American Journal of Cardiology最新文献

{"title":"Outcomes Following Arteriovenous Fistula Creation in Medicare Beneficiaries With End-Stage Kidney Disease.","authors":"Nathan W Kong, Joseph M Kim, Anna K Krawisz, Patrick Heindel, Archana Tale, Yang Song, Jeffrey L Weinstein, Mohamad A Hussain, Eric A Secemsky","doi":"10.1016/j.amjcard.2024.10.006","DOIUrl":"10.1016/j.amjcard.2024.10.006","url":null,"abstract":"<p><p>The objective of this study was to measure the contemporary patency rates and frequency of interventions required for arteriovenous fistula (AVF) care in a representative US population of patients with end-stage kidney disease, including by age, race, and gender. All Medicare beneficiaries aged >20 years who underwent AVF graft creation for end-stage kidney disease between 2017 and 2019 were included for analysis. The primary end points included primary patency, primary assisted patency, postintervention patency, and fistula functionality up to 1 year after AVF placement. The secondary end point included admission for an associated adverse event after AVF creation. Multivariate analysis of patency rates was also assessed. Of 43,457 patients included in the analysis, the cumulative primary patency at 90 days was 68.4% and at 1 year, 31.5%. At 1 year, the primary assisted patency rate, postintervention patency, and fistula use were 70.4%, 30.2%, and 59.1%, respectively. There was no difference in primary patency rates when comparing age groups (age 40 to 59 years: hazard ratio [HR] 1.01, 95% confidence interval [CI] 0.95 to 1.06, p = 0.84 or age ≥60 years: HR 0.99, 95% CI 0.93 to 1.04, p = 0.61) with the reference of age group 20 to 39 years. Women were at greater risk of experiencing primary patency failure than were men (HR 1.16, 95% CI 1.14 to 1.20, p <0.001), and Black patients were at greater risk of experiencing primary patency failure than were White patients (HR 1.34, 95% CI 1.31 to 1.38, p <0.001). The cumulative incidence of admissions for adverse events was 32.6% at 1 year. In conclusion, our findings suggest that the real-world AVF patency rates remain low, with disproportionately low rates in women and Black patients.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493049","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 Multiarterial versus Single Arterial Coronary Bypass Graft Surgery on Postoperative Atrial Fibrillation.","authors":"Qin Jiang, Keli Huang, Shanshan Lin, Deliang Wang, Zhiai Tang, Shengshou Hu","doi":"10.1016/j.amjcard.2024.10.004","DOIUrl":"10.1016/j.amjcard.2024.10.004","url":null,"abstract":"<p><p>The effect of multiarterial (MA) versus single arterial (SA) coronary bypass graft surgery on postoperative atrial fibrillation (POAF) was not investigated. From May 2017 to May 2024, the patients with CYP2C19*2 or *3 allele receiving coronary artery grafting and postoperational aspirin 100 mg/day and clopidogrel 75 mg/day were retrospectively reviewed and assigned to the MA or SA group. The primary end point was the incidence rate of POAF in the first week. The secondary end points were POAF burden, platelet aggregation, systemic immune-inflammation index, and heart rate variability. The study included 58 cases in the MA group and 174 cases in the SA group. The incidence of POAF was 17% in the MA group, contrasting with 42% in the SA group (hazard ratio 0.353, 95% confidence interval 0.218 to 0.569, p = 0.0012). A lower POAF burden was observed in the MA group than in SA group (2 [1 to 5] vs 10 hours [6 to 20], p = 0.02). Platelet aggregation (arachidonic acid: 46 ± 10% vs 56 ± 8%, p <0.01; adenosine diphosphate: 58 ± 17% vs 75 ± 13%, p <0.01) and inflammation response index (neutrophil to lymphocyte ratio: 26 ± 4 vs 28 ± 5, p = 0.006; systemic immune-inflammation index: 5,019 ± 771 vs 5,382 ± 1,204, p = 0.032) was notably lower in MA group than those in SA group at 1 day after coronary artery bypass grafting. Holter electrocardiogram showed a higher heart rate variability value in the SD of the normal-to-normal RR intervals and decreased low frequency/high frequency ratio in the MA group. In conclusion, MA was associated with a lower incidence rate of POAF and paralleled with a lower atrial fibrillation burden, platelet aggregation, and inflammation reaction and a higher parasympathetic nerve tone than the SA regimen.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493045","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":"Short-Term and Mid-Term Blood Pressure Variability and Long-Term Mortality.","authors":"David Steinsaltz, Hamish Patten, Dirk Bester, David Rehkopf","doi":"10.1016/j.amjcard.2024.10.005","DOIUrl":"10.1016/j.amjcard.2024.10.005","url":null,"abstract":"<p><p>Until recently, there has been a focus on exploring the influence of average blood pressure (BP) on risk of mortality. We go beyond average BP to also investigate mortality risk with respect to variation in BP over 2 timescales-short-term variation among multiple measures at 1 visit, and medium-term variation among the measures at 2 visits several months apart. We present an application of Bayesian hierarchical modeling to the problem of estimating the effect of BP variability on all-cause and cardiovascular mortality. We use data from the Third National Health and Nutrition Examination Survey linked with up to 27 years of mortality follow-up. We find that medium-term systolic BP variability had a very significant predictive value for all-cause mortality in addition to mortality from cardiovascular disease, cerebrovascular disease and heart-attacks combined, approximately 1/3 as large as the well-established impact of mean systolic BP. Medium-term diastolic variability had an additional, although smaller, predictive effect. Short-term variability, in contrast, had little or no measurable predictive value. The medium-term variability effect persisted when controlling for Framingham Risk Score.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493050","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":"Transradial Access Primetime: More Evidence Supporting Transradial Graft Percutaneous Coronary Intervention.","authors":"Abdallah Assaf, Karim Al-Azizi","doi":"10.1016/j.amjcard.2024.10.010","DOIUrl":"10.1016/j.amjcard.2024.10.010","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493053","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":"Rationale and Design of OPT-RATE AF: A Randomized Clinical Trial of Increased Physiologic Pacing Rates in Heart Failure With Preserved Ejection Fraction","authors":"Evan Czulada BS ,&nbsp;Jamal D. Smith MBBS ,&nbsp;Paul Kolm PhD ,&nbsp;Brototo Deb MD ,&nbsp;Sarahfaye F. Dolman MPH ,&nbsp;Nebu Alexander MD ,&nbsp;Ryan A. Braun BS, BA ,&nbsp;Rajiv A. Kabadi MD ,&nbsp;William S. Weintraub MD ,&nbsp;David Strouse MD ,&nbsp;Athanasios Thomaides MD","doi":"10.1016/j.amjcard.2024.09.033","DOIUrl":"10.1016/j.amjcard.2024.09.033","url":null,"abstract":"<div><div>Cardiac physiologic pacing (CPP) after atrioventricular node (AVN) ablation for persistent atrial fibrillation (AF) has improved outcomes in patients with heart failure with reduced and preserved ejection fraction (HFpEF). Emerging evidence suggests patients with HFpEF benefit from higher heart rates, yet the optimal pacing rate after AVN ablation remains unknown. Optimal Pacing Rate for cardiac resynchronization therapy after atrioventricular node ablation in persistent Atrial Fibrillation and heart failure (OPT-RATE AF) is a prospective, randomized crossover study of patients with HFpEF after AVN ablation for persistent AF (NCT06445439). Approximately 60 patients with AF and AVN ablation, CPP, and HF with left ventricular ejection fraction ≥50% will be enrolled. Participants will be randomly assigned 1:1 to a pacing lower rate limit of 60 beats/min for 3 months and then switched to a rate of 80 beats/min for 3 months and vice versa. The primary end point is the change in exercise capacity assessed using the 6-minute walk test. Notable secondary outcomes will include changes in the Kansas City Quality of Life Questionnaire (KCCQ-12), creatinine and natriuretic peptide, and clinical events. Patient mortality and HF hospitalizations will be recorded at each phase. Electrocardiogram, echocardiogram, pacemaker interrogation, and primary and secondary outcomes will be recorded at baseline, 3 months, and 6 months. Study enrollment is ongoing and estimated to be completed by 2026. OPT-RATE AF is a randomized clinical trial that will determine the effect of a higher pacing rate in patients with persistent AF and HFpEF after AVN ablation and/or CPP. Study findings will provide insight on the role of chronotropy in improving quality of life and other important cardiovascular outcomes.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456054","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":"Preprocedural Planning for Chronic Total Occlusion Percutaneous Coronary Intervention.","authors":"Keerthi T Gondi, Amit Goyal, Jesse Kane, Salman S Allana","doi":"10.1016/j.amjcard.2024.10.001","DOIUrl":"10.1016/j.amjcard.2024.10.001","url":null,"abstract":"<p><p>Chronic total occlusions (CTO) are frequently encountered in clinical practice. Although the success rates and safety of CTO percutaneous coronary intervention (PCI) have significantly improved with the development of newer equipment, use of an algorithmic approach, and advancement in procedural techniques, CTO PCI has a higher rate of complication than does non-CTO PCI. Therefore, meticulous preprocedural planning before CTO PCI is paramount to improve success and reduce the risk of complications. In this report, we review multiple aspects of preprocedural CTO PCI planning, including procedural indications, efficacy, safety, diagnostic angiography, scoring tools for procedural success and risk prediction, and preprocedural use of computed tomography coronary angiography.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456053","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":"Implementation of a Cardiovascular Implantable Electronic Device Heart Failure Prediction Tool-Guided Management Pathway","authors":"Allison Kratka MD ,&nbsp;Gregory Rohrbach DNP, NP ,&nbsp;Carrie Puckett DO ,&nbsp;Thomas L. Rotering MPH ,&nbsp;Merritt H. Raitt MD ,&nbsp;Mary A. Whooley MD ,&nbsp;Sanket S. Dhruva MD, MHS","doi":"10.1016/j.amjcard.2024.09.030","DOIUrl":"10.1016/j.amjcard.2024.09.030","url":null,"abstract":"<div><div>Cardiovascular implantable electronic devices (CIEDs) monitor physiologic variables that could identify subacute heart failure (HF) decompensation and impending HF hospitalization. One such algorithm uses measurements from the previous 30 days of CIED remote monitoring data to predict low-, medium-, or high-probability of HF hospitalization in the next 30 days. We sought to understand how to prospectively implement the use of such algorithms in routine HF care. From January 18, 2024 to April 19, 2024, HF risk categories were predicted from scheduled remote transmissions every 30 days and from unscheduled transmissions for all patients at 2 distinct cardiology clinics. Clinicians contacted and assessed patients at high risk regarding symptoms and then provided an empiric 3-day diuretic intervention (initiation or dose augmentation), adjusted guideline-directed medical therapy, or performed other clinical action as appropriate. Among 358 patients with 1,140 remote transmissions, 72 (20%) had ≥1 transmission categorized as high-risk. The mean patient age was 72.8 years, 346 (97%) were male, and 221 (62%) had a pre-existing diagnosis of HF. Of these 72 patients, 67 (93%) were successfully contacted, 34 (51%) had no HF symptoms, 24 (36%) had mild to moderate symptoms, and 2 (3%) had severe symptoms. A total of 46 patients (69%) had clinical action taken, including 28 (42%) with a diuretic intervention and 12 (18%) with guideline-directed medical therapy augmented. In this implementation study, clinicians contacted and assessed nearly all patients at high risk for HF decompensation based on CIED remote monitoring data and intervened in more than 2/3s. A randomized clinical trial is needed to determine whether this algorithm and subsequent intervention improves clinical outcomes.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456052","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":"Gender Disparities on the Use and Outcomes of Mechanical Circulatory Support in Patients With Cardiogenic Shock Complicating Acute Myocardial Infarction","authors":"Carlos Diaz-Arocutipa MD ,&nbsp;Norma Nicole Gamarra-Valverde MS ,&nbsp;Rafael Salguero MD ,&nbsp;Roberto Martín-Asenjo MD ,&nbsp;Lourdes Vicent MD PhD","doi":"10.1016/j.amjcard.2024.09.031","DOIUrl":"10.1016/j.amjcard.2024.09.031","url":null,"abstract":"<div><div>Cardiogenic shock complicating acute myocardial infarction (AMI-CS) remains a critical condition with high morbimortality. Despite advances, gender disparities persist in the management of this condition. Our aim was to evaluate gender differences in the utilization and outcomes of mechanical circulatory support (MCS) in AMI-CS. In addition, we addressed the management strategies for AMI-CS stratified by race/ethnicity. We performed a retrospective study using the National Inpatient Sample from 2016 to 2019, including admissions with AMI-CS. The use of MCS and outcomes were compared between genders using inverse probability of treatment weighting. Odds ratios (OR) with their 95% confidence interval (CI) were estimated. A total of 151,560 admissions for AMI-CS were analyzed, including 98,855 male and 52,705 female patients. After the inverse probability of treatment weighting adjustment, females were significantly less likely to receive MCS (OR 0.77, 95% CI 0.73 to 0.81, p &lt;0.001) and had higher in-hospital mortality rates (OR 1.09, 95% CI 1.00 to 1.18, p = 0.045) than males. No significant gender differences were observed in major bleeding, renal replacement therapy, or mechanical ventilation. Racial disparities were also evident, with female patients across all racial groups being less likely to receive MCS compared with their male counterparts. In conclusion, significant gender disparities exist in the utilization and outcomes of MCS in patients with AMI-CS. Female patients are less likely to receive MCS and have higher in-hospital mortality rates compared with male patients. Racial minorities, including Black and Hispanic patients, experience lower utilization of MCS compared with White patients. These findings underscore the complex interplay between gender, race/ethnicity, and health care access and outcomes.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456051","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":"Transcatheter Mitral Valve Repair for Multiple Valvular Heart Disease: Outcomes and Insights on Combined Aortic Insufficiency and Mitral Regurgitation","authors":"Craig Basman MD,&nbsp;Ahmad Mustafa MD,&nbsp;Arber Kodra MD,&nbsp;Denny Wang BS,&nbsp;Priyanka Singh BS,&nbsp;Ethan Paliwoda BS,&nbsp;Christopher Gasparis BS,&nbsp;Ythan Goldberg MD,&nbsp;Shangyi Liu MS,&nbsp;Chapman Wei MD,&nbsp;Michael Cinelli MD,&nbsp;Efstathia Mihelis PA-C, MBA,&nbsp;Caroline Ong MD,&nbsp;Biana Trost MD,&nbsp;Bruce Rutkin MD,&nbsp;Elana Koss MD,&nbsp;Gregory Maniatis MD,&nbsp;Sean Wilson MD,&nbsp;Jacob Scheinerman MD,&nbsp;Chad Kliger MD","doi":"10.1016/j.amjcard.2024.09.032","DOIUrl":"10.1016/j.amjcard.2024.09.032","url":null,"abstract":"<div><div>The presence of concomitant aortic insufficiency (AI) and mitral regurgitation (MR) is common and may further accelerate cardiac dysfunction. However, there exists no US regulatory–approved transcatheter device for the treatment of AI. The effectiveness of isolated transcatheter mitral therapy in this population is not well-understood; thus, we aimed to evaluate outcomes for patients with combined AI and MR compared with isolated MR who underwent mitral transcatheter edge-to-edge repair (m-TEER). Retrospective data were obtained from the Northwell m-TEER registry. A total of 587 patients who underwent m-TEER at 4 high-volume transcatheter aortic valve replacement/transcatheter edge-to-edge repair centers within the Northwell Health system were included. All patients had severe MR and were divided into 2 groups: group 1 with ≥3+ AI (AI+) and the group 2 with &lt;3+ AI (AI−). Echocardiographic outcomes were evaluated at 1 month. Clinical outcomes were evaluated at 1 month and 1 year. The primary end point was death or rehospitalization at 1 year. A total of 587 patients were included in the study, with 92 in the AI+ group. Baseline characteristics were similar in both groups. Approximately 2/3 of patients in the AI+ group demonstrated an improvement in AI severity after isolated mitral therapy. There was no difference in the primary outcome at 1 month or 1 year. There was also no significant difference in New York Heart Association functional class at 1 month between the groups. In conclusion, patients who underwent m-TEER with combined MR and AI (AI+ group) fared well compared with those with isolated mitral valve dysfunction (AI− group), with no discernible differences in survival, New York Heart Association class, or rehospitalization rates at 1 month or 1 year. Hence, isolated m-TEER is a reasonable treatment approach in patients with a high surgical risk with combined AI and MR.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399152","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":"Prognostic Impact of Target Vessel in Chronic Total Occlusions: A Population-Based Cohort Study","authors":"Emil Nielsen Holck MD, PhD ,&nbsp;Lars Jakosen MD, PhD ,&nbsp;Lone Juul-Hune Mogensen MSc ,&nbsp;Ashkan Eftekhari MD, PhD ,&nbsp;Evald Høj Christiansen MD, PhD","doi":"10.1016/j.amjcard.2024.09.029","DOIUrl":"10.1016/j.amjcard.2024.09.029","url":null,"abstract":"<div><div>Successful percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) in the coronary arteries in the left anterior descending (LAD) artery is associated with better outcome than unsuccessful PCI. Randomized data have not found invasive treatment of non-CTO LAD lesion to be associated with better outcome. This study aimed to investigate the prognostic impact of CTO revascularization stratified on target treated vessel compared with non-CTO LAD PCI. The hypothesis was that successful PCI of LAD CTO and non-LAD CTO and unsuccessful non-LAD CTO were associated with the same prognosis as non-CTO LAD lesions, whereas patients with unsuccessful LAD CTO were associated with a poorer prognosis. The study was a population-based cohort study, including consecutive patients who underwent PCI from 2009 to 2019 in the Central Denmark Region. Patients with acute myocardial infarction within 30 days were excluded. Patients with CTO were stratified by occluded vessel and procedural success. The primary end point was long-term all-cause mortality and was calculated as a hazard ratio with a 95% confidence interval. Secondary end points were myocardial infarction and target vessel revascularization<strong>.</strong> In total, 21,141 patients were screened, 4,518 had non-CTO LAD PCI, and 1,475 had CTO PCI. The median (interquartile range) follow-up was 5.8 years (3.6 to 8.8). In the successful CTO groups, the adjusted risk for all-cause mortality was equal to patients with non-CTO LAD (LAD CTO hazard ratio [95% confidence interval] 1.14 [0.90 to 1.44], non-LAD CTO 1.09 [0.95 to 1.27]). Patients with unsuccessful LAD CTO had a higher risk than patients with non-CTO LAD, whereas unsuccessful non-LAD CTO had not (unsuccessful LAD 1.88 [1.33 to 2.65], unsuccessful non-LAD 1.26 [0.97 to 1.63]). In conclusion, successful LAD and non-LAD CTO PCI had the same prognosis as non-CTO LAD PCI, whereas only unsuccessful LAD CTO PCI had a poorer prognosis. Patients with LAD CTO are a high-risk population, and dedicated CTO trials are needed to confirm this finding and establish guideline recommendations.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}