Acta Cardiologica Sinica最新文献

{"title":"Left Atrial Strain Predicts Cardiovascular and All-Cause Mortality.","authors":"Chien-Wei Chang, Wen-Hsien Lee, Tien-Chi Huang, Yi-Hsueh Liu, Po-Chao Hsu, Tsung-Hsien Lin, Wen-Chol Voon, Ho-Ming Su","doi":"10.6515/ACS.202401_40(1).20230818A","DOIUrl":"10.6515/ACS.202401_40(1).20230818A","url":null,"abstract":"<p><strong>Background: </strong>Left atrial strain can usefully reflect left atrial function. The follow-up periods in previous studies assessing left atrial strain as a survival predictor have been relatively short, and few studies have examined the ability of left atrial strain to predict mortality in patients with borderline diastolic function. This study sought to investigate the survival predictive value of left atrial strain with a longer follow-up duration. In addition, we also evaluated the survival predictive value of left atrial strain in patients with borderline diastolic function.</p><p><strong>Methods: </strong>In total, 652 participants who received routine echocardiography underwent 2-D speckle tracking echocardiography to evaluate left atrial reservoir function by peak atrial longitudinal strain. The study endpoints were all-cause and cardiovascular mortality.</p><p><strong>Results: </strong>The mean left atrial strain was 27.6%, and the median follow-up duration was 92 months. During follow-up, 72 patients died of cardiovascular causes and 181 died of all causes. Univariable Cox regression analysis revealed that lower left atrial strain significantly predicted an increase in all-cause and cardiovascular mortality. After adjusting for common clinical and echocardiographic parameters, lower left atrial strain was still associated with a higher risk of all-cause mortality [hazard ratio (HR) = 0.942, p = 0.011] and cardiovascular mortality (HR = 0.915, p = 0.018) in multivariable Cox-regression analysis. In addition, 293 patients had borderline left ventricular diastolic function. Multivariable analysis still revealed that left atrial strain could predict cardiovascular mortality in this population.</p><p><strong>Conclusions: </strong>Our data showed that left atrial strain could predict all-cause and cardiovascular mortality, even after adjusting for general clinical and echocardiographic parameters.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"40 1","pages":"50-59"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541131","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":"2023 TAMIS/TSOC/TACVPR Consensus Statement for Patients with Acute Myocardial Infarction Rehabilitation.","authors":"Kuan-Cheng Chen, Chih-Neng Hsu, Cheng-Hsueh Wu, Ko-Lung Lin, Shyh-Ming Chen, Yuchun Lee, Chien-Yi Hsu, Che-Wei Hsu, Chi-Yao Huang, Shou-Hsien Huang, Chia-Te Liao, Christina Soong, Po-Wei Chen, Shu-Ming Yeh, Chang-Cheng Wu, Cho-I Lin, Nai-Wen Guo, Yi-Heng Li, Tsung-Hsien Lin, Chia-Hsin Chen, Chun-Yao Huang, Ssu-Yuan Chen, Yu-Chen Wang, Wei-Chun Huang, Willy Chou, Wen-Jone Chen","doi":"10.6515/ACS.202311_39(6).20230921A","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230921A","url":null,"abstract":"<p><p>Cardiac rehabilitation is a comprehensive intervention recommended in international and Taiwanese guidelines for patients with acute myocardial infarction. Evidence supports that cardiac rehabilitation improves the health-related quality of life, enhances exercise capacity, reduces readmission rates, and promotes survival in patients with cardiovascular disease. The cardiac rehabilitation team is comprehensive and multidisciplinary. The inpatient, outpatient, and maintenance phases are included in cardiac rehabilitation. All patients admitted with acute myocardial infarction should be referred to the rehabilitation department as soon as clinically feasible. Pre-exercise evaluation, including exercise testing, helps physicians identify the risks of cardiac rehabilitation and organize appropriate exercise prescriptions. Therefore, the Taiwan Myocardial Infarction Society (TAMIS), Taiwan Society of Cardiology (TSOC), and Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation (TACVPR) address this consensus statement to assist healthcare practitioners in performing cardiac rehabilitation in patients with acute myocardial infarction.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"783-806"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457090","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":"A Deep-Learning Algorithm-Enhanced Electrocardiogram Interpretation for Detecting Pulmonary Embolism.","authors":"Yu-Cheng Chen, Sung-Chiao Tsai, Chin Lin, Chin-Sheng Lin, Wen-Hui Fang, Yu-Sheng Lou, Chia-Cheng Lee, Pang-Yen Liu","doi":"10.6515/ACS.202311_39(6).20230410B","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230410B","url":null,"abstract":"<p><strong>Background: </strong>The early diagnosis of pulmonary embolism (PE) remains a challenge. Electrocardiograms (ECGs) and D-dimer levels are used to screen potential cases.</p><p><strong>Objective: </strong>To develop a deep learning model (DLM) to detect PE using ECGs and investigate the clinical value of false detections in patients without PE.</p><p><strong>Methods: </strong>Among patients who visited the emergency department between 2011 and 2019, PE cases were identified through a review of medical records. Non-PE ECGs were collected from patients without a diagnostic code for PE. There were 113 PE and 51,456 non-PE ECGs in the training and validation sets for developing the DLM, respectively, and 27 PE and 13,105 non-PE cases in an independent testing set for performance validation. A human-machine competition was conducted from the testing set to compare the performance of the DLM with that of physicians. Receiver operating characteristic (ROC) curves, sensitivity, and specificity were used to determine the diagnostic value. Survival analysis was used to assess the prognosis of the patients without PE, stratified by DLM prediction.</p><p><strong>Results: </strong>The DLM was as effective as physicians in diagnosing PE, with 70.8% sensitivity and 69.7% specificity. The area under the ROC curve of DLM was 0.778 in the testing set and up to 0.9 with D-dimer and demographic data. The non-PE patients whose ECG was misclassified as PE by DLM had higher all-cause mortality [hazard ratio (HR) 2.13 (1.51-3.02)] and risk of non-cardiovascular hospitalization [HR 1.55 (1.42-1.68)] than those correctly classified.</p><p><strong>Conclusions: </strong>A DLM-enhanced ECG system may prompt PE recognition and provide prognostic outcomes in patients with false-positive predictions.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"913-928"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457099","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":"Validation of the Framingham General Cardiovascular Risk Score and Pooled Cohort Equations in a Community-Based Population: A Prospective Cohort Study Analysis 2006-2017.","authors":"Jia-Zhen Jian, I-Shiang Tzeng, Chuan-Fa Hsieh, Hsuan-Li Huang, Chien-Lung Chen, Kuan-Liang Liu","doi":"10.6515/ACS.202311_39(6).20230405A","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230405A","url":null,"abstract":"<p><strong>Background: </strong>The 10-year atherosclerotic cardiovascular disease (ASCVD) risk - as assessed using the Framingham general cardiovascular risk score (FRS-CVD) or pooled cohort equations (PCE) - is commonly used in Western cohorts for the primary prevention of cardiovascular disease (CVD). However, the FRS-CVD and PCE have not been validated in Taiwanese cohorts.</p><p><strong>Objectives: </strong>We aimed to validate the FRS-CVD and PCE for assessing the 10-year ASCVD risk using a Taiwanese community-based population.</p><p><strong>Methods: </strong>We extracted patient data from the Landseed Integrated Outreaching Neighborhood Screening registry, a community-based prospective cohort study established in 2006. Cardiovascular events from 2006 to 2017 were determined from electronic medical records. The discriminative power and calibration of the FRS-CVD and PCE were evaluated.</p><p><strong>Results: </strong>Overall, 5,139 subjects were analyzed; the 10-year follow-up rate was 99.6%. The mean age at baseline was 52.8 ± 13.1 years, and 44.6% of the subjects were male. In total, 430 of 4,631 (9.3%) and 227 of 4,022 (5.6%) of the FRS-CVD- and PCE-like cohorts, respectively, had ASCVD events. The calibration χ² of the FRS-CVD was 7.0267 (p = 0.6343) in males and 7.8845 (p = 0.5458) in females; the χ² of PCE was 13.007 (p = 0.1623) in males and 38.785 (p < 0.001) in females. The area under the receiver operating characteristic curve (AUROC) of the FRS-CVD was 0.76 (0.72-0.79) in males and 0.71 (0.67-0.74) in females; the AUROC of PCE was 0.68 (0.62-0.73) in males and 0.61 (0.56-0.67) in females.</p><p><strong>Conclusions: </strong>Except for PCE in females, the FRS-CVD and PCE provided good calibration and modest discrimination in statin-naïve Taiwanese individuals without prior CVD.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"879-887"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457130","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":"Galectin-3 as a Biomarker to Predict Cardiorenal Syndrome in Patients with Acute Heart Failure.","authors":"Serhan Ozyildirim, Omer Dogan, Hasan Ali Barman, Selim Tanyolaç, Adem Atıcı, Rasim Enar, Sait Mesut Doğan","doi":"10.6515/ACS.202311_39(6).20230903A","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230903A","url":null,"abstract":"<p><strong>Background: </strong>Galectin-3 affects cardiac tissue inflammation as an inflammatory mediator. The development of cardiorenal syndrome in heart failure patients is associated with a poor prognosis. This study aims to investigate whether serum galectin-3 levels can be used as a biomarker to predict cardiorenal syndrome in heart failure patients with reduced left ventricular ejection fraction.</p><p><strong>Methods: </strong>A total of 166 symptomatic heart failure patients [New York Heart Association (NYHA) functional class II-III] with reduced left ventricular ejection fraction (≤ 40%) were recruited prospectively. Cardiorenal syndrome type 1 was defined as an acute worsening of cardiac function leading to renal dysfunction. The patients were divided into two groups with and without cardiorenal syndrome. The galectin-3 levels of all patients were determined. The primary outcome of this study was the occurrence of cardiorenal syndrome.</p><p><strong>Results: </strong>Cardiorenal syndrome developed in 41 patients. Galectin-3 levels were found to be higher in the patients with cardiorenal syndrome (+) compared to those without cardiorenal syndrome (-) (20.7 ± 2.9 ng/mL vs. 17.8 ± 3.1 ng/mL, p < 0.001). After performing a multivariable analysis, galectin-3 levels [odds ratio (OR): 3.21, p = 0.001], NYHA functional class (OR: 1.98, p = 0.009), creatinine (OR: 3.18, p = 0.006), furosemide dose (OR: 1.21, p = 0.033), and angiotensin-converting enzyme inhibitor/angiotensin-receptor blockers usage (OR: 0.54, p = 0.029) were identified as independent predictors for the development of cardiorenal syndrome. Moreover, galectin-3 level demonstrated predictive capability for cardiorenal syndrome development (AUC = 0.761, p < 0.001).</p><p><strong>Conclusions: </strong>Serum galectin-3 level showed an association with cardiorenal syndrome development in patients with heart failure, indicating potential usefulness as a prognostic biomarker.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"862-870"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457104","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 Models for ASCVD Risk Prediction in an Asian Population - How to Validate the Model is Important.","authors":"Yu-Chung Hsiao, Chen-Yuan Kuo, Fang-Ju Lin, Yen-Wen Wu, Tsung-Hsien Lin, Hung-I Yeh, Jaw-Wen Chen, Chau-Chung Wu","doi":"10.6515/ACS.202311_39(6).20230528A","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230528A","url":null,"abstract":"<p><strong>Introduction: </strong>Atherosclerotic cardiovascular disease (ASCVD) is prevalent worldwide including Taiwan, however widely accepted tools to assess the risk of ASCVD are lacking in Taiwan. Machine learning models are potentially useful for risk evaluation. In this study we used two cohorts to test the feasibility of machine learning with transfer learning for developing an ASCVD risk prediction model in Taiwan.</p><p><strong>Methods: </strong>Two multi-center observational registry cohorts, T-SPARCLE and T-PPARCLE were used in this study. The variables selected were based on European, U.S. and Asian guidelines. Both registries recorded the ASCVD outcomes of the patients. Ten-fold validation and temporal validation methods were used to evaluate the performance of the binary classification analysis [prediction of major adverse cardiovascular (CV) events in one year]. Time-to-event analyses were also performed.</p><p><strong>Results: </strong>In the binary classification analysis, eXtreme Gradient Boosting (XGBoost) and random forest had the best performance, with areas under the receiver operating characteristic curve (AUC-ROC) of 0.72 (0.68-0.76) and 0.73 (0.69-0.77), respectively, although it was not significantly better than other models. Temporal validation was also performed, and the data showed significant differences in the distribution of various features and event rate. The AUC-ROC of XGBoost dropped to 0.66 (0.59-0.73), while that of random forest dropped to 0.69 (0.62-0.76) in the temporal validation method, and the performance also became numerically worse than that of the logistic regression model. In the time-to-event analysis, most models had a concordance index of around 0.70.</p><p><strong>Conclusions: </strong>Machine learning models with appropriate transfer learning may be a useful tool for the development of CV risk prediction models and may help improve patient care in the future.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"901-912"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457107","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":"Rupture of Giant Coronary Artery Aneurysm into Left Atrium Causing Acute Congestive Heart Failure.","authors":"Chia-Ying Wu, Ying-Nan Cheng, Hsin-Yueh Liang, Tzu-Yao Chuang, Ping-Chun Li","doi":"10.6515/ACS.202311_39(6).20230814B","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230814B","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"937-940"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457111","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":"Asian Female Athlete's Heart: The CHIEF Heart Study.","authors":"Ming-Yueh Liu, Pang-Yen Liu, Kun-Zhe Tsai, Joao A C Lima, Carl J Lavie, Gen-Min Lin","doi":"10.6515/ACS.202311_39(6).20230306F","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230306F","url":null,"abstract":"<p><strong>Background: </strong>The cardiac characteristics of Asian female endurance athletes and strength athletes have rarely been investigated.</p><p><strong>Methods: </strong>This study included 177 Taiwanese young women undergoing military training. Cardiac features were assessed by electrocardiography (ECG) and echocardiography. Then, all participants completed a 3000-meter run to assess endurance capacity, and 89 participants completed a 2-minute push-up test to assess muscular strength. Athletes were those whose exercise performance fell one standard deviation above the mean, and the remaining participants were defined as controls. Multiple logistic regression analysis was used to determine the predictors of the cardiac characteristics of female athletes.</p><p><strong>Results: </strong>Compared to the female controls, female endurance athletes had a greater QRS duration (ms) (92.12 ± 10.35 vs. 87.26 ± 9.89, p = 0.01) and a higher prevalence of right axis deviation (RAD) (34.9% vs. 11.1%, p < 0.001). There were no differences in any echocardiographic parameters. Greater QRS duration and RAD and lower systolic blood pressure were independent predictors of female endurance athletes [odds ratios (OR) and 95% confidence intervals: 1.05 (1.01-1.09), 2.91 (1.12-7.59) and 0.93 (0.88-0.98), respectively]. Female strength athletes had a greater right ventricular outflow tract (RVOT) (mm) (28.06 ± 3.57 vs. 25.38 ± 3.61, p = 0.007) but revealed no differences in ECG variables. Greater RVOT was the only predictor of female strength athletes [OR: 1.26 (1.05-1.50)].</p><p><strong>Conclusions: </strong>In Asian military women, a wider QRS duration and the presence of RAD in ECG rather than heart structure and function were found to characterize endurance athletes, whereas a wider RVOT but no ECG features were found to characterize strength athletes.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"888-900"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457100","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":"How to Interpret Changes in Myocardial Uptake in Serial ^99mTc-Pyrophosphate Scans in a Patient - A Case Report.","authors":"Yi-San Shih, Wen-Po Chuang, Shan-Ying Wang, Yen-Wen Wu","doi":"10.6515/ACS.202311_39(6).20230731A","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230731A","url":null,"abstract":"","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"932-936"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457105","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":"The Identification of Subsequent Events Following Out-of-Hospital Cardiac Arrests with Targeted Temperature Management.","authors":"Chia-Chen Lee, Hsiao-Yun Cheuh, Sheng-Nan Chang","doi":"10.6515/ACS.202311_39(6).20230529B","DOIUrl":"https://doi.org/10.6515/ACS.202311_39(6).20230529B","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital cardiac arrest (OHCA) is a critical issue due to poor neurological outcomes and high mortality rate. Severe ischemia and reperfusion injury often occur after cardiopulmonary resuscitation (CPR) and return of spontaneous circulation (ROSC). Targeted temperature management (TTM) has been shown to reduce neurological complications among OHCA survivors. However, it is unclear how \"time-to-cool\" influences clinical outcomes. In this study, we investigated the optimal timing to reach target temperature after cardiac arrest and ROSC.</p><p><strong>Methods: </strong>A total of 568 adults with OHCA and ROSC were admitted for targeted hypothermia assessment. Several events were predicted, including pneumonia, septic shock, gastrointestinal (GI) bleeding, and death.</p><p><strong>Results: </strong>One hundred and eighteen patients [70 men (59.32%); 48 women (40.68%)] were analyzed for clinical outcomes. The duration of CPR after ROSC was significantly associated with pneumonia, septic shock, GI bleeding, and mortality after TTM (all p < 0.001). The duration of CPR was also positively correlated with poor outcomes on the Elixhauser score (p = 0.001), APACHE II score (p = 0.008), Cerebral Performance Categories (CPC) scale (p < 0.001), and Glasgow Coma Scale (GCS) score (p < 0.001). There was a significant association between the duration of CPR and time-to-cool of TTM after ROSC (Pearson value = 0.447, p = 0.001). Pneumonia, septic shock, GI bleeding, and death were significantly higher in the patients who underwent TTM with a time-to-cool exceeding 360 minutes (all p < 0.001).</p><p><strong>Conclusions: </strong>For cardiac arrest patients, early cooling has clear benefits in reducing clinical sequelae. Clinical outcomes could be improved by improving the time to reach target temperature and feasibility for critically ill patients.</p>","PeriodicalId":6957,"journal":{"name":"Acta Cardiologica Sinica","volume":"39 6","pages":"831-840"},"PeriodicalIF":1.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457129","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}