JACC. Asia最新文献

{"title":"Validation of High Ischemic and Bleeding Risk Criteria of European Guidelines in Peripheral Arterial Disease","authors":"Kayo Yamamoto MD ,&nbsp;Yuichi Saito MD ,&nbsp;Yuji Ohno MD ,&nbsp;Norikiyo Oka MD ,&nbsp;Masayuki Takahara MD ,&nbsp;Sakuramaru Suzuki MD ,&nbsp;Raita Uchiyama MD ,&nbsp;Masahiro Suzuki MD ,&nbsp;Tadahiro Matsumoto MD ,&nbsp;Yo Iwata MD ,&nbsp;Yoshio Kobayashi MD","doi":"10.1016/j.jacasi.2025.01.018","DOIUrl":"10.1016/j.jacasi.2025.01.018","url":null,"abstract":"<div><h3>Background</h3><div>The 2024 European Society of Cardiology (ESC) guidelines for peripheral arterial disease (PAD) propose the dedicated high ischemic risk (HIR) and high bleeding risk (HBR) criteria.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to validate the ESC-HIR and HBR criteria using real-world data.</div></div><div><h3>Methods</h3><div>From January 2019 to December 2022, this multicenter retrospective registry included 824 patients undergoing endovascular treatment for aortoiliac and femoropopliteal PAD. The ESC-HIR criteria include previous amputation, critical limb-threatening ischemia, previous revascularization, high-risk comorbidities (heart failure, diabetes, polyvascular disease), and estimated glomerular filtration rate &lt;60 mL/min/1.73 m², while the ESC-HBR criteria include dialysis or renal impairment (estimated glomerular filtration rate &lt;15 mL/min/1.73 m²), acute coronary syndrome &lt;30 days, history of stroke or transient ischemic attack, and active or clinically significant bleeding. Although patients were initially divided into 4 groups according to the presence or absence of HIR and HBR, patients with HBR and no HIR were excluded caused by the small sample size (n = 2). Major adverse cardiovascular and limb events and bleedings were evaluated.</div></div><div><h3>Results</h3><div>Of the 822 patients, 62 (7.5%), 467 (56.8%), and 293 (35.6%) were grouped in the HIR (−)/HBR (−), HIR (+)/HBR (−), and HIR (+)/HBR (+). During the median follow-up period of 726 days, major adverse cardiovascular and limb events occurred in 0%, 9.5%, and 16.4% among the 3 groups <em>(P =</em> 0.005). The incidence of major bleeding events was 4.8%, 2.4%, and 6.8%, respectively <em>(P =</em> 0.009).</div></div><div><h3>Conclusions</h3><div>The ESC-HIR and HBR criteria successfully stratified ischemic and bleeding risks in patients with PAD undergoing endovascular treatment.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 744-754"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044818","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":"Nonadherence to Medication","authors":"Jeehoon Kang MD, PhD ,&nbsp;Jin-Eun Song MD","doi":"10.1016/j.jacasi.2025.05.001","DOIUrl":"10.1016/j.jacasi.2025.05.001","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 769-770"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203499","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":"Assessing the Tools for Assessing Frailty","authors":"Terence J. Quinn MD, MBChB (Hons), Bsc (Hons)","doi":"10.1016/j.jacasi.2025.03.006","DOIUrl":"10.1016/j.jacasi.2025.03.006","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 811-813"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061247","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":"Impact of Nonadherence to Any Antiplatelet Therapy After PCI With Drug-Eluting Stents on Critical Outcomes","authors":"Yuichiro Mori MD, MPH ,&nbsp;Tim Friede PhD ,&nbsp;Satoshi Hattori PhD ,&nbsp;Kyohei Yamaji MD, PhD ,&nbsp;Shingo Fukuma MD, PhD","doi":"10.1016/j.jacasi.2025.03.008","DOIUrl":"10.1016/j.jacasi.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Lifelong antiplatelet therapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is strongly recommended. However, the extent and temporal variation in the risk of nonadherence to this recommendation remain unclear.</div></div><div><h3>Objectives</h3><div>The aim of this study was to investigate how nonadherence to any antiplatelet therapy after PCI affects critical cardiac events and whether this effect varies over time.</div></div><div><h3>Methods</h3><div>This cohort study analyzed Japanese nationwide insurance claims and health checkup records of working-age patients who underwent PCI with DES between April 2016 and March 2022. Nonadherence was defined as prescription coverage of antiplatelet therapy &lt;50% within preceding 90 days. Landmark-time survival analysis with propensity-score matching was conducted every 5 days from 90th to 1,095th days after PCI. The primary outcome was a composite of all-cause death, myocardial infarction, or cardiopulmonary arrest. Results were synthesized to assess temporal variation in the risk magnitude.</div></div><div><h3>Results</h3><div>Among 40,902 patients (mean age, 58.3 ± 8.3 years; 5.5% women [2,240 of 40,902], median [IQR] follow-up: 653 days [Q1-Q3: 235-1,233 days]), nonadherence was observed in 1.18% (421 of 35,582) at 90 days and 4.70% (579 of 12,312) at 1,095 days after PCI. Critical cardiac events were more frequent in nonadherent patients (HR: 2.50 [95% CI: 1.92-3.26]; <em>P</em> &lt; 0.001), with no significant temporal variation across landmark times.</div></div><div><h3>Conclusions</h3><div>Nonadherence to any antiplatelet therapy after PCI was associated with a more than 2-fold increase in critical cardiac events, irrespective of post-PCI timing throughout 3 years. These findings emphasize the need for sustained efforts by health care providers and patients to maintain drug adherence over a prolonged period.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 758-768"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060351","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":"Current Practice of Guideline-Directed Medical Therapy After Acute Heart Failure Hospitalization","authors":"Koshiro Kanaoka MD, PhD ,&nbsp;Yoshitaka Iwanaga MD, PhD ,&nbsp;Koki Takegawa MD ,&nbsp;Wataru Fujimoto MD, PhD ,&nbsp;Yuichi Nishioka MD, PhD ,&nbsp;Tomoya Myojin MD ,&nbsp;Katsuki Okada MD, PhD ,&nbsp;Tatsuya Noda MD, PhD ,&nbsp;Tomoaki Imamura MD, PhD ,&nbsp;Yoshihiro Miyamoto MD, PhD","doi":"10.1016/j.jacasi.2025.01.015","DOIUrl":"10.1016/j.jacasi.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have provided nationwide, longitudinal data on practice patterns of guideline-directed medical therapy (GDMT) for heart failure.</div></div><div><h3>Objectives</h3><div>The authors aimed to clarify the doses and patterns of up-titration or discontinuation of GDMT following admission for acute heart failure and to determinants associated with its continuation in Japan.</div></div><div><h3>Methods</h3><div>We retrospectively included data, from the Japanese nationwide health insurance claims database, of patients hospitalized for acute heart failure without a recent history of hospitalization. Patients initiated on GDMTs during hospitalization were followed up for 12 months. We analyzed patient baseline characteristics associated with continuation 12 months after discharge by using a logistic regression model.</div></div><div><h3>Results</h3><div>Of 791,917 included patients, 405,605 (51.2%) were initiated on ≥1 GDMTs during the index hospitalization. These therapies were frequently discontinued within 3 months of discharge. The proportions of patients for whom the target dose was achieved at 12 months were 10.5%, 7.6%, 8.3%, 23.1%, 7.4%, and 60.2% for beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, angiotensin receptor-neprilysin inhibitor, mineralocorticoid receptor antagonists, and sodium-glucose cotransporter 2 inhibitors, respectively. Beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/angiotensin receptor-neprilysin inhibitor were more likely to be discontinued for older patients with anemia and dementia, whereas mineralocorticoid receptor antagonists were more likely to be discontinued for patients with chronic kidney disease, compared with other GDMT categories.</div></div><div><h3>Conclusions</h3><div>Initiation and up-titration of GDMTs were insufficient in nationwide clinical practice. Our results may help clinicians improve titration of GDMTs.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 786-795"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203385","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":"Guideline-Directed Medical Therapy in Heart Failure","authors":"Meixiang Xiang MD, PhD","doi":"10.1016/j.jacasi.2025.03.004","DOIUrl":"10.1016/j.jacasi.2025.03.004","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 796-798"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052557","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":"Epidemiology of Valvular Heart Disease in Asia Pacific Region","authors":"Kent Chak-yu So MBChB ,&nbsp;Jonathan Yap MD ,&nbsp;Guang-yuan Song MD ,&nbsp;Karl Poon MBBS ,&nbsp;Shih-Hsien Sung MD ,&nbsp;Mann Chandavimol MD ,&nbsp;Kentaro Hayashida MD ,&nbsp;Duk-Woo Park MD ,&nbsp;See-Hooi Ewe MD ,&nbsp;Mi Chen MD ,&nbsp;Vyanne Hei-tung Chan MBBS ,&nbsp;Juri Iwata MD ,&nbsp;Tarinee Tangcharoen MD ,&nbsp;Paul Tern MD ,&nbsp;Han-Su Park MD ,&nbsp;Mirvat Alasnag MD ,&nbsp;Yohei Ohno MD ,&nbsp;Jimmy Kim Fatt Hon MD ,&nbsp;Rohan Bhagwandeen MD ,&nbsp;Minoru Tabata MD, PhD, MPH ,&nbsp;Yat-yin Lam MD","doi":"10.1016/j.jacasi.2025.03.011","DOIUrl":"10.1016/j.jacasi.2025.03.011","url":null,"abstract":"<div><div>Valvular heart disease poses a significant health burden in the Asia-Pacific region, with its epidemiology varying widely across countries caused by diverse socioeconomic and health care situations. Rheumatic heart disease remains prevalent, especially in low- to middle-income areas, while degenerative valvular diseases are emerging in developed regions caused by an aging population. Significant disparities in access to health care and intervention result in variable clinical outcomes. In the past decade, transcatheter interventions have revolutionized the management of patients with valvular heart disease globally. In the Asia-Pacific region, the uptake and development of transcatheter valvular interventions has been slow until recent years. Continued collaboration across the Asia-Pacific region is essential to mitigate the impact of the upcoming surge of valvular heart disease in this diverse and rapidly changing area.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 718-743"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112590","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":"Regional Heterogeneity in the Risk of Thrombosis and Bleeding in Patients With Peripheral Artery Disease","authors":"Shinya Goto MD, PhD ,&nbsp;Daisuke Yamasawa MD, PhD ,&nbsp;Shinichi Goto MD, PhD","doi":"10.1016/j.jacasi.2025.03.007","DOIUrl":"10.1016/j.jacasi.2025.03.007","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 755-757"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112600","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":"Safety and Efficacy of Half-Half Inflation Strategy in Pulmonary Artery Stenosis Caused by Fibrosing Mediastinitis","authors":"Hongling Su MD ,&nbsp;Yaling Chen MD ,&nbsp;Aqian Wang MD ,&nbsp;Kaiyu Jiang MD ,&nbsp;Yating Zhao MD ,&nbsp;Mengfei Jia MD ,&nbsp;Bo Li MD ,&nbsp;Xuechun Sun MD ,&nbsp;Wenjie Dong MD ,&nbsp;Yunshan Cao PhD, MD","doi":"10.1016/j.jacasi.2025.03.005","DOIUrl":"10.1016/j.jacasi.2025.03.005","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 817-819"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060580","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":"Frailty Assessment Tools Influence the Outcome Associations Among Patients With Diabetes","authors":"Jui Wang PhD ,&nbsp;Szu-Ying Lee MD ,&nbsp;Chia-Ter Chao MD, PhD ,&nbsp;Jenq-Wen Huang MD, PhD ,&nbsp;Kuo-Liong Chien MD, PhD","doi":"10.1016/j.jacasi.2025.02.014","DOIUrl":"10.1016/j.jacasi.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>Frailty, characterized by aging-associated physiological reserve decline, leads to functional loss and adverse outcomes. Patients with diabetes mellitus (DM) have a high frailty risk. However, whether frailty assessment results derived from different tools diverge regarding their outcome correlations remains unclear.</div></div><div><h3>Objectives</h3><div>The authors analyzed associations between different frailty assessment results and DM patients’ outcomes</div></div><div><h3>Methods</h3><div>Between 2008 and 2016, adults (age &gt;40 years) with type 2 DM were identified from the National Taiwan University Hospital Integrated Medical Database. The frailty assessment was performed using modified FRAIL scale and frailty index. Cox proportional hazard and Poisson regression analyses were used to determine the relationship between frailty and multiple outcomes after multivariate adjustment.</div></div><div><h3>Results</h3><div>In total, 30,012 patients (mean 64.1 years, 45.4% women) with type 2 DM were included. The 2 frailty assessments were moderately positively correlated (r = 0.49; 95% CI: 0.48-0.49). After a median of 7.1 years (Q1-Q3: 3.9-10.4 years) of follow-up, FRAIL-identified mild and moderate-to-severe frailty did not correlate with a high mortality probability, but frailty index–identified severe and moderate frailty did. However, FRAIL-identified moderate-to-severe frailty correlated with a higher probability of all-cause hospitalization (incidence rate ratio [IRR]: 1.2; 95% CI: 1.09-1.32), intensive care unit admission (IRR: 4.19; 95% CI: 1.69-10.38), and cardiovascular hospitalization (IRR: 1.46; 95% CI: 1.28-1.66), whereas frailty index–identified mild, moderate, and severe frailty increased the probability of all-cause and cardiovascular hospitalizations only.</div></div><div><h3>Conclusions</h3><div>We observed major discrepancies in outcome associations between FRAIL scale and frailty index among DM patients. Carefully selecting tools for measuring DM-associated frailty is important.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 6","pages":"Pages 799-810"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065256","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}