JACC. Asia最新文献

{"title":"Nationwide Epidemiology and Management Time Trends for Atrial Fibrillation","authors":"So-Ryoung Lee MD, PhD ,&nbsp;Daehoon Kim MD ,&nbsp;Yun Gi Kim MD, PhD ,&nbsp;Pil-Sung Yang MD, PhD ,&nbsp;Ki Hong Lee MD, PhD ,&nbsp;Jaemin Shim MD, PhD ,&nbsp;Bong-Seong Kim PhD ,&nbsp;Kyung-Do Han PhD ,&nbsp;Eue-Keun Choi MD, PhD","doi":"10.1016/j.jacasi.2025.03.012","DOIUrl":"10.1016/j.jacasi.2025.03.012","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 947-962"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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":"Lipid Lowering Therapy on Coronary Artery Plaque in East Asians","authors":"Luca Franchin MD,&nbsp;Maurizio Bertaina MD","doi":"10.1016/j.jacasi.2025.06.008","DOIUrl":"10.1016/j.jacasi.2025.06.008","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1048-1049"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779443","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":"Mavacamten in Symptomatic Hypertrophic Cardiomyopathy","authors":"Chung-Lieh Hung MD, MSc, PhD ,&nbsp;Yen-Wen Liu MD, PhD ,&nbsp;Yen-Wen Wu MD, MSc, PhD","doi":"10.1016/j.jacasi.2025.06.010","DOIUrl":"10.1016/j.jacasi.2025.06.010","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 1075-1077"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781104","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":"How Far Can Time-Series Models Go in Capturing Dynamic Stroke Risk Post Atrial Fibrillation?","authors":"Yang Chen MD","doi":"10.1016/j.jacasi.2025.05.004","DOIUrl":"10.1016/j.jacasi.2025.05.004","url":null,"abstract":"","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 979-982"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781106","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 MD, PhD ,&nbsp;Yi-Hsien Hsieh ,&nbsp;Yen-Yun Yang MD ,&nbsp;Shu-Lin Chuang PhD ,&nbsp;Che Lin PhD ,&nbsp;Lian-Yu Lin MD, PhD","doi":"10.1016/j.jacasi.2025.04.003","DOIUrl":"10.1016/j.jacasi.2025.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a major risk factor for transient ischemic attack (TIA)/ischemic stroke (IS).</div></div><div><h3>Objectives</h3><div>Given the dynamic nature of IS risk, this study aimed to predict IS risk in AF patients using a high-dimensional time-series model.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 <em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>The innovative ForeSIIN model demonstrated accurate stroke prediction in AF patients and enhanced the interpretation of dynamic risk factors over time.</div></div>","PeriodicalId":73529,"journal":{"name":"JACC. Asia","volume":"5 8","pages":"Pages 966-978"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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":"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}