American Journal of Cardiology最新文献

{"title":"The Impact of Active Ascertainment on Sex-Specific Differences in the Prevalence and Phenotype of Transthyretin Cardiac Amyloidosis: The Screening for Cardiac Amyloidosis With Nuclear Imaging in Minority Populations Study.","authors":"Nicholas Chan, Andrew J Einstein, Sergio Teruya, Carlos Rodriguez, Stephen Helmke, Margaret Cuomo, Denisse Santana, Michelle Castillo, Dia Smiley, Natalia Sabogal, Sendy Lamour, Morgan Winburn, Denise Fine, Cinthia de Freitas, Cesia Gallegos Kattan, Edward J Miller, Mathew S Maurer, Frederick L Ruberg","doi":"10.1016/j.amjcard.2024.11.019","DOIUrl":"10.1016/j.amjcard.2024.11.019","url":null,"abstract":"<p><p>Transthyretin cardiac amyloidosis (ATTR-CA) is disproportionately diagnosed in older men. However, studies suggest that the true prevalence of ATTR-CA in women may be greater than previously reported. The Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations (SCAN-MP) study uses nuclear scintigraphy to identify ATTR-CA in self-identified Black and Caribbean Hispanic participants ≥60 years old with heart failure and left ventricular hypertrophy. We characterized the sex distribution and phenotypic characteristics of ATTR-CA in this active ascertainment cohort in comparison with a population of patients with ATTR-CA who were referred to a tertiary care academic center outpatient clinic. The active ascertainment SCAN-MP cohort had a greater proportion of women than did the referral clinic cohort (31.3% vs 13.3%, p = 0.016). This was mainly attributed to the greater proportion of women with wild-type ATTR-CA (27.8% vs 7.1%, p = 0.012). Women with ATTR-CA in the active ascertainment cohort exhibited higher left ventricular ejection fraction than did those in the referral cohort (61% vs 50%, p = 0.011), lower left ventricular mass index (110 vs 148 g/m², p = 0.014), and smaller posterior wall thickness (1.4 vs 1.6 cm, p = 0.01). An active ascertainment strategy for ATTR-CA identification showed a greater proportion of women than did a referral cohort, driven predominantly by the greater proportion of women with wild-type ATTR-CA, and echocardiographic evidence of a less severe phenotype. In conclusion, efforts for early identification of ATTR-CA in women are critical for reducing sex disparities in this clinically treatable disease.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"60-64"},"PeriodicalIF":2.3,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709028","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":"Untangling Right Ventricular-Pulmonary Artery Coupling and Pulmonary Hypertension Definitions in Transcatheter Edge-to-Edge Repair.","authors":"Kyeeun Park, Houman Khalili","doi":"10.1016/j.amjcard.2024.11.014","DOIUrl":"10.1016/j.amjcard.2024.11.014","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695113","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":"Calling the Right Plays in Hypertrophic Cardiomyopathy: Are Our Blockers Optimized for the Game?","authors":"Sarah Abou Alaiwi, Lynda E Rosenfeld","doi":"10.1016/j.amjcard.2024.11.025","DOIUrl":"10.1016/j.amjcard.2024.11.025","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695103","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 Congenitally Malformed Aortic Valve in Type A Aortic Dissection: Its Frequency and Consequences.","authors":"Kyle A McCullough, John B Eisenga, J Michael DiMaio, Charles S Roberts","doi":"10.1016/j.amjcard.2024.11.023","DOIUrl":"10.1016/j.amjcard.2024.11.023","url":null,"abstract":"<p><p>A congenitally malformed aortic valve, unicuspid (UAV), or bicuspid (BAV), occurs in about 1% of the population and is known to be more frequent in patients with aortic dissection. The clinical and operative findings in a series of 134 patients with spontaneous, acute type A aortic dissection were studied, comparing patients with normal and abnormal aortic valve morphology. The aortic valve was normal in 123 of 134 (92%) patients and abnormal in 11 of 134 (8%) patients: BAV in 10 of 134 (7.5%) and UAV in 1 of 134 (0.7%). Demographics were similar between groups, except for a lower frequency of systemic hypertension in the UAV/BAV group (46 vs 82%, p <0.01). The University of Pennsylvania malperfusion class stratification was also similar in the 2 groups. The UAV/BAV group had a greater frequency of aortic root aneurysm (64 vs 18%, p <0.01) and a larger median root diameter (5.7 vs 4.6 cm, p = 0.02). In the UAV/BAV group, the entry tear was more frequently in proximal (intrapericardial) zone 0 (91 vs 62%, p = 0.049). The frequency of abnormal aortic media histology was similar. The rate of root replacement was higher in the UAV/BAV group and early mortality was similar. The frequency of congenitally malformed aortic valve in this series was 8 times higher than in the normal population. The 1 UAV in the series was the only severely stenotic valve. In patients with type A aortic dissection with a congenitally malformed valve, aortic root aneurysm was more common and the entry tear was nearly always proximal.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"41-44"},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695111","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":"Genetic Determinants of Prosthetic Valve Thrombosis: Paving the Way for Personalized Anticoagulation.","authors":"Rahul Chaudhary, Matthew E Harinstein","doi":"10.1016/j.amjcard.2024.11.013","DOIUrl":"10.1016/j.amjcard.2024.11.013","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695109","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":"Diagnosis and Prognosis of Isolated Cardiac Sarcoidosis: Multidisciplinary Diagnosis Versus Japanese Circulation Society Criteria.","authors":"Manuel L Ribeiro Neto, Christine L Jellis, Ziad Taimeh, Paul Cremer, Anuhya V Pulapaka, Allison Wimer, Daniel Rozenbaum, Simran Ganeriwal, Daniel A Culver","doi":"10.1016/j.amjcard.2024.11.018","DOIUrl":"10.1016/j.amjcard.2024.11.018","url":null,"abstract":"<p><p>The prognosis of isolated cardiac sarcoidosis (ICS) has not been fully elucidated. The only diagnostic criteria available for ICS, the Japanese Circulation Society (JCS) criteria, have not been validated. We aimed to study the prognosis of ICS according to 2 different diagnostic strategies. We prospectively included patients with a high suspicion for cardiac sarcoidosis by a multidisciplinary sarcoidosis team from November 2016 to June 2021. We included only incident cases. We applied the JCS ICS criteria and our multidisciplinary diagnosis (MDD) ICS criteria. We included 198 incident patients who had a final diagnosis of cardiac sarcoidosis. The median follow-up time was 2.4 years (twenty-fifth to seventy-fifth percentile: 1.2 to 3.7). The prevalence of ICS was 7% (14 of 198) per the JCS criteria and 29% (57 of 198) per our MDD criteria. Compared with patients with non-ICS, patients with ICS per either criterion had similar rates of major cardiovascular outcomes (progression of atrioventricular block, worsening ejection fraction ≥10%, appropriate implantable cardioverter-defibrillator therapies, heart transplant, and death). The Kaplan-Meier analyses showed similar prognosis for ICS and non-ICS in all outcomes, except for an association between ICS by MDD criteria and a shorter time to cardiac hospitalization. The multivariable Cox regression analyses showed that ICS was not an independent predictor of death, heart transplant, or clinical worsening. In conclusion, our MDD ICS criteria were more inclusive than the JCS ICS criteria. The prognosis was similar between patients with ICS and patients with non-ICS, regardless of which criteria were used.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"45-53"},"PeriodicalIF":2.3,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695107","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":"Cigarette Smoking and Structural Brain Deficits in Patients With Atrial Fibrillation.","authors":"Raffaele Peter, Stefanie Aeschbacher, Rebecca E Paladini, Michael Coslovsky, Philipp Krisai, Adrian Schweigler, Tobias Reichlin, Nicolas Rodondi, Andreas Müller, Moa Haller, Merit Röhl, Annina Stauber, Tim Sinnecker, Leo H Bonati, Thilo Burkard, David Conen, Stefan Osswald, Michael Kühne, Christine S Zuern","doi":"10.1016/j.amjcard.2024.11.008","DOIUrl":"10.1016/j.amjcard.2024.11.008","url":null,"abstract":"<p><p>Cigarette smoking and atrial fibrillation (AF) are associated with impaired brain health. We investigated the association between smoking habits and brain lesions and volume in patients with AF. In patients with AF from a multicenter cohort study, we assessed smoking status (never, ex-, active), number of cigarettes smoked per day, smoking duration (years), pack-years, and time since smoking cessation. On brain magnetic resonance imaging, the prevalence and volumes of white matter lesions (WML) and small noncortical infarcts, and the volumes of gray matter and white matter were evaluated. Logistic and linear regression analyses were used to analyze the association between smoking habits and brain lesions and volumes. A total of 1,728 patients were enrolled (mean age 72.6 years, 27.5% female); 7.5% were active smokers; 48.5% were ex-smokers, and 44% had never smoked. We found linear associations of number of cigarettes smoked per day, pack-years, and older age at smoking cessation with reduced gray matter volume (p for linear trend <0.01, 0.02, and 0.01, respectively). Patients with a smoking duration in the second and third tertile had a greater risk for WML Fazekas ≥2 (odds ratio 1.86, 95% confidence interval 1.29 to 2.69, p <0.01 and 1.47 [1.02 to 2.12], p = 0.04), and exhibited larger WML volumes. Patients who had stopped smoking ≥16 years before enrollment were less likely to have small noncortical infarcts (odds ratio 0.46, 0.25 to 0.88, p = 0.02) and had smaller WML volumes (β: -0.451 mm³, -0.8 to -0.11, p = 0.01). In conclusion, smoking intensity and time since smoking cessation were associated with the presence and volume of brain lesions and with brain volumes in patients with AF.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"72-78"},"PeriodicalIF":2.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695105","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 Versus One-Year Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: an Updated Meta-Analysis.","authors":"Meghna Joseph, Mrinal Murali Krishna, Chidubem Ezenna, Vinicius Pereira, Mahmoud Ismayl, Michael G Nanna, Sripal Bangalore, Andrew M Goldsweig","doi":"10.1016/j.amjcard.2024.10.038","DOIUrl":"10.1016/j.amjcard.2024.10.038","url":null,"abstract":"<p><p>The present guidelines recommend dual antiplatelet therapy (DAPT) for 6 to 12 months after percutaneous coronary intervention (PCI), with recent trials assessing the safety and efficacy of shortening DAPT duration to ≤3 months. A systematic search of PubMed, Scopus, and Cochrane Central databases identified studies comparing short DAPT, followed by P2Y12i monotherapy (78% ticagrelor) versus standard 12-month DAPT in patients who underwent PCI with a drug-eluting stent. A total of 9 randomized controlled trials, including 42,770 patients (short DAPT n = 21,370, 49.96%), of whom 28,307 (66.18%) presented with acute coronary syndrome (ACS). Short DAPT significantly reduced net adverse clinical events (NACEs) (risk ratio [RR] 0.78, 95% confidence interval [CI] 0.67 to 0.91, p = 0.001, I² = 62%), major bleeding (RR 0.54, 95% CI 0.39 to 0.73, p <0.001, I² = 63%), and any bleeding (RR 0.55, 95% CI 0.43 to 0.72, p <0.001, I² = 77%) at 12 months compared with 1-year DAPT. No significant differences were observed in major adverse cardiovascular/cerebrovascular events, myocardial infarction, stroke, stent thrombosis, mortality, or revascularization. Ticagrelor monotherapy after short DAPT further reduced major adverse cardiovascular/cerebrovascular events (RR 0.85, 95% CI 0.73 to 0.99, p = 0.040, I² = 22%), NACE (RR 0.74, 95% CI 0.61 to 0.89, p = 0.001, I² = 68%), and major bleeding (RR 0.56, 95% CI 0.40 to 0.78, p <0.001, I² = 71%) compared with 1-year DAPT; however, the test for subgroup interaction (P_interaction >0.05) for clopidogrel subgroup was not significant. P2Y12i monotherapy reduced the risk of NACEs (RR 0.77, 95%CI 0.66 to 0.90, p = 0.001, I² = 52%, P_interaction = 0.58) and major bleeding (RR 0.44, 95%CI 0.35 to 0.55, p <0.001, I² = 0%, P_interaction <0.01) in the ACS cohort but not in the chronic coronary syndrome cohort. In conclusion, short DAPT for ≤3 months followed by P2Y12i monotherapy (particularly, ticagrelor) was associated with decreased NACEs and bleeding without differences in other outcomes and should be considered a favorable option in patients with either ACS or chronic coronary syndrome after PCI with a drug-eluting stent.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"17-28"},"PeriodicalIF":2.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692676","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":"Low Agreement Among Guidelines for Primary Prevention Implantable Cardioverter-Defibrillator Recommendations in Hypertrophic Cardiomyopathy.","authors":"Fernando Luís Scolari, Henrique Iahnke Garbin, Guilherme Dagostin de Carvalho, Fernanda Thomaz Rodrigues, Rodrigo Araujo de Menezes, Edileide de Barros Correia, Marcelo Imbroinise Bittencourt","doi":"10.1016/j.amjcard.2024.11.007","DOIUrl":"10.1016/j.amjcard.2024.11.007","url":null,"abstract":"<p><p>Sudden cardiac death (SCD) risk stratification and primary prevention implantable cardioverter-defibrillator (ICD) recommendations are based on differing strategies for hypertrophic cardiomyopathy (HCM). This study aimed to evaluate the impact of the 2023 European Society of Cardiology (ESC) guidelines on the 2014 ESC and the 2024 American Heart Association (AHA)/American College of Cardiology (ACC) systems in terms of primary prevention ICD recommendations for HCM. A cohort of 200 patients with HCM in Brazil was assessed for SCD risk profile according to current guidelines. The agreement for primary prevention ICD recommendations was evaluated among different strategies. SCD and appropriate shock were defined as the end points. Among the 200 patients, 63 (31%) received a primary prevention ICD, with 10 (15.8%) receiving appropriate shocks. Low agreement was found among the guidelines (Fleiss' kappa 0.340, 95% confidence interval [CI] 0.286 to 0.395, p <0.001). The European systems showed moderate agreement. The 2024 AHA/ACC algorithm placed 58% of patients in class IIa, whereas only 29% achieved this recommendation with the 2023 ESC model. The end points occurred in 8% of patients over 9.4 ± 6.5 years. The 2014 ESC guidelines had the highest accuracy (77%, 95% CI 71 to 83) and negative predictive value (96%, 95% CI 90 to 98) in detecting patients in class IIa with primary end points. However, all guidelines showed a low positive predictive value. The 2024 AHA/ACC guidelines classified the largest proportion of patients (81%) with the primary end point as class IIa. Low agreement was found among guidelines regarding primary prevention ICD recommendations in HCM, particularly between the 2023 ESC and 2024 AHA/ACC systems.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"86-91"},"PeriodicalIF":2.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666835","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":"Time-Point Clinical Outcomes in Patients With Acute Myocardial Infarction: One Step for Personalized Medicine","authors":"Kyung Hoon Cho MD, PhD ,&nbsp;Seok Oh MD, PhD ,&nbsp;Yongwhan Lim MD ,&nbsp;Joon Ho Ahn MD, PhD ,&nbsp;Seung Hun Lee MD, PhD ,&nbsp;Dae Young Hyun MD, PhD ,&nbsp;Min Chul Kim MD, PhD ,&nbsp;Doo Sun Sim MD, PhD ,&nbsp;Young Joon Hong MD, PhD ,&nbsp;Ju Han Kim MD, PhD ,&nbsp;Youngkeun Ahn MD, PhD ,&nbsp;Jang Hoon Lee MD, PhD ,&nbsp;Chang-Whan Yoon MD, PhD ,&nbsp;Sang Rok Lee MD, PhD ,&nbsp;Joo-Yong Hahn MD, PhD ,&nbsp;Jin-Ok Jeong MD, PhD ,&nbsp;Weon Kim MD, PhD ,&nbsp;Jin-Yong Hwang MD, PhD ,&nbsp;Myung Ho Jeong MD, PhD ,&nbsp;Korea Acute Myocardial Infarction Registry (KAMIR)-National Institutes of Health (NIH) Investigators","doi":"10.1016/j.amjcard.2024.11.011","DOIUrl":"10.1016/j.amjcard.2024.11.011","url":null,"abstract":"<div><div>Limited data exist regarding time-point risk stratification models after acute coronary syndrome. This study aimed to investigate time-point mortality rates in patients with acute myocardial infarction, focusing on comparison by type of myocardial infarction, in a real-world cohort. A total of 12,836 patients from a nationwide Korean registry were analyzed. Mortality rates at yearly, monthly, and weekly time points after admission were calculated by dividing the number of deaths during a specific period by the number of patients at risk in the same period for ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) groups. In the first week after admission, patients with STEMI had a significantly higher mortality rate than patients with NSTEMI (4.62% vs 1.79%, p &lt;0.001). However, this trend was inverted since the second week. The higher mortality rate in patients with STEMI versus NSTEMI was inverted since the second week for male patients but only since the tenth week for female patients. Temporal assessment of correlates of mortality revealed that several baseline variables, including Killip class, systolic blood pressure, total cholesterol, and STEMI diagnosis, had significantly different effects on deaths over time. In conclusion, temporal assessment of time-point outcomes from the Korean registry revealed that an initially higher mortality rate in patients with STEMI versus NSTEMI was inverted in the second week. This outcome assessment could be a step toward developing an advanced risk prediction model for time-course personalized medicine. Further studies are needed to clarify this issue.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"236 ","pages":"Pages 64-71"},"PeriodicalIF":2.3,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646713","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}