American Journal of Cardiology最新文献

{"title":"Treatment of Additional Vessels During Percutaneous Coronary Intervention for Unprotected Left Main Disease: Insights From a Large Prospective Registry","authors":"Sean Gilhooley MD,&nbsp;David Power MD,&nbsp;Anastasios Roumeliotis MD,&nbsp;Richard Tanner MD,&nbsp;Anton Camaj MD,&nbsp;Samantha Sartori PhD,&nbsp;Kenneth Smith MPH,&nbsp;Johny Nicolas MD,&nbsp;Rakhee R. Makhija MD,&nbsp;Pier Pasquale Leone MD,&nbsp;Keisuke Yasumura MD,&nbsp;Manish Vinayak MD,&nbsp;Amit Hooda MD,&nbsp;Parasuram Melarcode Krishnamoorthy MD,&nbsp;Serdar Farhan MD,&nbsp;Joseph Michael Sweeny MD,&nbsp;George D. Dangas MD, PhD,&nbsp;Roxana Mehran MD,&nbsp;Annapoorna S. Kini MD,&nbsp;Samin K. Sharma MD","doi":"10.1016/j.amjcard.2025.02.014","DOIUrl":"10.1016/j.amjcard.2025.02.014","url":null,"abstract":"<div><div>Percutaneous coronary intervention (PCI) is an established alternative to coronary artery bypass grafting for the treatment of select patients with unprotected left main (LM) coronary artery disease (CAD). This study evaluates the safety and clinical impact of treating additional coronary arteries during LM-PCI. Consecutive patients undergoing PCI with drug-eluting stents for unprotected LM-CAD between 2010 and 2021 at The Mount Sinai Hospital, New York, USA were eligible for inclusion. Patients were stratified based on whether they underwent treatment of the LM complex alone or had concomitant PCI to an additional vessel outside the LM complex. The primary outcome was major adverse cardiovascular events (MACE), a composite of death, myocardial infarction, or stroke, at 1 year following PCI. Among 869 consecutive patients (mean age 70.9, 33.0% female, 27.9 mean SYNTAX score) undergoing LM-PCI, 479 (55.1%) underwent treatment of the LM complex alone, and 390 (44.9%) had concomitant PCI of an additional non-LM vessel. Compared with LM complex PCI only, there were no significant differences in the rate of MACE at 1 year [HR 12.0% vs 13.3%; HR: 0.95; 95% CI (0.62–1.44), p = 0.797], even after adjustment for potential confounders [HR 12.0% vs 13.3%; HR: 0.87; 95% CI (0.56–1.36), p = 0.550]. In conclusion, in a large, real-world cohort of patients undergoing unprotected LM-PCI, treatment of an additional non-LM vessel did not increase the risk of MACE at 1 year compared to LM complex PCI alone.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 65-72"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466765","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":"Reply to the Comments on “Cardiovascular Prognosis in Limb Ischemia Patients with Heart Failure and Systolic Dysfunction Following Major Amputation”","authors":"Takuma Takada MD, PhD ,&nbsp;Makoto Kishihara MD ,&nbsp;Kentaro Jujo MD, PhD","doi":"10.1016/j.amjcard.2025.02.013","DOIUrl":"10.1016/j.amjcard.2025.02.013","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"245 ","pages":"Page 87"},"PeriodicalIF":2.3,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466763","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":"Aortic Valve Stenosis: Severe or Not, That is the Question!","authors":"Svend Aakhus, Brage Høyem Amundsen","doi":"10.1016/j.amjcard.2025.02.009","DOIUrl":"10.1016/j.amjcard.2025.02.009","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424858","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":"Survival After Endocarditis Surgery Needing Venoarterial Extracorporeal Membrane Oxygenation Support: Results from the Netherlands Heart Registration","authors":"Floris J. Heinen MD ,&nbsp;Sakir Akin MD, PhD ,&nbsp;Floris S. van den Brink MD, PhD ,&nbsp;Khalil Ayan MD ,&nbsp;Henning Hermanns MD, PhD ,&nbsp;Michelle D. van der Stoel MSc ,&nbsp;Marco C. Post MD, PhD ,&nbsp;Robert J.M. Klautz MD, PhD ,&nbsp;Wilco Tanis MD, PhD ,&nbsp;Cardiothoracic Surgery Registration Committee of the Netherlands Heart Registration","doi":"10.1016/j.amjcard.2025.02.005","DOIUrl":"10.1016/j.amjcard.2025.02.005","url":null,"abstract":"<div><div>The incidence of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support after cardiac surgery ranges from 0.4% to 3.7%, with in-hospital mortality rates reported at 60%. While the incidence of VA-ECMO after endocarditis (IE) surgery is unknown, these patients may face an even greater mortality risk due to additional IE-related complications. The primary objective of this study is to investigate the incidence and mortality rates of postoperative VA-ECMO following endocarditis surgery. The secondary objective is to compare clinical outcomes and to identify factors associated with in-hospital mortality in patients requiring and not requiring VA-ECMO support. Data were retrieved from the Netherlands Heart Registration. Of 3,468 IE surgeries performed between 2013 and 2022, 49 patients (1.4%) received postoperative VA-ECMO. The in-hospital mortality rate was 49% and the 1-year mortality rate was 60.9%. As expected, this was significantly higher compared to patients not requiring VA-ECMO support (49.0% vs 9.8% and 60.9% vs 15.2% respectively; p &lt;0.001). At baseline, VA-ECMO patients had statistically higher rates of previous valve surgery, peripheral vascular disease and pulmonary hypertension, as well as lower renal and left ventricular functions compared to than patients not requiring VA-ECMO support. In addition, VA-ECMO patients more frequently underwent emergency surgeries and required aortic root surgery and coronary artery bypass grafting more often. While several comorbidities were associated with in-hospital mortality in patients not requiring VA-ECMO, no such associations were observed in VA-ECMO patients. In conclusion, while the incidence of VA-ECMO support after IE surgery is low, it comes with high mortality rates. However, mortality rates do not seem to differ from those reported for non-IE postcardiotomy VA-ECMO patients in current literature, and mortality after VA-ECMO support remains difficult to predict. Based on our data, postcardiotomy VA-ECMO should not be withheld from IE patients because of high-anticipated mortality risk.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 45-49"},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424878","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}

{"title":"Extensive Pericardial Metastasis of Angiosarcoma: Diagnostic Challenge in a Young Case With Effusive Constrictive Pericarditis","authors":"Tatsunori Takahashi MD ,&nbsp;Debbie Lin Teodorescu MD ,&nbsp;Wyleen Kniola MD ,&nbsp;Daniel Luthringer MD ,&nbsp;Siddharth Singh MD","doi":"10.1016/j.amjcard.2025.02.008","DOIUrl":"10.1016/j.amjcard.2025.02.008","url":null,"abstract":"<div><div>A 32-year-old healthy man developed a small pericardial effusion following a motor vehicle accident, which progressed to cardiac tamponade and bilateral pleural effusions over 2 months. Pericardiocentesis drained 1.5 L of hemorrhagic, lymphocyte-predominant exudative fluid, leading to symptomatic improvement and close outpatient follow-up for suspected postcardiac injury syndrome. However, he was readmitted 1.5 months later with recurrent effusions, mediastinal lymphadenopathy, and enlarging hepatic lesions, but without elevated inflammatory markers. Extensive analyses of various fluids, including expert-reviewed cytology and immunostaining, were inconclusive. Despite conservative management, worsening respiratory failure and persistent high chest tube output necessitated venovenous extracorporeal membrane oxygenation. Suspected constrictive pericarditis on transthoracic echocardiography led to the patient's transfer to our quaternary-care hospital for evaluation for pericardiectomy. However, pericardiectomy was deferred due to his unstable respiratory status. Despite intensive care, he eventually died of multiorgan failure 7 months after his initial presentation. Autopsy revealed high-grade hepatic angiosarcoma metastatic to lungs and pericardium with diffuse invasion into the myocardium. This case highlights the importance of cautious interpretation of negative cytology results in patients with recurrent hemorrhagic pericardial effusion, especially without elevated inflammatory markers. When clinical exclusion of pericardial malignancy is challenging, early multidisciplinary consideration of pericardial biopsy may be considered to enhance the diagnostic yield and guide management.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 40-44"},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424863","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 Fellowship-Trained, Board-Certified Adult Congenital Heart Disease Interventionalist: Time to Reach for the Stars","authors":"Georges Ephrem MD, MSc","doi":"10.1016/j.amjcard.2025.02.006","DOIUrl":"10.1016/j.amjcard.2025.02.006","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 32-33"},"PeriodicalIF":2.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405382","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 Venous Pressure-Guided Decongestion: A New Approach Yet to Prove Beneficial.","authors":"Timir K Paul","doi":"10.1016/j.amjcard.2025.02.003","DOIUrl":"10.1016/j.amjcard.2025.02.003","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389655","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 of Arrhythmogenic Cardiomyopathy in a Young Patient With Recurrent Myocarditis: The Importance of Genetic Testing”","authors":"Juana Perez Morales ,&nbsp;Ana Spaccavento ,&nbsp;Marianna Guerchicoff ,&nbsp;Lucrecia Burgos ,&nbsp;Juan Pablo Costabel ,&nbsp;Eugenio Cingolani ,&nbsp;Alberto Alves de Lima","doi":"10.1016/j.amjcard.2025.01.034","DOIUrl":"10.1016/j.amjcard.2025.01.034","url":null,"abstract":"<div><div>Genetic testing for cardiomyopathies has become a pivotal tool in diagnosing conditions with diverse and often overlapping clinical presentations. Arrhythmogenic cardiomyopathy (ACM), which affects approximately 1 in 5000 individuals, is a life-threatening condition associated with life-threatening arrhythmias and sudden cardiac death (SCD). While ACM typically presents with right- or left-sided heart failure, ventricular arrhythmias, or SCD, it can also manifest as acute or recurrent myocarditis. These inflammatory episodes, known as the \"hot phase\" of ACM, are less common but highly relevant in certain clinical contexts. We present the case of a 20-year-old male with recurrent episodes of acute myocarditis, confirmed by evidence of myocardial inflammation on cardiac magnetic resonance imaging (cMRI). Genetic testing revealed a pathogenic mutation in the desmoplakin (DSP) gene associated with ACM, raising the suspicion that the recurrent myocarditis episodes represent a \"hot phase\" of this inherited condition. In conclusion, this case underscores the importance of considering ACM in patients with recurrent myocarditis and highlights the role of genetic testing in uncovering underlying etiologies.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"242 ","pages":"Pages 37-40"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389654","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":"Biomarkers in Chronic Total Occlusions: Guiding Risk, Not Yet Decisions?","authors":"Hannah I Chaudry, Ian C Gilchrist","doi":"10.1016/j.amjcard.2025.01.022","DOIUrl":"https://doi.org/10.1016/j.amjcard.2025.01.022","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373713","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":"Myocardial Revascularization in Patients With 3 Vessel Coronary Artery Disease and Chronic Kidney Disease: Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention","authors":"Nicholas Fialka MD ,&nbsp;Ryaan EL-Andari MD ,&nbsp;Jimmy Kang MD ,&nbsp;Yongzhe Hong MD, PhD ,&nbsp;Finlay A. McAlister MD, MSc ,&nbsp;Jayan Nagendran MD, PhD ,&nbsp;Jeevan Nagendran MD, PhD","doi":"10.1016/j.amjcard.2025.02.004","DOIUrl":"10.1016/j.amjcard.2025.02.004","url":null,"abstract":"<div><div>Coronary artery disease (CAD) and chronic kidney disease (CKD) commonly co-exist. Superior outcomes with coronary artery bypass grafting(CABG) compared to percutaneous coronary intervention (PCI) have been identified in patients with 3 vessel CAD (TVD) and CKD but have been limited to mid-term follow-up. Herein, we analyzed the long-term outcomes of patients with TVD and CKD undergoing surgical versus percutaneous revascularization. 1,599 patients with CKD and TVD without STEMI or previous revascularization underwent coronary angiography between 2009 and 2018. The primary outcome was all-cause mortality. Secondary outcomes included rates of readmission for myocardial infarction (MI), stroke, repeat revascularization, and overall rehospitalization. 453 patients were included in the final analysis (PCI 373; CABG 80; median follow-up 9.3 years). All results are presented as CABG versus PCI. The rate of all-cause mortality at the longest follow-up (14.1 years) was significantly lower in patients who underwent CABG (68.9% vs 83.1%, p = 0.039, adjusted Hazard Ratio (aHR) 0.68, 95% confidence interval (CI) 0.47–0.98). Readmission rates for MI (10.2% vs. 28.4%, p = 0.009, aHR 0.37, 95% CI 0.17–0.77) and repeat revascularization (3.1% vs. 24.4%, p &lt; 0.001, aHR 0.09, 95% CI 0.02–0.34) were also lower after CABG than after PCI. No significant difference was observed in the rates of readmission for stroke or all causes. In conclusion, in this retrospective single-center study, we confirmed that the previously described advantages of CABG over PCI in patients with CKD and TVD persist with extended long-term follow-up. CABG should be considered the gold standard approach to revascularization in this patient population.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"243 ","pages":"Pages 8-14"},"PeriodicalIF":2.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381556","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}