CJC Open最新文献

{"title":"Delayed Stimulus to V6 R-Wave Peak Time for Selective Left Bundle Branch Pacing: Characteristics and Underlying Mechanisms","authors":"Xinhui Peng MM,&nbsp;Longfu Jiang MM,&nbsp;Zaixing Zheng MM,&nbsp;Hao Wu MM,&nbsp;Haiming Feng MM,&nbsp;Jia bo Shen MM,&nbsp;Heng dong Li MM,&nbsp;Nan Zheng MM,&nbsp;Xiaoming Bao MM,&nbsp;Sujun Chen MBBS","doi":"10.1016/j.cjco.2026.04.008","DOIUrl":"10.1016/j.cjco.2026.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Selective left bundle branch pacing (SLBBP) preserves left ventricular synchrony via low stable capture thresholds and shortened stimulus-to-V6 R-wave peak time (S–V6 RWPT), yet delayed S–V6 RWPT (DRWPT) occurs in some recipients. This study aimed to define DRWPT’s electrocardiographic and intracardiac electrogram features during SLBBP and investigate its mechanisms.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 368 SLBBP patients (September 2020 to November 2024, continuous monitoring), enrolled 11 with DRWPT as the study group, enrolled 33 with 1:3 matched shortened S–V6 RWPT (SRWPT) as controls, and analyzed electrocardiogram/intracardiac electrogram features with the isoelectric interval as the endpoint.</div></div><div><h3>Results</h3><div>DRWPT was identified in 3% (11 of 368) of the cohort. Baseline pacing parameters in the DRWPT group were as follows: mean QRS duration 128 ± 35.4 ms, unipolar initial myocardial threshold 1.6 ± 0.7 V, initial left bundle branch threshold 0.7 ± 0.1 V, sensed R-wave amplitude 8.0 ± 2.6 mV, and pacing impedance of 644.1 ± 157.8 Ω. Compared with controls, the DRWPT group had a significantly higher right bundle branch block incidence (63.6% vs 6.06%, <em>P</em> &lt; 0.001), longer median QRS duration (138 ms [IQR 96-152] vs 96 ms [IQR 86-114], <em>P</em> = 0.03), longer isoelectric interval (45.0 ms [IQR 35.0-64.0] vs 31.0 ms [IQR 25.0-37.0], <em>P</em> = 0.005), and longer S–V6 RWPT (94 ms [IQR 81.0-122.0] vs 66 ms [IQR 63.0-72.0], <em>P</em> &lt; 0.001). No significant between-group difference was found in those with stimulus-to-V6 R-wave peak time for left ventricular septal pacing (<em>P</em> = 0.203).</div></div><div><h3>Conclusions</h3><div>DRWPT, linked to impaired left bundle branch conduction with prolonged isoelectric interval and S–V6 RWPT, is more prevalent in patients with native right bundle branch block. The isoelectric interval and current of injury (COI) are critical for guiding lead implantation during continuous monitoring-guided SLBBP.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 915-924"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699165","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":"Integrating Biomarkers and Hemodynamics for 1-Year Mortality Risk Stratification in Transcatheter Tricuspid Intervention","authors":"Christoph Edlinger MD, MSc,&nbsp;Johannes Schlegl MD,&nbsp;Marwin Bannehr MD,&nbsp;Michael Lichtenauer MD, PhD (Prof),&nbsp;Tanja Kücken MD,&nbsp;Alexander Krutz,&nbsp;Vera Paar MSc, PhD,&nbsp;Michael Neuß MD,&nbsp;Anja Haase-Fielitz PharmD (Prof),&nbsp;Christian Butter MD (Prof.)","doi":"10.1016/j.cjco.2026.03.006","DOIUrl":"10.1016/j.cjco.2026.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter tricuspid interventions for severe tricuspid regurgitation are being used increasingly, yet many patients present at an advanced stage, when clinical benefit is limited. The conventional biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) often fails to reflect systemic organ injury or right-sided hemodynamics. We hypothesized that systemic biomarkers combined with invasive haemodynamic data improve risk stratification for 1-year mortality after transcatheter tricuspid regurgitation intervention.</div></div><div><h3>Methods</h3><div>In this prospective, single-centre cohort, preprocedural blood samples for biomarker assessment (growth differentiation factor-15 [GDF-15], soluble urokinase plasminogen activator receptor [suPAR], heart-type fatty acid–binding protein [H-FABP], soluble suppression of tumorigenicity-2 [sST2}, NT-proBNP) and right atrial (RA) pressure were obtained in patients undergoing transcatheter tricuspid repair or valve implantation. Incremental prognostic value was assessed by adding RA pressure to biomarker-based models. Predictive performance for 1-year all-cause mortality was evaluated using receiver operating characteristic analyses. Optimal cutoffs were derived by Youden’s index, and survival was compared using Kaplan–Meier analysis and log-rank testing.</div></div><div><h3>Results</h3><div>Among 100 patients (mean age, 80.7 ± 6.7 years; 48% male), 22 (22%) died within 1 year. The cohort showed advanced disease and a high comorbidity burden. GDF-15 demonstrated the highest prognostic accuracy (area under the curve [AUC] 0.795, 95% confidence interval [CI] 0.675–0.915; <em>P</em> &lt; 0.001), followed by suPAR (AUC 0.746, 95% CI 0.626–0.866; <em>P</em> &lt; 0.001). NT-proBNP did not significantly predict mortality. Combining GDF-15 with RA pressure improved discrimination (AUC 0.805). An elevated level of GDF-15 or suPAR was associated with significantly reduced survival.</div></div><div><h3>Conclusions</h3><div>In patients undergoing transcatheter tricuspid intervention, GDF-15 and suPAR outperform NT-proBNP in predicting 1-year mortality. Integration of RA pressure further refines risk stratification and may aid patient selection and the timing of intervention.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 1135-1142"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Cushing's Cardiomyopathy with a Convoluted Course of Treatment","authors":"Feng Hu MD, PhD,&nbsp;Cheng Yu MD, PhD,&nbsp;Yuansheng Wu MD, PhD,&nbsp;Tao Yi MD, PhD,&nbsp;Lianglong Chen MD, PhD,&nbsp;Shumei Li MD, PhD","doi":"10.1016/j.cjco.2026.03.021","DOIUrl":"10.1016/j.cjco.2026.03.021","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 1036-1040"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699258","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":"From Lived Experiences to Systemic Change: Patient Perspectives on the Diagnostic Journey of Loeys-Dietz Syndrome","authors":"Sally Al-Mufty MSc,&nbsp;Michael P. Mackley MD, DPhil,&nbsp;Lindsay Parsons BA,&nbsp;Susan Randall Armel MSc, MS, MScCH,&nbsp;Jeanna McCuaig PhD,&nbsp;David Chitayat MD,&nbsp;Samantha Afonso MS","doi":"10.1016/j.cjco.2026.03.009","DOIUrl":"10.1016/j.cjco.2026.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Loeys-Dietz syndrome (LDS) is a rare genetic connective tissue disorder characterized by early-onset aortic aneurysms and dissections, making early diagnosis crucial for patients’ survival. Due to its rarity and overlap with other conditions, LDS is often challenging to diagnose. This study explored the diagnostic experiences of Canadians with LDS to identify perceived barriers, supports, and patient-informed gaps for improving diagnosis and care.</div></div><div><h3>Methods</h3><div>In-depth semi-structured interviews were conducted with 9 adults across Canada who were the first in their family to receive a confirmed diagnosis of LDS. Transcripts were generated, reviewed for accuracy, de-identified, and analyzed thematically using an inductive approach with iterative coding and team-based consensus around themes.</div></div><div><h3>Results</h3><div>Five themes emerged: (i) patient role—individuals demonstrated self-advocacy and persistence; (ii) clinician role—clinicians acted as either catalysts or constraints; (iii) system role—healthcare was perceived as reactive and unequal, with limited consistency; (iv) impact of diagnosis—receiving a diagnosis of LDS brought clarity but also emotional challenges; and (v) patient-identified gaps—participants recognized challenges and emphasized enhanced education, proactive detection, ongoing support, and centralized care pathways to improve the diagnostic journey.</div></div><div><h3>Conclusions</h3><div>The timeliness and accuracy of LDS diagnosis are shaped by interactions among patient persistence, clinician awareness, and coordination, with delays driven by limited knowledge, fragmented care, and system barriers, despite the life-threatening risk involved. Patients identified gaps in clinician awareness, diagnostic pathways, psychosocial support, and care coordination. These findings emphasize cardiologists’ central role in integrated multidisciplinary cardiology–genetics models to improve timely care and recognition of rare cardiovascular conditions.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 1064-1073"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699168","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":"Immune Checkpoint Inhibitor–Induced Effusive–Constrictive Pericarditis: The Role of Multimodality Imaging","authors":"Magdaline Zawadka MD,&nbsp;Davinder Jassal MD,&nbsp;Ahmad Didi MD,&nbsp;Iain Kirkpatrick MD,&nbsp;Robin Ducas MD","doi":"10.1016/j.cjco.2026.04.004","DOIUrl":"10.1016/j.cjco.2026.04.004","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 1131-1134"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699253","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":"MultiECGNet: Evaluation of a Deep-Learning Ensemble Method for Image-Based 12-Lead Electrocardiographic Detection of Atrial Fibrillation","authors":"George Parker BEng (Hons), BMedSc,&nbsp;Justin Phan MBBS, MMed (Clin Epi), MClinUS Grad Dip EP FRACP,&nbsp;Nigel H. Lovell BE (Hons) PhD,&nbsp;Rajesh N. Subbiah BSc (Med), MBBS, FRACP, PhD,&nbsp;Jamie I. Vandenberg BSc(Med), MBBS, PhD,&nbsp;Adam P. Hill BSc (Hons), PhD,&nbsp;Ahmadreza Argha BSc, MSc, PhD","doi":"10.1016/j.cjco.2026.03.022","DOIUrl":"10.1016/j.cjco.2026.03.022","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence holds significant promise for analysis and interpretation of electrocardiograms (ECGs) in cardiovascular disease. However, many ECGs are still stored as paper records or static images, necessitating deep-learning models that can operate on image-based ECG formats. This study aims to evaluate the performance of an ensemble classifier, MultiECGNet, using multi-format ECG images for the diagnosis of atrial fibrillation (AF).</div></div><div><h3>Methods</h3><div>An ensemble classifier was developed using 4 models derived by truncating the pretrained EfficientNet B3 model at different feature extraction layers. Transfer learning was employed to train the ensemble on the publicly available PTB-XL dataset for AF detection. External validation was performed using the Chinese Physiological Society Signal Challenge dataset. ECG samples were converted into 2 image formats (2 x 6 and 4 x 3), and performance was evaluated across same-format, cross-format, and mixed-format classification tasks.</div></div><div><h3>Results</h3><div>The classifier detected AF in the validation dataset with an accuracy of 0.95 with an F1-score of 0.87, comparable to a signal-based model (F1-score: 0.87 vs 0.83) and better than a single EfficientNet-B3 model (F1-score: 0.87 vs 0.71). Training on one ECG format and testing on a different format resulted in reduced performance (F1-score: 0.66-0.71). However, training on a dataset containing a mix of both formats closely matched the performance of the original same-format training (F1-score: 0.86).</div></div><div><h3>Conclusions</h3><div>The proposed image-based ensemble classifier demonstrated comparable performance to a strong signal-based model for AF detection. Although cross-format generalization posed a challenge, incorporating multiple ECG formats during training mitigated this limitation and improved model robustness.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 1074-1087"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699167","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":"Predicting Atrial Fibrillation Risk in Hypertrophic Cardiomyopathy Patients","authors":"Mahdi Montazeri MD,&nbsp;Negin Rashidi MD, MSc,&nbsp;Deacon Z.J. Lee MBChB, MRCP, CCDS,&nbsp;Ali Sakhnini MD,&nbsp;Sara Hoss MD,&nbsp;Arnon Adler MD,&nbsp;Harry Rakowski MD, FRCPC, FACC, FASE,&nbsp;Raymond H. Chan MD, MPH, FRCPC","doi":"10.1016/j.cjco.2026.04.005","DOIUrl":"10.1016/j.cjco.2026.04.005","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate whether the left atrium (LA) phasic function and myocardial deformation by cardiovascular magnetic resonance (CMR) in hypertrophic cardiomyopathy (HCM) patients is a predictor of atrial fibrillation (AF) development.</div></div><div><h3>Methods</h3><div>The baseline CMRs of HCM patients who later developed AF (n = 140; mean age = 61 ± 12 years; male = 86) were compared with those of HCM patients who did not develop AF (n = 70; mean ag e= 58 ± 11 years; male patients = 48). This case–control study was conducted at our quaternary referral centre between January 2001 and June 2021. The univariate and multivariable Cox proportional hazards model was used to assess the correlation between clinical and imaging parameters vs the likelihood of developing AF.</div></div><div><h3>Results</h3><div>Compared to the non-AF cohort, HCM patients with AF had larger baseline LA volumes and lower LA strain and LA strain rates. Maximum left ventricular (LV) wall thickness, absolute and indexed LV mass, and indexed LV end-diastolic volume were larger in patients with AF vs the non-AF group. LV ejection fraction assessed by CMR along with late gadolinium enhancement prevalence and pattern was similar between patients with vs without AF.</div><div>LA booster strain (5.8 ± 3.4 in the AF group vs 11.4 ± 4.2 in the non-AF group, <em>P</em> &lt; 0.00001) and total LA ejection fraction (32.9 ± 12.8 in the AF group vs 44.0 ± 9.3 in the non-AF group, <em>P</em> &lt; 0.00001) were significantly worse at baseline in the AF group. No significant relationship was present between markers of LV disease burden and AF.</div></div><div><h3>Conclusions</h3><div>LA booster strain and total LA ejection fraction at baseline CMR correlated with AF development in HCM patients.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 948-957"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699312","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":"Author Correction to “Variation in Availability of Continuous Ambulatory Electrocardiographic Monitors Across Canadian Provinces [CJC Open. Volume 7, Issue 9, Pages 1157-1161. DOI:doi.org/10.1016/j.cjco.2025.06.005]”","authors":"Amr Saleh BSc,&nbsp;Jason G. Andrade MD,&nbsp;Patrick Bergin MD,&nbsp;Derek S. Chew MD, MSc,&nbsp;Larry Sterns MD,&nbsp;Christian Steinberg MD,&nbsp;Mehrdad Golian MD,&nbsp;Evan Lockwood MD,&nbsp;Min-Shien Chen MD,&nbsp;Stephen Duffett MD,&nbsp;Jeff S. Healey MD, MSc,&nbsp;Ratika Parkash MD,&nbsp;Lena Rivard MD,&nbsp;Colette M. Seifer MD,&nbsp;Satish Toal MD,&nbsp;William F. McIntyre MD, PhD","doi":"10.1016/j.cjco.2026.03.016","DOIUrl":"10.1016/j.cjco.2026.03.016","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Page 971"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699309","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":"Long-Term Outcomes in Survivors of Fulminant Myocarditis Supported with Venoarterial Extracorporeal Membrane Oxygenation by Discharge Cardiac Function","authors":"Maria Lambadaris MD,&nbsp;Julie K.K. Vishram-Nielsen MD, PhD,&nbsp;Takahiro Okumura MD, PhD,&nbsp;Yee-Chun Chen MD, PhD,&nbsp;Aristine Cheng MD,&nbsp;Hsin-Yun Sun MD,&nbsp;Antonio Loforte MD, PhD,&nbsp;Yasuhide Asaumi MD, PhD,&nbsp;Kenichiro Sawada MD, PhD,&nbsp;Mingjie Huang MD,&nbsp;Wei C. Lee MD,&nbsp;Thomas Fux MD, PhD,&nbsp;Matteo Pozzi MD,&nbsp;Heather J. Ross MD, PhD,&nbsp;Finn Gustafsson MD, DMSc,&nbsp;Hasse Møller-Sørensen MD, PhD,&nbsp;Albert Ariza-Solé MD, PhD,&nbsp;Mario Senechal MD,&nbsp;Pierre Yves Turgeon MD,&nbsp;Manuel Martinez-Selles MD, PhD,&nbsp;Ana C. Alba MD, PhD","doi":"10.1016/j.cjco.2026.03.020","DOIUrl":"10.1016/j.cjco.2026.03.020","url":null,"abstract":"<div><h3>Background</h3><div>Fulminant myocarditis (FM) is a life-threatening cause of cardiogenic shock. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is often employed as a bridge to recovery, but data on long-term outcomes and prognostic markers post-discharge remain limited. We described long-term outcomes and explored the association between discharge left ventricular ejection fraction (LVEF) and post-discharge events.</div></div><div><h3>Methods</h3><div>This retrospective, international, multicentre cohort study included adult FM patients who required VA-ECMO and survived to hospital discharge. Patients were stratified by LVEF ≥ 50% or &lt; 50% at discharge. Cox proportional hazards models were used to assess the association between discharge LVEF and the primary composite endpoint of death, heart transplantation, or durable mechanical circulatory support postdischarge.</div></div><div><h3>Results</h3><div>A total of 106 patients from 11 centres were included, with a median age of 43 years (interquartile range 29-57); 42% were male. At discharge, LVEF was ≥ 50% in 69 patients and &lt; 50% in 37 patients. Over a median follow-up of 4.4 years (interquartile range 1.6-7.9), 3 patients (2.8%) experienced the composite outcome (2 deaths, 1 left ventricular assist device implantation). Compared with patients discharged with an LVEF ≥ 50%, those with an LVEF &lt; 50% had a numerically higher risk of the composite endpoint (hazard ratio 2.9, 95% confidence interval 0.19-42.9), although this difference was not statistically significant.</div></div><div><h3>Conclusions</h3><div>Given the low number of postdischarge events, this study was underpowered to assess the prognostic value of discharge LVEF. However, long-term outcomes were favourable among survivors of FM supported with VA-ECMO, regardless of their LVEF at discharge.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 1019-1026"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699260","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 Prevalence, Healthcare Resource Utilization, and Clinical Characteristics of Individuals with Atherosclerotic Cardiovascular Disease in Manitoba","authors":"Reid Whitlock MSc,&nbsp;Paul Komenda MD, MHA,&nbsp;Ryan Bamforth MSc,&nbsp;Carlos Rojas-Fernandez PharmD,&nbsp;Jay Hingwala MD","doi":"10.1016/j.cjco.2026.04.010","DOIUrl":"10.1016/j.cjco.2026.04.010","url":null,"abstract":"<div><h3>Background</h3><div>Many individuals with atherosclerotic cardiovascular disease (ASCVD) have elevated low-density lipoprotein cholesterol (LDL-C) levels, which increases the risk of adverse cardiovascular events such as stroke, myocardial infarction, and cardiovascular death. We conducted an observational study to report the point prevalence of ASCVD in Manitoba and to describe this population in terms of demographic, clinical characteristics, treatment received, and healthcare resource utilization.</div></div><div><h3>Methods</h3><div>Our retrospective cohort study linked population-level de-identified health administrative databases. We included adults (aged ≥ 18 years) with a diagnosis of ASCVD between April 1, 2006 and July 1, 2019. In a 1-year baseline period, we assessed LDL-C levels, lipid-lowering therapy (LLT) prescriptions, and cardiovascular events, along with their costs.</div></div><div><h3>Results</h3><div>A total of 112,601 individuals had ASCVD in Manitoba (point prevalence = 10.5%). The mean age was 68.6 ± 14.7 years, 60,353 (53.2%) were male, and 61,124 (54.3%) were being treated with LLT. In 19,046 individuals with an LDL-C at baseline, 7887 (41.4%) were meeting a target of &lt; 1.8 mmol/L. A total of 4619 cardiovascular events occurred (rate = 41.28/1000 person-years [95% confidence interval: 39.98-42.63]), with a cumulative estimated hospitalization cost of $77.8 million.</div></div><div><h3>Conclusions</h3><div>The estimated prevalence of ASCVD among adults in Manitoba is 10.5%, and 45.7% of these individuals were not being treated with LLT. In individuals with an LDL-C measurement at baseline, 41.4% were meeting a target of &lt; 1.8 mmol/L. These results may provide inputs to inform future cost-effectiveness analyses of incorporating smore novel LLT therapeutics to lower LDL-C levels in individuals with ASCVD.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 8","pages":"Pages 1010-1018"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148699305","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}