American Journal of Cardiology最新文献

{"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, Hiroki Shiomi, Ko Yamamoto, Takeshi Morimoto, Akiyoshi Miyazawa, Kenji Ando, Takenori Domei, Toru Naganuma, Satoru Suwa, Kazushige Kadota, Yuko Onishi, Koh Ono, Koichi Kishi, Kohei Yoneda, Hideki Okayama, Kensho Matsuda, Takanari Fujita, Shojiro Tatsushima, Hiroki Sakamoto, Yukihiro Hamaguchi, Tairo Kurita, Akihiro Takasaki, Masami Nishino, Naotaka Okamoto, Hidekuni Kirigaya, Ren Kawaguchi, Jun Kuribara, Junichi Yamaguchi, Hiroyuki Arashi, Kiyoshi Hibi, Takeshi Kimura","doi":"10.1016/j.amjcard.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.018","url":null,"abstract":"<p><p>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: 11.0-15.4%), which was significantly lower than the PCI performance goal (32.0%, P<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% versus 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% versus 7.7%, log-rank P=0.01, and 2.3% versus 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.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","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":"Angiographic Characteristics and Associated Risk Factors of Premature Coronary Artery Disease among South Asians: A Systematic Review.","authors":"Siddhant Passey, Jagriti Jha, Marissa Iverson, Kelin Zhong, Chia-Ling Kuo, Sameer Arora, Arman Qamar, Nirat Beohar","doi":"10.1016/j.amjcard.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.015","url":null,"abstract":"<p><p>Individuals living in South Asia are known to have earlier onset of coronary artery disease (CAD) compared with individuals of other ethnicities. No clear population specific risk factors have been identified for premature CAD in South Asians and studies on angiographic characteristics and their relationship with risk factors are lacking. A systematic literature search was conducted across Pubmed/Medline, Embase, Scopus, CENTRAL, CINAHL, Global Index Medicus and ClinicalTrials.gov databases to retrieve studies related to angiographic characteristics and related risk factors for premature CAD in South Asians. 40 studies with a total of 18,863 patients were included. Sixteen studies divided patients into different age groups, and twenty- four studies included only one premature CAD group. There was significant discrepancy in the age cut-offs used to define premature CAD. A majority of studies indicated single vessel disease to be the most common pattern of vessel involvement in young South Asians and left anterior descending artery was the most commonly involved vessel, while older individuals had more multivessel disease than younger counterparts. Younger individuals had higher prevalence of risk factors, demonstrated across individual studies, such as tobacco use, family history, obesity and dyslipidemia; all non-specific to South Asians. Current available literature does not identify any clear differences regarding angiographic characteristics or associated risk factors for premature CAD in South Asians compared with other ethnicities, however more research is needed using advanced coronary imaging modalities to describe the plaque characteristics. More research is also needed regarding gender differences and risk stratification tools in these patients.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172326","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":"Rising Burden of Hypertensive Heart Disease Mortality Among Young Adults in the United States, 1999 to 2024.","authors":"Arindam Bagga, Ian K Everitt, Ryan Osgueritchian, Sumanth Khadke, Sarju Ganatra, Jordan B Strom, Shady Abohashem, Monica Mukherjee","doi":"10.1016/j.amjcard.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.023","url":null,"abstract":"<p><p>Hypertensive heart disease (HHD) is a major contributor to cardiovascular (CV) morbidity and mortality. Once primarily seen in older adults, recent data suggest a rising burden among younger populations. National Center for Health Statistics (NCHS) mortality data for United States adults aged 15 to 44 from 1999 to 2024 were analyzed. Age-adjusted mortality rates were calculated overall and by demographic subgroup, including sex, race, ethnicity, age group, rural and urban residence, state, and Census region. The proportion of HHD mortality relative to other cardiovascular disease (CVD) deaths were examined. Joinpoint regression identified annual percent changes and inflection points. From 1999 to 2024, there were 119,264 HHD-related deaths among young adults. HHD mortality rose from 1.3 (95% CI, 1.23-1.36) to 6.3 (95% CI, 6.12-6.40), with the sharpest increase from 2018 to 2021. Males experienced greater HHD mortality over the study period (increasing from 1.76 to 9.13 deaths per 100,000 person-years) than females (0.76 to 3.31 deaths per 100,000 person-years). Differences were also noted by race and ethnicity, with Non-Hispanic Black individuals experiencing greater HHD mortality that Non-Hispanic White and Hispanic individuals. Age-related, and geographic differences were also observed. The proportionate HHD mortality increased from 3.8% in 1999 to 16.8% in 2024. Sustained increases in HHD mortality were observed after the COVID-19 pandemic relative to pre-pandemic levels. HHD-related mortality among young adults in the United States has risen significantly, with differences noted by sex, race and ethnicity, age, rural and urban residence, state, and Census region. The growing share of HHD deaths among CVD deaths in young adults signals its increasing role in premature CVD mortality. In conclusion, these trends underscore the urgent need for early prevention, equitable care, and targeted strategies to reduce HHD in young adults.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172317","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":"Effect of Amiodarone after Catheter Ablation According to Left Atrial Structure and Function: The AMIO-CAT Trial.","authors":"Flemming Javier Olsen, Stine Darkner, Xu Chen, Steen Pehrson, Arne Johannessen, Jim Hansen, Jesper Hastrup Svendsen, Tor Biering-Sørensen","doi":"10.1016/j.amjcard.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.017","url":null,"abstract":"<p><p>Catheter ablation (CA) is commonly used to obtain rhythm control in patients with atrial fibrillation (AF), yet AF recurrence is frequent. In this study, we hypothesized that measures of left atrial (LA) structure and function modified the treatment effect of amiodarone to prevent AF recurrence, which has otherwise not proven beneficial. This was a post-hoc analysis of the double-blinded AMIO-CAT trial. Patients undergoing CA were randomized to short-term amiodarone treatment or placebo. All patients underwent echocardiography to assess LA volumes and strain. The primary endpoint was AF recurrence at 6-months. Secondary endpoints were cardioversion and AF-related hospitalization during follow-up. Of 212 patients, 108 were randomized to amiodarone and 104 to placebo. 206 patients were eligible for analyses of the primary endpoint, of whom 90 (44%) developed AF recurrence. No measure of LA size or function significantly modified the effect of amiodarone for preventing AF recurrence (p for interaction>0.05 for all measures). However, abnormal LA strain (<22.7%) significantly modified the treatment effect for the secondary outcomes of cardioversions (p for interaction=0.013) and AF-related hospitalization (p for interaction=0.014). In patients with abnormal LA strain, amiodarone significantly reduced the risk of cardioversions (OR 0.35 (0.15-0.80), p=0.013) and AF-related hospitalization (OR 0.31 (0.14-0.73), p=0.007) compared to placebo. In conclusion, LA measures did not modify the treatment effect of amiodarone vs. placebo for preventing AF recurrence at 6 months in patients undergoing CA. However, in patients with abnormal LA strain, amiodarone may reduce cardioversions and AF-related hospitalizations as compared to placebo. Clinical trial registration: Clinicaltrials.gov unique identifier: NCT00826826.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172293","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 Role of Lipoprotein(a) in Cardiovascular Risk Stratification: IntegratingLow-density Lipoprotein Cholesterol and Polygenic Risk Scores.","authors":"Lei Liu, Huihui Ma, Senwen Yang, Chaoping Yu, Tianhu Liu, Mingjiang Liu, Xiangbin Xiao, Rong Luo, Xiaoping Li","doi":"10.1016/j.amjcard.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.012","url":null,"abstract":"<p><p>High-density lipoprotein(a) (Lp(a)) is a well-established independent risk factor for atherosclerotic cardiovascular diseases (ASCVD). However, the interaction between Lp(a), low-density lipoprotein cholesterol (LDL-C), and polygenic risk score (PRS) in cardiovascular diseases has been the subject of relatively limited research. The present study included a total of 346,751 participants from the UK Biobank. According to the guideline of Lp(a), the study subjects were divided into three groups: the first group was < 75 mmol/L (n = 272,643), the second group was 75 - 125 mmol/L (n = 35,792), and the third group was > 125 mmol/L (n = 38,316). Elevated Lp(a) levels were associated with a progressively increased risk of overall cardiovascular events (CVEs), including ischemic stroke (IS), coronary heart disease (CHD), angina pectoris, and myocardial infarction (MI). In contrast, the risks of atrial fibrillation (AF) and heart failure (HF) decreased with higher Lp(a) levels. Additive interaction analyses revealed significant synergistic effects between Lp(a) and LDL-C for CHD [relative excess risk interaction (RERI) = 0.081, attributable proportion of interaction (AP) = 0.046, synergy index (SI) = 1.117], angina pectoris [RERI = 0.112, AP = 0.055, SI = 1.121], and MI [RERI = 0.183, AP = 0.079, SI = 1.161], with MI showing the strongest synergy. Incorporating PRS further amplified these effects, and the RERI [CHD: RERI = 0.721; angina pectoris: RERI = 0.781; MI: RERI = 1.318] and SI [CHD: SI = 2.218; angina pectoris: SI = 1.97; MI: SI = 2.326)] were significantly higher than those of the interaction model containing only Lp(a) and LDL-C. In conclusion, Lp(a) and LDL-C show a significant synergistic effect in ASCVD, and this effect is more prominent in individuals with a higher PRS, suggesting that dual lipid management should be strengthened for such populations. While AF and HF may require alternative risk factor management.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172312","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":"High Heart Rate, Sympathetic Overdrive, And Cardiovascular Risk In Hypertension.","authors":"Guido Grassi, C Venkata S Ram, Paolo Palatini","doi":"10.1016/j.amjcard.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.022","url":null,"abstract":"<p><p>Elevated resting heart rate values accompanying essential hypertension are frequently detected in current clinical practice. Evidence shows that a heart rate greater than 80 beats/minute is triggered by pronounced sympathetic overactivity with adverse cardiovascular outcomes. These include the development and progression of hypertension-mediated organ damage, such as cardiac hypertrophy, endothelial dysfunction, impaired arterial distensibility, pro-atherogenic vascular alterations, and renal damage. They also include a greater risk of cardiovascular morbid events, such as myocardial infarction, chronic heart failure, and stroke, independent of other concomitant risk factors. Finally, they are associated with increased cardiovascular mortality. In conclusion, the present paper will provide a comprehensive in-depth review of the pathophysiological background, clinical impact, and therapeutic consequences of an elevated resting heart rate value as an independent cardiovascular risk factor in hypertension.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147411","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":"Implantable Cardioverter-Defibrillator And Frailty In Non-ischemic Heart Failure With Reduced Ejection Fraction: Extended Follow-Up Of The DANISH Trial.","authors":"Jawad H Butt, Johan Skovgaard Bundgaard, Morten Schou, Adelina Yafasova, Seiko N Doi, Jesper H Svendsen, Dan E Høfsten, Christian Hassager, Hans Eiskjær, Jens C Nielsen, Niels E Bruun, Lars Videbæk, Axel Brandes, Jens Jakob Thune, Steen Pehrson, Lars Køber","doi":"10.1016/j.amjcard.2025.08.068","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.08.068","url":null,"abstract":"<p><p>Patients with frailty are often perceived to have a less favorable risk/benefit profile for pharmacological and device-based therapies. We examined the long-term effects of a primary prevention implantable cardioverter-defibrillator (ICD), compared with usual care, according to frailty status in an extended follow-up study of the DANISH trial. The DANISH trial randomized 1,116 patients with non-ischemic HFrEF to ICD implantation or usual care. Frailty was measured using the Rockwood cumulative deficit approach. The primary outcome was all-cause death, and secondary outcomes were cardiovascular death and sudden cardiovascular death. A frailty index (FI) was calculable in 1,109 patients. In total, 618 (55.7%) patients were in frailty class 1 (FI <0.210, i.e., not frail), 361 (32.6%) in frailty class 2 (FI 0.211-0.310, i.e., more frail), and 130 (11.7%) in frailty class 3 (FI >0.311, i.e., most frail). Compared with patients in FI class 1, those in FI class 2 and 3 had a higher rate of all outcomes. The effect of ICD implantation on all-cause death did not vary significantly by frailty class (class 1, HR 0.92 [95% CI, 0.68-1.24]; class 2-3, 0.93 [0.73-1.19]; P_interaction=0.99). Consistent effects were observed for cardiovascular death (P_interaction=0.94), but not for sudden cardiovascular death (P_interaction=0.03); the beneficial effect of ICD implantation on this outcome appeared to be greater in patients who were more frail. However, when the FI was analyzed as a continuous variable, frailty no longer significantly modified the effects of ICD implantation on any outcome. In conclusion, in patients with non-ischemic HFrEF, frailty did not significantly modify the effects of ICD implantation compared with usual care. However, the need for a primary prevention ICD in frail patients with HFrEF receiving contemporary guideline-directed medical therapy remains uncertain Clinical Trial Registration Number: NCT00542945.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147392","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":"CMR-derived atrial strain in the prediction of adverse cerebrovascular events after myocardial infarction.","authors":"Riccardo Cau, Carlotta Onnis, Gianluca Pontone, Marco Guglielmo, Alessandro Pinna, Maria Francesca Marchetti, Jasjit S Suri, Roberta Montisci, Carlo Nicola De Cecco, Rodrigo Salgado, Luca Saba","doi":"10.1016/j.amjcard.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.020","url":null,"abstract":"<p><p>This study investigated whether cardiovascular magnetic resonance (CMR)-derived atrial strain parameters are associated with new-onset cerebrovascular events in patients with reperfused ST-segment elevation myocardial infarction (STEMI). In this retrospective analysis, CMR scans of 211 consecutive STEMI patients (77% male; mean age 64.5 ± 10.3 years) who underwent coronary revascularization were assessed. The primary endpoint was the occurrence of acute ischemic stroke or transient ischemic attack, collectively defined as cerebrovascular events. Atrial strain was analyzed offline from standard cine steady-state free precession sequences, focusing on left atrial (LA) reservoir, conduit, and booster strain. Over a median follow-up of 25 months (interquartile range 13-36), 23 patients (11%) experienced cerebrovascular events. In multivariable Cox regression analysis, LA reservoir and conduit strain were independent predictors of these events, irrespective of cardiovascular risk factors, LA volume, thrombus presence, and incident atrial fibrillation (HR: 0.84; 95% CI: 0.77-0.91; p = 0.001 and HR: 0.74; 95% CI: 0.63-0.87; p = 0.001, respectively). In conclusion, CMR-derived LA reservoir and conduit strain are independently associated with increased risk of cerebrovascular events, and their integration into the clinical assessment of STEMI patients may improve risk stratification.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136002","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":"Primary percutaneous coronary intervention is associated with improved survival for inpatient-onset STEMI across all age groups.","authors":"Jeffrey E Jones, Rajiv C Patel, George A Stouffer","doi":"10.1016/j.amjcard.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.019","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136081","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":"Single Arterial versus Multiple Arterial Grafting in 3,164 Diabetic Patients Undergoing Coronary Artery Bypass Surgery: A Propensity-Matched Analysis.","authors":"Albaraa Al-Holy, Maria Comanici, Anonna Das, Nandor Marczin, Sunil Kishore Bhudia, Shahzad Gull Raja","doi":"10.1016/j.amjcard.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.014","url":null,"abstract":"<p><p>Diabetic patients undergoing coronary artery bypass grafting (CABG) are at increased risk of adverse outcomes, yet the role of multiple arterial grafting (MAG) remains underutilized and understudied in this population. The objective of this study was to evaluate short-term safety and long-term survival outcomes of MAG compared with single arterial grafting (SAG) in diabetic patients, using a propensity-matched design. This retrospective single center study included 3,164 diabetic patients who underwent isolated CABG between January 1996 and September 2023, stratified by graft strategy: SAG (n = 2,499) and MAG (n = 665). Propensity score matching was applied to balance baseline differences, yielding 662 matched pairs. In the unmatched cohort, MAG was associated with a significantly higher number of grafts and a greater rate of deep sternal wound infection (3.0% vs 1.7%; p = .028), while 30-day mortality was comparable (2.7% vs 2.8%; p = .939). In the matched cohort, short-term outcomes did not differ significantly between groups (p > .3 for all). Kaplan-Meier survival estimates showed comparable survival (p = .954) at 1 year (92% vs 91%), 5 years (85% vs 83%), 10 years (73% vs 73%), 15 years (57% vs 62%), and 20 years (44% vs 41%). Multivariate Cox regression identified age, female sex, New York Heart Association class, prior cardiac surgery, reduced ventricular function, and disease extent as independent predictors of mortality. In conclusion, these findings suggest that MAG can be safely offered to diabetic patients, though its long-term survival benefit remains uncertain.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136191","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}