American Journal of Cardiology最新文献

{"title":"Exploring Current Diagnosis and Management of Amiodarone-induced Thyrotoxicosis","authors":"Yudi Her Oktaviono MD, PhD ,&nbsp;Ali Mustofa BSc ,&nbsp;Pandit Bagus Tri Saputra MD ,&nbsp;Wynne Widiarti MD ,&nbsp;Novia Nurul Faizah MD ,&nbsp;Firas Farisi Alkaff MD","doi":"10.1016/j.amjcard.2025.02.002","DOIUrl":"10.1016/j.amjcard.2025.02.002","url":null,"abstract":"<div><div>Amiodarone, commonly used to treat various types of arrhythmias, can potentially lead to catastrophic adverse effects like amiodarone-induced thyrotoxicosis (AIT). This review offers insights into diagnosing and managing AIT, involving thyroid function tests, imaging techniques, and strategies to prevent cardiac deterioration and reduce mortality. The approach to managing AIT has shifted from focusing on thyrotoxicosis control to a broader strategy that includes preventing heart deterioration, hospitalizations, and reducing mortality. Healthcare professionals should consider the patient's need for amiodarone, side effects, coexisting conditions, and personal perspective. Routine thyroid function monitoring and collaboration across medical specialties are essential for comprehensive AIT management. Effective management of AIT is crucial to diminish mortality and morbidity. Pharmacological treatment can be initiated. Further intervention such as thyroidectomy is recommended, especially in cases where cardiac status is deteriorating and amiodarone continuation is necessary. In conclusion, early diagnosis and timely treatment through interdisciplinary collaboration according to specific individual case are crucial to reduce morbidity and mortality in AIT patients.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"242 ","pages":"Pages 75-81"},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381529","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":"Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Cardiovascular Outcomes in Transthyretin Amyloid Cardiomyopathy","authors":"Stefano H. Byer MD, MS ,&nbsp;Aravinthasamy Sivamurugan BA ,&nbsp;Udhayvir S. Grewal MD ,&nbsp;Michael G. Fradley MD ,&nbsp;Paari Dominic MD","doi":"10.1016/j.amjcard.2025.01.012","DOIUrl":"10.1016/j.amjcard.2025.01.012","url":null,"abstract":"<div><div>Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive form of heart failure characterized by restrictive hemodynamics and high morbidity. Tafamidis remains the only approved treatment, but its limited availability underscores the need for alternative therapies. Sodium-glucose co-transporter 2 inhibitors (SGLT2i), shown to improve outcomes in heart failure with preserved ejection fraction (HFpEF), may offer therapeutic benefits in ATTR-CM due to shared pathophysiological mechanisms. A retrospective cohort analysis was conducted using data from the TriNetX Global Research Network. Patients with wild-type transthyretin amyloid cardiomyopathy (wtATTR-CM) were divided into 2 groups: those receiving SGLT2i therapy and those not treated with SGLT2i. Propensity score matching balanced 19 baseline characteristics. Clinical outcomes, including heart failure exacerbations, all-cause hospitalizations, acute kidney injury (AKI), and all-cause mortality, were assessed over 5 years. The study included 623 matched patients in each cohort. SGLT2i therapy was associated with significant reductions in heart failure exacerbations (hazard ratio [HR] 0.64, 95% confidence interval [CI]: 0.48 to 0.86, p &lt;0.01), all-cause hospitalizations (HR 0.72, 95% CI: 0.58 to 0.91, p &lt;0.01), and AKI (HR 0.53, 95% CI: 0.35 to 0.79, p &lt;0.01). A trend toward reduced all-cause mortality (HR 0.83, 95% CI: 0.63 to 1.08, p = 0.165) was observed, though not statistically significant. In conclusions, SGLT2 inhibitors demonstrate significant potential to reduce morbidity and healthcare utilization in wt-ATTR-CM patients, with promising trends toward improved survival. These findings highlight SGLT2i as a viable adjunct to existing therapies like tafamidis and warrant further investigation through prospective randomized trials.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 15-18"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373724","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":"Clinical Impact of P2Y12 Pretreatment in ST-Segment Elevation Myocardial Infarction: Insights from the SEMPRE (St-Elevation Mestre Pretreatment Registry) Study","authors":"Francesco Gallo MD ,&nbsp;Ada Cutolo MD ,&nbsp;Antonio Antonucci MD ,&nbsp;Gabriele Cordoni MD ,&nbsp;Elisabetta Demurtas MD ,&nbsp;Andrea Panza MD ,&nbsp;Sakis Themistoclakis MD","doi":"10.1016/j.amjcard.2025.02.001","DOIUrl":"10.1016/j.amjcard.2025.02.001","url":null,"abstract":"<div><div>Early administration of P2Y12 receptor antagonists, in patients admitted with ST-segment elevation myocardial infarction (STEMI) diagnosis, is still debatable. Aim of this observational registry was to describe the clinical impact of a preloading strategy on coronary reperfusion and in-hospital bleeding in a real-world population, compared with patients who did not receive a P2Y12 receptor antagonist. Consecutive patients from January 2016 to April 2021 with STEMI, who underwent emerging coronary angiography in our institution were included. Primary outcomes were: infarct related artery (IRA) patency; definite or probable stent thrombosis (ST) and in-hospital BARC3-5 bleeding. To overcome the limit of the observational nature of the study an inverse-probability-weighting (IPW) analysis has been performed to adjust for baseline differences. A total of 1004 patients were included, 70% of them did not receive a P2Y12 inhibitor, while 301 patients (30%) were pretreated with a P2Y12 inhibitor before coronary angiography. We have not found differences in IRA reperfusion (46.9% vs. 46.8%; p = 0.81), final TIMI 3 flow after PCI (85.6% vs. 84.9%; p = 0.47) and acute or subacute ST (2% vs. 0.7%; p = 0.17). BARC 3-5 bleeding was significantly higher in the P2Y12 inhibitor-pretreated group (7.3% vs. 3.3%; p = 0.005). At multivariate analysis, pretreatment with a P2Y12 inhibitor, before knowing the coronary anatomy, was an independent predictor of hemorrhagic events (adj OR 3.45 [95% CI 1.78 to 6.69]; p &lt;0.001), In STEMI patients, a routine pretreatment strategy with a P2Y12 inhibitor, before the coronary angiography, seems to not impact on reperfusion outcomes, despite a trend toward increased risk of stent thrombosis; on the other hand, it may increase the risk of major bleedings.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 1-7"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373717","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":"Comments on: “Cardiovascular Prognosis in Limb Ischemia Patients With Heart Failure and Systolic Dysfunction Following Major Amputation”","authors":"Sravani Modumudi MD,&nbsp;Chandana Padmanabham Reddy MD","doi":"10.1016/j.amjcard.2025.01.036","DOIUrl":"10.1016/j.amjcard.2025.01.036","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"242 ","pages":"Page 41"},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373723","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":"Better Endothelization Looking Forward to a Clinical Impact.","authors":"Antonio Colombo, Pier Pasquale Leone","doi":"10.1016/j.amjcard.2025.01.035","DOIUrl":"10.1016/j.amjcard.2025.01.035","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254514","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":"Bilateral Internal Mammary Artery in Off-Pump Coronary Artery Grafting in Diabetic Patients","authors":"Giuseppe Tavilla MD, PhD,&nbsp;Md Anamul Islam PhD,&nbsp;Amber Malhotra MD,&nbsp;Daniel Lincoln Beckles MD, PhD","doi":"10.1016/j.amjcard.2025.01.030","DOIUrl":"10.1016/j.amjcard.2025.01.030","url":null,"abstract":"<div><div>Bilateral internal mammary artery (BIMA) grafts utilization in coronary artery bypass grafting (CABG) for diabetic patients has been limited due to concerns regarding postoperative morbidity, especially sternal wound infections (SWI). However, outcomes for BIMA grafting combined with off-pump CABG (OPCAB) in diabetic patients remain underexplored. This study aimed to compare BIMA and single internal mammary artery (SIMA) grafting outcomes in diabetic OPCAB patients. A single-center retrospective analysis was conducted on diabetes patients who underwent OPCAB with BIMA or SIMA grafts from January 2020 to December 2023. Baseline characteristics, including STS risk scores, were matched between cohorts using stabilized inverse probability treatment weighting (sIPTW). The study included 412 diabetic patients: 207 (50.2%) received BIMA and 205 (49.8%) received SIMA grafts. After sIPTW matching, 30-day mortality was identical (1.4%, p = 0.40), with comparable rates of deep (0.9% vs 0.8%, p = 0.89) and superficial sternal wound infections (4% vs 1.8%, p = 0.19). Composite complication rates (40% vs 47%; p = 0.13) and individual components such as renal injury, reoperation bleeding, stroke, and atrial fibrillation were similar between groups. Rates of overall readmission and cardiac readmission, discharge-to-home versus acute care facilities, and hospital stays longer than 7 days were comparable. Notably, BIMA showed significantly lower rates of blood transfusion (31% vs 40%; p = 0.038) and prolonged ventilation (9% vs 16%; p = 0.033) than SIMA group. In conclusion, our findings suggest that BIMA grafting combined with OPCAB may be safely used in diabetic patients despite historical concern about wound healing complications.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 34-39"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254516","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":"Association of Coronary Revascularization Modality and Timing With Outcomes of Acute Coronary Syndrome in Kidney Transplant Recipients","authors":"Oh Jin Kwon MD ,&nbsp;Esteban Aguayo MD ,&nbsp;Joseph Hadaya MD ,&nbsp;Kevin Tabibian BS ,&nbsp;Dariush Yalzadeh BS ,&nbsp;Matthew Gandjian MD ,&nbsp;Yas Sanaiha MD ,&nbsp;Radoslav Zinoviev MD ,&nbsp;Peyman Benharash MD","doi":"10.1016/j.amjcard.2025.01.029","DOIUrl":"10.1016/j.amjcard.2025.01.029","url":null,"abstract":"<div><div>Coronary artery disease (CAD) remains a leading cause of morbidity and mortality among renal transplant (RTx) recipients, with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) representing a disproportionately high burden. However, the optimal revascularization strategy for NSTE-ACS in RTx recipients remains unclear. This retrospective study analyzed the 2016 to 2021 Nationwide Readmissions Database. RTx recipients (≥18 years) undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) for NSTE-ACS were included. The primary outcome was in-hospital mortality, while perioperative complications, unplanned 30- and 90-day readmissions, repeat revascularization, and renal allograft failure were also considered. Multivariable logistic regression and Royston–Parmar models were used to identify the risk-adjusted association of revascularization modality, timing, and outcomes. Of an estimated 3,323 patients, 20.5% underwent CABG and 79.5% PCI. Following adjustment, CABG was associated with higher perioperative complications (AOR 3.46, 95% CI 2.31 to 5.19) and demonstrated a trend toward increased mortality risk (AOR 1.79, 95% CI 0.76 to 4.18). Royston–Parmar analysis demonstrated no difference in freedom from readmission or renal allograft failure within 90 days of discharge, but CABG was associated with a lower hazard of repeat revascularization (HR 0.24, 95% CI 0.08 to 0.76). Timing analysis revealed stable mortality rates across intervals for both modalities. While PCI complications increased with longer delays to revascularization, CABG demonstrated a more stable pattern. In conclusion, our findings suggest that PCI appears to be associated with lower risks of mortality and complications compared to CABG in RTx recipients with NSTE-ACS. However, CABG may offer benefits of reduced risk of repeat revascularization and greater flexibility in timing without compromising renal allograft function.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"242 ","pages":"Pages 53-60"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254512","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":"Regression and Worsening of Tricuspid Regurgitation Following Transvenous Cardiac Implantable Electronic Device Implantation","authors":"Gulmira Kudaiberdieva MD, PhD, DSc","doi":"10.1016/j.amjcard.2024.09.027","DOIUrl":"10.1016/j.amjcard.2024.09.027","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 96-97"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364004","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":"Impact of Intensified Outpatient Follow-Up on Rehospitalization After Transcatheter Aortic Valve Implantation: Results From the HOSPITAVI Trial.","authors":"Pernille Steen Bække, Troels Højsgaard Jørgensen, Gintautas Bieliauskas, Lars Sondergaard, Ole De Backer","doi":"10.1016/j.amjcard.2025.01.031","DOIUrl":"10.1016/j.amjcard.2025.01.031","url":null,"abstract":"<p><p>Patients undergoing transcatheter aortic valve implantation (TAVI) are at increased risk of rehospitalization in the early period after discharge from TAVI. The HOSPITAVI study aimed to compare the impact of a standard versus intensified outpatient follow-up on rehospitalization rates within 90 days after TAVI discharge. Patients were 1:1 randomized to either a standard or intensified outpatient follow-up after TAVI discharge. The primary endpoint was the 90-day hospital rehospitalization rate. In total, 300 patients were included: 150 patients were randomized to standard follow-up and 150 patients to intensified outpatient follow-up. The study population had a median age of 79 years, a median EuroSCORE II of 2.9%, and 72% were discharged the day after TAVI. Within 90 days after discharge, the mean number of all-cause hospital readmissions per patient was 0.44 versus 0.35 (HR 0.8 [95% CI, 0.6-1.2], p = 0.23) in the standard versus intensified group, respectively. The mean number of cardiovascular (CV) readmissions per patient was 0.27 versus 0.15 (HR 0.6 [95% CI, 0.4-1.0], p = 0.04) in the standard versus intensified group, respectively. This resulted in a mean number of CV readmission days per patient of 1.52 days versus 0.49 days within the first 90 days in the standard versus intensified group, respectively (p < 0.05). Following TAVI discharge, there was no significant difference in all-cause rehospitalization rates using a standard versus intensified outpatient follow-up approach. However, an intensified outpatient follow-up reduces the burden of early CV rehospitalization after TAVI discharge. (Rehospitalization after transcatheter aortic valve implantation [HOSPITAVI]; NCT05670041).</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121733","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":"Beyond Angiography in Peripheral Interventions: When and How to Incorporate Peri-Procedural Physiology.","authors":"Adam S Vohra, Dmitriy N Feldman","doi":"10.1016/j.amjcard.2025.01.037","DOIUrl":"10.1016/j.amjcard.2025.01.037","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143121732","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}