American Journal of Cardiology最新文献

{"title":"Examining the Association Between Diabetes and Cardiovascular Outcomes in South Asian Compared With White North American Patients Undergoing Primary Percutaneous Coronary Intervention for ST-elevation Myocardial Infarction.","authors":"Razi Khan, Shanjot Brar, Farshad Hosseini, Navraj Malhi, Nima Moghaddam, J L Tycho Vuurmans, Albert Chan, Roger Philipp, Jahangir Charania, Minh Vo, Md Nazmul Karim","doi":"10.1016/j.amjcard.2026.08.015","DOIUrl":"10.1016/j.amjcard.2026.08.015","url":null,"abstract":"<p><p>The aim of this study was to examine the frequency and impact of diabetes (DM) in South Asian (SA) compared with white North American (WNA) patients with ST-elevation myocardial infarction (STEMI). Consecutive patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI between 2016 and 2018 were included for analysis. Patients with and without DM were divided into distinct cohorts. Cardiovascular outcomes at 1-year, including mortality and composite major adverse cardiovascular events (MACE), were compared between SA and WNA in each cohort. Overall, 1,303 patients underwent PPCI for STEMI. Average age for patients was 63.81 ± 12.48 years, 73.4% were male and 27% had DM at the time of presentation. Patient ethnicity was distributed as 407 (31%) SA and 896 (69%) WNA. DM was significantly more frequent in SA compared with WNA (34% vs 24%, p <0.01). In the DM cohort, SA were more likely to have multivessel disease on coronary angiography (SA 55% vs WNA 44%, p = 0.04) and had significantly increased mortality (SA 14% vs WNA 7%, p = 0.04) and mortality/MACE (SA 22% vs WNA 12%, p <0.01) 1-year after PPCI. In multivariate analysis of 1-year outcomes amongst DM, SA ethnicity was an independent predictor of both mortality (odds ratio [OR] 2.82, 95% confidence interval [CI] 1.15, 6.89) and mortality/MACE (OR 2.62, 95% CI 1.33, 5.16). In the non-DM cohort, SA ethnicity was not associated with outcomes or presence of multivessel disease. In conclusion, SA compared to WNA with STEMI were more likely to have DM, while SA ethnicity amongst DM patients conferred worsened 1-year prognosis for cardiovascular outcomes.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759306","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":"Trends and Projections in Valvular Heart Disease Mortality Among Older Adults in the United States, 1999 to 2040.","authors":"Muhammad Rafay Shahzad Cheema, Hritvik Jain, Mahmoud Ismayl, Michael N Young, Aravdeep S Jhand, Naeem K Tahirkheli, Salman Khalid, Sahil Khera, Amit N Vora, Islam Y Elgendy, Ankur Kalra, Andrew M Goldsweig","doi":"10.1016/j.amjcard.2026.08.018","DOIUrl":"10.1016/j.amjcard.2026.08.018","url":null,"abstract":"<p><p>Valvular heart disease (VHD) contributes substantially to cardiovascular mortality. We evaluated long-term VHD mortality trends among older adults to inform healthcare planning. CDC WONDER mortality data (1999 to 2023) were analyzed for adults aged ≥65 years to calculate age-adjusted mortality rates (AAMRs). Joinpoint regression identified temporal trends, alongside a subtype analysis stratifying AAMRs by nonrheumatic aortic (ICD-10 I35), mitral (ICD-10 I34), tricuspid (ICD-10 I36), and chronic rheumatic (ICD-10 I05 to I09) valve disorders. Age-period-cohort modeling assessed generational effects, and ARIMA models projected mortality rates through 2040. Among 1,204,490 VHD deaths, the AAMR declined from 1999 to 2018 (annual percent change [APC] -0.87) but significantly increased from 2018 to 2023 (APC 1.52). Nonrheumatic aortic valve disorders accounted for the vast majority of deaths, demonstrating a continuous decline (APC -0.20). Tricuspid valve disorders showed a sustained rise (APC 7.30), mitral valve disorders exhibited a biphasic pattern reversing after 2012, and chronic rheumatic diseases showed a post-2017 resurgence. Mortality was highest among non-Hispanic White individuals, men, nonmetropolitan residents, and in the West. Age-period-cohort analysis demonstrated generational divergence: recent cohorts experienced lower mortality at ages 65 to 69, whereas adults aged ≥85 years faced progressively higher risks. Forecasting models project the recent resurgence will transition into a sustained plateau, stabilizing at 109.2 deaths per 100,000 population through 2040. Ultimately, after 2 decades of decline, the VHD mortality trend reversed course and is projected to remain stably elevated. This disproportionate impact among the oldest-old and rural populations underscores the need for targeted strategies to mitigate widening disparities.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148756979","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":"Early Transcatheter Edge-to-Edge Repair Is Associated With Improved Mid-term Outcomes in Degenerative Mitral Regurgitation.","authors":"Tetsuro Shimura, Masanori Yamamoto, Itta Kawamura, Azusa Kurita, Hitoshi Matsuo, Ai Kagase, Takahiro Tokuda, Atsushi Sugiura, Hiroshi Tsunamoto, Ryo Yamaguchi, Mike Saji, Yuki Izumi, Masahiko Asami, Yusuke Enta, Daisuke Hachinohe, Shinichi Shirai, Masaki Izumo, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Hisao Otsuki, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiro Yamawaki, Hiroshi Ueno, Gaku Nakazawa, Toshiaki Otsuka, Shunsuke Kubo, Kentaro Hayashida","doi":"10.1016/j.amjcard.2026.08.007","DOIUrl":"10.1016/j.amjcard.2026.08.007","url":null,"abstract":"<p><p>Current guidelines offer limited guidance on the optimal timing of mitral transcatheter edge-to-edge repair (M-TEER) in degenerative mitral regurgitation (DMR). We evaluated whether the interval between diagnosis of DMR with heart failure (HF) and M-TEER was associated with clinical outcomes. We analyzed 1,061 patients with DMR who underwent M-TEER, stratified by timing: early group (n = 667, ≤1 year after DMR-HF diagnosis) versus delayed group (n = 394, >1 year after DMR-HF diagnosis). Echocardiographic markers of cardiac damage were compared. Outcomes were all-cause mortality, the composite of mortality and HF hospitalization, and changes in HF hospitalization and New York Heart Association (NYHA) class III/IV symptoms. The early group had less cardiac damage (higher ejection fraction, smaller left ventricular dimensions and left atrial volume index) and lower rates of atrial fibrillation and severe tricuspid regurgitation (all p < 0.05). At 3 years, mortality (25.1% vs 32.7%, p = 0.013) and the composite endpoint (34.1% vs 45.8%, p = 0.015) were lower in the early group. Earlier intervention was independently associated with lower risks of mortality (hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.52-0.95, p = 0.020) and the composite endpoint (HR 0.70, 95% CI 0.54-0.89, p = 0.004). Within 1 year, HF hospitalization fell from 71.8% to 7.0% (early group) and 62.2% to 8.4% (delayed group), and NYHA class III/IV symptoms from 58.6% to 3.3% and 61.7% to 4.0%, respectively. In conclusion, in patients with DMR and HF, earlier M-TEER was associated with lower mortality and fewer adverse events, although causality cannot be inferred. Both groups showed reductions in HF hospitalizations and improved symptoms.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757701","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 Brugada Syndrome: Is Provocative Testing Necessary?","authors":"Gerald V Naccarelli","doi":"10.1016/j.amjcard.2026.08.011","DOIUrl":"10.1016/j.amjcard.2026.08.011","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757362","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":"Is the Machine Learning Model for No-Reflow Ready for Primetime? A Methodological Perspective.","authors":"Rajeev Gupta, Anshul Yadav, Zameer Ahmed, Neelesh Gupta, Rohit Mody","doi":"10.1016/j.amjcard.2026.07.034","DOIUrl":"10.1016/j.amjcard.2026.07.034","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757774","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":"Incidence, Predictors, and Clinical Impact of Early Readmission After Complex Percutaneous Coronary Intervention.","authors":"Frank Kalaba, Yash Garg, Chukwunonyelum Odukwe, Angelo Oliva, Samantha Sartori, Kenneth F Smith, Asif Shaikh, Javed Suleman, Amit Hooda, Joseph Sweeny, George Dangas, Deepak L Bhatt, Roxana Mehran, Annapoorna Kini, Samin K Sharma","doi":"10.1016/j.amjcard.2026.08.009","DOIUrl":"10.1016/j.amjcard.2026.08.009","url":null,"abstract":"<p><p>Early (≤30-day) rehospitalization after percutaneous coronary intervention (PCI) is associated with increased morbidity and mortality and is used to measure quality performance. We evaluated the impact and predictors of early readmission following complex PCI using a retrospective analysis of the Mount Sinai Hospital (New York) PCI registry. Associations with 1-year outcomes were evaluated using Cox proportional hazards models with readmission as a time-dependent covariate, and predictors of 30-day readmission were derived using multivariable logistic regression. Between 2012 and 2023, a total of 11,654 patients underwent complex PCI. After excluding staged PCI, 5.8% (n = 675) of patients were hospitalized within 30 days postprocedure. Early readmission was associated with significantly worse 1-year outcomes, including higher mortality (4.8% vs 2.7%, p < 0.001). Acute coronary syndrome (ACS), dialysis, multivessel disease, and 3-vessel PCI were independent predictors of early rehospitalization, whereas previous PCI, use of Impella, and femoral access were associated with lower readmission risk. When stratified by sex, ACS was consistently associated with a higher risk of readmission; the protective effect of Impella and the risk associated with multivessel disease and 3-vessel PCI were evident only in men. In conclusion, early rehospitalization after complex PCI is associated with worse 1-year outcomes, and clinical and procedural predictors-including sex-specific differences-should inform risk-mitigation strategies to optimize post-PCI care.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757590","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":"Performance of Cardiovascular Risk Equations for Cardiovascular Mortality Prediction in Adults With Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Jing Kai Tioh, Tsubasa Tsutsumi, Kazuma Mori, Hirokazu Takahashi, Mark Muthiah, Anurag Mehta, Laurence Sperling, Cheng Han Ng, Weiting Huang, Masato Yoneda","doi":"10.1016/j.amjcard.2026.08.006","DOIUrl":"10.1016/j.amjcard.2026.08.006","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759296","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 Left Atrium in Heart Failure: When the Left Ventricle Faces a Stiff Competition.","authors":"Aurelia Brescia, Victoria Delgado","doi":"10.1016/j.amjcard.2026.08.012","DOIUrl":"10.1016/j.amjcard.2026.08.012","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757179","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":"Interpreting the Clinical Impact of Proximal Optimization Technique in Provisional Bifurcation PCI Beyond Overall Treatment Effects.","authors":"Ezgi Gültekin Güner, Kaan Gökçe, Ali Öztürk, Adnan Özel, Ahmet Güner","doi":"10.1016/j.amjcard.2026.08.013","DOIUrl":"10.1016/j.amjcard.2026.08.013","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761296","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":"Reducing Unnecessary Preoperative Cardiology Referral and Cost in Patients Undergoing Bariatric Surgery.","authors":"Andrew Deak, Lauren E Tragesser, Kaitlyn D Ibrahim, Rohit Soans, Abdullah Haddad, Raj Dalsania, V Jon Eddy, Liti Zhang, Anika Ross, Joseph McComb, Martin G Keane, Sezgin Ciftci, Isaac R Whitman","doi":"10.1016/j.amjcard.2026.08.010","DOIUrl":"10.1016/j.amjcard.2026.08.010","url":null,"abstract":"<p><p>Candidates for metabolic and bariatric surgery (MBS) are at increased risk for cardiovascular disease (CVD), which may increase surgical risk. Currently, there are no society guidelines indicating which patients are appropriate for preoperative cardiac risk stratification. We hypothesized that applying a standardized surgical risk calculator with a novel referral algorithm to stratify patients for preoperative cardiac risk stratification would decrease unnecessary referrals and cost to patients and the healthcare system. All patients undergoing MBS at our institution between 2014 and 2023 were identified. Baseline patient characteristics, referrals to cardiology, subsequent cardiac testing ordered, and surgical outcomes were measured. Revised Cardiac Risk Index (RCRI) score was retrospectively calculated for each patient and grouped as low versus increased risk (RCRI score of 0 vs ≥1). Deriving a novel scoring system (RCRI score, ever smoker, age ≥65, and/or METS ≤4) and imputing this retrospective referral algorithm using this score to guide cardiology referral, we calculated how the referral pattern would be affected and the resultant change in costs. Postoperative cardiac complications were assessed as defined by myocardial infarctions, cardiac arrests, stroke, or cardiovascular death. A total of 1,528 patients underwent MBS during the study period, of which 56% (n = 852) were referred to cardiology preoperatively. Those referred were older, had more hypertension, hyperlipidemia, and diabetes, were ever smokers, had heart failure and atrial fibrillation, and were more likely to have BMI >50 kg/m². Of those patients with an RCRI score of 0, 45% (n = 435) underwent further cardiac testing. Strictly applying our standardized referral algorithm, of the 852 patients referred to cardiology, 30% (n = 255) were referred despite being low risk. Based on Medicare reimbursement for Level 4 outpatient consults and unnecessary testing, this would have resulted in a savings of approximately $28,000. There were no postoperative cardiac complications. In conclusion, among candidates for bariatric surgery, a novel referral algorithm based on RCRI and other CVD risk factors may reduce unnecessary preoperative cardiology referrals, with resultant reduction in resource utilization and overall cost savings.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757539","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}