IJC Heart and Vasculature最新文献

{"title":"Short and long-term outcomes of percutaneous coronary intervention in patients with active or prior history of cancer: a systematic review and meta-analysis","authors":"Nikolaos Vythoulkas-Biotis ,&nbsp;David-Dimitris Chlorogiannis ,&nbsp;Theoni Theodoropoulou ,&nbsp;Ioannis Gialamas ,&nbsp;Evangelos Oikonomou ,&nbsp;Konstantinos Kalogeras ,&nbsp;Helena Michalopoulou ,&nbsp;Gerasimos Siasos ,&nbsp;Manolis Vavuranakis","doi":"10.1016/j.ijcha.2025.101806","DOIUrl":"10.1016/j.ijcha.2025.101806","url":null,"abstract":"<div><h3>Background</h3><div>Percutaneous coronary intervention (PCI) in patients with active or prior history of cancer presents a challenge due to the increased rates of cardiovascular complications. Therefore, we aimed to evaluate the mortality rates, in addition to early and long-term adverse cardiovascular outcomes in this high-risk population.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted across PubMed, Cochrane, and Scopus databases to identify eligible studies comparing clinical outcomes between patients with active or prior history of cancer and patients without cancer. Our primary outcomes were all-cause mortality and cardiovascular mortality at different time points. Secondary outcomes included bleeding, stroke, recurrent myocardial infarction (MI), and heart failure events between the two groups.</div></div><div><h3>Results</h3><div>Overall, 18 studies with a total of 8 million patients were included. Active or prior history of cancer was associated with increased in-hospital all-cause mortality (RR: 1.43; 95 % CI: 1.03–1.99; p = 0.03), 1-year all-cause mortality (RR: 2.35; 95 % CI: 1.75–3.16; p &lt; 0.001), as well as, increased 1-year cardiovascular mortality (RR: 1.35; 95 % CI: 1.15–1.59; p &lt; 0.001) compared to patients without a history of cancer. Patients with active or prior history of cancer have higher rates of in-hospital (RR: 1.77; 95 % CI: 1.75–1.79; p &lt; 0.001), 1-year (RR: 1.63; 95 %CI: 1.26–2.11; p &lt; 0.001), and long-term bleeding events (RR: 2.08; 95 % CI: 1.30–3.35; p &lt; 0.003) compared to patients without cancer. No significant differences were recorded regarding recurrent MI between the two groups.</div></div><div><h3>Conclusions</h3><div>Active or prior history of cancer was associated with a negative impact on early and long-term clinical outcomes in patients undergoing PCI. These findings underline the importance of individualized and multidisciplinary approaches when treating this high-risk population.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101806"},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118220","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":"Mental stress is associated with coronary endothelial dysfunction in women with chest pain and non-obstructive coronary artery disease","authors":"Jaskanwal Deep S Sara ,&nbsp;Nazanin Rajai ,&nbsp;Scott Breitinger ,&nbsp;Betsy Medina-Inojosa ,&nbsp;Lilach O Lerman ,&nbsp;Amir Lerman","doi":"10.1016/j.ijcha.2025.101802","DOIUrl":"10.1016/j.ijcha.2025.101802","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluate the association between chronic mental stress (MS) and coronary endothelial function in patients with chest pain and nonobstructive coronary artery disease (CAD) separately in males and females.</div></div><div><h3>Methods</h3><div>Patients with nonobstructive CAD (stenosis &lt;40 %) at coronary angiography underwent an invasive assessment for coronary endothelial dysfunction (CED). Macrovascular CED was defined as a percentage change in coronary artery diameter<!--> <!-->to acetylcholine (%ΔCADAch) ≤ −10 % and microvascular CED was defined as a percentage change in coronary blood flow<!--> <!-->to acetylcholine (%ΔCBFAch) ≤−50 %. Patients completed a questionnaire within 2 years of the index procedure that included questions regarding chronic MS. The frequency of macrovascular, microvascular and any type of CED was compared across groups. Logistic regression analyses were performed to assess the association between MS and CED.</div></div><div><h3>Results</h3><div>Between January 2017 and December 2022, 211 patients (mean (sd) age 54.4 (13.6) yrs, 71.0 % female) were included. One hundred forty-two (67.3 %)<!--> <!-->patients had any type of CED. In females with significant MS there was a higher proportion of individuals with any type of CED compared to without CED (43 (42.6 %) vs. 12 (24.5 %), p = 0.0362). In a multivariable analysis<!--> <!-->MS was associated with any type of CED in females: OR (95 % CI) 2.70 (1.24–6.25); p = 0.0156.</div></div><div><h3>Conclusion</h3><div>Chronic MS is associated with CED in females with chest pain and nonobstructive CAD. Chronic MS may<!--> <!-->underly the mechanism for chest pain in these patients<!--> <!-->and<!--> <!-->may play a contributory<!--> <!-->to<!--> <!-->cardiovascular disease through its association with<!--> <!-->endothelial dysfunction.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101802"},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118221","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":"Atorvastatin pretreatment, ST-segment resolution and long-term prognosis for ST-segment elevation myocardial infarction with primary percutaneous coronary intervention","authors":"Chao Wu ,&nbsp;Pei Gao ,&nbsp;Tiange Chen ,&nbsp;Haiyan Xu ,&nbsp;Xiang Li ,&nbsp;Yan Wang ,&nbsp;Honglei Zhao ,&nbsp;Zhifang Wang ,&nbsp;Guotong Xie ,&nbsp;Yuejin Yang ,&nbsp;Xiaojin Gao ,&nbsp;Jingang Yang","doi":"10.1016/j.ijcha.2025.101808","DOIUrl":"10.1016/j.ijcha.2025.101808","url":null,"abstract":"<div><h3>Background</h3><div>The benefit of statin pretreatment before primary percutaneous coronary intervention (PCI) on myocardial reperfusion and prognosis in ST-segment elevation myocardial infarction (STEMI) remains unclear. In this study, we evaluated whether atorvastatin pretreatment could improve ST-segment resolution (STR) and long-term clinical outcomes in this setting.</div></div><div><h3>Methods</h3><div>From the China Acute Myocardial Infarction Registry, we conducted propensity score matching to compare STR and 2-year major adverse cardiovascular events (MACE, all-cause death, reinfarction, and stroke) in 2426 STEMI patients undergoing primary PCI (1213 patients per group).</div></div><div><h3>Results</h3><div>Within the pretreatment group, 75, 726, 60, and 691 patients received 20 mg, 40 mg, 60 mg or 80 mg atorvastatin respectively. In the matched cohort of 2426 patients with available STR data (1213 pretreated), STR &lt; 50 % occurred in 258 (21 %) patients in the control group versus 159 (13 %) in the pretreatment group (adjusted hazard ratio [HR]: 0.53; 95 % CI: 0.41–0.70). Multivariable analysis showed that atorvastatin pretreatment was significantly associated with lower 2-year MACE rates (6.9 % vs 8.7 %; adjusted HR: 0.68; 95 % CI: 0.48–0.97), which were consistent across multiple subgroups.</div></div><div><h3>Conclusion</h3><div>A single dose of atorvastatin pretreatment before primary PCI significantly improves myocardial reperfusion parameters and may be associated with long-term clinical benefits, supporting further validation in randomized trials.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101808"},"PeriodicalIF":2.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099883","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":"Increased dose of adenosine and the relationship between the resting full-cycle ratio and fractional flow reserve","authors":"Christian A. Christensen ,&nbsp;Jens Trøan ,&nbsp;Kirstine N. Hansen ,&nbsp;Manijeh Noori ,&nbsp;Anders Junker ,&nbsp;Karsten Veien ,&nbsp;Martin K. Christensen ,&nbsp;Julia Ellert-Gregersen ,&nbsp;Kristian Wachtell ,&nbsp;Henrik S. Hansen ,&nbsp;Jens F. Lassen ,&nbsp;Diyako Qanie ,&nbsp;Mikkel Hougaard ,&nbsp;Lisette O. Jensen","doi":"10.1016/j.ijcha.2025.101803","DOIUrl":"10.1016/j.ijcha.2025.101803","url":null,"abstract":"<div><h3>Background</h3><div>Intermediate coronary artery stenosis can be evaluated with fractional flow reserve (FFR) and resting full-cycle ratio (RFR) to determine if the stenosis is functionally significant. However, RFR and FFR have shown discordance in around 20% of examinations. One explanation could be that maximal hyperemia was not achieved during adenosine infusion. The aim was to investigate if increased doses of adenosine would reduce FFR further, and if the agreement between RFR and FFR would improve.</div></div><div><h3>Method</h3><div>Two hundred patients underwent physiological assessment of an intermediate stenosis with RFR and FFR at 140 µg/kg/min (FFR₁₄₀) and 200 µg/kg/min (FFR₂₀₀) of adenosine infusion. The microcirculation function was assessed using the index of microvascular resistance (IMR).</div></div><div><h3>Results</h3><div>Median RFR was 0.89 (interquartile range [IQR] 0.85–0.93). Median FFR decreased significantly during increased adenosine doses: FFR₁₄₀ = 0.85 (IQR 0.77–0.90) versus FFR₂₀₀ = 0.82 (IQR 0.75–0.87), <em>p</em> &lt; 0.001. Reduction in FFR during increased adenosine doses was higher in patients with IMR ≥ 24 (FFR₁₄₀ 0.85 [IQR 0.78–0.92] versus FFR₂₀₀ 0.82 [IQR 0.75–0.86], <em>p</em> &lt; 0.001) compared to patients with IMR &lt; 24 (FFR₁₄₀ 0.83 [IQR 0.77–0.89] versus FFR₂₀₀ 0.81 [IQR 0.75–0.87], <em>p</em> &lt; 0.001) with an absolute difference of −0.03 (−0.05, −0.01) versus −0.01 (−0.02, 0.0), <em>p</em> &lt; 0.001. Area under the curve (AUC) of RFR compared to FFR₁₄₀ was 0.88 (95 % confidence interval [CI] 0.84–0.93), and for FFR_200, AUC was 0.88 (CI: 0.84–0.93).</div></div><div><h3>Conclusion</h3><div>Increased doses of adenosine significantly reduced FFR values, whereas the correlation agreement between RFR and FFR was not improved.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101803"},"PeriodicalIF":2.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099882","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 spontaneous echo contrast following mitral valve transcatheter edge-to-edge repair","authors":"Makoto Takeuchi ,&nbsp;Hiroto Utsunomiya ,&nbsp;Kiyotaka Tohgi ,&nbsp;Ayano Hamada ,&nbsp;Yohei Hyodo ,&nbsp;Akane Tsuchiya ,&nbsp;Atsuo Mogami ,&nbsp;Hajime Takemoto ,&nbsp;Kanako Izumi ,&nbsp;Kosuke Takahari ,&nbsp;Yusuke Ueda ,&nbsp;Kiho Itakura ,&nbsp;Hiroki Ikenaga ,&nbsp;Yukiko Nakano","doi":"10.1016/j.ijcha.2025.101801","DOIUrl":"10.1016/j.ijcha.2025.101801","url":null,"abstract":"<div><h3>Background</h3><div>Although no studies predict thrombotic events after mitral valve transcatheter edge-to-edge repair (MV-TEER), 34% of patients experience worsening spontaneous echocardiographic contrast (SEC) following MV-TEER. We hypothesized that predicting the SEC occurrence or rapid progression after MV-TEER and identifying associated cases would be valuable.</div></div><div><h3>Methods</h3><div>This retrospective study included 176 consecutive patients who underwent MV-TEER at Hiroshima University Hospital. SEC worsening was assessed using intraoperative transesophageal echocardiography pre- and post-procedure.</div></div><div><h3>Results</h3><div>The study analyzed 168 patients undergoing MV-TEER (median age 80, 56 % male). Severe mitral regurgitation (MR), secondary MR, and atrial fibrillation were present in 67.5 %, 70.2 %, and 57.7 % (36.9 % paroxysmal) of patients, respectively. Overall, 149 patients (88 %) and 19 (12 %) had SEC grade ≤ 2 and SEC grade ≥ 3, respectively, considerably worsening post-MV-TEER in 30 %. Severe SEC or sludge (11 %) correlated with higher rates of non-paroxysmal atrial fibrillation (AF), cardiomyopathy, increased right atrial area index (RAAI), elevated atrial pressures, and reduced cardiac index. Multivariate analysis identified non-paroxysmal AF, RAAI, and preoperative SEC grade ≥ 3 as key predictors of severe SEC or sludge. Rapid SEC worsening (15 cases) was associated with non-paroxysmal AF, reduced left atrial strain, larger RAAI, and lower cardiac index. A predictive scoring model incorporating RAAI, left atrial strain, and cardiac index showed good discrimination (area under the curve: 0.79), aiding risk assessment for post-MV-TEER SEC progression.</div></div><div><h3>Conclusions</h3><div>Patients with non-paroxysmal AF, right atrial enlargement, reduced left atrial reservoir strain, or low cardiac index are at risk of rapid SEC worsening after MV-TEER, regardless of initial SEC grades.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101801"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060612","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":"Transcatheter tricuspid valve intervention versus optimal medical therapy alone for severe tricuspid regurgitation: an updated meta-analysis with reconstructed time-to-event data","authors":"Ahmed Ibrahim ,&nbsp;Laila Shalabi ,&nbsp;Sofian Zreigh ,&nbsp;Shrouk Ramadan ,&nbsp;Ahmed Samir ,&nbsp;Mohamed Adel Elsawy ,&nbsp;Mohamed Mahmoud Fathy ,&nbsp;Belal Mohamed Hamed ,&nbsp;Hossam Elbenawi ,&nbsp;Mustafa Turkmani ,&nbsp;Ahmed Y. Azzam ,&nbsp;Hani Mahmoud-Elsayed ,&nbsp;Islam Y. Elgendy","doi":"10.1016/j.ijcha.2025.101794","DOIUrl":"10.1016/j.ijcha.2025.101794","url":null,"abstract":"<div><h3>Background</h3><div>Severe tricuspid regurgitation (TR) is strongly associated with high mortality and morbidity. This <em>meta</em>-analysis aims to compare the outcomes of transcatheter tricuspid valve intervention (TTVI) versus optimal medical treatment (OMT) alone among patients with severe TR.</div></div><div><h3>Methods</h3><div>Electronic databases were systematically searched to identify randomized controlled trials (RCTs) and propensity score-matched observational studies comparing TTVI with OMT. The primary outcome was all-cause mortality. Summary estimates were calculated using a random-effects model.</div></div><div><h3>Results</h3><div>Five studies (3 RCTs, 2 observational; <em>n</em> = 1988 patients) were included. TTVI was associated with a nonsignificant trend toward a lower incidence of all-cause mortality (risk ratio [RR]: 0.70, 95 % confidence interval [CI] 0.48–1.03; P = 0.071), primarily driven by observational studies. TTVI demonstrated significant benefits in terms of TR severity reduction (RR: 7.82, 95 % CI 5.60–10.93; P &lt; 0.0001), enhanced health status as measured by the Kansas City Cardiomyopathy Questionnaire (mean difference: +14.46 points, 95 % CI 11.55–17.38; p &lt; 0.0001), and reduced heart failure (HF) hospitalization rates (RR: 0.73, 95 % CI 0.56–0.96; P = 0.025). However, TTVI was associated with an increased risk of major bleeding (RR: 3.21, 95 % CI 1.61–6.39; P = 0.0009).</div></div><div><h3>Conclusion</h3><div>Among patients with severe TR, TTVI was not statistically associated with a lower incidence of all-cause mortality but was associated with a reduced risk of HF hospitalization, significant reduction in TR severity, and improved quality of life. Future large RCTs with extended follow-up are needed to confirm these findings and identify the subset of patients who benefit the most.</div><div><strong>Systematic review protocol:</strong> CRD420251002402 (PROSPERO)</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101794"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049166","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":"Prognostic impact of systemic immune-inflammation index (SII) on infarct size and clinical outcomes in patients with ST-segment elevation myocardial infarction","authors":"Ya-li Zhu ,&nbsp;Lai Wei ,&nbsp;Xu Wang ,&nbsp;Yong Zhou ,&nbsp;Jun Pu","doi":"10.1016/j.ijcha.2025.101798","DOIUrl":"10.1016/j.ijcha.2025.101798","url":null,"abstract":"<div><h3>Background</h3><div>Systemic immune-inflammation index (SII), calculated as platelet count × neutrophil count/lymphocyte count, is a novel and easily accessible inflammatory marker. Its prognostic value in predicting infarct size and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) remains to be fully explored.</div></div><div><h3>Methods</h3><div>We analyzed 421 patients who underwent primary percutaneous coronary intervention (PCI) within 12 h of symptom onset, enrolled in a prospective multicenter registry (NCT03768453).All patients received immediate admission blood tests for SII calculation (platelet × neutrophil/lymphocyte counts) and completed standardized CMR imaging within 10 days post-PCI.Receiver operating characteristic (ROC) analysis identified the optimal SII cut-off value (914) to predict large infarct size (≥20 % of left ventricular mass). Patients were stratified into high (≥914) and low (&lt;914) SII groups. The relationships between SII, infarct size, and MACE were analyzed using multivariate logistic and Cox regression models.</div></div><div><h3>Results</h3><div>Patients with high SII had significantly larger infarct size (median 29.0 % vs. 22.3 %, p &lt; 0.001). SII ≥ 914 was independently associated with large infarct size (OR 1.889, 95 %CI: 1.100–3.242, p = 0.021) and higher incidence of MACE (HR 1.874, 95 % CI: 1.255–2.796, p = 0.002).</div></div><div><h3>Conclusions</h3><div>Elevated SII (≥914) independently associates with larger infarct size and increased MACE risk post-PCI, suggesting potential utility in risk stratification.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101798"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049167","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":"The long-term prognostic value of CT coronary artery calcium score in asymptomatic patients with type 2 diabetes","authors":"Amir Aker ,&nbsp;David Halon ,&nbsp;Yuval Avidan ,&nbsp;Amir Yahav ,&nbsp;Shada Makhoul ,&nbsp;Barak Zafrir","doi":"10.1016/j.ijcha.2025.101799","DOIUrl":"10.1016/j.ijcha.2025.101799","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery calcium scoring (CACS) may improve risk stratification of diabetics, in whom coronary artery disease (CAD) is often more diffuse and progressive. We examined the long-term value of CACS in outcome prediction of asymptomatic patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>A population-based cohort recruited between 2006 and 2008 of type 2 diabetics aged 55–74 years, with at least one additional risk factor and no history or symptoms of CAD. The association of overall (n = 735) and individual vessel (n = 596) CACS with the occurrence of myocardial infarction (MI), ischemic stroke, or all-cause death (MACE) was assessed over a median follow-up of 17.3 years.</div></div><div><h3>Results</h3><div>Increasing levels of CACS independently predicted MACE and its components, particularly MI, with no events of MI observed in those with zero CACS, and an adjusted hazard ratio (95 % confidence interval) of 2.31 (1.30–4.11) for MI in those with CACS &gt; 300 compared to 1–100 Agatston units. The addition of CACS to MESA 10-year coronary heart disease risk score increased significantly the discriminatory capacity for MI [combined AUC 0.75 (0.72–0.78)]. For each additional coronary artery with any CACS, the adjusted HR for MI was 1.68 (1.34–2.10), and for MACE 1.18 (1.08–1.30), p &lt; 0.001. The hazard for MI or MACE did not increase in proportion to the percentage of CACS localized to the left-main coronary artery.</div></div><div><h3>Conclusions</h3><div>The predictive value of CACS in asymptomatic diabetics is retained over 17 years of follow-up, particularly for MI. The number of coronary arteries with calcified plaques may provide additional prognostic information.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101799"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049168","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":"Assisted therapy optimizing module to improve physician adhErence with guideLine-directed medical heart failure therapy rationale and design of the AMPEL trial","authors":"Luca Brunelli ,&nbsp;Luiza Hoch ,&nbsp;Bernhard Pfeifer ,&nbsp;Sabrina Neururer ,&nbsp;Elisabeth Kleinheinz ,&nbsp;Bettina Fetz ,&nbsp;Aaron Lauschensky ,&nbsp;Günter Schreier ,&nbsp;Robert Modre-Osprian ,&nbsp;Marc-Michael Zaruba ,&nbsp;Moritz Messner ,&nbsp;Maria Ungericht ,&nbsp;Markus Wallner ,&nbsp;Cosima Stark ,&nbsp;Stefan Pötz ,&nbsp;Bernadette Taucher ,&nbsp;Almut Frank ,&nbsp;Gerhard Pölzl","doi":"10.1016/j.ijcha.2025.101797","DOIUrl":"10.1016/j.ijcha.2025.101797","url":null,"abstract":"<div><h3>Background</h3><div>Guideline-directed medical therapy (GDMT) is very effective in the early, vulnerable phase after discharge following an acute heart failure (HF) event, but its widespread implementation in everyday clinical practice is limited.</div><div>AMPEL is a guideline-based decision support software service for physicians to improve adherence with GDMT. The four drug classes that make up the GDMT and the percentage of each prescribed dose in relation to the target dose according to the current ESC guidelines are displayed graphically. A daily update considers the current therapy as well as absolute or relative contraindications.</div></div><div><h3>Methods and results</h3><div>We present the rationale and protocol of the AMPEL trial, a multicenter randomized trial with a parallel-group design to investigate the effectiveness of the AMPEL service on GDMT implementation and patient clinical outcomes in a total of 260 patients. Salient features of the AMPEL study are that it is being conducted as part of the established disease management program (DMP) for HF, HerzMobil, and that participating physicians are given randomised access to the AMPEL service compared to the standard of care in the control group. The primary endpoint includes an implementation endpoint for assessment of the quality of indication- and dose-adjusted GDMT at 90 days and a clinical endpoint assessed with a stratified win ratio.</div></div><div><h3>Conclusions</h3><div>The AMPEL trial is a prospective, randomized trial investigating the effectiveness of a guideline-based decision support software service for physicians to improve adherence with GDMT in a telemedicine-assisted disease management program for patients with heart failure.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101797"},"PeriodicalIF":2.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145049169","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":"Linking factor XIII activity to all-cause mortality after myocardial infarction: the overlooked role of serum albumin","authors":"Jan Traub ,&nbsp;Makram Abu Hussein ,&nbsp;Dominik Schmitt ,&nbsp;Anna Frey","doi":"10.1016/j.ijcha.2025.101796","DOIUrl":"10.1016/j.ijcha.2025.101796","url":null,"abstract":"<div><h3>Background</h3><div>Acute myocardial infarction (MI) remains a major cause of morbidity and mortality despite therapeutic advances. Factor XIII (FXIII), a fibrin-stabilizing enzyme with roles in coagulation, inflammation, and tissue repair, has emerged as a potential biomarker in MI. While low FXIII activity has been linked to adverse outcomes, the underlying determinants and its independent prognostic value remain unclear.</div></div><div><h3>Methods</h3><div>In this retrospective study, FXIII activity was measured in 926 MI patients treated at University Hospital Würzburg between 2018 and 2023. Blood samples were collected within 24 h of cardiac catheterization. FXIII activity was assessed photometrically, and patients were followed for all-cause mortality. Multivariable regression and Cox models were used to identify predictors of FXIII activity and mortality.</div></div><div><h3>Results</h3><div>Median FXIII activity was 110 %. Lower FXIII activity was associated with older age, female sex, lower albumin, higher CRP, and reduced kidney function. While crude mortality at 30 days and 1 year was significantly higher in patients with FXIII ≤ 110 %, FXIII activity was not an independent predictor of mortality after adjustment. Key predictors included albumin (HR = 0.221, p &lt; 0.001), age (HR = 1.048, p &lt; 0.001), eGFR (HR = 0.988, p = 0.001), and ASAT (HR = 1.001, p = 0.002).</div></div><div><h3>Conclusions</h3><div>Although lower FXIII activity is associated with higher mortality post-MI, this effect is largely mediated by albumin levels. Albumin appears to be a central determinant of both FXIII activity and prognosis, highlighting its potential role as a key marker in risk stratification. Further studies are warranted to explore therapeutic implications of hypoalbuminemia in MI.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"61 ","pages":"Article 101796"},"PeriodicalIF":2.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050040","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}