The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology最新文献

{"title":"Trends in ischemic heart disease mortality among older adults with co-existing colorectal cancer in the US (1999-2023): a 25-Year retrospective study.","authors":"Muhammad Shaheer Bin Faheem, Muhammad Mujtaba Shahid Baig, Rimsha Zafar, Syed Tawassul Hassan, Arfa Ahmed Assad, Talha Ali, Nafila Zeeshan, Faheem Feroze","doi":"10.1186/s43044-025-00695-3","DOIUrl":"https://doi.org/10.1186/s43044-025-00695-3","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic heart disease (IHD) continues to be the primary cause of death among older adults in the United States (U.S.), while colorectal cancer (CRC), being the 3rd most common cancer, contributes to increased mortality when co-occurs with IHD. This study examines national trends in IHD mortality from 1999 to 2023 among older adults with co-existing CRC.</p><p><strong>Methods: </strong>The study retrospectively analyzed death certificates from the CDC's Wide-ranging ONline Data for Epidemiologic Research (WONDER) database, including older adults (aged ≥ 65 years) who listed IHD as the underlying cause of death while CRC was a contributing cause. Crude and age-adjusted mortality rates (AAMRs) per 100,000 individuals, as well as the annual percent change (APC) in AAMRs with a 95% confidence interval, were obtained.</p><p><strong>Results: </strong>A total of 43,417 deaths were attributed to IHD among patients with coexisting CRC. AAMR declined significantly throughout the study, being more prominent from 2003 to 2016 (APC - 8.65; p < 0.05). Males (6.3) had doubled the AAMR that of females (3.1). Non-Hispanic (NH) African Americans represented the highest AAMR (4.5), followed by other races/ethnicities. Regionally, peak AAMR was observed in the northeast (5.7) and non-metropolitan areas (4.7).</p><p><strong>Conclusions: </strong>A substantial (75%) reduction in AAMR was observed from 1999 to 2023. However, disparities across different demographical and geographical highlight the need for targeted interventions to lower IHD burned among patients with co-existing CRC.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"96"},"PeriodicalIF":0.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287900","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":"Pacemaker lead perforations: a five-year study from a high-volume center in India.","authors":"Mohd Iqbal Dar, Imran Hafeez, Sheikh Mohamad Tahir, Jan Mohd Sheikh, Farooq A Ganie, Syed Bilal, Ajaz A Lone, Hilal A Rather","doi":"10.1186/s43044-025-00694-4","DOIUrl":"10.1186/s43044-025-00694-4","url":null,"abstract":"<p><strong>Background: </strong>Device therapy for various cardiac rhythm disturbances has seen a tremendous increase in recent times, and so have the various complications associated with this therapy. Pacemaker lead perforation is one of the most feared complications associated with these device implantations. This prospective observational study was conducted to evaluate the clinical features, diagnosis, and outcome of pacemaker lead perforation in our setting.</p><p><strong>Results: </strong>A total of 5493 patients were included in the study. It included 3438 temporary pacemaker (TPM) lead placements and 2055 patients who had undergone CIED implantation. The comorbidities of the study population include hypertension in 3582(65.21%), Diabetes in 2089(38%), dyslipidemia in 2293(41.74%) and hypothyroidism in 1527(42.6%). The indication of TPM lead implantation include complete heart block (CHB) in 1323(38.48%), TPM during CIED implantation in Sick sinus syndrome (SSS)/trifascicular block and high-grade AV block 766(22.28%), permanent pacemaker generator replacement 330(9.95%), EP study250(7.27%), drug induced heart block 13(0.38%). Indications of CIED implantation include CHB in 1103(53.67%), SSS in 221(10.75%), DCM in 132(6.42%) and ICD in 38(1.85%). There were 23 lead-induced RV perforations, with an incidence of 0.42%. There were 18(78.2%) perforations due to TPM Lead and 5(21.8%) due to CIED leads. Bradycardia was seen in 18(78.3%), hypotension in 8(34.8%), capture loss in 14(60.87%), pain abdomen in 4(17.4%). Pericardial effusion developed in 19(82.6%), tamponade needing pericardiocentesis was seen in 8(34.78%). Surgical intervention was required in 1(4.34%) case. With one death mortality in the study was 4.34%.</p><p><strong>Conclusion: </strong>Careful monitoring and nonsurgical management of lead perforation has favourable outcomes.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"95"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired renal blood perfusion is closely related to right heart volume overload in congestive heart failure.","authors":"Ruisi Liu, Yuqing Yang, Lizhuo Li, Qingzhen Zhao, Yuzhi Zhen, Chao Liu, Yue Li","doi":"10.1186/s43044-025-00692-6","DOIUrl":"10.1186/s43044-025-00692-6","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the impact of right heart volume overload on renal perfusion in patients with heart failure (HF). We retrospectively analyzed 304 ambulatory HF patients enrolled between October 2017 and August 2022. Echocardiographic parameters-including left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), right atrial diameter (RAD), right ventricular diameter (RVD), and left ventricular ejection fraction (LVEF)-were measured and adjusted for body surface area (BSA). Renal perfusion was assessed via time-to-peak of renal blood flow (TTPr) using renal scintigraphy. Relationships between echocardiographic measures and TTPr were evaluated using Spearman correlation and multivariable ordinal logistic regression analyses.</p><p><strong>Results: </strong>In the overall cohort, RAD/BSA showed the strongest correlation with TTPr (rs = 0.608, P < 0.001), which remained significant after multivariable adjustment. LVEDD/BSA and LVEF showed weak or no associations. Subgroup analyses demonstrated that RAD/BSA had the strongest correlation in HF with reduced ejection fraction (rs = 0.602, P < 0.001) and HF with preserved ejection fraction (rs = 0.496, P < 0.001), while LAD/BSA was most strongly correlated in HF with mildly reduced ejection fraction (rs = 0.586, P < 0.001), all remaining significant after adjustment.</p><p><strong>Conclusions: </strong>Echocardiographic parameters of the right heart volume overload were associated with TTPr, suggesting a connection between right heart overload and renal perfusion in cardiorenal syndrome. This points to potential therapeutic targets to improve renal perfusion and outcomes in CHF patients.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Efficacy and safety of combination therapy Ezetimibe 10/rosuvastatin 40 in Egyptian patients at very high risk of atherosclerotic cardiovascular disease.","authors":"Mohamed Sobhy, Hala Mahfouz Badran, Mahmoud Hassanein, Samir Rafla, Tarek Zawawy, Amr Zaki, Mohamed Loutfi, Mohamed Sadaka, Sherif Ayad, Amr Kamal, Ahmed Mokhtar, Zeos Investigator Group","doi":"10.1186/s43044-025-00690-8","DOIUrl":"10.1186/s43044-025-00690-8","url":null,"abstract":"","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of ST-segment agreement between Spandan Pro and gold standard electrocardiogram for percutaneous coronary intervention decision-making.","authors":"C B Pandey, Yogendra Singh, Shashank Pandey, Deepak Tomar, Nitin Chandola, Deeksha Agarwal, Sengar Yashwardhan Pratap Singh","doi":"10.1186/s43044-025-00691-7","DOIUrl":"10.1186/s43044-025-00691-7","url":null,"abstract":"<p><strong>Background: </strong>ST-elevation myocardial infarction (STEMI) is a critical condition requiring rapid diagnosis and treatment. Smartphone-based Electrocardiogram (ECG) devices, like Spandan Pro, offer the potential for timely Percutaneous Coronary Intervention (PCI) in STEMI patients, particularly in resource-limited environments.</p><p><strong>Objective: </strong>To assess the agreement between ST-segment elevation measurements obtained from the Spandan Pro ECG device and those from a Gold standard ECG (BPL Cardiart), using Bland-Altman (BA) analysis, in the context of decision-making for PCI.</p><p><strong>Methods: </strong>A cross-sectional, observational study was conducted on 200 patients who presented to the local Hospital with complaints of chest pain. After strict application of exclusion criteria, a total of 184 patients were assessed in the study. BA analysis has been used to estimate the agreement between ST-segment elevation measurements obtained from the Spandan Pro ECG device with the Gold standard ECG. The ECG reports assist the cardiologist in making decisions regarding PCI.</p><p><strong>Results: </strong>Of the 184 patients, 55 met the criteria for PCI, 33 of whom presented within 120 h of symptom onset. BA analysis revealed that the mean differences between the two methods were clinically insignificant, with agreement limits falling within acceptable ranges across all leads, confirming the reliability of the Spandan Pro.</p><p><strong>Conclusion: </strong>The Spandan Pro ECG device shows good agreement in diagnosing ST elevation with the Gold standard ECG, making it a valuable tool in decision-making regarding PCI by the cardiologist. It also improves patient outcomes by enabling rapid diagnosis and treatment, especially in resource-limited or prehospital environments.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"92"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose oral flecainide provocation test for Brugada syndrome: a case series.","authors":"Xuan Nguyen Thanh, Tuan Ngoc Tran, Thuan Nguyen Van, Nguyen Nguyen Duc, Thao Pham Ngoc, Hanh Nguyen Thi, Hoi Nguyen Van, Luyen Nguyen Van","doi":"10.1186/s43044-025-00679-3","DOIUrl":"10.1186/s43044-025-00679-3","url":null,"abstract":"<p><strong>Background: </strong>Brugada syndrome is a rare, inherited cardiac disorder that predisposes individuals to life-threatening ventricular arrhythmias, often leading to sudden cardiac arrest. In many cases, the characteristic electrocardiographic (ECG) findings of Brugada syndrome are not present at baseline but can be unmasked using sodium channel blockers. While intravenous ajmaline is the preferred agent, its limited availability has led to the increased use of oral flecainide for provocation testing. Previous studies have used 300-400 mg doses, but the efficacy and safety of a lower dose, such as 200 mg, have not been systematically evaluated. This report presents three cases demonstrating that a 200 mg oral flecainide dose may be sufficient to unmask the diagnostic Type 1 Brugada ECG pattern in selected patients.</p><p><strong>Case presentation: </strong>Three male patients (aged 44, 48, and 60 years) with suspected Brugada syndrome based on Type 2 ECG patterns underwent flecainide challenge testing. One patient received a 400 mg oral dose, while the other two received 200 mg doses. ECG changes were monitored continuously for 24 h. All three patients developed coved-type ST-segment elevation in the right precordial leads (Type 1 Brugada ECG pattern), confirming the diagnosis. The time to onset of diagnostic ECG changes ranged from 15 to 60 min, with peak changes occurring between 90 min and 5 h. No patients experienced syncope, ventricular arrhythmias, or conduction disturbances during or after testing.</p><p><strong>Conclusions: </strong>This case series suggests that a 200 mg oral flecainide challenge can effectively and safely unmask the diagnostic Type 1 Brugada ECG pattern in selected patients. However, given the small sample size and absence of serum drug concentration data, caution is warranted in interpreting these findings. A lower dose may be a practical alternative to the conventional 400 mg, maintaining diagnostic sensitivity while potentially reducing adverse event risk. Further prospective studies with larger cohorts and longer follow-up are essential to validate the diagnostic performance, safety, and clinical implications of low-dose oral flecainide provocation testing.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"91"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case series of OMI: time for revisiting STEMI/NSTEMI ECG criteria.","authors":"Edwin Adhi Darmawan Batubara, Bambang Widyantoro, Siska Suridanda Danny, Dafsah Arifa Juzar","doi":"10.1186/s43044-025-00688-2","DOIUrl":"10.1186/s43044-025-00688-2","url":null,"abstract":"<p><strong>Background: </strong>The current STEMI criteria fail to detect roughly one-third of occlusive MI (OMI). STEMI criteria demonstrated only a sensitivity of around 21% for OMI. Compared to STEMI, patients with NSTEMI-OMI have higher short-term and long-term all-cause mortality and longer reperfusion delays. This case series presents three NSTEMI patients with OMI and a delayed reperfusion strategy.</p><p><strong>Case presentation: </strong>We present three cases of patients initially diagnosed with NSTEMI who were later found to have occlusive myocardial infarction (OMI) based on angiographic findings, all of whom underwent delayed reperfusion strategies. The first two cases shared similar clinical profiles, presenting with typical infarct angina, elevated cardiac enzymes, and regional wall motion abnormalities on echocardiography. Their electrocardiograms showed bifascicular blocks, right bundle branch block (RBBB) with left posterior fascicular block (LPFB) in the first case, and RBBB with left anterior fascicular block (LAFB) in the second. Both were classified as high-risk NSTEMI and scheduled for an early invasive approach. Angiography revealed total occlusions in the OM1 and left main arteries, respectively. In the third case, the patient presented with new-onset angina and elevated cardiac biomarkers, but without ECG features fulfilling STEMI or high-risk OMI criteria. However, due to persistent chest pain despite initial treatment in the emergency department, an immediate invasive strategy was pursued. Coronary angiography revealed a total occlusion in the proximal left anterior descending (LAD) artery.</p><p><strong>Conclusions: </strong>These three cases underscore the diagnostic challenge of identifying occlusive myocardial infarction (OMI) in patients presenting with acute coronary syndrome (ACS) when relying exclusively on traditional STEMI criteria. They emphasize the need to recognize alternative ECG markers indicative of acute coronary occlusion, as failure to do so may result in delayed reperfusion and subsequently worse clinical outcomes compared to patients who receive timely intervention based on prompt STEMI recognition.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"90"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial fungal mass masquerading as myxoma: the importance of histopathological confirmation: a case report.","authors":"Mohamed Mounir Nesnassi, Asmae Benssied, Inasse Bargach, Siham Hallab, Safae Hilal, Ibtissam Fellat, Mohamed Cherti","doi":"10.1186/s43044-025-00687-3","DOIUrl":"10.1186/s43044-025-00687-3","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) remains a serious and potentially life-threatening condition. Fungal infective endocarditis is a rare form of endocarditis that occur in immunodeficient patients. Atrial myxoma are a common cause of cardiac tumors in the left atrium. However, infective endocarditis is a differential diagnosis of cardiac masses in general and atrial myxoma particularly. A 49-year-old male with subacute infective endocarditis presentation underwent an echocardiogram examination that showed a left atrial mass with features of atrial myxoma. However, the histological examination after surgical removal of the mass showed a fungal mass.</p><p><strong>Conclusion: </strong>This case shows that a fungal infective endocarditis may present with a cardiac mass sharing typical features with left atrial myxoma. It also shows the importance of histological examination for the final diagnosis and a prompt treatment.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"89"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12443644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of venous closure systems on time to ambulation and discharge following AF ablation: a systematic review and meta-analytic review.","authors":"Muhammad Ashir Shafique, Hira Mustafa Nagra, Aisha Farooq, Sajal Ahmad, Syed Muhammad Fahad Gardezi, Usman Faisal, Muhammad Hamza Anees, Hafiz Muhammad Haris, Iman Moradi, Mathew Fredericks, Hassaan Dar, Behrooz Shojai Rahnama, Sher Ali Khan, Saif Khalid, Javed Iqbal, Janta Devi","doi":"10.1186/s43044-025-00685-5","DOIUrl":"10.1186/s43044-025-00685-5","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, significantly impacting global health and healthcare costs. Pulmonary vein isolation (PVI) is the preferred method for catheter-based AF ablation, reducing arrhythmia recurrence. However, vascular access complications remain a concern. This systematic review and meta-analysis aimed to compare the efficacy and safety of venous closure systems (VCSs), like Perclose™ ProGlide™, with traditional manual compression (MC) techniques, focusing on time to hemostasis (TTH), time to ambulation in hours (TTA), time to discharge (TTD), and complication rates.</p><p><strong>Method: </strong>A comprehensive search was conducted in PubMed, Medline, Scopus, and Embase, adhering to PRISMA guidelines. Five studies met the inclusion criteria, comprising randomized controlled trials (RCTs) and observational studies. Data were analyzed using OpenMeta, applying a random-effects model to calculate standardized mean differences (SMDs) and odds ratios (ORs). Heterogeneity was assessed using the I² statistic, and funnel plots evaluated publication bias.</p><p><strong>Result: </strong>The meta-analysis included 5 studies with a total of 240 patients. VCSs significantly reduced TTA (SMD - 2.029, 95% CI - 3.097 to - 0.962, p = 0.001) and TTD (SMD - 2.081, 95% CI - 3.870 to - 0.292, p = 0.023) compared to MC, but showed no significant reduction in TTH (SMD - 1.109, 95% CI - 2.524 to 0.307, p = 0.125). No significant differences were observed in bleeding complications (OR 1.35, 95% CI 0.413 to 4.125, p = 0.604) or hematoma rates (OR 4.665, 95% CI 0.768 to 28.345, p = 0.094).</p><p><strong>Conclusion: </strong>VCSs demonstrated faster ambulation and discharge times compared to MC techniques, suggesting potential benefits in improving patient flow and satisfaction. However, the slight increase in hematoma risk warrants further investigation. These findings could guide clinical decision-making in vascular access management post-AF ablation.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"88"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential clinical outcomes in ACS: the amplified risk of diabetes in patients treated with drug-coated balloon angioplasty.","authors":"Sheeren Khaled, Saleh Khouj, Mamdouh Ismail, Ahmed Ebrahim, Ghada Shalaby, Anas Sheikh, Abdullatif Ujami, Mohamed Elsheikh, Mohammed Sadhiq, Ahmed Darwish","doi":"10.1186/s43044-025-00686-4","DOIUrl":"10.1186/s43044-025-00686-4","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence supports drug-coated balloons (DCBs) as a compelling alternative to stent-based interventions in acute coronary syndrome (ACS), particularly in diabetic populations where lesion complexity and metabolic dysfunction often undermine long-term outcomes. This study explores real-world safety and efficacy of DCB-only angioplasty in ACS patients, with focused analysis of diabetic subgroups.</p><p><strong>Methods: </strong>A single-center, retrospective cross-sectional analysis was conducted at King Abdullah Medical City between 2019 and 2023. The study enrolled patients presenting with ACS who underwent DCB treatment during this period.</p><p><strong>Results: </strong>Of 212 patients, 55% had diabetes mellitus. Diabetic individuals exhibited significantly higher comorbid burden-hypertension, dyslipidemia, and prior coronary interventions. Non-ST-elevation myocardial infarction (NSTEMI) predominated among diabetics, and in-stent restenosis (ISR) was more frequently observed than de novo lesions. At one-month follow-up, diabetic patients experienced marginally fewer major adverse cardiovascular events (MACE) than non-diabetics; however, parity was observed at one year. Within the diabetic group, insulin therapy and suboptimal glycemic control (HbA1c > 8.0%) were strongly associated with increased 12-month cardiovascular risk, particularly due to repeat revascularization. Importantly, neither clinical presentation nor angiographic features predicted these risks. Instead, elevated HbA1c and reduced left ventricular ejection fraction (LVEF) independently forecasted adverse outcomes post-DCB.</p><p><strong>Conclusion: </strong>In the context of ACS, diabetic patients remain uniquely vulnerable. Metabolic control and cardiac function-not anatomy alone-emerge as decisive prognostic factors after DCB therapy. Despite inherent challenges, DCB offers a targeted and promising revascularization approach when patient-specific risk modifiers are proactively addressed.</p>","PeriodicalId":74993,"journal":{"name":"The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology","volume":"77 1","pages":"87"},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12431977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}