American Journal of Cardiology最新文献_第7页

Increasing Rate of Unfilled Training Positions in the Advanced Heart Failure and Transplant Cardiology Match 晚期心力衰竭和移植心脏病学匹配培训岗位空缺率的增加。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-02 DOI: 10.1016/j.amjcard.2025.08.047

Jason Silvestre MD , Ahmed Brgdar MD , Jay Chen MD , Thomas G Di Salvo MD

{"title":"Increasing Rate of Unfilled Training Positions in the Advanced Heart Failure and Transplant Cardiology Match","authors":"Jason Silvestre MD , Ahmed Brgdar MD , Jay Chen MD , Thomas G Di Salvo MD","doi":"10.1016/j.amjcard.2025.08.047","DOIUrl":"10.1016/j.amjcard.2025.08.047","url":null,"abstract":"<div><div>Advanced Heart Failure and Transplant Cardiology (AHFTC) is a vital subspecialty addressing the growing burden of heart failure and the increasing need for advanced therapies such as mechanical circulatory support and heart transplantation. Despite rising clinical demand, interest in AHFTC fellowship training appears to be declining. This study evaluated trends in applicants, training positions, match rates, and unfilled positions in the AHFTC match from 2020 to 2025. We performed a national, cross-sectional analysis of all AHFTC fellowship applicants during this period. Primary outcomes included the annual number of applicants and training positions, match rates, and the percentage of unfilled positions. Temporal trends were analyzed using linear regression. Between 2020 and 2025, 470 applicants competed for 737 training positions, resulting in an overall fill rate of 58%. Matched fellows included 52% US allopathic and 48% non-US allopathic graduates. The number of training positions per year increased by 10% (115 to 127) while the number of applicants per year decreased by 24% (84 to 64). The applicant-to-position ratio decreased significantly from 0.7 to 0.5 (p < 0.001), and unfilled positions rose from 30% to 52% (p < 0.001). The proportion of applicants matching at their first-choice program increased from 67% to 83% (p < 0.001). These findings highlight a growing mismatch between AHFTC training capacity and applicant interest. To preserve the future workforce needed to address the rising burden of heart failure, efforts are needed to stimulate interest in AHFTC training.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 69-75"},"PeriodicalIF":2.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999459","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

Representation of Heart Failure Patients According to Age, Sex, and Race in US-Based Exercise Trials: A Systematic Review with Meta-Analysis of Randomized Trials 美国运动试验中心衰患者的年龄、性别和种族：随机试验荟萃分析的系统综述

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-02 DOI: 10.1016/j.amjcard.2025.08.060

George A. Kelley DA, FACSM , Kristi S. Kelley MEd , Brian L. Stauffer MD, FACC

引用次数: 0

Angiotensin Receptor-Neprilysin Inhibitors and Mortality Among Patients With HFrEF. 血管紧张素受体-奈普利素抑制剂与HFrEF患者的死亡率。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-02 DOI: 10.1016/j.amjcard.2025.08.063

Henrik Svanström, George Frederick Mkoma, Anders Hviid, Björn Pasternak

{"title":"Angiotensin Receptor-Neprilysin Inhibitors and Mortality Among Patients With HFrEF.","authors":"Henrik Svanström, George Frederick Mkoma, Anders Hviid, Björn Pasternak","doi":"10.1016/j.amjcard.2025.08.063","DOIUrl":"10.1016/j.amjcard.2025.08.063","url":null,"abstract":"<p><p>While trial evidence supports the benefit of angiotensin receptor-neprilysin inhibitor (ARNI) therapy in heart failure with reduced ejection fraction (HFrEF), its effectiveness in routine clinical practice is less explored. This study investigated the relative and absolute effectiveness of ARNI in patients with HFrEF. This nationwide Danish database study included patients with left ventricular ejection fraction (LVEF) ≤40%, 2018 to 2023. Using a prevalent new user design, 2,446 ARNI initiators were matched 1:2 to 4,892 users of angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) based on propensity scores, age, LVEF, and NT-proBNP. The primary outcome was all-cause mortality; secondary outcomes were cardiovascular mortality and hospitalization. There were 279 deaths among ARNI initiators (5.6/100 person-years) and 533 among ACE-I/ARB users (6.7/100 person-years), yielding a hazard ratio (HR) of 0.85 (95% CI, 0.74 to 0.98) for all-cause mortality. A significant interaction was observed for recent hospitalization (p = 0.04), with ARNI yielding a lower HR in this group. HRs were otherwise consistent across age, sex, LVEF, NT-proBNP, NYHA class, ischemic heart disease, chronic kidney disease, and type 2 diabetes. The largest absolute mortality reductions were seen in subgroups with recent hospitalization, NYHA class III to IV, and severely elevated NT-proBNP. ARNI was also associated with a lower risk of cardiovascular death (HR, 0.81; 95% CI, 0.65 to 0.99), but not with other secondary outcomes. In this study, ARNI was associated with a 15% reduction in all-cause mortality vs ACE-I/ARB. Patients with advanced or symptomatic heart failure appeared to experience the greatest absolute benefit.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999441","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

Comparative 3-Year Outcomes of Transcatheter Aortic Valve Replacement in Failed Transcatheter Versus Surgical Valves 经导管主动脉瓣置换术失败与手术瓣膜置换术3年疗效的比较。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-02 DOI: 10.1016/j.amjcard.2025.08.052

Akiva Rosenzveig MD, Shivabalan Kathavarayan Ramu MBBS, Ankit Agrawal MD, Osamah Badwan MD, Faysal Massad MD, Grant Reed MD, MSc, Rishi Puri MD, PhD, Amar Krishnaswamy MD, Samir Kapadia MD

引用次数: 0

Identifying Pathogenesis of Acute Coronary Syndromes using Sequence Contrastive Learning in Coronary Angiography 利用冠状动脉造影序列对比学习识别急性冠状动脉综合征的发病机制。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-01 DOI: 10.1016/j.amjcard.2025.08.051

Xiaozhi Ma , Yusaku Shibata MD, PhD , Osamu Kurihara MD, PhD , Nobuaki Kobayashi MD, PhD , Masamichi Takano MD, PhD , Toru Kurihara PhD

{"title":"Identifying Pathogenesis of Acute Coronary Syndromes using Sequence Contrastive Learning in Coronary Angiography","authors":"Xiaozhi Ma , Yusaku Shibata MD, PhD , Osamu Kurihara MD, PhD , Nobuaki Kobayashi MD, PhD , Masamichi Takano MD, PhD , Toru Kurihara PhD","doi":"10.1016/j.amjcard.2025.08.051","DOIUrl":"10.1016/j.amjcard.2025.08.051","url":null,"abstract":"<div><div>Advances in intracoronary imaging have made it possible to distinguish different pathological mechanisms underlying acute coronary syndrome (ACS) in vivo. Accurate identification of these mechanisms is increasingly recognized as essential for enabling tailored therapeutic strategies. ACS pathogenesis is primarily classified into 2 major types: plaque rupture (PR) and plaque erosion (PE). Patients with PR are treated with intracoronary stenting, whereas those with PE may be potentially managed conservatively without stenting. The aim of this study is to develop neural networks capable of distinguishing PR from PE solely using coronary angiography (CAG). A total of 842 videos from 278 ACS patients (PR:172, PE:106) were included. To ensure the reliability of the ground truth for PR/PE classification, the ACS pathogenesis for each patient was confirmed using Optical Coherence Tomography (OCT). To enhance the learning of discriminative features across consecutive frames and improve PR/PE classification performance, we propose Sequence Contrastive Learning (SeqCon), which addresses the limitations inherent in conventional contrastive learning approaches. In the experiments, the external test set consisted of 18 PR patients (46 videos) and 11 PE patients (30 videos). SeqCon achieved an accuracy of 82.8%, sensitivity of 88.9%, specificity of 72.3%, positive predictive value of 84.2%, and negative predictive value of 80.0% at the patient-level. This is the first report to use contrastive learning for diagnosing the underlying mechanism of ACS by CAG. We demonstrated that it can be feasible to distinguish between PR and PE without intracoronary imaging modalities.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 89-99"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991113","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

One-Year Outcomes in PAD Patients With Elevated Lipoprotein(a): A Propensity-Matched Analysis 脂蛋白升高的PAD患者1年预后(a)：倾向匹配分析

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-01 DOI: 10.1016/j.amjcard.2025.08.045

Osman Yousafzai MD , Kainat Kanwal MD , Frank Annie PhD , Sarah Rinehart MD

{"title":"One-Year Outcomes in PAD Patients With Elevated Lipoprotein(a): A Propensity-Matched Analysis","authors":"Osman Yousafzai MD , Kainat Kanwal MD , Frank Annie PhD , Sarah Rinehart MD","doi":"10.1016/j.amjcard.2025.08.045","DOIUrl":"10.1016/j.amjcard.2025.08.045","url":null,"abstract":"<div><div>Lipoprotein(a) (Lp(a)) is a genetically determined, proatherogenic lipoprotein linked to increased cardiovascular risk. Although elevated Lp(a) levels have been implicated in peripheral artery disease (PAD) development, their prognostic significance in patients with established PAD remains unclear. To evaluate whether elevated Lp(a) independently predicts short-term cardiovascular and limb outcomes in patients with established PAD. Using the TriNetX Research Network, we conducted a retrospective cohort study of adults with PAD between January 1, 2010, and January 1, 2025. Patients with Lp(a) measurements were stratified by Lp(a) levels (≥50 mg/dL vs <50 mg/dL). A 1:1 propensity score matching (PSM) controlled for demographics and cardiovascular comorbidities. Primary outcomes included 1-year rates of myocardial infarction, stroke, major adverse cardiovascular events (MACE), all-cause mortality, and major adverse limb events (MALE). Among 1,790,984 PAD patients, 3,397 (0.2%) had elevated Lp(a). After PSM, 2 balanced cohorts of 3,397 patients were analyzed. In the unmatched cohort, elevated Lp(a) was associated with higher rates of myocardial infarction, stroke, and MACE, but paradoxically lower all-cause mortality and major adverse limb events (MALE). However, in the matched cohort, these differences were no longer statistically significant, suggesting the initial findings were likely driven by baseline differences and confounding. In patients with established PAD, elevated Lp(a) was not independently associated with increased short-term cardiovascular or limb events after accounting for comorbidities. These findings suggest that Lp(a)’s prognostic value may be limited in secondary prevention settings but could remain relevant for primary prevention and risk stratification. Further prospective studies are needed to assess the utility of Lp(a)-lowering therapies in PAD populations.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"258 ","pages":"Pages 24-26"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991092","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

Erratum to 'Lipid Management in United States Commercial and Medicare Enrollees With Atherosclerotic Cardiovascular Disease: Treatment Patterns and Low-Density Lipoprotein Cholesterol Control' [The American Journal of Cardiology 242 (2025) 1-9]. 对“美国商业和医疗保险登记的动脉粥样硬化性心血管疾病患者的脂质管理：治疗模式和低密度脂蛋白胆固醇控制”的勘误[美国心脏病学杂志242(2025)1-9]。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-01 Epub Date: 2025-05-17 DOI: 10.1016/j.amjcard.2025.05.010

Ann Marie Navar, Batul Electricwala, Jasjit K Multani, Zifan Zhou, Chi-Chang Chen, Barnabie C Agatep, Allison A Petrilla, Taylor T Schwartz, Laetitia N'dri, Joaquim Cristino, Fatima Rodriguez

引用次数: 0

Unmasking Nonresponders: Right Ventricular Function as the Missing Link in Transcatheter Mitral Valve Repair Outcomes. 揭示无应答者：右心室功能是经导管二尖瓣修复结果的缺失环节。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-01 Epub Date: 2025-04-25 DOI: 10.1016/j.amjcard.2025.04.019

Rahul Chaudhary, George Chalhoub, Matthew E Harinstein

引用次数: 0

Peripheral Arterial Disease, Procedure Complexity, and Outcomes in Patients Undergoing Percutaneous Coronary Intervention. 外周动脉疾病、手术复杂性和经皮冠状动脉介入治疗患者的预后。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-01 Epub Date: 2025-04-14 DOI: 10.1016/j.amjcard.2025.04.006

Charles Maynard

引用次数: 0

Percutaneous Coronary Intervention for Acute Coronary Syndrome in Young Adults on Dialysis: Insights From Houston Methodist Young ACS-PCI Registry. 经皮冠状动脉介入治疗透析患者急性冠状动脉综合征：来自休斯顿卫理公会青年ACS-PCI登记的见解。

IF 2.1 3区医学

American Journal of Cardiology Pub Date : 2025-09-01 DOI: 10.1016/j.amjcard.2025.08.044

Chloe Kharsa, Taha Hatab, Rody Bou Chaaya, Fatima Qamar, Sahar Samimi, Safi U Khan, Syed Zaid, Joe Aoun, Sachin S Goel, Neal S Kleiman, Alpesh R Shah

{"title":"Percutaneous Coronary Intervention for Acute Coronary Syndrome in Young Adults on Dialysis: Insights From Houston Methodist Young ACS-PCI Registry.","authors":"Chloe Kharsa, Taha Hatab, Rody Bou Chaaya, Fatima Qamar, Sahar Samimi, Safi U Khan, Syed Zaid, Joe Aoun, Sachin S Goel, Neal S Kleiman, Alpesh R Shah","doi":"10.1016/j.amjcard.2025.08.044","DOIUrl":"10.1016/j.amjcard.2025.08.044","url":null,"abstract":"<p><p>AMI and coronary intervention in patients undergoing dialysis are associated with poor survival outcomes. Despite a downward trend in the overall incidence of MI, the incidence among young adults is on the rise. This is a retrospective study including patients from the Houston Methodist Young ACS-PCI registry. The cohort incorporates patients ≤50 years old experiencing type 1 MI and undergoing PCI between 2010 and 2022. The primary endpoint was 1-year major adverse cardiovascular events (MACE) (all-cause mortality, MI, and ischemic stroke). Secondary endpoints included components of MACE and repeat revascularization. Of 628 young adults undergoing PCI for ACS (median age 45 years, 23.6% women), 10.4% were on dialysis. Patients receiving dialysis were more often women (49.2% vs 20.6%, p < 0.001), Black (32.3% vs 16.5%, p = 0.009), and had more frequent cardiovascular risk factors. There was no difference in terms of ACS presentation. Angiographic characteristics were similar, but femoral access was more common in the dialysis group (98.5% vs 83.7%, p = 0.006). Patients on dialysis had longer hospital stays (4 vs 2 days; p < 0.001), major bleeding (10.8% vs 2.3%; p = 0.001) and higher 1-year MACE (26.2% vs 9.8%; p < 0.001), 1-year all-cause mortality (13.9% vs 3.4%; p < 0.001), and recurrent MI (13.9% vs 6.4%, p = 0.02). The risk of MACE (HR 2.7, 95% CI: 1.5-4.7) and long-term mortality (HR 4.9, 95% CI: 2.6-9.0) were higher among patients receiving dialysis. In conclusion, young adults on dialysis who undergo PCI for ACS face significantly higher comorbidity burden, bleeding risk, and long-term adverse outcomes, including increased MACE and mortality. Careful consideration is essential in this high-risk group and preventive measures should be undertaken to improve outcomes in this high-risk population.</p>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":"119-127"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991163","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