Hellenic Journal of Cardiology最新文献

{"title":"Transthyretin amyloidosis cardiomyopathy in Greece: Clinical insights from the National Referral Center","authors":"","doi":"10.1016/j.hjc.2023.09.019","DOIUrl":"10.1016/j.hjc.2023.09.019","url":null,"abstract":"<div><h3>Background</h3><p>Clinical characteristics and outcomes of patients with transthyretin amyloidosis cardiomyopathy (ATTR-CM) vary by region, necessitating the acquisition of country-specific evidence for proper management.</p></div><div><h3>Methods</h3><p>This is an observational study including sequential patients presenting in the Amyloidosis Reference Center of Greece, from 01/2014 to 12/2022. ATTR-CM was diagnosed by positive scintigraphy and exclusion of light-chain amyloidosis or positive biopsy typing. Genetic testing was performed in all cases.</p></div><div><h3>Results</h3><p>In total, 109 ATTR-CM patients were included (median age, 81 years) of which 15 carried <em>TTR</em> mutations (27% Val30Met). Most patients (82%) presented with heart failure and 59% with atrial fibrillation, while 10% had aortic stenosis. Importantly, 78 (71.6%) had clinically significant extracardiac manifestations (45% musculoskeletal disorder, 40% peripheral neuropathy, and 33% gastrointestinal symptoms). Sixty-five (60%) received disease-specific treatment with tafamidis. Estimated median survival was 48 months; advanced NYHA class, National Amyloidosis Center stage, eGFR&lt;45 ml/kg/1.73 m², NT-pro-BNP&gt;5000 pg/mL were associated with worse survival, while tafamidis treatment was associated with improved survival in patients with IVS≥ 12 mm.</p></div><div><h3>Discussion</h3><p>These are the first data describing the characteristics, management, and outcomes of patients with ATTR-CM in Greece, which could influence local guidelines.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001902/pdfft?md5=3a3da55ff2cbab019ccb1dba4a84b69c&pid=1-s2.0-S1109966623001902-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BEAT-IT: A de-novo cardiac screening programme in Maltese adolescents","authors":"","doi":"10.1016/j.hjc.2023.09.012","DOIUrl":"10.1016/j.hjc.2023.09.012","url":null,"abstract":"<div><h3>Aims</h3><p>Sudden cardiac death (SCD) in young individuals is often unexpected, provoking substantial emotional stress for family and friends of the deceased. Cardiac screening may identify individuals who harbour disorders linked to SCD. The feasibility and diagnostic yield of a nationwide cardiac screening programme in adolescents has never been explored.</p></div><div><h3>Methods</h3><p>All individuals eligible for cardiac screening (students aged 15 years) were systematically invited to enrol. Students were provided with a health questionnaire. ECGs were acquired at school. A physician led consultation was carried out on site. Participants with an abnormal screen were then referred for secondary evaluation to the nation’s tertiary centre. Feasibility criteria included a) participation rate &gt;60%, b) adherence to secondary evaluation &gt;80%, and c) cost per individual screened equating to &lt;€100. The diagnostic yield was also evaluated.</p></div><div><h3>Results</h3><p>At the end of enrolment, 2708 students gave consent (mean 15 years, 50.4% male), equating to 67.9% of the eligible cohort. Overall, 109 participants (4.0%) were referred for further evaluation. An abnormal electrocardiogram (ECG) was the most common reason for referral (3.7%). Fifteen individuals (0.6%) were diagnosed with a cardiac condition. Nine (0.3%) had a condition linked to SCD (n = 1 Long-QT syndrome, n = 1 Hypertrophic Cardiomyopathy, n = 5 Wolff-Parkinson White, n = 2 coronary anomalies). The yield was similar in athletes and non-athletes (p = 0.324). The cost per cardiac individual screened equated to €51.15.</p></div><div><h3>Conclusion</h3><p>A nationwide systematic cardiac screening programme for adolescent athletes and non-athletes is feasible and cost-efficient, provided that responsible centres have the appropriate infrastructure.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001835/pdfft?md5=009f3bc36731352127b11180f39b6d43&pid=1-s2.0-S1109966623001835-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"β1-blockers in the reduction of bleeding risk in patients prescribed with potent dual antiplatelet therapy after acute coronary syndrome or percutaneous coronary intervention","authors":"","doi":"10.1016/j.hjc.2023.09.017","DOIUrl":"10.1016/j.hjc.2023.09.017","url":null,"abstract":"<div><h3>Background</h3><p>β1-blockers could improve clinical outcomes in patients with coronary artery disease by lowering the heart rate, blood pressure, and myocardial contractility. Moreover, recent studies have suggested that β1-blockers may also have the potential to reduce bleeding risk.</p></div><div><h3>Objectives</h3><p>This study aimed to evaluate the association between β1-blockers and bleeding risk in the patients prescribed with potent dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI).</p></div><div><h3>Methods</h3><p>Patients with ACS or undergoing PCI treated by DAPT of ticagrelor and aspirin were consecutively recruited. Follow-up for all eligible patients was conducted for 1 year. Major bleeding outcomes were defined as events that were type ≥2 based on the Bleeding Academic Research Consortium (BARC) criteria.</p></div><div><h3>Results</h3><p>A total of 1,113 eligible ticagrelor-treated patients were recruited. During the 1-year follow-up interval, 142 (12.6%) patients experienced BARC ≥2 bleedings including 23 patients (2.1%) suffering BARC ≥3 bleedings, with the most common site of bleeding located in the gastrointestinal tract. β1-blockers treatment was associated with a lower risk of BARC ≥2 bleedings (11.2% vs. 23.3%, adjusted HR: 0.42, 95% CI: 0.28-0.62, P &lt; 0.01). Moreover, metoprolol (11.1% vs. 23.3%, adjusted HR: 0.56, 95% CI: 0.37-0.83, P &lt; 0.01) and bisoprolol (11.3% vs. 23.3%, adjusted HR: 0.56, 95% CI: 0.33-0.96, P = 0.04) had similar effects on the reduction of bleeding risk.</p></div><div><h3>Conclusion</h3><p>β1-blockers might be beneficial for the reduction of bleeding risk in potent dual antiplatelet therapy patients with ACS or undergoing PCI.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001884/pdfft?md5=e72e7b457e71d814b3af94e351f326fb&pid=1-s2.0-S1109966623001884-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of 10-year cardiovascular disease risk by diabetes status and lipoprotein-a levels; the HellenicSCORE II+","authors":"","doi":"10.1016/j.hjc.2023.10.001","DOIUrl":"10.1016/j.hjc.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to develop an updated model to predict 10-year cardiovascular disease (CVD) risk for Greek adults, i.e., the HellenicSCORE II+, based on smoking, systolic blood pressure (SBP), total and high-density-lipoprotein (HDL) cholesterol levels, and stratified by age group, sex, history of diabetes, and lipoprotein (Lp)-a levels.</p></div><div><h3>Methods</h3><p>Individual CVD risk scores were calculated through logit-function models using the beta coefficients derived from SCORE2. The Attica study data were used for the calibration (3,042 participants, aged 45 (14) years; 49.1% men). Discrimination ability of the HellenicSCORE II+ was assessed using C-index (range 0-1), adjusted for competing risks.</p></div><div><h3>Results</h3><p>The mean HellenicSCORE II+ score was 6.3% (95% confidence interval (CI) 5.9% to 6.6%) for men and 3.7% (95% CI 3.5% to 4.0%) for women (p &lt; 0.001), and were higher compared to the relevant SCORE2; 23.5% of men were classified as low risk, 40.2% as moderate, and 36.3% as high risk, whereas the corresponding percentages for women were 56.2%, 18.6%, and 25.2%. C-statistic index was 0.88 for women and 0.79 for men when the HellenicSCORE II+ was applied to the Attica study data, suggesting very good accuracy. Stratified analysis by Lp(a) levels led to a 4% improvement in correct classification among participants with high Lp(a).</p></div><div><h3>Conclusion</h3><p>HellenicSCORE II+ values were higher than SCORE2, confirming that the Greek population is at moderate-to-high CVD risk. Stratification by Lp(a) levels may assist in better identifying individuals at high CVD risk.</p></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966623001926/pdfft?md5=5100bdb9cda9aab8be398b0ad545e22e&pid=1-s2.0-S1109966623001926-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of sodium-glucose cotransporter 2 inhibitors in preventing atrial fibrillation recurrence after catheter ablation","authors":"","doi":"10.1016/j.hjc.2024.03.008","DOIUrl":"10.1016/j.hjc.2024.03.008","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1109966624000691/pdfft?md5=835320d8c44fd90ac03b171bba4d8674&pid=1-s2.0-S1109966624000691-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical phenotypes and outcomes of patients with left ventricular thrombus: an unsupervised cluster analysis.","authors":"Aloysius S T Leow, Fang Qin Goh, Benjamin Y Q Tan, Jamie S Y Ho, William K F Kong, Roger S Y Foo, Mark Y Y Chan, Leonard L L Yeo, Ping Chai, A Geru, Tiong-Cheng Yeo, Siew Pang Chan, Xin Zhou, Gregory Y H Lip, Ching-Hui Sia","doi":"10.1016/j.hjc.2024.08.010","DOIUrl":"10.1016/j.hjc.2024.08.010","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular thrombus (LVT) can develop in a diverse group of patients with various underlying causes, resulting in divergent natural histories and trajectories with treatment. Our aim was to use cluster analysis to identify unique clinical profiles among patients with LVT and then compare their clinical characteristics, treatment strategies, and outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective study involving 472 patients with LVT whose data were extracted from a tertiary center's echocardiography database, from March 2011 to January 2021. We used the TwoStep cluster analysis method, examining 19 variables.</p><p><strong>Results: </strong>Our analysis of the 472 patients with LVT revealed two distinct patient clusters. Cluster 1, comprising 247 individuals (52.3%), was characterized by younger patients with a lower incidence of traditional cardiovascular risk factors and relatively fewer comorbidities compared with Cluster 2. Most patients had LVT attributed to an underlying ischemic condition, with a larger proportion being due to post-acute myocardial infarction in Cluster 1 (68.8%), and due to ischemic cardiomyopathy in Cluster 2 (57.8%). Notably, patients in Cluster 2 exhibited a reduced likelihood of LVT resolution (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.44-0.77, p < 0.001) and a higher risk of all-cause mortality (HR 2.27, 95% CI 1.43-3.60, p = 0.001). These associations persisted even after adjusting for variables such as anticoagulation treatment, the presence of left ventricular aneurysms, and specific LVT characteristics such as mobility, protrusion, and size.</p><p><strong>Conclusion: </strong>Through TwoStep cluster analysis, we identified two distinct clinical phenotypes among patients with LVT, each distinguished by unique baseline clinical attributes and varying prognoses.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114942","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}

{"title":"Detection and Classification of electrocardiography using hybrid deep learning models.","authors":"Immaculate Joy S, Moorthi M, Senthil Kumar K","doi":"10.1016/j.hjc.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.hjc.2024.08.011","url":null,"abstract":"<p><strong>Background: </strong>Electrocardiography (ECGs) has been a vital tool for cardiovascular disease (CVD) diagnosis, which visually depicts the heart's electrical activity. To enhance automatic classification between normal and diseased ECG, it is essential to extract consistent and qualitative features.</p><p><strong>Methods: </strong>Precision of ECG classification through hybrid Deep Learning (DL) approach leverages both Convolutional Neural Network (CNN) architecture and Variational Autoencoder (VAE) techniques. By combining these methods, we aim to achieve more accurate and robust ECG interpretation. The method is trained and tested over PTB-XL dataset, which contains 21,799 with 12-lead ECGs from 18,869 patients, each spanning 10 seconds. The classification evaluation of 5 super-classes and 23 sub-classes of CVD, with the proposed CNN-VAE model is compared.</p><p><strong>Results: </strong>The classification of various CVD had resulted with the highest accuracy of 98.51%, specificity of 98.12%, sensitivity 97.9% and F1-score 97.95%. We have also achieved the minimum false positive and false negative rates as 2.07 and 1.87 respectively during validation. The results are validated upon the annotations given by individual cardiologists, who assigned potentially multiple ECG statements to each record.</p><p><strong>Conclusion: </strong>When compared to other deep learning methods, our suggested CNN-VAE model performs significantly better in testing phase. This study proposes a new architecture of combining CNN-VAE for CVD classification from ECG data, this can help the clinicians to identify the disease earlier and carry further treatment. The CNN-VAE model can better characterize input signals due to its hybrid architecture.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114943","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}

{"title":"Nationwide mortality trends from 2001 to 2020 in Greece: health policy implications under the scope of aging societies.","authors":"Maria Nikolaou, Nikolaos Theodorakis, Georgios Feretzakis, Georgia Vamvakou, Christos Hitas, Sofia Kalantzi, Aikaterini Spyridaki, Anastasios Apostolos, Vassilios S Verykios, Konstantinos Toutouzas","doi":"10.1016/j.hjc.2024.08.009","DOIUrl":"10.1016/j.hjc.2024.08.009","url":null,"abstract":"<p><strong>Objective: </strong>This nationwide study aims to analyze mortality trends for all individual causes in Greece from 2001 to 2020, with a specific focus on 2020, a year influenced by the COVID-19 pandemic. As Greece is the fastest-aging country in Europe, the study's findings can be generalized to other aging societies, guiding the reevaluation of global health policies.</p><p><strong>Methods: </strong>Data on the population and the number of deaths were retrieved from the Hellenic Statistical Authority. We calculated age-standardized mortality rates (ASMR) and cause-specific mortality rates by sex in three age groups (0-64, 65-79, and 80+ years) from 2001 to 2020. Proportional mortality rates for 2020 were determined. Statistical analysis used generalized linear models with Python Programming Language.</p><p><strong>Results: </strong>From 2001 to 2020, the ASMR of cardiovascular diseases (CVD) decreased by 42.7% (p < 0.0001), with declines in most sub-causes, except for hypertensive diseases, which increased by 2.8-fold (p < 0.0001). In 2020, the proportional mortality rates of the three leading causes were 34.9% for CVD, 23.5% for neoplasms, and 9.6% for respiratory diseases (RD). In 2020, CVD were the leading cause of death among individuals aged 80+ years (39.3%), while neoplasms were the leading cause among those aged 0-79 years (37.7%). Among cardiovascular sub-causes, cerebrovascular diseases were predominant in the 80+ year age group (30.3%), while ischemic heart diseases were most prevalent among those aged 0-79 years (up to 60.0%).</p><p><strong>Conclusions: </strong>The global phenomenon of population aging necessitates a reframing of health policies in our aging societies, focusing on diseases with either a high mortality burden, such as CVD, neoplasms, and RD, or those experiencing increasing trends, such as hypertensive diseases.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114944","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}

{"title":"Renin-angiotensin system inhibitors and non-ST-elevation myocardial infarction outcomes based on left ventricular ejection fraction.","authors":"Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Cheol Ung Choi, Byoung Geol Choi, Soohyung Park, Dong Oh Kang, Se Yeon Choi, Jinah Cha, Su Jin Hyun, Jung Rae Cho, Min-Woong Kim, Ji Young Park, Sang-Ho Park, Myung Ho Jeong","doi":"10.1016/j.hjc.2024.08.007","DOIUrl":"10.1016/j.hjc.2024.08.007","url":null,"abstract":"<p><strong>Background: </strong>We assessed left ventricular ejection fraction (LVEF) to compare the effects of renin-angiotensin system inhibitors (RASI) in patients with non-ST-segment elevation myocardial infarction (NSTEMI).</p><p><strong>Methods: </strong>We categorized 4558 patients with NSTEMI as either RASI users (3752 patients) or non-users (806 patients). The 3-year patient-oriented composite outcome (POCO), which included all-cause death, recurrent myocardial infarction, any repeat revascularization, or hospitalization for heart failure (HF), was the primary outcome. To compare clinical outcomes, a multivariable-adjusted hazard ratio (aHR) was calculated after performing multicollinearity tests on all significant confounding variables (P < 0.05).</p><p><strong>Results: </strong>Among RASI users, the aHRs for POCO, all-cause death, and cardiac death were significantly higher in the HF with reduced EF (HFrEF) subgroup than in the HF with mildly reduced EF (HFmrEF) (1.610, 2.120, and 2.489; P < 0.001, <0.001, and <0.001; respectively) and HF with preserved EF (HFpEF) (2.234, 3.920, and 5.215; P < 0.001, <0.001, and <0.001; respectively) subgroups. The aHRs for these variables were significantly higher in the HFmrEF subgroup than the HFpEF subgroup (1.416, 1.843, and 2.172, respectively). Among RASI non-users, the aHRs for these variables were significantly higher in the HFrEF subgroup than the HFmrEF (2.573, 3.172, and 3.762, respectively) and HFpEF (2.425, 3.805, and 4.178, respectively) subgroups. In three LVEF subgroups, RASI users exhibited lower aHRs for POCO and all-cause death than RASI non-users.</p><p><strong>Conclusion: </strong>In the RASI users group, the aHRs for POCO and mortality were highest in the HFrEF subgroup, intermediate in the HFmrEF subgroup, and lowest in the HFpEF subgroup.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996971","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}

{"title":"Better performance of the APPLE score for the prediction of very early atrial fibrillation recurrence post-ablation.","authors":"Wenchao Huang, Huaxin Sun, Yan Luo, Shiqiang Xiong, Yan Tang, Yu Long, Zhen Zhang, Hanxiong Liu","doi":"10.1016/j.hjc.2024.08.008","DOIUrl":"10.1016/j.hjc.2024.08.008","url":null,"abstract":"<p><strong>Objective: </strong>The benefits of rhythm control in early atrial fibrillation (AF) are increasingly recognized. This study aimed to investigate whether early AF ablation contributes to long-term sinus rhythm maintenance and to identify a suitable predictive score.</p><p><strong>Methods: </strong>According to diagnosis-to-ablation time, this study prospectively enrolled 245 patients with very early AF, 262 with early AF, and 588 with late AF for radiofrequency ablation from June 2017 to December 2022. Clinical data, risk scores, and follow-up results were collected and analyzed.</p><p><strong>Results: </strong>Baseline characteristics were similar among the three cohorts. During a median follow-up period of 26 months, AF recurrence was observed in 61 (24.9%), 66 (25.2%), and 216 (36.7%) patients in the very early, early, and late AF cohorts, respectively. In the multivariable-adjusted model, very early and early AF were associated with a reduced risk of AF recurrence, with hazard ratios of 0.72 (95% confidence interval [CI] 0.52-0.99) and 0.57 (95% CI 0.41-0.78), respectively. The APPLE score demonstrated the highest predictive power for very early AF, with an area under the curve (AUC) of 0.74. However, its predictive power decreased with time from diagnosis, showing low predictive power for late AF (AUC = 0.58). In addition, the time-dependent concordance index showed consistent results. For very early AF, the Akaike information criterion and decision curve analysis showed that APPLE had the highest predictive value.</p><p><strong>Conclusion: </strong>Very early AF ablation was associated with a lower recurrence rate, and the APPLE score provided a higher predictive value for these patients. (URL: https://www.chictr.org.cn/; Unique identifier: ChiCTR-OIN-17013021).</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989555","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}