Journal of the American Heart Association最新文献

{"title":"Heart Disease Mortality in the United States, 1970 to 2022.","authors":"Sara J King, Tenzin Yeshi Wangdak Yuthok, Adrian M Bacong, Abha Khandelwal, Dhruv S Kazi, Michael E Mussolino, Sally S Wong, Seth S Martin, Eldrin F Lewis, Fatima Rodriguez, Latha P Palaniappan","doi":"10.1161/JAHA.124.038644","DOIUrl":"https://doi.org/10.1161/JAHA.124.038644","url":null,"abstract":"<p><strong>Background: </strong>Studying trends in mortality is essential to advance understanding of population health. Further evaluation of long-term heart disease mortality trends and subtypes in the United States is needed to guide public health and clinical interventions.</p><p><strong>Methods: </strong>This study used the National Vital Statistics System Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data for adults aged 25 years and older in the United States from 1970 to 2022. Outcomes included absolute number and age-adjusted mortality of total heart disease, ischemic heart disease, and other heart disease subtypes.</p><p><strong>Results: </strong>From 1970 to 2022, overall age-adjusted heart disease mortality decreased by 66% from 1970 to 2022 (from 761 to 258 per 100 000). In 1970, 91% of all heart disease deaths were ischemic, declining to 53% of all heart disease deaths in 2022. From 1970 to 2022, age-adjusted mortality decreased by 89% for acute myocardial infarction (from 354 to 40 per 100 000) and 81% for all ischemic heart disease (from 693 to 135 per 100 00). In contrast, from 1970 to 2022 age-adjusted mortality for other heart disease subtypes increased by 81% (from 68 to 123 per 100 000), with the greatest increases in heart failure (146% increase), hypertensive heart disease (106% increase) and arrhythmias (450% increase).</p><p><strong>Conclusions: </strong>Heart disease mortality has decreased over the past 5 decades. There is an increasing burden of mortality from other heart conditions including heart failure, hypertensive heart disease, and arrhythmias. Further efforts must be undertaken to address the growing challenge of these other heart conditions.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e038644"},"PeriodicalIF":5.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487116","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":"Valvular Endothelial Cell Heterogeneity Reflects Different Pathogenesis of Tricuspid and Bicuspid Aortic Valve Stenosis in Humans.","authors":"Adrian Brandtner, Alexander Brückner, Wilhelm Röll, Farhad Bakhtiary, Bernd K Fleischmann, Daniela Wenzel","doi":"10.1161/JAHA.124.040556","DOIUrl":"https://doi.org/10.1161/JAHA.124.040556","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040556"},"PeriodicalIF":5.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487117","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":"Thirty-Year Prevalence of Spontaneous Hemoptysis in Palliated Single Ventricle Circulation.","authors":"Anna K Dibbs, Liyun Zhang, Amy Y Pan, Andrew D Spearman","doi":"10.1161/JAHA.124.040713","DOIUrl":"https://doi.org/10.1161/JAHA.124.040713","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous hemoptysis is a well-recognized risk of palliated single ventricle circulation, yet published literature is limited to case reports and small case series. In this study, we sought to determine the long-term prevalence of spontaneous hemoptysis among patients with palliated single ventricle circulation at a single institution. Secondarily, we sought to characterize the clinical outcomes after spontaneous hemoptysis.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients with a history of Glenn or Fontan palliation seen from January 1, 1990 to January 21, 2023. Episodes of spontaneous hemoptysis were identified through 2 independent database screens that queried <i>International Classification of Diseases, Ninth Revision</i> (<i>ICD-9</i>) and <i>Tenth Revision</i> (<i>ICD-10</i>) codes and electronic medical records for \"pulmonary hemorrhage\" and \"hemoptysis.\" Positive screens were subsequently confirmed or reclassified by manual chart review.</p><p><strong>Results: </strong>Of 799 patients with palliated single ventricle circulation, 10.9% (87/799) screened positive for hemoptysis. Following verification with manual chart review, 3.4% (27/799) of patients with palliated single ventricle circulation had spontaneous hemoptysis. A total of 61 episodes of spontaneous hemoptysis occurred in 27 patients. Of all hemoptysis episodes, 83.6% (51/61) occurred after Fontan palliation. Of patients with hemoptysis, 51.9% (14/27) had multiple episodes of hemoptysis with recurrence at a median of 0.6 years (range 1 day-8.5 years) after the first episode.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first study that quantifies prevalence of hemoptysis in a large cohort of patients with palliated single ventricle circulation. Overall, prevalence of spontaneous hemoptysis was low (3.4%) among patients with palliated single ventricle circulation and there was a moderate rate of recurrence (51.9%).</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040713"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477889","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":"Impact of Additional Left Atrial Lines Beyond Pulmonary Vein Isolation: Analysis of the CABANA Trial.","authors":"Matthew W Segar, Anish Badjatiya, Jordan Gales, Kaleb Lambeth, Mehdi Razavi, Mohammad Saeed","doi":"10.1161/JAHA.125.042203","DOIUrl":"https://doi.org/10.1161/JAHA.125.042203","url":null,"abstract":"","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e042203"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477881","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":"Incidence of Right Ventricular Dysfunction in an Echocardiographic Referral Cohort.","authors":"Jonah D Garry, Shi Huang, Jeffrey Annis, Suman Kundu, Anna Hemnes, Matthew Freiberg, Evan L Brittain","doi":"10.1161/JAHA.125.041096","DOIUrl":"https://doi.org/10.1161/JAHA.125.041096","url":null,"abstract":"<p><strong>Background: </strong>Incidence rates of right ventricular dysfunction (RVD) are unknown. We examined the rates, risk factors, and heart failure (HF) hospitalization hazard associated with incident RVD and right ventricle-pulmonary artery (RV-PA) uncoupling in patients referred for transthoracic echocardiogram (TTE).</p><p><strong>Methods: </strong>In this retrospective cohort study, we extracted data from TTEs at Vanderbilt University Medical Cente (2010-2023). We followed patients from their earliest TTE with normal right ventricle function (tricuspid annular plane systolic excursion [TAPSE] ≥17 mm). The primary outcomes were new RVD (TAPSE <17 mm) and RV-PA uncoupling (TAPSE/right ventricular systolic pressure <0.36 mm/mm Hg). We evaluated risk factors for and hazard of HF hospitalization associated with each outcome. We estimated incidence rates using the Poisson distribution and hazard ratios using Cox models adjusted for demographics, comorbidities, and TTE measures.</p><p><strong>Results: </strong>There were 45 753 patients (aged 63 years [interquartile range, 50-72], 45% men, 13% Black) meeting inclusion criteria. Of the patients, 13 735 had a follow-up TAPSE. The incidence rates of RVD and RV-PA uncoupling were 8.2 per person-year (95% CI, 8.0-8.5) and 3.4 per 100 person-years (95% CI, 3.2-3.6), respectively. Incidence rates increased with rising right ventricular systolic pressure. Risk factors for RVD and RV-PA uncoupling were most prominently HF, atrial fibrillation, and other cardiovascular comorbidities. Baseline right ventricular systolic pressure >35 mm Hg associated with TAPSE declined over time. The hazard of HF hospitalization increased with incident RVD (hazard ratio, 2.02 [95% CI, 1.85-2.21]) or when TAPSE declined by ≥5 mm.</p><p><strong>Conclusions: </strong>RVD incidence is substantial among patients referred for TTE. Clinical monitoring is warranted if right ventricular systolic pressure is >35 mm Hg. Cardiovascular comorbidities drive RVD and RV-PA uncoupling in this population. Incident RVD associates with increased HF hospitalization hazard.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e041096"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477882","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":"Sex Differences in In-Hospital Mortality Among Patients Receiving Veno-Arterial Extracorporeal Membrane Oxygenation and Extracorporeal Cardiopulmonary Resuscitation: A Propensity Score-Matched Analysis.","authors":"Jung-Chi Hsu, Chen-Hsu Pai, Ling-Yi Wei, Chih-Hsien Wang, Nai-Hsin Chi, Shu-Chien Huang, Jeng-Wei Chen, Heng-Wen Chou, Ron-Bin Hsu, Nai-Kuan Chou, Hsi-Yu Yu, Lian-Yu Lin, Yih-Sharng Chen","doi":"10.1161/JAHA.124.039541","DOIUrl":"https://doi.org/10.1161/JAHA.124.039541","url":null,"abstract":"<p><strong>Background: </strong>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is used in cardiogenic shock, but sex-specific outcomes remain unclear. This study investigated in-hospital mortality differences by sex among patients receiving extracorporeal cardiopulmonary resuscitation (ECPR).</p><p><strong>Methods: </strong>We retrospectively reviewed adults with cardiogenic shock treated with VA-ECMO at National Taiwan University Hospital between 2010 and 2021. After propensity score matching to improve comparability between groups, survival outcomes were assessed using Kaplan-Meier estimates, and Cox proportional hazards models were used to evaluate the effect of sex on in-hospital mortality.</p><p><strong>Results: </strong>Of the 1329 patients (average age: 57.1±15.0 years; 953 men), 670 underwent VA-ECMO for ECPR. Women in the VA-ECMO group exhibited a lower prevalence of out-of-hospital cardiac arrest (6.7% versus 10.7%, <i>P</i>=0.031), a lower body mass index (24.0±4.4 versus 25.0±4.3, <i>P</i><0.001), and lower rates of diabetes (26.2% versus 33.2%, <i>P</i>=0.017) and coronary artery disease (20.9% versus 28.6%, <i>P</i>=0.005) after propensity score matching. No discernible sex differences were observed in the baseline characteristics of the ECPR subgroup. Kaplan-Meier analyses showed no significant sex differences in mortality for VA-ECMO (log-rank <i>P</i>=0.1), but significant disparities were noted for ECPR (log-rank <i>P</i>=0.006). In the ECPR group, female patients exhibited higher mortality rates compared with men (hazard ratio, 1.37 [95% CI, 1.09-1.72]; <i>P</i>=0.007), independent of Survival After Veno-Arterial ECMO score severity.</p><p><strong>Conclusions: </strong>Women who underwent ECPR had higher in-hospital mortality rates regardless of the severity of their Survival After Veno-Arterial ECMO scores, despite the absence of significant sex differences in VA-ECMO mortality. This emphasizes the necessity for sex-based strategies in ECPR administration.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e039541"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477887","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":"Temporal Trends in the Association Between Female Sex and Ischemic Stroke Among Patients With Atrial Fibrillation.","authors":"Mark T Mills, Tommaso Bucci, Peter Calvert, Dhiraj Gupta, Gregory Y H Lip","doi":"10.1161/JAHA.124.040325","DOIUrl":"https://doi.org/10.1161/JAHA.124.040325","url":null,"abstract":"<p><strong>Background: </strong>Female sex has historically been associated with higher risk of ischemic stroke in patients with atrial fibrillation. However, contemporary European studies suggest this association may have attenuated and become nonsignificant over recent years. This study aims to characterize temporal trends in cardiovascular outcomes in a large, global cohort of patients with atrial fibrillation.</p><p><strong>Methods: </strong>Nonanticoagulated patients with newly diagnosed atrial fibrillation were identified from a global federated research network (TriNetX) between 2000 and 2019. One-year ischemic stroke risk and risk ratios were calculated for women versus men. Secondary outcomes included all-cause death, myocardial infarction, heart failure, and dementia. Cohorts were compared before and after adjustment for age and comorbidities.</p><p><strong>Results: </strong>Overall, 1 204 852 patients were included (44% women). Unadjusted risk of ischemic stroke increased in women (1.75% to 4.24%) and men (1.13% to 3.55%) from 2000-2004 to 2015-2019, while all-cause death decreased over the same periods (women, 10.36% to 7.79%; males, 10.76% to 7.59%). After adjustment, female sex remained independently associated with higher risk of ischemic stroke, although the risk decreased over time (2000-2004: risk ratio, 1.54 [95% CI, 0.94-2.51]; 2015-2019: risk ratio, 1.09 [95% CI, 1.06-1.13]). After adjustment, male sex was associated with risk of all-cause death and myocardial infarction, while risk of dementia and heart failure was similar between sexes.</p><p><strong>Conclusions: </strong>Between 2000 and 2019, the risk of ischemic stroke increased among nonanticoagulated patients with atrial fibrillation. While the association between female sex and ischemic stroke decreased over time, female sex remained associated with a higher stroke risk in 2015 to 2019 after adjustment.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040325"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477888","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":"Serotonin Norepinephrine Reuptake Inhibitor Is Associated With Lower Mortality Among Patients Presenting With Takotsubo Cardiomyopathy.","authors":"Garba Rimamskep Shamaki, Anderson Anuforo, Israel Safiriyu, David Corteville, Monika Sanghavi, Samit Shah, Katherine Clark","doi":"10.1161/JAHA.124.037951","DOIUrl":"https://doi.org/10.1161/JAHA.124.037951","url":null,"abstract":"<p><strong>Background: </strong>Serotonin-norepinephrine reuptake inhibitors (SNRIs) inhibit the presynaptic reuptake of serotonin and norepinephrine and are widely used in the treatment of depression and neuropathic pain. We evaluate the impact of SNRIs use on the clinical outcomes of patients presenting with Takotsubo cardiomyopathy (TCM).</p><p><strong>Methods: </strong>We analyzed data from the TriNetX research network. Patients aged ≥18 years with a principal diagnosis of TCM were identified from January 1, 2003, to December 31, 2023. After excluding patients on SSRIs, stimulants, 5-fluorouracil, capecitabine, gemcitabine, and trastuzumab, patients with myocarditis, pheochromocytoma, acute myocardial infarction, cocaine-related disorders, and opioid-related disorders, were also excluded. The final study population was divided into 2 cohorts: patients on SNRIs and patients not on SNRIs. Propensity score matching was used to adjust for potential confounders. The primary outcome was all-cause mortality, and the secondary outcome was Takotsubo cardiomyopathy-related complications.</p><p><strong>Results: </strong>A total of 16 853 patients with a diagnosis of TCM were identified, of which 2482 (14.7%) were on SNRIs. The SNRIs cohort were older (mean age 64.1 versus 63.4 years, <i>P</i>=0.012). After propensity score matching, patients on SNRI had lower 7-day mortality (odds ratio [OR], 0.59 [95% CI, 0.41-0.84], <i>P</i>=0.004), cardiac arrest (OR, 0.58 [95% CI, 0.40-0.84], <i>P</i>=0.004), and ventricular fibrillation (OR, 0.496 [95% CI, 0.248-0.995], <i>P</i>=0.044). At 1 year, patients on SNRI had lower mortality (OR, 0.80 [95% CI, 0.67-0.96], <i>P</i>=0.015).</p><p><strong>Conclusions: </strong>The use of SNRIs among patients presenting with TCM is associated with lower mortality and lower TCM-related complications.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e037951"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477886","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":"Anticoagulation Therapy for Atrial Fibrillation After Transcatheter Aortic Valve Replacement: National Database Insights.","authors":"Koki Takegawa, Koshiro Kanaoka, Yoshitaka Iwanaga, Tetsuo Sasano, Yuichi Nishioka, Tomoya Myojin, Tatsuya Noda, Tomoaki Imamura, Yoshihiro Miyamoto","doi":"10.1161/JAHA.124.040030","DOIUrl":"https://doi.org/10.1161/JAHA.124.040030","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) is increasingly used in patients with aortic stenosis; however, the optimal postoperative anticoagulation therapy for patients with atrial fibrillation (AF) remains controversial. We aimed to investigate the association between anticoagulant therapy selection and outcomes in patients with AF after TAVR.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with AF who underwent TAVR. Patients were divided into 2 groups according to the anticoagulant therapy administered 3 months after the index TAVR (direct oral anticoagulant [DOAC] and vitamin K antagonist [VKA] groups). The primary end points were thromboembolic and major bleeding events after a landmark period of 3 months. We analyzed the association between oral anticoagulants and outcomes using propensity score matching.</p><p><strong>Results: </strong>Among 47 883 patients who underwent TAVR between April 2014 and March 2021, 10 041 had a history of AF and anticoagulant therapy. Of these, 8191 patients were prescribed a DOAC, while 1850 received a VKA. Before matching, the thromboembolic event rate was 2.2 per 100 person-years in the DOAC group and 3.6 per 100 person-years in the VKA group, whereas the bleeding event rates were 7.1 and 10.0 per 100 person-years, respectively. After matching, VKA was associated with higher risks of thromboembolic events (hazard ratio [HR], 1.46 [95% CI, 1.12-1.91]; <i>P</i>=0.004) and bleeding events (HR, 1.21 [95% CI, 1.03-1.42]; <i>P</i>=0.016).</p><p><strong>Conclusions: </strong>DOAC use in patients with AF who undergo TAVR may be preferable to VKA use in a real-world clinical setting.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040030"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477874","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":"Early Rhythm Control of Atrial Fibrillation in Cancer Survivors: A Nationwide Population-Based Study.","authors":"Seokmoon Han, So-Ryoung Lee, Eue-Keun Choi, Bongseong Kim, Kyung-Do Han, JungMin Choi, Kyung-Yeon Lee, Hyo-Jeong Ahn, Soonil Kwon, Seil Oh, Gregory Y H Lip","doi":"10.1161/JAHA.125.040908","DOIUrl":"https://doi.org/10.1161/JAHA.125.040908","url":null,"abstract":"<p><strong>Background: </strong>Although early rhythm control (ERC) is effective in reducing stroke in patients with atrial fibrillation (AF), its benefits have not been well elucidated in cancer survivors. This study aimed to compare the risk of ischemic stroke between ERC and usual care in cancer survivors with AF.</p><p><strong>Methods: </strong>This nationwide observational study was conducted using the Korean National Health Insurance Service database. Patients aged ≥20 years with newly diagnosed AF between 2009 and 2018 were included. Patients who received rhythm control therapy within 1 year of AF diagnosis were defined as the ERC group, while the remaining patients were defined as usual care group. The risk of ischemic stroke in the ERC group was compared with those of the usual care group in cancer survivors (cancer diagnosis ≥5 years) and the noncancer group.</p><p><strong>Results: </strong>A total of 591 692 patients were included in the study (18 747 patients [3.2%] with cancer; mean age, 65.7±14.6 years; 53.7% men). During a mean 4-year follow-up, stroke occurred in 52 500 patients (1338 cancer survivors and 51 182 noncancer survivors). The ERC group showed a lower risk of stroke than the usual care group, regardless of the presence of a cancer history (adjusted hazard ratio, 0.67 [95% CI, 0.58-0.76] in cancer survivors versus 0.76 [95% CI, 0.74-0.78] in the noncancer group).</p><p><strong>Conclusions: </strong>ERC is associated with a lower risk of ischemic stroke among cancer survivors. An integrated approach that incorporates appropriate rhythm control strategies should be considered for cancer survivors with newly diagnosed AF.</p>","PeriodicalId":54370,"journal":{"name":"Journal of the American Heart Association","volume":" ","pages":"e040908"},"PeriodicalIF":5.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477878","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}