European heart journal. Quality of care & clinical outcomes最新文献

{"title":"The complexity of congestion in heart failure: a critical review of the evidence and a proposal for a multimodality approach.","authors":"Alberto Palazzuoli, Nicolas Girerd, Massimo Piepoli, Andrew P Ambrosy, Guillaume Baudry, Juan Carlos Lopez-Azor, Mateusz Guzik, Òscar Miró, Jeroen Dauw, Gracian Iwanek, Peder Myhre, Marta Cobo Marcos, Masatake Kobayashi, Jan Biegus","doi":"10.1093/ehjqcco/qcag149","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag149","url":null,"abstract":"<p><p>Congestion remains the first cause of hospitalization in acute heart failure patients, and it is the primary goal of treatment during early phases of hospitalization. Despite its clinical relevance, a universal algorithm for quantification or characterization is lacking. Indeed, congestion has been differently evaluated across several studies in terms of timing checks and diagnostic methods. Recent analyses have highlighted the importance of differentiating between intravascular and tissue congestion. Although it is associated with haemodynamic dysfunction, extravascular congestion may occur even in the absence of overt intravascular fluid overload. Importantly, tissue congestion is not merely a reflection of intravascular volume expansion. In this framework, the interstitial space surrounding the capillary barrier and its integrity may be accounted as additive drivers for tissue congestion. In clinical practice, this distinction remains anchored in simplistic clinical assessment, and poorly evaluated. A critical review of the evidences has been performed and multimodal approaches combining ultrasonography, invasive measurements, and biomarkers have been proposed.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225666","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":"Correction to: Advanced maternal age at first delivery as a risk factor for long-term cardiovascular disease.","authors":"","doi":"10.1093/ehjqcco/qcag152","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag152","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140361","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":"Associations of Life's Essential 10 with Mortality and Healthspan Free of Cardiovascular Disease and Cancer: Findings in Two Nationwide Cohorts.","authors":"Yaoshan Dun, Liwen He, Randal J Thomas, Feiran Yang, Qing Ye, Ray W Squires, Thomas P Olson, Jeffrey W Ripley-Gonzalez, Irene Xin Yin Wu, Suixin Liu","doi":"10.1093/ehjqcco/qcag151","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag151","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate associations of cardiovascular health (CVH) based on Life's Essential 10 (LE10) with all-cause mortality, cardiovascular disease (CVD) and cancer mortality and incidence, and life expectancy free of CVD and cancer.</p><p><strong>Methods and results: </strong>This prospective study included 110,806 UK Biobank participants (aged 37-73) and 20,031 National Health and Nutrition Examination Survey (NHANES) participants (aged ≥20). LE10 (0-100), which integrates alcohol consumption and mental health with Life's Essential 8, categorised CVH as low (<60), moderate (60-79), and high (≥80). Cox regression and competing risk models were applied to estimate adjusted hazard ratios (aHRs). Life expectancy was calculated using multi-state and flexible parametric survival models. Over a median follow-up of 13.8 years, 6137 deaths, 13,968 CVD events, and 18,077 cancer cases were documented in UK Biobank. In UK Biobank, high CVH was associated with lower risks of all-cause mortality (men: aHR 0.43, 95% CI 0.39-0.48; women: aHR 0.34, 95% CI 0.29-0.39), alongside CVD and cancer mortality and incidence, compared to low CVH. At age 50, high CVH conferred greater projected overall (men +5.47 years, women +5.85) and disease-free life expectancy (men +4.02 years, women +4.40). Having more low-risk CVH metrics was associated with up to 9.73 years of projected gains in life expectancy. Associations were replicated and consistent in 7.2-year NHANES follow-up.</p><p><strong>Conclusion: </strong>Higher LE10-based CVH levels were associated with lower all-cause mortality, reduced CVD and cancer mortality and incidence, and longer life expectancy free of CVD and cancer. LE10 may provide additional targets for CVH management.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122711","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 cardiovascular disease knowledge, risk perception, and preventive care prior to first myocardial infarction.","authors":"Virginia De Martin Topranin, Gunhild Brørs, Julie C Sæther, Elisabeth K Vesterbekkmo, Eva Gerdts, Siri Vangen, Anja Bye","doi":"10.1093/ehjqcco/qcag146","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag146","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to investigate sex differences in cardiovascular disease knowledge, risk perception, and preventive care prior to first myocardial infarction (MI).</p><p><strong>Methods: </strong>The study adopted a cross-sectional design. Using a web-based solution, 1628 Norwegian individuals who experienced a first-ever MI in 2024, mean (SD) age 64.1 (10.0) years, of which 25.4% women, completed the Norwegian ABCD Risk Questionnaire along with a de novo questionnaire. Sex differences were tested using linear regression for total scale scores, logistic regression for binary variables, and ordinal logistic regression for categorical variables.</p><p><strong>Results: </strong>On the ABCD Risk Questionnaire, women scored lower than men on risk perception (B = -0.50, 95% CI = -0.87 to -0.13) and higher on healthy eating attitude (B = 0.68, 95% CI = 0.34 to 1.02). On the de novo questionnaire, MI knowledge was low in both women and men, but women could identify significantly more MI risk factors (B = 0.52, 95% CI = 0.02 to 1.01) and symptoms (B = 1.20, 95% CI = 0.88 to 1.51) than men. Women were less likely than men to report previous MI risk assessment, including smoking status (OR = 0.54, 95% CI = 0.41 to 0.71). Women were also less likely than men to report receipt of lifestyle advice to prevent MI (OR = 2.29, 95% CI = 1.71 to 3.06).</p><p><strong>Conclusion: </strong>Cardiovascular knowledge and risk perception were poor among Norwegian individuals prior to MI, with indication that women had better knowledge but poorer risk perception than men. Substantial gaps in self-reported preventive care were identified, particularly among women. Sex-specific strategies are spoken for to improve cardiovascular awareness at both individual and clinical level.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032942","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":"Temporal trends in sociodemographic and risk factors among patients enrolled in cardiovascular rehabilitation over 25 years.","authors":"Matheus Hausen, Ariany Marques Vieira, Jennifer Harris, Carley D O'Neill, Karen Bouchard, Heather Tulloch, Jodi D Edwards, David Birnie, Hassan Mir, Rod S Taylor, Barry Franklin, Andrew L Pipe, Jennifer L Reed","doi":"10.1093/ehjqcco/qcag150","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag150","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to assess the temporal trends in sociodemographic characteristics, cardiometabolic risk factors, and health behaviours among patients enrolled in cardiovascular rehabilitation (CR) between 2001 and 2025.</p><p><strong>Methods: </strong>A retrospective cohort study of patients with cardiovascular diseases who enrolled in a CR program at Canada's largest cardiovascular health centre between 2001 and 2025. Baseline measures included sociodemographic variables, cardiometabolic risk factors, physical activity, smoking status, nutritional profile, and mental health factors.</p><p><strong>Results: </strong>Among 40,822 participants (mean (SD) age, 63 (13) years; 30.7% females; 59.5% with coronary artery disease), sociodemographic diversity significantly increased over the two decades. A significant temporal trend toward older age with participant age increasing by 0.3 years annually (p < 0.001). Participants also had progressively greater odds of being female (OR=1.004; 95% CI: 1.001-1.008; p = 0.02), non-White (OR=1.02; 95% CI: 1.01-1.03; p < 0.001) and not married (OR=1.02; 95% CI: 1.02-1.03; p < 0.001), while the odds of being occupationally inactive decreased over time (OR=0.95; 95% CI: 0.94-0.96; p < 0.001). Atherosclerotic coronary artery disease was the predominant cardiovascular condition (59%), followed by valvular heart disease (14%) and arrhythmias (10%). Significant annual decreases were observed in systolic blood pressure (-0.37; 95% CI: -0.41 - -0.33; p < 0.001) and LDL cholesterol (-0.02; 95% CI: -0.02 - -0.02; p < 0.001). The odds of low moderate-to-vigorous physical activity (OR=0.98; 95% CI: 0.98-0.99; p < 0.001) and moderate-to-high anxiety symptoms (OR=0.98; 95% CI: 0.98-0.99; p < 0.001) also declined over time.</p><p><strong>Conclusion: </strong>Despite encouraging trends toward greater diversity, females, non-White individuals, and those with lower educational attainment remain underrepresented in CR, highlighting persistent equity gaps in enrollment. Additionally, encouraging improvements were observed in key cardiometabolic and behavioural risk factors, including lower blood pressure and LDL cholesterol levels, reduced physical inactivity, and fewer anxiety symptoms.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042710","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":"Disparities in Invasive Coronary Diagnostics and Revascularization Across the ESC EuroAsia Region: A Cross-Sectional Rapid Communication.","authors":"Hamlet Hayrapetyan, Khurshid Fozilov, Rusudan Agladze, Yusupova Hafiza Furkatovna, Marine Sargsyan, Yasmin Rustamova, Jacek Bil, Cecilia Linde, Thomas Luscher, Robert Gil","doi":"10.1093/ehjqcco/qcag147","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag147","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019559","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":"Mortality risk in multivessel CAD - contemporary assessment of the SYNTAX Score.","authors":"Felix Wollmann, Brian A Bergmark, Paul M Haller","doi":"10.1093/ehjqcco/qcag148","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag148","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019496","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":"Care Gaps Following Newly Detected Dipstick Proteinuria in Treated Hypertension: A Japanese Nationwide Database Study.","authors":"Koya Nagase, Takahiro Imaizumi, Yuko Asano, Kenta Mitsubayashi, Nobuhiro Nishibori, Takaya Ozeki, Yoshihiro Nakamura, Masaki Okazaki, Shimon Kurasawa, Tsuyoshi Watanabe, Kazuhiro Furuhashi, Shoichi Maruyama","doi":"10.1093/ehjqcco/qcag144","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag144","url":null,"abstract":"<p><strong>Aims: </strong>Clinical guidelines recommend follow-up quantitative testing after dipstick-positive proteinuria and, when proteinuria is confirmed, subsequent initiation of renin-angiotensin system inhibitors (RASi) in patients with hypertension. However, real-world adherence to these recommendations remains unclear. We investigated management patterns following newly detected dipstick proteinuria in patients with treated hypertension.</p><p><strong>Methods: </strong>Using the JMDC claims database, we identified treated hypertensive patients with newly detected dipstick proteinuria (≥1+, with prior results <1+) between January 2005 and March 2025. The study outcomes were quantitative urine albumin/protein testing and RASi initiation. Cumulative incidence was estimated using the Kaplan-Meier method, and multivariable Cox models were used to identify factors associated with outcomes.</p><p><strong>Results: </strong>The 365-day cumulative incidence of quantitative testing was 7.5% (95% CI: 7.2-7.7) in the overall population (n = 47,210), and that of RASi initiation was 13.2% (95% CI: 12.6-13.8) among baseline RASi non-users (n = 14,599). Both outcomes became more frequent with increasing dipstick grade but remained infrequent in the higher-grade groups: among patients with 2+ and 3+ proteinuria, quantitative testing was performed in 12.9% and 16.1%, respectively, and RASi initiation occurred in 17.5% and 21.7%, respectively. Temporal trend analysis indicated that RASi initiation rates showed no improvement (aHR per year: 1.01; 95% CI: 0.99-1.03).</p><p><strong>Conclusion: </strong>Follow-up quantitative testing and RASi initiation after newly detected dipstick proteinuria were infrequent, even among patients with higher dipstick grades, and RASi initiation showed no clear improvement over time. These findings highlight opportunities to improve guideline-concordant urinary protein assessment and antihypertensive therapy.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003186","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":"Pharmacological therapies and clinical outcomes.","authors":"Gianluigi Guida, Massimo Piepoli","doi":"10.1093/ehjqcco/qcag127","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag127","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":"12 6","pages":"889-890"},"PeriodicalIF":4.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978855","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":"Anti-obesity medications in adults with congenital heart disease: a comprehensive review and expert clinical recommendations.","authors":"Panagiota Mitropoulou, Katja Prokšelj, Andrej Janež, Fernando Riesgo Gil, Suman Verma, Ivana Jurić, Vladimiro Vida, Michael A Gatzoulis, Margarita Brida","doi":"10.1093/ehjqcco/qcag067","DOIUrl":"10.1093/ehjqcco/qcag067","url":null,"abstract":"<p><p>Overweight and obesity are recognized as a public health crisis and considered a global pandemic. In adults with congenital heart disease (ACHD) it is also considered a growing menace affecting up to half of this population. In ACHD, the negative impact of obesity on cardiovascular outcomes is likely amplified by already present underlying structural and physiological cardiac abnormalities, further increasing the risk of heart failure, arrhythmias, and other cardiovascular complications. As a potentially reversible risk factor, obesity represents a clear target for improving outcomes in this already vulnerable population. While lifestyle interventions remain foundational, the use of anti-obesity medications has expanded rapidly, though evidence in ACHD remains scarce. In this state-of-the-art review, informed by a comprehensive 30-year literature overview and the expertise of an international, multidisciplinary authorship, we provide clinically practical recommendations for the judicious use of anti-obesity therapies in ACHD. This document aims to guide clinicians in real-world decision-making and serve as a foundation for future research at the intersection of obesity and congenital heart disease.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"927-946"},"PeriodicalIF":4.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}