CJC Open最新文献

{"title":"CArdiovasculaR Outcomes Based Upon EjectIon Systolic TimE in Patients With ST Elevation Myocardial Infarction (ARISE-STEMI) Study","authors":"Tyler Szun BSc ,&nbsp;Alexander Zaremba BSc ,&nbsp;Aleksander Dokollari MD, PhD ,&nbsp;Azin Khafipour MSc ,&nbsp;Hilary Bews MD, FRCPC ,&nbsp;Seth Cheung ,&nbsp;James W. Tam MD, FRCPC ,&nbsp;Shuangbo Liu MD, FRCPC ,&nbsp;Derek So MD, FRCPC ,&nbsp;Sean Van Diepen MD, FMSc ,&nbsp;Ashish H. Shah MD, MD-Research, FRCP","doi":"10.1016/j.cjco.2024.11.014","DOIUrl":"10.1016/j.cjco.2024.11.014","url":null,"abstract":"<div><h3>Background</h3><div>Despite improvements in revascularization, systems of care, and secondary prevention therapies, 30-day mortality rates in patients presenting with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remains 4% to 6%. This study aims to investigate the utility of the ejection systolic time (EST) and ejection systolic period (ESP) in identifying high-risk STEMI patients.</div></div><div><h3>Methods</h3><div>In this retrospective study, consecutive patients with STEMI undergoing PPCI at a tertiary cardiac center between January 2020 and October 2021 were included. EST and ESP were calculated on the MacLab. Univariable and multivariable Cox regression analysis were used to identify risk predictors. The primary outcome was mortality at 30 days.</div></div><div><h3>Results</h3><div>Six hundred forty-one STEMI patients (mean age: 64.4 ± 13.2 years; 182/641 [28.4%] female patients) were recruited. Within 30 days of presentation, 32 patients (5.0%) died, and they were more frequently older, female, and had higher rates of previous stroke, chronic kidney disease, and dialysis use. Patients dying within 30 days had lower EST (0.20 ± 0.04 vs 0.24 ± 0.04 seconds/beat; <em>P</em> &lt; 0.0001) and ESP (17.64 ± 2.66 vs 19.29 ± 2.74 seconds/min; <em>P</em> = 0.004). After multivariable modeling, only EST was a significant predictor of early (&lt;30 days) mortality (hazard ratio 4.5, 95% confidence interval 1.7-12.1; <em>P</em> = 0.003), prolonged in-hospital stay (&gt;4 days), diuretic use, new diagnosis of heart failure, need for intubation or ventilation, and inotrope and/or vasopressor use during the index hospital admission. ESP and EST were not associated with the mortality between 30 days and 1 year.</div></div><div><h3>Conclusions</h3><div>A lower EST was associated with mortality at 30 days and in-hospital adverse outcomes. EST may serve as a useful hemodynamic marker to risk-stratify STEMI patients.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 516-524"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791434","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":"Unraveling Heart Failure Phenotypes: A Systematic Review and Meta-analysis of Peak Oxygen Uptake and Its Determinants","authors":"Corey R. Tomczak PhD ,&nbsp;Stephen J. Foulkes PhD ,&nbsp;Christopher Weinkauf BSc ,&nbsp;Devyn Walesiak BSc ,&nbsp;Jing Wang PhD ,&nbsp;Veronika Schmid MSc ,&nbsp;Sarah Paterson BSc ,&nbsp;Wesley J. Tucker PhD ,&nbsp;Michael D. Nelson PhD ,&nbsp;Simon Wernhart MD, PhD ,&nbsp;Jan Vontobel MD ,&nbsp;David Niederseer MD, PhD ,&nbsp;Mark J. Haykowsky PhD","doi":"10.1016/j.cjco.2025.01.012","DOIUrl":"10.1016/j.cjco.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the impact of heart failure (HF) phenotype on peak oxygen uptake (peak <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O₂) is essential for advancing personalized treatment strategies and enhancing patient outcomes. Therefore, we conducted a systematic review and meta-analysis of the evidence examining differences in peak <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O₂ (primary objective) and its determinants (secondary objectives) between patients with HF with reduced (HFrEF) or preserved ejection fraction (HFpEF).</div></div><div><h3>Methods</h3><div>Studies comparing peak <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O₂ in HFrEF vs HFpEF were found through PubMed (1967-2024), Scopus (1981-2024), and Web of Science (1985-2024). Data extraction and methodologic quality assessment were completed by 2 independent coders. Differences between HFrEF and HFpEF were compared using weighted mean difference (WMD) and 95% confidence intervals (95% CIs) derived from random effects meta-analysis.</div></div><div><h3>Results</h3><div>After screening 3107 articles, 25 unique studies were included in the analysis for the primary outcome (HFrEF n = 3783; HFpEF n = 3279). Peak <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O₂ (WMD: –1.6 mL/kg/min, 95% CI: –2.3 to –0.8 mL/kg/min), and peak exercise measures of cardiac output (WMD: –1.1 L/min, 95% CI: –2.1 to –0.2 L/min), stroke volume (WMD: –10.1 mL, 95% CI: –16.6 to –3.7 mL), heart rate (WMD: –4 bpm, 95% CI: –6 to –2 bpm), and left ventricular ejection fraction (WMD: –28.2%, 95% CI: –32.6% to –23.8%) were significantly lower while peak exercise arterial-venous oxygen difference was significantly higher in HFrEF compared with HFpEF (2.3 mL/dL, 95% CI: 1.6-2.9 mL/dL).</div></div><div><h3>Conclusions</h3><div>Our findings highlight distinct physiological impairments along the oxygen cascade in HFrEF compared with HFpEF, with direct implications for the management and treatment strategies of these HF subtypes.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 367-379"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791426","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 Prognostic Value of the Triglyceride-Glucose and Fibrosis-4 Indices in Patients Undergoing Coronary Angiography: A Retrospective Cohort Analysis","authors":"Amir Aker MD ,&nbsp;Tom Tarchitzky BsC ,&nbsp;Yuval Avidan MD ,&nbsp;Barak Zafrir MD","doi":"10.1016/j.cjco.2025.01.005","DOIUrl":"10.1016/j.cjco.2025.01.005","url":null,"abstract":"<div><h3>Background</h3><div>The triglyceride-glucose (TYG) index, which reflects insulin resistance, and the fibrosis-4 (FIB-4) index, a measure of liver fibrosis, are noninvasive laboratory-based indicators associated with cardiometabolic risk.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of 12,165 patients who underwent coronary angiography, to investigate the association of the TYG and FIB-4 indices with the occurrence of myocardial infarction, stroke, or all-cause death (major cardiovascular events [MACE]), using multivariate Cox proportional hazards models.</div></div><div><h3>Results</h3><div>The mean age of the study population was 65 ± 10 years; 63% presented with acute coronary syndrome. During a median follow-up period of 6.1 years, the first MACE occurred in 4174 patients. Compared to the TYG index ≤ 50th percentile (≤ 8.81), the multivariable adjusted hazard ratio (95% confidence interval) for MACE was 1.17 (1.10-1.45), 1.32 (1.23-1.43), and 1.72 (1.55-1.99) for TYG index levels ≥ 50th (&gt; 8.81), ≥ 75th (&gt; 9.23), and ≥ 90th (9.66) percentiles, respectively. FIB-4 index levels of 1.3-2.67 and &gt; 2.67 were associated with an adjusted hazard ratio of 1.19 (1.11-1.27) and 1.67 (1.51-1.87), respectively, compared to FIB-4 index levels of &lt; 1.3. Regarding the risk of developing MACE, no significant interaction was detected between TYG or FIB-4 index levels and the presence of diabetes or obesity. In a combined model of both predictive measures, a gradual increase in the incidence rate of MACE was observed, ranging from 3.93 (TYG index ≤ 8.81; FIB-4 index &lt; 1.3) to 8.56 (TYG index &gt; 9.23; FIB-4 index &gt; 2.67) events per 100 patient-years.</div></div><div><h3>Conclusions</h3><div>The TYG and FIB-4 indices, both individually and when concomitantly elevated, were independently associated with an increased risk of developing MACE in patients undergoing coronary angiography. ,. These simple-to-calculate, noninvasive metabolic biomarkers may aid in the prediction of cardiovascular diseases.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 465-472"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791428","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":"Misclassification of Hypertension Status According to Office Blood Pressure vs 24-Hour Ambulatory Blood Pressure Monitoring","authors":"Gregory L. Hundemer MD, MPH ,&nbsp;Ayub Akbari MD, MSc ,&nbsp;Amos Buh PhD ,&nbsp;Nandini Biyani BSc ,&nbsp;Shaafi Mahbub BSc ,&nbsp;Maria Salman BSc ,&nbsp;Pierre A. Brown MD ,&nbsp;Greg A. Knoll MD, MSc ,&nbsp;Manish M. Sood MD, MSc ,&nbsp;Swapnil Hiremath MD, MPH ,&nbsp;Marcel Ruzicka MD, PhD","doi":"10.1016/j.cjco.2025.01.007","DOIUrl":"10.1016/j.cjco.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Ambulatory blood pressure monitoring (ABPM) is the gold standard for establishing the diagnosis of hypertension yet remains underused in Canada. There remains a scarcity of Canadian data surrounding how commonly misclassification of hypertension phenotypes occurs without regular use of ABPM.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 964 consecutive adult patients referred to the Ottawa Hospital Hypertension Clinic who underwent same-day ABPM and automated office-based blood pressure measurement (AOBPM) between 2019 and 2023. The proportion of hypertension status misclassification was determined by comparing ABPM and AOBPM values. White coat hypertension (if on no antihypertensive medication) or white coat effect (if on antihypertensive medication) was defined as AOBPM ≥140/90 mm Hg but mean 24-hour ABPM &lt;130/80 mm Hg. Masked hypertension (if on no antihypertensive medication) or masked uncontrolled hypertension (if on antihypertensive medication) was defined as AOBPM &lt;140/90 mm Hg but mean 24-hour ABPM ≥130/80 mm Hg.</div></div><div><h3>Results</h3><div>The mean (SD) age was 60 (16) years, and 46% of the patients were female. Among 296 patients with normotension or controlled hypertension based on ABPM, 146 (49%) met criteria for white coat hypertension (n = 21) or white coat effect (n = 125). Among 668 patients with uncontrolled hypertension based on ABPM, 364 (54%) met criteria for masked hypertension (n = 65) or masked uncontrolled hypertension (n = 299).</div></div><div><h3>Conclusions</h3><div>The hypertension status of approximately 50% of patients was misclassified by AOBPM vs ABPM. Broader use of ABPM in Canada will improve hypertension awareness, treatment, and control rates.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 508-515"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791433","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":"Repeated Transcatheter Valve Interventions After Surgical Mitral Valve Replacement: A 20-Year Journey Avoiding Surgical Redo","authors":"Christos Papageorgiou MD ,&nbsp;Marco B. Ancona MD ,&nbsp;Ciro Vella MD ,&nbsp;Vittorio Romano RT ,&nbsp;Luca A. Ferri MD ,&nbsp;Filippo Russo MD ,&nbsp;Barbara Bellini MD ,&nbsp;Giulia Ghizzoni MD ,&nbsp;Greca Zanda MD ,&nbsp;Domitilla Gentile MD ,&nbsp;Francesca Napoli MD ,&nbsp;Antonio Esposito MD ,&nbsp;Eustachio Agricola MD ,&nbsp;Alaide Chieffo MD ,&nbsp;Matteo Montorfano MD","doi":"10.1016/j.cjco.2025.01.020","DOIUrl":"10.1016/j.cjco.2025.01.020","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 489-492"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791431","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":"Low Socioeconomic Status Is Associated with Reduced Access to Natriuretic Peptide Testing in the Outpatient Setting: A Population-based Evaluation","authors":"Ismail R. Raslan MD, MSc ,&nbsp;Anna Chu MHSc ,&nbsp;Peter C. Austin PhD ,&nbsp;Xuesong Wang MSc ,&nbsp;David Bobrowski MD ,&nbsp;Barbara S. Doumouras MD ,&nbsp;Joseph J. Lee BSc ,&nbsp;Candace D. McNaughton MD, PhD ,&nbsp;Peter A. Kavsak PhD ,&nbsp;Husam Abdel-Qadir MD, PhD ,&nbsp;Heather J. Ross MD, MHSc ,&nbsp;Douglas S. Lee MD, PhD","doi":"10.1016/j.cjco.2025.01.002","DOIUrl":"10.1016/j.cjco.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Tests of natriuretic peptide (NP) concentrations are guideline-recommended for diagnosis and prognostication in heart failure (HF). Although NP testing is available at some hospitals, outpatient access has been limited to those who can pay out-of-pocket. We investigated whether residents who have lower socioeconomic status have differential access to NP testing.</div></div><div><h3>Methods</h3><div>Using a case-control design, we compared patients who had NP tests with age-matched patients undergoing non-NP blood tests (January 2015-June 2020), performed in the outpatient or acute hospital setting. The association of socioeconomic status measures (eg, deprivation quintile) with receipt of NP testing was assessed using conditional logistic regression, adjusted for sex, test location, and comorbidities, and was stratified by incidence of prior HF.</div></div><div><h3>Results</h3><div>Among 96,919 patients without prior HF (median age, 72 years; 50% female) who underwent NP testing, the majority of tests (66.6%) were performed in an acute hospital setting rather than in an outpatient clinic. Residents of more-deprived neighbourhoods had a higher incidence of HF (<em>P</em> &lt; 0.001), but they were more likely to undergo NP testing in an acute care setting (odds ratio [OR] for most- vs least-deprived, 1.269; 95% confidence interval [CI], 1.104-1.216) and less likely to undergo testing as outpatients (OR, 0.807; 95% CI, 0.764-0.853 vs least-deprived; all <em>P</em> &lt; 0.001). Among 70,362 matched patients with known HF (median aged, 78 years; 45% female), outpatient NP testing was also less likely to be performed among patients living in the most-deprived neighbourhoods (OR, 0.723; 95% CI, 0.677-0.772; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Although those of lower socioeconomic status exhibit a higher risk of incident HF, they had less NP testing performed in outpatient settings, and more testing performed in resource-intense acute-care settings.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 390-401"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792024","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":"Dual Pathway Inhibition in Patients with Atherosclerosis with or without Heart Failure: Insights from the XATOA Registry","authors":"Pishoy Gouda MB, BCh, BAO, MSc ,&nbsp;Justin A. Ezekowitz MD, MSc ,&nbsp;Alain Gay MD ,&nbsp;Kai Vogtländer MSc ,&nbsp;Victor Aboyans MD, PhD ,&nbsp;Sebastian Debus MD ,&nbsp;Keith Fox MB, ChB ,&nbsp;Uwe Zeymer MD ,&nbsp;Robert Welsh MD","doi":"10.1016/j.cjco.2025.01.013","DOIUrl":"10.1016/j.cjco.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>Patients with atherosclerotic cardiovascular disease might benefit from dual pathway inhibition (DPI) therapy, which includes rivaroxaban and aspirin. Patients with concomitant heart failure (HF) are a subgroup with a higher risk for ischemic events. Accordingly, we explored the risks and benefits of DPI therapy in a generalizable population of patients with concomitant atherosclerotic cardiovascular disease and HF.</div></div><div><h3>Methods</h3><div>The <strong>X</strong>arelto plus <strong>A</strong>cetylsalicylic acid <strong>T</strong>reatment patterns and <strong>O</strong>utcomes in patients with <strong>A</strong>therosclerosis (XATOA) registry is a prospective, multicentre registry of patients with either coronary artery or peripheral artery disease that were given DPI therapy. The primary end point was a composite of cardiovascular death, myocardial infarction, or stroke, and the safety outcome was major bleeding. Multivariable logistic regression was performed to assess the association of HF status and ejection fraction (EF) on the outcomes of interest.</div></div><div><h3>Results</h3><div>Of 5532 participants, 4022 (72.7%) had documentation of HF status. Of those 873 (21.5%) had a history of HF (EF &gt; 40%, 461; EF ≤ 40%, 181, EF unknown, 231). Over a median follow-up of 465 days (interquartile range, 372-576), the primary outcome occurred in 4.9% of participants with HF compared with 2.4% in those without HF (adjusted hazard ratio, 1.57; 95% confidence interval, 1.02-2.41). The safety outcome was similar in patients with and without HF (0.9% vs 1.11%; a hazard ratio, 0.7; 95% confidence interval, 0.31-1.67).</div></div><div><h3>Conclusions</h3><div>In a generalizable cohort of patients with atherosclerotic disease and HF, the use of DPI therapy is associated with outcomes similar to those observed in recent randomized controlled clinical trials.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 473-480"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791429","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":"Pregnancy-Induced Hypertension and Atherosclerotic Cardiovascular Disease Risk Score in China","authors":"Honghong He MM ,&nbsp;Junyan Sun MM ,&nbsp;Hongqiu Huo MB ,&nbsp;Yanxiu Wang MD ,&nbsp;Yuntao Wu MM ,&nbsp;Suhua Chen MB ,&nbsp;Yangyang Wang MM ,&nbsp;Xiaoming Zheng MD ,&nbsp;Haiyan Zhao MD","doi":"10.1016/j.cjco.2025.01.006","DOIUrl":"10.1016/j.cjco.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy-induced hypertension (PIH) poses a significant threat to maternal health. This study aims to explore the association between PIH and the risk of atherosclerotic cardiovascular disease (ASCVD).</div></div><div><h3>Methods</h3><div>The cohort comprised 1947 pregnant women delivering a single child between 2004 and 2020 in the Kailuan study. Participants, categorized into PIH and non-PIH (NPIH) groups based on PIH history, completed questionnaires and underwent physical examinations and laboratory assessments within 2 years after delivery. Predicted ASCVD risks used the Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) model, distinguishing lifetime ASCVD risk as \"low\" (&lt;32.8%) and \"high\" (≥32.8%). χ² tests and logistic regression were used to investigate the association between PIH and high lifetime risk China-PAR categories.</div></div><div><h3>Results</h3><div>Overall, 6.17% of the PIH group had high lifetime risk, compared with 0.96% in the NPIH group (χ² 29.59, <em>P</em> &lt; 0.001). After adjusting for confounders, PIH was independently associated with high-risk China-PAR categories, with the PIH group having a 5.03 times higher probability than the NPIH group (95% CI 2.20-11.51, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Pregnancy-induced hypertension was associated with increased lifetime risk of ASCVD.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 435-440"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792023","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 Hannover Postinfarction Ventricular Septal Rupture Score: A New Scoring System Predicting 30-Day Mortality","authors":"Lisa Baustert ,&nbsp;Dietmar Boethig MD ,&nbsp;Adelheid Görler MD ,&nbsp;Christian Kühn MD ,&nbsp;Alexander Weymann MD ,&nbsp;Bastian Schmack MD ,&nbsp;Aron-Frederik Popov MD ,&nbsp;Arjang Ruhparwar MD ,&nbsp;Bettina Wiegmann MD","doi":"10.1016/j.cjco.2024.12.013","DOIUrl":"10.1016/j.cjco.2024.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Because of the increasing importance of quality assurance and individualised patient treatment, EuroSCOREs were analysed for reliability in predicting 30-day mortality in patients with postinfarction ventricular septal rupture (piVSR). To address the specific conditions of patients with piVSR, the Hannover piVSR Score (HpiVSR) was developed.</div></div><div><h3>Methods</h3><div>Between 2001 and 2019, 45 patients with piVSR underwent surgery. Data were collected as necessary for EuroSCORE calculation. Clinically relevant variables were validated for the HpiVSR Score using a nonparsimonious binary logistic regression model. All models were tested for their significant predictive power for 30-day mortality. Their validity was assessed using Hosmer-Lemeshow test and Nagelkerke <em>R</em>². Receiver operating characteristic curve and area under the curve were used to illustrate and quantify score accuracy.</div></div><div><h3>Results</h3><div>The specificity was 77.8% for all EuroSCOREs and 92.6% for the HpiVSR Score, and the sensitivity was in the random range for the EuroSCOREs and 83.3% for the HpiVSR Score. Accordingly, the areas under the curve were 0.676 (95% CI 0.507-0.845) for EuroSCORE II; 0.729 (95% CI 0.581-0.878) and 0.739 (95% CI 0.591-0.886) for the additive and logistic EuroSCORE, respectively; and 0.949 (95% CI 0.891-1.006) for the HpiVSR Score.</div></div><div><h3>Conclusion</h3><div>The HpiVSR Score enables a more reliable and accurate prediction of 30-day mortality than the EuroSCOREs using 7 significant, objective, reliable, and preoperatively determinable variables. Because of the small sample size of the present study and the fact that only internal validation has been performed so far, the weighting of the factors of the HpiVSR Score can be adjusted after studies with larger patient samples.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 456-464"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791427","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 Intersection of Chronic Obstructive Pulmonary Disease and Cardiovascular Disease: Recent Insights in a Challenging Area","authors":"Michael Heffernan MD, PhD, FRCPC, FACC ,&nbsp;Samantha Rutherford BHSc","doi":"10.1016/j.cjco.2025.01.001","DOIUrl":"10.1016/j.cjco.2025.01.001","url":null,"abstract":"<div><div>Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are 2 prevalent and interconnected health conditions that have a significant global impact. COPD is characterized by airflow obstruction and is caused by smoking and/or environmental factors. COPD is associated with chronic inflammation and structural changes in the airways and lung parenchyma. CVD encompasses various cardiac and vascular conditions and is a leading global cause of mortality, with risk factors that include diabetes, smoking, and dyslipidemia. CVDs discussed in this review, in relation to COPD, include hypertension, coronary artery disease and ischemic heart disease, heart failure, cardiac arrhythmias, and cerebrovascular disease. The interplay between COPD and CVD is evident, with shared risk factors and physiological mechanisms contributing to their frequent comorbidity. Therefore, an integrated approach to care involving primary care physicians, respirologists, and cardiologists is essential to effectively manage the dual burden of COPD and CVD.</div><div>This review outlines the shared risks and underlying mechanisms of these conditions, their diagnosis, and the clinical implications of dual COPD and CVD in a patient, including how COPD exacerbations significantly elevate the risk of cardiovascular (CV) events and mortality. Pharmacologic CVD and COPD therapies, as well as their CV and respiratory effects, are discussed. Key trials (Towards a Revolution in COPD Health [TORCH]; Study to Understand Mortality and Morbidity in COPD [SUMMIT]; InforMing the Pathway of COPD Treatment [IMPACT]; and <strong>E</strong>fficacy and Safety of Triple <strong>Th</strong>erapy in <strong>O</strong>bstructive Lung Di<strong>s</strong>ease [ETHOS]) are discussed that demonstrate the effectiveness of triple bronchodilator therapy in reducing exacerbation rates, as well as all-cause and cardiovascular mortality in patients with COPD and CVD. Overall, this review highlights the need for an integrated approach to patient management, involving collaboration among primary care physicians, respirologists, and cardiologists, to effectively address the dual burden of these diseases.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 4","pages":"Pages 493-507"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791432","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}