American Journal of Cardiology最新文献

{"title":"From Prediction to Practice: Evaluating the Limitations of BAN ADHF Risk Score against Natriuresis-Guided Diuresis.","authors":"Christopher Maulion, Jason Feliberti, Amit Alam","doi":"10.1016/j.amjcard.2025.03.008","DOIUrl":"10.1016/j.amjcard.2025.03.008","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603569","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 Calcified Nodules on Clinical Outcomes in Hemodialysis Patients Undergoing Percutaneous Coronary Intervention","authors":"Tatsuo Yokomine MD ,&nbsp;Takashi Kajiya MD ,&nbsp;Tatsuro Takei MD ,&nbsp;Kazunari Kitazono MD ,&nbsp;Toshiko Ninomiya MD ,&nbsp;Takafumi Inoue MD ,&nbsp;Junichiro Takaoka MD ,&nbsp;Yoshihiko Atsuchi MD ,&nbsp;Nobuhiko Atsuchi MD, PhD ,&nbsp;Mitsuru Ohishi MD, PhD","doi":"10.1016/j.amjcard.2025.03.007","DOIUrl":"10.1016/j.amjcard.2025.03.007","url":null,"abstract":"<div><div>Calcified nodules (CNs) are associated with poor prognosis after percutaneous coronary intervention (PCI) and have been reported to occur more frequently in hemodialysis patients. However, their prognosis in hemodialysis patients undergoing PCI has not been fully elucidated. We aimed to investigate the prognosis of hemodialysis patients who underwent PCI for CNs using intravascular ultrasound (IVUS) and/or optical coherence tomography (OCT)/optical frequency domain imaging (OFDI). About 141 hemodialysis patients who underwent PCI between January 2020 and December 2021 were analyzed retrospectively in a single center. CNs are defined as heavily calcified plaques that protruding into lumen in a convex shape. MACE (a composite of cardiovascular death, target lesion related myocardial infarction, and target lesion revascularization) between CNs and Non-CNs at 1 year were compared. In the entire study population, the mean age was 69.3 ± 10.7 years, and 94 (77.0%) were male. At 1 year, the incidence of MACE following PCI was significantly higher in the CNs group (39.2% vs 9.9%, log-rank p &lt;0.001), particularly for cardiovascular death (17.7% vs 4.2%, log-rank p = 0.009). After multivariate analysis adjusting for demographic characteristics, CNs remained independently associated with increased risk of MACE (adjusted hazard ratio: 4.93, 95% confidence interval 2.07 to 11.76; p &lt;0.001). CNs were associated with a higher incidence of MACE and a higher cardiovascular death rate in hemodialysis patients who underwent PCI.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Pages 35-37"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596071","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":"Hemolytic Anemia Following SAPIEN 3 Ultra RESILIA Implantation (from the OCEAN-TAVI Registry)","authors":"Kenichi Ishizu MD ,&nbsp;Shinichi Shirai MD ,&nbsp;Masaomi Hayashi MD ,&nbsp;Toru Morofuji MD ,&nbsp;Akihiro Isotani MD ,&nbsp;Nobuhisa Ohno MD ,&nbsp;Shinichi Kakumoto MD ,&nbsp;Kenji Ando MD ,&nbsp;Fumiaki Yashima MD ,&nbsp;Hidetaka Nishina MD ,&nbsp;Masaki Izumo MD ,&nbsp;Masahiko Asami MD ,&nbsp;Norio Tada MD ,&nbsp;Masahiro Yamawaki MD ,&nbsp;Toru Naganuma MD ,&nbsp;Futoshi Yamanaka MD ,&nbsp;Yohei Ohno MD ,&nbsp;Hiroshi Ueno MD ,&nbsp;Masahiko Noguchi MD ,&nbsp;Kazuki Mizutani MD ,&nbsp;Kentaro Hayashida MD","doi":"10.1016/j.amjcard.2025.02.036","DOIUrl":"10.1016/j.amjcard.2025.02.036","url":null,"abstract":"<div><div>Decompensated hemolytic anemia after transcatheter aortic valve implantation (TAVI) requiring specific treatment is rarely encountered in actual clinical practice. Nevertheless, there have been several cases of clinically relevant hemolytic anemia following implantation of the recently launched SAPIEN 3 Ultra RESILIA (S3UR). This study aimed to elucidate the clinical features of hemolytic anemia following S3UR implantation. Patients who underwent TAVI using S3UR from the end of March 2023 to November 2023 were enrolled from the Japanese multicenter OCEAN (Optimized CathEter vAlvular iNtervention)–TAVI registry. Hemolytic anemia was defined as (1) a drop in hemoglobin level by &gt;2.0 g/dL within 3 months after the index TAVI procedure and (2) the diagnosis of mechanical hemolysis as the cause of anemia made by the attending physician and hematologist based on the presence of any 2 of the following criteria: (1) serum lactate dehydrogenase level &gt;220 IU/L; (2) haptoglobin level &lt;0.5 g/L; and (3) reticulocyte count ≥2%. Of the 1,070 patients, 18 (1.7%) patients developed hemolytic anemia after TAVI. These patients had a significantly lower prosthesis oversizing relative to native annulus (−3.7% [−5.9% to 0.1%] vs 7.5% [0.6% to 14.0%], p &lt;0.001) and a higher prevalence of paravalvular leakage (PVL) ≥mild (mild PVL: 61.1% vs 12.4%; moderate-to-severe PVL: 16.7% vs 0.2%; p &lt;0.001) than those without hemolytic anemia. PVL ≥mild was associated with a higher incidence of hemolytic anemia particularly in patients with oversizing of &lt;−5% (33.3% vs 1.3%, p &lt;0.001) and in those with −5%≤ oversizing &lt;10% (8.3% vs 0.7%, p &lt;0.001). In conclusion, the incidence of decompensated hemolytic anemia after S3UR implantation was not negligible, and the results of the present study support the importance of selecting a prosthesis size with a sufficient oversizing relative to native annulus to minimize residual PVL ≥mild leading to hemolytic anemia after TAVI.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Pages 71-80"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596070","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":"Fainting Spells and Flow: Revisiting the Role of Syncope in Pulmonary Embolism.","authors":"Shubhadarshini Pawar, Adan Khan, Derek Wu, Hamza Waraich, Jaideep Menda","doi":"10.1016/j.amjcard.2025.03.003","DOIUrl":"10.1016/j.amjcard.2025.03.003","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596069","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 Impact of Sodium-Glucose Cotransporter-2 Inhibitors on Atrial Fibrillation Burden in Diabetic Patients.","authors":"George G Kidess, Mohammad Hamza, Rohit Goru, Jawad Basit, Mowaffak Alraiyes, M Chadi Alraies","doi":"10.1016/j.amjcard.2025.03.002","DOIUrl":"10.1016/j.amjcard.2025.03.002","url":null,"abstract":"<p><p>Atrial Fibrillation (AF) and Type 2 Diabetes Mellitus (T2DM) are comorbid conditions associated with increased adverse outcomes. Recent evidence suggests that antidiabetic therapies such as sodium-glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 agonists (GLP1a) may influence the risk of AF and stroke differently. This study aims to compare the risk of new-onset AF and stroke in T2DM patients treated with SGLT2i versus GLP1a. A systematic literature review was performed on Pubmed and Embase, including studies comparing the effect of SGLT2i or GLP1a on new-onset AF and stroke incidence in T2DM patients. A random effects model was used to pool relative risk and 95% confidence intervals to assess the study outcomes. Univariate metaregression analysis was performed for selected demographics and comorbidities. Six observational studies were included in the analysis comprising 847,028 patients. Our meta-analysis found a significantly lower risk of new-onset AF in patients with T2DM treated with SGLT2i compared to those receiving GLP1a (RR = 0.76, 95% CI: 0.65 to 0.89). There was no statistically significant difference in the risk of stroke between SGLT2i and GLP1a (RR = 1.09, 95% CI = 0.98 to 1.21). Univariate meta-regression indicated male sex was a significant negative effect modifier for new-onset AF (coefficient = -0.0191, p-value = 0.0158). In conclusion, SGLT2i may reduce AF risk in T2DM patients, while GLP1a may provide a modest, nonsignificant protective effect against stroke. Further research is needed to confirm these results and guide cardiovascular risk management in patients with T2DM.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584309","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 Significance of Diabetes in Asymptomatic Individuals With Zero Coronary Artery Calcium Score","authors":"Yong-Hoon Yoon MD ,&nbsp;Tae Oh Kim MD ,&nbsp;Gyung-Min Park MD ,&nbsp;Jong-Young Lee MD ,&nbsp;Jae-Hyung Roh MD ,&nbsp;Jae-Hwan Lee MD ,&nbsp;Kyusup Lee MD ,&nbsp;Pil Hyung Lee MD ,&nbsp;Jaewon Choe MD ,&nbsp;Young-Hak Kim MD ,&nbsp;Seung-Whan Lee MD","doi":"10.1016/j.amjcard.2025.03.005","DOIUrl":"10.1016/j.amjcard.2025.03.005","url":null,"abstract":"<div><div>The clinical significance of diabetes mellitus (DM) on the cardiovascular disease in the zero coronary artery calcium (CAC) group is not well studied. This study investigated the impact of DM in an asymptomatic population with zero CAC scores. Overall, 9269 adults who received coronary computed tomography angiography (CCTA) scans for coronary disease evaluation during a general medical checkup were initially selected. After excluding participants with CAC &gt;0, 4139 were included in the analysis. Baseline characteristics, CCTA findings including significant stenosis ≥50%, and clinical outcomes were assessed, including all-cause death, cardiovascular death, myocardial infarction (MI), or revascularization. The average age was 51.8 years, and 2706 participants (65.3%) were male. DM group had a higher prevalence of noncalcified plaque (16.7% vs 11.6%), significant stenosis (3.4% vs 1.5%), and a greater atherosclerosis burden than the non-DM group. DM was identified as a significant predictor of significant stenosis (adjusted odds ratio 1.88 [1.07–3.33], p = 0.029). During the median follow-up of 5.3 years, participants with DM experienced a higher rate of revascularization (1.2% vs 0.3%, adjusted hazard ratio 3.64 [1.25–10.56], p = 0.018), with a remarkably low incidence of cardiovascular death (0% vs 0.1%) and MI (both 0%). The risk of significant stenosis and revascularization increased gradually according to the severity of DM. In conclusion, asymptomatic patients with DM and zero CAC scores may face an increased risk of coronary artery disease presence compared to non-DM individuals. Despite zero CAC suggesting a low risk of cardiovascular disease, patients with DM may still exhibit a demonstrable atherosclerotic burden.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Pages 29-34"},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584295","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":"Lipoprotein(a) – From Biomarker to Therapy: A Review for the Clinician","authors":"Mawra Jha MBBS ,&nbsp;Inbar R. McCarthy MD ,&nbsp;Eli V. Gelfand MD","doi":"10.1016/j.amjcard.2025.02.034","DOIUrl":"10.1016/j.amjcard.2025.02.034","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) remains the predominant cause of morbidity and mortality globally. Amid rising CVD rates, Lipoprotein(a) [Lp(a)] has been recognized as a critical biomarker identifying individuals at an increased risk of atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis (AS), independent of traditional risk factors. Lp(a) is a lipoprotein variant similar to LDL but includes apolipoprotein(a), which influences its pathogenic potential. Elevated Lp(a) levels are genetically determined and have been implicated in promoting vascular inflammation, atherogenesis, enhanced calcification, and thrombosis. Emerging antisense oligonucleotide (ASO)- and small interfering ribonucleic acids (siRNAs)- based therapies have been shown to lower Lp(a) concentrations, with ongoing trials underway to determine whether they reduce the risk of CVD. While guidelines on screening and management continue to evolve, the advent of specific Lp(a)-lowering therapies may transform CVD prevention and treatment. This review aims to consolidate the current knowledge on Lp(a) from its biological functions to its implications for clinical practice, focusing on its role as a biomarker and potential therapeutic target.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Pages 42-53"},"PeriodicalIF":2.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584306","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":"Giant Cell Myocarditis: Navigating Diagnosis and Management of a Mysterious Entity","authors":"Ibrahim Mortada MD ,&nbsp;Mohammed Mhanna MD ,&nbsp;Kathryn Eschbacher MD ,&nbsp;Shareef Mansour MD","doi":"10.1016/j.amjcard.2025.02.035","DOIUrl":"10.1016/j.amjcard.2025.02.035","url":null,"abstract":"<div><div>Giant cell myocarditis (GCM) is a rare but often fatal disease commonly affecting young adults. Its nonspecific presentation and possible co-occurrence with other cardiac diseases make it a challenging diagnosis. We report a case of 48-year-old patient who presented with progressive dyspnea on exertion due to GCM, and discuss their hospital course leading to recovery. We also review the literature on this rare disease entity, highlighting its diagnosis and management.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Pages 25-28"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Aortic Valve Replacement in Asymptomatic Severe Aortic Stenosis: A Meta-Analysis of Randomized Controlled Trials","authors":"Sameena K. Brar BS ,&nbsp;Derek W. Leong MD ,&nbsp;Rabia R. Razi MD, MPH ,&nbsp;Naing Moore MD ,&nbsp;Ray Zadegan MD ,&nbsp;Prakash Mansukhani MD ,&nbsp;Somjot S. Brar MD, MPH","doi":"10.1016/j.amjcard.2025.02.025","DOIUrl":"10.1016/j.amjcard.2025.02.025","url":null,"abstract":"<div><div>Determining the best time for aortic valve replacement (AVR) in asymptomatic severe aortic stenosis (AS) with preserved left ventricular function remains controversial, as current guidelines recommend waiting until symptoms appear. Recent evidence suggests that early AVR may improve outcomes for select patients. This meta-analysis of randomized controlled trials evaluated the efficacy of early AVR, including surgical and transcatheter approaches, versus conservative management in asymptomatic severe AS. We systematically searched PubMed, Embase, CENTRAL, and ClinicalTrials.gov to identify eligible trials. The outcomes of interest included all-cause mortality, unplanned hospitalization, stroke, as well as the composite endpoint of each trial, which was derived from combinations of these outcomes. Four trials involving 1,427 patients were included. Early AVR significantly reduced the risk of unplanned hospitalizations (HR 0.42, 95% CI 0.33 to 0.53, p &lt;0.001, I² = 0%). Although there was a trend towards reduced all-cause mortality, it did not reach statistical significance (HR 0.76, 95% CI 0.48 to 1.21, I² = 42%). Stroke also trended lower with early AVR (HR 0.63, 95% CI 0.40 to 1.00, p = 0.05, I² = 0%). In conclusion, these findings indicate that early AVR may provide clinical benefits by reducing adverse events in asymptomatic severe AS, in particular unplanned rehospitalization, suggesting that early AVR could be beneficial and should be considered in future guideline revisions.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Pages 11-16"},"PeriodicalIF":2.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584298","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":"Meta-Analysis of Racial and Ethnic Disparities in Rhythm Control Strategies for Atrial Fibrillation in the United States","authors":"Sheikh Moinul MD ,&nbsp;Manuel Urina-Jassir MD ,&nbsp;Joan Rodriguez-Taveras MD ,&nbsp;Adelqui O. Peralta MD ,&nbsp;Peter S. Hoffmeister MD ,&nbsp;Scott Kinlay MBBS, PhD ,&nbsp;Hirad Yarmohammadi MD, MPH ,&nbsp;William E. Boden MD ,&nbsp;Jacob Joseph MBBS, MD ,&nbsp;Matthew F. Yuyun MD, MPhil, PhD","doi":"10.1016/j.amjcard.2025.02.028","DOIUrl":"10.1016/j.amjcard.2025.02.028","url":null,"abstract":"<div><div>Rhythm control strategies are a key component of atrial fibrillation (AF) therapy, with recent reports suggesting racial and ethnic disparities in their utilization. We aimed to determine differences in the utilization of catheter ablation (CA), direct current cardioversion (DCCV), and anti-arrhythmic drugs (AAD) among different racial and ethnic groups. We searched PubMed/MEDLINE, EMBASE, and Cochrane Library (from inception to January 31st, 2024) for studies including adults with AF and reporting CA, DCCV, or AAD utilization rates in at least 2 racial and ethnic groups. Our primary outcome was the likelihood of Black, Hispanic, and Asian individuals undergoing each rhythm control strategy compared to White patients. Pooled estimates were calculated with a random-effects model and were reported as odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs). Nineteen studies were included comprising 12,598,109 patients. The pooled ORs (95% CI) of undergoing CA for Black individuals was 0.68 (95% CI 0.56 to 0.83), for Hispanic individuals was 0.72 (95% CI 0.63 to 0.82), and for Asian individuals was 0.64 (95% CI 0.48 to 0.86), compared to White individuals. The likelihood of undergoing DCCV (OR [95% CI]) was lower in Black (0.69 [95% CI 0.57 to 0.82]), Hispanic (0.67 [95% CI 0.57 to 0.80]), Asian (0.68 [95% CI 0.64 to 0.72]) patients compared to White patients. Our results identified that racial and ethnic minoritized groups with AF are significantly less likely to undergo treatment with a rhythm control strategy. In conclusion, these findings highlight a significant gap in healthcare delivery that stakeholders, healthcare systems, and clinicians should address.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Pages 1-10"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539919","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}