IJC Heart and Vasculature最新文献

{"title":"Expert opinion on a safe same day discharge strategy as standard of care after leadless pacemaker implantation","authors":"Riyaz Somani ,&nbsp;James Daniels ,&nbsp;Alexis Mechulan ,&nbsp;Vincent Paul ,&nbsp;David Sharman ,&nbsp;Shirley Sze ,&nbsp;Xavier Viñolas Prat","doi":"10.1016/j.ijcha.2025.101649","DOIUrl":"10.1016/j.ijcha.2025.101649","url":null,"abstract":"<div><h3>Introduction</h3><div>Leadless pacemaker (LPs) is a safe and effective alternative to conventional transvenous pacing. There is currently no guidance on which patients could be safely discharged the same day post-procedure.</div></div><div><h3>Purpose</h3><div>To provide guidance to medical teams regarding safe same day discharge (SDD) after LP implantation.</div></div><div><h3>Methods</h3><div>An Advisory Board (AB) of 6 expert Micra™ implanters was formed. Interviews were conducted with each member to understand their experience on patient selection, care pathway, complications, and follow-up of Micra™ implanted patients. This information was used to develop a patient pathway for safe SDD after Micra™ implantation. A further survey was conducted to obtain consensus regarding decision points within the pathway.</div></div><div><h3>Results</h3><div>The SDD after Micra™ Implantation Patient Pathway consists of four phases:</div><div>Pre-procedure assessment: Social factors are key in deciding suitability of SDD (6/6 AB members agreed, 100%). Patient’s comorbidities, frailty status and timing of procedure are also important in decision-making for SDD.</div><div>Micra™ implant: Ultrasound-guidance reduces vascular access-related complications, increasing the likelihood for SDD (100%).</div><div>Post-procedure observation: Peri-procedural complications such as pericardial effusion, severe vascular complications, bleeding from access site and device complications would prevent SDD (100%). Patients should complete 6 h of observation prior to discharge (100%).</div><div>Follow-up: First follow-up should be in-person, 1–4 weeks post-procedure (84 %). Long-term follow-up should be organised as per Micra™ standard of care at each centre (100 %).</div></div><div><h3>Conclusions</h3><div>SDD after Micra™ Implantation Patient Pathway was developed via expert consensus. Adoption of the pathway in clinical practice may facilitate safe SDD after Micra™ Implantation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101649"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642848","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 use of sacubitril/valsartan in different forms of heart failure","authors":"Mohammad Abumayyaleh,&nbsp;Nazha Hamdani,&nbsp;Ibrahim El-Battrawy,&nbsp;Ibrahim Akin","doi":"10.1016/j.ijcha.2025.101650","DOIUrl":"10.1016/j.ijcha.2025.101650","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101650"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642847","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":"Association of indexed aortic dimensions with the presence and extent of coronary artery ectasia in patients with acute coronary syndrome","authors":"Martijn J.H. van Oort ,&nbsp;Federico Oliveri ,&nbsp;Florens W.J. de Lange ,&nbsp;Madelien V. Regeer ,&nbsp;B.O. Bingen ,&nbsp;J.Wouter Jukema ,&nbsp;Frank van der Kley ,&nbsp;Ibtihal Al Amri ,&nbsp;Jose M. Montero-Cabezas","doi":"10.1016/j.ijcha.2025.101654","DOIUrl":"10.1016/j.ijcha.2025.101654","url":null,"abstract":"<div><h3>Background</h3><div>Conflicting findings have been reported on the potential association between CAE and aortic dilatation. This study aimed to investigate the relationship between CAE extent and aortic dimensions in patients with acute coronary syndrome (ACS).</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 448 adult patients who underwent coronary angiography for ACS between 2004 and 2015. The cohort was divided into 224 patients with CAE and 224 control patients without CAE, matched for age, sex, and hypertension. Aortic dimensions at the annulus, sinus of Valsalva (SOV), sinotubular junction (STJ), and ascending aorta were measured using transthoracic echocardiography and indexed to body surface area (BSA). The extent of CAE was classified using the Markis and Markis-Harirkrishnan systems. Statistical analysis included ANOVA to assess differences in aortic dimensions and their correlation with CAE extent.</div></div><div><h3>Results</h3><div>Patients with CAE had significantly larger non-indexed aortic dimensions compared to those without CAE (e.g., ascending aorta diameter: 35.2 ± 4.0 mm vs. 33.6 ± 3.7 mm, p &lt; 0.0001). However, when indexed to BSA, these differences were not significant. No significant correlation was found between CAE extent and aortic dimensions (e.g., indexed ascending aorta: F = 1.161, p = 0.325). The incidence of bicuspid aortic valve was similar between both groups (0.9 % vs. 0.4 %, p = 0.554).</div></div><div><h3>Conclusion</h3><div>In patients with ACS, there were no significant differences in indexed aortic diameters in those with and without CAE. Additionally, no correlation was found between CAE extent and aortic dimensions and the incidence of bicuspid aortic valve was comparable in both groups.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101654"},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636427","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":"Increased neprilysin expression is linked to atrial fibrotic remodeling in cardiovascular surgery patients","authors":"Toshiaki Nakajima ,&nbsp;Akiko Haruyama ,&nbsp;Taira Fukuda ,&nbsp;Kentaro Minami ,&nbsp;Takafumi Nakajima ,&nbsp;Takaaki Hasegawa ,&nbsp;Seiko Tokoi ,&nbsp;Syotaro Obi ,&nbsp;Gaku Oguri ,&nbsp;Masashi Sakuma ,&nbsp;Ikuko Shibasaki ,&nbsp;Hirotsugu Fukuda ,&nbsp;Shigeru Toyoda","doi":"10.1016/j.ijcha.2025.101647","DOIUrl":"10.1016/j.ijcha.2025.101647","url":null,"abstract":"<div><h3>Background</h3><div>Neprilysin (NEP) is a membrane-bound neutral endopeptidase with various physiological functions. We investigated the roles of NEP in atrial fibrotic remodeling and atrial fibrillation (AF) in patients undergoing cardiovascular surgery.</div></div><div><h3>Methods</h3><div>Atrial tissue samples were obtained from left atrium (LA) appendages, and mRNA expression level was analyzed by real-time reverse transcription polymerase chain reaction in 61 cases (25 paroxysmal fibrillation (PAF), 36 AF). Adipose tissue (AT) mRNA expression levels were also analyzed. Western blotting and immunohistochemical staining were used for determining tissue protein expression. Serum NEP levels were measured by enzyme-linked immunosorbent assay (ELISA). Two-dimensional speckle tracking echocardiography was performed to measure mean left atrial reservoir strain (mLASr) to evaluate atrial remodeling in pre-operative patients and control participants.</div></div><div><h3>Results</h3><div>Immunohistochemical staining and western blotting revealed NEP expression in both AT and LA. Serum NEP levels did not correlate with NEP mRNA or protein expression in AT and LA. NEP mRNA expression levels correlated with fibrosis-related gene expression. NEP mRNA, protein, and fibrosis-related gene expression levels increased in PAF patients with low mLASr compared with high mLASr. PAF patients with high NEP mRNA expression showed increased fibrosis-related gene expression compared with those with low NEP expression. Multiple regression analysis revealed that NEP mRNA expression level was an independent variable for predicting fibrosis-related gene expression, whereas NOX4 and NLRP3 were independent variables for predicting NEP expression levels.</div></div><div><h3>Conclusions</h3><div>Increased atrial expression of NEP is linked to atrial fibrotic remodeling, and the development of AF in patients undergoing cardiovascular surgery.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101647"},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637624","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":"Efficacy of glucagon-like peptide-1 receptor agonists for prevention of stroke among patients with and without diabetes: A meta-analysis with the SELECT and FLOW trails","authors":"Asmita Gera ,&nbsp;Fakhar Latif ,&nbsp;Vamsikalyan Borra ,&nbsp;Sidra Naz ,&nbsp;Vivek Mittal ,&nbsp;Fathima Shehnaz Ayoobkhan ,&nbsp;Tushar Kumar ,&nbsp;Zarghoona Wajid ,&nbsp;Novonil Deb ,&nbsp;Tanisha Prasad ,&nbsp;Jishanth Mattumpuram ,&nbsp;Vikash Jaiswal","doi":"10.1016/j.ijcha.2025.101638","DOIUrl":"10.1016/j.ijcha.2025.101638","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a reduction in major adverse cardiovascular events (MACE) among patients with type 2 diabetes mellitus (T2DM). However, its efficacy on cerebrovascular events is yet to be well established among diabetic and non diabetic patients.</div></div><div><h3>Objective</h3><div>We sought to evaluate the efficacy of GLP-1 RAs on stroke risk among its different types in patients with and without Diabetes.</div></div><div><h3>Methods</h3><div>We performed a systematic literature search on PubMed, EMBASE, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> for relevant randomized controlled trials (RCTs) from inspection until 15th July 2024, without any language restrictions. Odds ratios (OR) and 95 % confidence intervals (CI) were pooled using a random-effect model, and a p-value of &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 11 RCTs with 85,373 patients were included (43,339 in GLP-1 RA and 42,034 in the placebo group) in the analysis. The mean age of the patients in GLP-1 RAs and the placebo groups was 63.5 and 63.1 years, respectively. Pooled analysis of primary and secondary endpoints showed that GLP-1 RAs significantly reduced the risk of incidence of stroke by 15 % (OR, 0.85(95 %CI: 0.77–0.93), <em>P</em> &lt; 0.001) and nonfatal stroke by 13 % (OR, 0.87(95 %CI: 0.79–0.95), <em>P</em> &lt; 0.001) compared with placebo. However, the risk of fatal stroke (OR, 0.94(95 %CI: 0.75–1.17), <em>P =</em> 0.56) was comparable between both groups of patients. Similarly, the risk of serious adverse events such as cerebrovascular accident (OR, 0.75(95 %CI: 0.57–1.00), <em>P =</em> 0.05), hemorrhagic stroke (OR, 0.82(95 %CI: 0.42–1.60), <em>P =</em> 0.57, and ischemic stroke (OR, 0.85(95 %CI: 0.64–1.13), <em>P =</em> 0.26) was comparable between GLP-1RAs and placebo.</div></div><div><h3>Conclusion</h3><div>Treatment with GLP-1 receptor agonists has beneficial effects in reducing the risk of stroke, and nonfatal stroke in patients with and without diabetes. However, no such effect was observed for fatal stroke.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101638"},"PeriodicalIF":2.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629263","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":"Surgical ablation in patients with atrial fibrillation and left ventricular dysfunction: A systematic review and meta-analysis","authors":"Leo Noanh Consoli ,&nbsp;Eren Cetinel ,&nbsp;Mir Wajid Majeed ,&nbsp;Pawel Lajczak ,&nbsp;Ilias Georgios Koziakas ,&nbsp;Prajna Wijaya ,&nbsp;Alexandros Apostolou ,&nbsp;Raheel Ahmed ,&nbsp;Konstantinos Perreas","doi":"10.1016/j.ijcha.2025.101648","DOIUrl":"10.1016/j.ijcha.2025.101648","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) and left ventricular dysfunction (LVD) are common conditions that often coexist, with about 25% of patients in NYHA classes I-II having AF. Efficacy and safety of surgical ablation (SA) in this population remains unclear.</div></div><div><h3>Methods</h3><div>We aimed to perform a single-arm <em>meta</em>-analysis to assess the outcomes of standalone and concomitant SA in adult patients with AF and LVD. We searched PubMed, Scopus and the Cochrane Library. Endpoints of interest were maintenance of sinus rhythm, freedom from anti-arrhythmic drug (AAD) use, change in LVEF, 30-day mortality, 1 year mortality and major procedural complications. We calculated pooled proportions or means for binary and continuous endpoints, respectively, with a 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>Ten observational studies comprising 863 patients (mean follow-up of 19 months) were included. At 1 year, SA resulted in a sinus rhythm rate of 83.9 % (95 % CI: 69.5–92.3); freedom from AAD use of 81.6 % (95 % CI: 64.7–91.7); and mortality of 5.77 (95 % CI:3.7–8.9). 30-day mortality was 2.16 % (95 % CI: 0.9–4.9); major complications 16.73 % (95 % CI: 12–23); and an improvement in LVEF of 12 % (95 % CI: 9–17).</div></div><div><h3>Conclusion</h3><div>This <em>meta</em>-analysis found that SA appears to be an effective strategy to achieve sinus rhythm in patients with AF and LVD, with a pooled 30-day mortality of 2.2%. Comparative studies are warranted to evaluate the relative safety and efficacy of SA compared with other rhythm control strategies in this population.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"58 ","pages":"Article 101648"},"PeriodicalIF":2.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of preoperative hyperuricemia on the prognosis of patients with acute type A aortic dissection","authors":"Songhao Jia ,&nbsp;Maozhou Wang ,&nbsp;Meili Wang ,&nbsp;Wei Luo ,&nbsp;Yuyong Liu ,&nbsp;Wenjian Jiang ,&nbsp;Hongjia Zhang","doi":"10.1016/j.ijcha.2025.101646","DOIUrl":"10.1016/j.ijcha.2025.101646","url":null,"abstract":"<div><h3>Background</h3><div>The mortality of patients with acute type A aortic dissection remains high, and it is imperative to explore the risk factors that affect patient prognosis.</div></div><div><h3>Methods and results</h3><div>485 patients with acute type A aortic dissection who underwent surgery were included in our study. Based on preoperative serum uric acid tests, the patients were divided into two groups. After adjusting baseline data (SMD &lt; 0.1), the 30-day mortality (19.4 % vs 6.2 %, P &lt; 0.001) in the hyperuricemia group were significantly higher. Univariate and multivariate COX regression revealed that hyperuricemia was an independent risk factor for 30-day mortality in patients (HR, 2.2; P = 0.016). In subgroup analysis, the trend of increased mortality in the hyperuricemia group was consistent. In a median follow-up time of 6.2 years, Landmark analysis showed that the mortality of the hyperuricemia group mainly increased significantly within 1 month after surgery (Log-rank P &lt; 0.001), and there was no significant difference after 1 month (Log-rank P = 0.506). Through restricted cubic spline, it was found that the risk of death gradually increases with preoperative blood uric acid levels above 330 μmol/L.</div></div><div><h3>Conclusion</h3><div>Preoperative hyperuricemia was an independent risk factor for early mortality in patients with acute type A aortic dissection, but it did not affect the mid-term survival in patients who survived the early postoperative period.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101646"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of periprocedural anticoagulation on patient outcomes after transcatheter edge to edge repair of mitral valve with MitraClipTM; an insight from nationwide dataset","authors":"Shahzad Ahmad ,&nbsp;Aiham Albaeni ,&nbsp;Salman Salehin ,&nbsp;Ramy Abdelmaseih ,&nbsp;Yuanyi Zhang ,&nbsp;Syed Mustajab Hasan ,&nbsp;Umamahesh Rangasetty ,&nbsp;Syed Abbas Gilani ,&nbsp;Afaq Motiwala ,&nbsp;Hani Jneid","doi":"10.1016/j.ijcha.2025.101644","DOIUrl":"10.1016/j.ijcha.2025.101644","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcatheter edge to edge repair (TEER) with MitraClip^TM has been increasingly used after its FDA approval. Peri-procedural antithrombotic therapy is not yet clearly defined. We compared the outcomes of patients on anticoagulation with those on antiplatelets in this retrospective study.</div></div><div><h3>Methods</h3><div>We identified 2,422 patients with MitraClip^TM placement in Optum’s de-identified Clinformatics® Data Mart Database from January 2016 to December 2020. Anticoagulation (AC group) were compared with dual antiplatelet (DAPT group). Patients were followed for 3 years. Primary outcome was occurrence of ischemic stroke, secondary outcomes were clinically significant bleeding requiring hospital visit and readmission within 30 days.</div></div><div><h3>Results</h3><div>Of 2,422 patients, 957 (39.5 %) were on anticoagulation. Mean age was 79 + SD with 51 % males and 78 % Caucasians. Apixaban and aspirin were used in 486 (50.8 %) patients while 366 (38.24 %) patients used warfarin and aspirin. There was no statistically significant between groups difference in the incidence of stroke (HR 0.85, CI: 0.71–1.01, p = 0.07), clinically significant bleeding (HR 0.96, 95 % CI: 0.86–1.07, p = 0.46), or 30-days readmission rate (HR 1.07, 95 % CI: 0.84–1.36, p = 0.60). Subgroup analysis showed statistically significant benefit of using anticoagulation in atrial fibrillation patients (CI: 0.68–0.99, HR = 0.82, p = 0.04,). Heart failure was the most common cause of 30 days readmission.</div></div><div><h3>Conclusion</h3><div>DAPT has comparable results to anticoagulation after TEER with MitraClip^TM in terms of stroke prevention, bleeding and 30-days readmission with the exception of patients with atrial fibrillation, who benefit from anticoagulation. Prospective studies are needed to clarify the importance of periprocedural anticoagulation and to reduce readmissions.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101644"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600857","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":"Clinical implications of the MELD-XI score in patients undergoing percutaneous coronary intervention: Insights from the SAKURA PCI2 Antithrombotic registry","authors":"Mitsumasa Sudo ,&nbsp;Riku Arai ,&nbsp;Keisuke Kojima ,&nbsp;Eizo Tachibana ,&nbsp;Wataru Atsumi ,&nbsp;Michiaki Matsumoto ,&nbsp;Naoya Matsumoto ,&nbsp;Kazumiki Nomoto ,&nbsp;Takaaki Kogo ,&nbsp;Ken Arima ,&nbsp;Masaru Arai ,&nbsp;Yutaka Koyama ,&nbsp;Koji Oiwa ,&nbsp;Hironori Haruta ,&nbsp;Yasuo Okumura","doi":"10.1016/j.ijcha.2025.101645","DOIUrl":"10.1016/j.ijcha.2025.101645","url":null,"abstract":"<div><h3>Background</h3><div>The association between hepatorenal function, assessed by the Model for End-stage Liver Disease eXcluding International normalized ratio (MELD-XI) score, and clinical prognosis remains unclear in patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to evaluate the clinical implications of the MELD-XI score.</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent PCI from June 2020 to September 2022 in the SAKURA PCI2 Antithrombotic registry, a multi-center observational prospective cohort study, were reviewed. Patients with missing data for calculating the MELD-XI score were excluded. Study participating patients were stratified into two groups based on the MELD-XI score: high (&gt;10) and low (≤10). The primary outcome was defined as two-year all-cause mortality. The secondary outcome was defined as major bleeding in accordance with the Bleeding Academic Research Consortium 3 or 5.</div></div><div><h3>Results</h3><div>Among 1064 patients, 265 (24.9 %) were stratified into a high MELD-XI score. Patients with a high MELD-XI had higher two-year all-cause mortality than those with a low MELD-XI score (19.6 % vs. 4.7 %, log-rank p &lt; 0.01). This association was supported in the multivariable analysis (adjusted HR 3.26, 95 %CI 1.84–5.75, p &lt; 0.01) and further supported by spline curve analysis. A high MELD-XI score was also associated with an increased risk of major bleeding (adjusted HR 2.94, 95 %Ci 1.55–5.56, p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>A high MELD-XI score was associated with an increased risk of all-cause mortality and major bleeding within two years. Therefore, the MELD-XI score could provide valuable additional information for risk stratification in patients undergoing PCI.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101645"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593219","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":"Causal relationship between type I diabetes mellitus and atrial fibrillation: A Mendelian randomization study","authors":"Yongkai Li ,&nbsp;Shasha Liu ,&nbsp;Yiming Dong ,&nbsp;Jianzhong Yang ,&nbsp;Yingping Tian","doi":"10.1016/j.ijcha.2025.101643","DOIUrl":"10.1016/j.ijcha.2025.101643","url":null,"abstract":"<div><h3>Background</h3><div>Patients with type 1 diabetes mellitus have been at heightened risk for developing atrial fibrillation. We aimed to investigate whether this association is causal using Mendelian randomization.</div></div><div><h3>Methods</h3><div>Using publicly available genome-wide association studies data, we selected single nucleotide polymorphisms significantly associated with type 1 diabetes mellitus as instrumental variables. We employed inverse variance-weighted, weighted median, MR-Egger regression, simple mode, and weighted mode methods within a two-sample Mendelian randomization framework to assess the causal relationship between type 1 diabetes mellitus and atrial fibrillation. We evaluated the pleiotropy and heterogeneity levels of the included genetic instruments using MR-PRESSO, MR-Egger intercept test, Cochran’s Q test, funnel plots, and leave-one-out plots.</div></div><div><h3>Results</h3><div>Causal impact of type 1 diabetes mellitus on atrial fibrillation: Inverse variance weighted (odds ratio [OR] = 0.996, 95 % confidence interval [CI]: 0.985–1.007, <em>P</em> = 0.498). MR-Egger (OR = 1.000, 95 % CI: 0.985–1.016, <em>P</em> = 0.963). Weighted median (OR = 0.985, 95 % CI: 0.973–0.998, <em>P</em> = 0.022). Simple mode (OR = 1.007, 95 % CI: 0.974–1.040, <em>P</em> = 0.698). Weighted mode (OR = 0.995, 95 % CI: 0.984–1.005, <em>P</em> = 0.298). MR-Egger intercept test (<em>P</em> = 0.437). There was no evidence of pleiotropy among the genetic instrumental variables included in the analysis.</div></div><div><h3>Conclusions</h3><div>In Mendelian randomization analysis, we did not find evidence of a causal relationship between genetically determined type 1 diabetes mellitus in European ancestry populations and atrial fibrillation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"57 ","pages":"Article 101643"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593220","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}