American Journal of Cardiology最新文献

{"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}

{"title":"Causes of In-Hospital Death in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention in Beijing Area","authors":"Jing Li MDPhD ,&nbsp;Yinghua Zhang MD ,&nbsp;Yixin Ma MM ,&nbsp;Jinghao Sun BM ,&nbsp;Xiaojie Li BM ,&nbsp;Buxing Chen MD ,&nbsp;Hui Chen MD ,&nbsp;Peng Dong MD ,&nbsp;Jingxuan Guo MD ,&nbsp;Lijun Guo MD ,&nbsp;Hengjian Hao MD ,&nbsp;Hanhua Ji MD ,&nbsp;Kang Li MD ,&nbsp;Hongxu Liu MD ,&nbsp;Shuzheng Lv MD ,&nbsp;Luhua Shen MD ,&nbsp;Zhujun Shen MD ,&nbsp;Guohong Wang MD ,&nbsp;Lefeng Wang MD ,&nbsp;Lei Wang MD ,&nbsp;Yuejin Yang MD","doi":"10.1016/j.amjcard.2025.09.030","DOIUrl":"10.1016/j.amjcard.2025.09.030","url":null,"abstract":"<div><div>This study aimed to identify causes of in-hospital death in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PPCI) in the Beijing metropolitan area. A total of 56,763 PPCIs were performed at 56 eligible hospitals between January 1, 2010, and December 31, 2018, among which 1,278 patients died. Causes of death were analyzed and finally adjudicated by a review board. The overall in-hospital mortality rate was 2.25%, ranging annually from 1.96% to 2.48% over the study period. Of these, 1,069 (83.6%) deaths were attributed to disease severity-related causes, mainly cardiogenic shock of 44.4%, mechanical complications of 15.2%, malignant arrhythmia of 8.1% and heart failure of 6.2%. Another 209 (16.4%) patients died from PPCI-related complications, including coronary no-reflow of 8.5%, stent thrombosis of 3.5%, and PPCI-related bleeding of 2.4%. The incidence of PPCI-related death has decreased from 1.02% in 2010 to 0.15% in 2018 (p &lt;0.001). Hospitals in the highest quartile PPCI volume (&gt;130 PPCI annually) had lower incidence of in-hospital death (1.97% vs 2.62%, 2.99%, and 2.56%, p &lt;0.001), disease severity-related death (1.66% vs 2.13%, 2.4%, and 2.17%, p &lt;0.001) and PPCI-related death (0.31% vs 0.48%, 0.59%, and 0.39%, p = 0.003), as compared to those with the first, second and third quartiles of annual PPCI volume. In conclusion, among patients with STEMI and treated with PPCI, in-hospital mortality keeps at a relatively low level in Beijing area. Most deaths are due to pathophysiological deteriorations following STEMI. Hospital PPCI volume remains serve as an important indicator for quality of care.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 29-37"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190652","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":"Surgical Aortic Valve Replacement Following TAVR: Long-Term Comparative Outcomes Versus Non-SAVR Cardiac Surgery","authors":"Osamah Badwan MD ,&nbsp;Issam Motairek MD ,&nbsp;Fawzi Zghyer MD ,&nbsp;Rishi Puri MD, PhD ,&nbsp;Grant Reed MD, MSc ,&nbsp;Amar Krishnaswamy MD ,&nbsp;James Yun MD, PhD ,&nbsp;Samir Kapadia MD","doi":"10.1016/j.amjcard.2025.09.009","DOIUrl":"10.1016/j.amjcard.2025.09.009","url":null,"abstract":"<div><h3>Background</h3><div>As TAVR use expands, some patients require later cardiac surgery, including SAVR with TAVR valve explant in certain scenarios. The long-term risks of SAVR after TAVR compared with other cardiac surgeries remain unclear.</div></div><div><h3>Methods</h3><div>We studied adults in the TriNetX network who underwent TAVR followed by either SAVR or non-SAVR open-heart surgery (OHS) between 2010 and 2023. Propensity-score matching was done on 26 clinical and demographic factors. We compared outcomes at 3 and 5 years.</div></div><div><h3>Results</h3><div>After matching, 132 patients were included in each group. The groups were well-balanced at baseline. At 3 years, mortality was similar (18.9% SAVR vs 22.0% OHS; HR: 0.83, 95% CI: 0.46 to 1.51). At 5 years, mortality remained comparable (20.5% vs 24.2%; OR: 0.80, 95% CI 0.45 to 1.44). Rates of stroke, acute coronary syndrome, heart failure hospitalization, major bleeding, new atrial fibrillation, and renal failure were also similar.</div></div><div><h3>Conclusions</h3><div>SAVR after TAVR was associated with similar long-term outcomes compared with OHS. These findings suggest that risks may be more related to patient complexity than to the valve explant itself.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 127-131"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172352","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":"Secondary Erythrocytosis in Patients With Heart Failure on SGLT2 Inhibitors: Insights from a Multicenter “Real World” Study","authors":"Melissa S. Pherai ,&nbsp;Fenne E.I. de Jong MD ,&nbsp;Joris Jansen MD ,&nbsp;Martijn Tukker BSc ,&nbsp;Selina Özoğul ,&nbsp;Samantha Lenting ,&nbsp;Thomas F. Kok MSc ,&nbsp;Behiye Özcan MD, PhD ,&nbsp;Dennis A. Hesselink MD, PhD ,&nbsp;Peter A.W. Te Boekhorst MD, PhD ,&nbsp;René A. Tio MD, PhD ,&nbsp;Kadir Caliskan MD, PhD","doi":"10.1016/j.amjcard.2025.09.011","DOIUrl":"10.1016/j.amjcard.2025.09.011","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 71-73"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181820","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 Impact of Comorbidity Patterns on Clinical Outcomes in Heart Failure: A Machine Learning-Based Cluster Analysis","authors":"Bingxin Liu BS ,&nbsp;Yimei Zhong BS ,&nbsp;Xuan Yin MS ,&nbsp;Ruijian Huang MS ,&nbsp;Cheng Xie ,&nbsp;Jifang Zhou MD, PhD, MPH","doi":"10.1016/j.amjcard.2025.09.044","DOIUrl":"10.1016/j.amjcard.2025.09.044","url":null,"abstract":"<div><div>Heart failure (HF) is a major global health burden, and complex comorbidity patterns can worsen clinical outcomes and complicate patient care. This study aimed to identify distinct comorbidity-based clusters among HF patients and evaluate their associations with short-term clinical outcomes. We analyzed electronic health records from 1,010,573 HF patients in China between 2021 and 2024 and classified into 5 distinct clusters using the Clustering Large Applications (CLARA) algorithm. Cluster 5, characterized by the highest comorbidity burden, was associated with an increased risk of 30-day readmission (adjusted OR: 1.29, 95% CI: 1.25 to 1.33), whereas Clusters 2 and 3 demonstrated lower risks compared with the reference group. XGBoost achieved the best predictive performance among multiple machine learning models (area under the receiver operating characteristic curve 0.76; Brier score 0.17). Age and Charlson Comorbidity Index score were the most influential predictors, and features derived from the comorbidity clusters provided additional predictive value. In conclusion, these findings demonstrate substantial heterogeneity among HF patients, highlight the clinical relevance of comorbidity-based clustering, and suggest its potential to improve risk stratification and personalized care strategies.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 88-96"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197914","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":"Acute Myocardial Infarction With High Thrombus Burden: Improved Outcomes With Intravascular Imaging-Guided Percutaneous Coronary intervention","authors":"Gjin Ndrepepa MD","doi":"10.1016/j.amjcard.2025.09.036","DOIUrl":"10.1016/j.amjcard.2025.09.036","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 277-279"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184538","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":"Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Left Main Coronary Artery Disease: The OPTIVUS-Complex PCI Study LMCA Cohort","authors":"Ryusuke Nishikawa MD ,&nbsp;Hiroki Shiomi MD ,&nbsp;Ko Yamamoto MD ,&nbsp;Takeshi Morimoto MD, MPH ,&nbsp;Akiyoshi Miyazawa MD ,&nbsp;Kenji Ando MD ,&nbsp;Takenori Domei MD ,&nbsp;Toru Naganuma MD ,&nbsp;Satoru Suwa MD ,&nbsp;Kazushige Kadota MD ,&nbsp;Yuko Onishi MD ,&nbsp;Koh Ono MD ,&nbsp;Koichi Kishi MD ,&nbsp;Kohei Yoneda MD ,&nbsp;Hideki Okayama MD ,&nbsp;Kensho Matsuda MD ,&nbsp;Takanari Fujita MD ,&nbsp;Shojiro Tatsushima MD ,&nbsp;Hiroki Sakamoto MD ,&nbsp;Yukihiro Hamaguchi MD ,&nbsp;Takeshi Kimura MD","doi":"10.1016/j.amjcard.2025.09.018","DOIUrl":"10.1016/j.amjcard.2025.09.018","url":null,"abstract":"<div><div>The impact of optimal intravascular ultrasound (IVUS)-guided left main coronary artery (LMCA) percutaneous coronary intervention (PCI) on clinical outcomes has not been adequately evaluated yet. The OPTIVUS-Complex PCI study LMCA cohort was a prospective multicenter single-arm trial enrolling 902 patients undergoing LMCA PCI targeting the prespecified IVUS criteria (minimal stent area ≥5.0 mm² for left circumflex artery ostium, ≥6 mm² for left anterior descending coronary artery ostium, ≥7 mm² for polygon of confluence, and ≥8.0 mm² for proximal LMCA). The primary endpoint was a composite of death, myocardial infarction, stroke, or any coronary revascularization. The predefined performance goals were based on the CREDO-Kyoto PCI/coronary artery bypass grafting (CABG) registry cohort-2 (PCI: 32.0%, and CABG: 13.9%). The OPTIVUS criteria were met in 73.7% of patients. The prevalence of true bifurcation LMCA lesion was 18.4%. The cumulative 1-year incidence of the primary endpoint was 13.2% (95% CI 11.0% to 15.4%), which was significantly lower than the PCI performance goal (32.0%, p &lt;0.0001), and numerically lower than the CABG performance goal (13.9%). The cumulative 1-year incidences of target-lesion revascularization and target-lesion revascularization for LMCA lesions were 4.2% and 3.0%. The cumulative 1-year incidence of the primary endpoint was not different regardless of meeting or not meeting the OPTIVUS criteria (13.4% vs 14.2%, log-rank p = 0.79), while those of target-lesion revascularization and target-lesion revascularization for LMCA lesions were significantly lower in patients meeting the OPTIVUS criteria than in patients not meeting the OPTIVUS criteria (3.3% vs 7.7%, log-rank p = 0.01, and 2.3% vs 5.5%, log-rank p = 0.02). In conclusion, IVUS-guided LMCA PCI targeting the OPTIVUS criteria in the contemporary clinical practice was associated with a significantly lower rate of cardiovascular event than the predefined PCI performance goal, and with a numerically lower rate of cardiovascular event than the predefined CABG performance goal at 1 year.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 202-211"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172354","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":"Functional Capacity in Heart Failure: A Rising Tide Lifts All Boats","authors":"Marco Giuseppe Del Buono MD, PhD ,&nbsp;Gianluigi Saponara MD ,&nbsp;Tommaso Sanna MD","doi":"10.1016/j.amjcard.2025.09.029","DOIUrl":"10.1016/j.amjcard.2025.09.029","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"259 ","pages":"Pages 275-276"},"PeriodicalIF":2.1,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184554","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}