American Journal of Cardiology最新文献

{"title":"Meta-Analysis of Intravascular Ultrasound-Guided Versus Angiography-Guided Endovascular Treatment in Lower Extremity Artery Disease","authors":"Jae-Sik Jang MD, PhD ,&nbsp;Han-Young Jin MD, PhD ,&nbsp;Young-Ah Park MD ,&nbsp;Tae-Hyun Yang MD, PhD ,&nbsp;Jeong-Sook Seo MD, PhD ,&nbsp;Dae-Kyeong Kim MD, PhD ,&nbsp;Jin-Hong Wi MD, PhD","doi":"10.1016/j.amjcard.2024.12.012","DOIUrl":"10.1016/j.amjcard.2024.12.012","url":null,"abstract":"<div><div>Intravascular ultrasound (IVUS) offers precise information about lesion morphology and enhances the optimization of endovascular treatments (EVT). Nevertheless, the impact of IVUS on the durability of EVTs and clinical outcomes remains uncertain. The aim of this systematic review and meta-analysis was to evaluate the efficacy of IVUS-guided EVT compared with angiography-guided EVT. We conducted a meta-analysis of trials comparing IVUS-guided and angiography-guided EVT. The primary end point was binary restenosis, whereas the secondary end points included reintervention, major amputation, death or amputation, and major adverse limb events (MALE). This meta-analysis included 19 studies with 800,452 patients. Compared with angiography-guided EVT, IVUS-guided EVT significantly reduced the risk of binary restenosis (risk ratio [RR] 0.63, 95% confidence interval [CI] 0.43 to 0.91, p = 0.02). It also reduced the risk of reintervention (RR 0.59, 95% CI 0.39 to 0.90, p = 0.01), major amputation (RR 0.85, 95% CI 0.74 to 0.98, p = 0.02), death or amputation (RR 0.72, 95% CI 0.56 to 0.91, p = 0.007), and MALE (RR 0.52, 95% CI 0.28 to 0.94, p = 0.03). Subgroup analysis for femoropopliteal disease revealed consistent benefits of IVUS guidance regarding binary restenosis (RR 0.63, 95% CI 0.42 to 0.94, p = 0.03), reintervention (RR 0.51, 95% CI 0.33 to 0.80, p = 0.003), major amputation (RR 0.85, 95% CI 0.73 to 0.99, p = 0.04), death or amputation (RR 0.68, 95% CI 0.51 to 0.90, p = 0.007), and MALE (RR 0.51, 95% CI 0.27 to 0.96, p = 0.04). The sensitivity analysis of studies using drug-coated devices also showed the consistent benefit of IVUS guidance regarding binary restenosis. In conclusion, compared with angiography, IVUS-guided EVT provided improved clinical outcomes in terms of binary restenosis, reintervention, major amputation, death or amputation, and MALE in lower extremity artery disease, including femoropopliteal disease.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"239 ","pages":"Pages 8-17"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823764","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":"Meta-Analysis Comparing Immediate Versus Staged Complete Revascularization for ST-Elevation Myocardial Infarction With Multivessel Disease","authors":"Abdulrahman M. Almizel MD ,&nbsp;Jeremy Y. Levett MD ,&nbsp;Tetiana Zolotarova MD ,&nbsp;Mark J. Eisenberg MD, MPH","doi":"10.1016/j.amjcard.2024.12.013","DOIUrl":"10.1016/j.amjcard.2024.12.013","url":null,"abstract":"<div><div>Patients with ST-segment elevation myocardial infarction (STEMI) frequently present with multivessel coronary artery disease (CAD) during primary percutaneous coronary intervention, and the optimal timing of complete revascularization (CR) in these cases remains uncertain. This study aims to assess major adverse cardiovascular events (MACEs) and procedural complications in patients with STEMI with multivessel CAD who underwent immediate (index procedure) versus staged CR. We conducted a systematic review and meta-analysis of randomized controlled trials comparing immediate to staged CR in STEMI and multivessel CAD. Trials were identified by way of a systematic search of MEDLINE, Embase, and Cochrane Libraries from database inception to March 6, 2024. The data were analyzed using the RevMan software. A total of 5 randomized controlled trials (n = 1,415) were included in our study, which showed no significant differences in MACEs (13.3% vs 9.8%, relative risk [RR] 1.07, 95% confidence interval [CI] 0.62 to 1.83), all-cause mortality (3% vs 4.55%, RR 0.70, 95% CI 0.41 to 1.21), or myocardial infarction (4.5% vs 2.6%, RR 1.43, 95% CI 0.58 to 3.55) at a weighted mean follow-up duration of 16 months. However, the staged group had a higher rate of unplanned revascularization (8.6% vs 4.4%, RR 1.92, 95% CI 1.21 to 3.04). In conclusion, in patients with STEMI with multivessel CAD, at a mean follow-up of approximately 1.3 years, there is no significant difference in immediate versus staged revascularization (SR) for MACEs; however, SR was associated with a significantly higher incidence of unplanned ischemia-driven revascularization. SR within the index hospitalization may be as effective as immediate CR; further trials are needed to confirm this.</div><div><strong>Condensed Abstract</strong></div><div>We conducted a meta-analysis of 5 randomized controlled trials comparing immediate to staged complete revascularization in patients with ST-segment elevation myocardial infarction with multivessel coronary artery disease. There was no significant difference in major adverse cardiovascular events, all-cause mortality, and myocardial infarction rates between immediate and staged complete revascularization. However, staged revascularization was associated with a higher incidence of unplanned ischemia-driven revascularization.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"239 ","pages":"Pages 75-81"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Driven Assessment of Coronary Computed Tomography Angiography for Intermediate Stenosis: Comparison With Quantitative Coronary Angiography and Fractional Flow Reserve","authors":"Jung In Jo MD ,&nbsp;Hyun Jung Koo MD ,&nbsp;Joon Won Kang MD ,&nbsp;Young Hak Kim MD ,&nbsp;Dong Hyun Yang MD","doi":"10.1016/j.amjcard.2024.12.011","DOIUrl":"10.1016/j.amjcard.2024.12.011","url":null,"abstract":"<div><div>We aimed to compare artificial intelligence (AI)-based coronary stenosis evaluation of coronary computed tomography angiography (CCTA) with its quantitative counterpart of invasive coronary angiography (ICA) and invasive fractional flow reserve (FFR). This single-center retrospective study included 195 symptomatic patients (mean age 61 ± 10 years, 149 men, 585 coronary arteries) with 215 intermediate coronary lesions, with quantitative coronary angiography (QCA) diameter stenosis ranging from 20% to 80%. An AI-driven research prototype (AI-CCTA) was used to quantify stenosis on CCTA images. The diagnostic accuracy of AI-CCTA was assessed on a per-vessel basis using ICA stenosis grading (with ≥50% stenosis) or invasive FFR (≤0.80) as reference standards. AI-driven diameter stenosis was correlated with the QCA results and expert manual measurements subsequently. The disease prevalence in the 585 coronary arteries, as determined by invasive angiography (≥50%), was 46.5%. AI-CCTA exhibited sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve (AUC) of 71.7%, 89.8%, 85.9%, 78.5%, and 0.81, respectively. The diagnostic performance of AI-CCTA was moderate for the 215 intermediate lesions assessed using QCA and FFR, with an AUC of 0.63 for QCA and FFR. AI-CCTA demonstrated a moderate correlation with QCA (r = 0.42, p &lt;0.001) for measuring the degree of stenosis, which was notably better than the results from manual quantification versus QCA (r = 0.26, p = 0.001). In conclusion, AI-driven CCTA analysis exhibited promising results. AI-CCTA demonstrated a moderate relation with QCA in intermediate coronary stenosis lesions; however, its results surpassed those of manual evaluations.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"239 ","pages":"Pages 82-89"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821833","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":"Transient Low-Intensity Late Gadolinium Enhancement in Takotsubo Cardiomyopathy.","authors":"Haojie Wang","doi":"10.1016/j.amjcard.2024.12.006","DOIUrl":"10.1016/j.amjcard.2024.12.006","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821834","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":"Gender- and Age-Based Differences in Nonsyndromic Arteriopathies in Younger Adults","authors":"George Bcharah BS ,&nbsp;Christine E. Firth MD ,&nbsp;Merna M. Abdou MD ,&nbsp;Srekar N. Ravi MD ,&nbsp;Ramzi Ibrahim MD ,&nbsp;Girish Pathangey MD ,&nbsp;Sant J. Kumar MD ,&nbsp;Mahmoud Abdelnabi MBBCh, MSc ,&nbsp;Yuxiang Wang MD ,&nbsp;Mayowa A. Osundiji MBBS, PhD ,&nbsp;Fadi E. Shamoun MD","doi":"10.1016/j.amjcard.2024.12.009","DOIUrl":"10.1016/j.amjcard.2024.12.009","url":null,"abstract":"<div><div>Aneurysms are often associated with connective tissue disorders, but most occur sporadically and are nonsyndromic. Manifestations of these nonsyndromic arteriopathies across genders and age groups have not been discussed extensively in previous studies, especially in younger cohorts. We analyzed data from 84,496 patients in the Mayo Clinic Tapestry DNA Sequencing Study, excluding those with known vascular syndromes. Patients aged ≤60years were included and grouped by gender and into 5 age groups (18 to 60 years). The odds and prevalence of various arteriopathies and complications (i.e., revascularization, stroke, dissection, and death) were compared. Overall, 909 patients aged ≤60 years were included, with 68.0% women (mean age 47.49 years). Women were more likely to have carotid/cerebral aneurysms (55.2% vs 31.6%, p &lt;0.0001), and men were more likely to have thoracic (50.9% vs 21.8%, p &lt;0.0001) and abdominal aortic aneurysms (7.22% vs 2.59%, p &lt;0.01). Men with splanchnic and carotid/cerebral aneurysms were more likely to dissect (58.14% vs 21.49% and 45.65% vs 30.79%, p &lt;0.05, respectively). Women were more likely to have multisite aneurysms (16.34% vs 12.03%, p &lt;0.05), with the most common being concurrent carotid/cerebral and splanchnic aneurysms. Both genders showed peak dissection rates at ages 36 to 45 years, although men experienced more complications in older age groups (56 to 60 years) and women in younger ones (46 to 55 years). In conclusion, men are more susceptible to large vessel aneurysms and complications later in life, whereas women more frequently experience medium-vessel aneurysms, complications earlier in life, and co-occurring multisite aneurysms. Potential unidentified genetic factors could be influencing these patterns.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"239 ","pages":"Pages 36-42"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816979","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":"Noninvasive Multimodality Imaging and Special Treatment Considerations for Pericarditis in Pregnancy","authors":"Rehan Karmali DO, MS ,&nbsp;Issam Motairek MD ,&nbsp;Samia Mazumder MD ,&nbsp;Felix Berglund MD ,&nbsp;Lorenzo Braghieri MD ,&nbsp;Astefanos Al-Dalakta MD ,&nbsp;Katherine Singh MD ,&nbsp;Brittany Weber MD ,&nbsp;Allan Klein MD","doi":"10.1016/j.amjcard.2024.12.007","DOIUrl":"10.1016/j.amjcard.2024.12.007","url":null,"abstract":"<div><div>Pericarditis in women who are pregnant or of childbearing age poses a challenge to clinicians. At present, there are no guidelines regarding the optimal approach for managing pericarditis in pregnancy regarding selecting the appropriate method of diagnostic imaging or tailoring the treatment regimen to gestational age. Pericarditis in pregnancy may manifest as an autoimmune or autoinflammatory phenotype but the predominant etiology is idiopathic. Transthoracic echocardiography and cardiac magnetic resonance are considered safe, but data are lacking on the use of gadolinium-based contrast agents. Shared decision-making is paramount to balance the risks and benefits of radiation and contrast exposure to the mother and fetus. The safety profile of treatment options differs at each time interval from preconception to the 3 trimesters and postpartum phase. A multidisciplinary approach using imaging guidance can improve outcomes in pregnant patients with pericarditis. Further studies are needed to ascertain the safety of interleukin-1 blocking agents in pregnancy.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"238 ","pages":"Pages 70-77"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816977","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":"Coronary Artery Dissection in Drug-Coated Balloon Angioplasty: Incidence, Predictors, and Clinical Outcomes","authors":"Mauro Gitto MD ,&nbsp;Pier Pasquale Leone MD, MSc ,&nbsp;Francesco Gioia MD ,&nbsp;Mauro Chiarito MD, PhD ,&nbsp;Alessia Latini MD ,&nbsp;Francesco Tartaglia MD ,&nbsp;Ismail Dogu Kilic MD ,&nbsp;Marco Luciano Rossi MD ,&nbsp;Damiano Regazzoli MD ,&nbsp;Gabriele Gasparini MD ,&nbsp;Ottavia Cozzi MD ,&nbsp;Alessandro Sticchi MD ,&nbsp;Gianluigi Condorelli MD, PhD ,&nbsp;Bernhard Reimers MD ,&nbsp;Giulio Stefanini MD, PhD, MSc ,&nbsp;Antonio Mangieri MD ,&nbsp;Antonio Colombo MD","doi":"10.1016/j.amjcard.2024.12.008","DOIUrl":"10.1016/j.amjcard.2024.12.008","url":null,"abstract":"<div><div>Coronary dissection is a potential occurrence after lesion preparation for percutaneous coronary intervention (PCI). Unlike stents, drug-coated balloons (DCBs) do not allow to cover dissections, thus demanding an assessment of their safety in this setting. This study aimed to evaluate the incidence, predictors, and clinical outcomes of dissections occurring with DCB-based PCI for de novo coronary artery disease. Consecutive patients with de novo coronary artery disease who underwent PCI with intention-to-treat DCB angioplasty, with or without stent implantation, were retrospectively enrolled between 2018 and 2022 at 2 Italian centers. The decision whether to leave a dissection untreated or to proceed with bail-out stenting was based on a combined angiographic evaluation of Thrombolysis In Myocardial Infarction flow, residual minimal lumen diameter, and persistent extraluminal contrast hang-up. The primary end point at 2-year follow-up was target lesion failure, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization. Among 522 DCB-treated lesions (466 patients), dissections were angiographically evident in 39.1% of cases, with 21.1% which underwent bail-out stenting and 78.9% left untreated. The incidence of bail-out stenting increased from type A to type E dissections (p for trend &lt;0.001). Left anterior descending artery involvement (odds ratio 1.64, 95% confidence interval 1.12 to 2.39) was the strongest risk factors for dissection. Target lesion failure at 2 years occurred in 2.7% of lesions with untreated dissection compared with 4.2% of those with no dissection (log-rank p = 0.324). In conclusion, coronary dissections often complicate PCI with DCB angioplasty but do not correlate with increased risk of adverse events at midterm follow-up.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"239 ","pages":"Pages 28-35"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816975","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":"Patterns and Prognostic Impact of Postdischarge Ischemic, Bleeding, and Heart Failure Events After Myocardial Infarction","authors":"Shogo Okita MD ,&nbsp;Yuichi Saito MD ,&nbsp;Hiroaki Yaginuma MD ,&nbsp;Kazunari Asada MD ,&nbsp;Hiroki Goto MD ,&nbsp;Osamu Hashimoto MD ,&nbsp;Takanori Sato MD ,&nbsp;Hideki Kitahara MD ,&nbsp;Yoshio Kobayashi MD","doi":"10.1016/j.amjcard.2024.12.004","DOIUrl":"10.1016/j.amjcard.2024.12.004","url":null,"abstract":"<div><div>Although the in-hospital prognosis after acute myocardial infarction (AMI) has considerably improved to date, ischemic, bleeding, and heart failure (HF) events after discharge remain clinical challenges. However, the pattern of such events is not fully understood in contemporary clinical practice. This study aimed to evaluate the timing and prognostic impact of cardiovascular and bleeding events after AMI. This multicenter, retrospective registry included 2,059 patients with AMI who underwent percutaneous coronary intervention. Patients were grouped according to their first events after discharge, consisting of ischemic events (recurrent AMI or ischemic stroke), major bleeding, and HF hospitalization, whereas those without such events were classified as the no cardiovascular event group. All-cause mortality after discharge and the ischemic, bleeding, and HF events were evaluated. Ischemic events, major bleedings, and HF hospitalization as their first clinical outcome measures after discharge occurred in 99 (4.8%), 57 (2.8%), and 75 (3.6%) patients, respectively, during the median follow-up period of 538 days. Postdischarge mortality was highest in the major bleeding group, followed by the ischemic events, HF hospitalization, and no cardiovascular event groups. HF hospitalization occurred earlier than major bleeding and ischemic events after discharge. The mortality impact after the first events was greater in the major bleeding rather than ischemic events and HF hospitalization. In conclusion, patterns and prognostic impact of postdischarge outcomes differed significantly among ischemic, bleeding, and HF events, suggesting that timely and tailored follow-up may be needed after AMI.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"239 ","pages":"Pages 1-7"},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794292","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":"Type A Aortic Dissection After Thoracic Endovascular Aortic Repair for Type B","authors":"Kyle A. McCullough MD ,&nbsp;Katherine R. Hebeler MD ,&nbsp;John B. Eisenga MD ,&nbsp;Baron L. Hamman MD ,&nbsp;Charles S. Roberts MD","doi":"10.1016/j.amjcard.2024.12.005","DOIUrl":"10.1016/j.amjcard.2024.12.005","url":null,"abstract":"<div><div>Type A aortic dissection (TAAD) has been associated with thoracic endovascular aortic repair (TEVAR) for aortic conditions: dissection and aneurysm. Our purpose was to study a subset of patients who had an initial TEVAR for type B aortic dissection, followed by a TAAD, which was treated by open ascending aortic repair. Over a 6-year period, 171 consecutive patients underwent open ascending aortic repair for TAAD, of whom 21 (12%) had a previous cardiovascular procedure, 17 of which were endovascular. A total of 9 (5.2%) of 171 patients with TAAD had a previous TEVAR for a type B. The mean interval from TEVAR to open ascending aortic repair for TAAD was 4.6 years, with only 1 occurring within a month. Only 1 patient had abnormal aortic media by histology. In 5 of the 9 patients, the entry tear was in the proximal ascending aorta, remote from the endograft, which suggests that a TAAD late after TEVAR for type B represents a new spontaneous event.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"237 ","pages":"Pages 79-82"},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811697","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":"Life-Threatening Ventricular Tachyarrhythmia in Isolated Cardiac Sarcoidosis Compared With Cardiac Sarcoidosis With Extracardiac Involvement","authors":"Yoichi Takaya MD, PhD,&nbsp;Koji Nakagawa MD, PhD,&nbsp;Toru Miyoshi MD, PhD,&nbsp;Nobuhiro Nishii MD, PhD,&nbsp;Hiroshi Morita MD, PhD,&nbsp;Kazufumi Nakamura MD, PhD,&nbsp;Shinsuke Yuasa MD, PhD","doi":"10.1016/j.amjcard.2024.12.002","DOIUrl":"10.1016/j.amjcard.2024.12.002","url":null,"abstract":"<div><div>Although isolated cardiac sarcoidosis (CS) is not uncommon, little is known about the risk of life-threatening ventricular tachyarrhythmia. We aimed to evaluate the incidence of ventricular tachyarrhythmia in patients with isolated CS. A total of 94 patients with CS were enrolled. Isolated CS was diagnosed by histologic or clinical confirmation in the heart alone. The end points were sudden cardiac death, ventricular fibrillation, sustained ventricular tachycardia, or implantable cardioverter-defibrillator therapy for ventricular fibrillation or sustained ventricular tachycardia. A total of 25 patients were diagnosed with isolated CS, and 69 were diagnosed with CS with extracardiac involvement. As the initial cardiac manifestation leading to the CS diagnosis, 10 patients (40%) with isolated CS had ventricular tachyarrhythmia. Over the median follow-up of 48 months after the CS diagnosis, sudden cardiac death occurred in 2 patients (8%) with isolated CS. Ventricular fibrillation or sustained ventricular tachycardia, including implantable cardioverter-defibrillator therapy, occurred in 15 patients (60%) with isolated CS and 13 (19%) with CS with extracardiac involvement. The rate of ventricular tachyarrhythmia was higher in patients with isolated CS than in those with CS with extracardiac involvement (log-rank, p &lt;0.01). Cox proportional hazard analysis showed that isolated CS was independently associated with ventricular tachyarrhythmia. A total of 2 or more ventricular tachyarrhythmias more frequently occurred in patients with isolated CS (52% vs 13%, p &lt;0.01). Electric storm more frequently occurred in patients with isolated CS (24% vs 6%, p = 0.01). In conclusion, patients with isolated CS have ventricular tachyarrhythmia at a higher rate than those with CS with extracardiac involvement.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"238 ","pages":"Pages 65-69"},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799103","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}