JACC. Asia最新文献

{"title":"Joint Associations of Frailty and Cardiometabolic Diseases With Risk of All-Cause and Cardiac Mortality.","authors":"Chen Zhu, Tianqi Ma, Lingfang He, Xunjie Cheng, Yongping Bai","doi":"10.1016/j.jacasi.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.04.013","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic diseases (CMDs) are common for middle-aged and older adults. Whether frailty exacerbates CMD-related risk of mortality outcomes is unclear.</p><p><strong>Objectives: </strong>The authors sought to investigate the joint associations of frailty and CMDs with mortality risk.</p><p><strong>Methods: </strong>This prospective cohort study included 467,406 participants from UK biobank. Frailty was assessed using frailty phenotype and frailty index (FI). CMD status was defined as no CMD, single CMD, and cardiometabolic multimorbidity (CMM, coexistence of ≥2 CMDs). Multiplicative and additive interactions between frailty and CMDs two exposures on all-cause and cardiac mortality were examined, and then the joint association of coexisting frailty and CMDs with outcomes were estimated.</p><p><strong>Results: </strong>During median follow-up of 13.08 years, 33,435 participants (7.2%) died, with 6,709 (1.4%) experiencing cardiac mortality. For frailty phenotype measurement, significant multiplicative and additive interactions existed with CMD status. Coexisting frailty phenotype and CMM were associated with a 4.91 (95% CI: 4.49-5.38) times and 8.33 (95% CI: 7.13-9.72) times higher risk of all-cause and cardiac mortality, with 23% and 36% attributable to the additive interaction, respectively. For FI measurements, a significant multiplicative interaction was observed with CMDs, and similar frailty-CMD joint associations with mortality outcomes were also observed.</p><p><strong>Conclusions: </strong>Coexisting frailty and CMDs were associated with an accumulatively increased risk of mortality. Comprehensive screening and management of frailty and CMDs is advisable in aged populations.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644309","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":"Position Statement on Antiplatelet Therapy for East Asians With Coronary Artery Disease","authors":"Yanjun Gong MD ,&nbsp;Young-Hoon Jeong MD, PhD ,&nbsp;Tzung-Dau Wang MD ,&nbsp;Jack Wei Chieh Tan MD ,&nbsp;Juying Qian MD ,&nbsp;Hongbing Yan MD ,&nbsp;Mark Y. Chan MD ,&nbsp;Yundai Chen MD ,&nbsp;Shuning Zhang MD ,&nbsp;Zuyi Yuan MD ,&nbsp;Tse-Min Lu MD ,&nbsp;Jiyan Chen MD ,&nbsp;Yujie Zhou MD ,&nbsp;Bin Liu MD ,&nbsp;Guosheng Fu MD ,&nbsp;Yawei Xu MD ,&nbsp;Lang Li MD ,&nbsp;Sidney C. Smith Jr. MD ,&nbsp;Junbo Ge MD ,&nbsp;Yong Huo MD","doi":"10.1016/j.jacasi.2025.04.010","DOIUrl":"10.1016/j.jacasi.2025.04.010","url":null,"abstract":"<div><div>Growing clinical evidence has indicated that East Asian patients have a lower risk for cardiovascular events but a higher risk of serious bleeding during antiplatelet therapy compared with Western populations—referred to as the “East Asian Paradox.” The unique risk-benefit tradeoff observed in East Asian populations has been a topic of interest, which may be influenced by a complex interplay of genetic and environmental risk factors—such as specific atherothrombotic cardiovascular risks, helicobacter pylori infection, sites of cranial atherosclerosis, and low body weight. There exist knowledge gaps in the antiplatelet therapy among East Asian populations with coronary artery disease, such as the individualized assessment of ischemic and bleeding risk, de-escalation strategy of dual antiplatelet therapy and the compliance of long-term secondary prevention. A substantial body of positive evidence supporting de-escalation strategies of dual antiplatelet therapy comes from East Asia, possibly caused by the distinct therapeutic range of antiplatelet effects and heightened pharmacodynamic response to potent P2Y₁₂ inhibitors observed in this population. This consensus update focuses on the latest progress and hotspot issues on antiplatelet therapy in the East Asian population with coronary artery disease and therapeutic recommendations based on the best available evidence.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 821-846"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524197","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":"Cardiovascular Implications of Lipoprotein(a) and its Genetic Variants","authors":"Ayman El-Menyar MD ,&nbsp;Naushad A. Khan PhD ,&nbsp;Wael Al Mahmeed MD ,&nbsp;Jassim Al Suwaidi MD ,&nbsp;Hassan Al-Thani MD","doi":"10.1016/j.jacasi.2025.04.012","DOIUrl":"10.1016/j.jacasi.2025.04.012","url":null,"abstract":"<div><div>Dyslipidemia, a significant risk factor for cardiovascular diseases (CVDs), is prevalent in the Middle East (ME) countries. With a variable prevalence, elevated lipoprotein (a) [Lp(a)] is the most widespread monogenic dyslipidemic disorder. Genetic studies have established Lp(a) as a heritable and independent risk factor for CVD. This discovery has shifted the perception of Lp(a) and the <em>LPA</em> gene from mere biomarkers of atherosclerotic risk to a viable target for therapeutic intervention. Significant differences in serum Lp(a) levels have been observed across racial and ethnic groups, with few independent genetic variants affecting Lp(a) levels outside the <em>LPA</em> gene region. Data specific to the ME and Arab populations remains scarce. ME populations exhibit genetic diversity and higher consanguinity rates, which may uniquely influence Lp(a) distribution and associated variations. This review examines the genetic and observational factors that shape Lp(a) levels and their role in CVD risk, focusing on ME populations.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 847-864"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524198","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":"China Multi-Center Cohort Study on Risk Evaluation of Arrhythmogenic Cardiomyopathy","authors":"Yuxiao Hu MD ,&nbsp;Zhongli Chen MD, PhD ,&nbsp;Anteng Shi MD ,&nbsp;Zemeng Li MD ,&nbsp;Zixian Chen MD ,&nbsp;Yingying Zheng MD, PhD ,&nbsp;Xi Zhao MD, PhD ,&nbsp;Shimo Dai MD, PhD ,&nbsp;Yubi Lin MD, PhD ,&nbsp;Yifei Li MD, PhD ,&nbsp;Bing Yang MD, PhD ,&nbsp;Xiaoyan Zhao MD, PhD ,&nbsp;Guoliang Li MD, PhD ,&nbsp;Xianliang Zhou MD, PhD ,&nbsp;Shengshou Hu MD, PhD ,&nbsp;Lingmin Wu MD, PhD ,&nbsp;Liang Chen MD, PhD","doi":"10.1016/j.jacasi.2025.04.005","DOIUrl":"10.1016/j.jacasi.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Arrhythmogenic cardiomyopathy (ACM) patients in China exhibit unique genetic and clinical characteristics. There is a lack of prognostic models specific to Chinese ACM patients.</div></div><div><h3>Objectives</h3><div>This study aims to establish a large, national ACM patient cohort with uniformly collected, high-quality data for future risk prediction.</div></div><div><h3>Methods</h3><div>This study includes patients with definite or borderline ACM diagnoses, along with their genotype-positive relatives. At baseline, comprehensive data collection includes medical history, electrocardiograms, imaging data, genetic testing, and laboratory evaluations. Outcome data include heart failure events and malignant ventricular arrhythmias.</div></div><div><h3>Results</h3><div>As of September 2024, the registry has enrolled 622 participants, including 552 probands (88.7%) and 70 family members (11.3%) carrying ACM-related variants. Preliminary cohort includes 577 patients (92.8%), of whom 495 were diagnosed with definite arrhythmogenic right ventricular cardiomyopathy. The median age of symptom onset was 33.0 years (Q1-Q3: 22.0-45.0 years), with 41.6% experiencing arrhythmia-related symptoms. Abnormal electrocardiogram findings included T-wave inversion (72.7%) and epsilon waves (24.8%) in leads V₁ to V₃. Imaging evaluation revealed RV dilatation in 44.6% and left ventricular dilatation in 29.8%, with a mean left ventricular ejection fraction of 53.0% ± 14.5%. Regarding outcomes, malignant ventricular arrhythmias occurred in 255 (40.1%) individuals, while 21.9% developed end-stage heart failure, including 35 individuals who died of heart failure and 101 patients who underwent heart transplantation.</div></div><div><h3>Conclusions</h3><div>The ChinaCORE ACM (China Multi-Center Cohort Study on Risk Evaluation of Arrhythmogenic Cardiomyopathy) registry is a national, longitudinal, observational cohort study. This study contributes to expanding the understanding of the disease spectrum of Chinese ACM patients and improving prognostic predictions.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 914-923"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032140","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":"Cardiovascular-Kidney-Metabolic Syndrome in China","authors":"Meihan Guo PhD","doi":"10.1016/j.jacasi.2025.05.007","DOIUrl":"10.1016/j.jacasi.2025.05.007","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 911-913"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524192","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":"Prevalence and Mortality of Cardiovascular-Kidney-Metabolic Syndrome in China","authors":"Congyi Zheng PhD ,&nbsp;Anping Cai MD, PhD ,&nbsp;Muyi Sun MS ,&nbsp;Xin Wang MD ,&nbsp;Qingjie Song MS ,&nbsp;Xuyan Pei MS ,&nbsp;Xue Cao MS ,&nbsp;Yixin Tian MS ,&nbsp;Gregory Y.H. Lip MD ,&nbsp;Gianfranco Parati MD ,&nbsp;Zengwu Wang MD, PhD ,&nbsp;Yingqing Feng MD, PhD ,&nbsp;Zhen Zhou PhD","doi":"10.1016/j.jacasi.2025.04.007","DOIUrl":"10.1016/j.jacasi.2025.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular-kidney-metabolic (CKM) syndrome is a novel staging framework used to evaluate CKM health. The burden of CKM syndrome in China is relatively unknown, and such data may inform future health priority.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to assess the prevalence and mortality risk across CKM stages.</div></div><div><h3>Methods</h3><div>Nationally representative populations (n = 33,685) were included from the China Hypertension Survey. The weighted prevalence of each CKM stage was calculated. All-cause, cardiovascular (CV), and non-CV death associated with CKM stages were analyzed using Cox regression analysis. Population attributable fraction (PAF) was calculated to estimate the mortality burden related to each CKM stage.</div></div><div><h3>Results</h3><div>Between 2012 and 2015, 18.8% of Chinese adults met criteria for stage 0, 15.5% for stage 1, 42.1% for stage 2, 14.7% for stage 3, and 8.9% for stage 4, with advanced stage (stages 3-4) was 23.6%. After 5-year follow-up, compared with stage 0, adjusted HR for all-cause death in stage 1 was 0.77 (95% CI: 0.51-1.15), stage 2 was 1.36 (95% CI: 1.04-1.77), stage 3 was 2.47 (95% CI: 1.91-3.19), and stage 4 was 4.00 (95% CI: 3.07-5.22). Similarly, adjusted HRs for CV death and non-CV death progressively increased from stage 2 to 4 (both <em>P</em>-trend values &lt; 0.001). For all-cause, CV, and non-CV death, PAFs increased with advancing CKM stages. For instance, for all-cause death, PAFs caused by stages 2, 3, and 4 were 13.4%, 18.6%, and 22.0%.</div></div><div><h3>Conclusions</h3><div>Poor CKM health is widespread in China, underscoring the urgent need for collaborative and comprehensive management strategies to tackle CKM syndrome epidemic.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 898-910"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267971","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":"Full Issue PDF","authors":"","doi":"10.1016/S2772-3747(25)00311-4","DOIUrl":"10.1016/S2772-3747(25)00311-4","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages I-CXXIX"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524195","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":"Developing an ML-Based Pretest Probability Model of Obstructive CAD in Patients With Stable Chest Pain","authors":"Guanhua Dou MMS ,&nbsp;Jia Zhou MD ,&nbsp;Ziqiang Guo MBBS ,&nbsp;Dongkai Shan MD ,&nbsp;Xi Wang MD ,&nbsp;Tao Li MD ,&nbsp;Xinghua Zhang MD ,&nbsp;Lei Xu MD ,&nbsp;Mei Zhang MD ,&nbsp;Xudong Lv MD ,&nbsp;Junjie Yang MD ,&nbsp;Yundai Chen MD, PhD","doi":"10.1016/j.jacasi.2025.03.015","DOIUrl":"10.1016/j.jacasi.2025.03.015","url":null,"abstract":"<div><h3>Background</h3><div>Updated pretest probability models (ESC2019, the PTP model supported by the European Society of Cardiology after a pooled analysis; and RF-CL, the risk factor-weighted model) are recommended for initial evaluation of patients with stable chest pain before coronary computed tomography angiography to reduce unnecessary examination by recent guidelines. However, the reliability of those pretest probability models has not been fully investigated, especially in Chinese population.</div></div><div><h3>Objectives</h3><div>This study aims to build a machine learning-based pretest probability model in patients with stable chest pain and compare it with ESC2019 and RF-CL model in a Chinese population.</div></div><div><h3>Methods</h3><div>This is an analysis of the Chinese registry in China, with a large scale, foresight, and a multicenter cohort. Obstructive coronary artery disease refers to at least 1 lesion ≥70% diameter stenosis in main branches or ≥50% left main stenosis by coronary computed tomography angiography. A pretest probability model, the C-STRAT (Chinese Registry in Early Detection and Risk Stratification of Coronary Plaques) score, was conducted by an ensemble machine learning algorithm in training data set and compared with other pretest probability models.</div></div><div><h3>Results</h3><div>In the testing data set, the C-STRAT score gave the best performance in discrimination evaluation (AUC: 0.769; 95% CI: 0.753-0.784). It also performed well in calibration evaluation. The integrated discrimination improvement and net reclassification improvement of the C-STRAT score were positive compared with other pretest probability models.</div></div><div><h3>Conclusions</h3><div>A high-performance pretest probability model derived from machine learning algorithm was developed based on a multicenter Chinese population and expected to facilitate the decision making for downstream tests. (Chinese Database of National Coronary Plaques Registry; <span><span>ChiCTR1800015864</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 865-880"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268042","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":"Cancer Therapy–Related Cardiac Dysfunction in Patients Using Immune Checkpoint Inhibitors","authors":"Chieh-Yu Chang MD ,&nbsp;Chun-Chi Chen MD ,&nbsp;Wen-Kuan Huang MD, PhD ,&nbsp;Ming-Jer Hsieh MD, PhD ,&nbsp;Ming-Lung Tsai MD ,&nbsp;Cheng-Hung Lee MD, PhD ,&nbsp;Tien-Hsing Chen MD ,&nbsp;Shao-Wei Chen MD, PhD ,&nbsp;Kuo-Chun Hung MD ,&nbsp;Wen-Cheng Chang MD ,&nbsp;Pao-Hsien Chu MD ,&nbsp;I-Chang Hsieh MD ,&nbsp;Ming-Shien Wen MD ,&nbsp;Yu-Ching Wang MPH ,&nbsp;Dong-Yi Chen MD","doi":"10.1016/j.jacasi.2025.04.009","DOIUrl":"10.1016/j.jacasi.2025.04.009","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 942-945"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327983","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":"Transcatheter Aortic Valve Replacement for Pure Aortic Regurgitation","authors":"Vyanne Hei-Tung Chan MBBS,&nbsp;Kent Chak-yu So MBChB","doi":"10.1016/j.jacasi.2025.05.005","DOIUrl":"10.1016/j.jacasi.2025.05.005","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 7","pages":"Pages 895-897"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524310","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}