Acta cardiologica最新文献

{"title":"Revisiting the role of sex in stroke risk stratification in atrial fibrillation: a systematic review and meta-analysis.","authors":"Chun-Yu Yeh, Po-Heng Lee, Chen-Shu Wu, Po-Huang Chen, Hsin-Hui Chen, Po-Kai Chan, Hiroyuki Yoshimura, Wen-Yu Lin, Chiao-Chin Lee","doi":"10.1080/00015385.2026.2757891","DOIUrl":"https://doi.org/10.1080/00015385.2026.2757891","url":null,"abstract":"<p><strong>Background: </strong>The 2024 European Society of Cardiology guidelines introduced the CHA₂DS₂-VA score, omitting female sex from stroke risk stratification in atrial fibrillation (AF). However, evidence on the relative predictive performance of CHA₂DS₂-VA versus CHA₂DS₂-VASc across diverse populations remains inconsistent. We therefore conducted a systematic evaluation of their discrimination and reclassification performance.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of observational cohort studies comparing CHA₂DS₂-VA and CHA₂DS₂-VASc for prediction of ischaemic stroke or thromboembolic events in patients with AF. Discrimination was evaluated using the difference in <i>C</i>-statistics (ΔAUC) and integrated discrimination improvement (IDI), and reclassification using continuous net reclassification improvement (NRI). Pooled estimates were derived using random-effects models.</p><p><strong>Results: </strong>Seven studies including 250,112 patients were analysed. In the overall population, discriminative performance was comparable between the CHA₂DS₂-VA and CHA₂DS₂-VASc scores (ΔAUC 0.00065, 95% CI -0.00288 to 0.00417; IDI 0.00010, 95% CI -0.00063 to 0.00083). Continuous NRI indicated a modest advantage for CHA₂DS₂-VASc (-0.05615; 95% CI: -0.10350 to -0.00880). Among patients not receiving oral anticoagulation, both discrimination and reclassification were similar between the two scores. Variability in reclassification performance was observed across regions and study periods.</p><p><strong>Conclusions: </strong>The CHA₂DS₂-VA and CHA₂DS₂-VASc scores showed comparable discrimination for stroke risk prediction in patients with AF when evaluated as continuous scores, although reclassification modestly favoured the CHA₂DS₂-VASc score. The clinical contribution of female sex to risk prediction appears context-dependent and warrants further evaluation.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-13"},"PeriodicalIF":4.0,"publicationDate":"2026-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149357034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cement bridge sign: complete azygos-vein pathway of asymptomatic bone cement embolism detected during acute myocardial infarction workup.","authors":"Jing Kang, Jie Wang, Xiaojing Ma","doi":"10.1080/00015385.2026.2758428","DOIUrl":"https://doi.org/10.1080/00015385.2026.2758428","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cement that travelled: bone‑cement pulmonary embolism after percutaneous vertebroplasty.","authors":"Xiequan Hu, Youfeng Dai","doi":"10.1080/00015385.2026.2758427","DOIUrl":"https://doi.org/10.1080/00015385.2026.2758427","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-2"},"PeriodicalIF":4.0,"publicationDate":"2026-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149316979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circumflex feeder sign on CTA: a warning for safe redo resection of cardiac sarcoma.","authors":"Hongping Yang, Min Chen, Wenjun Deng","doi":"10.1080/00015385.2026.2747493","DOIUrl":"https://doi.org/10.1080/00015385.2026.2747493","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-3"},"PeriodicalIF":4.0,"publicationDate":"2026-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149293792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-deployment steering technique for Watchman FLX implantation in a complex retrobend chicken-wing anatomy.","authors":"Adel Aminian, Elias Al Hage, Mohamed Ben Yedder, Cécile Godefroid, Gregory Angelo Sgueglia","doi":"10.1080/00015385.2026.2732695","DOIUrl":"https://doi.org/10.1080/00015385.2026.2732695","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-3"},"PeriodicalIF":4.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149284554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of the hemodynamic profile for survival in patients undergoing transcatheter edge-to-edge mitral valve repair.","authors":"Felix Ausbuettel, Fares Kano, Nikolaos Patsalis, Christin Fichera, Dimitar Divchev, Carlo-Federico Fichera","doi":"10.1080/00015385.2026.2750010","DOIUrl":"https://doi.org/10.1080/00015385.2026.2750010","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter edge-to-edge mitral valve repair (M-TEER) represents a safe treatment modality for patients with high-grade mitral regurgitation (MR). While clinical decision-making concerning the referral of suitable candidates for M-TEER is guided primarily by clinical and echocardiographic parameters, the potential of hemodynamic parameters obtained at the time of screening in predicting treatment outcomes has not been sufficiently investigated.</p><p><strong>Methods: </strong>All patients who underwent M-TEER and who provided sufficient right heart catheterisation (RHC) data prior to M-TEER were enrolled for analysis. The investigated hemodynamic parameters were analysed descriptively and their associations with survival were estimated by univariable Cox regression analysis and Kaplan-Meier's analysis.</p><p><strong>Results: </strong>A total of 94 patients were analysed, of whom 92.6% (87/94) had concomitant pulmonary hypertension (PH). Analysis of the hemodynamic profile revealed that 46.8% (44/94) of patients had advanced-stage congestive heart failure with a cardiac index < 2 L/min/m², and 68% (64/94) of patients had a cardiac power index <0.5 W/m². According to the results of the Kaplan-Meier and Cox regression analyses, a systolic pulmonary artery pressure (sPAP) > 60 mmHg and a mean right atrial pressure (RAP) > 20 mmHg were proven to be significant predictors of long-term survival after M-TEER.</p><p><strong>Conclusions: </strong>Analysis of the hemodynamic profile, specifically the identified predictors, contributes to the improved identification of scenarios associated with a favourable prognosis in patients undergoing M-TEER.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-9"},"PeriodicalIF":4.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149260471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between waist-to-height-haemoglobin A1c index and subclinical myocardial injury in individuals with and without hypertension.","authors":"Tala Tabrizi, Mohammad Sadra Kiani, Mobin Masoudimoghaddam, Shakiba Fardoost, Soroush Soraneh","doi":"10.1080/00015385.2026.2750006","DOIUrl":"https://doi.org/10.1080/00015385.2026.2750006","url":null,"abstract":"<p><strong>Aims: </strong>Recently, a novel metabolic indicator, the Waist-to-Height-Haemoglobin A1c (WHH) index, has been shown to be associated with diabetes risk. This study investigated the association of WHH with the Cardiac Infarction/Injury Score (CIIS) and the risk of subclinical myocardial injury (SC-MI), stratified by hypertension status.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 5,597 adults aged ≥40 years from the Third National Health and Nutrition Examination Survey who were free of CVD. The WHH index was calculated as waist circumference/height × HbA1c. SC-MI was defined as a CIIS ≥10 on a 12-lead electrocardiogram. Using weighted generalised linear and logistic regression models, we examined the associations of WHH with CIIS and SC-MI. Nonlinear relationships were assessed using restricted cubic spline (RCS) models.</p><p><strong>Results: </strong>The WHH index was not associated with SC-MI among adults without hypertension (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.73-1.24 per SD increase), but was positively associated among adults with hypertension (OR, 1.37; 95% CI, 1.08-1.72; <i>P</i>_interaction = 0.007). For the CIIS, each 1-SD higher WHH index was positively associated only among those with hypertension (β = 0.81; 95% CI, 0.12 to 1.63; <i>P</i>_interaction = 0.020). RCS analysis confirmed a linear relationship between WHH and SC-MI risk among individuals with hypertension.</p><p><strong>Conclusions: </strong>These findings demonstrate a significant association between the WHH index and subclinical myocardial injury, particularly among adults with hypertension.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-12"},"PeriodicalIF":4.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular imaging improves outcomes in left main PCI: insights from acute and chronic presentations.","authors":"Ana Sofia Nogueira Fernandes, Mónica Patrícia Silva Dias, Carla Rafaela Oliveira Ferreira, Filipe Xavier Silva Vilela, Catarina Quina Rodrigues, João Fernando Dos Santos Costa, Jorge Manuel Gomes Sousa Marques, Carlos Galvão de Oliveira Braga","doi":"10.1080/00015385.2026.2747420","DOIUrl":"https://doi.org/10.1080/00015385.2026.2747420","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) has emerged as an established revascularization strategy for selected patients with left main coronary artery (LMCA) disease. However, data regarding outcomes in unselected real-world populations and the impact of intravascular imaging remain limited. We aimed to evaluate clinical outcomes following LMCA PCI according to clinical presentation and to assess the prognostic impact of intravascular imaging guidance.</p><p><strong>Methods: </strong>We conducted a retrospective single-centre study including consecutive patients undergoing LMCA PCI between 2019 and 2022. Patients were classified as having chronic (CCS) or acute coronary syndrome (ACS). Major adverse cardiac and cerebrovascular events (MACCE) were assessed during follow-up. Kaplan-Meier and Cox regression and stabilised inverse probability of treatment weighting (SIPTW) analyses were performed.</p><p><strong>Results: </strong>A total of 107 patients were included (19 CCS and 88 ACS; mean age 68.6 ± 11.3 years; 80.4% male). During a mean follow-up of 1121 ± 574 days, ACS patients experienced higher rates of MACCE (40.9% vs. 15.8%; <i>p</i> = 0.039) and all-cause mortality (29.5% vs. 5.3%; <i>p</i> = 0.027) compared with CCS patients. Intravascular imaging-guided PCI was associated with a significantly lower risk of MACCE in multivariable analysis (HR 0.32, 95% CI 0.14-0.75; <i>p</i> = 0.009). In a SIPTW-adjusted analysis, the association remained directionally favourable, although statistical significance was not maintained (HR 0.57, 95% CI 0.26-1.29; <i>p</i> = 0.178).</p><p><strong>Conclusions: </strong>Clinical presentation significantly influences outcomes after LMCA PCI, with worse long-term prognosis among ACS patients. Intravascular imaging-guided PCI was associated with lower rates of MACCE and remained directionally favourable after weighting analyses, supporting its role in optimising LMCA interventions.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-13"},"PeriodicalIF":4.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association is not mechanism: limitations in linking systemic inflammation to impaired right ventricular reserve in HFpEF.","authors":"Amna Faiz, Wazzuha Gulalai, Summaya Gul","doi":"10.1080/00015385.2026.2752313","DOIUrl":"https://doi.org/10.1080/00015385.2026.2752313","url":null,"abstract":"","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-3"},"PeriodicalIF":4.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From SCORE-Belgium to SCORE2: impact of successive guideline updates on cardiovascular risk categorization.","authors":"Martin Benoit, Olivier Descamps, Elias Bentakhou, Fabian Demeure","doi":"10.1080/00015385.2026.2747548","DOIUrl":"https://doi.org/10.1080/00015385.2026.2747548","url":null,"abstract":"<p><p><b>Background:</b> Successive European guideline updates have modified the estimation and categorisation of cardiovascular risk. The transition from the Belgian SCORE calibration to SCORE2 in 2021, followed by revision of SCORE2 thresholds in 2025, may substantially alter clinical interpretation without changes in individual patient characteristics.<b>Methods:</b> Adults aged 40-69 years in primary prevention were retrospectively included from two Belgian centres. Both cohorts were pooled into a single analytical population. Cardiovascular risk was assessed using the HDL-corrected SCORE-Belgium model (2019), SCORE2 (2021), and the updated SCORE2 thresholds (2025), applied to identical baseline data. Low and moderate categories were harmonised. Reclassification was analysed descriptively.<b>Results:</b> Among 413 individuals, 84.3% were classified as low-moderate risk with SCORE-Belgium, 11.6% as high risk, and 4.1% as very high risk. With SCORE2 (2021), 58.8% were categorised as high risk and 7.3% as very high risk. Application of the 2025 thresholds reversed this distribution: 93.5% were classified as low-moderate risk, 6.5% as high risk, and none as very high risk. These variations affected largely the same individuals and occurred despite identical underlying risk estimates.<b>Conclusion:</b> Guideline updates markedly influence cardiovascular risk categorisation in primary prevention. The changes observed are predominantly attributable to the definitions of thresholds, rather than to differences in the underlying risk estimates. Risk categories should, therefore, be interpreted in the context of the specific assessment framework employed. In addition, supplementary methods for refining individual risk remain necessary.</p>","PeriodicalId":6979,"journal":{"name":"Acta cardiologica","volume":" ","pages":"1-7"},"PeriodicalIF":4.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}