American Journal of Cardiology最新文献_第3页

3D Mitral Valve Area Impact on Post-procedural Gradient after M-TEER with Single Clip Deployment. 单夹M-TEER对术后梯度的三维二尖瓣面积影响

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-09 DOI: 10.1016/j.amjcard.2025.10.002

Antonio Sisinni, Elena Cozza, Chiara Mainardi, Antonio Popolo Rubbio, Marta Barletta, Marco Guerrini, Nedy Brambilla, Luca Testa, Francesco Bedogni, Maurizio Tusa

引用次数: 0

Reply to Letter to the Editor: ''Interpreting the Outcomes of Crossover versus Ostial Stenting in the CROSS-ANATOLIA Registry''. 给编辑的回复：“在跨安纳托利亚注册中解释交叉与开口支架置入的结果”。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-09 DOI: 10.1016/j.amjcard.2025.09.056

Ezgi Gültekin Güner, Ahmet Güner, Veysel Ozan Tanık, Bülent Özlek, Fatih Uzun

引用次数: 0

Specialty Balloons Versus Plain Old Balloon Angioplasty for Vessel Preparation Before Drug-Coated Balloon Therapy in Femoropopliteal Occlusive Disease. 药物包覆球囊治疗股腘动脉闭塞性疾病前血管准备的专用球囊与普通球囊血管成形术比较。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-08 DOI: 10.1016/j.amjcard.2025.09.054

Xinyuan Wang, Meng Ye, Chunshui He, Xin Fang, Ziheng Wu, Qiang Li, Weihao Shi, Zhenyu Shi, Lianrui Guo, Zibo Feng

{"title":"Specialty Balloons Versus Plain Old Balloon Angioplasty for Vessel Preparation Before Drug-Coated Balloon Therapy in Femoropopliteal Occlusive Disease.","authors":"Xinyuan Wang, Meng Ye, Chunshui He, Xin Fang, Ziheng Wu, Qiang Li, Weihao Shi, Zhenyu Shi, Lianrui Guo, Zibo Feng","doi":"10.1016/j.amjcard.2025.09.054","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.054","url":null,"abstract":"Specialty balloons are a novel category of vessel preparation devices. This study compared their effectiveness and safety with plain old balloon angioplasty (POBA) in a real-world setting. A total of 1,574 patients who underwent drug-coated balloon (DCB) therapy for femoropopliteal occlusive disease at ten Chinese centers (2021-2023) were analyzed. Propensity score matching generated 434 balanced pairs. Compared with POBA, specialty balloons were associated with a lower stent implantation rate (19% vs 28%; P = 0.003), shorter median stent length (15 cm vs 19 cm; P = 0.017), and use of larger-diameter DCB (4.9 ± 0.5 mm vs 4.8 ± 0.6 mm; P < 0.001). Perioperative complications, ankle-brachial index, hospital stay, and 1-year outcomes-including clinically driven target lesion revascularization, major amputation, mortality, and composite endpoints-did not differ between groups. In the overall cohort, 26% required stenting. Independent predictors of stent implantation were chronic total occlusion, smoking, moderate-to-severe calcification, and greater lesion length, while specialty balloon use was protective. In conclusion, compared with POBA, specialty balloon demonstrated superior vessel preparation outcomes, manifesting as significantly reduced stent implantation requirements, shorter average stent length, and enabling the use of larger-diameter DCB.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273511","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}

引用次数: 0

Sudden Arrhythmic Death Syndrome in the Young: Risk Factors are Identifiable Prior to Sudden Cardiac Arrest. 年轻人突发性心律失常死亡综合征：心脏骤停前可识别的危险因素

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-08 DOI: 10.1016/j.amjcard.2025.09.062

Matilda Frisk Torell, Bodil Svennblad, Aase Wisten, Erik Börjesson, Lennart Bergfeldt, Eva-Lena Stattin, Mats Börjesson

{"title":"Sudden Arrhythmic Death Syndrome in the Young: Risk Factors are Identifiable Prior to Sudden Cardiac Arrest.","authors":"Matilda Frisk Torell, Bodil Svennblad, Aase Wisten, Erik Börjesson, Lennart Bergfeldt, Eva-Lena Stattin, Mats Börjesson","doi":"10.1016/j.amjcard.2025.09.062","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.062","url":null,"abstract":"Sudden arrhythmic death syndrome (SADS) is one of the most common post-mortem diagnoses in the young suffering sudden cardiac death (SCD). Phenotypic characterization may facilitate prevention. The aim of the present study was to characterize phenotypes of SADS in the young including comparison with up to 10 controls per case. All SCD cases among 0-35 years old in Sweden during 2000-2010, have previously been included in the SUDden cardiac Death in the Young cohort (SUDDY), including five controls. Medical records, ECGs, death certificates, autopsy reports and national register data were analyzed. SADS accounted for 22% (149/670) of all SCDs in 1-35 years old during the study period. Most victims were male (n= 97,65%) and median age at death was 23. Pathological ECGs were found in 18%, with preexcitation being the most prevalent finding. Previous healthcare visits within 180 days prior to death was significantly more common in SADS victims (34 vs 23%; p=0.011). Among SADS victims, health care contacts within a year prior to death were significantly more common for syncope (4 vs 0.2%; p=0.007) and seizure/convulsion (4% vs 0.4%; p=0.006). A family history of cardiac disease/SCD was present in 13%. Psychiatric diagnoses and psychotropic use were found in 17% and 11%, respectively. Infection (9%) and nausea/vomiting (7%) were the most reported symptoms within 24 hours of death. We conclude that a high prevalence of prior healthcare visits, symptoms and ECG abnormalities offers an opportunity to identify subjects at risk of SADS. Psychiatric disease and the use of psychotropics might be risk factors for SADS.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273522","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}

引用次数: 0

Supraventricular Tachycardia Burden on Ambulatory ECG Monitoring Predicts Recurrent Atrial Fibrillation Following Catheter Ablation for Atrial Fibrillation. 室上性心动过速对动态心电图监测的负担预测心房颤动导管消融后复发性心房颤动。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-08 DOI: 10.1016/j.amjcard.2025.09.051

Ghazal Sanadgol, Adham Ramadan, Mohammad Hosein Yazdanpanah, Mohamed Doma, Tristan Alfie, Acile Nahlawi, Leon Ptaszek, Jeremy N Ruskin

{"title":"Supraventricular Tachycardia Burden on Ambulatory ECG Monitoring Predicts Recurrent Atrial Fibrillation Following Catheter Ablation for Atrial Fibrillation.","authors":"Ghazal Sanadgol, Adham Ramadan, Mohammad Hosein Yazdanpanah, Mohamed Doma, Tristan Alfie, Acile Nahlawi, Leon Ptaszek, Jeremy N Ruskin","doi":"10.1016/j.amjcard.2025.09.051","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.051","url":null,"abstract":"This study aims to evaluate the predictive value of supraventricular tachycardia (SVT) detected on 7-14-day ambulatory electrocardiogram (AECG) monitoring for atrial fibrillation (AF) recurrence following catheter ablation (CA) for AF. A retrospective analysis of patients who underwent CA for AF between 2015 and 2023 and underwent AECG monitoring within 1 year after CA was performed. The data in this study was extracted from electronic health records. Receiver operating characteristic (ROC) curve analysis was used to identify optimal SVT thresholds predictive of AF recurrence. Three SVT parameters were analyzed: total number of SVT episodes, average number of episodes per day, and % e of monitored days with SVT. Multivariable Cox regression models adjusted for age, sex, comorbidities, AF type, cardioversion history, and prior SVT were used to estimate hazard ratios (HRs) for AF recurrence. Adjusted Kaplan-Meier curves and log-rank tests were utilized to assess AF-free survival. Of 1,245 patients monitored with AECG, 573 (46.02%) experienced AF recurrence, with 232 (40.48%) undergoing AECG prior to AF recurrence. These patients were compared to 672 (53.97%) patients without recurrence. Patients with recurrence were more often female and had a higher comorbidity burden (p <0.05). Non-sustained (<30s) and sustained (≥30s) SVT episodes were significantly associated with increased risk for recurrence (HR 2.56 and 3.03, respectively; P=0.01). A total SVT count ≥15, ≥5 episodes/day, and SVT on ≥85% of monitored days also independently predicted AF recurrence (p=0.002). In conclusion, a high SVT burden on 7- to 14-day AECG post-ablation is a strong, independent predictor of AF recurrence and may help guide post-procedural risk stratification and monitoring strategies.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273561","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}

引用次数: 0

Comparison of Functional Tricuspid Regurgitation Following Transcatheter Atrial Septal Defect Closure in Adult Patients with Sinus Rhythm, Post-ablation Sinus Rhythm, and Permanent Atrial Fibrillation. 成人窦性心律、消融后窦性心律和永久性心房颤动患者房间隔缺损关闭后功能性三尖瓣反流的比较

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-06 DOI: 10.1016/j.amjcard.2025.09.052

Satoshi Noda, Tsutomu Murakami, Hitomi Horinouchi, Kaho Hashimoto, Junichi Miyamoto, Katsuaki Sakai, Norihiko Kamioka, Yohei Ohno, Atsuhiko Yagishita, Gaku Nakazawa, Yuji Ikari

{"title":"Comparison of Functional Tricuspid Regurgitation Following Transcatheter Atrial Septal Defect Closure in Adult Patients with Sinus Rhythm, Post-ablation Sinus Rhythm, and Permanent Atrial Fibrillation.","authors":"Satoshi Noda, Tsutomu Murakami, Hitomi Horinouchi, Kaho Hashimoto, Junichi Miyamoto, Katsuaki Sakai, Norihiko Kamioka, Yohei Ohno, Atsuhiko Yagishita, Gaku Nakazawa, Yuji Ikari","doi":"10.1016/j.amjcard.2025.09.052","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.052","url":null,"abstract":"The changes in tricuspid regurgitation (TR) following transcatheter atrial septal defect (ASD) closure, in relation to pre-procedural cardiac rhythms, remain unknown. This study aimed to assess sequential changes in TR after ASD closure based on cardiac rhythms. Patients were categorized as sinus rhythm (SR group, n=89), SR after catheter ablation for atrial fibrillation (ABL group, n=14), and permanent atrial fibrillation (AF group, n=12). Echocardiography was performed at baseline, 1 day, 1 month, and 12 months after the procedure. There were significant differences in age (54.5 ± 17.5 years vs. 63.9 ± 12.6 years vs. 74.3 ± 8.4 years; p<0.01) and prevalence of moderate ≥ TR at baseline (44.9% vs. 78.6% vs. 91.7%; p<0.01) in the SR, ABL, and AF groups, respectively. The SR group showed significant improvement in TR as early as 1-day post-closure, which persisted at 12 months, whereas the ABL and AF groups exhibited no significant improvements in TR at any point post-procedure. Independent predictors of residual moderate ≥ TR at 12 months included being in the ABL or AF groups and having a higher right atrial volume index (RAVI) at baseline. In conclusion, persistent TR may remain after ASD closure, even for patients who achieve SR post-ablation and those with permanent AF. This persistence may reflect baseline atrial remodeling, as indicated by larger RAVI, beyond volume unloading after ASD closure. These findings highlight the importance of timely therapeutic interventions and careful monitoring for residual TR following ASD closure, especially in patients with a history of AF.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249319","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}

引用次数: 0

Relationship between QRS fragmentation on electrocardiogram and myocardial scar characterization on cardiac magnetic resonance imaging in patients with ischemic and non-ischemic cardiomyopathy. 缺血性和非缺血性心肌病患者心电图QRS片段与心脏磁共振成像心肌疤痕特征的关系

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-06 DOI: 10.1016/j.amjcard.2025.09.053

Meshal AlAnezi, Scott Barichello, Hirmand Nouraei, Sheldon M Singh, Nigel S Tan, Vivek Singh Parmar, Paul Dorian, Binita Riya Chacko, Raymond T Yan, Yin Ge, Kamran Ahmad, Tamar Shalmon, Laura Jimenez-Juan, Djeven P Deva, Andrew T Yan

{"title":"Relationship between QRS fragmentation on electrocardiogram and myocardial scar characterization on cardiac magnetic resonance imaging in patients with ischemic and non-ischemic cardiomyopathy.","authors":"Meshal AlAnezi, Scott Barichello, Hirmand Nouraei, Sheldon M Singh, Nigel S Tan, Vivek Singh Parmar, Paul Dorian, Binita Riya Chacko, Raymond T Yan, Yin Ge, Kamran Ahmad, Tamar Shalmon, Laura Jimenez-Juan, Djeven P Deva, Andrew T Yan","doi":"10.1016/j.amjcard.2025.09.053","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.053","url":null,"abstract":"Fragmented QRS (fQRS) on electrocardiogram (ECG) may reflect myocardial fibrosis in both ischemic and non-ischemic cardiomyopathy. Gray zone on cardiac magnetic resonance (CMR), which represents a heterogeneous interface between dense scar and viable myocardium, is a known predictor of appropriate implantable cardioverter-defibrillator (ICD) shocks or death. The relationship between fQRS and myocardial scar on CMR remains poorly studied and may improve risk stratification for ICD therapy. This study aimed to evaluate the relationship between fQRS and scar core/gray zone by CMR late gadolinium enhancement (LGE), and to determine whether fQRS predicts benefit from ICD therapy. We included 388 adults who underwent CMR followed by ICD implantation for primary or secondary prevention between 2005 and 2018 at two tertiary centers. ECGs were assessed for fQRS and CMR images were independently evaluated. The primary endpoint was a composite of all-cause mortality or appropriate ICD shock. Mean age was 61 ± 13 years and mean left ventricular ejection fraction (LVEF) was 32%. LGE was present in 69% and fQRS in 28%. fQRS was associated with greater scar burden on visual LGE assessment (p=0.036), but not with quantitative LGE measures (2SD, 4SD, FWHM) or gray zone. Over a median follow-up of 61 months, 36% experienced the primary outcome. In multivariable analysis adjusting for LVEF and other prognosticators, fQRS was not independently associated with the primary outcome (HR 0.85; 95% CI: 0.67-1.08; p = 0.20). In conclusion, fQRS is associated with scar burden by visual assessment but does not provide incremental predictive value for ICD benefit.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249392","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}

引用次数: 0

Persistent Racial Disparities in Chronic Limb-Threatening Ischemia Outcomes and Utilization Among US Medicare Patients. 在美国医疗保险患者中，慢性肢体威胁缺血结局和利用的持续种族差异。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-04 DOI: 10.1016/j.amjcard.2025.09.047

Lorenzo V Arvanitis, Joseph M Kim, Siling Li, Yang Song, Mohit K Manchella, Eric A Secemsky

{"title":"Persistent Racial Disparities in Chronic Limb-Threatening Ischemia Outcomes and Utilization Among US Medicare Patients.","authors":"Lorenzo V Arvanitis, Joseph M Kim, Siling Li, Yang Song, Mohit K Manchella, Eric A Secemsky","doi":"10.1016/j.amjcard.2025.09.047","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.047","url":null,"abstract":"Background: Chronic limb-threatening ischemia (CLTI) disproportionately affects racial minority populations, with Black patients experiencing higher amputation rates and reduced access to vascular care. Recent national campaigns have aimed to improve early screening and diagnosis of peripheral arterial disease (PAD), but it is unclear whether these efforts have improved outcomes.Objectives: To assess temporal trends in treatment, outcomes, and healthcare utilization for Black versus White Medicare beneficiaries with CLTI undergoing endovascular revascularization.Methods: We conducted a retrospective cohort study using Medicare claims data for beneficiaries aged ≥66 years who underwent endovascular revascularization for CLTI from January 2016 to December 2023. The primary outcome was a composite of major amputation or death over 4 years, evaluated using Cox models. Healthcare utilization was assessed via adjusted rate ratios (aRRs) for vascular provider visits, emergency department use, and hospital admissions.Results: Among 303,906 patients, 17.2% (N=52,376) identified as Black. Black patients were younger, had more comorbidities, and more often presented with gangrene. They more frequently underwent angioplasty alone and less frequently received stents. Over a median 1.7 years of follow-up, Black patients had higher risk of major amputation (HR 1.49; 95% CI, 1.45-1.53) and lower mortality (HR 0.91; 95% CI, 0.90-0.93). They had fewer vascular visits before (aRR 0.91) and after (aRR 0.92) revascularization, but more ED visits (aRR 1.09) and hospital readmissions (aRR 1.28).Conclusions: Despite national initiatives, Black patients with CLTI continue to face higher amputation risk and reduced access to longitudinal vascular care, underscoring the need for sustained, equity-focused interventions.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237537","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}

引用次数: 0

Healthcare Resource Utilization and Outcomes in Intermediate-risk Pulmonary Embolism in the United States. 美国中危性肺栓塞的医疗资源利用和结果

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-04 DOI: 10.1016/j.amjcard.2025.09.050

Parag J Patel, Suhail Y Dohad, John M Moriarty, Rachel Rosovsky, Richard Channick, Ido Weinberg

{"title":"Healthcare Resource Utilization and Outcomes in Intermediate-risk Pulmonary Embolism in the United States.","authors":"Parag J Patel, Suhail Y Dohad, John M Moriarty, Rachel Rosovsky, Richard Channick, Ido Weinberg","doi":"10.1016/j.amjcard.2025.09.050","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.09.050","url":null,"abstract":"Patients with intermediate-risk pulmonary embolism (PE) often experience extended hospitalizations and varied outcomes depending on the treatment modality. This study compares outcomes and healthcare resource utilization among patients treated with anticoagulation (AC), catheter-directed thrombolysis (CDL), other mechanical thrombectomy (MT), or computer-assisted vacuum thrombectomy (CAVT) in the U.S. Adult inpatients with intermediate-risk PE discharged between 07/01/2020 and 09/30/2023 were retrospectively identified from the Vizient Clinical Data Base. ICD-10 codes identified treatment modalities. Propensity score matching (PSM) equated groups 1:1 using demographics, payer and hospital type. Outcomes included length of stay (LOS), post-procedure LOS (PPLOS), post-procedure intensive care unit days (PPICU), in-hospital mortality, composite complications, discharge status, and readmission rates. PSM matched 515 patients across groups. Baseline data were similar. CAVT had shorter LOS (4.6±3.23d) than AC (6.2±3.72d, P<0.0001), CDL (7.1±4.42d, P<0.0001), and MT (7.0±4.62d, P<0.0001). CAVT had shorter PPLOS (3.8±3.16d) than CDL (6.1±4.33d, P<0.0001) and MT (6.2±4.52d, P<0.0001). CAVT had fewer and shorter PPICU stays than CDL (44.3% vs 82.7%, P <0.0001; 0.7±1.3d vs 1.6±1.5d, P<0.0001). CAVT showed lower composite complications than MT (1.2% vs. 4.1%, P=0.0034), and lower incidence of acute kidney injury development during hospitalization than MT (1.9% vs. 4.9%, P=0.0099) and CDL (1.9% vs. 4.5%, P=0.0214). In-hospital mortality, 30-day all-cause and PE-related readmissions were similar. CAVT had a higher rate of discharge-to-home (69%) than AC (55.5%, P<0.0001), CDL (56.3%, P<0.0001) and MT (52.6%, P<0.0001). In conclusion, CAVT for intermediate-risk PE may shorten LOS, PPLOS, reduce complications, and improve discharge outcomes without increasing mortality compared to other treatment modalities.","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237612","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}

引用次数: 0

Systematic Review and Meta-analysis of Short-Term Outcomes in Patients Following Protected High-Risk PCI 高危PCI术后患者短期预后的系统评价和meta分析

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-10-03 DOI: 10.1016/j.amjcard.2025.09.008

Gianluca Di Pietro , Riccardo Improta , Ovidio De Filippo , Francesco Bruno , Lucia Ilaria Birtolo , Riccardo Colantonio , Achille Gaspardone , Fabrizio Tomai , Gennaro Sardella , Fabrizio D’Ascenzo , Massimo Mancone

{"title":"Systematic Review and Meta-analysis of Short-Term Outcomes in Patients Following Protected High-Risk PCI","authors":"Gianluca Di Pietro , Riccardo Improta , Ovidio De Filippo , Francesco Bruno , Lucia Ilaria Birtolo , Riccardo Colantonio , Achille Gaspardone , Fabrizio Tomai , Gennaro Sardella , Fabrizio D’Ascenzo , Massimo Mancone","doi":"10.1016/j.amjcard.2025.09.008","DOIUrl":"10.1016/j.amjcard.2025.09.008","url":null,"abstract":"<div><div>Surgical revascularization is still considered the gold standard for patients with complex coronary artery disease and left ventricular dysfunction. The advent of Impella has sparked growing interest, yet current evidence on its efficacy remains inconclusive. All studies reporting outcomes beyond 30 days outcomes of pPCI with any Impella device were included. Pooled effect of estimated outcomes was calculated according to a random-effect model with generic inverse variance weighting. Primary endpoint was all-cause mortality. Secondary outcomes were myocardial infarction, repeat revascularization, rehospitalization for heart failure and stroke. Six studies globally encompassing 1,581 patients were included in the quantitative analysis. Median age was 70 years old (IQR 69 to 72) with a median left ventricular ejection fraction (LVEF) of 27 % (SD ± 6) and a SYNTAX SCORE of 31 (IQR 29 to 35). Impella 2.5 was the most common micro axial flow pump used to support high-risk PCI. All-cause of death was observed in 13.4% (95% CI: 10.4 to 16.4) of patients at 6 months median follow-up. Myocardial infarction occurred in 5.8% (95% CI 3.4 to 8.1) of patients, repeat revascularization in 9.1% (95% CI: 4.8 to 13.3) of patients, stroke in 1.6% (IQR 1.2 to 2.1) of patients and, finally, heart failure rehospitalization in 8.4% (95% CI 3.3 to 13.6) of patients. In conclusion, for high-risk patients, PCI with the Impella device represented a viable strategy with an acceptable risk profile when surgical revascularization is not an option, and a poor prognosis is predicted.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 172-179"},"PeriodicalIF":2.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231354","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}

引用次数: 0