American Journal of Cardiology最新文献

{"title":"Inflammation and Contrast-Associated Acute Kidney Injury in Patients Undergoing Percutaneous Coronary Intervention","authors":"Mark Shneyderman BS, Johny Nicolas MD, MSc, Samantha Sartori PhD, Angelo Oliva MD, Yihan Feng MS, Birgit Vogel MD, Benjamin Bay MD, Mauro Gitto MD, Francesca Maria Di Muro MD, Raman Sharma MD, Joseph Sweeny MD, Amit Hooda MD, Samin K. Sharma MD, George D. Dangas MD, PhD, Annapoorna S. Kini MD, Roxana Mehran MD","doi":"10.1016/j.amjcard.2025.04.021","DOIUrl":"10.1016/j.amjcard.2025.04.021","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 68-70"},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956263","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":"Usefulness of Digital Smart Care in the Management of Systemic Hypertension","authors":"Nataliya Kasimovskaya PhD,&nbsp;Mariya Krivetskaya MSc,&nbsp;Natalia Geraskina MSc,&nbsp;Nina Ulianova MSc,&nbsp;Ekaterina Chalova MSc,&nbsp;Anastasia Shushpanova MSc","doi":"10.1016/j.amjcard.2025.04.010","DOIUrl":"10.1016/j.amjcard.2025.04.010","url":null,"abstract":"<div><div>The study aims to determine the effectiveness of a digital smart care model for patients with Systemic Hypertension (SH) compared to traditional care methods. Conducted from January 2022 to December 2024 in Moscow, Russia, the study involved 3 medical organizations and 800 participants randomly divided into 2 groups: 1 utilizing the digital smart care model and a control group following traditional care methods. Patients were surveyed using the SF-36 and EQ-5D questionnaires, along with patient satisfaction surveys and physician satisfaction assessments. The study revealed a statistically significant improvement in health indicators for the group using the digital smart care model compared to traditional methods. Specifically, average blood pressure levels decreased by 10% in the digital care model group, while patient satisfaction increased by 15%. These results indicate the effectiveness of the digital smart care model in enhancing the health and satisfaction of patients with SH. In conclusion, this highlights the potential of digital technologies in medical practice to improve care quality and enhance treatment outcomes for patients with SH.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"250 ","pages":"Pages 1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966514","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":"Comparison of Outcomes Between Total Arterial Off-Pump Versus On-Pump Coronary Artery Bypass Surgery: A Meta-Analysis and Meta-Regression","authors":"Maria Comanici MD,&nbsp;Nadia Bithi MBBS,&nbsp;Shahzad Gull Raja FRCS (C-Th)","doi":"10.1016/j.amjcard.2025.04.007","DOIUrl":"10.1016/j.amjcard.2025.04.007","url":null,"abstract":"<div><div>An essential aspect of achieving early optimal outcomes in coronary artery bypass grafting (CABG) is the careful selection of conduits. Total arterial grafting (TAG) has been debated, and recent studies suggest its benefits, especially when combined with off-pump coronary artery bypass grafting (OPCAB). We conducted a systematic review and meta-analysis of studies comparing outcomes of TAG in OPCAB versus on-pump CABG (ONCAB), using data from OVID MEDLINE, EMBASE, SCOPUS, and PUBMED. Seven studies with a total of 5417 patients were included. Short-term outcomes showed no significant differences in perioperative complications between TAG-OPCAB and TAG-ONCAB, but TAG-OPCAB was associated with reduced short-term mortality (OR 0.48, 95% CI [0.26, 0.89], p = 0.02), lower incidence of postoperative low cardiac output, atrial fibrillation, and MACCEs, as well as shorter intubation duration and hospital stay. Meta-regression did not reveal any associations between pre- or intraoperative variables and short-term mortality. In conclusion, TAG-OPCAB demonstrates favorable short-term outcomes and may be considered a safe and effective strategy in selected patients, while long-term outcomes remain inconclusive due to limited data.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 43-50"},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935620","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":"Do Pulmonary Embolism Response Teams for Acute Pulmonary Embolism Improve Outcomes? Insights from a Meta-analysis","authors":"M. Haisum Maqsood MD, MS ,&nbsp;Robert S. Zhang MD ,&nbsp;Kenneth Rosenfeld MD, MSC ,&nbsp;John M. Moriarty MD ,&nbsp;Rachel P. Rosovsky MD, MPH ,&nbsp;James M. Horowitz MD ,&nbsp;Carlos L. Alviar MD ,&nbsp;Sripal Bangalore MD, MHA","doi":"10.1016/j.amjcard.2025.04.017","DOIUrl":"10.1016/j.amjcard.2025.04.017","url":null,"abstract":"<div><div>Pulmonary embolism response teams (PERTs) are being increasingly used for the management of patients admitted with acute pulmonary embolism (PE) and are endorsed by societal guidelines. Whether PERT improves outcomes remains unknown. The objective of this meta-analysis was to compare the outcomes of patients with acute PE treated by a PERT versus no PERT. A systematic review and study level meta-analysis was conducted by searching PubMed and EMBASE databases from inception until November 10, 2024 and included studies evaluating efficacy of PERT vs no PERT in patients admitted for acute PE. Outcomes included all-cause mortality (in-hospital and 30-day mortality), major and clinically relevant bleeding, advanced therapies utilization, length of stay (LOS), and 30-day readmission. Twenty-four retrospective observational studies met the inclusion criteria, comprising 15,809 patients (mean age 61.6 years with 49% male) with acute PE of which 6228 were treated with a PERT and 9,581 without a PERT. Lower all-cause mortality (in-hospital or 30-day mortality) (odds ratio [OR] = 0.72; 95% CI: 0.56 to 0.93; 24 studies), major or clinically relevant bleeding (OR = 0.60; 95% CI: 0.42 to 0.86; 15 studies), higher utilization of advanced therapies (OR = 3.16; 95% CI: 1.81 to 5.49; 19 studies), and lower hospital LOS (MD = −1.49; 95% CI: −2.59 to −0.39; 14 studies) were seen in the patients treated by a PERT compared to those not treated by a PERT. In this large meta-analysis of observational studies comparing outcomes in patients treated by PERT versus not treated by PERT, there were significantly lower short-term mortality, lower major or clinically relevant bleeding, higher utilization of advanced therapies and lower hospital length of stay with the existence of PERT. PERT should be the standard of care for the management of patients with acute PE.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 71-82"},"PeriodicalIF":2.3,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952280","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":"Association of Body Mass Index With Procedural Success and Outcomes in Patients undergoing Transcatheter Aortic Valve Implantation","authors":"Jakob J. Reichl MD ,&nbsp;Adisa Poljo MD ,&nbsp;Thorald Stolte MD ,&nbsp;Ramona Schmitt MD ,&nbsp;Jasper Boeddinghaus MD ,&nbsp;Max Wagener MD ,&nbsp;Gregor Leibundgut MD ,&nbsp;Christoph Kaiser MD ,&nbsp;Dirk Westermann MD ,&nbsp;Tau Hartikainen MD ,&nbsp;Felix Mahfoud MD ,&nbsp;Philipp Ruile MD ,&nbsp;Philipp Breitbart MD ,&nbsp;Thomas Nestelberger MD","doi":"10.1016/j.amjcard.2025.04.012","DOIUrl":"10.1016/j.amjcard.2025.04.012","url":null,"abstract":"<div><div>Obesity is a major public health concern linked to adverse cardiovascular outcomes. Recent studies suggest an obesity paradox, showing lower mortality in obese patients after transcatheter aortic valve implantation (TAVI). This study investigates the impact of body mass index (BMI) on procedural and long-term clinical outcomes in patients undergoing TAVI. Patients undergoing TAVI at two high-volume centers were analyzed and categorized into four BMI groups: underweight (BMI &lt;18.5 kg/m²), normal (BMI 18.5-24.9 kg/m²), overweight (BMI 25.0-29.9 kg/m²), and obese (BMI ≥30.0 kg/m²). To relax the proportional hazards assumption, restricted cubic splines were constructed. The primary outcome was procedural success and safety, including 30-day all-cause-mortality, stroke, and overall bleeding. Secondary outcomes included all-cause mortality at one and five years. In total, 6,156 patients were included: 114 (1.8%) were underweight, 2,393 (38.8%) normal weight, 2,380 (38.6%) overweight, and 1,269 (20.6%) obese. No significant differences between BMI groups were found in 30-day mortality, stroke, or bleeding. However, underweight patients had higher mortality compared to normal-weight patients at one year (23.7 vs 13.2%, p = 0.001) and five years (53.2% vs. 44.0%, p = 0.048). Obese patients had similar mortality to normal-weight patients at one year (11.4 vs 13.2%, p = 0.120) and five years (41.0 vs 44.0%, p = 0.200). Obesity showed no outcome advantage over normal weight, while underweight was an independent predictor of higher all-cause mortality after TAVI. These findings challenge the obesity paradox in the context of TAVI.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"248 ","pages":"Pages 67-72"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906230","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":"Navigating Diagnosis and Management for Takotsubo Syndrome Following Esophageal Cancer Surgery","authors":"Woon Ling Lim MBBS ,&nbsp;Madeleine Goh Yee Hong MBBS ,&nbsp;Yuka Iijima MBBS ,&nbsp;Yan Yan MD ,&nbsp;Xin Zhao MD ,&nbsp;Juying Qian MD ,&nbsp;Junbo Ge MD","doi":"10.1016/j.amjcard.2025.04.015","DOIUrl":"10.1016/j.amjcard.2025.04.015","url":null,"abstract":"<div><div>Takotsubo syndrome (TTS), despite its low incidence, often remains underrecognized or misdiagnosed due to its clinical similarity to acute coronary syndromes and atypical cardiac manifestations in critically ill patients. This applied clinical evidence presents a case of a 72-year-old male patient who developed TTS following esophagectomy. The discussion focuses on the most appropriate diagnostic approach for critically ill patients presenting with chest pain in the intensive care unit (ICU). In addition, it explores the optimal management strategy for TTS in the context of rapid atrial fibrillation and pulmonary complications, emphasizing the importance of timely recognition and targeted intervention.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 5-8"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912018","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":"A Typical ECG Presentation and intracardiac mapping of Bayes Syndrome","authors":"Hao Wang PhD,&nbsp;Yunfei Gu PhD","doi":"10.1016/j.amjcard.2025.04.009","DOIUrl":"10.1016/j.amjcard.2025.04.009","url":null,"abstract":"<div><div>This case report presents a 71-year-old female with paroxysmal atrial fibrillation (PAF) exhibiting typical Bayes syndrome characteristics. We discuss the electrocardiographic features, intracardiac mapping findings, and the clinical implications of this often overlooked condition. This case emphasizes the importance of recognizing interatrial block (IAB) in clinical practice and its potential impact on atrial fibrillation management and stroke risk assessment.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 1-4"},"PeriodicalIF":2.3,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906152","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":"Peripheral Arterial Disease, Procedure Complexity, and Outcomes in Patients Undergoing Percutaneous Coronary Intervention.","authors":"Charles Maynard","doi":"10.1016/j.amjcard.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.04.006","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956448","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 Chronic Total Occlusion PCI in Non-LAD Coronary Arteries on Patients With Cardiomyopathy","authors":"Michael Megaly MD, MS ,&nbsp;Samer Zakhour MD ,&nbsp;Mohamed Maki MD ,&nbsp;Linda Albusoul MD ,&nbsp;Asaad Nakhle MD ,&nbsp;Judit Karacsonyi MD, PhD ,&nbsp;Kambis Mashayekhi MD ,&nbsp;Stephane Rinfret MD, SM ,&nbsp;Emmanouil S. Brilakis MD, PhD ,&nbsp;Khaldoon Alaswad MD","doi":"10.1016/j.amjcard.2025.04.004","DOIUrl":"10.1016/j.amjcard.2025.04.004","url":null,"abstract":"<div><div>To evaluate the impact of left circumflex artery (LCX) or right coronary artery (RCA) chronic total occlusion percutaneous coronary intervention (CTO PCI) on left ventricular ejection fraction (LVEF) in heart failure patients with reduced ejection fraction (HFrEF). The effect of RCA or LCX CTO PCI on HFrEF patients remains understudied. We conducted a retrospective analysis of patients with HFrEF (EF &lt;40%) who underwent LCX or dominant RCA CTO PCI at a high-volume center. The primary outcome was LVEF change, while secondary outcomes included in-hospital and long-term major adverse cardiovascular events (MACE). Subgroup analyses assessed the influence of myocardial viability testing and optimal heart failure therapy (OHFT) on LVEF change. From December 2014 to February 2022, 111 HFrEF patients underwent non-LAD CTO PCI, with a 93.6% technical success rate and 5.4% in-hospital MACE rate. At a median 27.4-month follow-up, LVEF significantly improved by 8.2% (95% CI 5.9% to 10.7%, p &lt;0.001). RCA CTO PCI led to a 9.6% LVEF increase (95% CI 6.7% to 12.6%, p &lt;0.001), while LCX PCI resulted in a 5.6% improvement (95% CI 1.3% to 9.8%, p = 0.011). Preprocedure viability testing (p = 0.310) and postprocedural OHFT (defined as three classes of guideline-directed medical therapy, p = 0.673) were not significantly associated with LVEF changes. Non-LAD CTO PCI significantly improved LVEF (8.2%) in HFrEF patients over 2 years, regardless of preprocedure viability testing or postprocedural medical therapy.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"249 ","pages":"Pages 9-15"},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928906","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":"Ventricular-Coronary Interaction Delay is Associated With Discordance Between Fractional Flow Reserve and Coronary Flow Reserve in Intermediate Coronary Stenoses","authors":"Ahmet Tas MD ,&nbsp;Yaren Alan ,&nbsp;Alp Ozcan MD ,&nbsp;Kim H. Parker PhD ,&nbsp;Tim van de Hoef MD, PhD ,&nbsp;Murat Sezer MD ,&nbsp;Jan J. Piek MD, PhD","doi":"10.1016/j.amjcard.2025.04.003","DOIUrl":"10.1016/j.amjcard.2025.04.003","url":null,"abstract":"<div><div>Recently, the multicenter DEFINE-FLOW and ILIAS registry studies revealed that a preserved coronary flow reserve (CFR) (≥2.0) may justify the deferral of revascularization for lesions with abnormal fractional flow reserve (FFR) (≤0.8). We used wave intensity analysis (WIA) in lesions with concordant and discordant FFR-CFR to elucidate underlying cardiac-coronary coupling dynamics and how these indices relate to the magnitude and timing of the net coronary WI profile. Preserved FFR is primarily associated with earlier coronary flow-accelerating effect of ventricular compression and expansion (peak times of FCW-BEW: tFCW_peak: <em>r</em> = −0.275 p <em>&lt;</em>0.001, tBEW_peak: <em>r</em> = −0.388 p &lt;0.001) while preserved CFR is associated with earlier peaks of backward travelling waves of microvascular origin, which may be decelerating (tBCW_peak <em>r</em>= −0.281 p <em>&lt;</em>0.001) or accelerating (tBEW_peak <em>r</em> = −0.221 p <em>&lt;</em>0.001). Concordant abnormal FFR-CFR lesions exhibited delayed peaks of FCW, BCW and BEW compared to concordant normal lesions (p <em>&lt;</em>0.001), whereas discordant FFR-CFR lesions had preserved tBEW_peak despite dyssynchrony of systolic WI peaks (relative FCW-BCW peak times: tFCW_peak: 48% ± 22% vs 34% ± 18% p <em>&lt;</em>0.001, tBCW_peak:38% ± 26% vs 51% ± 33% ± of compression period p <em>&lt;</em>0.001). A resting BEW peak within the first 13% of the ventricular expansion phase had a 87% negative predictive value for concordant abnormal FFR-CFR lesions. In conclusion, discordantly abnormal FFR or CFR are associated with dyssynchrony of ventricular-coronary interactions revealed by WIA. The relative time to peak microvascular suction effect, which is responsible for diastolic filling, is preserved in discordant lesions. This is marked by reference level tBEW_peak,similar to that of lesions with concordant normal FFR and CFR, that may explain the good prognosis of discordant lesions without revascularization. In contrast, the concordantly abnormal FFR-CFR group exhibits a substantial delay of tBEW_peak, which may serve as a potential unified marker for lesions that would benefit from revascularization.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"248 ","pages":"Pages 80-88"},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927912","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}