American heart journal plus : cardiology research and practice最新文献

{"title":"Integration of BNP and blood glucose for identifying coronary flow reserve impairment: A cardiovascular–kidney–metabolic perspective","authors":"Kotaro Matsumoto ,&nbsp;Kenichiro Otsuka ,&nbsp;Shunsuke Kagawa ,&nbsp;Hiroki Yamaura ,&nbsp;Tsubasa Miura ,&nbsp;Kazuya Sugioka ,&nbsp;Wataru Saitoh ,&nbsp;Akihiro Okamoto ,&nbsp;Go Kajio ,&nbsp;Naoki Fujisawa ,&nbsp;Tomohiro Yamaguchi ,&nbsp;Takenobu Shimada ,&nbsp;Yusuke Hayashi ,&nbsp;Atsushi Shibata ,&nbsp;Asahiro Ito ,&nbsp;Takanori Yamazaki ,&nbsp;Daiju Fukuda","doi":"10.1016/j.ahjo.2025.100671","DOIUrl":"10.1016/j.ahjo.2025.100671","url":null,"abstract":"<div><div>Cardiovascular-kidney-metabolic (CKM) syndrome may predispose patients to coronary microvascular dysfunction (CMD) through systemic microvascular injury. We investigated the association between CKM risk factors and CMD, focusing on the diagnostic performance of accessible biomarkers. In this exploratory analysis, we retrospectively analyzed 65 patients who underwent invasive coronary physiological assessment with thermodilution-derived coronary flow reserve (CFR) and index of microcirculatory resistance (IMR). Clinical variables included casual blood glucose, B-type natriuretic peptide (BNP), and the urine albumin-to-creatinine ratio (ACR), along with echocardiographic indices of diastolic function. Among the 65 patients, 20 (31 %) had impaired CFR. BNP (AUC = 0.74; 95 % confidence interval, CI, 0.60–0.88) and casual blood glucose (area under the curve, AUC = 0.64; 95 % CI, 0.49–0.80) showed diagnostic accuracy for impaired CFR of &lt;2.0, while ACR improved model performance when combined with BNP or E/e′. The combination of BNP and casual glucose significantly improved diagnostic performance compared with either marker alone (AUC = 0.83 vs. 0.75; 95 % CI, 0.73–0.93; <em>p</em> = 0.03). The elevated BNP (AUC = 0.77, 95 % CI: 0.59–0.95) and higher ACR (AUC = 0.71, 95 % CI: 0.52–0.90) were significantly associated with structural CMD defined as CFR &lt; 2.0 and IMR ≥ 25, whereas casual blood glucose was not. From a CKM perspective, BNP and casual blood glucose were associated with impairment of CFR and may serve as simple, accessible biomarkers for its early detection and risk stratification.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100671"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher hemoglobin is associated with better survival in coronary artery disease, heart failure with reduced ejection fraction, and chronic kidney disease","authors":"Cheng-Yu Hung ,&nbsp;Wen-Lieng Lee ,&nbsp;Wayne H.-H. Sheu ,&nbsp;Kae-Woei Liang","doi":"10.1016/j.ahjo.2025.100685","DOIUrl":"10.1016/j.ahjo.2025.100685","url":null,"abstract":"<div><h3>Background</h3><div>Anemia is a common comorbidity in patients with heart failure (HF) or chronic kidney disease (CKD) and could be associated with worse clinical outcomes. However, to date, the impact of anemia on survival in a complex triple-comorbidity of coronary artery disease (CAD), HF with reduced ejection fraction (HFrEF), and CKD remains inconclusive.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data for subjects with significant CAD, HFrEF (defined as left ventricular ejection fraction (EF) &lt;40 %) and CKD (defined as estimated glomerular filtration rate (eGFR) ≦60 ml/min/1.73m²) from our cardiac catheterization laboratory between January 2010 and September 2019. Clinical and laboratory variables were recorded from traceable chart records from our hospital. All-cause and cardiovascular mortality were counted until December 2019 and served as study outcomes.</div></div><div><h3>Results</h3><div>A total of 128 subjects with CAD, HFrEF and CKD were analyzed. Anemia was prevalent (81/128 = 63.3 %) in this complex disease combination. The median follow-up duration was 36 months and 77 subjects (60.1 %) died. Cox survival analysis revealed that higher baseline hemoglobin (hazard ratio 0.864, 95 % CI 0.753–0.992, per 1 g/dl increase), higher eGFR, better EF, and the use of beta-blockers were associated with lower all-cause mortality.</div></div><div><h3>Conclusions</h3><div>A higher baseline admission hemoglobin value was associated with lower all-cause mortality in subjects with significant CAD, HFrEF, and CKD.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100685"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The gut-heart axis: Exploring the role of the gut microbiome in cardiovascular health – A focused systematic review","authors":"Yahya Makkieh ,&nbsp;Haider Hussain Shah ,&nbsp;Sakan Binte Imran ,&nbsp;Shadman Mahmood Khan Pathan ,&nbsp;Anagha Chirayath Saju ,&nbsp;Mounica Majooju ,&nbsp;Aastha Garg ,&nbsp;Tarun Naag ,&nbsp;Rabeeul Islam ,&nbsp;Cheeranthodika Fahima ,&nbsp;Ramsha Ali","doi":"10.1016/j.ahjo.2025.100687","DOIUrl":"10.1016/j.ahjo.2025.100687","url":null,"abstract":"<div><div>This focused systematic review examines the role of the gut microbiota in cardiovascular disease (CVD). The review explores mechanisms linking gut dysbiosis with CVD via microbial metabolites such as trimethylamine-N-oxide (TMAO) and short-chain fatty acids (SCFAs), which affect inflammation, endothelial function, and lipid metabolism. Interventions including dietary modifications, probiotics, prebiotics, fecal microbiota transplantation, and pharmacological agents such as statins, rifaximin, and empagliflozin are evaluated for their impact on microbial composition and cardiovascular outcomes. Probiotic strains and fiber-rich diets demonstrated modest improvements in blood pressure, lipid profiles, and inflammatory markers. Studies revealed that gut microbiome alterations influence drug metabolism and bleeding risk in patients taking oral anticoagulants. Limited evidence suggests that modulation of the microbiota may reduce chemotherapy-induced cardiotoxicity. However, only nine eligible studies met the inclusion criteria, reflecting the early and heterogeneous nature of this research area. Consequently, these findings should be interpreted as exploratory and hypothesis-generating. The focused review emphasizes the need for large-scale trials to validate microbiome-targeted strategies in CVD prevention and management. This focused systematic review is registered with PROSPERO (ID: CRD420251022190).</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100687"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the interaction between klotho and TyG index in cardiovascular risk stratification: A metabolic-inflammatory network analysis with mediation and machine learning insights","authors":"Jieqing Min ,&nbsp;Yunjuan Yang","doi":"10.1016/j.ahjo.2025.100681","DOIUrl":"10.1016/j.ahjo.2025.100681","url":null,"abstract":"<div><h3>Background</h3><div>This study explores the relationship of metabolic-inflammatory network and cardiovascular disease (CVD), offering new insights into the roles of Klotho and the Triglyceride-Glucose (TyG) index in CVD pathogenesis.</div></div><div><h3>Methods</h3><div>Data from 5402 adults (mean age: 58.04 ± 10.83 years; 50.96 % female) from the NHANES in 2007–2016 database were analyzed. We proposed a prediction model for CVD risk incorporating Klotho protein, TyG index, and their interaction. The predictive value of these factors was evaluated using machine learning techniques, including random forest analysis and CHAID decision tree modeling.</div></div><div><h3>Results</h3><div>The study found no association between serum alpha-Klotho levels and CVD risk. However, the TyG index was demonstrated to be a significant predictor of CVD risk, particularly when lifestyle and socio-economic factors were not accounted for. TyG values were associated with an increased risk of metabolic syndrome and CVD (Model 1 <em>OR</em>: 1.234; Model 2 <em>OR</em>: 1.268). There was a significant interaction between Klotho-TyG was observed (coefficient − 2.608 × 10⁶). In addition, the random forest model achieved an accuracy of 66.63 % with high specificity and precision, and in the CHAID model an error of 27 %.</div></div><div><h3>Conclusions</h3><div>This study underscores the TyG index as a key biomarker for CVD risk, with the Klotho-TyG interaction improving risk stratification, and supporting early screening, treatment, and personalized interventions for more effective CVD management.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100681"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and predictors of palliative care use in acute heart failure hospitalizations","authors":"Aimen Shafiq ,&nbsp;Ali Salman ,&nbsp;Sadia Akram ,&nbsp;Muhammad Rizwan Farooq ,&nbsp;Qais Bin Abdul Ghaffar ,&nbsp;Anam Ijaz ,&nbsp;Abdullah Imtiaz ,&nbsp;Humna Irshad ,&nbsp;Aroon Kumar ,&nbsp;Muhammad Faisal Riaz ,&nbsp;Saman Rauf ,&nbsp;Usman Sarwar ,&nbsp;Kaneez Fatima ,&nbsp;Ali Hasan ,&nbsp;Raheel Ahmed","doi":"10.1016/j.ahjo.2025.100667","DOIUrl":"10.1016/j.ahjo.2025.100667","url":null,"abstract":"<div><h3>Background</h3><div>Palliative care consultation (PCC) in acute decompensated heart failure (ADHF) may enhance care quality and align treatment with patient goals. However, national trends and predictors of PCC in ADHF remain poorly defined.</div></div><div><h3>Methods</h3><div>We used the National Inpatient Sample (2018–2020) to identify hospitalizations for adults (≥18 years) with a primary diagnosis of ADHF using ICD-10-CM codes. PCC was defined by ICD-10-CM code Z51.5. Multivariable survey-weighted logistic regression identified predictors of PCC use, adjusting for demographics, socioeconomic status, comorbidities, and hospital factors.</div></div><div><h3>Results</h3><div>Among 3,655,265 hospitalizations, older age was associated with higher odds of PCC (aOR 1.05 per year; 95 % CI, 1.05–1.05). Compared to White individuals, odds of PCC were lower for Asian or Pacific Islander (aOR 0.74), Black (aOR 0.83), and Hispanic individuals (aOR 0.76). Medicare patients had lower odds than those with Medicaid (aOR 0.72). The highest income quartile was associated with greater PCC use (aOR 1.18). PCC was less common in the Northeast (aOR 0.88), South (aOR 0.93), and West (aOR 0.91) compared to the Midwest. Urban teaching hospitals had higher PCC rates than rural hospitals (aOR 1.48). Patients with greater comorbidity and higher mortality risk were more likely to receive PCC.</div></div><div><h3>Conclusion</h3><div>PCC use in ADHF is influenced by demographic, socioeconomic, clinical, and institutional factors. Racial, regional, and hospital-level disparities suggest a need for interventions to promote equitable access to palliative care for patients with ADHF.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100667"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of epicardial adipose tissue thickness and human neutrophil lipocalin with mitral annular calcification","authors":"Yeheng Xue ,&nbsp;Xinyi Wang ,&nbsp;Xiaohong Liu ,&nbsp;Qingxue Zhang ,&nbsp;Zhijian Liu ,&nbsp;Bin Leng ,&nbsp;Xiuchang Li","doi":"10.1016/j.ahjo.2025.100672","DOIUrl":"10.1016/j.ahjo.2025.100672","url":null,"abstract":"<div><h3>Study objective</h3><div>Mitral annular calcification (MAC) is significantly associated with coronary artery stenosis and valvular dysfunction. And epicardial adipose tissue (EAT) can secrete inflammatory factors and human neutrophil lipocalin (HNL) are widely used as indicators of inflammation. There is now increasing evidence of a strong link between MAC and the inflammatory response. This study aims to investigate the effects of EAT thickness and HNL in MAC.</div></div><div><h3>Design</h3><div>A cross-sectional approach was used in this study.</div></div><div><h3>Setting</h3><div>The Second Affiliated Hospital of Shandong First Medical University.</div></div><div><h3>Participants</h3><div>The included patients was classified into a calcification group (MAC group) and a control group based on the presence or absence of MAC on echocardiography.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main outcome measures</h3><div>The clinical data, HNL, EAT thickness of the two groups were measured, collected and analyzed. Logistic regression analysis was used to assess the independent risk factors for MAC and the receiver operating characteristic (ROC) curve was plotted to evaluate the effectiveness of EAT thickness and HNL in diagnosing MAC.</div></div><div><h3>Results</h3><div>Patients in the MAC group had significantly higher basal and apical EAT thickness and HNL level than those in the control group. Basal EAT thickness was independently associated with MAC (OR = 2.003, 95 % CI = 1.474–2.721, <em>P</em> &lt; 0.001). The AUC for basal EAT thickness to predict MAC was 0.880.</div></div><div><h3>Conclusion</h3><div>Our data suggest EAT thickness and HNL were significantly associated with MAC, and basal EAT thickness near the right coronary artery was independently associated with MAC and had a high predictive value for MAC.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100672"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single centre experience of rotablation-assisted left main percutaneous coronary intervention","authors":"Mohd Maqbool Sohil ,&nbsp;Ishtiyaq Masood ,&nbsp;Dixit Goyal ,&nbsp;Haider Rashid","doi":"10.1016/j.ahjo.2025.100678","DOIUrl":"10.1016/j.ahjo.2025.100678","url":null,"abstract":"<div><h3>Background</h3><div>CABG has limitations as a treatment modality in patients with Left main disease and high synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score. Some patients are unsuitable for surgery owing to high surgical risk. Importantly, limited centers are offering CABG, particularly in our part of the world. Limited data exist on long-term outcomes in Indian patients undergoing rotablation-assisted PCI for such lesions. Our objective was to assess in-hospital and two-year clinical outcomes of patients undergoing rotablation-assisted left main PCI at our center.</div></div><div><h3>Methods</h3><div>This prospective observational study included 45 consecutive patients undergoing rotablation-assisted left main PCI from January 2020 to January 2023. Baseline characteristics, procedure-related factors, in-hospital, and two-year outcomes were assessed. Subgroup analysis was done to assess the predictors of adverse outcomes.</div></div><div><h3>Results</h3><div>Our cohort had anatomically complex coronary artery disease with a SYNTAX score of 40.1 ± 8.2. 86.7 % (<em>n</em> = 39) of patients had severe angiographic calcification. Intravascular ultrasound (IVUS) was done in 75.6 % of patients (<em>n</em> = 34). 71.1 % (<em>n</em> = 32) of patients had a true bifurcation lesion. Rotablation was performed using Rotablator RA system. The target burr-artery ratio was 0.7. Burrs used were sized from 1.25 mm to 2 mm and were operated at speeds of 140,000 to 180,000 rpm. Multiple burrs were used when clinically necessary. 75.6 % (<em>n</em> = 34) of patients were done by the two-stent technique. Double kissing CRUSH (DK CRUSH) was the most common two-stent technique used in 71.1 % (<em>n</em> = 32) patients. Angiographic success was 100 %, while procedural success was 97.8 %. In-hospital mortality was 2.2 %. At two years, major adverse cardiovascular events (MACE) free survival was 93.3 %.</div></div><div><h3>Conclusion</h3><div>Rotablation-assisted PCI in severely calcified left main lesions is safe and effective, offering good procedural success and favourable mid-term clinical outcomes.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100678"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is predictive modeling the missing link for post-STEMI recovery in rural and resource-poor regions?","authors":"Jose Eric M. Lacsa","doi":"10.1016/j.ahjo.2025.100697","DOIUrl":"10.1016/j.ahjo.2025.100697","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100697"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential effects of pre-procedural atorvastatin versus rosuvastatin on hematologic and inflammatory markers in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: A randomized controlled trial","authors":"Ramin Khameneh Bagheri ,&nbsp;Ali Eshraghi ,&nbsp;Hasan Amirsoleimani ,&nbsp;Faeze Keihanian","doi":"10.1016/j.ahjo.2025.100701","DOIUrl":"10.1016/j.ahjo.2025.100701","url":null,"abstract":"<div><h3>Background</h3><div>The pleiotropic effects of statins may benefit patients with acute coronary syndromes. This study compared the impact of pre-procedural atorvastatin versus rosuvastatin on hematologic and inflammatory indexes in the hyper-acute setting of ST-elevation myocardial infarction (STEMI).</div></div><div><h3>Methods</h3><div>In this pre-specified, multi-centric, triple-blind trial, STEMI patients were randomized to receive either 80-mg atorvastatin (<em>n</em> = 98) or 40-mg rosuvastatin (<em>n</em> = 102) before primary percutaneous coronary intervention (PPCI). Key hematologic indexes—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and platelet distribution width (PDW)—were measured at baseline, 24, and 48 h post-PPCI. Contrast-induced nephropathy (CIN) incidence was also assessed.</div></div><div><h3>Results</h3><div>The incidence of CIN was similarly low in both groups (atorvastatin 3.0 % vs. rosuvastatin 3.5 %, <em>p</em> = 0.99). However, hematologic markers showed significant differences. The atorvastatin group had a significantly lower NLR at 48 h compared to the rosuvastatin group (Median [IQR]: 5.1 [3.2–8.1] vs. 7.8 [4.9–10.2], <em>p</em> = 0.003). Conversely, the rosuvastatin group demonstrated a significantly higher PDW at 24 h (15.6 ± 1.5 vs. 14.7 ± 1.5, <em>p</em> &lt; 0.001). No significant inter-group difference was found in the 48-h PLR.</div></div><div><h3>Conclusion</h3><div>While both high-intensity statins provided similar nephroprotection, they exhibited distinct modulatory effects. Atorvastatin was associated with a more pronounced anti-inflammatory effect (lower NLR), whereas rosuvastatin was linked to increased platelet activity (higher PDW). These findings suggest differential pleiotropic properties that warrant further investigation for their impact on clinical outcomes.</div><div>Registry Accessibility: <span><span>http://irct.ir/trial/27377</span><svg><path></path></svg></span></div><div>Trial registration code: IRCT2017101236737N1.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100701"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dementia is associated with higher mortality and worse patient-centered outcomes after complex and high-risk coronary artery stenting","authors":"Khanjan B. Shah ,&nbsp;Lingwei Xiang ,&nbsp;Samir K. Shah ,&nbsp;Rachel R. Adler ,&nbsp;Joel S. Weissman","doi":"10.1016/j.ahjo.2025.100689","DOIUrl":"10.1016/j.ahjo.2025.100689","url":null,"abstract":"<div><h3>Objectives</h3><div>The aims of this study were to assess whether dementia status influences outcomes of complex high-risk indicated percutaneous coronary intervention (CHIP-PCI).</div></div><div><h3>Background</h3><div>CHIP-PCI is a type of coronary artery stenting procedure for patients with anatomically complex coronary artery disease and significant medical comorbidities. As the population ages, more patients will require CHIP-PCI including those with Alzheimer's dementia and related dementias (ADRD). Outcomes of CHIP-PCI in patients with ADRD are underexplored.</div></div><div><h3>Methods</h3><div>We compared outcomes of Medicare fee-for-service (FFS) beneficiaries 66 years or older with and without ADRD who underwent CHIP-PCI from July 1, 2017 to December 31, 2019. The primary clinical outcome was 1-year mortality, and secondary clinical outcomes were complications and readmissions. Patient-centered outcomes were time-at-home ratio and discharge to higher level of care.</div></div><div><h3>Results</h3><div>8884 patients undergoing CHIP-PCI met study criteria, and 766 (8.6 %) patients carried a diagnosis of ADRD. Patients with ADRD were more likely to be older (81.2 vs 77.5, <em>p</em> &lt; 0.001) and frail (52.1 % vs. 27.3 %, p &lt; 0.001). 1-year mortality was higher among patients with ADRD (OR 1.34, 95 % CI 1.14–1.57) as was 90-day major complications (OR 1.22, 95 % CI 1.03–1.43) and readmissions (OR 1.27, 95 % CI 1.07–1.50). Patients with ADRD were more likely to be discharged to a higher level of care (OR 1.81, 95 % CI 1.48–2.22) and have lower time-at-home ratios (Mean Difference −5.48, 95 % CI −9.24 to −2.45).</div></div><div><h3>Conclusions</h3><div>Patients with ADRD demonstrate higher 1-year mortality as well as major complications. They demonstrate especially poor time-at-home ratio and risk for discharge to a higher level of care. These data should be used by patients, their families, and physicians to facilitate goal-concordant care.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100689"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}