Acta Cardiologica Sinica最新文献

{"title":"Risk Factors for Upper Gastrointestinal Bleeding in Patients Undergoing Percutaneous Coronary Intervention on Dual Antiplatelet Therapy with Assessment of Anti-Ulcer Medication Effects.","authors":"Chun-Ting Shih, Ting-Hsin Huang, Chih-Ming Liang, You-Cheng Zheng, Yi-Lin Chen, Han-Tan Chai, Po-Jui Wu, Chien-Jen Chen, Huang-Chung Chen, Shaur-Zheng Chong","doi":"10.6515/ACS.202503_41(2).20240722A","DOIUrl":"10.6515/ACS.202503_41(2).20240722A","url":null,"abstract":"<p><strong>Background: </strong>Patients in the coronary care unit (CCU) who undergo percutaneous coronary intervention (PCI) and receive dual antiplatelet treatment (DAPT) are at an increased risk of upper gastrointestinal bleeding (UGIB). The effectiveness of histamine-2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs) in preventing UGIB in this context remains uncertain.</p><p><strong>Methods: </strong>This retrospective study enrolled 288 CCU patients undergoing DAPT after PCI, and the incidence of UGIB was assessed at specific timeframes: within 72 hours and beyond 72 hours post catheterization. Factors considered included patient histories, medication regimens (PPIs, H2RAs), and the absence of prophylactic UGIB medication.</p><p><strong>Results: </strong>Within 72 hours, acute UGIB occurred in 8.3% of the patients, with a history of cerebrovascular accident and higher Killip grade identified as risk factors. Excluding the acute cases, the other patients received PPIs (n = 41), H2RAs (n = 57), or no prophylactic medication (n = 166). Delayed UGIB (> 72 hours) occurred in 4.9% of the patients, with chronic kidney disease and higher Killip grade identified as significant risk factors. UGIB rates in the PPI, H2RA, and non-prophylactic groups showed no significant difference (p = 0.264), and TriMatch analysis revealed consistent rates (7.5%, 7.5%, 5.0%) (p = 0.875).</p><p><strong>Conclusions: </strong>No significant difference was found in the incidence of UGIB post PCI between the patients who did and did not receive prophylactic anti-ulcer medications. However, prophylactic medication and vigilant monitoring are suggested for high-risk UGIB patients within the critical CCU setting.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"183-191"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutual Effect of Nutritional Status and Inflammatory Processon Mortality after Superficial Artery Intervention: NAPLES Score.","authors":"Tugba Aktemur, Mehmet Altunova, Omer Tasbulak, Emine Altuntas, Ahmet Arif Yalcin, Fatih Uzun, Mehmet Erturk","doi":"10.6515/ACS.202503_41(2).20240812B","DOIUrl":"10.6515/ACS.202503_41(2).20240812B","url":null,"abstract":"<p><strong>Introduction: </strong>Superficial femoral artery (SFA) stenosis is a common type of peripheral arterial disease. Percutaneous treatment has similar long amputation rates with open surgery. There are various predictors of worse outcomes in this patient group, such as chronic kidney disease and malnutrition. The NAPLES score (NPS) is simple scoring system which consists of four elements. We aimed to investigate the role of NPS in predicting long-term mortality in patients with SFA stenosis who underwent a percutaneous intervention.</p><p><strong>Methods: </strong>A total of 567 patients who underwent percutaneous treatment for stenosis of the SFA from January 2012 to December 2020 were enrolled. The primary endpoint was mortality, and the secondary endpoints were in-hospital thrombosis, restenosis, residual stenosis and postintervention complications. The patients were divided into two groups: high NPS (3, 4) and low NPS (0, 1, 2). Each group was evaluated in terms of clinical, laboratory and technical aspects.</p><p><strong>Results: </strong>The patients with high NPS had a higher rate of mortality (34% vs. 16.3%, p < 0.05), and shorter time to (17.2 ± 14.7 vs. 29.2 ± 19.3 months, p < 0.05). In multivariate analysis, after adjusting for confounding factors, age [hazard ratio (HR): 1.049, 95% confidence interval (CI): 1.025-1.073, p < 0.001], chronic kidney disease (HR: 1.994, 95% CI: 1.347-2.951, p = 0.001), Rutherford class 5-6 (HR: 1.839, 95% CI: 1.195-2.830, p = 0.006), high C-reactive protein values (HR: 1.004, 95% CI: 1.001-1.008, p = 0.022), and estimated higher NPS (HR: 1.748, 95.5 CI: 1.189-2.572, p = 0.005) were shown to be independent risk factors of mortality.</p><p><strong>Conclusions: </strong>NPS is a simple scoring system that can be used to predict long-term mortality in this group. More strict control of risk factors is required in patients with a high NPS.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"200-209"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reappraisal of the New Clinical Pathway National Consensus on Lipid Profile in Taiwan 2025: Where Do We Stand Now?","authors":"Ping-Yen Liu","doi":"10.6515/ACS.202503_41(2).20250210A","DOIUrl":"10.6515/ACS.202503_41(2).20250210A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"166-168"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the Naples Prognostic Score Predict Long-Term Mortality in Patients with Advanced-Stage Heart Failure?","authors":"Sefa Tatar, Hasan Kan, Ahmet Taha Sahin, Ahmet Lutfu Sertdemir, Abdullah İcli, Hakan Akilli","doi":"10.6515/ACS.202503_41(2).20241023A","DOIUrl":"10.6515/ACS.202503_41(2).20241023A","url":null,"abstract":"<p><strong>Background: </strong>Inflammation and malnutrition have negative effects on heart failure. The Naples Prognostic Score (NPS) is a new scoring system that incorporates these two parameters.</p><p><strong>Objectives: </strong>Our aim was to investigate the relationship between the NPS and long-term mortality in patients with advanced-stage heart failure.</p><p><strong>Methods: </strong>The study included 148 patients with advanced-stage heart failure. The patients were divided into two groups: those who died, and those who survived. Demographic, clinical, and laboratory characteristics of the groups were compared. The impact of NPS on mortality was examined.</p><p><strong>Results: </strong>The patients were further classified into three groups according to NPS. The patients with NPS 3 had a higher mortality rate compared to those with NPS 1 and NPS 2 (died vs. survived respectively, NPS 3: 75% vs. 25%, NPS 1: 31.1% vs. 68.9%, NPS 2: 48.9% vs. 51.1%, p < 0.001). In multivariate regression analysis, NPS 3 was found to be an independent predictor [odds ratio: 0.13, 95% confidence interval (CI): 0.051-0.333; p = 0.0001]. Receiver operating characteristic analysis revealed that NPS had a sensitivity of 82% and specificity of 53% for mortality, with an area under curve of 0.699 (95% CI: 0.614-0.784, p = 0.0001). Kaplan-Meier survival analysis demonstrated a higher mortality rate in those with a high NPS (long-rank: 5.29, p = 0.021). In patients with advanced-stage heart failure, NPS may be considered a determinant of long-term mortality.</p><p><strong>Conclusions: </strong>This study demonstrated an association between NPS and long-term mortality in patients with advanced-stage heart failure. NPS, indicating inflammation and nutritional status, can be utilized as a long-term prognostic indicator in patients with advanced-stage heart failure.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"210-218"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on \"Impact of Abnormal Ankle Brachial Index on Sepsis Survival: One-Year Prospective Study Results\": Expanding the Perspective.","authors":"Ömer Faruk Yılmaz, Yusuf Ziya Şener","doi":"10.6515/ACS.202503_41(2).20250109A","DOIUrl":"10.6515/ACS.202503_41(2).20250109A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"261-262"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Algorithm-Based Discovery of Potential Regulators of Immune-Related Dilated Cardiomyopathy.","authors":"Yi-Ting Yang, Bao Zhen, Xue Cao, Hong-Yuan Xia, Ying-Zi Gong, Yan-Li Yang","doi":"10.6515/ACS.202503_41(2).20241022A","DOIUrl":"10.6515/ACS.202503_41(2).20241022A","url":null,"abstract":"<p><strong>Purpose: </strong>Dilated cardiomyopathy (DCM) is considered a severe non-ischemic myocardial disease, and there is currently no effective method for the early detection of DCM. Therefore, we aimed to use machine learning algorithms to discover more accurate factors to guide clinical drug development and precision medicine diagnosis.</p><p><strong>Methods: </strong>Two datasets containing patients with DCM and healthy controls were downloaded from the Gene Expression Omnibus database. After data preprocessing, differentially expressed genes (DEGs) between the DCM patients and normal samples were identified using the limma package. In addition, to screen for DEGs closely associated with immune inflammation, we collected immune-related genes and defined overlapping genes as differential immune genes (Immune-DEGs). Protein-protein interaction (PPI) network construction and functional enrichment analysis were then functionally validated for the differential immune genes. Subsequently, we further screened the immune-DEGs using the least absolute shrinkage and selection operator (LASSO) technique and support vector machine algorithm (SVM), resulting in the screening of five potential modulators closely associated with DCM. Finally, the diagnostic efficacy of the modifiers was assessed using subject operating characteristic curves based on independent external data, and the intrinsic pathological mechanisms of different differential immune genes were explored by immune infiltration analysis.</p><p><strong>Results: </strong>A consensus of 184 differential immune genes were identified, and the functional enrichment results of their PPI network modules suggested that inflammation, immune disorders, and viral infections play an essential role in the pathogenesis of DCM. Five signature genes were then further screened using LASSO and SVM algorithms: KLRC4, CCL4, IGHV3-33, ITGAL, and inducible T-cell kinase.</p><p><strong>Conclusions: </strong>This study constructed a gene set of potential DCM regulators with five immune-related genes, which could provide a new strategy for the diagnosis and treatment of DCM.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"230-241"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Reflections on \"Impact of Abnormal Ankle Brachial Index on Sepsis Survival: One-Year Prospective Study Results\": Expanding the Perspective.","authors":"Mu-Yang Hsieh, Hsinyu Tseng","doi":"10.6515/ACS.202503_41(2).20241216A","DOIUrl":"10.6515/ACS.202503_41(2).20241216A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"263-264"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter Experience of Percutaneous Left Atrial Appendage Occlusion in Current Indications and Different Anesthetic Approaches.","authors":"Shu-I Lin, Chun-Yen Chen, Wei-Ta Chen, Chi-Hsu Wang, Chu-Po Hua, Po-Lin Lin, Wei-Ru Chiou, Kuangte Wang, Cheng-Ting Tsai, Ying-Hsiang Lee","doi":"10.6515/ACS.202503_41(2).20241030A","DOIUrl":"10.6515/ACS.202503_41(2).20241030A","url":null,"abstract":"<p><strong>Background: </strong>Stroke remains a concern in patients with atrial fibrillation despite the efficacy of oral anticoagulants. Left atrial appendage closure has emerged as a treatment option for patients with suboptimal pharmacological therapy.</p><p><strong>Objectives: </strong>This retrospective multicenter study aimed to evaluate the feasibility, safety, and outcomes of left atrial appendage occlusion procedures for two different indications. Short-term outcomes between two different methods of general anesthesia during the procedures were also compared.</p><p><strong>Methods: </strong>The study included patients who underwent appendage closure between September 2017 and June 2021. Two indications for the procedures, anticoagulant intolerance, and anticoagulant inadequacy were recorded. One-year outcomes were analyzed between groups. Short-term outcomes were compared between the intravenous general anesthesia with high-flow nasal cannula oxygen therapy and intubated general anesthesia groups.</p><p><strong>Results: </strong>A total of 75 consecutive patients were enrolled: 19 patients in the anticoagulant inadequacy group and 56 in the anticoagulant intolerance group. Appendage occlusion was effective in reducing stroke risk in atrial fibrillation patients with suboptimal pharmacological therapy. There were no significant differences in outcomes between the two indication groups. Appendage closure under high-flow nasal cannula oxygen therapy was found to be feasible and safe, with comparable results to intubated general anesthesia.</p><p><strong>Conclusions: </strong>Appendage occlusion is effective and safe for Taiwan National Health Insurance-approved indications, with no difference between indication groups during 1-year of follow-up. Appendage occlusion under high-flow nasal cannula oxygen therapy is feasible and comparable to intubated general anesthesia. Larger randomized studies with longer follow-up are needed to confirm these findings.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"251-260"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional Chinese Medicine for the Treatment of Geriatric Heart Disease: A Review.","authors":"Jianyun Bi","doi":"10.6515/ACS.202503_41(2).20240929A","DOIUrl":"10.6515/ACS.202503_41(2).20240929A","url":null,"abstract":"<p><p>Geriatric heart disease is a common disease in modern society. Due to the characteristics of advanced age and multiple underlying diseases, elderly patients with heart disease have a variety of types and treatment methods compared to other diseases. We searched the databases of CNKI, PubMed, and Web of Science to search for the causes and treatment methods of traditional Chinese and Western medicine for heart diseases using the terms \"geriatric heart disease\", \"treatment\", \"ischemic heart disease\", \"pulmonary heart disease\", \"hypertensive heart disease\", \"rheumatic heart disease\", \"thyroid heart disease\", \"coronary heart disease\", \"arrhythmia\", and \"heart conduction block\". The search also included the terms \"reasonable emotional therapy\", \"Baduanjin\", \"TaiChi\", \"Wuqinxi\", \"Qigong\", \"acupuncture and moxibustion\", \"moxibustion\", \"guasha\" and so on, auxiliary Chinese medicine therapies for geriatric heart disease. The results showed that traditional Chinese medicine (TCM) has a relatively comprehensive treatment plan for different types of geriatric heart disease. Generally, TCM combined with Western medicine or surgery can effectively improve heart function and treat the disease. Chinese exercise and TCM therapy also play an indispensable role in the auxiliary treatment of geriatric heart disease, effectively improving the living conditions of the elderly.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"169-182"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 Consensus on the Clinical Pathway of Blood Cholesterol Management in Taiwan.","authors":"Yi-Heng Li, Chung-Liang Shih","doi":"10.6515/ACS.202503_41(2).20250215A","DOIUrl":"10.6515/ACS.202503_41(2).20250215A","url":null,"abstract":"<p><p>Increased low-density lipoprotein cholesterol (LDL-C) is one of the most important risk factors for atherosclerotic cardiovascular disease (ASCVD). However, the attainment rate of recommended LDL-C targets is not optimal with significant scope for improvement in Taiwan. This clinical pathway for cholesterol management was developed based on the Taiwan lipid guidelines and expert opinions from major medical societies in Taiwan. It was designed with the aim of improving the outcomes of people at risk of or with ASCVD who would benefit from lipid control to reduce the risk of new or recurrent cardiac events. The pathway proposes adequate LDL-C targets for people at different risk levels of ASCVD and standardizes lipid management and follow-up in patients receiving lipid lowering therapy. The ultimate purpose is to facilitate the attainment of individual LDL-C targets and ensure that patients are monitored adequately and optimized on the appropriate lipid lowering therapy to reduce the risk of ASCVD.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"41 2","pages":"161-165"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}