JACC. Asia最新文献

{"title":"At the Cutting Edge","authors":"Khung Keong Yeo MBBS","doi":"10.1016/j.jacasi.2025.07.010","DOIUrl":"10.1016/j.jacasi.2025.07.010","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1155-1156"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934242","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":"Subclassification of Phenotypic Homozygous Familial Hypercholesterolemia","authors":"Hayato Tada MD, PhD ,&nbsp;Mariko Harada-Shiba MD, PhD","doi":"10.1016/j.jacasi.2025.06.006","DOIUrl":"10.1016/j.jacasi.2025.06.006","url":null,"abstract":"<div><div>Homozygous familial hypercholesterolemia (HoFH) is a rare situation where biallelic genetic disturbance of low-density lipoprotein (LDL) metabolism leads to extreme elevation of LDL cholesterol. There is a great variety of severity in their phenotype, where some patients exhibit premature supravalvular aortic stenosis at their early childhood, whereas others experience myocardial infarction at their adolescence. In addition, there is a set of familial hypercholesterolemia (FH) patients whose phenotype fall into between heterozygous FH and HoFH. Recently, the International Atherosclerosis Society reclassified such patients with FH as “severe FH.” Given that we have several different treatment approaches for these FH patients, including those with HoFH, it is quite important to reclassify them according to their severity of phenotype and types of complications. Here, we propose to clarify so-called “phenotypic HoFH” into 3 groups: severe heterozygous FH, typical HoFH, and severe HoFH based on their LDL cholesterol, genetic backgrounds, frequency, residual LDL receptor activity, and their complications.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1217-1220"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934315","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":"Joint Associations of Frailty and Cardiometabolic Diseases With Risk of All-Cause and Cardiac Mortality","authors":"Chen Zhu MB ,&nbsp;Tianqi Ma MD ,&nbsp;Lingfang He MD ,&nbsp;Xunjie Cheng PhD ,&nbsp;Yongping Bai MD, PhD","doi":"10.1016/j.jacasi.2025.04.013","DOIUrl":"10.1016/j.jacasi.2025.04.013","url":null,"abstract":"<div><h3>Background</h3><div>Cardiometabolic diseases (CMDs) are common for middle-aged and older adults. Whether frailty exacerbates CMD-related risk of mortality outcomes is unclear.</div></div><div><h3>Objectives</h3><div>The authors sought to investigate the joint associations of frailty and CMDs with mortality risk.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1157-1167"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","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":"Early- Versus Newer-Generation Transcatheter Mitral Valve Edge-to-Edge Repair Systems","authors":"Taishi Okuno MD ,&nbsp;Masaki Izumo MD ,&nbsp;Shingo Kuwata MD ,&nbsp;Yoshihiro J. Akashi MD ,&nbsp;Masanori Yamamoto MD ,&nbsp;Shunsuke Kubo MD ,&nbsp;Mike Saji MD ,&nbsp;Yuki Izumi MD ,&nbsp;Yusuke Enta MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Shingo Mizuno MD ,&nbsp;Yusuke Watanabe MD ,&nbsp;Makoto Amaki MD ,&nbsp;Kazuhisa Kodama MD ,&nbsp;Junichi Yamaguchi MD ,&nbsp;Toru Naganuma MD ,&nbsp;Hiroki Bota MD ,&nbsp;Yohei Ohno MD ,&nbsp;Masahiko Asami MD ,&nbsp;Daisuke Hachinohe MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.jacasi.2025.05.013","DOIUrl":"10.1016/j.jacasi.2025.05.013","url":null,"abstract":"<div><h3>Background</h3><div>Comparative data on early- (G2) vs newer-generation (G4) MitraClip transcatheter edge-to-edge repair (TEER) systems remain limited.</div></div><div><h3>Objectives</h3><div>The authors compared procedural and clinical outcomes of both devices in patients with degenerative mitral regurgitation (DMR) or functional mitral regurgitation (FMR).</div></div><div><h3>Methods</h3><div>Using the OCEAN (Optimized Catheter Valvular Intervention)-Mitral registry, 3,738 patients undergoing TEER with either G2 (n = 1,481) or G4 (n = 2,257) MitraClips were analyzed. Outcomes included procedural metrics, echocardiographic parameters, and clinical events.</div></div><div><h3>Results</h3><div>Despite being older (<em>P</em> = 0.010) and higher-risk (EuroSCORE [European System for Cardiac Operative Risk Evaluation] II: <em>P</em> = 0.002), the newer-generation group achieved comparable procedural success (residual MR ≤2+) with shorter procedure time and fewer clips, resulting in significantly lower transmitral mean pressure gradients (TMPG) (DMR: median: 3.0 [Q1-Q3: 2.0-4.0] mm Hg vs 2.7 [Q1-Q3: 2.0-3.8] mm Hg; <em>P</em> = 0.009; FMR: median 3.0 [Q1-Q3: 2.0-4.0] mm Hg vs 2.5 [Q1-Q3: 1.9-3.5] mm Hg; <em>P</em> &lt; 0.001) in both DMR and FMR cohorts. Rates of mechanical complications, such as single leaflet device attachment and leaflet tear, were rare across both device generations but were further reduced in the newer-generation device. The newer-generation device was associated with reduced heart failure (HF) rehospitalization in DMR (adjusted HR: 0.51; 95% CI: 0.33-0.77; <em>P</em> = 0.001) and FMR (adjusted HR: 0.76; 95% CI: 0.61-0.93; <em>P</em> = 0.009), with a greater risk reduction in DMR (<em>P</em>_interaction &lt; 0.001). A causal mediation analysis revealed that postprocedural TMPG modestly mediated the association between device generation and HF rehospitalization risk (proportion mediated = 1.8% [Q1-Q3: 0.3%-4.0%]; <em>P</em> = 0.016).</div></div><div><h3>Conclusions</h3><div>The newer-generation TEER system offers a safer and more efficient procedure, with shorter procedural time, fewer mechanical complications, fewer clips, and a lower postprocedural TMPG, contributing to reduced HF rehospitalization risk, particularly in DMR.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1110-1120"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644308","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":"Influence of Age at Diagnosis on Clinical Disease Parameters in Wild-Type Transthyretin Amyloid Cardiomyopathy","authors":"Naoto Kuyama MD, PhD ,&nbsp;Yasuhiro Izumiya MD, PhD ,&nbsp;Seiji Takashio MD, PhD ,&nbsp;Hiroki Usuku MD, PhD ,&nbsp;Akihisa Tabira MD ,&nbsp;Masanobu Ishii MD, MPH, PhD ,&nbsp;Masafumi Kidoh MD, PhD ,&nbsp;Seitaro Oda MD, PhD ,&nbsp;Shinsuke Hanatani MD, PhD ,&nbsp;Yasushi Matsuzawa MD, PhD ,&nbsp;Eiichiro Yamamoto MD, PhD ,&nbsp;Toshinori Hirai MD, PhD ,&nbsp;Mitsuharu Ueda MD, PhD ,&nbsp;Kenichi Tsujita MD, PhD","doi":"10.1016/j.jacasi.2025.06.003","DOIUrl":"10.1016/j.jacasi.2025.06.003","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1202-1205"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746306","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 Evolution and Clinical Significance of M-TEER Device Innovation From the OCEAN-Mitral Registry","authors":"Krissada Meemook MD,&nbsp;Tawai Ngernsritrakul MD","doi":"10.1016/j.jacasi.2025.06.018","DOIUrl":"10.1016/j.jacasi.2025.06.018","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1121-1123"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934310","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":"Toward Better Risk Stratification After Iliofemoral Endovascular Therapy in Lower Extremity Artery Disease","authors":"Yang Chen MD ,&nbsp;Mingfang Li MD, PhD ,&nbsp;Minglong Chen MD","doi":"10.1016/j.jacasi.2025.07.008","DOIUrl":"10.1016/j.jacasi.2025.07.008","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1196-1198"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934308","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 Persistent Burden of Rheumatic Heart Disease in Africa","authors":"Hilaryano Da Silva Ferreira MD, MSc ,&nbsp;Humberto Morais MD","doi":"10.1016/j.jacasi.2025.06.016","DOIUrl":"10.1016/j.jacasi.2025.06.016","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1221-1222"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934316","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":"CYP2C19 Polymorphism and Clopidogrel Efficacy in Long-Term Outcomes of Large-Artery Atherosclerotic Stroke: The NCVC Genome Registry.","authors":"Takeshi Yoshimoto, Yorito Hattori, Hiroyuki Ishiyama, Yuriko Nakaoku, Soshiro Ogata, Soichiro Abe, Kenji Ninomiya, Kunihiro Nishimura, Masafumi Ihara","doi":"10.1016/j.jacasi.2025.07.020","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.020","url":null,"abstract":"<p><strong>Background: </strong>CYP2C19 polymorphisms influence clopidogrel metabolism, which may influence long-term stroke prognosis.</p><p><strong>Objectives: </strong>The authors sought to investigate whether CYP2C19 polymorphisms were associated with long-term recurrent ischemic events in patients with acute ischemic stroke due to large-artery atherosclerosis (LAA).</p><p><strong>Methods: </strong>The present study, comprising a sub-data set from the National Cerebral and Cardiovascular Center Genome Registry-a data registry from a multicenter, prospective, observational study-enrolled patients with LAA stroke within 7 days of stroke onset who consented to genotyping of CYP2C19 polymorphism between 2004 and 2022. Based on CYP2C19 polymorphisms, participants were assigned to 1 of 3 groups: extensive metabolizers (∗1/∗1), intermediate metabolizers (∗1/∗2, ∗1/∗3), and poor metabolizers (∗2/∗2, ∗2/∗3, ∗3/∗3). The primary endpoint was the recurrence of symptomatic ischemic stroke/transient ischemic attack.</p><p><strong>Results: </strong>Among 369 participants with LAA stroke (96 females [26.0%]; age, median [Q1-Q3], 74 [65-80] years) and a median follow-up of 5.1 years, poor or intermediate metabolizers (PM/IMs) (n = 164) had a significantly higher risk of recurrent symptomatic ischemic stroke transient ischemic attack than extensive metabolizers (n = 205) (adjusted HR: 2.33; 95% CI: 1.28-4.24). Furthermore, restricting the analysis to patients taking clopidogrel, PM/IMs exhibited a similarly significant risk (adjusted HR: 5.26; 95% CI: 1.87-14.56).</p><p><strong>Conclusions: </strong>In patients with LAA stroke, CYP2C19 PM/IMs had a significantly higher long-term recurrence rate of ischemic events than extensive metabolizers.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056270","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":"Medical Therapy for Heart Failure After Mitral Valve Transcatheter Repair","authors":"Matteo Mazzola MD,&nbsp;Cristina Giannini MD","doi":"10.1016/j.jacasi.2025.06.015","DOIUrl":"10.1016/j.jacasi.2025.06.015","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 9","pages":"Pages 1107-1109"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144934309","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}