IJC Heart and Vasculature最新文献

{"title":"Clinical outcomes of SGLT2 inhibitor use in Thai patients with heart failure: a five-year retrospective cohort study","authors":"Thananan Chanchanayothin ,&nbsp;Chuttikan Klomwong ,&nbsp;Tanawit Saisri ,&nbsp;Suphasin Panudom ,&nbsp;Sakchai Chaiyamahapurk ,&nbsp;Nonthikorn Theerasuwipakorn ,&nbsp;Noppachai Siranart ,&nbsp;Patavee Pajareya ,&nbsp;Nattakorn Songsirisuk ,&nbsp;Chalinee Pravarnpat ,&nbsp;Akenarong Pipatputthapong ,&nbsp;Pongpun Jittham ,&nbsp;Paisit Kosum","doi":"10.1016/j.ijcha.2026.101873","DOIUrl":"10.1016/j.ijcha.2026.101873","url":null,"abstract":"<div><h3>Introduction &amp; Objectives</h3><div>Heart failure is one of the major public health concerns and a leading cause of hospitalization and mortality worldwide, including in Thailand. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated significant cardiovascular benefits in clinical trials. This study aimed to evaluate the real-world effectiveness of SGLT2i in reducing all-cause mortality and heart failure hospitalization among patients with heart failure at Naresuan University Hospital.</div></div><div><h3>Materials &amp; Methods</h3><div>This retrospective cohort study included patients newly diagnosed with heart failure at Naresuan University Hospital between January 1, 2019, and December 31, 2023. Patients were divided into those who received SGLT2i and those who did not. The primary outcome was a composite of all-cause mortality and hospitalization for worsening heart failure. Rate ratios were calculated using multilevel mixed-effects Poisson regression, adjusting for baseline characteristics.</div></div><div><h3>Results</h3><div>A total of 1,378 patients were included (1,080 SGLT2i visits; 5,243 non-SGLT2i visits). The proportion of patients with reduced left ventricular ejection fraction (LVEF ≤ 40%) was higher in the SGLT2i group than the non-SGLT2i group (39.9% vs. 29.4%, p &lt; 0.001). The SGLT2i group also had a higher prevalence of coronary artery disease, myopathy, and chronic kidney disease. Rate of composite outcome (death or heart failure hospitalization) was lower in the SGLT2i group (rate 10.93 per 100 vs. 17.58 per 100). The incidence of the composite outcome was significantly lower in the SGLT2i group compared to the non-SGLT2i group (rate ratio 0.60, 95% CI: 0.42–0.87; p = 0.006). The all-cause mortality rate in the SGLT2i group was markedly lower (rate ratio 0.02, 95% CI: 0.00–0.18; p = 0.001), while heart failure hospitalization showed a favorable trend without reaching statistical significance.</div></div><div><h3>Conclusion</h3><div>SGLT2i were associated with a significantly lower risk of death and heart failure hospitalization in this real-world cohort of Thai heart failure patients. These findings reinforce the clinical benefits of SGLT2i and support their broader implementation in heart failure management in Thailand.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101873"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022482","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 role of membranous septum length as a predictor for post-TAVR pacemaker implantation in patients with pre-existing RBBB","authors":"Ayman Jubran ,&nbsp;Raumil V Patel ,&nbsp;Denis Qeska ,&nbsp;Ragavie Manoragavan ,&nbsp;Issac Yang ,&nbsp;Anastasia Oikonomou ,&nbsp;Harindra C Wijeysundera","doi":"10.1016/j.ijcha.2025.101855","DOIUrl":"10.1016/j.ijcha.2025.101855","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101855"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924279","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":"Association of elevated cyclic GMP levels with hemodynamic changes in HFrEF patients treated with sacubitril/valsartan and vericiguat: a pilot study","authors":"Takumi Inoue ,&nbsp;Hiroyuki Takahama ,&nbsp;Hideaki Suzuki ,&nbsp;Marina Arai ,&nbsp;Nobuhiro Kikuchi ,&nbsp;Taijyu Satoh ,&nbsp;Nobuhiro Yaoita ,&nbsp;Saori Yamamoto ,&nbsp;Kotaro Nochioka ,&nbsp;Makoto Nakano ,&nbsp;Shunsuke Tatebe ,&nbsp;Jun Takahashi ,&nbsp;Naoto Minamino ,&nbsp;Satoshi Yasuda","doi":"10.1016/j.ijcha.2025.101863","DOIUrl":"10.1016/j.ijcha.2025.101863","url":null,"abstract":"<div><h3>Background</h3><div>Patients with heart failure (HF) often present with a relative deficiency of cyclic guanosine monophosphate (cGMP) despite elevated B-type natriuretic peptide (BNP) levels. Sacubitril/valsartan and vericiguat target the cGMP pathway, but the relative contribution of cardiac versus systemic cGMP production remains uncertain. This study evaluated the association between cGMP changes and hemodynamic changes in patients with HF with reduced ejection fraction (HFrEF) receiving these agents.</div></div><div><h3>Methods</h3><div>Fourteen symptomatic HFrEF patients (median age 65.0 [IQR: 56.0–72.3]years, EF 25.5 [24.0–33.3]%) and 20 control patients without HF (66.0 years, EF 66.5 %) were enrolled. Of the HFrEF patients, five received sacubitril/valsartan alone and nine received vericiguat (newly initiated or added to sacubitril/valsartan). All HFrEF patients underwent right heart catheterization before the treatment and two months after treatment. Blood samples were collected from the coronary sinus, arteries, and veins.</div></div><div><h3>Results</h3><div>HFrEF patients showed higher coronary sinus cGMP levels compared with controls (15.8 ± 1.7 vs. 10.9 ± 1.2 nM, p &lt; 0.05) but a markedly lower cGMP/BNP ratio (0.09 ± 0.02 vs. 1.71 ± 0.63, p &lt; 0.05), suggesting a relative cGMP deficiency. After the therapy, the cGMP/BNP ratio significantly increased (0.278, p &lt; 0.05). The change in coronary sinus cGMP correlated with improvement in cardiac index (r = 0.57, p = 0.039). cGMP levels rose consistently across all sampling sites, indicating a systemic augmentation of the cGMP pathway.</div></div><div><h3>Conclusion</h3><div>Elevation of cGMP levels were associated with hemodynamic improvement in HFrEF patients treated with sacubitril/valsartan and vericiguat. These findings highlight the therapeutic relevance of cGMP pathway augmentation and provide mechanistic insights aligned with the known clinical effects of these agents in HFrEF.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101863"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924323","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":"Circulating angiogenic progenitor cell apoptosis in Post-COVID-19 syndrome","authors":"Julia M. Kröpfl ,&nbsp;Christoph Hauser ,&nbsp;Luca Beugger ,&nbsp;Henner Hanssen ,&nbsp;Fabian Schwendinger ,&nbsp;Arno Schmidt-Trucksäss","doi":"10.1016/j.ijcha.2025.101866","DOIUrl":"10.1016/j.ijcha.2025.101866","url":null,"abstract":"<div><h3>Background</h3><div>Cellular endothelial dysfunction in patients recovering from Coronavirus disease 2019 (COVID-19) remains poorly understood. This study examined circulating angiogenic progenitor cells (CAC) and mature endothelial cells (CEC) in individuals with persistent symptoms following hospitalization for COVID-19 (PH-PCS) at ≥ 18-months post-infection.</div></div><div><h3>Methods</h3><div>We compared PH-PCS (n = 14) to matched controls without symptomatic COVID-19 (n = 7). Examinations included macro- and microvascular structure and function and the analysis of CAC and CEC using flow cytometry.</div></div><div><h3>Results</h3><div>Estimates indicated somewhat lower apoptotic CAC concentrations (mean difference[md] [95 %CI] = 0.050 cells/µl [0.003, 0.137], p = 0.084) and proportions (% total CAC, 7.7 percentage points (pp) [0.3, 12.9], p = 0.066) in patients compared to controls, though estimates were imprecise. Similar results were observed for apoptotic CEC concentrations (1.202 cells/µl [0.040, 7.518], p = 0.066) and proportions (% total CEC, 2.7 pp [0.2, 23.8], p = 0.048). Live CAC (−7.6 pp [-12.7, −1.1], p = 0.084) and live CEC proportions (−4.9 pp [–23.7, −0.3], p = 0.042) were somewhat enhanced in PH-PCS. Brachial-arterial flow-mediated dilation (baFMD) and retinal vessel imaging parameters showed little evidence for differences between groups, except for maximal arteriolar constriction, where estimates suggested on average higher values in PH-PCS (md [95 %CI] = 1.64 [0.050, 3.63], p = 0.084), but estimates were uncertain. Pooling PH-PCS and controls, correlations were observed between reduced baFMD and both elevated total CEC concentrations (ρ = -0.56, p = 0.038) and decreased apoptotic CAC proportions (ρ = 0.56, p = 0.042).</div></div><div><h3>Conclusions</h3><div>This study suggests the possibility of unbalanced CAC and CEC apoptosis in PH-PCS, but with uncertain magnitude. The findings might inform hypothesis generation for future studies on (cellular) endothelial function in PH-PCS.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101866"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924277","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":"Syndecan-1, endocan and non-culprit coronary plaque composition following non-ST elevation myocardial infarction","authors":"Naomi E. Wattchow ,&nbsp;Thalia Salagaras ,&nbsp;Mau T. Nguyen ,&nbsp;Lauren Y.J. Sandeman ,&nbsp;Gemma A. Figtree ,&nbsp;Giuseppe Di Giovanni ,&nbsp;Dennis T.L. Wong ,&nbsp;Stephen J. Nicholls ,&nbsp;Christina A. Bursill ,&nbsp;Peter J. Psaltis","doi":"10.1016/j.ijcha.2025.101865","DOIUrl":"10.1016/j.ijcha.2025.101865","url":null,"abstract":"<div><h3>Background</h3><div>Syndecan-1 and endocan are biomarkers of endothelial damage, which associate with worse outcomes after myocardial infarction (MI). As it is unclear how this is mediated, we investigated how they associate with the composition of residual, non-culprit coronary atherosclerotic plaques following acute MI.</div></div><div><h3>Methods</h3><div>This <em>post hoc</em> analysis of the COCOMO-ACS trial used serum samples from forty-five patients with non-ST elevation MI who underwent blood collection and optical coherence tomography (OCT) imaging of non-culprit, lipid-rich coronary plaques at baseline and after a median of 17.8 months. Serum syndecan-1 and endocan concentrations at both time-points were measured by ELISA. Relationships between these biomarkers and OCT parameters of rupture-prone plaque were examined.</div></div><div><h3>Results</h3><div>Serum levels of syndecan-1 (median 161.0 ng/mL at baseline vs 93.5 ng/mL at follow-up, P &lt; 0.0001) and endocan (225.7 pg/mL vs 191.2 pg/mL, P = 0.003) both decreased from time of MI to follow-up, with strong correlation between their changes (R² = 0.64, P &lt; 0.0001). Only syndecan-1 showed a weak negative correlation with minimum fibrous cap thickness at baseline (R² = 0.10, P = 0.03) and a weak positive correlation with maximum lipid arc at follow-up (R² = 0.14, P = 0.01). While syndecan-1 and endocan showed no relationship with plasma lipid concentrations, there were weak associations between follow-up syndecan-1 and interleukin-1-beta (R² = 0.21, P = 0.001), and follow-up endocan and interleukin-6 (R² = 0.15, P = 0.008).</div></div><div><h3>Conclusions</h3><div>Although serum syndecan-1 and endocan levels decreased in peripheral blood over time post-MI on guideline-directed therapy, this study identified only modest relationships between syndecan-1 (and not endocan) and OCT compositional characteristics of lipid-rich, rupture-prone plaque.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101865"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924324","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":"Cardiac conduction abnormalities in myotonic dystrophy type I: The ongoing value of the ECG","authors":"Mohammad Abumayyaleh,&nbsp;Tobias Schupp,&nbsp;Michael Behnes,&nbsp;Ibrahim Akin","doi":"10.1016/j.ijcha.2025.101860","DOIUrl":"10.1016/j.ijcha.2025.101860","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101860"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977012","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":"Corrigendum to “Effectiveness of cerebral embolic protection during transcatheter aortic valve replacement: a systematic review and meta-analysis of randomized trials”. [IJC Heart Vasculature 61 (2025) 101842]","authors":"Rodolfo Caminiti ,&nbsp;Alfonso Ielasi ,&nbsp;Giampaolo Vetta ,&nbsp;Antonio Parlavecchio ,&nbsp;Domenico Giovanni Della Rocca ,&nbsp;Silvia Moscardelli ,&nbsp;Andrea Marrone ,&nbsp;Giulia Laterra ,&nbsp;Maurizio Tespili ,&nbsp;Giampiero Vizzari ,&nbsp;Marco Barbanti ,&nbsp;Antonio Micari","doi":"10.1016/j.ijcha.2025.101843","DOIUrl":"10.1016/j.ijcha.2025.101843","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101843"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571178","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":"Echocardiographic reference values in elderly with a focus on octogenarians and older","authors":"Miguel Quintana ,&nbsp;Mira Carling ,&nbsp;Anders Olofsson ,&nbsp;Dag Isaksson ,&nbsp;Jenny Fahlen ,&nbsp;Elin Kärrman ,&nbsp;Fredrik Pihl ,&nbsp;Roland Forsberg ,&nbsp;Björn Persson ,&nbsp;Alen Lovric ,&nbsp;Thomas Gustafsson ,&nbsp;Karin Bouma","doi":"10.1016/j.ijcha.2026.101872","DOIUrl":"10.1016/j.ijcha.2026.101872","url":null,"abstract":"<div><h3>Aims</h3><div>Most published material on echocardiographic reference values includes individuals up to the age of 60–70, but reference values for older individuals remain scarce. Accurate interpretation of transthoracic echocardiographic reference values in octogenarians and older individuals requires updated values that reflect healthy ageing. This study aims to compare transthoracic echocardiographic reference values of healthy octogenarians and older individuals with those of younger age groups.</div></div><div><h3>Methods and results</h3><div>A total of 248 individuals were studied. The group was divided into three age categories: sexagenarians, septuagenarians, and octogenarians or older. The participants underwent a standard transthoracic echocardiographic examination according to current guidelines. The main differences between age groups were observed in values related to left ventricular diastolic function. There was a significant difference in some values related to systolic function, such as a significant decrease in mitral annular plane systolic excursion in octogenarians compared to sexagenarians and septuagenarians.</div></div><div><h3>Conclusion</h3><div>The present study showed statistically significant differences in some echocardiographic parameters primarily reflecting the left ventricular diastolic function. In addition, a significant difference in some values related to systolic function were also found. These findings emphasize the need for age-adapted reference values to improve diagnostic accuracy in elderly.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101872"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022360","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":"Comparative efficacy and safety of pulsed field ablation versus cryoballoon ablation in atrial fibrillation: A meta-analysis of mid- and long-term outcomes","authors":"Peier Xu ,&nbsp;Xinhu Tang ,&nbsp;Jichao Zhang ,&nbsp;Le Zhou ,&nbsp;Naijing Gao ,&nbsp;Xueyun Yan ,&nbsp;Huaming Cao","doi":"10.1016/j.ijcha.2025.101845","DOIUrl":"10.1016/j.ijcha.2025.101845","url":null,"abstract":"<div><h3>Background</h3><div>Pulsed field ablation (PFA) is an emerging non-thermal modality for pulmonary vein isolation (PVI) in atrial fibrillation (AF), offering enhanced tissue selectivity and reduced collateral damage compared to cryoballoon ablation (CBA).</div></div><div><h3>Objective</h3><div>This <em>meta</em>-analysis compares the mid- to long-term efficacy, safety, and procedural characteristics of PFA versus CBA in AF treatment.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, EMBASE, and the Cochrane Library through July 2025 identified nine comparative studies involving 2,718 patients (1,381 PFA; 1,337 CBA). Pooled risk ratios (RRs) and mean differences (MDs) were calculated using random-effects models, with subgroup analyses for paroxysmal and persistent AF.</div></div><div><h3>Results</h3><div>PFA showed a trend toward lower recurrence rates (RR = 0.86, 95 % CI: 0.70–1.04), particularly in paroxysmal AF (RR = 0.83, 95 % CI: 0.68–1.01), while outcomes in persistent AF were comparable (RR = 0.98, 95 % CI: 0.69–1.38). Procedure time was significantly shorter with PFA (MD = –9.59 min, 95 % CI: –17.80 to –1.37), whereas fluoroscopy duration showed no significant difference. Safety analysis revealed a non-significant trend favoring PFA (RR = 0.75, 95 % CI: 0.49–1.14), with fewer cases of phrenic nerve injury and cardiac tamponade.</div></div><div><h3>Conclusion</h3><div>PFA and CBA demonstrate comparable efficacy and safety in AF ablation. PFA may offer procedural advantages and improved outcomes in paroxysmal AF, supporting its expanding role in clinical practice. Further randomized trials are warranted to validate these findings and guide optimal treatment strategies.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101845"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616243","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":"Coronary anatomy detects, ischemia predicts: Real-world insights from the Nancy ischemia registry","authors":"Zukaï Chati ,&nbsp;Nacima Benzaghou ,&nbsp;Clémence Balaj ,&nbsp;Samuel Tissier","doi":"10.1016/j.ijcha.2026.101870","DOIUrl":"10.1016/j.ijcha.2026.101870","url":null,"abstract":"<div><h3>Background</h3><div>The respective roles of coronary atherosclerosis assessment and myocardial ischemia testing for cardiovascular risk stratification remain debated, particularly in real-world clinical practice where imaging strategies are guided by patient risk profile rather than random assignment.</div></div><div><h3>Methods</h3><div>The Nancy Ischemia Registry prospectively included 3,020 consecutive patients between February 2021 and December 2022. Patients underwent either anatomical imaging [coronary artery calcium score (CACS) or coronary CT angiography (CCTA)] or functional ischemia testing [stress echocardiography or stress cardiovascular magnetic resonance (CMR)]. Follow-up was completed through December 2023. The primary endpoint was major adverse cardiovascular events (MACE), defined as cardiovascular death or myocardial revascularization.</div></div><div><h3>Results</h3><div>Anatomical imaging was used almost exclusively in primary prevention, whereas ischemia-based testing included both primary and secondary prevention populations. Kaplan–Meier analysis showed a higher cumulative incidence of MACE among patients undergoing ischemia screening (20 %) compared with anatomical screening (15 %), with divergence after approximately 500 days. However, this difference was not confirmed after multivariable adjustment (HR 1.03, 95 % CI 0.87–1.23; p = 0.73), and residual confounding related to incomplete adjustment for cardiovascular risk factors cannot be excluded. Myocardial ischemia, particularly when associated with revascularization, was strongly associated with adverse events, while total atherosclerotic burden remained independently associated with outcomes. Age and male sex were additional predictors of MACE.</div></div><div><h3>Conclusions</h3><div>In this real-world registry, anatomical imaging provided information on total atherosclerotic burden, whereas functional imaging identified patients with high-risk myocardial ischemia and subsequent revascularization. These findings offer real-world insights into the complementary roles of anatomical and functional imaging in distinct clinical populations and support an integrated, imaging-guided approach to personalized CAD management.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"62 ","pages":"Article 101870"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924275","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}