JACC. Asia最新文献

{"title":"A Novel Radiation Shield for Interventional Echocardiographers With Application During Structural Heart Disease Procedures.","authors":"Akihisa Kataoka, Takeshi Takata, Ayaka Yanagawa, Kento Kito, Taiga Katayama, Hideyuki Kawashima, Takeyuki Sajima, Yuko Toda, Kunihiro Sakoda, Yusuke Watanabe, Ken Kozuma, Hodaka Nakanishi, Jun'ichi Kotoku","doi":"10.1016/j.jacasi.2025.07.021","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.021","url":null,"abstract":"<p><strong>Background: </strong>During structural heart disease procedures, interventional echocardiographers are exposed to high doses of radiation, particularly in their right waist and lower body regions. Currently, no radiation shields that are practical for use during transesophageal echocardiography are available.</p><p><strong>Objectives: </strong>The authors aimed to develop a novel radiation shield that enables interventional echocardiographers to perform transesophageal echocardiography with minimal radiation exposure during structural heart disease procedures.</p><p><strong>Methods: </strong>A shape prototype model, including a freestanding radioprotective board with lateral windows, was used to assess clinical usability and Monte Carlo simulations were employed. Real-life radiation exposures, both with and without completed shields, were measured during 193 consecutive structural heart disease procedures (114 transcatheter edge-to-edge repairs of the mitral valve and 79 transcatheter aortic valve replacements).</p><p><strong>Results: </strong>The shape prototype experiment determined the optimal window size to be 300 mm wide and 200 mm high. The actual use of the shield was trouble-free in all procedures. Real-life exposure measurements showed a significant reduction in both types of procedures when the shield was used, especially around the waist (median: 0-8.0 μSv; P < 0.001 for transcatheter edge-to-edge repair and median: 0-14.0 μSv; P < 0.001 for transcatheter aortic valve replacement).</p><p><strong>Conclusions: </strong>Through assessment of clinical usability using a shape prototype model and Monte Carlo simulations, a novel radiation shield with practical use was developed for interventional echocardiographers. Clinical studies and simulations demonstrated that this shield is practical for transesophageal echocardiography monitoring and guidance while providing sufficient radiation protection during structural heart disease procedures. (Japanese Development of radiation protection plates for catheter surgery for structural heart disease [echocardiologist and anesthesiologist]; UMIN000046478).</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056275","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":"Sex Disparities in Ischemic Heart Disease in South Asia: The Role of Dietary Factors.","authors":"Tania Rahaman, Edina Cenko, Olivia Manfrini, Angela Maas, Maria Bergami, Chris P Gale, Martha Gulati, Raffaele Bugiardini","doi":"10.1016/j.jacasi.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.012","url":null,"abstract":"<p><strong>Background: </strong>South Asia bears the highest global burden of ischemic heart disease (IHD). Understanding variations in IHD outcomes by sex, income level, and country can inform targeted public health strategies.</p><p><strong>Objectives: </strong>This study aimed to analyze sex-specific trends in IHD prevalence and mortality across South Asia.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using Global Burden of Disease (GBD) study data from 2005 and 2021. Age-standardized mortality rates (ASMRs) for IHD and age-standardized prevalence rates (ASPR) were estimated for 5 South Asian countries (Bangladesh, Bhutan, India, Nepal, and Pakistan). The ASMR-to-ASPR index was calculated to assess the risk of death among individuals with IHD. Sex-based comparisons were performed using Z-scores with a 95% confidence threshold (Z = 1.96).</p><p><strong>Results: </strong>In all countries, men exhibited higher ASMR values than women (average: 167 vs 102 in 2005 and 190 vs 112 in 2021). The ASMR-to-ASPR index was higher in women than men only in Pakistan, in 2005 (4.3% vs 2.9%, respectively) and 2021 (4.4% vs 3.1%, respectively), indicating greater mortality risk among women with IHD. Z-score analysis comparing Bhutan (lowest female ASMR) and Pakistan (highest) revealed differences in deaths attributable to high systolic blood pressure (Z score: 3.30), low vegetable intake (Z score: 2.02), and low fiber intake (Z score: 2.00). These differences were not observed in men.</p><p><strong>Conclusions: </strong>Mortality among people with IHD remains high across South Asia, with sex disparities in outcomes observed primarily in Pakistan. Leading risk factors for IHD mortality among women include high systolic blood pressure and low intake of vegetables and fiber.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981300","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":"Atrial Fibrillation Detected by Handheld ECG and Ischemic Stroke Risk in a 55- to 64-Year-Old Chinese Population.","authors":"Wen Sun, Ben Freedman, Carlos Martinez, Christopher Wallenhorst, Christy K Y Chan, Bryan P Yan","doi":"10.1016/j.jacasi.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.06.020","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) screening is recommended at age ≥65 years, but the age threshold in Asians is uncertain because of higher ischemic stroke risk <65 years.</p><p><strong>Objectives: </strong>This study evaluated AF screening yield in a Chinese population aged 55 to 64 years, comparing stroke risk of those with and without AF, and the effect of oral anticoagulants (OAC).</p><p><strong>Methods: </strong>Patients aged 55 to 64 years attending Hong Kong outpatient clinics underwent opportunistic handheld electrocardiogram screening. Repeat screening was performed if >1 clinic visits. Crude incidence rate ratios of ischemic stroke were determined and compared between 3 cohorts: screen-detected AF; clinically diagnosed AF; and no AF. Ischemic stroke risk for all AF categories was compared with individuals without AF, using adjusted subdistribution HRs (aSHRs) accounting for death as a competing risk.</p><p><strong>Results: </strong>Of 3,926 subjects screened, 338 (8.6%) had known AF, and 3,588 had no AF history. New AF yield was 0.8% (28/3,588). AF was clinically diagnosed during follow-up in 2.3% (n = 82) and during subsequent screening in 7 subjects. Of 35 subjects with screen-detected AF, 26 (74%) had ≥1 non-age, non-sex risk factor for stroke, mean age 60.8 ± 2.5 years, and mean CHA₂DS₂-VASc score 1.9 ± 1.4. At a median follow-up of 5.0 years, 2 patients (6%) with screen-detected AF experienced ischemic stroke, both with ≥1 non-age, non-sex risk factor. AF exposure without OAC treatment was associated with highest risk of ischemic stroke (aSHR: 3.4 [1.3-8.5]). OAC treatment had similar low ischemic stroke risk as no AF.</p><p><strong>Conclusions: </strong>Although diagnostic yield of AF screening in Chinese patients aged 55 to 64 years is low, those with AF are at increased stroke risk and may warrant being on anticoagulation.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981282","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":"Association and Prognostic Implications of \"No-Reflow Phenomenon\" and Hypercoagulability in Patients With ST-Segment Elevation Myocardial Infarction.","authors":"Mohamed Omar, Min Gyu Kang, Moon Ki Jung, Jong-Hwa Ahn, Jin-Sin Koh, Phil Iver Guevarra, Sang-Wook Kim, Udaya S Tantry, Paul A Gurbel, Jin-Yong Hwang, Young-Hoon Jeong","doi":"10.1016/j.jacasi.2025.07.015","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.015","url":null,"abstract":"<p><strong>Background: </strong>Following percutaneous coronary intervention (PCI), the \"no-reflow phenomenon\" is associated with a worse outcome. However, it remains unclear how to prevent and treat this phenomenon during PCI.</p><p><strong>Objectives: </strong>This study aimed to evaluate the association between thrombogenicity profiles and \"no-reflow phenomenon\" during primary PCI in patients with ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Methods: </strong>From a real-world registry, we prospectively enrolled patients with STEMI who underwent primary PCI (n = 334). Thrombolysis In Myocardial Infarction flow grade was assessed at final angiography, and the \"no-reflow phenomenon\" was defined as Thrombolysis In Myocardial Infarction flow between 0 and 2. Thrombogenicity profiles were assessed with thromboelastography (TEG) and conventional hemostatic measurements.</p><p><strong>Results: </strong>Thirty-seven patients (11.1%) showed no-reflow after primary PCI. High platelet-fibrin clot strength (P-FCS: ≥ 68 mm) measured by TEG was significantly associated with an increased risk of post-PCI \"no-reflow phenomenon\" (OR: 2.611; 95% CI: 1.220-5.584; P = 0.010). The risk stratification with \"no-reflow phenomenon\" and \"high P-FCS phenotype\" appeared to be additive to predict the risk of 3-year clinical event (log-rank P < 0.001 across the groups). Patients with both \"no-reflow phenomenon\" and high P-FCS had a higher risk of adverse clinical events compared with normal-reflow subjects with low P-FCS (adjusted HR: 6.654; 95% CI: 2.678-16.530; P < 0.001).</p><p><strong>Conclusions: </strong>This study demonstrated a close relationship between heightened thrombogenicity (assessed by TEG P-FCS) with \"no-reflow phenomenon,\" and their additive prognostic implications after primary PCI in STEMI patients. Effective control of clot strength may reduce the risk of \"no-reflow phenomenon\" and improve clinical outcomes in these patients. (Gyeongsang National University Hospital Registry [GNUH]; NCT04650529).</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002113","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 Effect of Volume-Flow Discordance on Survival in Severe Aortic Stenosis.","authors":"Sara L Hungerford, Ning Song, Brandon Loo, Eleanor Rye, Hari Sritharan, Kay D Everett, Christopher S Hayward, Navin K Kapur, David W M Muller, Audrey I Adji","doi":"10.1016/j.jacasi.2025.07.016","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.016","url":null,"abstract":"<p><strong>Background: </strong>Current flow (Q) assessment in aortic stenosis (AS) uses stroke volume index (SVi), a volume (V)-based measure. However, V differs fundamentally from Q, which is defined as volume per unit time (mL/s).</p><p><strong>Objectives: </strong>This study evaluates the prognostic significance of volume-flow (V-Q) discordance in patients with severe AS (aortic valve area <1 cm²) undergoing transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>We studied 291 patients >65 years of age who underwent TAVR over 5 years (median follow-up, 3.0 years; [Q1-Q3: 3.0-3.0 years]). Aortic flow was assessed using Doppler echocardiography; transaortic flow rate (TFR) was calculated mathematically. Low V-Q discordance was defined as SVi <35 mL/m² with TFR >210 mL/s; normal V-Q discordance as SVi >35 mL/m² with TFR <210 mL/s.</p><p><strong>Results: </strong>V-Q discordance was observed in 29% of patients (15% low, 14% normal). Among those with SVi <35 mL/m², discordance was more frequent in patients without hypertension (75% vs 65%), coronary disease (57% vs 35%), or diabetes (15% vs 2%; all P < 0.05). Diastolic blood pressure was lower (mean SD: 66+15 vs 59+14 mm Hg; P = 0.018), and arterial compliance was higher (median and Q1-Q3: 1.3 [1.1-1.6] vs 1.0 [0.9-1.2] mL/mm Hg; P = 0.028), independent of SVi and left ventricular ejection fraction (both P > 0.05). Low V-Q discordance was associated with improved 3-year survival (86.0% [95% CI: 72.3%-95.1%] vs 73.8% [95% CI: 64.3%-82.1%]; log-rank P = 0.030) and was a stronger survival predictor (Akaike information criterion [AIC]: 23.79; P = 0.013) than SVi <35 mL/m² (AIC: 29.59; P = 0.047) or TFR <210 mL/s (AIC: 32.80; P = 0.049).</p><p><strong>Conclusions: </strong>V-Q discordance occurs in nearly one-third of patients with AS post-TAVR and offers superior prognostic value over existing SVi and TFR thresholds.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981269","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":"Accelerated Biological Aging, Genetic Predisposition, and Incident Valvular Heart Disease.","authors":"Yong-Jian Zhu, Xiang-Ying Suo, Jing Guo, Shuo Lu, Jun-Xi Zhang, Ya-Cong Bo, Zhan-Ying Han, Chun-Guang Qiu","doi":"10.1016/j.jacasi.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>The association between biological aging and valvular heart disease (VHD) has not yet been evaluated.</p><p><strong>Objectives: </strong>This study aimed to evaluate the associations between 2 biological age indicators, Klemera-Doubal method biological age (KDM-BA) acceleration and PhenoAge acceleration, and the risk of VHD, as well as explore the potential gene-environment interplay.</p><p><strong>Methods: </strong>The study included 341,460 UK Biobank participants without VHD at enrollment. Biological age was assessed using KDM-BA and PhenoAge methods. Genetic risk was measured by genome-wide-association study-based polygenic risk scores (PRS). Cox models were used to assess the individual and joint effects of biological age and PRS on incident VHD. Both multiplicative and additive interactions between the 2 factors were also estimated.</p><p><strong>Results: </strong>During a median follow-up of 13.58 years (Q1-Q3: 12.83-14.25 years), 8,146 VHD cases were documented. The results showed a significant association between older biological age and an increased risk of VHD, with a HR of 1.35 (95% CI: 1.32-1.38) for each 1-SD increase in KDM-BA acceleration, and 1.29 (95% CI: 1.26-1.32) for PhenoAge acceleration. Compared with individuals in the first quartile group (Q1) for KDM-BA acceleration, those in Q4 showed the highest risk of VHD, with an 86% higher risk (HR: 1.86; 95% CI: 1.74-1.99). There was an additive interaction between KDM-BA acceleration and PRS for VHD. Similar results were found for the association between PhenoAge acceleration and VHD.</p><p><strong>Conclusions: </strong>Advanced biological aging was significantly associated with an increased risk of VHD and could serve as a potential target for clinical prediction and intervention.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859967","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 Value of Periprocedural Pulmonary Artery Pulsatility Index in Patients After Transcatheter Aortic Valve Replacement.","authors":"Mikio Shigehara, Hiroki Ikenaga, Atsushi Kuraishi, Ayano Osawa, Makoto Takeuchi, Ayano Hamada, Yohei Hyodo, Atsuo Mogami, Akane Tsuchiya, Atsushi Takeda, Takayuki Nakano, Kosuke Takahari, Yusuke Ueda, Yuichi Morita, Tasuku Higashihara, Nanami Taketomi, Yasushi Orihashi, Noriaki Watanabe, Yoshiharu Sada, Hiroto Utsunomiya, Taiichi Takasaki, Shinya Takahashi, Yukiko Nakano","doi":"10.1016/j.jacasi.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.jacasi.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>The pulmonary artery pulsatility index (PAPi) is a hemodynamic index that reflects right ventricular function. However, the association between PAPi and prognosis in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) remains unclear.</p><p><strong>Objectives: </strong>This study aimed to determine how periprocedural changes in the PAPi are associated with patients' prognosis after TAVR.</p><p><strong>Methods: </strong>Of the 405 consecutive patients who underwent TAVR for severe aortic stenosis at Hiroshima University Hospital, those with available periprocedural right heart catheter data were included in this study. Patients were divided into 2 groups with a cutoff PAPi value of 3.11 post-TAVR determined by the receiver-operating characteristic curve for the primary endpoint. The primary endpoint was the composite of all-cause mortality and hospitalization caused by heart failure. The secondary endpoint was all-cause mortality. Additionally, factors in the nonimproved PAPi group were investigated.</p><p><strong>Results: </strong>This study enrolled 238 patients. The median follow-up was 405.5 days (Q1-Q3: 353-861 days). A lower PAPi was associated with an increased risk of the primary endpoint (23.3% vs 9.9%; log-rank P < 0.001). After multivariate Cox proportional hazard analysis, post-TAVR PAPi >3.11 was still predictive factor for the primary endpoint (HR: 3.04; 95% CI: 1.30-7.13; P = 0.011). Furthermore, the secondary endpoint was significantly increased in lower PAPi group (log-rank P = 0.010). A nonimproved PAPi predictor was pre-TAVR aortic valve mean pressure gradient in multivariate analysis (OR: 1.02; 95% CI: 1.01-1.04; P = 0.003).</p><p><strong>Conclusions: </strong>The post-TAVR PAPi was associated with all-cause mortality and heart failure hospitalization.</p>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859969","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)00341-2","DOIUrl":"10.1016/S2772-3747(25)00341-2","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages I-CXXXIX"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781105","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":"Discordance of Small Dense LDL Cholesterol Beyond LDL Cholesterol or Non–HDL Cholesterol and Carotid Plaque","authors":"Jinqi Wang PhD ,&nbsp;Xiaoyu Zhao MS ,&nbsp;Yanchen Zhao MS ,&nbsp;Rui Jin MS ,&nbsp;Yunfei Li MS ,&nbsp;Jiahe Wang MS ,&nbsp;Yueruijing Liu MS ,&nbsp;Zhiyuan Wu PhD ,&nbsp;Xiuhua Guo PhD ,&nbsp;Lixin Tao PhD","doi":"10.1016/j.jacasi.2025.04.015","DOIUrl":"10.1016/j.jacasi.2025.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Different low-density lipoprotein (LDL) particles exhibit distinct proatherogenic properties.</div></div><div><h3>Objectives</h3><div>This study sought to evaluate associations of small dense low-density lipoprotein cholesterol (sdLDL-C), large buoyant low-density lipoprotein cholesterol (lbLDL-C), sdLDL-C/LDL-C ratio, and sdLDL-C/lbLDL-C ratio with carotid plaque (CP) risk in the general population, and to perform discordance analyses to determine which biomarker better reflects CP risk beyond low-density lipoprotein cholesterol (LDL-C) and non–high-density lipoprotein cholesterol (non-HDL-C).</div></div><div><h3>Methods</h3><div>This study enrolled 20,369 participants from Beijing Health Management Cohort. Discordant sdLDL-C, lbLDL-C, or ratio metrics (sdLDL-C/LDL-C and sdLDL-C/lbLDL-C) relative to LDL-C or non-HDL-C, and discordant ratio metrics relative to sdLDL-C, were defined by residual differences and median values. Logistic regression models were used to estimate ORs and 95% CIs.</div></div><div><h3>Results</h3><div>In this study, higher levels of sdLDL-C (OR: 1.354; 95% CI: 1.299-1.410), sdLDL-C/LDL-C ratio (OR: 1.196; 95% CI: 1.148-1.247), and sdLDL-C/lbLDL-C ratio (OR: 1.153; 95% CI: 1.110-1.197) were more strongly associated with increased odds of CP than lbLDL-C (OR: 1.110; 95% CI: 1.070-1.151). Additionally, discordantly high sdLDL-C or low lbLDL-C relative to LDL-C or non-HDL-C were associated with increased odds of CP, whereas discordantly low sdLDL-C or high lbLDL-C were associated with reduced odds. Finally, discordantly high sdLDL-C/LDL-C and sdLDL-C/lbLDL-C ratios relative to LDL-C, non-HDL-C, or sdLDL-C were linked to increased odds of CP.</div></div><div><h3>Conclusions</h3><div>The sdLDL-C, sdLDL-C/LDL-C, and sdLDL-C/lbLDL-C, but not lbLDL-C, are superior to LDL-C and non-HDL-C in identifying individuals at increased risk of CP. The sdLDL-C/LDL-C and sdLDL-C/lbLDL-C ratios may capture additional risk information beyond sdLDL-C.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1012-1028"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593068","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":"Systolic Dyssynchrony Index","authors":"Yuri Ochi MD,&nbsp;Toru Kubo MD,&nbsp;Hiroaki Kitaoka MD","doi":"10.1016/j.jacasi.2025.06.002","DOIUrl":"10.1016/j.jacasi.2025.06.002","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1062-1063"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692627","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}