Circulation Journal最新文献_第10页

Serum Apolipoprotein-A2 Levels Are a Strong Predictor of Future Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention. 血清载脂蛋白-A2 水平是经皮冠状动脉介入治疗患者未来心血管事件的有力预测指标

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-25 Epub Date: 2024-06-20 DOI: 10.1253/circj.CJ-24-0242

Takumi Akiyama, Ryutaro Ikegami, Naoki Kubota, Toshiki Takano, Shintaro Yoneyama, Takeshi Okubo, Makoto Hoyano, Kazuyuki Ozaki, Takayuki Inomata

{"title":"Serum Apolipoprotein-A2 Levels Are a Strong Predictor of Future Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention.","authors":"Takumi Akiyama, Ryutaro Ikegami, Naoki Kubota, Toshiki Takano, Shintaro Yoneyama, Takeshi Okubo, Makoto Hoyano, Kazuyuki Ozaki, Takayuki Inomata","doi":"10.1253/circj.CJ-24-0242","DOIUrl":"10.1253/circj.CJ-24-0242","url":null,"abstract":"Background: Because apolipoprotein-A2 (ApoA2), a key component of high-density lipoprotein cholesterol (HDL-C), lacks clear clinical significance, we investigated its impact on cardiovascular events in patients undergoing percutaneous coronary intervention (PCI).Methods and results: We examined 638 patients who underwent PCI with a new-generation drug-eluting stent for acute or chronic coronary syndrome and had their apolipoprotein levels measured between 2016 and 2021. The patients were divided into 2 groups based on the median serum ApoA2 values, and the incidence of major adverse cardiovascular events (MACE) was assessed. Of the 638 patients, 563 (88%) received statin treatment, with a median serum LDL-C level of 93 mg/dL. Furthermore, 137 patients (21.5%) experienced MACE, and Kaplan-Meier analysis revealed that the higher ApoA2 group had a significantly lower incidence of MACE than the lower ApoA2 group (30.9% vs. 41.6%). However, the other apolipoproteins, including ApoA1, ApoB, ApoC2, ApoC3, and ApoE, showed no significant differences in MACE. Multivariable Cox hazard analysis indicated that ApoA2 was an independent predictor of MACEs (hazard ratio, 0.666; 95% confidence interval, 0.465-0.954). Furthermore, ApoA2 levels exhibited the strongest inverse association with high-sensitivity C-reactive protein levels (rs=-0.479).Conclusions: Among all the apolipoproteins, the serum ApoA2 level may be the strongest predictor of future cardiovascular events and prognosis in patients undergoing PCI.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1770-1777"},"PeriodicalIF":3.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

JCS 2023 Guideline on Diagnosis and Treatment of Sleep Disordered Breathing in Cardiovascular Disease. JCS 2023 心血管疾病睡眠呼吸障碍诊断和治疗指南。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-25 Epub Date: 2024-08-26 DOI: 10.1253/circj.CJ-23-0489

Takatoshi Kasai, Takashi Kohno, Wataru Shimizu, Shinichi Ando, Shuji Joho, Naohiko Osada, Masahiko Kato, Kazuomi Kario, Kazuki Shiina, Akira Tamura, Akiomi Yoshihisa, Yoshihiro Fukumoto, Yoshifumi Takata, Motoo Yamauchi, Satomi Shiota, Shintaro Chiba, Jiro Terada, Morio Tonogi, Keisuke Suzuki, Taro Adachi, Yuki Iwasaki, Yoshihisa Naruse, Shoko Suda, Tomofumi Misaka, Yasuhiro Tomita, Ryo Naito, Ayumi Goda, Tomotake Tokunou, Makoto Sata, Tohru Minamino, Tomomi Ide, Kazuo Chin, Nobuhisa Hagiwara, Shinichi Momomura

引用次数: 0

Basal Coronary Microvascular Resistance Predicting Death and Heart Failure in Patients Without Functional Coronary Stenosis. 预测无功能性冠状动脉狭窄患者死亡和心力衰竭的基础冠状动脉微血管阻力

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-25 Epub Date: 2024-06-20 DOI: 10.1253/circj.CJ-24-0022

Tadashi Murai, Hiroyuki Hikita, Masao Yamaguchi, Aki Ito, Takayuki Warisawa, Hiroshi Ikeda, Ken Takahashi, Hirotaka Yano, Joonmo Chang, Takahiro Watanabe, Hiroshi Yoshikawa, Yoshinori Kanno, Keiichi Hishikari, Atsushi Takahashi, Hiroyuki Fujii, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta

{"title":"Basal Coronary Microvascular Resistance Predicting Death and Heart Failure in Patients Without Functional Coronary Stenosis.","authors":"Tadashi Murai, Hiroyuki Hikita, Masao Yamaguchi, Aki Ito, Takayuki Warisawa, Hiroshi Ikeda, Ken Takahashi, Hirotaka Yano, Joonmo Chang, Takahiro Watanabe, Hiroshi Yoshikawa, Yoshinori Kanno, Keiichi Hishikari, Atsushi Takahashi, Hiroyuki Fujii, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta","doi":"10.1253/circj.CJ-24-0022","DOIUrl":"10.1253/circj.CJ-24-0022","url":null,"abstract":"Background: Abnormal coronary microcirculation is linked to poor patient prognosis, so the aim of the present study was to assess the prognostic relevance of basal microvascular resistance (b-IMR) in patients without functional coronary stenosis.Methods and results: Analyses of 226 patients who underwent intracoronary physiological assessment of the left anterior descending artery included primary endpoints of all-cause death and heart failure, as well as secondary endpoints of cardiovascular death and atherosclerotic vascular events. During a median follow-up of 2 years, there were 12 (5.3%) primary and 21 (9.3 %) secondary endpoints. The optimal b-IMR cutoff for the primary endpoints was 47.1 U. Kaplan-Meier curve analysis demonstrated worse event-free survival of the primary endpoints in patients with a b-IMR below the cutoff (χ2=21.178, P<0.001). b-IMR was not significantly associated with the secondary endpoints (P=0.35). A low coronary flow reserve (CFR; <2.5) had prognostic value for both endpoints (primary endpoints: χ2=11.401, P=0.001; secondary endpoints: (χ2=6.015; P=0.014), and high hyperemic microvascular resistance (≥25) was associated only with the secondary endpoints (χ2=4.420; P=0.036). Incorporating b-IMR into a clinical model that included CFR improved the Net Reclassification Index and Integrated Discrimination Improvement for predicting the primary endpoints (P<0.001 and P=0.034, respectively).Conclusions: b-IMR may be a specific marker of the risk of death and heart failure in patients without functional coronary stenosis.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":"1788-1797"},"PeriodicalIF":3.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Basal Microvascular Resistance　- Another Invasively Measured Physiological Index for Predicting Future Heart Failure Events. 基础微血管阻力--另一项用于预测未来心衰事件的侵入性测量生理指标

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-25 Epub Date: 2024-06-21 DOI: 10.1253/circj.CJ-24-0401

Yuichi Saito, Takeshi Nishi, Yoshio Kobayashi

引用次数: 0

Delays in Cardiopulmonary Resuscitation, Defibrillation, and Epinephrine Administration in Out-of-Hospital Cardiac Arrest　- Composite Time-Dependent Effects of Prehospital Interventions on 30-Day Favorable Neurological Outcomes and Social Implications From a Prospective Nationwide Population-Based Cohort Study. 院外心脏骤停患者心肺复苏、除颤和肾上腺素给药的延迟--一项前瞻性全国人群队列研究中院前干预对 30 天良好神经系统预后的时间依赖性综合影响及其社会意义。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-24 DOI: 10.1253/circj.CJ-24-0638

Toshihide Izumida, Teruhiko Imamura, Shizukiyo Ishikawa, Nikhil Narang, Koichiro Kinugawa, Naohiro Yonemoto, Yoshio Tahara, Takanori Ikeda

{"title":"Delays in Cardiopulmonary Resuscitation, Defibrillation, and Epinephrine Administration in Out-of-Hospital Cardiac Arrest　- Composite Time-Dependent Effects of Prehospital Interventions on 30-Day Favorable Neurological Outcomes and Social Implications From a Prospective Nationwide Population-Based Cohort Study.","authors":"Toshihide Izumida, Teruhiko Imamura, Shizukiyo Ishikawa, Nikhil Narang, Koichiro Kinugawa, Naohiro Yonemoto, Yoshio Tahara, Takanori Ikeda","doi":"10.1253/circj.CJ-24-0638","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0638","url":null,"abstract":"Background: Our study investigated the prognostic impacts of the interval between collapse and the initiation of cardiopulmonary resuscitation (CPR), and subsequent intervals to defibrillation or epinephrine administration, on 30-day favorable neurological outcomes following out-of-hospital cardiac arrest (OHCA).Methods and results: This nationwide population-based cohort study used the All Japan Utstein Registry, encompassing OHCA patients in Japan between January 2006 and December 2021. The primary outcome was 30-day favorable neurological outcomes, defined as Cerebral Performance Category 1 or 2. Three-dimensional plots and multivariable logistic regression models were used to assess the time-dependent prognostic impacts of prehospital CPR interventions. In all, 184,731 OHCA patients (86,246 with shockable rhythm and 98,485 with non-shockable rhythm) were included in the study. Three-dimensional plots revealed that the interval between collapse and initiation of CPR, and subsequent intervals to defibrillation or epinephrine, were independently associated with 30-day favorable neurological outcomes in the groups with shockable and non-shockable rhythms, respectively (P<0.05 for all).Conclusions: Among patients with witnessed OHCA, there was a dose-response relationship between delays in the collapse-CPR initiation interval, and subsequent intervals to defibrillation or epinephrine administration, and 30-day favorable neurological outcomes. Our findings provide valuable insights into OHCA management.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of Type 1a Endoleak After Hybrid Thoracic Endovascular Aortic Repair for Aortic Arch Diseases. 主动脉弓疾病的混合胸腔内血管主动脉修复术后 1a 型内膜渗漏的预测因素

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-24 DOI: 10.1253/circj.CJ-24-0580

Tomoaki Kudo, Toru Kuratani, Yoshiki Sawa, Shigeru Miyagawa

{"title":"Predictors of Type 1a Endoleak After Hybrid Thoracic Endovascular Aortic Repair for Aortic Arch Diseases.","authors":"Tomoaki Kudo, Toru Kuratani, Yoshiki Sawa, Shigeru Miyagawa","doi":"10.1253/circj.CJ-24-0580","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0580","url":null,"abstract":"Background: This study analyzed the risk factors for type 1a endoleak after hybrid thoracic endovascular repair (TEVAR) for aortic arch diseases based on preoperative patient characteristics and multidetector computed tomography measurements.Methods and results: In all, 213 patients who underwent proximal landing zone 1 and 2 hybrid TEVAR for aortic arch pathologies (zone 1, n=82 [38.5%]; zone 2, n=131 [61.5%]; median age 72 years) between May 2008 and February 2020 were enrolled in this study; the median follow-up period was 6.0 years. The rates of type 1a endoleak at 1, 3, 5, and 10 years were 1.4%, 1.4%, 4.1%, and 4.1%, respectively. Multivariate Cox proportional hazard regression analysis revealed that the angle of the aortic arch was a significant risk factor for type 1a endoleak (hazard ratio 1.08; 95% confidence interval 0.85-0.99; P=0.045). The estimated area under the curve in receiver operating characteristic curve analysis was 0.76, and the cut-off value of the aortic arch angle was 95°.Conclusions: It is essential to prevent type 1a endoleak, the most severe complication of hybrid TEVAR. The risk factor for type 1a endoleak in this study was a sharper angle of the aortic arch (≤95°). For patients at high risk of type 1a endoleak, it is necessary to consider alternative procedures depending on a patient's surgical risk.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association Between White Blood Cell Counts at Diagnosis and Clinical Outcomes in Venous Thromboembolism　- From the COMMAND VTE Registry-2. 静脉血栓栓塞症诊断时白细胞计数与临床结果之间的关系--来自 COMMAND VTE 注册中心-2。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-22 DOI: 10.1253/circj.CJ-24-0581

Shinya Ikeda, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Ryusuke Nishikawa, Koh Ono, Takeshi Kimura

{"title":"Association Between White Blood Cell Counts at Diagnosis and Clinical Outcomes in Venous Thromboembolism　- From the COMMAND VTE Registry-2.","authors":"Shinya Ikeda, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Ryusuke Nishikawa, Koh Ono, Takeshi Kimura","doi":"10.1253/circj.CJ-24-0581","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0581","url":null,"abstract":"Background: White blood cell (WBC) counts were reported to be a risk factor for acute adverse events in patients with venous thromboembolism (VTE). However, there are limited data on VTE patients without active cancer.Methods and results: The COMMAND VTE Registry-2 was a multicenter study enrolling 5,197 consecutive patients with acute symptomatic VTE. We divided 3,668 patients without active cancer into 4 groups based on WBC count quartiles (Q1-Q4) at diagnosis: Q1, ≤5,899 cells/μL; Q2, 5,900-7,599 cells/μL, Q3, 7,600-9,829 cells/μL; and Q4, ≥9,830 cells/μL. Patients in Q4 more often presented with pulmonary embolism (PE) than patients in Q1, Q2, and Q3 (68% vs. 37%, 53%, and 61%, respectively; P<0.001). The proportion of massive PEs among all PEs was higher in Q4 than in Q1, Q2, and Q3 (21% vs. 3.4%, 5.8%, and 11%, respectively; P<0.001). Compared with Q1, Q2, and Q3, patients in Q4 had a higher cumulative 5-year incidence of all-cause death (17.0%, 15.2%, 16.1%, and 22.8%, respectively; P<0.001) and major bleeding (10.9%, 11.0%, 10.3%, and 14.4%, respectively; P=0.002). The higher mortality risk of Q4 relative to Q2 was consistent regardless of the presentations of VTEs.Conclusions: An elevated WBC count on VTE diagnosis was associated with a higher risk of mortality and major bleeding regardless of VTE presentation, suggesting the potential usefulness of WBC counts for further risk stratification.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of the Stress Hyperglycemia Ratio on Heart Failure and Atherosclerotic Cardiovascular Events After Acute Myocardial Infarction. 应激性高血糖比率对急性心肌梗死后心力衰竭和动脉粥样硬化性心血管事件的影响

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-22 DOI: 10.1253/circj.CJ-24-0612

Shogo Okita, Yuichi Saito, Hiroaki Yaginuma, Kazunari Asada, Hiroki Goto, Osamu Hashimoto, Takanori Sato, Hideki Kitahara, Yoshio Kobayashi

{"title":"Impact of the Stress Hyperglycemia Ratio on Heart Failure and Atherosclerotic Cardiovascular Events After Acute Myocardial Infarction.","authors":"Shogo Okita, Yuichi Saito, Hiroaki Yaginuma, Kazunari Asada, Hiroki Goto, Osamu Hashimoto, Takanori Sato, Hideki Kitahara, Yoshio Kobayashi","doi":"10.1253/circj.CJ-24-0612","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0612","url":null,"abstract":"Background: An acute hyperglycemic status is reportedly associated with poor prognosis in patients with acute cardiovascular diseases. Although the stress hyperglycemia ratio (SHR) is used to evaluate the hyperglycemic condition on admission, relationships between SHR and clinical outcomes, particularly heart failure (HF), remain uncertain in acute myocardial infarction (AMI).Methods and results: This retrospective multicenter study included 2,386 patients with AMI undergoing percutaneous coronary intervention. SHR was calculated using blood glucose and HbA1c levels. Co-primary endpoints included HF-related events (death, worsening HF, and hospitalization for HF) and major adverse cardiovascular events (MACE; death, recurrent AMI, and ischemic stroke) during the index hospitalization and after discharge. The mean (±SD) SHR was 1.30±0.51; HF events and MACE occurred in 680 (28.5%) and 233 (9.8%) patients during hospitalization, respectively. SHR was independently associated with in-hospital HF events and MACE. Of 2,017 patients who survived to discharge, 195 (9.7%) and 214 (10.6%) experienced HF events and MACE, respectively, over a median follow-up of 536 days. The risk of HF events was higher in patients with a high (>1.45) SHR than in those with SHR ≤1.45; there was no significant difference in MACE rates after discharge between these 2 groups.Conclusions: In AMI patients, SHR was predictive of in-hospital outcomes, including HF events and MACE, whereas after discharge a higher SHR was associated with higher HF risks, but not MACE.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of High Lipoprotein(a) Levels on Delayed Wound Healing in Patients With Chronic Limb-Threatening Ischemia After Peripheral Endovascular Therapy. 高脂蛋白（a）水平对外周血管治疗后慢性肢体缺血患者伤口延迟愈合的影响

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-19 DOI: 10.1253/circj.CJ-24-0383

Yusuke Tomoi, Mitsuyoshi Takahara, Yoshimitsu Soga, Taichi Hirano, Kazuki Tsunoda, Tomonori Katsuki, Kenji Ando

{"title":"Impact of High Lipoprotein(a) Levels on Delayed Wound Healing in Patients With Chronic Limb-Threatening Ischemia After Peripheral Endovascular Therapy.","authors":"Yusuke Tomoi, Mitsuyoshi Takahara, Yoshimitsu Soga, Taichi Hirano, Kazuki Tsunoda, Tomonori Katsuki, Kenji Ando","doi":"10.1253/circj.CJ-24-0383","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0383","url":null,"abstract":"Background: Elevated lipoprotein(a) [Lp(a)] levels are a causal risk factor for peripheral artery disease. However, data on their effect on delayed wound healing in patients with chronic limb-threatening ischemia (CLTI) are limited. The present study assessed the association between elevated Lp(a) levels and delayed wound healing in patients with CLTI.Methods and results: This study included 280 patients who successfully received endovascular therapy for CLTI between September 2016 and August 2021. High Lp(a) levels were defined as those >30 mg/dL. The primary outcome was wound healing. During a median follow-up of 20.4 months (interquartile range 6.8-38.6 months), 146 patients achieved wound healing. The wound healing rate at 24 months was significantly lower in the high Lp(a) than low Lp(a) group (41.1% vs. 86.3%, respectively; P<0.001). The adjusted risk ratio was 0.19 (95% confidence interval 0.13-0.29, P<0.001). Lp(a) levels of 31-50 and >50 mg/dL, but not 16-30 mg/dL, were significantly associated with delayed wound healing relative to Lp(a) levels of ≤15 mg/dL.Conclusions: Elevated Lp(a) levels were independently associated with delayed wound healing in patients with CLTI treated with endovascular therapy.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal Function-Stratified Comparison of Short- and Long-Term Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention With Third-Generation Drug-Eluting Stents　- Post Hoc Analysis From the HOST-IDEA Randomized Clinical Trial. 使用第三代药物洗脱支架进行经皮冠状动脉介入治疗的患者短期和长期双联抗血小板疗法的肾功能分层比较--来自 HOST-IDEA 随机临床试验的事后分析。

IF 3.1 3区医学

Circulation Journal Pub Date : 2024-10-12 DOI: 10.1253/circj.CJ-24-0481

Jung-Kyu Han, Seung Do Lee, Doyeon Hwang, Sang-Hyeon Park, Jeehoon Kang, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Jin-Man Cho, Janghyun Cho, Duk Won Bang, Jae-Hwan Lee, Han Cheol Lee, Kyung-Jin Kim, Woojung Chun, Won-Woo Seo, Woo-Jung Park, Sang Min Park, Seung Jin Lee, Hyo-Soo Kim

{"title":"Renal Function-Stratified Comparison of Short- and Long-Term Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention With Third-Generation Drug-Eluting Stents　- Post Hoc Analysis From the HOST-IDEA Randomized Clinical Trial.","authors":"Jung-Kyu Han, Seung Do Lee, Doyeon Hwang, Sang-Hyeon Park, Jeehoon Kang, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Jin-Man Cho, Janghyun Cho, Duk Won Bang, Jae-Hwan Lee, Han Cheol Lee, Kyung-Jin Kim, Woojung Chun, Won-Woo Seo, Woo-Jung Park, Sang Min Park, Seung Jin Lee, Hyo-Soo Kim","doi":"10.1253/circj.CJ-24-0481","DOIUrl":"https://doi.org/10.1253/circj.CJ-24-0481","url":null,"abstract":"Background: The optimal duration of dual antiplatelet therapy (DAPT) in patients with chronic kidney disease undergoing percutaneous coronary intervention (PCI), especially with third-generation drug-eluting stents (DES), remains unknown.Methods and results: We conducted a prespecified post hoc analysis of the HOST-IDEA trial, randomizing patients undergoing PCI with third-generation DES to 3- to 6-month or 12-month DAPT. In all, 1,997 patients were grouped by their estimated glomerular filtration rate (eGFR): high (>90 mL/min/1.73 m2), intermediate (60-90 mL/min/1.73 m2), and low (<60 mL/min/1.73 m2). The primary outcome was net adverse clinical events (NACE), a composite of cardiac death, target vessel myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, or major bleeding (Bleeding Academic Research Consortium Type 3 or 5) at 12 months. Secondary outcomes were target lesion failure (TLF) and major bleeding. The low eGFR group had the highest rates of NACE, TLF, and major bleeding compared with the other 2 groups (P<0.001). Rates of NACE were similar in the 3- to 6-month and 12-month DAPT in the high (2.9% vs. 3.2%; P=0.84), intermediate (2.1% vs. 2.8%, P=0.51), and low (8.9% vs. 9.1%; hazard ratio 0.99; P=0.97; Pinteraction=0.88) eGFR groups. TLF and major bleeding events showed similar trends.Conclusions: In patients undergoing PCI with third-generation DES, 3- to 6-month DAPT was comparable to 12-month DAPT for clinical outcomes regardless of renal function.","PeriodicalId":50691,"journal":{"name":"Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0