JACC. Asia最新文献

{"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}

{"title":"Interpretable Independent Recurrent Networks for Forecasting Stroke in Atrial Fibrillation.","authors":"Jung-Chi Hsu, Yi-Hsien Hsieh, Yen-Yun Yang, Shu-Lin Chuang, Che Lin, Lian-Yu Lin","doi":"10.1016/j.jacasi.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a major risk factor for transient ischemic attack (TIA)/ischemic stroke (IS).</p><p><strong>Objectives: </strong>Given the dynamic nature of IS risk, this study aimed to predict IS risk in AF patients using a high-dimensional time-series model.</p><p><strong>Methods: </strong>We conducted a cohort study at the National Taiwan University Hospital from 2014 to 2019, including 7,710 AF patients, with external validation in 6,822 patients from the National Taiwan University Hospital Yunlin Branch. The Forecasting Strokes via Interpretable Independent Networks (ForeSIIN) model, based on gated recurrent units, was proposed. Kaplan-Meier analysis with log-rank test evaluated risk group differences.</p><p><strong>Results: </strong>The annual TIA/IS incidence rate ranged from 181.96 (95% CI: 164.42-200.93) to 15.81 (95% CI: 12.38-20.18) per 1,000 person-years, with an overall incidence of 42.40 (95% CI: 39.60-45.39). The ForeSIIN model achieved the best prediction with an area under the receiver-operating characteristics curve of 0.764 (95% CI: 0.722-0.810), compared with the CHA₂DS₂-VASc score (AUC: 0.650; 95% CI: 0.596-0.699) and other nonsequential models: extreme gradient boosting AUC: 0.722 (95% CI: 0.676-0.769), support vector machine AUC 0.691 (95% CI: 0.637-0.741), random forest AUC: 0.689 (95% CI: 0.637-0.742). External validation showed area under the receiver-operating characteristics curve of 0.646 (95% CI: 0.618-0.671) and area under the precision-recall curve of 0.222 (95% CI: 0.184-0.259). Feature impact analysis identified the top 5 factors: history of TIA/IS, estimated glomerular filtration rate, C-reactive protein, hematocrit, and plasma fasting glucose. Kaplan-Meier analysis showed significant risk differences between ForeSIIN groups (log-rank P < 0.001).</p><p><strong>Conclusions: </strong>The innovative ForeSIIN model demonstrated accurate stroke prediction in AF patients and enhanced the interpretation of dynamic risk factors over time.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268043","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":"Nationwide Epidemiology and Management Time Trends for Atrial Fibrillation: Insights From the Korean AF Factsheet.","authors":"So-Ryoung Lee, Daehoon Kim, Yun Gi Kim, Pil-Sung Yang, Ki Hong Lee, Jaemin Shim, Bong-Seong Kim, Kyung-Do Han, Eue-Keun Choi","doi":"10.1016/j.jacasi.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.03.012","url":null,"abstract":"<p><p>Atrial fibrillation (AF) represents the most prevalent cardiac arrhythmia in clinical practice, with its incidence rising globally. Korea's comprehensive national health insurance system facilitates the meticulous collection and management of health care utilization data for its entire population. This robust data infrastructure has enabled numerous recent studies on AF in Korea, encompassing its prevalence, incidence, anticoagulation treatment rates, health care burden, and associated complications. A comprehensive understanding of AF epidemiology and patient characteristics is essential for enhancing both primary and secondary prevention strategies and improving clinical outcomes. This review presents an up-to-date analysis of AF epidemiology, patient demographics, and treatment modalities in Korea, drawing from the extensive Korea National Health Insurance Service database.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164044","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":"Implication of the Dose of Mineralocorticoid Receptor Antagonist Following Transcatheter Edge-To-Edge Mitral Valve Repair.","authors":"Teruhiko Imamura, Shuhei Tanaka, Nobuyuki Fukuda, Hiroshi Ueno, Koichiro Kinugawa, Shunsuke Kubo, Masanori Yamamoto, Yuki Izumi, Mike Saji, Masahiko Asami, Yusuke Enta, Shinichi Shirai, Masaki Izumo, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Toru Naganuma, Hiroki Bota, Yohei Ohno, Daisuke Hachinohe, Masahiro Yamawaki, Kazuki Mizutani, Toshiaki Otsuka, Kentaro Hayashida","doi":"10.1016/j.jacasi.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.03.014","url":null,"abstract":"<p><strong>Background: </strong>Mineralocorticoid receptor antagonists (MRAs) are integral components of medical therapy for patients with heart failure with reduced ejection fraction. However, implication of MRA dosing in older patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) for secondary mitral regurgitation remains uncertain.</p><p><strong>Objectives: </strong>The authors aimed to investigate the prognostic impacts of MRA dosing in older patients receiving TEER for secondary mitral regurgitation.</p><p><strong>Methods: </strong>This study included patients who underwent TEER and were enrolled in the OCEAN (Optimized CathEter vAlvular iNtervention)-Mitral registry. Patients with a left ventricular ejection fraction <50% and secondary mitral regurgitation were selected. The dose-dependent effects of MRA, administered at discharge, on the 2-year composite outcome of all-cause mortality and heart failure hospitalization were evaluated.</p><p><strong>Results: </strong>A total of 2,026 patients (median age 77 years; 1,287 men) were included and followed for a median 416 days (Q1-Q3: 294-730 days). Post-TEER, the administration of MRA at a dose of ≥12.5 mg/d (ie, any doses of MRA) was independently associated with a lower 2-year cumulative incidence of the primary composite outcome, with an adjusted HR of 0.83 (95% CI: 0.69-0.99; P = 0.046). In contrast, higher doses of MRA were not significantly associated with a further reduction in the risk of the primary outcome (P = 0.97).</p><p><strong>Conclusions: </strong>In older patients who underwent TEER for secondary mitral regurgitation caused by systolic heart failure, even a low-dose MRA was associated with improved clinical outcomes compared with no MRA administration. However, further up-titration of the MRA dose did not result in additional improvements in clinical outcomes. (OCEAN-Mitral registry; UMIN000023653).</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164100","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":"Long-Term and Time-Dependent Association of Predictors on Mortality in Patients With Iliofemoral Artery Disease.","authors":"Yoshimitsu Soga, Mitsuyoshi Takahara, Osamu Iida, Kenji Suzuki, Shinsuke Mori, Daizo Kawasaki, Kazuki Haraguchi, Terutoshi Yamaoka, Kenji Ando","doi":"10.1016/j.jacasi.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>Although several predictors affect long-term mortality in patients with lower extremity artery disease, long-term association of predictors on mortality over time remain unclear.</p><p><strong>Objectives: </strong>The aim of this study was to explore the long-term and time-dependent association of baseline characteristics with mortality in patients with iliofemoral arterial disease.</p><p><strong>Methods: </strong>This study is a multicenter retrospective analysis of 4,086 consecutive patients (mean age 72 ± 9 years, 74% men) who underwent endovascular therapy for symptomatic de novo iliofemoral arterial disease between January 2004 and December 2011 at 16 cardiovascular centers in Japan.</p><p><strong>Results: </strong>During the median follow-up of 3.8 years (Q1-Q3: 1.4-7.4 years), 1,100 deaths, and 637 major adverse cardiovascular events (MACE) (defined as death, myocardial infarction, and stroke) were observed. Overall survival and MACE-free rates were estimated to be 56.1% and 50.6% at 10 years. Old age, chronic kidney disease stage, heart failure, the lack of renin-angiotensin-system inhibitor use, chronic limb threatening ischemia (CLTI), decreased ankle-brachial index, femoropopliteal lesion were significantly associated with an increased risk of mortality. while the prognostic impact of CLTI was significantly attenuated afterwards. Old age, chronic kidney disease stage, cerebrovascular disease, coronary artery disease, heart failure, warfarin use, the lack of statin use, and CLTI were significantly associated with an increased risk of MACE, while the prognostic impact of cerebrovascular disease and CLTI was significantly attenuated afterwards.</p><p><strong>Conclusions: </strong>This study demonstrated long-term and time-dependent association of predictors on mortality and MACE following endovascular therapy. It highlights the need for continuous management of cardiovascular risk factors in this high-risk population.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164102","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":"Prognostic Significance of Time Between Balloon and Peak CK-MB in AMI Patients Undergoing Primary PCI","authors":"Eiji Shibahashi MD, PhD ,&nbsp;Ryoko Kawakami PhD ,&nbsp;Noritoshi Fukushima MD, PhD ,&nbsp;Issei Ishida MD ,&nbsp;Hisao Otsuki MD, PhD ,&nbsp;Takehiro Hata MD ,&nbsp;Kazuho Kamishima MD, PhD ,&nbsp;Kensuke Shimazaki MD ,&nbsp;Takahiro Yamada MD ,&nbsp;Natsuko Shiozaki MD ,&nbsp;Shohei Kataoka MD, PhD ,&nbsp;Yuta Morioka MD ,&nbsp;Toshiaki Oka MD, PhD ,&nbsp;Yutaka Terajima MD, PhD ,&nbsp;Yoshimi Ota MD ,&nbsp;Katsumi Saito MD, PhD ,&nbsp;Atsushi Honda MD, PhD ,&nbsp;Hiroyuki Tanaka MD, PhD ,&nbsp;Junichi Yamaguchi MD, PhD ,&nbsp;Kentaro Jujo MD, PhD","doi":"10.1016/j.jacasi.2024.12.013","DOIUrl":"10.1016/j.jacasi.2024.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Peak creatine kinase-MB (CK-MB) level is an established predictor of clinical outcomes following acute myocardial infarction (AMI). However, the significance of the duration between balloon inflation and peak CK-MB level (BP time) after primary percutaneous coronary intervention (PCI) remains underexplored in terms of prognostic impact.</div></div><div><h3>Objectives</h3><div>This study aimed to elucidate the relationship between BP time and prognostic outcomes in patients with AMI.</div></div><div><h3>Methods</h3><div>In this multicenter observational study, 935 AMI patients who underwent primary PCI and achieved TIMI flow grade 3 on final angiography were included. CK-MB levels were measured systematically at admission and at 3-hour intervals post-PCI. Based on a BP time threshold of 553 minutes, patients were categorized into 2 groups: the long BP-time group (n = 183) and the short BP-time group (n = 752).</div></div><div><h3>Results</h3><div>The mean age of the patients was 67 years, with a median BP time of 334 minutes (Q1-Q3: 248-491 minutes). The long BP-time group exhibited a higher prevalence of male patients and a history of prior PCI. Cardiovascular mortality was significantly greater in the long BP-time group (log-rank test: <em>P =</em> 0.002). Multivariable Cox regression analysis indicated that a prolonged BP time was independently associated with increased cardiovascular mortality (HR: 2.63; 95% CI: 1.19-5.78).</div></div><div><h3>Conclusions</h3><div>Our findings reveal a significant association between BP time and 1-year cardiovascular mortality in patients with AMI. As a readily assessable parameter, BP time can be a valuable tool for early mortality risk stratification in patients post-primary PCI. (Prognostic Implications of Time between Balloon to Peak Creatinine Kinase-MB in patients with Acute Myocardial Infarction Undergoing Primary PCI: Multicenter Cohort Study; <span><span>UMIN000049942</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 650-659"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912878","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":"CK-MB Kinetics as a Superior Prognostic Indicator in Primary PCI","authors":"Abhishek Goyal MBBS, MD, DM","doi":"10.1016/j.jacasi.2025.02.004","DOIUrl":"10.1016/j.jacasi.2025.02.004","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 5","pages":"Pages 660-662"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912879","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}