Revista española de cardiología (English ed.)最新文献

{"title":"Advanced echocardiography and cluster analysis to identify secondary tricuspid regurgitation phenogroups at different risk.","authors":"Luigi P Badano, Marco Penso, Michele Tomaselli, Kyu Kim, Alexandra Clement, Noela Radu, Geu-Ru Hong, Diana R Hădăreanu, Alexandra Buta, Caterina Delcea, Samantha Fisicaro, Gianfranco Parati, Chi Young Shim, Denisa Muraru","doi":"10.1016/j.rec.2025.02.004","DOIUrl":"10.1016/j.rec.2025.02.004","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Significant secondary tricuspid regurgitation (STR) is associated with poor prognosis, but its heterogeneity makes predicting patient outcomes challenging. Our objective was to identify STR prognostic phenogroups.</p><p><strong>Methods: </strong>We analyzed 758 patients with moderate-to-severe STR: 558 (74±14 years, 55% women) in the derivation cohort and 200 (73±12 years, 60% women) in the external validation cohort. The primary endpoint was a composite of heart failure hospitalization and all-cause mortality.</p><p><strong>Results: </strong>We identified 3 phenogroups. The low-risk phenogroup (2-year event-free survival 80%, 95%CI, 74%-87%) had moderate STR, preserved right ventricular (RV) size and function, and a moderately dilated but normally functioning right atrium. The intermediate-risk phenogroup (HR, 2.20; 95%CI, 1.44-3.37; P<.001) included older patients with severe STR, and a mildly dilated but uncoupled RV. The high-risk phenogroup (HR, 4.67; 95%CI, 3.20-6.82; P<.001) included younger patients with massive-to-torrential tricuspid regurgitation, as well as severely dilated and dysfunctional RV and right atrium. Multivariable analysis confirmed the clustering as independently associated with the composite endpoint (HR, 1.40; 95%CI, 1.13-1.70; P=.002). A supervised machine learning model, developed to assist clinicians in assigning patients to the 3 phenogroups, demonstrated excellent performance both in the derivation cohort (accuracy=0.91, precision=0.91, recall=0.91, and F1 score=0.91) and in the validation cohort (accuracy=0.80, precision=0.78, recall=0.78, and F1 score=0.77).</p><p><strong>Conclusions: </strong>The unsupervised cluster analysis identified 3 risk phenogroups, which could assist clinicians in developing more personalized treatment and follow-up strategies for STR patients.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiplatelet therapy for primary prevention of nonsignificant coronary lesions.","authors":"Jose Antonio Esteban-Chapel, Juan Antonio Franco-Peláez, Alvaro Aceña","doi":"10.1016/j.rec.2025.01.019","DOIUrl":"10.1016/j.rec.2025.01.019","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-year clinical outcomes after left main coronary artery stenting with new-generation or early-generation DES.","authors":"Jens Wiebe, Constantin Kuna, Tareq Ibrahim, Sebastian Kufner, Isabella Hintz, Paul Justenhoven, Thorsten Kessler, Heribert Schunkert, Marco Valgimigli, Gert Richardt, Jola Bresha, Karl-Ludwig Laugwitz, Adnan Kastrati, Salvatore Cassese","doi":"10.1016/j.rec.2025.02.003","DOIUrl":"10.1016/j.rec.2025.02.003","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Long-term data after stenting of the left main coronary artery (LMCA) are scarce, especially regarding new-generation drug-eluting stents (DES). This analysis aimed to describe the 10-year clinical outcomes of patients who underwent percutaneous coronary intervention with different DES generations for LMCA disease.</p><p><strong>Methods: </strong>Individual patient data from the randomized controlled ISAR-LEFT MAIN and ISAR-LEFT MAIN 2 trials were pooled and 10-year clinical follow-up was obtained. The Kaplan-Meier method was used to calculate event rates. The main endpoints of interest for this analysis were all-cause mortality, myocardial infarction, target lesion revascularization and definite stent thrombosis.</p><p><strong>Results: </strong>A total of 1257 patients were included in this analysis, of which 650 patients were treated with new-generation DES and 607 with early-generation DES. At 10 years, the mortality rate was more than 40% in both groups. After statistical adjustment, 10-year mortality was significantly reduced in patients treated with new-generation DES compared with those treated with early-generation DES (HR_adj, 0.78; 95%CI, 0.62-0.97). After 10 years, the risk of myocardial infarction (HR_adj, 0.43; 95%CI, 0.23-0.80), target lesion revascularization (HR_adj, 0.66; 95%CI, 0.49-0.89), and definite stent thrombosis (HR_adj, 0.13, 95%CI, 0.04-0.49) was significantly reduced by new-generation DES compared with early-generation DES.</p><p><strong>Conclusions: </strong>Patients undergoing percutaneous coronary intervention for LMCA disease have high 10-year mortality regardless of DES generation. The use of new-generation DES in patients with LMCA disease is associated with improved long-term clinical outcomes compared with early-generation DES.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anthracycline cardiotoxicity is associated with aberrant cardiac myosin energetics.","authors":"Danielle Medina-Hernández, Carlos Galán-Arriola, Javier Sánchez-González, Julien Ochala, Borja Ibáñez","doi":"10.1016/j.rec.2025.02.001","DOIUrl":"10.1016/j.rec.2025.02.001","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of atrial fibrillation and atrial flutter in patients with non-ST-segment elevation acute coronary syndrome.","authors":"Martín Negreira-Caamaño, Felipe Díez-Delhoyo, Pedro Cepas-Guillén, María Thiscal López-Lluva, Alfonso Jurado-Román, Pablo Bazal-Chacón, Iván Olavarri-Miguel, Ane Elorriaga, Ricardo Rivera-López, Emilio Blanco-López, Pablo Díez-Villanueva","doi":"10.1016/j.rec.2025.02.002","DOIUrl":"10.1016/j.rec.2025.02.002","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Arrhythmias such as atrial fibrillation and atrial flutter (AF/AFl) complicate the management of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). The aim of this study was to analyze the prognostic impact of AF/AFl in this clinical setting.</p><p><strong>Methods: </strong>The IMPACT-TIMING-GO is a prospective, multicenter registry that enrolled patients with NSTEACS undergoing invasive management. In this subanalysis, patients were categorized based on the presence of AF/AFl (either pre-existing or occurring during admission). Clinical management and complications were assessed both during hospitalization (using a composite endpoint of death, renal failure, ventricular arrhythmias, delirium, new infarction, mechanical complications, and major bleeding) and after 1 year of follow-up (using a composite endpoint of death, cardiovascular admissions, and major bleeding).</p><p><strong>Results: </strong>A total of 1020 patients (mean age, 66.8±12.7 years; 23.5% women) were included. Of these, 79 (7.7%) had prior AF/AFl, and 37 (3.6%) developed de novo AF/AFl during admission. Patients with AF/AFl were older and had a higher comorbidity burden, with de novo AF/AFl being associated with greater clinical severity. After multivariate adjustment, only de novo AF/AFl, and not previous AF/AFl, was independently associated with the composite endpoint of in-hospital complications (OR, 5.12; 95%CI, 2.30-11.43; P <.001 vs OR, 1.70, 95%CI, 0.91-3.58; P=.166) and adverse events at 1 year (HR, 1.95; 95%CI, 1.02-3.76; P=.045 vs HR, 1.02, 95%CI, 0.55-5.86; P=.957).</p><p><strong>Conclusions: </strong>In patients with NSTEACS, de novo AF/AFl is independently associated with higher rates of both in-hospital and follow-up complications.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictability and device tilting in edge-to-edge mitral valve repair.","authors":"Chi-Hion Pedro Li, Lluís Asmarats, Albert Massó van Roessel, Helena Capellades, Xavier Millán, Dabit Arzamendi","doi":"10.1016/j.rec.2025.01.017","DOIUrl":"10.1016/j.rec.2025.01.017","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent chronic thromboembolic pulmonary hypertension following balloon pulmonary angioplasty.","authors":"Claudio M Rivadulla Varela, Ignacio Fernández Herrero, Nicolás Maneiro Melón, Fernando Sarnago Cebada, Pilar Escribano Subías, Maite Velázquez Martín","doi":"10.1016/j.rec.2024.11.019","DOIUrl":"10.1016/j.rec.2024.11.019","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in mitral regurgitation anatomy and outcomes of transcatheter edge-to-edge repair.","authors":"Chi-Hion Pedro Li, Lluís Asmarats, Albert Massó van Roessel, Helena Capellades, Estefanía Fernández-Peregrina, Dabit Arzamendi","doi":"10.1016/j.rec.2025.01.018","DOIUrl":"10.1016/j.rec.2025.01.018","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic total occlusion location and outcomes after percutaneous coronary intervention or medical therapy: ten-year follow-up of a single-center registry.","authors":"Woochan Kwon, Taek Kyu Park, Ki Hong Choi, Joo Myung Lee, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Hyeon-Cheol Gwon, Seung-Hyuk Choi","doi":"10.1016/j.rec.2025.01.015","DOIUrl":"10.1016/j.rec.2025.01.015","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The clinical benefits of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remain controversial. This study aimed to investigate whether PCI for CTO located in the left anterior descending artery (LAD) could have beneficial effects on clinical outcomes.</p><p><strong>Methods: </strong>Patients were retrospectively selected from a single-center CTO registry and followed up for approximately 10 years. The patients were grouped based on the presence of LAD CTO and whether the CTO was revascularized. Inverse probability weighting adjustment was also performed. The primary outcome was the composite of cardiac death or myocardial infarction at 10 years.</p><p><strong>Results: </strong>Among 1323 patients with CTO, 1034 were male, and 417 had LAD CTO. PCI was attempted in 72.2% of participants in the LAD CTO group and in 49.9% of those in the non-LAD CTO group. In the non-LAD CTO group, PCI did not significantly affect the primary outcome (medical therapy vs PCI, 20.7% vs 13.4%, adjusted HR: 0.72, 95%CI, 0.47-1.10; P=.13). However, a significant difference in the incidence of the primary outcome between the treatment methods was observed in the LAD CTO group (30.8% vs 15.4%; adjusted HR: 0.44; 95%CI, 0.25-0.81; P=.007). A significant interaction was observed between LAD CTO and treatment method (P for interaction=.011).</p><p><strong>Conclusions: </strong>The benefits of PCI compared with medical therapy for CTO might be more apparent when the CTO is located in the LAD.</p>","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden death in a homozygous familial hypercholesterolemic child with noncompaction cardiomyopathy. Just a coincidence?","authors":"Daiana Ibarretxe-Guerediaga, Cristina Marimón, Albert Feliu, Cèlia Rodríguez-Borjabad, Núria Plana, Lluís Masana","doi":"10.1016/j.rec.2025.01.016","DOIUrl":"10.1016/j.rec.2025.01.016","url":null,"abstract":"","PeriodicalId":38430,"journal":{"name":"Revista española de cardiología (English ed.)","volume":" ","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}