IJC Heart and Vasculature最新文献

{"title":"Visual coronary calcium scoring to support opportunistic CAD screening: comparative evaluation of three established systems and introduction of a novel scoring system","authors":"Philipp Nicol ,&nbsp;Rafael Adolf ,&nbsp;Salvatore Cassese ,&nbsp;Adnan Kastrati ,&nbsp;Michael Joner ,&nbsp;Heribert Schunkert ,&nbsp;Martin Hadamitzky ,&nbsp;Leif-Christopher Engel","doi":"10.1016/j.ijcha.2026.101875","DOIUrl":"10.1016/j.ijcha.2026.101875","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery calcium (CAC) scoring is an established marker of atherosclerotic burden and cardiovascular risk. While the Agatston score is the clinical gold standard, alternative visual scoring methods—including the Visual Ordinal Score, Weston Score, and Vessel-specific extent-based score—are increasingly used, particularly in non-gated or opportunistic CT imaging. This study aimed to compare the diagnostic performance, inter-observer reliability, and correlation of different visual scoring methods against the Agatston score.</div></div><div><h3>Methods</h3><div>A total of 299 cases were evaluated using ECG-gated CT scans. Each case was independently scored in a blinded fashion by two observers using three visual methods: (1) Visual Ordinal Score (VS), (2) Weston Score (WS) and (3) Vessel-specific extent-based score (VSES). A novel visual CAC score was derived by combining Weston and Vessel-specific extent-based scoring (= Weston Extent Score, WES). Cohen’s Kappa and Intraclass Correlation Coefficients (ICC) were used for inter-observer agreement. Classification performance was assessed against Agatston-based categories (No CAC, Mild, Moderate, Severe), including accuracy, precision, sensitivity, and specificity. Correlation analyses were conducted using Pearson and Spearman coefficients.</div></div><div><h3>Results</h3><div>All scoring methods showed high correlation with the Agatston score (Spearman ρ &gt; 0.87; p &lt; 0.001). Visual scoring demonstrated the highest inter-observer agreement (Kappa = 0.94, ICC = 0.97), followed by Weston (Kappa = 0.90) and Vessel-Specific scores (Kappa = 0.77). Visual scoring also yielded the highest accuracy (Observer 1: 91.3 %, Observer 2: 90.0 %) The newly derived WES score achieved 80.9 % accuracy, with macro-averaged specificity of 93.8 % and improving diagnostic accuracy compared to WS and VSES.</div></div><div><h3>Discussion</h3><div>Different visual scoring offers excellent reproducibility and diagnostic accuracy for CAC classification, with strong correlation to the Agatston score. The newly-derived WES score could be useful in providing a practical balance regarding volumetric information (CAC densitiy) and anatomical distribution of CAC. These findings support the implementation of structured visual CAC scoring in clinical and opportunistic CT settings.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101875"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022367","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":"Major bleeding complications and antithrombotic treatment after isolated surgical bioprosthetic aortic valve replacement","authors":"Rikhard Björn ,&nbsp;Joonas Lehto ,&nbsp;Markus Malmberg ,&nbsp;Vesa Anttila ,&nbsp;Jarmo Gunn ,&nbsp;Tuomo Nieminen ,&nbsp;Juha E.K. Hartikainen ,&nbsp;Fausto Biancari ,&nbsp;K.E.Juhani Airaksinen ,&nbsp;Tuomas Kiviniemi","doi":"10.1016/j.ijcha.2025.101861","DOIUrl":"10.1016/j.ijcha.2025.101861","url":null,"abstract":"<div><h3>Background</h3><div>Despite advancements in surgical techniques and perioperative care, postoperative bleeding and neurological complications remain significant concerns after bioprosthetic surgical aortic valve replacement (SAVR). The present study assessed the incidence of short-term and long-term major bleeding and strokes and their association with antithrombotic treatment after isolated bioprosthetic SAVR.</div></div><div><h3>Methods</h3><div>The CAREAVR study included 721 patients who underwent isolated bioprosthetic SAVR at four Finnish university hospitals between 2002 and 2014. The day-to-day information on short-term antithrombotic treatment was available from a subgroup including 227 patients.</div></div><div><h3>Results</h3><div>The median follow-up time was 4.9 (interquartile range 3.0–7.0) years. During the 30-day postoperative period, in the subgroup of 227 patients, 31 (13.7 %) patients experienced a major bleeding event, and 13 (5.7 %) patients a major stroke. A vast majority of the bleedings (80.6 %) occurred within two days after the surgery, and the tail effect of preoperative aspirin was present in 54.8 % of episodes, indicating unintentional antithrombotic effect. During the long-term follow-up (&gt;30 days after the index surgery), major bleeding episodes occurred in 40 (5.5 %) patients, and 47 (6.5 %) patients experienced a major stroke. Overall, 23 (57.5 %) of the patients with major bleeding and 13 (27.7 %) of the patients experiencing major stroke were on OAC during the event.</div></div><div><h3>Conclusion</h3><div>The incidence of perioperative major bleeding was over two-fold compared to major stroke, the majority occurring during the tail effect of preoperatively used aspirin. During the long-term follow-up, the rates of stroke and major bleeds were similar, and most bleeding episodes occurred while on OAC.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101861"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924392","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":"Impact of atrial fibrillation status on clinical outcomes in patients admitted with heart failure","authors":"Jia Yi Anna Ne ,&nbsp;Clara K. Chow ,&nbsp;Vincent Chow ,&nbsp;Karice Hyun ,&nbsp;Leonard Kritharides ,&nbsp;David Brieger ,&nbsp;Austin Chin Chwan Ng","doi":"10.1016/j.ijcha.2025.101858","DOIUrl":"10.1016/j.ijcha.2025.101858","url":null,"abstract":"<div><h3>Background</h3><div>Few studies comprehensively examine the association of atrial fibrillation (AF) status with rehospitalisation for adverse clinical outcomes in heart failure (HF) patients.</div></div><div><h3>Methods</h3><div>Patients admitted with a primary diagnosis of HF between 1-July-2003 and 31-March-2021 were identified from the Australian New South Wales Admission-Patient-Data-Collection database and stratified by AF status (no-AF vs new-AF vs prior-AF) (end-of-follow-up: 31-March-2022). Multivariable Cox regression and Fine-Gray competing risk methods were used to assess the association of AF status with risk of MACE/all-cause mortality and rehospitalisation for non-fatal outcomes respectively. MACE was defined as all-cause mortality, admission for myocardial infarction, ischemic stroke, HF or coronary revascularisation (percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery), whichever occurred first.</div></div><div><h3>Results</h3><div>The cohort comprised 152,638 admitted HF patients (median age: 80.4 years; 51.4 % males): 10.7 % New-AF; 37.0 % Prior-AF. During a median 1.24 years follow-up, compared to no-AF HF patients, new-AF and prior-AF patients had significantly higher rates of MACE (no-AF:78.5 % vs new-AF:81.7 % vs prior-AF:86.3 %) (both logrank P &lt; 0.001). However, after adjusting for differences in baseline characteristics and admission year-groups, new-AF and prior-AF status had differential impact on MACE compared to no-AF patients (adjusted hazard ratio [aHR] = 0.93, 95 % confidence interval [CI] = 0.91–0.94; aHR = 1.14, 95 %CI = 1.13–1.16 respectively; both P &lt; 0.001); results were similar for all-cause death. Rehospitalisation risk for most non-fatal clinical outcomes were significantly higher in HF patients with new-AF and prior-AF.</div></div><div><h3>Conclusion</h3><div>This study shows AF status has a differential impact on clinical outcomes in patients admitted with HF. Drivers behind these differences require further elucidation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101858"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924393","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":"Combining topical and intravenous tranexamic acid in cardiac surgery: does it really matter? – a systematic review and meta-analysis","authors":"Paul C. Onyeji ,&nbsp;Leo Consoli ,&nbsp;Amrinder Kaur ,&nbsp;Shivank Dani ,&nbsp;Sonise Momplaisir-Onyeji ,&nbsp;Felipe S. Passos ,&nbsp;Hristo Kirov ,&nbsp;Torsten Doenst ,&nbsp;Tulio Caldonazo","doi":"10.1016/j.ijcha.2025.101848","DOIUrl":"10.1016/j.ijcha.2025.101848","url":null,"abstract":"<div><h3>Background</h3><div>The benefit-to-risk ratio of administration of intravenous (IV) and topical tranexamic acid (TXA) together in cardiac surgery has not yet been determined. This study aims to evaluate whether the combined approach (IV plus topical TXA) offers superior bleeding control compared to IV TXA alone, while maintaining an acceptable safety profile.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and <em>meta</em>-analysis of randomized controlled trials (RCTs) and observational studies comparing combined topical and intravenous TXA administration versus IV TXA alone in patients undergoing cardiac surgery. The primary outcome was cumulative blood loss. Secondary outcomes included all-cause mortality, transfusion-free status, and the number of transfused blood products. A random-effects model was used for all pooled analyses.</div></div><div><h3>Results</h3><div>We included a total of five studies (four RCTs, one observational; n = 880). Pooled analysis showed that the combined approach significantly, but modest, reduced total blood loss when compared to an IV-only TXA strategy (MD −39.84, 95 %CI −74.80 to −4.88; p = 0.03; I² = 39 %). However, this benefit did not translate into a significant reduction in transfusion requirements (OR 1.00, 95 %CI 0.72 to 1.37; p = 0.98; I² = 0 %), volume of blood products used (MD −0.01, 95 %CI −0.04 to 0.02; p = 0.51; I² = 0 %), or all-cause mortality (OR 0.85, 95 %CI 0.24 to 3.08; p = 0.81; I² = 0 %).</div></div><div><h3>Conclusion</h3><div>Combined topical and IV TXA application is associated with reduced total blood loss after cardiac surgery compared to an IV-only approach. However, no significant differences were observed in transfusion rates, blood product utilization, or mortality.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101848"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684635","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":"Sex differences in the presentation and management of acute coronary syndrome patients: Insights from the FORCE-ACS registry","authors":"Shabiga Sivanesan ,&nbsp;Aleksandra Gąsecka ,&nbsp;Niels M.R. van der Sangen ,&nbsp;Wout W.A. van den Broek ,&nbsp;Jaouad Azzahhafi ,&nbsp;Dean R.P.P. Chan Pin Yin ,&nbsp;Qiu Ying F. van de Pol ,&nbsp;Ronald J. Walhout ,&nbsp;Melvyn Tjon Joe Gin ,&nbsp;Ron Pisters ,&nbsp;Deborah M. Nicastia ,&nbsp;Gerben J. de Roest ,&nbsp;Georgios J. Vlachojannis ,&nbsp;Rutger J. van Bommel ,&nbsp;Wouter J. Kikkert ,&nbsp;José P.S. Henriques ,&nbsp;Jurriën M. ten Berg ,&nbsp;Yolande Appelman","doi":"10.1016/j.ijcha.2025.101849","DOIUrl":"10.1016/j.ijcha.2025.101849","url":null,"abstract":"<div><h3>Aims</h3><div>This study reports sex differences in the clinical presentation, treatment management and outcomes of patients with acute coronary syndrome (ACS) in The Netherlands, using data from the FORCE-ACS registry.</div></div><div><h3>Methods</h3><div>A prospective analysis was conducted using data from 5023 patients admitted with ACS between 2015 and 2019, with complete three-year follow-up. Demographic data, clinical characteristics, in-hospital treatment and outcomes were compared by sex. Multivariable regression analyses explored associations between sex and clinical outcomes.</div></div><div><h3>Results</h3><div>Of the 5023 patients, 29 % were women. Women were generally older, with a significantly higher prevalence of hypertension (61.7 % vs 54.2 %), chronic kidney disease (25.7 % vs. 18.5 %) and myocardial infarction with non-obstructive coronary arteries (MINOCA) (13.5 % vs. 6.5 %). Women less frequently underwent revascularisation, even after excluding those with non-obstructive coronary artery disease, and received less medical treatment compared to their male counterparts. At 36 months, women had higher unadjusted mortality rate (13.7 % vs. 11.0 %, OR 1.28, 95 % CI: 1.07–1.54) and bleeding events (26.2 % vs. 22.3 %, OR 1.24, 95 % CI: 1.08–1.43). However, after adjustment for age and baseline characteristics, these differences were no longer statistically significant. Recurrent ACS and stroke remained similar in both groups, also after correction.</div></div><div><h3>Conclusion</h3><div>Differences between women and men were observed in clinical presentation, interventional treatment, pharmacotherapy and outcomes among ACS patients in The Netherlands. Despite receiving less guideline-recommended care, women had similar adjusted 36-month outcomes as men. These findings show that there is room for improvement in the management of ACS, with a focus on optimized treatment strategies for women.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101849"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737345","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":"Serum aminoterminal type III procollagen peptide reflects increased vascular thickness in healthy, young adults","authors":"Manar Bitar ,&nbsp;Dieter Samyn ,&nbsp;Madeleine Helgesson ,&nbsp;Martin Vink ,&nbsp;Paul Pettersson-Pablo","doi":"10.1016/j.ijcha.2026.101876","DOIUrl":"10.1016/j.ijcha.2026.101876","url":null,"abstract":"<div><h3>Background</h3><div>Procollagen III, aminoterminal peptide (PIIINP) is a degradation product of collagen type III-synthesis. Collagen type III is distributed in many tissues, and an increase in serum PIIINP could reflect an increase in collagen turnover and pro-fibrotic activity. In this study, on a population of younger, healthy adults, we examined whether serum PIIINP correlates with early markers of vascular health, to evaluate its potential as a biomarker for early screening of preclinical cardiovascular risk.</div></div><div><h3>Methods</h3><div>PIIINP levels, pulse wave velocity (PWV) and Carotid-intima media thickness (cIMT) was measured in 834 healthy, non-smoking, individuals aged 18–26. In univariable and multivariable linear regression models, we examined the association between PIIINP and vascular measurements, PWV and cIMT with adjustment for serum lipids, liver enzymes and systolic blood pressure.</div></div><div><h3>Results</h3><div>The average of PIIINP, PWV and cIMT measurements in this population, were low (7.1 and 7.3 µg/L, 5.5 and 5.2 m/s, and 0.50 and 0.49 mm for men and women, respectively). In univariable analyses, PIIINP correlated positively with cIMT (p = 0.0061) and negatively with PWV (p = 0.0069). In multivariable analyses, a statistically significant association remained between PIIINP and cIMT (p &lt; 0.001), but not with PWV.</div></div><div><h3>Conclusion</h3><div>Serum PIIINP correlates with cIMT in a healthy population, indicating its potential as a biomarker of cardiovascular risk at a preclinical stage. PIIINP measurement being easier to perform and less examiner dependent than the more time consuming and cumbersome cIMT, are suggestive of its possible merits as an early screening tool for cardiovascular disease.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101876"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022368","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 significance of subsequent decline in LVEF in heart failure with improved ejection fraction − A report from the CHART-2 study −","authors":"Takuya Takigahira ,&nbsp;Kotaro Nochioka ,&nbsp;Satoshi Miyata ,&nbsp;Takashi Shiroto ,&nbsp;Takumi Inoue ,&nbsp;Kai Susukita ,&nbsp;Hideka Hayashi ,&nbsp;Hiroyuki Takahama ,&nbsp;Jun Takahashi ,&nbsp;Hiroaki Shimokawa ,&nbsp;Satoshi Yasuda","doi":"10.1016/j.ijcha.2026.101877","DOIUrl":"10.1016/j.ijcha.2026.101877","url":null,"abstract":"<div><h3>Background</h3><div>Some patients of heart failure with improved ejection fraction (HFimpEF) have subsequent decline in left ventricular ejection fraction (LVEF) after improvement, and their prognosis is uncertain.</div></div><div><h3>Aims</h3><div>We aimed to examine the clinical characteristics and long-term prognosis of this sub-population of HFimpEF.</div></div><div><h3>Methods</h3><div>We examined 399 consecutive patients with HF with reduced ejection fraction (HFrEF, LVEF ≤ 40 %) with LVEF data at both baseline and follow-up in the CHART-2 Study. We classified them as follows; persistent HFrEF group (LVEF ≤ 40 % at 1-year and 2-year follow-up, n = 238), temporary HFimpEF group (≥10 % increase from baseline with LVEF &gt; 40 % at 1-year follow-up but LVEF ≤ 40 % at 2-year follow-up, n = 22), and persistent HFimpEF group (≥10 % increase from baseline with LVEF &gt; 40 % at 1-year follow-up, and LVEF &gt; 40 % at 2-year follow-up, n = 139).</div></div><div><h3>Results</h3><div>The temporary HFimpEF group (adjusted hazard ratio: 2.95; 95 % CI: 1.55–5.63) and the persistent HFrEF group (2.53; 1.75–3.67) were associated with increased risks for the composite of cardiovascular death and HF hospitalization. The risk factors for decline in LVEF included LVEF (adjusted odds ratio: 0.80; 95 %CI: 0.69–0.90), LV end-diastolic dimension (LVDd) (1.14; 1.05–1.25), B-type natriuretic peptide (BNP) levels (1.04 per 10 pg/mL increase; 1.00–1.08), estimated glomerular filtration rate (eGFR) levels (0.95; 0.92–0.99) and serum sodium levels (0.70; 0.50–0.91) at 1-year follow-up.</div></div><div><h3>Conclusions</h3><div>These results indicate that patients with HFrecEF account for 23% of those with HFrEF and that 12% of them have subsequent decline in LVEF associated with similar worse prognosis as in those with persistent HFrEF.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101877"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022365","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 efficacy of carvedilol in improving cardiac function and survival in patients with anthracycline-induced cardiotoxicity: a comprehensive systematic review and meta-analysis","authors":"Sabahat Ul Ain Munir Abbasi ,&nbsp;Riya Bhagwan ,&nbsp;Aamna Rehman ,&nbsp;Neha Malik ,&nbsp;Sanya Ashraf Khaskheli ,&nbsp;Najaf Ahmed Rajpar ,&nbsp;Rayyan Nabi ,&nbsp;Ayesha Amir Basra ,&nbsp;Shehdev Meghwar ,&nbsp;Raheel Ahmed ,&nbsp;Kalpana Singh","doi":"10.1016/j.ijcha.2025.101862","DOIUrl":"10.1016/j.ijcha.2025.101862","url":null,"abstract":"<div><h3>Background</h3><div>Anthracyclines (ANT) are widely used in chemotherapy, but their dose-dependent Cardiotoxicity limits long-term use. Carvedilol, a non-selective beta-blocker, has shown potential as a Cardioprotective agent for patients receiving ANT, though its overall effectiveness remains unclear. This systematic review and <em>meta</em>-analysis aimed to assess the impact of carvedilol on cardiac function and survival in patients with anthracycline-induced Cardiotoxicity.</div></div><div><h3>Methods</h3><div>We performed a comprehensive search of major electronic databases through March 2025 for studies comparing carvedilol with placebo or no treatment in human subjects with ANT-Induced Cardiotoxicity. Primary outcomes included left ventricular ejection fraction (LVEF), left ventricular systolic dysfunction (LVSD), left ventricular systolic and diastolic diameters (LVsD, LVdD), and mortality. Secondary outcomes included echocardiographic and Doppler parameters. Random-effects models were used to calculate standard mean differences (SMDs) and risk ratios (RR) using RevMan 5.4.</div></div><div><h3>Results</h3><div>A total of fourteen studies were included, thirteen in the <em>meta</em>-analysis and one in the systematic review only, comprising 1,245 participants (carvedilol: 679; control: 566). Carvedilol significantly preserved LVEF (SMD: 0.33, 95% CI: 0.09, 0.58) and reduced the risk of LVSD (RR: 0.26, 95% CI: 0.11, 0.62). It also decreased systolic (SMD: −0.39, 95% CI: −0.53, −0.26) as well as diastolic ventricular diameter (SMD: −0.19, 95% CI: −0.38, −0.00). However, no significant difference in short-term mortality was observed.</div></div><div><h3>Conclusion</h3><div>Carvedilol appears to protect cardiac function in patients undergoing ANT therapy, though it does not significantly impact mortality. Further research is needed to determine optimal dosing, timing, and long-term survival benefits.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101862"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924276","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":"Comparison of efficacy and safety between TIcagrelor and clopidogrel in Chinese patients with acute coronary syndrome (COSTIC study)","authors":"Man Huang ,&nbsp;Yang Sun ,&nbsp;Ke Li ,&nbsp;Ting Yu ,&nbsp;Hu Zhao ,&nbsp;Min Tao ,&nbsp;Xiuli Song ,&nbsp;Linlin Wang ,&nbsp;Xin Xu ,&nbsp;Yanghui Chen ,&nbsp;Guanglin Cui ,&nbsp;Hu Ding ,&nbsp;Jiangtao Yan ,&nbsp;Jiangang Jiang ,&nbsp;Hesong Zeng ,&nbsp;Yan Wang ,&nbsp;Xiaoqing Shen ,&nbsp;Hong Wang ,&nbsp;Dao Wen Wang","doi":"10.1016/j.ijcha.2026.101868","DOIUrl":"10.1016/j.ijcha.2026.101868","url":null,"abstract":"<div><h3>Background</h3><div>Ticagrelor is recommended as the preferred antiplatelet agent for patients with acute coronary syndrome (ACS), which is controversial in East Asians, Chinese patients in particular. This study aimed to compare the efficacy and safety of ticagrelor vs. clopidogrel in Chinese ACS patients following coronary stenting.</div></div><div><h3>Methods</h3><div>Between August 2014 and October 2020, COSTIC recruited 9,040 patients prescribed with ticagrelor or clopidogrel. Applying propensity score matching, ticagrelor was compared with clopidogrel for 1-year risks of the primary efficacy endpoint (a composite of cardiovascular (CV) death, myocardial infarction and stroke) and bleeding endpoint.</div></div><div><h3>Results</h3><div>The risk of the primary efficacy endpoint was comparable between the two groups but numerically higher after clopidogrel at 6 months (HR, 1.33 [95 % CI, 0.98–1.80]; <em>P</em> = 0.07). Clopidogrel was associated with high incidences of CV death (HR, 1.49 [95 % CI, 1.04–2.15]; <em>P</em> = 0.03 at 6 months; HR, 1.42 [95 % CI, 1.04–1.93]; <em>P</em> = 0.02 at 12 months) and all-cause death (HR, 1.43 [95 % CI, 1.02–1.99]; <em>P</em> = 0.04 at 6 months). BARC type 3 or 5 bleeding (OR, 0.60 [95 % CI, 0.40–0.88]; <em>P</em> = 0.008 at 6 months; OR, 0.71 [95 % CI, 0.52–0.96]; <em>P</em> = 0.03 at 12 months) and BARC type 2 bleeding risks (OR, 0.47 [95 % CI, 0.34–0.66] at 1 month, OR, 0.41 [95 % CI, 0.32–0.52] at 6 months, OR, 0.43 [95 % CI, 0.35–0.53] at 12 months, <em>P</em> &lt; 0.001 at 1, 6 and 12 months) were higher with ticagrelor, as compared to clopidogrel. In terms of the net clinical benefit events, clopidogrel was comparable to ticagrelor in the total cohort.</div></div><div><h3>Conclusions</h3><div>Among Chinese ACS patients with successful PCI, ticagrelor did not significantly reduce the risk of major ischemic events; instead, it was associated with a significant elevation bleeding risk.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101868"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924278","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":"Anteroposterior versus anterolateral pacer pad position in patients with symptomatic bradycardia","authors":"Andreas Goldschmied ,&nbsp;Manuel Sigle ,&nbsp;Ioannis Toskas ,&nbsp;Mirac Senel ,&nbsp;Livia Dingemann ,&nbsp;Malte Kranert ,&nbsp;Tobias Harm ,&nbsp;Meinrad Gawaz ,&nbsp;Michal Droppa ,&nbsp;Andreas Brendlin ,&nbsp;Karin Anne Lydia Mueller","doi":"10.1016/j.ijcha.2025.101857","DOIUrl":"10.1016/j.ijcha.2025.101857","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcutaneous cardiac pacing (TCP) is an important emergency treatment option in patients with symptomatic bradycardia. With the help of a portable pulse generator an electrical current is delivered through the patient́s thorax in order to induce ventricular contractions. Data on patients in sinus rhythm suggests favorable pacing thresholds when using an anteroposterior (AP) compared to an anterolateral (AL) pacer pad positioning. However, evidence in bradycardic patients is lacking.</div></div><div><h3>Methods</h3><div>We conducted a prospective crossover clinical study which included 16 patients with symptomatic bradycardia. Patients received consecutive TCP in an AP and AL position under sedoanalgesia. TCP was carried out in an AP and an AL pacer pad position if patients were hemodynamically stable (systolic blood pressure &gt; 90 mmHg). Minimal required current and other variables were noted for both pacer pad positions and Wilcoxon Signed Rank tests were used to compare differences.</div></div><div><h3>Results</h3><div>We did not overserve a significant difference in minimal required pacing current between the AP and AL pacer pad position (median threshold AP = 125 mA [±48], median threshold AL = 140 mA [±78], p = 0.53). However, a linear mixed-effects model revealed higher pacing thresholds in patients on beta blockers (B = 72.1, p &lt; 0.001, 95 % CI = 36.6–107.7) and with lower myocardial mass (B = -0.41, p &lt; 0.001, 95 % CI = −0.59- −0.23).</div></div><div><h3>Conclusion</h3><div>We observed no significant difference in pacing thresholds between an AP and AL pacer pad position in patients with symptomatic bradycardia. These results do not align with prior work investigating a monitor with pulsed current delivery.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101857"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924394","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}