillation During the Postoperative Period of Patients Undergoing Cardiac Surgery. 心房传导阻滞作为心脏手术患者术后房颤预测途径的作用
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000384
Alfredo J Meza-Delgado, Osmar Antonio Centurión, Christian O Chavez-Alfonso, Rocío Del Pilar Falcón-Fleytas, Laura B García-Bello, Orlando R Sequeira-Villar, Carmen R Montiel-Gómez, José C Candia-Irala, Erdulfo J Galeano
{"title":"Role of the Presence of Interatrial Block as a Prediction Pathway of Atrial Fibrillation During the Postoperative Period of Patients Undergoing Cardiac Surgery.","authors":"Alfredo J Meza-Delgado, Osmar Antonio Centurión, Christian O Chavez-Alfonso, Rocío Del Pilar Falcón-Fleytas, Laura B García-Bello, Orlando R Sequeira-Villar, Carmen R Montiel-Gómez, José C Candia-Irala, Erdulfo J Galeano","doi":"10.1097/HPC.0000000000000384","DOIUrl":"10.1097/HPC.0000000000000384","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most frequently recorded arrhythmia in clinical practice, and its appearance conditions high risk of morbidity and mortality. The role of the interatrial block (IAB) as a predictor pathway of the development of AF in the postoperative period of patients undergoing cardiac surgery has been studied scantly.</p><p><strong>Methods: </strong>Partial IAB was defined as the P wave >120 ms and advanced IAB as the P wave >120 ms with biphasic morphology in inferior leads. The presurgical electrocardiography was analyzed, and the frequency of AF onset in the postoperative period was determined. A comparative analysis was performed between the patients who presented AF and those who did not.</p><p><strong>Results: </strong>A total of 94 patients were included, with a mean age of 61 ± 16 years. Of the total number of patients, 42 (45%) presented some degree of IAB (partial 42.8% and advanced 57.1%). There was a significant relationship between patients with IAB and those who developed AF postcardiac surgery (21.3%; P < 0.01). The presence of IAB had an area under the curve of 0.75 (95% confidence interval, 0.66-0.85) and demonstrated a specificity of 69%, a sensitivity of 83%, and a negative predictive value of 92% for predicting AF development.</p><p><strong>Conclusions: </strong>IAB has a relatively frequent incidence in patients undergoing cardiac surgery. There was a significant association between the presence of IAB and the development of AF in the postoperative period. Our findings establish for the first time that IAB has high specificity, sensitivity, and negative predictive value for predicting AF development postcardiac surgery.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0384"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Temporal Trends and Outcomes of Peripheral Artery Disease and Critical Limb Ischemia in the United States. 美国外周动脉疾病和严重肢体缺血的时间趋势和结果。
Critical Pathways in Cardiology Pub Date : 2025-06-01 Epub Date: 2025-05-23 DOI: 10.1097/HPC.0000000000000377
Chayakrit Krittanawong, Kimberly Imoh, Song Peng Ang, Yusuf Kamran Qadeer, Hafeez Ul Hassan Virk, Mahboob Alam, Carl J Lavie, Raman Sharma
{"title":"Temporal Trends and Outcomes of Peripheral Artery Disease and Critical Limb Ischemia in the United States.","authors":"Chayakrit Krittanawong, Kimberly Imoh, Song Peng Ang, Yusuf Kamran Qadeer, Hafeez Ul Hassan Virk, Mahboob Alam, Carl J Lavie, Raman Sharma","doi":"10.1097/HPC.0000000000000377","DOIUrl":"10.1097/HPC.0000000000000377","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral artery disease (PAD) is a progressive, systemic atherosclerotic disease that is associated with an increased risk of coronary artery disease, cerebrovascular disease, and critical limb ischemia (CLI). CLI represents the most severe stage of PAD, characterized by progressive endothelial dysfunction and arterial narrowing. We hypothesized that the incidence of CLI and PAD would increase over the study period and that the rates of in-hospital mortality and major amputations among patients admitted with CLI would rise correspondingly.</p><p><strong>Methods: </strong>We utilized the National Inpatient Sample database from 2016 to 2021 using the International Classification of Disease, Tenth Edition, Clinical Modification codes. Patients with primary or secondary diagnoses of PAD were initially selected, and subsequently hospitalization with CLI was appropriately identified. The Cochran Armitage test was used to describe the trend of outcomes across the years. All statistical analyses were conducted using the software Stata version 17.0.</p><p><strong>Results: </strong>From 2016 to 2021, there were 2,930,639 admissions for CLI. Up to 65% of these patients were over the age of 60, and 35.8% of these patients were women. Most of these individuals were white (64.7%), followed by African Americans (15.8%) and Hispanics (12.6%). In-hospital mortality rates varied by revascularization method, with hybrid revascularization showing the highest rate at 2.6%, followed by endovascular revascularization at 1.8%, and surgical revascularization at 1.6%. Additionally, hospitalization costs were highest for patients undergoing hybrid revascularization ($46,257 ± $36,417), compared with endovascular ($36,924 ± $27,945) and surgical revascularization ($35,672 ± $27,127). Endovascular revascularization rates seemed to increase while surgical revascularization rates decreased during this time period.</p><p><strong>Conclusions: </strong>PAD is a progressive, systemic atherosclerotic disease that is associated with an increased risk of coronary artery disease, cerebrovascular disease, and CLI. Our data showed that the rates of PAD and CLI hospitalizations have remained relatively stable from 2016 to 2021, but there seems to be a trend toward doing more revascularization via an endovascular approach as compared to a surgical approach.</p>","PeriodicalId":35914,"journal":{"name":"Critical Pathways in Cardiology","volume":" ","pages":"e0377"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信