Journal of the American Heart Association最新文献

{"title":"Expanding the Role of Drug-Coated Balloons in Contemporary Percutaneous Coronary Intervention: Start of the Next Revolution or Just One More Weapon in a Growing Arsenal?","authors":"Sandeep Nathan","doi":"10.1161/JAHA.125.042448","DOIUrl":"https://doi.org/10.1161/JAHA.125.042448","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042448"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of High Systolic Blood Pressure in the Eastern Mediterranean Region, 1990 to 2021: Results From the Global Burden of Disease Study 2021.","authors":"Malihe Rezaee, Mohammad-Mahdi Bastan, Alireza Yaghoobi, Amir Hossein Behnoush, Kaveh Hosseini","doi":"10.1161/JAHA.124.039158","DOIUrl":"https://doi.org/10.1161/JAHA.124.039158","url":null,"abstract":"<p><strong>Background: </strong>High systolic blood pressure (HSBP) is a significant public health issue, increasing the risk of various chronic and acute diseases. This study comprehensively analyzes the HSBP-attributed burden in the Eastern Mediterranean Region (EMR).</p><p><strong>Methods: </strong>We extracted and analyzed data on deaths, disability-adjusted life-years (DALYs), years of life lost, years lived with disability, and summary exposure values (SEVs) related to HSBP from the Global Burden of Disease (GBD) 2021 study for the EMR countries from 1990 to 2021.</p><p><strong>Results: </strong>In 2021, HSBP accounted for an estimated age-standardized death rate of 228.4 (95% UI: 189.6 to 266) and DALYs rate of 4554.9 (3719.7 to 5279.6) per 100,000 population in the EMR. From 1990 to 2021, there was a 12.7% and 14.1% decline in age-standardized death and DALYs rates linked to HSBP, respectively, with greater reduction among women. During this period, all countries except Pakistan and Libya experienced a decrease in age-standardized death and DALYs rates, and also countries with higher socio-demographic index (SDI) reported a lower burden attributable to HSBP in 2021. Despite the overall reduction in burden, age-standardized SEVs of HSBP increased by 21.3% (12.2% to 31.7%) from 1990 to 2021, with a more significant rise in men than in women.</p><p><strong>Conclusion: </strong>While the HSBP-attributed burden has decreased in the EMR from 1990 to 2021, the increasing trend in age-standardized SEVs indicates a rising exposure. Therefore, implementing effective strategies aimed at further reducing the burden and exposure values of HSBP in this region is essential.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e039158"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fitness First: How High-Intensity Interval Training Responses Shape Clinical Outcomes During a 15-Year Follow-Up Among Patients With Heart Failure.","authors":"Thomas G Bissen, Joseph D Vondrasek","doi":"10.1161/JAHA.125.042535","DOIUrl":"https://doi.org/10.1161/JAHA.125.042535","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042535"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Dapagliflozin in Patients With Systemic Right Ventricular Dysfunction: DAPA-SRV Trial.","authors":"Mathieu Albertini, Victor Waldmann, Pauline David, Alexis Barat, Antoine Legendre, Anne-Solene Chaussade, Laurence Iserin, Magalie Ladouceur","doi":"10.1161/JAHA.124.040302","DOIUrl":"https://doi.org/10.1161/JAHA.124.040302","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is the leading cause of death in adults with a systemic right ventricle (sRV). While dapagliflozin has proven benefits in patients with acquired heart diseases and heart failure with reduced ejection fraction, its impact remains unknown in patients with an sRV. We aimed to evaluate the safety and efficacy of dapagliflozin in this population.</p><p><strong>Methods: </strong>We conducted a prospective, observational, single-center study including symptomatic patients (New York Health Association [NYHA] functional class ≥2) with sRV dysfunction despite medical treatment, enrolled from February 2023 to February 2024. Patients were assessed at baseline and 3 and 6 months after dapagliflozin introduction. The primary end point was 6-Minute Walk Distance (6MWD). Secondary end points included N-terminal pro-B-type natriuretic peptide, quality of life (according to the Kansas City Cardiomyopathy Questionnaire-12-item version [KCCQ-12]), NYHA class, systemic and subpulmonary ventricular systolic function, and treatment-related side effects.</p><p><strong>Results: </strong>A total of 32 patients were included. The mean age of the participants was 48 years (range, 19-79 years), 20 (62%) patients were men, 12 (38%) had congenitally corrected transposition of the great arteries, and 20 (62%) had transposition of the great arteries with atrial switch. At 6 months, 6MWD significantly improved (585 m versus 558 m, <i>P</i>=0.04). Quality of life (91.5 versus 80.5, <i>P</i><0.001), sRV function (fractional area change: 33% versus 28% [<i>P</i>=0.02]; global longitudinal strain: -13.1% versus -11.2% [<i>P</i>=0.04]) also improved. No significant side effects were observed.</p><p><strong>Conclusions: </strong>This is the first study, to our knowledge, demonstrating the functional benefits and safety of dapagliflozin in symptomatic patients with sRV dysfunction under medical treatment with sacubitril/valsartan. These results support the need for larger randomized trials to further evaluate this therapeutic option in this population.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040302"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smooth Muscle Cell-Derived Fibronectin Promotes an Atheroprotective Smooth Muscle Cell Phenotype Associated With Altered NO-cGMP Signaling.","authors":"Susanne Feil, Maria T K Zaldivia, Jacek Kiesel, Malte Roessing, Andreas Peter, Daniel Morales-Cano, Jacob F Bentzon, Moritz Lehners, Robert Feil","doi":"10.1161/JAHA.124.040395","DOIUrl":"https://doi.org/10.1161/JAHA.124.040395","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease due to atherosclerosis is the leading cause of death worldwide. Recent studies revealed an important role of smooth muscle cell (SMC) phenotypic switching in atherogenesis. How the extracellular matrix affects SMC phenotype in atherosclerotic lesions is not well understood. Fibronectin (Fn1) is an abundant component of the extracellular matrix in plaques and has been linked to coronary artery disease risk in humans.</p><p><strong>Methods: </strong>We used mouse genetics combined with single-cell analyses, cell lineage tracing, and immunostaining of murine and human atherosclerotic lesions.</p><p><strong>Results: </strong>Genetic ablation of SMC-derived Fn1 in mice led to a decrease of alpha smooth muscle actin-positive cells in atherosclerotic lesions and a reduced collagen content in the fibrous cap indicative of decreased plaque stability. Plaques lacking SMC-derived Fn1 contained more modulated SMCs with relatively low collagen expression. Interestingly, a subset of the modulated SMCs showed high expression of NO-sensitive guanylyl cyclase (NO-GC). NO-GC is a major cGMP generator in SMCs and like Fn1 has been implicated in coronary artery disease. Fn1 knockout SMCs showed increased cell growth and activity of the NO-cGMP pathway. Expression of Fn1 and NO-GC was also detected in modulated SMCs of human atherosclerotic lesions.</p><p><strong>Conclusions: </strong>SMC-derived Fn1 promotes plaque stability through suppression of SMC phenotypes with low alpha smooth muscle actin and collagen expression. This atheroprotective effect might be mediated, at least in part, by a crosstalk between Fn1 and the NO-cGMP axis in SMCs. Our study identifies a mechanistic link between 2 coronary artery disease risk genes, Fn1 and NO-GC, which explains how the extracellular matrix regulates SMC phenotype and plaque stability.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040395"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Endothelial Alterations, Cardiac Function, and Outcomes From Health to Heart Failure: Insight From the STANISLAS, MEDIA-DHF, and BIOSTAT-CHF Cohorts.","authors":"Jeremy Lagrange, Mohammad Jahangiri, Guillaume Baudry, Nathalie Mercier, Luca Monzo, Zohra Lamiral, Kévin Duarte, Jozine M Ter Maaten, Faiez Zannad, Adriaan A Voors, Nicolas Girerd","doi":"10.1161/JAHA.124.040179","DOIUrl":"https://doi.org/10.1161/JAHA.124.040179","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) is a multifaceted syndrome, likely stemming from comorbidity-induced inflammation resulting in endothelial dysfunction. Endothelial glycocalyx degradation's role in the development and prognosis of HFpEF remains largely unexplored. Our study aimed at exploring the association between glycocalyx degradation and diastolic dysfunction and determining whether glycocalyx degradation can predict clinical outcomes in patients with HFpEF.</p><p><strong>Methods: </strong>Perlecan and thrombomodulin concentrations were assessed in individuals deemed healthy (STANISLAS [Suivi Temporaire Annuel Non-Invasif de la Santé des Lorrains Assurés Sociaux (Annual Noninvasive Temporary Monitoring of the Health of Insured Lorrainers)] cohort, n=1705) and patients with HFpEF (MEDIA-DHF [Metabolic Road to Diastolic Heart Failure], n=460 and BIOSTAT-CHF [Biology Study to Tailored Treatment in Chronic Heart Failure], n=556) to evaluate endothelial glycocalyx degradation.</p><p><strong>Results: </strong>In patients with HFpEF, perlecan but not thrombomodulin was increased compared with controls (<i>P</i><0.0001 versus <i>P</i>=0.73). In adjusted analysis, perlecan was associated with peak early mitral inflow velocity/peak early diastolic mitral annular velocity ratio and thrombomodulin with peak early diastolic mitral annular velocity in control individuals, whereas perlecan and thrombomodulin were associated with peak early mitral inflow velocity/peak early diastolic mitral annular velocity and left atrial volume index in patients with HFpEF (all <i>P</i><0.03). Perlecan was significantly associated with cardiovascular hospitalization and death in the MEDIA-DHF (adjusted hazard ratio [HR] for highest tertile versus first tertile, 2.44 [95% CI, 1.11-5.34]; <i>P</i>=0.026) and BIOSTAT-CHF cohorts (adjusted HR, 2.12 [95% CI, 1.49-3.03]; <i>P</i><0.0001). Thrombomodulin was associated with a worse outcome in BIOSTAT-CHF (<i>P</i>=0.004) but not in MEDIA-DHF.</p><p><strong>Conclusions: </strong>Higher circulating levels of the endothelial glycocalyx degradation biomarkers like perlecan and, to a lesser extent, thrombomodulin are associated with features of diastolic dysfunction in population and HFpEF settings and predict poor outcome in patients with HFpEF. These results suggest that glycocalyx degradation may be an early step in the pathological processes leading to HFpEF and gain further prognostic value in later stages (ie, overt HFpEF).</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov/; Unique identifiers: NCT01391442, https://clinicaltrials.gov/study/NCT01391442?cond=stanislas&rank=1; NCT02446327; URL: https://cordis.europa.eu; BIOSTAT-CHF ID: 242209.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040179"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Characteristics and Outcomes of Urgent/Emergent Versus Elective Aortic Valve Replacement.","authors":"Joseph E Ebinger, Aakriti Gupta, Tzu Yu Huang, Marcella A Kelley, Christin Thompson, Maria Platanis, Susan Cheng","doi":"10.1161/JAHA.125.041148","DOIUrl":"https://doi.org/10.1161/JAHA.125.041148","url":null,"abstract":"<p><strong>Background: </strong>Despite the slowly progressive nature of aortic stenosis, a proportion of aortic valve replacements (AVRs) still occur on an urgent/emergent basis. We sought to characterize the predictors, outcomes, and potential opportunities to prevent urgent/emergent AVRs.</p><p><strong>Methods: </strong>We analyzed Medicare data to identify patients undergoing AVRs from 2017 to 2022. We used multivariable regression to identify factors associated with nonelective AVRs; we also examined the association of nonelective AVRs with clinical outcomes and health care costs.</p><p><strong>Results: </strong>In total, 15 305 patients (16% urgent/emergent) underwent AVR during the study period. Compared with patients undergoing elective AVRs, those receiving urgent/emergent AVRs were more frequently of Black race or Hispanic ethnicity, and less likely to have received a diagnosis of aortic stenosis, despite 91.7% having seen a cardiologist or primary care provider in the prior year. In multivariable-adjusted analyses, dual Medicare-Medicaid enrollment, male sex, and recent heart failure hospitalization were associated with increased risk for urgent/emergent AVR; conversely, recent aortic stenosis diagnosis and cardiologist visit were associated with lower odds of urgent/emergent AVR. In turn, urgent/emergent compared with elective AVR increased risk for in-hospital death, intensive care unit admission, and discharge to a facility versus home, in addition to longer lengths of stay and higher health care costs.</p><p><strong>Conclusions: </strong>Urgent/emergent AVR occurs more frequently among Black, Hispanic, and dual Medicare-Medicaid-eligible patients. Nonelective AVR is also associated with worse hospital outcomes as well as greater health care costs. Importantly, variable timing in diagnosis of aortic stenosis appears to be a key determinant; thus, augmented screening efforts may improve outcomes and reduce disparities.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041148"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous Exercise Responses to High-Intensity Interval Training Are Associated With Varied Long-Term Cardiovascular Outcomes in Patients With Heart Failure: A 15-Year Follow-Up.","authors":"Tieh-Cheng Fu, Shu-Chun Huang, Shin-Sheng Yuan, Chao-Hung Wang, Jong-Shyan Wang, Wen-Chung Tsai, Wen-Jin Cherng, Yu-Chiau Shyu, Chih-Chin Hsu","doi":"10.1161/JAHA.124.040330","DOIUrl":"https://doi.org/10.1161/JAHA.124.040330","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study investigated exercise response heterogeneity and its mediating role in survival for patients with heart failure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and results: &lt;/strong&gt;We conducted a retrospective cohort study by examining the registry satabase in 3 institutes from 2009 to 2024. All 182 included patients with heart failure completed 36 sessions of high-intensity interval training (HIIT) at alternating intensities of 80% and 40% peak oxygen consumption (&lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;&lt;sub&gt;o&lt;/sub&gt;&lt;sub&gt;2peak&lt;/sub&gt;). Based on the improvement of &lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt; (Δ&lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt;=post-HIIT &lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt;-baseline &lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt;), they were classified as responders (Δ&lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt;&gt;0) or nonresponders (Δ&lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt; ≤0). The end points were the long-term survivals and readmissions for them. The prevalence of nonresponders was 21% (39/182). Responders (n=143) showed significant improvement of oxygen uptake efficiency slope, arteriovenous oxygen difference and skeletal muscle mass after HIIT. The above physiological adaptations in responders were significantly greater than in nonresponders. The 14-year cardiovascular event-free survival was significantly better in responders (91.3%) than nonresponders (76.8%). Higher &lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt; was a protective factor for cardiovascular death (adjusted hazard ratio [aHR], 0.411 [95% CI, 0.172-0.985]; &lt;i&gt;P&lt;/i&gt;=0.046). Male sex (aHR, 0.320 [95% CI, 0.136-0.757]; &lt;i&gt;P&lt;/i&gt;=0.009) and higher oxygen uptake efficiency slope (aHR, 0.995 [95% CI, 0.992-0.998]; &lt;i&gt;P&lt;/i&gt;=0.005) were protective factors against cardiovascular readmissions. Causal mediation analysis revealed that &lt;math&gt;&lt;semantics&gt;&lt;mrow&gt;&lt;mover&gt;&lt;mtext&gt;V&lt;/mtext&gt;&lt;mo&gt;˙&lt;/mo&gt;&lt;/mover&gt;&lt;/mrow&gt;&lt;annotation&gt;$$ dot{mathrm{V}} $$&lt;/annotation&gt;&lt;/semantics&gt;&lt;/math&gt;o&lt;sub&gt;2peak&lt;/sub&gt; mediated the association between HIIT and all-cause death, while heart rate reserve mediated HIIT effects on cardiovascular","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040330"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful or Uncomplicated Use of Drug-Coated Balloon Versus Drug-Eluting Stent Strategies for De Novo Culprit Lesions in Acute Coronary Syndromes: Insights from a Nationwide Registry in Japan.","authors":"Tomonori Takahashi, Kyohei Yamaji, Shun Kohsaka, Hideki Ishii, Yuichiro Mori, Yuetsu Kikuta, Tetsuzo Wakatsuki, Koji Yamaguchi, Daisuke Nishioka, Kenya Kusunose, Tetsuya Amano, Masataka Sata, Ken Kozuma","doi":"10.1161/JAHA.124.038071","DOIUrl":"https://doi.org/10.1161/JAHA.124.038071","url":null,"abstract":"<p><strong>Background: </strong>Randomized trials demonstrated that drug-coated balloon (DCB) was not inferior to drug-eluting stent (DES) for acute coronary syndrome (ACS). However, generalizability in clinical settings remains unclear. The present study compared the outcomes of DCB and DES strategies in percutaneous coronary intervention for ACS within a nationwide procedure-based registry.</p><p><strong>Methods and results: </strong>This was a retrospective analysis of a cohort study from a prospective, nationwide registry between January 2017 and December 2020 in Japan, focusing on patients with ACS who underwent DCB or DES for a single de novo lesion. Patients who required bailout stenting after treatment with DCB were excluded from the analysis. The 1-year incidence of all-cause mortality, cardiovascular death, noncardiovascular death, nonfatal ACS, stroke, and major bleeding events was compared. A subgroup analysis included lesion-based and ST-elevation myocardial infarction/non-ST-elevation ACS stratifications. Among 5212 propensity score-matched patients with ACS, no significant differences were observed in the 1-year incidence of all-cause mortality (4.5% versus 4.6%, hazard ratio [HR], 0.92 [95% CI, 0.72-1.19]); cardiovascular death (2.5% versus 2.5%, HR, 0.90 [95% CI, 0.64-1.26]); noncardiovascular death (2.0% versus 2.1%, HR, 0.96 [95% CI, 0.65-1.42]); or nonfatal ACS (1.7% versus 2.0%, HR, 1.04 [95% CI, 0.70-1.54]) between DCB and DES. DCB was associated with a higher incidence of stroke (0.8% versus 0.3%, HR, 2.33 [95% CI, 1.06-5.08]) and lower incidence of major bleeding events (1.4% versus 2.3%, HR, 0.65 [95% CI, 0.43-0.99]); however, these results were not reproduced in the subgroup analysis.</p><p><strong>Conclusions: </strong>The DCB strategy for successfully treated ACS cases achieved similar clinical outcomes to DES after 1 year. Further studies with an extended follow-up are needed to confirm these results.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038071"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-Glucose Cotransporter 2 Inhibitors in Patients With Systemic Right Ventricles: Incrementally Building the Evidence Base.","authors":"William H Marshall, Curt J Daniels","doi":"10.1161/JAHA.125.043096","DOIUrl":"https://doi.org/10.1161/JAHA.125.043096","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e043096"},"PeriodicalIF":5.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}