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

{"title":"Beyond weight loss in hypertrophic cardiomyopathy: metabolic therapy and the evolving treatment paradigm.","authors":"Priyanka Boettger, Samuel Sossalla","doi":"10.1093/ehjqcco/qcag064","DOIUrl":"10.1093/ehjqcco/qcag064","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"740-742"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795410","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":"Atrial fibrillation and risk of myocardial infarction by sex and time since diagnosis. The Tromsø Study 1994-2021.","authors":"Linn Nilsen, Ekaterina Sharashova, Maja-Lisa Løchen, Jan T Mannsverk, Tom Wilsgaard","doi":"10.1093/ehjqcco/qcag039","DOIUrl":"10.1093/ehjqcco/qcag039","url":null,"abstract":"<p><strong>Aims: </strong>The relationship between atrial fibrillation (AF) and myocardial infarction (MI) remain unclear. We aimed to examine the sex-specific risk of MI, ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI) in participants with AF, overall and by time since AF diagnosis.</p><p><strong>Methods and results: </strong>We followed 25 132 participants (53% women) from the Tromsø Study (1994-95) without AF and MI at baseline through 2021. Cox proportional- and Fine-Gray sub-distribution-hazard regression assessed AF as a risk factor for MI, STEMI and NSTEMI overall and by time since AF diagnosis (0 to <0.5, 0.5 to <1, 1 to <5, 5 to <10 and ≥10 years). During follow-up, 115 women and 124 men experienced incident AF and subsequent MI. AF was associated with increased hazard of MI in women (sub-distribution hazard ratio [sHR] 1.39, 95% confidence interval [CI] 1.12-1.72), but not in men. In women, the hazard of MI increased 1-10 + years since AF, peaking at ≥10 years (sHR 1.75, 95% CI 1.07-2.84). In men, hazard was increased within the first six months (sHR 2.27, 95% CI 1.45-3.54) but not thereafter. STEMI hazard was increased only in men within six months. NSTEMI hazard was elevated in women 1-10 + years since AF and in men within the first year.</p><p><strong>Conclusion: </strong>AF is a risk factor for MI in both sexes, but risk patterns differ. Women are at increased hazard of NSTEMI 1-10 + years since AF, while men are at increased hazard of STEMI within six months and NSTEMI within the first year.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"792-801"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795400","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}

{"title":"Cost-effectiveness of the ABCStroke pathway in ischaemic stroke care: a UK pilot analysis.","authors":"Borislav Borissov, Dimitrios Sagris, Jacopo Imberti, Anna Podlasek, Mondher Toumi, Renate B Schnabel, Dimitrios N Nikas, George Ntaios, Konstantinos Vemmos, Nikola Kozhuharov, Gregory Y H Lip","doi":"10.1093/ehjqcco/qcaf157","DOIUrl":"10.1093/ehjqcco/qcaf157","url":null,"abstract":"<p><strong>Aims: </strong>The ABCStroke pathway is a structured, person-centred approach to post-stroke care encompassing antithrombotic therapy, functional and psychological optimization, and cardiovascular risk factor management, proposed by the European Society of Cardiology Council on Stroke. Adherence to the pathway has been associated with improved outcomes in observational studies, but its cost-effectiveness remains unknown. We evaluated the long-term cost-effectiveness of the ABCStroke pathway in the UK.</p><p><strong>Methods and results: </strong>A Markov model was developed to simulate lifetime costs and outcomes of patients following an ischaemic stroke, using clinical data from the Athens Stroke Registry and UK-specific cost and utility inputs from the Oxford Vascular Study. Patients were stratified by adherence to all three ABCStroke pathway components vs. non-adherence. Over a 20-year horizon, pathway-aligned/adherent care was associated with higher costs (£129 143 vs. £71 472) and greater quality-adjusted life years (QALYs; 9.84 vs. 5.94), yielding an incremental cost-effectiveness ratio (ICER) of £14 804 per QALY gained. At a willingness-to-pay threshold of £25 000 per QALY, the net monetary benefit of the ABCStroke pathway was £116,857, compared with £77 028 for non-aligned care, indicating a net gain of £39 829 in favour of the ABC-aligned strategy. Deterministic sensitivity analyses showed the ICER remained below £16 000 per QALY across plausible parameter ranges. Even assuming a 100-fold increase in pathway implementation costs, the strategy remained within or near the lower boundary of the UK National Institute for Health and Care Excellence willingness-to-pay threshold.</p><p><strong>Conclusion: </strong>In the UK, implementation of the ABCStroke pathway is cost-effective. These findings support strategic investment in structured, multidisciplinary integrated care for stroke survivors.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"825-832"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021197","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}

{"title":"Mind the missed-fibrinolysis gap.","authors":"Joan Siquier-Padilla, Vicente Peral Disdier, Xavier Rossello","doi":"10.1093/ehjqcco/qcag057","DOIUrl":"10.1093/ehjqcco/qcag057","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"780-781"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611684","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":"Bridging the cardio-psychiatric divide in the era of COVID-19: a critical appraisal of post-MI outcomes in patients with mental disorders.","authors":"Hengyuan Zhang, Lingyue Sun","doi":"10.1093/ehjqcco/qcag087","DOIUrl":"10.1093/ehjqcco/qcag087","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"849-851"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978492","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":"Validation of the European SCORE2 algorithm in one European and one Latin-American cohort studies with contrasting populations.","authors":"Ko Ko Maung, Eirini Trichia, Henrique Barros, Vlada Hanchar, Jesus Alegre-Díaz, Jaime Berumen, Pablo Kuri-Morales, Roberto Tapia-Conyer, Louisa Gnatiuc Friedrichs, Pedro Marques-Vidal","doi":"10.1093/ehjqcco/qcag009","DOIUrl":"10.1093/ehjqcco/qcag009","url":null,"abstract":"<p><strong>Aims: </strong>SCORE2 estimates the 10-year risk of developing non-fatal and fatal cardiovascular disease (CVD), and it was designed for mostly Europeans. However, its transferability to non-European populations has not been extensively studied. The aim of this study was to evaluate the performance of the SCORE2 in ethnically and socioeconomically diverse populations, including those outside of Europe.</p><p><strong>Methods and results: </strong>We leveraged cohort studies from Mexico (N = 95,660, mean age 52.4 years, 32.6% men, mean follow-up 9.7 years), and Portugal (N = 1,216, 52.9 years, 36.9% men, 8.8 years follow-up). SCORE2 has differentially classified frequency of CVD events across levels of risk severity, ranging from 0.7-1.0% CVD events among those with low-moderate risk-profiles, vs. 6.6-9.0% among those with high risk-profiles, respectively. The area under the receiver operating curve (AROC) was 0.762 in Mexico and 0.718 in Portugal. Sensitivities (95% CI) were 85.7 (84.2-87.2) and 95.0 (86.1-99.0), and specificities were 42.8 (42.5-43.1) and 24.3 (21.9-26.9) for Mexico and Portugal, respectively. In all cases, the positive predictive values were below 7%, whereas the negative predictive values were all above 98%. Harrell's C were 0.717 and 0.692, and Brier's scores were 0.022 and 0.052 for Mexico and Portugal, respectively. In Mexico, SCORE2 showed good calibration, with a slight overestimation in the higher-risk categories. In Portugal, overestimation in higher-risk categories was more substantial.</p><p><strong>Conclusion: </strong>SCORE2 estimates modest to acceptable performance for predicting the 10-year CVD in Mexicans but performed less favourably in the Portuguese cohort, indicating a need for recalibration.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"863-871"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069398","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}

{"title":"Mitral valve prolapse: incidence and prognosis related to serum levels of sex hormone-binding globulin.","authors":"Zhaolin Fu, Zhennan Lin, Qiang Li, Xunan Guo, Xinmin Liu, Kaiyang Lin, Guangyuan Song","doi":"10.1093/ehjqcco/qcaf156","DOIUrl":"10.1093/ehjqcco/qcaf156","url":null,"abstract":"<p><strong>Aims: </strong>Mitral valve prolapse (MVP) is common, with higher prevalence in women. We hypothesized that sex hormones and regulatory protein sex hormone binding globulin (SHBG) play a pivotal role in development and prognosis of MVP.</p><p><strong>Methods and results: </strong>We prospectively study 472 178 participants in the UK Biobank. Univariable and multivariable regression analyses estimated associations of SHBG and sex hormones (including testosterone and oestradiol) with incidence and prognosis of MVP, and differences between sexes. Mendelian randomization (MR) further assessed the causal relationship between SHBG and MVP. Out of 472 178 participants, 970 patients without a baseline MVP diagnosis developed MVP over a median follow-up of 13.67 years. Serum SHBG and testosterone were positively associated with MVP incidence. In the multivariable model adjusted for confounders, SHBG remained significantly associated with MVP risk [hazard ratio (HR) = 1.440, 95% confidence interval (CI): 1.201-1.726]. Compared to individuals with the lowest quintile of SHBG level, those in the second, third, and fourth quintiles had an 8.1, 39.1, and 49.3% higher risk of incident MVP. The association between SHBG and incident MVP was consistent across sexes (P for interaction = 0.4434). Elevated SHBG level was also significantly associated with all-cause mortality (HR = 2.223, 95% CI: 1.430-3.457) in MVP patients. One-sample and two-sample MR using European ancestry GWAS data supported a causal relationship between genetically predicted SHBG levels and increased MVP risk in both females and males.</p><p><strong>Conclusion: </strong>Elevated serum SHBG levels are associated with increased risk and adverse prognosis of MVP, providing insights into sex-related differences, risk stratification, and potential therapeutic targets.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"805-815"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770527","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":"Evaluating TAVI quality indicators: critical insights from the SWEDEHEART experience and future directions.","authors":"Weikai Dong, Meng Liu, Qifeng Song","doi":"10.1093/ehjqcco/qcag043","DOIUrl":"10.1093/ehjqcco/qcag043","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"883"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470793","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":"Low fear, high fallout: employment-centred lessons from ICD driving restrictions.","authors":"Yangjuan Xi, Yan Liu, Rong Li","doi":"10.1093/ehjqcco/qcag006","DOIUrl":"10.1093/ehjqcco/qcag006","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"887"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055895","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":"Method validation of cardiopulmonary exercise testing: intra- and inter-device comparisons across four metabolic carts.","authors":"Robin Willixhofer, Marlus Karsten, Arianna Galotta, Elisabetta Salvioni, Carlo Vignati, Alice Bonomi, Anna Apostolo, Mauro Contini, Pietro Palermo, Jeness Campodonico, Beatrice Pezzuto, Stefania Farina, Massimo Mapelli, Irene Mattavelli, Piergiuseppe Agostoni","doi":"10.1093/ehjqcco/qcag036","DOIUrl":"10.1093/ehjqcco/qcag036","url":null,"abstract":"<p><strong>Aims: </strong>Cardiopulmonary exercise testing (CPET) is the gold standard for assessing exertional dyspnoea, providing peak oxygen uptake (VO2), and the VE/VCO2 slope. Different metabolic carts, may introduce systematic variability, confounding longitudinal assessments and multicentre trials.We evaluated intra-device reliability and inter-device comparability of CPET parameters.</p><p><strong>Methods and results: </strong>In this prospective, single-centre, within-subject, repeated-measures, multi-device comparison study 34 healthy adults (35 ± 11 years; 59% males) completed eight CPETs: two per cart, on four systems (MGC Ultima™ CPX, COSMED Quark CPET™, Schiller PowerCube® Ergo, Vyaire Vyntus™ CPX). Tests used randomized order, ramp protocols on cycle ergometer, and standardized calibration, masks, and timing (2-10 days apart; within 40 days). Breath by breath data were 10-second averaged. Analyses included paired tests for intra-device reliability, repeated-measures ANOVA for inter-device comparisons, and iso-workload evaluation at 25-100% of lowest peak workload (ISO-Wpeak). Intra-device reliability was high, with no significant differences in VO2, heart rate or workload at anaerobic threshold (AT), respiratory compensation point (RCP) or peak. Minor variances occurred in resting VO2 (COSMED: 56 mL/min, P = 0.0427) and peak ventilation (Medical Graphic 9 L/min, P < 0.05). Inter-device comparability showed no differences in peak VO2 and the VE/VCO2 slope calculated up to the RCP. The VE/VCO2 slope assessed as the full slope however, showed significant differences between machines (P = 0.0048). Across standardized ISO-Wpeak (25%, 50%, 75%, and 100% of ISO-Wpeak), VO2 values were largely comparable between devices, with significant differences only for VO2 (mL/kg/min) at 25% ISO-Wpeak (P = 0.022).</p><p><strong>Conclusion: </strong>Under standardized conditions, the tested metabolic carts yield comparable values both for intra-device reliability and inter-device comparability.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"753-764"},"PeriodicalIF":4.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370815","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}