American Journal of Cardiology最新文献

{"title":"Association Between Cardiac Computed Tomography-Detected Patent Foramen Ovale and Risk of Ischemic Stroke.","authors":"Takahiro Ueno, Shinichiro Tanaka, Keitaro Watanabe, Hiroto Yagasaki, Takashi Yoshizane, Takashi Kato, Kentaro Morishita, Makoto Iwama, Masazumi Arai, Toshiyuki Noda","doi":"10.1016/j.amjcard.2026.09.030","DOIUrl":"https://doi.org/10.1016/j.amjcard.2026.09.030","url":null,"abstract":"<p><p>Patent foramen ovale (PFO) is associated with embolic stroke; however, the prognostic significance of PFO detected by cardiac computed tomography (CT) remains unclear. Objectives: This study aimed to evaluate the association between CT-detected PFO and subsequent ischemic stroke risk, and to assess its agreement with transthoracic echocardiography with agitated saline (Bubble-TTE). We retrospectively analyzed 1,028 patients who underwent cardiac CT between 2016 and 2018. PFO was diagnosed on cardiac CT using criteria adapted from previous reports. In a subset of 86 patients, intermodality agreement between cardiac CT and Bubble-TTE was assessed. The primary outcome was ischemic stroke, and the secondary outcome was all-cause mortality. CT-detected PFO was identified in 212 patients (20.6%). In the subset analysis, cardiac CT showed moderate agreement with Bubble-TTE for PFO detection (κ = 0.41, p < 0.001). During follow-up, ischemic stroke occurred in 49 patients (4.7%), and 116 patients died (11.3%). CT-detected PFO was independently associated with ischemic stroke (adjusted hazard ratio 2.41, 95% confidence interval 1.36-4.29, p = 0.003), whereas no significant association was observed with all-cause mortality (adjusted hazard ratio 0.96, 95% confidence interval 0.61-1.50, p = 0.86). In conclusion, CT-detected PFO was associated with an increased risk of ischemic stroke but not with all-cause mortality, suggesting prognostic relevance for ischemic stroke.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103019","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":"Predictors of In-Hospital Mortality and Prolonged Hospital Stay in Veterans Hospitalized With COVID-19 Infection.","authors":"Jenilkumar H Patel, Mailing Flores Chang, Samer Zakhour, Sudesh Srivastav, Anand Irimpen","doi":"10.1016/j.amjcard.2026.09.035","DOIUrl":"10.1016/j.amjcard.2026.09.035","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103171","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":"Chocolate Balloon Versus Conventional Balloon for Vessel Preparation Before Drug-Coated Balloon Angioplasty in Femoropopliteal Lesions: A Real-World Propensity Score-Matched Study.","authors":"Chunbo Li, Youpeng Zhu, Wenbo Yang, Ye Du, Qiong Song, Tingyu Wang, Xinyuan Wang, Leixin Li, Zhimin Chen, Zibo Feng","doi":"10.1016/j.amjcard.2026.09.021","DOIUrl":"10.1016/j.amjcard.2026.09.021","url":null,"abstract":"<p><p>To evaluate the procedural and 1-year clinical outcomes of the Chocolate balloon versus conventional plain old balloon angioplasty (POBA) for vessel preparation before drug-coated balloon (DCB) treatment of femoropopliteal lesions. This retrospective subgroup analysis of the multicenter PROMISING registry included patients with femoropopliteal lesions treated with DCB. Before propensity score matching (PSM), 817 patients underwent POBA and 379 underwent Chocolate balloon angioplasty. After 1:1 PSM, 254 patients were included in each group. The primary endpoint was bailout stenting. Secondary endpoints included maximum DCB diameter, stent length, postprocedural ankle-brachial index (ABI), 1-year clinically driven target lesion revascularization (CD-TLR), major amputation, all-cause mortality, amputation-free survival (AFS), and major adverse events (MAE). After PSM, bailout stenting occurred less frequently in the Chocolate balloon group than in the POBA group (20.47% vs 29.92%, p = 0.014). The Chocolate balloon group also showed a trend toward shorter stent length (20.67 ± 9.75 cm vs 23.71 ± 10.62 cm, p = 0.097) and allowed use of larger DCBs (4.96 ± 0.52 mm vs 4.74 ± 0.61 mm, p < 0.001). Multivariable logistic regression identified Chocolate balloon use as an independent protective factor against bailout stenting, whereas chronic total occlusion and severe calcification were independent predictors of bailout stenting. No significant differences were observed in 1-year clinical outcomes. Compared with POBA, Chocolate balloon vessel preparation reduced bailout stenting and enabled use of larger DCBs, suggesting potential procedural advantages in complex femoropopliteal lesions. However, these procedural benefits did not translate into improved 1-year clinical outcomes.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103027","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":"Drug-Coated Balloon Versus Drug-Eluting Stent in Calcified De Novo Coronary Lesions: Long-Term Outcomes from the SPARTAN Registry.","authors":"Rajkumar Natarajan, Natasha Corballis, Ioannis Merinopoulos, Tharusha Gunawardena, Upul Wickramarachchi, Allan B Clark, Vassilios S Vassiliou, Simon C Eccleshall","doi":"10.1016/j.amjcard.2026.09.034","DOIUrl":"10.1016/j.amjcard.2026.09.034","url":null,"abstract":"<p><p>Coronary artery calcification presents major challenges during percutaneous coronary intervention, including device deliverability, suboptimal lesion preparation, impaired stent expansion, increased restenosis, stent thrombosis, and mortality. Drug-coated balloons (DCBs) offer a stentless alternative, but evidence in de novo calcified lesions is limited. This study compared long-term clinical outcomes between DCB and drug-eluting stent (DES) strategies in such lesions. We retrospectively identified all patients undergoing percutaneous coronary intervention for operator-reported angiographically calcified de novo lesions between January 2015 and November 2019. Patients presenting with cardiac arrest, intubation, or cardiogenic shock were excluded. The primary end point was target lesion failure (TLF), defined as a composite of target lesion revascularization, target lesion myocardial infarction (TLMI), and cardiovascular death. Secondary end points included the individual components of TLF and all-cause mortality. A total of 1,057 patients were included (DCB n = 506, DES n = 551). Over a median follow-up of 3.7 years, TLF was similar between groups (11.5% DCB vs 10.9% DES, adjusted hazard ratio [HR] 1.07, 95% confidence interval [CI] 0.71 to 1.62, p = 0.733). Target lesion revascularization rates were also similar (6.7% vs 6.4%, HR 1.02, 95% CI 0.60 to 1.73, p = 0.954). TLMI was significantly lower with DCB (1.6% vs 3.4%, HR 0.38, 95% CI 0.16 to 0.89, p = 0.025). Cardiovascular and all-cause mortality did not differ significantly between groups. Independent predictors of TLF were age, diabetes, and renal dysfunction, reflecting underlying systemic atherosclerotic burden. In this retrospective study involving operator-reported calcified lesions, DCB use was associated with similar overall outcomes with observed lower rates of TLMI compared with DES. These findings are exploratory and require confirmation in randomized controlled trials.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103064","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":"Cost-Effectiveness of Sotagliflozin in Heart Failure Patients With Preserved and Reduced Ejection Fractions-Results From SOLOIST-WHF.","authors":"Zugui Zhang, Paul Kolm, Sarahfaye Dolman, Maria Alva, Katherine Andrade, Deepak L Bhatt, William S Weintraub","doi":"10.1016/j.amjcard.2026.09.025","DOIUrl":"10.1016/j.amjcard.2026.09.025","url":null,"abstract":"<p><p>In the SOLOIST-WHF trial (Effect of Sotagliflozin on Cardiovascular Events in Patients with Type 2 Diabetes Post Worsening Heart Failure), evaluating patients with type 2 diabetes and recent worsening heart failure (HF), initiation of sotagliflozin before or soon after hospital discharge reduced cardiovascular and HF-related clinical events, including hospitalizations and urgent visits. We assessed the long-term cost-effectiveness of sotagliflozin in the overall trial population and according to ejection fraction (EF) subtype, including HF with preserved EF (HFpEF ≥50%) and reduced EF (HFrEF <50%). A patient-level Markov microsimulation model incorporating treatment effects observed in SOLOIST-WHF, national cost estimates, and externally derived health-state utility values was used to project lifetime clinical and economic outcomes from a healthcare payer perspective. Net monthly treatment costs for sotagliflozin were estimated at $434. Lifetime projections included healthcare expenditures, cardiovascular and HF events, survival, and quality-adjusted life-years (QALYs) comparing sotagliflozin with placebo among patients eligible for SOLOIST-WHF. Incremental cost-effectiveness ratios (ICERs) were expressed as cost per QALY gained, and uncertainty was evaluated through sensitivity analyses. Across the lifetime horizon, sotagliflozin increased quality-adjusted survival by 0.39 QALYs (4.43 vs 4.04) and life expectancy by 0.64 LYs (7.12 vs 6.48) compared with placebo, with an incremental cost of $29,449 (95% uncertainty interval [UI] $26,610 to $32,528), corresponding to an ICER of $75,510 per QALY gained (UI $55,640 to $98,300). Among patients with HFpEF, treatment produced gains of 0.43 QALYs (4.53 vs 4.10) and 0.68 LYs (7.14 vs 6.46) at an incremental cost of $30,587 (UI $28,459 to $35,826), yielding an ICER of $71,135 per QALY (UI $61,482 to $87,652). In patients with HFrEF, sotagliflozin increased outcomes by 0.37 QALYs (4.33 vs 3.96) and 0.63 LYs (7.09 vs 6.46) with incremental costs of $32,425 (UI $31,011 to $38,127), resulting in an ICER of $87,635 per QALY (UI $74,751 to $112,287). Improvements in QALYs were primarily driven by reductions in cardiovascular events, and results were most sensitive to medication cost and readmission rates. At an estimated monthly price of $434, sotagliflozin represents a clinically beneficial and economically favorable treatment for patients with diabetes and recent worsening HF across EF groups, with slightly greater cost-effectiveness observed among patients with HFpEF than HFrEF (ClinicalTrials.gov identifier: NCT03521934).</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103091","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":"Breaking the AF-TR Cycle: Does Ablation Add Benefits Beyond Antiarrhythmic Therapy?","authors":"Sara Ebrahimi","doi":"10.1016/j.amjcard.2026.09.029","DOIUrl":"10.1016/j.amjcard.2026.09.029","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103106","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":"From Prognostication to Precision Resuscitation After In-Hospital Cardiac Arrest.","authors":"Jignesh K Patel, Puja B Parikh","doi":"10.1016/j.amjcard.2026.09.026","DOIUrl":"10.1016/j.amjcard.2026.09.026","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103043","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":"Drug-Eluting Resorbable Scaffolds for Infrapopliteal Peripheral Artery Disease: A State-of-the-Art Review.","authors":"Nathan W Watson, Maxime Dubosq-Lebaz, Peter A Schneider, Marianne Brodmann, John H Rundback, Eric A Secemsky","doi":"10.1016/j.amjcard.2026.09.024","DOIUrl":"10.1016/j.amjcard.2026.09.024","url":null,"abstract":"<p><p>Drug-eluting resorbable scaffolds (DRS) have been developed to overcome the key limitations of conventional endovascular therapies for below-the-knee (BTK) peripheral artery disease (PAD), including acute recoil, restenosis, and the sequela of long-term permanent metallic implants. DRS provides a temporary mechanical support and localized antiproliferative drug delivery after which the scaffold is gradually resorbed, ultimately restoring native vessel architecture to preserve future revascularization options. Over the past decade, numerous prospective and observational studies have evaluated both polymer- and magnesium alloy-based DRS platforms and have demonstrated favorable patency, wound healing, and limb salvage outcomes in patients with advanced infrapopliteal PAD. Most recently, randomized evidence from the LIFE-BTK trial has demonstrated superior patency and reduced rates of revascularization with DRS-treated lesions as compared with plain balloon angioplasty. In this state-of-the-art review, we summarize the existing evidence evaluating DRS devices for BTK PAD and present an updated systematic review and meta-analysis of clinical outcomes for DRS-based endovascular interventions.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103101","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":"Feasibility of Functionally Standardized AI-Assisted Coronary CT Angiography Training for Radiology Residents: A Multicenter Randomized Pilot Study.","authors":"Qi Han, Lirong Huang, Caixia Zhang, Feihua Jing, Jian Wang, Hongqin Liang","doi":"10.1016/j.amjcard.2026.09.020","DOIUrl":"10.1016/j.amjcard.2026.09.020","url":null,"abstract":"<p><p>Artificial intelligence (AI)-assisted systems are increasingly used in coronary computed tomography angiography (CCTA), but their role in resident training and subsequent unaided interpretation remains unclear. This multicenter randomized pilot feasibility study evaluated a functionally standardized AI-assisted CCTA learning workflow with longitudinal unaided assessment in radiology resident training. Ten novice radiology residents from 3 centers were randomized 1:1 to conventional workstation-based or AI-assisted workflow training. Locally available AI platforms were required to meet predefined core-function criteria. After standardized instruction, residents completed a 4-week learning phase with next-day standardized disclosure of invasive coronary angiography (ICA) reference results and no additional expert case-by-case teaching. Formal assessments were independently performed without any support at baseline, after 2 and 4 weeks of learning, and 1 week after learning completion. Feasibility outcomes included completion, protocol adherence, data completeness, multicenter implementation, and collection of prespecified exploratory metrics. Exploratory metrics included diagnostic time, confidence, inter-rater consistency, agreement with ICA, and diagnostic discrimination for ICA-defined stenosis ≥70%. All residents completed training and scheduled assessments, with no withdrawals or missing assessment data. The workflow was implemented across all centers, and all exploratory metrics were collected at each time point, with descriptive learning-related changes in both groups. In conclusion, functionally standardized AI-assisted CCTA learning with longitudinal unaided assessment was feasible in structured multicenter resident training, supporting larger trials of training effectiveness.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103080","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":"Tricuspid Transcatheter Edge-to-Edge Repair in Patients With Transvalvular Cardiac Implantable Electronic Device Leads: A Systematic Review and Meta-Analysis.","authors":"Lorenzo Moscato, Francesco Stabile, Giuseppe Vadalà, Nathalia Schettino Samad, Bezalel Hakkeem, Cristina Madaudo, Egle Corrado, Giuseppina Novo, Alfredo Ruggero Galassi","doi":"10.1016/j.amjcard.2026.09.022","DOIUrl":"10.1016/j.amjcard.2026.09.022","url":null,"abstract":"<p><p>Severe tricuspid regurgitation (TR) is associated with adverse outcomes, particularly in patients with cardiac implantable electronic devices (CIEDs), in whom transvalvular leads may contribute to valve dysfunction. Evidence supporting tricuspid transcatheter edge-to-edge repair (T-TEER) in this population remains limited. We performed a systematic review and meta-analysis to evaluate whether the presence of transvalvular CIED leads is associated with differences in procedural success, early safety, or mid-term outcomes after T-TEER. PubMed, Scopus, and Cochrane Library databases were systematically searched for studies comparing T-TEER outcomes in patients with and without CIEDs. Prespecified analyses focused on procedural success, early safety, functional status, residual TR, and 1-year all-cause mortality. Pooled mean differences and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Eight observational studies were included, comprising 2,779 patients, of whom 820 (29.5%) had transvalvular CIED leads. Procedural success was comparable between groups (RR 1, 95% CI 0.95 to 1.04). No significant differences were observed in early safety outcomes or functional status at 30 days. At 1-year follow-up, no significant differences were observed in residual TR ≤2+ (RR 0.95, 95% CI 0.88 to 1.02), while all-cause mortality was higher in patients with CIEDs (RR 1.33, 95% CI 1.03 to 1.72). In conclusion, in this meta-analysis, T-TEER demonstrated comparable procedural success and early safety in patients with and without transvalvular CIED leads. Despite similar TR reduction at 1 year, patients with CIEDs exhibited higher midterm mortality, suggesting a possible discordance between valve-level technical success and patient-level clinical outcomes.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"5-11"},"PeriodicalIF":2.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079452","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}