CJC Open最新文献

{"title":"Real-Life Management of Elevated Troponin Level in Patients Treated with Immune Checkpoint Inhibitors","authors":"Lior Zornitzki MD ,&nbsp;Dana Viskin MD ,&nbsp;Ophir Freund MD ,&nbsp;Ido Wolf MD ,&nbsp;Anna Rozenfeld Hemed MD ,&nbsp;Noam Weiss MS ,&nbsp;Shir Frydman MD, Ms ,&nbsp;Maor Tzuberi MS ,&nbsp;Shafik Khoury MD ,&nbsp;Ofer Havakuk MD ,&nbsp;Yan Topilsky MD ,&nbsp;Shmuel Banai MD ,&nbsp;Michal Laufer-Perl MD, MHA","doi":"10.1016/j.cjco.2025.02.005","DOIUrl":"10.1016/j.cjco.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) have revolutionized the clinical outcomes of cancer. Nevertheless, their use may lead to myocardial injury. The 2022 European Society of Cardiology cardio-oncology guidelines recommend routine follow-up of troponin level; however, current guidelines do not provide specific protocols for managing elevated troponin levels during ICI therapy. We aimed to describe the real-life assessment of patients treated with ICIs, presenting with an elevated high-sensitivity troponin I (hs-TnI) level following therapy.</div></div><div><h3>Methods</h3><div>Tel Aviv Sourasky Medical Center has implemented a routine follow-up of hs-TnI level measurement during ICI therapy. We performed a retrospective analysis evaluating the clinical assessment and management of patients presenting with an elevated hs-Tnl level (&gt; 50 ng/L) following therapy.</div></div><div><h3>Results</h3><div>Among 455 patients performing baseline and follow-up hs-TnI measurements, 50 patients (11%) presented with an elevated hs-TnI level (median 159 ng/L; interquartile range 76-362) following ICI therapy. All patients underwent an electrocardiogram, showing changes in 5 patients (10%). Among 24 patients (48%) who received echocardiography, 4 (8%) showed abnormalities. A cardiology consultation was ordered for 17 patients (34%), and none received cardiac magnetic resonance imaging or coronary angiography. A total of 13 patients (26%) were diagnosed with probable or possible myocarditis, resulting in corticosteroid therapy and discontinuation of ICI therapy in 84% and 92% of the patients, respectively. Only 2 patients reinitiated ICI therapy at a later stage.</div></div><div><h3>Conclusions</h3><div>We describe for the first time the management of elevated hs-TnI levels following ICI therapy, which was diagnosed in routine serial surveillance. We found a wide diversity in management, low cardiology involvement, and high interruption of therapy, emphasizing the need for standardized protocol management guidelines.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 8","pages":"Pages 1075-1082"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858168","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}

{"title":"Cytisine Use Vs Nicotine Replacement Therapy in Relapsed Smokers with Heart Disease: Feasibility Results from a Pilot Randomized Trial","authors":"Hassan Mir MD, MHI, MPH, FRCPC, FACP ,&nbsp;Kerri-Anne Mullen PhD ,&nbsp;Javad Heshmati PhD ,&nbsp;Ashley Baldwin BAHsc ,&nbsp;Evyanne Quirouette BSc ,&nbsp;Emilie Serano RN, MN ,&nbsp;Mustafa Coja BPHE, BA ,&nbsp;Andrew L. Pipe MD ,&nbsp;Robert D. Reid PhD","doi":"10.1016/j.cjco.2025.05.005","DOIUrl":"10.1016/j.cjco.2025.05.005","url":null,"abstract":"<div><h3>Background</h3><div>Cytisine use has proven efficacy for smoking cessation. We plan to investigate whether cytisine use is effective for relapse recovery and conducted a pilot randomized trial to assess the feasibility of a definitive trial.</div></div><div><h3>Methods</h3><div>A 2-group, single-site pilot randomized controlled trial was conducted. Adults with heart disease, who were actively enrolled in a smoking-cessation program and had relapsed to smoking, were randomly assigned to receive cytisine or combination nicotine replacement therapy for 25 days. Primary outcomes were rates of participant recruitment and treatment adherence, compared to targets. Secondary outcomes included end-of-treatment abstinence and treatment effects on cigarettes smoked per day and tobacco-withdrawal symptoms.</div></div><div><h3>Results</h3><div>Over the course of 18 months, we screened 62 relapsed smokers, identifying 32 (52%) who were eligible. We recruited 13 participants (41% of eligible), of whom 9 (69%) completed the study. A total of 5 of 13 participants (38.5%) used study medication on ≥ 80% of the days during the treatment period (50.0% in the cytisine group vs 28.6% in the nicotine replacement therapy group). At 25 days, 1 quitter was present in the cytisine group, and no quitters were present in the nicotine replacement therapy group (16.7% vs 0%). Cigarettes smoked per day decreased over the course of treatment.</div></div><div><h3>Conclusions</h3><div>Modifications to trial design, trial processes, and intervention delivery are required to make a definitive trial useful. To increase recruitment level, we will use a pragmatic design embedded within typical cessation-program practices, conduct a multisite study, and expand eligibility to include participants with other clinical conditions. To increase treatment adherence, we will use simplified dosing for cytisine. Sample size for the definitive trial will be based on the number needed to determine a clinically meaningful change in long-term abstinence.</div></div><div><h3>Clincial Trial Registration</h3><div>NCT04286295.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 8","pages":"Pages 1062-1069"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858114","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}

{"title":"Common Change Criteria for High-Sensitivity Cardiac Troponin for Serial Measurements Greater Than 2 Hours Apart","authors":"Peter A. Kavsak PhD,&nbsp;Niklas Thießen MD,&nbsp;John W. Pickering PhD,&nbsp;Li Liu MD, PhD,&nbsp;Sameer Sharif MD, MSc,&nbsp;David Kirkwood MSc,&nbsp;Richard Perez MSc,&nbsp;Dennis T. Ko MD, MSc,&nbsp;Craig Ainsworth MD,&nbsp;Andrew Worster MD, MSc,&nbsp;Martin Than MD,&nbsp;Johannes T. Neumann MD, PhD,&nbsp;Allan S. Jaffe MD","doi":"10.1016/j.cjco.2025.05.010","DOIUrl":"10.1016/j.cjco.2025.05.010","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 8","pages":"Pages 1073-1074"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858167","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}

{"title":"Usefulness of Intracardiac Echocardiography-Guided Endomyocardial Biopsy for Diagnosing Transthyretin Cardiac Amyloidosis During Catheter Ablation","authors":"Maoko Atsumi MD,&nbsp;Koji Sudo MD,&nbsp;Kenji Kuroki MD, PhD,&nbsp;Akira Sato MD, PhD","doi":"10.1016/j.cjco.2025.05.011","DOIUrl":"10.1016/j.cjco.2025.05.011","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 8","pages":"Pages 1014-1015"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858118","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}

{"title":"Device Therapy in Patients with Heart Failure: Is Medication Use Optimized and Are We Targeting Those Patients Most Likely to Benefit?","authors":"Robert Wannamaker MD, MSc ,&nbsp;Roopinder K. Sandhu MD, MPH ,&nbsp;Justin A. Ezekowitz MBBCh, MSc ,&nbsp;Sheri L. Koshman PharmD ,&nbsp;Derek S. Chew MD, MSc ,&nbsp;Luke R. Gagnon MD, MSc ,&nbsp;Chen-Hsiang Ma MD ,&nbsp;Chandu Sadasivan ,&nbsp;Gavin Y. Oudit MD, PhD ,&nbsp;Finlay A. McAlister MD, MSc","doi":"10.1016/j.cjco.2025.04.016","DOIUrl":"10.1016/j.cjco.2025.04.016","url":null,"abstract":"<div><h3>Background</h3><div>To determine what proportion of device-eligible patients with heart failure treated in a specialized clinic are on optimal guideline-directed medical therapy (GDMT) at the time of device referral and their benefit–risk status.</div></div><div><h3>Methods</h3><div>A cohort study was conducted of all patients seen between January 2013 and August 2024. We characterized GDMT by the modified Heart Function Collaboratory score at the time of device referral and grouped patients by Multicenter Automatic Defibrillator Implantation Trial-II (MADIT-ICD) benefit–risk score.</div></div><div><h3>Results</h3><div>Of 250 patients potentially eligible for a primary prophylaxis implantable cardioverter defibrillator (ICD), 136 (54.4%) were referred within 6 months of GDMT initiation—34 (25%) were in the lowest MADIT-ICD benefit–risk group and 6 (9.7%) of those not referred were in the highest benefit–risk group. No differences occurred in ICD referral based on sex (<em>P</em> = 0.92) or New York Heart Association class (<em>P</em> = 0.11), but younger patients (<em>P</em> = 0.007), those with ischemic heart disease (<em>P</em> = 0.006), and those with a longer QRS interval (<em>P</em> = 0.001) were more likely to be referred. Of 54 patients who met cardiac resynchronization therapy indications, 32 (59.3%) were referred within 6 months of GDMT initiation. The median modified Heart Function Collaboratory score was 83.3 (interquartile range, 66.7-100) at the time of ICD referral, and 75.0 (interquartile range, 65.6–100) at the time of cardiac resynchronization therapy referral, but up to one third of patients had ≥ 1 element of GDMT dosed at &lt; 50% target.</div></div><div><h3>Conclusions</h3><div>Within 6 months of initiating GDMT, more than half of eligible patients with heart failure had been referred for a device, but one quarter were in the group least likely to benefit from a device, and not all were on optimal GDMT.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 8","pages":"Pages 997-1006"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858116","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}

{"title":"A Transcriptomic Approach to Sex Differences in Calcific Aortic Valve Stenosis in Patients with a Tricuspid Aortic Valve","authors":"Emma Le Nezet MSc ,&nbsp;Rose Tam MSc ,&nbsp;Zhonglin Li MSc ,&nbsp;Nathalie Gaudreault BSc ,&nbsp;Patrick Mathieu MD, MSc ,&nbsp;Nancy Côté PhD ,&nbsp;Isabelle Guisle PhD ,&nbsp;Sébastien Thériault MD, MSc ,&nbsp;Yohan Bossé PhD ,&nbsp;Marie-Annick Clavel DVM, PhD","doi":"10.1016/j.cjco.2025.02.007","DOIUrl":"10.1016/j.cjco.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Valvular lesions in calcific aortic valve stenosis are sex-specific: female patients reach a similar level of severity as male patients but with less valvular calcification and more valvular fibrosis. We thus aim to assess the transcriptome of stenotic aortic valves according to patients’ sex.</div></div><div><h3>Methods</h3><div>A total of 300 valves were collected, and genomewide gene expression was quantified using a microarray on 240. Among these, 62 female patients were matched with 62 male patients, for age (within 2 years), body mass index (within 2 kg/m²), arterial pressure (within 10/5 mm Hg), diabetes (exact), hypertension (exact), and calcific aortic valve stenosis severity. Among the 60 remaining valves, 16 female and 16 male patients were similarly matched for real-time quantitative polymerase chain reaction analysis.</div></div><div><h3>Results</h3><div>Clinical and echocardiographic characteristics of the patients were comparable between female and male patients, except for the incidence of coronary artery disease and body surface area (greater in male patients). A total of 190 genes were regulated differently in female vs male patients—132 on autosomes, and 58 on sexual chromosomes. Differences were found in inflammation and lipid metabolism–associated genes. Genes linked to intensified fibrosis processes (eg, <em>TGFβ2</em>, <em>KIF1A</em>, <em>FRAS1</em>) were overexpressed in female vs male patients. Genes associated with increased calcification were overexpressed in both male (<em>CPAMD8, STC2</em>) and female (<em>RCN2, TPD52L1</em>) patients. Genes involved in apoptosis (<em>CES4</em>, <em>SFRP4</em>, <em>TGFB2</em>) were overexpressed in female vs male patients. Only <em>KIF1A</em> was validated by real-time quantitative polymerase chain reaction analyses.</div></div><div><h3>Conclusions</h3><div>This study provides evidence that sex may influence aortic valve gene expression through different mechanisms in female vs male individuals.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 8","pages":"Pages 1027-1037"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858164","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}

{"title":"Outcomes of Surgical Myectomy and Mitral Valve Repair for Hypertrophic Cardiomyopathy With vs Without Marked Septal Hypertrophy","authors":"Kenza Rahmouni MDCM ,&nbsp;Hugo M.N. Issa MD ,&nbsp;Omar Toubar ,&nbsp;Andrew M. Crean MD, MPH ,&nbsp;Anne Williams MD ,&nbsp;Hanh Nguyen MD ,&nbsp;Menaka Ponnambalam RN(EC), NP ,&nbsp;Juan Grau MD ,&nbsp;Sean Dickie MD ,&nbsp;Gyaandeo Maharajh MDCM ,&nbsp;Marc Ruel MD, MPH","doi":"10.1016/j.cjco.2025.04.007","DOIUrl":"10.1016/j.cjco.2025.04.007","url":null,"abstract":"<div><h3>Background</h3><div>This study reports a single institution’s clinical and echocardiographic outcomes for septal myectomy with vs without concomitant mitral valve interventions in patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction.</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent transaortic septal myectomy with vs without subvalvular mitral apparatus intervention for HCM between October 2019 and March 2024 were included. All patients underwent transesophageal echocardiography and cardiac magnetic resonance imaging to confirm the pathology, measure intracavitary gradients, and assess mitral valve morphology. Patients were analyzed as an entire cohort and stratified by the presence of marked (&gt; 15 mm) or only mild (≤ 15 mm) septal hypertrophy.</div></div><div><h3>Results</h3><div>A total of 61 patients (32 male) were included, of whom 28 (45.9%) had mild septal hypertrophy. The follow-up assessment was 100% complete and averaged 26.9 ± 16.2 months. In addition to septal myectomy, 32 patients (52.5%) underwent concomitant papillary muscle realignment, and aberrant chordae were resected in 40 patients (65.6%). All patients with a septal thickness ≤ 15 mm had a mitral valve repair intervention. The 30-day and 2-year mortality were 1.6% and 3.3%, respectively. No postoperative ventricular septal defects occurred, including in the thin septum subgroup. Peak LVOT gradients were significantly reduced with surgery, both at rest (47.8 ± 34.7 mm Hg preoperatively vs 8.8 ± 12.3 mm Hg postoperatively, <em>P</em> &lt; 0.001) and under stress (114.2 ± 58.7 mm Hg preoperatively vs 17.6 ± 18.5 postoperatively, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In patients with symptomatic HCM, even in those without marked septal hypertrophy, septal myectomy with a concomitant mitral valve apparatus intervention is safe and provides excellent relief of LVOT obstruction.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 851-859"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587514","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}

{"title":"Prediction of Atrial Fibrillation Using Radiomic Features of Left Atrial Epicardial Adipose Tissue on Noncontrast Cardiac Computed Tomography","authors":"Shayna Cohen-Dor MD ,&nbsp;Moshe Rav-Acha MD, PhD ,&nbsp;Fauzi Shaheen MD ,&nbsp;Boris Chutko MD ,&nbsp;Hadas Labrisch-Kaye MD ,&nbsp;Zohar Ben-Haim MD ,&nbsp;Yoav Michowitz MD ,&nbsp;Hilla Gérard MD ,&nbsp;Naama Bogot MD ,&nbsp;Shemi Carraso MD ,&nbsp;Itzhak Vitkon-Barkay MD ,&nbsp;Laurian Copel MD ,&nbsp;Michael Glikson MD ,&nbsp;Arik Wolak MD","doi":"10.1016/j.cjco.2025.03.024","DOIUrl":"10.1016/j.cjco.2025.03.024","url":null,"abstract":"<div><h3>Background</h3><div>Early detection of atrial fibrillation (AF) can prevent AF-related complications. Radiomic analysis of epicardial adipose tissue (EAT) was shown to predict AF recurrence postablation, but only limited data exist regarding left atrial EAT (LA-EAT) radiomic analysis for predicting AF in patients with yet unknown AF. Our aim was to develop prediction model for AF, based on the association of machine learning-based radiomic analysis of LA-EAT and AF.</div></div><div><h3>Methods</h3><div>Retrospective matched case-control study of patients with and without AF, undergoing noncontrast electrocardiographic (ECG)-gated cardiac computed tomography (CT). Segmentation of LA-EAT and extraction of LA-EAT radiomic features were performed using syngo.via Frontier (Siemens Healthineers, Forchheim, Germany). Univariate analysis identified radiomic features associated with AF. Predictive models for AF were developed via logistic regression and machine learning-based random forest analyses. Models were validated on external cohort of patients with 1:1 AF : control ratio and deployed in a real-world setting with an AF : control ratio of 15:85.</div></div><div><h3>Results</h3><div>The study included 280 patients, 120 with documented AF and 160 matched controls. Based on LA-EAT radiomic features, which were significantly associated with AF, logistic regression and random forest models were constructed and tested on separate internal cohort of patients, yielding area under the curve (AUC) of 0.88 and 0.86, respectively, for prediction of AF. External validation verified these results (AUC 0.84 and 0.78, respectively). Both models were further validated in a real-world setting cohort (AUC 0.85 and 0.81, respectively).</div></div><div><h3>Conclusions</h3><div>Models, based on LA-EAT radiomic features extracted from noncontrast ECG-gated cardiac CT, could accurately predict AF, suggesting a potential widespread noninvasive method for predicting the presence of AF.</div></div><div><h3>Clinical Registration Number</h3><div>0281-23-ASF.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 936-947"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587378","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}

{"title":"Factors Associated with Smoking Cessation in Patients with Coronary Artery Diseases According to Sex: Cohort of Smoking Cessation Services Data from France","authors":"Ingrid Allagbé PhD ,&nbsp;Marianne Zeller PhD ,&nbsp;Daniel Thomas MD, PhD ,&nbsp;Guillaume Airagnes MD, PhD ,&nbsp;Frédéric Limosin MD, PhD ,&nbsp;Abdelali Boussadi PhD ,&nbsp;Frédéric Chagué MD ,&nbsp;Anne-Laurence Le Faou MD, PhD","doi":"10.1016/j.cjco.2025.02.002","DOIUrl":"10.1016/j.cjco.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>In smokers with coronary artery diseases (CADs), smoking cessation (SC) is a major prevention goal. From the French national database of SC services (SCSs), CDTnet, we aimed to describe the social, medical, and smoking characteristics of smokers with CAD, as well as factors associated with their SC, according to sex.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted of smokers with CAD included in the CDTnet from January 2001 to December 2018. Endpoints were abstinence and reduction of daily cigarette consumption. Abstinence was defined as SC maintained for ≥ 28 consecutive days, confirmed by a carbon monoxide measure in exhaled breath testing &lt; 10 parties per million, and reduction was defined as at least a halving of consumption compared to consumption at the time of the first consultation. Sex stratification was performed.</div></div><div><h3>Results</h3><div>Among 4532 smokers included, 21% were women, and their mean age was 55 years in both sexes. Nearly half smoked ≥ 20 cigarettes daily, and most (80%) received nicotine replacement therapy. The 28-day abstinence rate (54%) and reduction rate (24%) were similar in both sexes. Factors positively associated with SC in women were having made ≥ 1 previous quit attempt, and dual use of conventional and electronic cigarettes at the time of the first consultation. In men, being employed, being overweight or obese, being confident in quitting, and being prescribed nicotine replacement therapy at the first consultation were factors associated with success. Other cardiovascular and respiratory diseases were associated negatively with SC in both sexes.</div></div><div><h3>Conclusions</h3><div>Abstinence rates were similar for both sexes, with different factors associated with quit attempt results, according to sex, highlighting the need for tailored interventions that address the specific needs of men and women who intend to quit.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 986-996"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587386","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}

{"title":"Concomitant Atrial Fibrillation Ablation in Surgical Aortic Valve Replacement: A Systematic Review and Meta-Analysis","authors":"Emre Polat MD ,&nbsp;Rohit K. Kharbanda MD, PhD ,&nbsp;Moustafa Ghafar BSc ,&nbsp;Jan W. Schoones MA ,&nbsp;Robert J.M. Klautz MD, PhD ,&nbsp;Marta de Riva MD, PhD ,&nbsp;Meindert Palmen MD, PhD ,&nbsp;Evaldas Girdauskas MD ,&nbsp;Anton Tomšič MD, PhD","doi":"10.1016/j.cjco.2025.05.001","DOIUrl":"10.1016/j.cjco.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is common in patients undergoing surgical aortic valve replacement; however, surgical ablation remains underused due to limited data on its efficacy.</div></div><div><h3>Methods</h3><div>We conducted a systematic review of the literature by searching PubMed, Embase, Web of Science, Emcare, and the Cochrane Library for studies reporting outcomes of concomitant surgical AF ablation in patients undergoing surgical aortic valve replacement. The primary outcomes included freedom from AF recurrence, overall survival, and complications. We analyzed outcomes using traditional meta-analysis at specific time points, alongside pooled Kaplan-Meier curves.</div></div><div><h3>Results</h3><div>Nine studies were included, encompassing a total of 12,683 patients. Concomitant ablation reduced the risk of postoperative AF but increased the risk of permanent pacemaker implantation (risk ratio 1.36, 95% confidence interval [CI] 1.16-1.60, <em>P</em> &lt; 0.01) and postoperative renal failure (RR 1.38, 95% CI 1.11-1.71, <em>P</em> &lt; 0.01). During follow-up, concomitant ablation effectively restored and maintained sinus rhythm, with up to 80% of patients remaining free from recurrent AF 2-4 years post-surgery. Moreover, improved late survival was observed with concomitant ablation (unadjusted hazard ratio 0.84, 95% CI 0.73-0.96, <em>P</em> = 0.013).</div></div><div><h3>Conclusions</h3><div>Surgical ablation during surgical aortic valve replacement was effective in restoring and maintaining sinus rhythm after surgery. Preoperative rhythm status may play an important role in guiding treatment plans, potentially enhancing the clinical outcomes for patients scheduled for aortic valve intervention.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 887-896"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587519","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}