American Journal of Cardiology最新文献

{"title":"Risk Reduction by IMPELLA Support in High-Risk Percutaneous Coronary Intervention","authors":"Takashi Ishimatsu MD, PhD, Yoshihiro Fukumoto MD, PhD","doi":"10.1016/j.amjcard.2025.10.001","DOIUrl":"10.1016/j.amjcard.2025.10.001","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 91-93"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Predictors of In-hospital Mortality in Nonagenarians with NSTEMI: A Comparison of PCI and Medical Management","authors":"Minjung Kim PhD ,&nbsp;Priyesh Thakurathi MD ,&nbsp;Jai Nagpal BS ,&nbsp;Vaibhav Satija MD ,&nbsp;Juyong Lee MD, PhD ,&nbsp;Kyutae Park MD, PhD ,&nbsp;Agnes S. Kim MD, PhD","doi":"10.1016/j.amjcard.2025.11.016","DOIUrl":"10.1016/j.amjcard.2025.11.016","url":null,"abstract":"<div><div>Nonagenarians, the fastest-growing U.S. age group, face a high burden of Non-ST-Elevation Myocardial Infarction (NSTEMI), yet the utilization and outcomes of percutaneous coronary intervention (PCI) in this population remain poorly understood. The aims of this study were to assess patient characteristics, comorbidities, and in-hospital outcomes in nonagenarians and identify predictors of in-hospital mortality. We analyzed 122,845 hospitalizations with a principal discharge diagnosis of NSTEMI among nonagenarians using the National Inpatient Sample (2015-2019) to compare PCI (8%) versus medical management (92%). Over the study period, there was an 18% reduction in medically managed cases (p = 0.04), while PCI utilization increased from 7% to 9% (p = 0.03). The medical management cohort had significantly higher Elixhauser comorbidity (EC) scores (p &lt;0.001), 30-day readmission EC scores (p &lt;0.001), in-hospital mortality EC scores (p &lt;0.001), and in-hospital mortality rate (7.9% vs 4.2%; p &lt;0.001). Mortality predictors differed: mortality in the medical management group was most strongly associated with alcohol abuse, chronic blood loss anemia, and diabetes; whereas mortality in the PCI group correlated most strongly with inotrope/vasopressor use, chronic pulmonary disease, prior transient ischemic attack, and peripheral vascular disease. Despite rising adoption, PCI remains underutilized in nonagenarians. PCI is linked to lower in-hospital mortality. The distinct comorbidity profiles and mortality predictors underscore the need for individualized treatment strategies in this vulnerable elderly population.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 36-43"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The OPTIVUS-Complex PCI Study: Striving for Left Main Perfection","authors":"Darcy Banco MD,&nbsp;Eric A Secemsky MD MSc","doi":"10.1016/j.amjcard.2025.10.023","DOIUrl":"10.1016/j.amjcard.2025.10.023","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 96-98"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Abdominal Aortic Aneurysm Imaging to Improve Access, Clinical Utility, and Value-Based Medicine","authors":"Daniel Raskin MD ,&nbsp;Sasan Partovi MD ,&nbsp;Abraham Levitin MD ,&nbsp;Paul Schoenhagen MD, PhD ,&nbsp;Sean P. Lyden MD ,&nbsp;Gregory Piazza MD ,&nbsp;Levester Kirksey MD","doi":"10.1016/j.amjcard.2025.11.008","DOIUrl":"10.1016/j.amjcard.2025.11.008","url":null,"abstract":"<div><div>Abdominal aortic aneurysm (AAA) care relies on imaging for screening, surveillance, prerepair planning, and postrepair follow-up, yet both overuse and underuse can harm patients and inflate costs. We performed a narrative synthesis of contemporary guidelines and primary studies to outline a value-based pathway that emphasizes clinical safety, equity, and resource stewardship. Evidence supports an ultrasound-first strategy for unrepaired AAAs, targeted 1-time ultrasound screening in at-risk populations, and a single computed tomography angiogram (CTA) before repair to define anatomy and device planning. After endovascular aneurysm repair (EVAR), routine follow-up can be centered on duplex ultrasonography (DUS) ± contrast-enhanced ultrasound (CEUS), reserving computed tomography angiogram (CTA)/MRA for sac growth, suspected endoleak, or complex repairs. Implementation levers include guideline-embedded order sets, automated capture of incidental AAAs, and operational steps that improve access for disadvantaged patients. In conclusion, a risk-adapted, ultrasound-lean imaging strategy preserves outcomes while lowering cumulative radiation exposure, reducing expenditures, and improving access, thereby advancing value-based cardiovascular care.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 54-60"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter or Surgical Strategy for Aortic Stenosis and Coronary Artery Disease: A Kaplan–Meier-Derived Meta-Analysis","authors":"Massimo Baudo MD ,&nbsp;Pier Pasquale Leone MD, MSc ,&nbsp;Serge Sicouri MD ,&nbsp;Dimitrios E. Magouliotis MD, PhD, MSc ,&nbsp;Yoshiyuki Yamashita MD, PhD ,&nbsp;Francesco Cabrucci MD ,&nbsp;Matteo Sturla MD ,&nbsp;Azeem Latib MD ,&nbsp;Basel Ramlawi MD","doi":"10.1016/j.amjcard.2025.11.018","DOIUrl":"10.1016/j.amjcard.2025.11.018","url":null,"abstract":"<div><div>Coronary artery disease (CAD) is commonly found in patients with severe aortic stenosis (AS) and combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG) is currently recommended as the preferred treatment in this setting. Transcatheter aortic valve replacement (TAVR) and percutaneous coronary intervention (PCI) represent a valid alternative. This study sought to investigate clinical outcomes after TAVR+PCI versus SAVR+CABG in patients with severe AS and CAD. A systematic review was conducted from inception until December 2024 for randomized controlled and propensity score-matched studies comparing TAVR+PCI and SAVR+CABG for patients with severe AS and CAD. Kaplan–Meier-derived individual patient data was retrieved when available. Primary endpoint was all-cause mortality. The study was registered with PROSPERO (CRD42025642206). Six studies met our inclusion criteria with a total of 1,998 patients: 1,007 in the TAVR+PCI group and 991 in the SAVR+CABG group. The hazard ratio of all-cause mortality varied over time between groups: TAVR+PCI showed a lower incidence of all-cause mortality in the first 19 days, with a reversal at 73 days favoring SAVR+CABG. Patients undergoing TAVR+PCI group experienced lower rates of stroke-free survival (p = 0.039), postoperative reintervention (p = 0.020), atrial fibrillation (p &lt;0.001), and acute kidney injury (p = 0.001) rates, while they were at higher risk of postoperative moderate/severe aortic regurgitation (p &lt;0.001), permanent pacemaker implantation (p = 0.005) and major vascular complication (p &lt;0.001). Major bleeding didn’t differ (p = 0.358). A percutaneous treatment approach offered an early survival benefit over a surgical approach in patients with severe AS and CAD but was associated with worse survival at mid-term follow-up.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 80-88"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Clinical Characteristics and Prognosis of Acute Heart Failure in Patients with Chronic Obstructive Pulmonary Disease’ [The American Journal of Cardiology 257(2025) Pages 101-109]","authors":"Han Xia PhD,&nbsp;Junlei Li PhD,&nbsp;Jianzeng Dong PhD","doi":"10.1016/j.amjcard.2025.12.001","DOIUrl":"10.1016/j.amjcard.2025.12.001","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Page 53"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145832805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular Lithotripsy in Diabetic Patients Undergoing Percutaneous Coronary Intervention: Long-Term Outcomes from the BENELUX Registry","authors":"Akshay A.S. Phagu MD ,&nbsp;Martijn J.H. van Oort MSc ,&nbsp;Federico Oliveri MD ,&nbsp;Brian O. Bingen MD, PhD ,&nbsp;Valeria Paradies MD ,&nbsp;Gianluca Mincione MD ,&nbsp;Bimmer E.P.M. Claessen MD, PhD ,&nbsp;Aukelien C. Dimitriu-Leen MD, PhD ,&nbsp;Tessel N. Vossenberg MD ,&nbsp;Joelle Kefer MD, PhD ,&nbsp;Alessandro Mandurino-Mirizzi MD ,&nbsp;Marios Sagris MD, PhD ,&nbsp;Frank van der Kley MD, PhD ,&nbsp;J. Wouter Jukema MD, PhD ,&nbsp;Ibtihal Al Amri MD, PhD ,&nbsp;Jose M. Montero-Cabezas MD, PhD","doi":"10.1016/j.amjcard.2025.11.007","DOIUrl":"10.1016/j.amjcard.2025.11.007","url":null,"abstract":"<div><div>Diabetes mellitus (DM) is associated with increased coronary calcification and adverse outcomes after percutaneous coronary intervention (PCI), yet the performance of intravascular lithotripsy (IVL) in this high-risk population remains insufficiently defined. This study, conducted within the all-comers BENELUX-IVL registry, evaluated the safety and efficacy of IVL-assisted PCI in patients with and without DM. The primary endpoint was major adverse cardiovascular events (MACE) at 1 and 2 years, defined as cardiovascular death, nonfatal myocardial infarction, or clinically driven target vessel revascularization. Secondary endpoints included procedural outcomes, complications, and all-cause mortality. A total of 574 patients were included, of whom 193 (33.6%) had DM and 381 (66.4%) did not. Procedural (87.0% vs 89.5%; p = 0.381) and device success (95.3% vs 97.9%; p = 0.087) were similar between groups. Post-PCI minimum lumen diameter (2.80 ± 0.59 vs 2.95 ± 0.70 mm; p = 0.027) and area (6.0 [4.80 to 7.75] vs 6.6 [4.98 to 8.90] mm²; p = 0.045) were smaller in patients with DM. Thirty-day MACE was higher among diabetics (3.1% vs 0.3%; p = 0.007), whereas 1- and 2-year MACE and mortality rates were comparable. Diabetes was not independently associated with mortality (adjusted OR 1.51; p = 0.17). In conclusion, IVL-assisted PCI is safe and effective in diabetic patients, with long-term outcomes comparable to those without diabetes, although the higher early MACE risk, particularly in type 1 DM, warrants careful procedural planning and follow-up.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 10-17"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalization Outcomes After Acute Myocardial Infarction in Patients With Prior Thoracic Irradiation","authors":"Sahil Ghay DO ,&nbsp;Aren Singh Saini BS ,&nbsp;Baneet Kaur DO ,&nbsp;Armando A. Vera MD ,&nbsp;Derek M. Isrow MD","doi":"10.1016/j.amjcard.2025.11.010","DOIUrl":"10.1016/j.amjcard.2025.11.010","url":null,"abstract":"<div><div>Thoracic radiation therapy is a cornerstone in the treatment of malignancies such as breast cancer, lung cancer, esophageal cancer, and lymphoma. While its long-term cardiac risks are well known, there is limited data on how prior thoracic irradiation is associated with outcomes in patients hospitalized with acute myocardial infarction (AMI). This study evaluates the association between prior chest irradiation and in-hospital outcomes among patients admitted with AMI. A retrospective cohort study using the National Inpatient Sample (2016–2022) was conducted. Adult AMI admissions were identified via ICD-10 codes and stratified by history of thoracic radiation. Multivariable regression and propensity matching were used to evaluate the association of prior radiation on in-hospital mortality (primary outcome), and secondary outcomes including hospitalization cost, length of stay, and use of intensive interventions. Of 4,353,204 AMI hospitalizations, 5,280 had a history of thoracic radiation. Prior radiation was associated with increased in-hospital mortality (aOR: 1.55, 95% CI 1.06 to 2.27, p = 0.023). There were no significant differences in hospitalization cost (−$6,126, p = 0.196) or length of stay (−0.20 days, p = 0.327). Patients with prior radiation were more likely to have do-not-resuscitate orders (aOR: 2.15, p &lt;0.001) and receive palliative care consultations (aOR: 2.43, p &lt;0.001). Prior thoracic radiation is associated with worse in-hospital survival following AMI, along with greater palliative involvement and end-of-life care decisions. These findings underscore the need for cardio-oncology–informed inpatient care in this high-risk population.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 44-52"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Mortality in Male Patients with Takotsubo Cardiomyopathy Appears to Be Related to Higher Complication Rates","authors":"Ashwin Siby MS ,&nbsp;Mehrtash Hashemzadeh MS ,&nbsp;Mohammad Reza Movahed MD, PhD,","doi":"10.1016/j.amjcard.2025.11.013","DOIUrl":"10.1016/j.amjcard.2025.11.013","url":null,"abstract":"<div><div>Mortality in male patients with Takotsubo cardiomyopathy appears to be double that of Women. The goal of this study was to determine whether a higher mortality rate is associated with a higher complication rate in male adults. Using ICD-10 codes for Takotsubo cardiomyopathy, we evaluated differences in the occurrence of complications between Men and women. A total of 199,890 patients were diagnosed with Takotsubo cardiomyopathy, comprising 34,770 male and 195,120 female patients. All major complications are significantly higher in men than in women, despite multivariate adjustment for age and cardiovascular risk factors. Cardiogenic Shock: 9.88% versus 5.98% p &lt;0.001, OR 1.57, 95% confidence interval (CI) 1.43 to 1.73, Atrial Fibrillation: 23.96% versus 20.12%, p &lt;0.001, OR 1.55, 95% CI 1.45 to 1.66, Cardiac Arrest: 5.71% versus 2.94%, p &lt;0.001, OR 1.71, 95% CI 1.51 to 1.94, Congestive Heart Failure: 39.52% versus 35.18% p &lt;0.001, OR 1.23, 95% CI 1.16 to 1.30, Stroke: 7.45% versus 4.94%, p &lt;0.001, OR 1.51, 95% CI 1.36 to 1.68. In conclusion, all major cardiovascular complications are higher in men compared to women with a diagnosis of Takotsubo cardiomyopathy, as a plausible explanation for the higher mortality in men.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 4-9"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Patients with HFrEF; Overcoming Clinical Inertia","authors":"Iain Squire MD","doi":"10.1016/j.amjcard.2025.09.028","DOIUrl":"10.1016/j.amjcard.2025.09.028","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 273-274"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}