Archives of Cardiovascular Diseases最新文献

{"title":"Real world data from a nationwide survey: Current approaches in post-acute coronary syndromes by cardiologists","authors":"P. Sabouret ,&nbsp;F. Dievart ,&nbsp;A. Sharareh ,&nbsp;T. Garban ,&nbsp;S. Cohen ,&nbsp;O. Hoffman ,&nbsp;D. Guedj-Meynier ,&nbsp;J.C. Dib ,&nbsp;L. Ouazana ,&nbsp;M. Villaceque ,&nbsp;B. Lequeux ,&nbsp;E. Parrens ,&nbsp;J.-L. Georges ,&nbsp;F. Schiele ,&nbsp;N. Lellouche ,&nbsp;W. Amara","doi":"10.1016/j.acvd.2024.10.076","DOIUrl":"10.1016/j.acvd.2024.10.076","url":null,"abstract":"<div><h3>Introduction</h3><div>New ESC guidelines and statement by EAS have recently been published based on recent advances in lipid lowering treatments. However, real world data are lacking regarding the implementation among the community of French cardiologists.</div></div><div><h3>Objective</h3><div>To determine the current approach and therapeutic strategies concerning lipid lowering treatments in post-acute coronary syndromes in France.</div></div><div><h3>Method</h3><div>This national survey was performed during October and November 2023 in France with an online questionnaire on the sites of 2 national French Societies of Cardiologists.</div><div>Four mailings were sent to cardiologists to invite them to answer to the questionnaire.</div><div>A total of 400 answers of cardiologists were collected during this 2 months period.</div></div><div><h3>Results</h3><div>For ASCVD patients, cardiologists agree with a LDL-C goal below 55 mg/dL in 69%, below 70 mg/dL in 16.5%, and 14.5% between 70 mg/dL and 100 mg/dL. An upfront strategy using fixed lipid lowering combinations was prescribed in less than 5% of patients, whereas high-intensity statins was prescribed in more than 90% of patients.</div></div><div><h3>Conclusion</h3><div>In this contemporary national survey, we report an excellent agreement of lipid goals in secondary prevention by cardiologists. Despite the declared consensus concerning the low levels of LDL-C targets in ACS patients, lipid lowering strategies are suboptimal as mainly represented by the use of high intensity statins, whereas a combination of statins and ezetimibe is prescribed only for a minority of patients, especially as an early upfront strategy. The use of PCSK9i remains marginal and the interval between the ACS and initiation of these molecules remain high, advocating a better implementation of intensive and early strategies to reduce recurrent ischemic events.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S15"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150787","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":"Invasive versus conservative strategy after acute coronary syndrome in the elderly > 75 ans: Which strategy for which patient","authors":"A. Bouchlarhem ,&nbsp;N. Ismaili ,&nbsp;N. El Ouafi","doi":"10.1016/j.acvd.2024.10.072","DOIUrl":"10.1016/j.acvd.2024.10.072","url":null,"abstract":"<div><h3>Introduction</h3><div>Elderly patients represent a special entity in the management of acute coronary syndrome (ACS), given the fragility of this population.</div></div><div><h3>Objective</h3><div>We analyzed the invasive versus conservative revascularization strategy in patients admitted for ACS over 75 years.</div></div><div><h3>Method</h3><div>We analyzed in the prospective analysis the invasive versus conservative revascularization strategy in patients admitted for ACS over 75 years to our CICU over a 3-year. The principal endpoint of our study is a composite of all-cause mortality, or readmissions for ACS or acute heart failure (AHF) during follow-up at 1-year.</div></div><div><h3>Results</h3><div>We included 414 patients who met the inclusion criteria: 173 (41.8%) in the invasive group and 241 (58.2%) in the conservative group, with 66.6% of patients admitted for STEMI. Men represented 63.8%. The invasive strategy group was younger (77.44 <em>vs.</em> 79.93 <em>p</em> <!-->&lt;<!--> <!-->0.001), with no difference for arterial hypertension (32.9% <em>vs.</em> 21.3%: <em>p</em> <!-->=<!--> <!-->0.273) or diabetes (25.1% <em>vs.</em> 17.1%: <em>p</em> <!-->=<!--> <!-->0.688), nor for admission time since onset of pain (11.88 <em>vs.</em> 17.93 <em>p</em> <!-->=<!--> <!-->0.056), and higher ejection fraction (46.28 <em>vs.</em> 42.66 <em>p</em> <!-->=<!--> <!-->0.002). For the primary endpoint, 50 (12.1%) were observed with 11 (6.4%) in the invasive group versus 38 (15.8%) in the conservative group (<em>p</em> <!-->=<!--> <!-->0.003). In the multivariate Cox proportional regression analysis, the invasive strategy was independently associated with a reduction in the principal endpoint at 1-year in all ACS population (HR at 0.483, 95% CI (0.240; 0.975), <em>p</em> <!-->=<!--> <!-->0.042), but in the subgroup analysis, this reduction is significant only for patients with STEMI (HR at 0.366, 95% CI (0.172; 0.778), <em>p</em> <!-->=<!--> <!-->0.009) (<span><span>Fig. 1</span></span>A). However in patients with NSTEMI, the invasive strategy does not reduce the principal endpoint (HR at 0.370, 95% CI (0.820; 1,668), <em>p</em> <!-->=<!--> <!-->0.168) (<span><span>Fig. 1</span></span>B).</div></div><div><h3>Conclusion</h3><div>If PCI remains effective in older STEMI patients, then for NSTEMI patients, further clinical trials will be required to fully assess its efficacy.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S13-S14"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150840","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":"Femoral venous stasis index infor prediction of elevated right atrial pressure and mortality in pulmonary hypertension","authors":"J.-E. Trihan ,&nbsp;M. De Géa ,&nbsp;E.-M. Jutant ,&nbsp;E. Larrieu-Ardilouze ,&nbsp;C. Beaufort ,&nbsp;M. Puyade ,&nbsp;D. Montani ,&nbsp;C. Thollot ,&nbsp;C. Bouleti ,&nbsp;D. Lanéelle ,&nbsp;M. Croquette","doi":"10.1016/j.acvd.2024.10.097","DOIUrl":"10.1016/j.acvd.2024.10.097","url":null,"abstract":"<div><h3>Introduction</h3><div>Elevated right atrial pressure (RAP) is associated with poor prognosis regarding 1-year mortality in pulmonary hypertension (PH) patients. Unfortunately, there is currently no reliable non-invasive technique for estimating RAP in PH patients. Recently, femoral venous stasis index (FVSI) has been described as highly correlated to RAP in PH patients.</div></div><div><h3>Objective</h3><div>Our goal was to confirm the diagnostic accuracy of FVSI for estimating RAP, and compare the prognostic value of FVSI, RAP and renal venous stasis index (RVSI) at 2 years in PH patients.</div></div><div><h3>Method</h3><div>In this prospective cross-sectional study, we included 101 patients with suspected or known PH undergoing right heart catheterization (RHC) for 18 months. Each included patient underwent DUS of the femoral and renal veins within 4<!--> <!-->hours prior to the RHC, to blindly assess FVSI and RVSI. FVSI and RVSI (no unit) was calculated as the percentage of non anterograde flow time over an index cardiac cycle, during a short apnea ([Index cardiac cycle(ms)<!--> <!-->−<!--> <!-->Anterograde flow time (ms)/Index cardiac cycle(ms)]). For RAP analysis, we chose the cut-off values based on the 2022 ESC/ERS guidelines (RAP<!--> <!-->&lt;<!--> <!-->8<!--> <!-->mmHg, 8–14<!--> <!-->mmHg and<!--> <!-->&gt;<!--> <!-->14<!--> <!-->mmHg).</div></div><div><h3>Results</h3><div>FVSI was highly correlated to RAP (rs<!--> <!-->=<!--> <!-->0.77, <em>p</em> <!-->&lt;<!--> <!-->0.001). On multivariate analysis, only FVSI remained significantly associated with RAP (<em>p</em> <!-->&lt;<!--> <!-->0.001) compared to clinical and biological signs, echocardiography and RVSI. With a cutoff of 0.18, FVSI can exclude a RAP<!--> <!-->&gt;<!--> <!-->8<!--> <!-->mmHg with an 87% sensitivity (area under ROC curve (AUROC)<!--> <!-->=<!--> <!-->0.88) and, with a cutoff of 0.45, can confirm a RAP<!--> <!-->&gt;<!--> <!-->14<!--> <!-->mmHg with a 93% specificity (AUROC<!--> <!-->=<!--> <!-->0.93). During 2-year follow-up, the composite endpoint (hospitalization; increase in PH-treatment and all-cause death) occurred in 32 patients (31.7%). FVSI independently predicted PH morbidity/mortality (FVSI<!--> <!-->≥<!--> <!-->0.45 versus FVSI<!--> <!-->&lt;<!--> <!-->0.18: HR<!--> <!-->=<!--> <!-->5.41 [1.53–19.2], <em>p</em> <!-->=<!--> <!-->0.009) (<span><span>Figure 1</span></span>). Inter-observer reproducibility between junior and senior operators was excellent (intraclass coefficient of 0.97 [IC95% 0.95–0.98]).</div></div><div><h3>Conclusion</h3><div>We propose FVSI as the first non-invasive tool for estimating RAP, according to the recommended cut-off values, in PH patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S53-S54"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143151191","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":"Effectiveness of PCI for delayed STEMI patients: Insights from Moroccan cardiology intensive care units","authors":"A. Bouchlarhem ,&nbsp;N. Ismaili ,&nbsp;N. El Ouafi","doi":"10.1016/j.acvd.2024.10.077","DOIUrl":"10.1016/j.acvd.2024.10.077","url":null,"abstract":"<div><h3>Introduction</h3><div>The benefits of myocardial revascularization in ST-segment elevation acute coronary syndrome (ACS) after 12 to 24 hours from symptom onset remain a topic of debate, especially in stable, asymptomatic patients.</div></div><div><h3>Objective</h3><div>We analyzed the benefit of late revascularization by PCI in patients admitted to Moroccan cardiac intensive care units (CICUs) with STEMI after 12 h of symptom onset.</div></div><div><h3>Method</h3><div>We carried out a retrospective study between 2017 and 2021 to assess the benefit of late revascularization by PCI in STEMI patients. The primary endpoint of our study is all-cause mortality at 1-year. The secondary endpoint was a composite of readmissions for acute coronary syndrome (ACS) or acute heart failure (AHF) during follow-up.</div></div><div><h3>Results</h3><div>We included a total of 406 patients who met the inclusion criteria, 262 patients in the invasive strategy group and 144 patients in the conservative strategy group. A total of 74.6% were men and 25.4% were women. For the primary outcome, death from all causes after at 2-years was observed in 46 (11.3%) of all patients, with 33 (23%) patients in the conservative strategy group, and 13 (5%) patients in the invasive strategy group, with a significant difference between the two groups (<em>p</em> <!-->&lt;<!--> <!-->0.001). Kaplein Meier survival analysis showed a significant difference in survival rate with a significant Lok-rank test (<em>p</em> <!-->&lt;<!--> <!-->0.001) (<span><span>Fig. 1</span></span>). For secondary outcomes, 19 (4.7%) patients were readmitted for ACS, and 14 (3.4%) patients for AHF, but with no significant difference for either in the two groups (<em>p</em> <!-->=<!--> <!-->0.277, <em>p</em> <!-->=<!--> <!-->0.205). Cardiogenic shock in the ICU was higher in the conservative strategy group, with a percentage of 19.4% versus 7.25% in the invasive strategy group, with a significant difference (<em>p</em> <!-->&lt;<!--> <!-->0.001). In multivariable analysis, 2-year all-cause mortality was independently associated with revascularization between 12 h and 48 h (HR at 0.372, 95% CI (0.182; 0.762), <em>p</em> <!-->=<!--> <!-->0.007), EF<!--> <!-->&lt;<!--> <!-->35% at discharge (HR at 1.92, 95% CI (1.22; 2.54), <em>p</em> <!-->=<!--> <!-->0.04) and cardiogenic shock in-CICU (HR at 2.69, 95% CI (1.82; 3.78), <em>p</em> <!-->=<!--> <!-->0.005).</div></div><div><h3>Conclusion</h3><div>Although no evidence exists to date on the true benefit of late PCI revascularization in STEMI patients, this practice remains common, as demonstrated by the results of the majority of registries.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S16"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150106","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":"Evaluation of the feasibility and efficacy of a coronary revascularization strategy by drug coated balloon","authors":"R. Bakdi ,&nbsp;L. Meunier ,&nbsp;C. Allix-Beguec","doi":"10.1016/j.acvd.2024.10.070","DOIUrl":"10.1016/j.acvd.2024.10.070","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Percutaneous coronary revascularization (PCI) by drug eluting stenting (DES) still faces challenges such as complex revascularization procedures and stent (restenosis, thrombosis). The drug coated balloon (DCB) appears to be an attractive concept as no metallic material is left in the vascular wall. The SCRAP study found a satisfying efficacy profile with a 1-year MACE rate of 7.1% among patients who benefited from a stent-less coronary revascularization strategy (SLS). Uncertainties remain regarding the factors influencing the effectiveness and feasibility of this SLS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;We aimed to assess the prognostic role of LVEF in the occurrence of MACE at 3 years during a strategy of coronary revascularization by DCB. Secondary objectives were to evaluate the impact of clinical presentation and angiographic data on the occurrence of bailout stenting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;983 unselected patients were prospectively and consecutively included between March 2019 and April 2020, and scheduled to benefit PCI at the La Rochelle Hospital Center. Patients without hemodynamic or rhythm instability were eligible for a SLS by DCB (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;546). Otherwise, revascularization by DES was performed (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;143). In the event of any iatrogenic coronary dissection, bailout stenting (BO-DES) was performed (&lt;em&gt;n&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;294). LVEF at admission and MACE at 3 years were collected. The clinical presentation leading to the PCI (acute or chronic coronary syndrome) was notified, as well as the angiographic data of the lesions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The overall MACE rate at 3-year follow-up was 15.1% (distribution shown in &lt;span&gt;&lt;span&gt;Fig. 1&lt;/span&gt;&lt;/span&gt;). In case of LVEF&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;50%, the MACE were more frequent when the implantation of at least 1 stent was performed (15.7% &lt;em&gt;vs.&lt;/em&gt; 9.2%; &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.007). No statistically significant difference was observed if LVEF was impaired, particularly when&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;35% (42.3% if at least 1 stent was implanted &lt;em&gt;vs.&lt;/em&gt; 36.8% if DCB-only; &lt;em&gt;p&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.71). The risk of BO-stenting was higher if the clinical presentation was an ACS (OR&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;1.97; IC [1.26–3.07]), in case of a multi-vessel involvement (OR&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;2.44; IC [1.64–3.63]) or a total treated lesion length (TTL)&lt;!--&gt; &lt;!--&gt;&gt;&lt;!--&gt; &lt;!--&gt;60 mm (OR&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;1.64; IC [1.12–2.40]).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The LVEF remains an important prognostic factor in an all-comers population of patients requiring PCI. There was a lower rate of MACE occurrence when the LVEF was preserved. Furthermore the SLS appears to be applicable in patients with severely impaired LVEF as no manifest deleterious effect has been observed when LVEF was&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;35%. Patients presenting with an ACS, a multi-vessel dis","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S12-S13"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150109","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":"Anatomical classification of patent foramen ovale before percutaneous closure","authors":"G. Chevrot,&nbsp;P. Guedeney,&nbsp;M. Dupuy,&nbsp;N. Bouziri,&nbsp;M. Zeitouni,&nbsp;W. Thomas,&nbsp;P. Devos,&nbsp;N. Procopi,&nbsp;N. Hammoudi,&nbsp;J. Silvain,&nbsp;G. Montalescot","doi":"10.1016/j.acvd.2024.10.100","DOIUrl":"10.1016/j.acvd.2024.10.100","url":null,"abstract":"<div><h3>Introduction</h3><div>Anatomical characteristics of patent foramen ovale (PFO) vary a lot, potentially impacting the embolic risk, selection of the device and the final sealing results of the closure procedure.</div></div><div><h3>Objective</h3><div>To categorize the different PFO anatomies and evaluate the consequence on the type of device used and the incidence of residual shunt.</div></div><div><h3>Method</h3><div>In total, 624 consecutive patients who underwent PFO percutaneous closure with transoesophageal echocardiography (TEE) guidance in our center in France were retrospectively reviewed. Four types of PFO were identified, with two subcategories (<span><span>Figure 1</span></span>).</div><div>For each category, the number and types of implanted devices were collected, and the presence of residual shunt was evaluated 6 months after the procedure.</div></div><div><h3>Results</h3><div>Our population had a median age of 51 [41-59] years and included 43.8% women. The type II PFO was the most frequently encountered, with 42% of the patients (<span><span>Table 1</span></span>).</div><div>A total of 93 (14.9%) patients presented multiple types concomitantly (mostly type II and III). PFO occluders were the most implanted devices overall, particularly with type I and IIa, while ASD occluders were more frequently used with types IV and IIb. Cribriform/Uni devices were more frequently used with type IV. Large devices were predominantly used with type III and IV, but scarcely employed with type I and II. Within type II anatomies, large devices were more frequently used with type IIb. At 6 months ultrasound evaluation, large right-to-left residual shunt was significantly more frequent with type IV anatomy. No significant differences were observed regarding clinical outcomes during follow-up.</div></div><div><h3>Conclusion</h3><div>Based on specific anatomical characteristics, four types of PFO may be identified, presenting with increasing procedural complexity, and requesting specific closure devices.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S55-S56"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143151190","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":"Predicting one-year mortality after discharge using Acute Heart Failure Score (AHFS)","authors":"M. Magaldi ,&nbsp;N. Erika ,&nbsp;N. Molinari ,&nbsp;D.L. Nicola ,&nbsp;A.-M. Dupuy ,&nbsp;F. Leclercq ,&nbsp;J.-L. Pasquie ,&nbsp;C. Roubille ,&nbsp;G. Mercier ,&nbsp;J.-P. Cristol ,&nbsp;F. Roubille","doi":"10.1016/j.acvd.2024.10.055","DOIUrl":"10.1016/j.acvd.2024.10.055","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute heart failure (AHF) represents a leading cause of unscheduled hospital stays, frequent rehospitalisations, and mortality worldwide.</div></div><div><h3>Objective</h3><div>The aim of our study was to develop a bedside prognostic tool, a multivariable predictive risk score, that is useful in daily practice, thus providing an early prognostic evaluation at admission and an accurate risk stratification after discharge in patients with AHF.</div></div><div><h3>Method</h3><div>This study is a subanalysis of the STADE HF study, which is a single-centre, prospective, randomised controlled trial enrolling 123 patients admitted to hospital for AHF. Here, 117 patients were included in the analysis, due to data exhaustivity. Regression analysis was performed to determine predictive variables for one-year mortality and/or rehospitalisation after discharge.</div></div><div><h3>Results</h3><div>During the first year after discharge, 23 patients died. After modellisation, the variables considered to be of prognostic relevance in terms of mortality were (1) non-ischaemic aetiology of HF, (2) elevated creatinine levels at admission, (3) moderate/severe mitral regurgitation, and⁴ prior HF hospitalisation. We designed a linear model based on these four independent predictive variables, and it showed a good ability to score and predict patient mortality with an AUC of 0.84 (95%CI: 0.76–0.92), thus denoting a high discriminative ability. A risk score equation was developed. During the first year after discharge, we observed as well that 41 patients died or were rehospitalised; hence, while searching for a model that could predict worsening health conditions (i.e., death and/or rehospitalisation), only two predictive variables were identified: non-ischaemic HF aetiology and previous HF hospitalisation (also included in the one-year mortality model). This second modellisation showed a more discrete discriminative ability with an AUC of 0.67 (95% C.I. 0.59–0.77).</div></div><div><h3>Conclusion</h3><div>The proposed risk score and model, based on readily available predictive variables, are promising and useful tools to assess, respectively, the one-year mortality risk and the one-year mortality and/or rehospitalisations in patients hospitalised for AHF and to assist clinicians in the management of patients with HF aiming at improving their prognosis.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S50-S51"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143151195","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":"Incidence and prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA)","authors":"I. Chamtouri ,&nbsp;W. Jomaa ,&nbsp;A. Turki ,&nbsp;K. Ben Hamda","doi":"10.1016/j.acvd.2024.10.089","DOIUrl":"10.1016/j.acvd.2024.10.089","url":null,"abstract":"<div><h3>Introduction</h3><div>Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a heterogeneous entity often overlooked in contemporary medicine. Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a heterogeneous entity often overlooked in contemporary medicine.</div></div><div><h3>Objective</h3><div>To assess incidence and characteristics of MINOCA in a large cohort of patients admitted for myocardial infarction.</div></div><div><h3>Method</h3><div>A total of 1734 consecutive patients were retrospectively enrolled in the STEMI registry of the cardiology B department of Fattouma Bourguiba university. MINOCA was defined as a non-obstructive coronary artery disease and a lack of previous coronary revascularization. Clinical profile and prognosis of all patients were assessed.</div></div><div><h3>Results</h3><div>The proportion of MINOCA patients among all myocardial infarction was 2.7%. The MINOCA patients were younger (age 47<!--> <!-->±<!--> <!-->14.9 <em>vs.</em> 60.7<!--> <!-->±<!--> <!-->12.4 years), more often males (87.2% <em>vs.</em> 78.7%) with significantly lower rates of diabetes mellitus (19.1% <em>vs.</em> 36.4%, <em>p</em> <!-->=<!--> <!-->0.015), hypertension (10.6% <em>vs.</em> 30.6%, <em>p</em> <!-->=<!--> <!-->0.003), kidney disease (2.1% <em>vs.</em> 7.8%, <em>p</em> <!-->=<!--> <!-->0.032), peripheral artery disease (2.8% <em>vs.</em> 8.3%, <em>p</em> <!-->=<!--> <!-->0.015) and previous MI (2.1% <em>vs.</em> 11.1%, <em>p</em> <!-->=<!--> <!-->0.028) comparing to patients with obstructive coronary artery disease (CAD). History of smoking was more common in the MINOCA group. Typical chest pain at presentation was higher in MINOCA patients (98.6% <em>vs.</em> 93,4%, <em>p</em> <!-->=<!--> <!-->0.046). MINOCA patients presented more frequently anterior ST- segment elevation. All-cause in-hospital and 5 years follow-up mortality rate was lower in the MINOCA patients (1.5% <em>vs.</em> 9.6%, <em>p</em> <!-->&lt;<!--> <!-->0.001; 7.6 <em>vs.</em> 13.8%, <em>p</em> <!-->=<!--> <!-->0.036 respectively).</div></div><div><h3>Conclusion</h3><div>MINOCA represents a challenging group of heterogeneous patients whose clinical characteristics contrast with classical cardiovascular risk factors. A search for etiology and eventual treatment provides a rich avenue for improving prognosis in patients with MINOCA.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S22"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149743","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":"First African validation study of HARMS2-AF and C2HEST scores to predict the onset of atrial fibrillation in patients with acute coronary syndrome treated by PCI: A report from the Moroccan data","authors":"A. Bouchlarhem ,&nbsp;N. Ismaili ,&nbsp;N. El Ouafi","doi":"10.1016/j.acvd.2024.10.082","DOIUrl":"10.1016/j.acvd.2024.10.082","url":null,"abstract":"<div><h3>Introduction</h3><div>New-onset atrial fibrillation (NOAF) during acute coronary syndrome (ACS) represents a complex association given the high thrombo-embolic risk.</div></div><div><h3>Objective</h3><div>We analyzed the validity of the HARMS2-AF and C2HEST score in predicting NOAF in patients with ACS treated by PCI in an African population using data from a Moroccan population.</div></div><div><h3>Method</h3><div>We examined the medical data of patients admitted to our CICU over a 4-year period. We excluded patients with AF prior to admission. Our primary outcome was an episode of NOAF in-hospital. Discrimination for NOAF was assessed using area under the receiver characteristic curve (AUC) values, and a comparison between the two scores was made using the De-long test. We also performed a multivariable logistic regression analysis to predict NOAF using the C2HEST score for a cut-off at 3 and the HARMS2-AF score for a cut-off at 7.</div></div><div><h3>Results</h3><div>We included 763 patients, 76.3% men, with 75% of patients admitted for STEMI. NOAF was diagnosed in 8.4% with 93% within the first 48 h after admission. Patients with NOAF were older (70.27<!--> <!-->±<!--> <!-->11.64 <em>vs.</em> 64.24<!--> <!-->±<!--> <!-->11.55, <em>p</em> <!-->&lt;<!--> <!-->0.001), with a longer length of hospital stay (5.7<!--> <!-->±<!--> <!-->3.86 <em>vs.</em> 3.8<!--> <!-->±<!--> <!-->2.05, <em>p</em> <!-->&lt;<!--> <!-->0.001), a lower ejection fraction (40, 96<!--> <!-->±<!--> <!-->12.25 <em>vs.</em> 46.6<!--> <!-->±<!--> <!-->12.06, <em>p</em> <!-->&lt;<!--> <!-->0.001), a higher C2HEST score (2.45<!--> <!-->±<!--> <!-->1.79 <em>vs.</em> 2.27<!--> <!-->±<!--> <!-->1.43, <em>p</em> <!-->=<!--> <!-->0.003), and a higher HARMS2-AF score (9.22<!--> <!-->±<!--> <!-->3.50 <em>vs.</em> 6.72<!--> <!-->±<!--> <!-->2.94, <em>p</em> <!-->&lt;<!--> <!-->0.001). In multivariate logistic regression analysis, a C2HEST score<!--> <!-->&gt;<!--> <!-->3 was independently associated with the occurrence of NOAF (odds ratio 3.54; 95% CI 2.07–6.07, <em>p</em> <!-->&lt;<!--> <!-->0.001), as was a HARMS2-AF score<!--> <!-->&gt;<!--> <!-->7 (odds ratio 5.56; 95% CI 2.91–10.61, <em>p</em> <!-->&lt;<!--> <!-->0.001). ROC curve analysis showed good accuracy of the C2HEST score (AUC 0.69, 95% CI 0.665; 0.731; <em>p</em> <!-->&lt;<!--> <!-->0.001) and HARMS2-AF score (AUC 0.72, 95% CI 0.689; 0.754; <em>p</em> <!-->&lt;<!--> <!-->0.001) in predicting NOAF, with no significant difference between the two scores (De long test <em>p</em> value<!--> <!-->=<!--> <!-->0.326) (<span><span>Fig. 1</span></span>)</div></div><div><h3>Conclusion</h3><div>As demonstrated by our results, HARMS2-AF and C2HEST scores can predict NOAF after ACS treated with PCI, which will allow selection of patients with a higher risk of stroke.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Pages S18-S19"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150110","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":"Use of the AHEAD score in acute heart failure","authors":"O. Zidi ,&nbsp;Z. Ibn El Hadj ,&nbsp;O. Ferchichi ,&nbsp;H. Ben Arbia ,&nbsp;L. Mariem ,&nbsp;A. Sghaier ,&nbsp;M.A. Almi ,&nbsp;T. Amani ,&nbsp;S. Bousnina ,&nbsp;Z. Ajra ,&nbsp;J. Arfaoui ,&nbsp;A. Ben Halima ,&nbsp;E. Bennour ,&nbsp;I. Kammoun","doi":"10.1016/j.acvd.2024.10.043","DOIUrl":"10.1016/j.acvd.2024.10.043","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a major public-health problem. Recognition of predictors of an unfavourable outcome in HF is very important. With time many scores have been used to evaluate prognostic in HF. AHEAD score is based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.</div></div><div><h3>Objective</h3><div>The aim of this paper is to find a correlation between AHEAD score and both mortality and re-hospitalization.</div></div><div><h3>Method</h3><div>In this prospective study we enrolled 108 patients admitted to our cardiology department between 2021 and 2023 for acute HF. AHEAD score was calculated for each patient and the correlation between this ratio and mortality, re-hospitalizations, was studied.</div></div><div><h3>Results</h3><div>The mean age was 63.5<!--> <!-->±<!--> <!-->11.9 years (79.6% men). Ischemic HF was the most common etiology (57.4%). Of these patients 30.6% were aged<!--> <!-->&gt;<!--> <!-->70 years, 28.7% had atrial fibrillation (AF), 42.2% had diabetes mellitus, 23.1% had anemia, and 16.7% had creatinine<!--> <!-->&gt;<!--> <!-->130<!--> <!-->mmol/l. The mean AHEAD score was 1.4<!--> <!-->±<!--> <!-->1. No patient had a score equal to 5. The one-year mortality rates in patients with AHEAD score of 0 to 4 were 0%, 2.5%, 10.7%, 0%, 40% respectively. The re-hospitalization rates in patients with AHEAD score of 0 to 4 were 8.7%, 5%, 17.9%, 0%, 20% respectively. The ROC curve analysis revealed a correlation between the AHEAD score and the occurrence of mortality (AUC<!--> <!-->=<!--> <!-->0.763, <em>P</em> <!-->=<!--> <!-->0.031) with a cutoff value of 2 with a sensitivity of 83.3% and a specificity of 60.8%. No correlation was found between the AHEAD score and re-hospitalization.</div></div><div><h3>Conclusion</h3><div>Our findings show that the AHEAD score estimates with good performance the mortality in patients with AHF. These results provide new insights into the evaluation of AHF patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 1","pages":"Page S44"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150457","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}