American Journal of Cardiology最新文献

{"title":"Comment on “Road Exposure After Cardioverter-Defibrillator Implantation and Its Potential Influence on Reported Motor Vehicle Crash Risks”","authors":"Bhumesh Tyagi MD, Leelabati Toppo MD, Aishwarya Biradar MD","doi":"10.1016/j.amjcard.2025.12.004","DOIUrl":"10.1016/j.amjcard.2025.12.004","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"261 ","pages":"Pages 31-32"},"PeriodicalIF":2.1,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846378","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":"Revascularization in Patients Over 75 With Acute Coronary Syndrome","authors":"Samantha Pozo Navarro BS ,&nbsp;Kendall Hammonds MPH ,&nbsp;Timothy Mixon MD ,&nbsp;Srini Potluri MD ,&nbsp;Karim Al-Azizi MD ,&nbsp;Molly I. Szerlip MD ,&nbsp;J. Michael DiMaio MD ,&nbsp;R. Jay Widmer MD, PhD","doi":"10.1016/j.amjcard.2025.11.014","DOIUrl":"10.1016/j.amjcard.2025.11.014","url":null,"abstract":"<div><div>Observational data have demonstrated that patients presenting with acute coronary syndromes (ACS) and multivessel coronary artery disease (MV-CAD) experience improved 1-year outcomes including lower rates of death, rehospitalization, and repeat ACS when treated with coronary artery bypass graft (CABG) compared with percutaneous coronary intervention (PCI) and medical management (MM). However, limited data exists that studies these practices in adults over the age of 75. This retrospective, multi-centered, observational study from 2018 to 2022 from a healthcare center in Texas compared outcomes among patients with ACS and MV-CAD, stratified by revascularization strategy and age group (&lt;75 vs ≥75 years). The primary endpoint was 1 year mortality, and secondary endpoints include readmission or myocardial infarction (MI) within 1 year, index length of stay, and repeat revascularization within 30 days and 1 year. Cox proportional hazards modeling was used to evaluate the effect of age on mortality outcomes. A total of 2161 patients met inclusion criteria (<em>n</em> = 1559 CABG, <em>n</em> = 295 PCI, and <em>n</em> = 307 MM). There were 1547 patients under the age of 75 (median age 63.82, IQR = 57.24, 69.44) and 614 over the age of 75 (median age 80.43, IQR = 77.62-84.58). Patients who underwent CABG had significantly reduced mortality compared with PCI or MM (RR = 0.324, CI 0.172 to 0.612, p &lt;0.0001). In conclusion, CABG was associated with improved and comparable outcomes in patients with ACS and MV-CAD both under and over 75 years of age compared with PCI and MM.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"261 ","pages":"Pages 18-22"},"PeriodicalIF":2.1,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754975","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":"Refining Risk Stratification in Ventricular Arrhythmias: The Expanding Role of Cardiac MRI","authors":"Haojie Wang MD, PhD","doi":"10.1016/j.amjcard.2025.10.020","DOIUrl":"10.1016/j.amjcard.2025.10.020","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"261 ","pages":"Pages 61-62"},"PeriodicalIF":2.1,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421043","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 Rapid Drug-Induced Granulomatous Dermatitis to Amlodipine","authors":"Chirag Vasavda MD, PhD ,&nbsp;Beatrix B. Thompson BA ,&nbsp;Steven R. Tahan MD ,&nbsp;Christopher Iriarte MD","doi":"10.1016/j.amjcard.2025.11.028","DOIUrl":"10.1016/j.amjcard.2025.11.028","url":null,"abstract":"<div><div>A 65-year-old man with a history of coronary artery disease, myocardial infarction, hypertension, hypereosinophilic syndrome, and chronic hepatitis B presented with a pruritic, generalized rash 3 weeks after initiating amlodipine for refractory hypertension. Physical examination demonstrated widespread indurated pink-red papules coalescing into plaques over the trunk, extremities, face, and scalp. Laboratory evaluation, including complete blood count, metabolic panel, and peripheral flow cytometry, was unremarkable. A skin biopsy revealed vacuolar interface change with a perivascular lymphocytic and granulomatous infiltrate containing eosinophils, consistent with an interstitial granulomatous drug reaction (IGDR). Amlodipine was discontinued and he was initiated on high-dose systemic and high-potency topical corticosteroids. Within 1 week, he experienced significant improvement in pruritus and had not developed any new lesions. Prednisone was successfully tapered without recrudescence of his rash. IGDR is an uncommon hypersensitivity reaction that is most associated with broadly prescribed cardiovascular medications such as calcium channel blockers (CCB) and statins. IGDR rests along a spectrum of reactive granulomatous dermatitides that are triggered by medications, autoimmune diseases, malignancies, or other underlying conditions. Recognition of IGDR by history, exam, and pathology is important for cardiologists and other prescribing clinicians, as its clinical presentation differs from more common drug exanthems as it can develop weeks to months after starting a CCB and can persist long after it is withdrawn. This case underscores the importance of maintaining vigilance for drug eruptions in patients presenting with new rashes while on antihypertensive therapy.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"261 ","pages":"Pages 23-26"},"PeriodicalIF":2.1,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888623","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":"Advancing Management of Patients With Lower Extremity Peripheral Artery Disease: A Focused Review and Our Institution’s Approach to Postendovascular Intervention Care","authors":"Rabih Tabet MD ,&nbsp;Iliana S. Hurtado Rendon MD ,&nbsp;Golsa Joodi MD ,&nbsp;Jose Eduardo Costa Filho MD ,&nbsp;Gaelle Romain PhD ,&nbsp;Christiany Tapia MD ,&nbsp;Kim G. Smolderen PhD ,&nbsp;Carlos Mena-Hurtado MD","doi":"10.1016/j.amjcard.2025.11.022","DOIUrl":"10.1016/j.amjcard.2025.11.022","url":null,"abstract":"<div><div>Peripheral artery disease (PAD) remains one of the leading causes of atherosclerotic cardiovascular diseases affecting millions of people worldwide. Clinical presentation ranges from asymptomatic disease to chronic limb-threatening ischemia, and patients are not only at a higher risk of amputation and limb loss but also at increased risk of cardiovascular events and mortality. Nowadays, many physicians from various specialties are involved in the care of patients with PAD and provide a wide range of vascular interventions and procedures, but to date, there is still a huge discrepancy as to how these patients are managed and followed up after their interventions. This review aims to provide a comprehensive road map for physicians to help them administer a more standardized care covering all aspects of management of patients with PAD in the postintervention phase based on our institution’s best-practice approach.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"261 ","pages":"Pages 50-58"},"PeriodicalIF":2.1,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846431","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":"Balloon Postdilation After Transcatheter Aortic Valve Implantation (TAVI) Among Self- and Balloon-Expandable Valves: A Systematic Review and Meta-Analysis","authors":"Mohammad Cheikh-Ibrahim MD ,&nbsp;Vinicius Bittar de Pontes ,&nbsp;Nawar Alachkar MD ,&nbsp;Sebastian Jaramillo ,&nbsp;Ines Martins Esteves MSc ,&nbsp;Alexander Lauten MD","doi":"10.1016/j.amjcard.2025.11.012","DOIUrl":"10.1016/j.amjcard.2025.11.012","url":null,"abstract":"<div><div>Balloon postdilation (BPD) is used to optimize valve expansion after transcatheter aortic valve implantation (TAVI). However, the clinical impact, particularly between balloon-expandable (BE) and self-expanding (SE) valves, remains unclear. We conducted a systematic search of PubMed, Embase, and Cochrane Library to compare patients undergoing TAVI with and without BPD. We pooled the risk ratios (RR) and mean differences (MD) for binary and continuous outcomes, respectively. All statistical analyses were performed using a random effects model. Sixteen observational studies comprising 15,508 patients were included, of which 3,397 (22%) underwent TAVI with BPD. BPD was associated with a significantly higher risk of in-hospital stroke (RR, 1.66; 95% CI 1.15 to 2.40; p &lt;0.01) and 30-day mortality (RR, 1.28; 95% CI 1.05 to 1.56; p = 0.01). No significant differences were observed in terms of 30-day, 1-year, or overall stroke; pacemaker implantation; myocardial infarction; or cardiovascular or all-cause mortality. Regarding echocardiographic outcomes, BPD resulted in a larger effective orifice area (EOA) (MD 0.06; 95% CI 0.01 to 0.11; p = 0.01), with no differences in the mean transvalvular gradient and paravalvular regurgitation. In prespecified subgroup analyses, BPD was associated with an increased risk of 1-year stroke in patients receiving BE valves (RR, 1.57; 95% CI, 1.11 to 2.24; p = 0.01) and a higher 30-day mortality with SE valves (RR, 1.28; 95% CI 1.01 to 1.62; p = 0.04) compared with non-BPD. BPD is associated with an increased risk of early mortality and periprocedural stroke, albeit with a slightly larger EOA. Further randomized trials are needed to confirm our findings.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 61-70"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676063","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":"Is FFR Better Than iFR for Left Main Assessment?","authors":"Arnold Seto MD, MPA,&nbsp;Derek Antoku MD","doi":"10.1016/j.amjcard.2025.09.027","DOIUrl":"10.1016/j.amjcard.2025.09.027","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 89-90"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211348","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":"Bicuspid and Unicuspid Aortic Valves: Development, Genetics, and Lifelong Management","authors":"Ashish H. Shah MD MD-Research ,&nbsp;Ole De Backer MD PhD","doi":"10.1016/j.amjcard.2025.11.005","DOIUrl":"10.1016/j.amjcard.2025.11.005","url":null,"abstract":"<div><div>Bicuspid and unicuspid aortic valves represent the most common congenital aortic valve malformations and pose unique challenges in clinical management across the lifespan. These anomalies are associated with progressive valvular dysfunction and aortopathy, often necessitating early intervention. Multiple publications have described life-long management of aortic stenosis (AS), affecting tricuspid valve. This review outlines the embryologic basis, natural history, and clinical spectrum of uni- and bicuspid aortic valve, highlighting diagnostic strategies, surveillance protocols, and surgical – transcatheter interventions. Emphasis is placed on longitudinal care, including transition from pediatric to adult congenital cardiology, multimodality imaging, and timing of surgical or transcatheter interventions. In conclusion, the article aims to provide a framework for evidence-informed, individualized management of these complex valvulo-aortic disorders.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 26-35"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627781","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":"Road Exposure After Cardioverter-Defibrillator Implantation and its Potential Influence on Reported Motor Vehicle Crash Risks","authors":"John A. Staples MD ,&nbsp;Daniel Daly-Grafstein PhD ,&nbsp;Mayesha Khan MA ,&nbsp;Shannon Erdelyi MSc ,&nbsp;Nathaniel M. Hawkins MD ,&nbsp;Herbert Chan PhD ,&nbsp;Santabhanu Chakrabarti MD ,&nbsp;Christian Steinberg MD ,&nbsp;Andrew D. Krahn MD ,&nbsp;Jeffrey R. Brubacher MD","doi":"10.1016/j.amjcard.2025.11.011","DOIUrl":"10.1016/j.amjcard.2025.11.011","url":null,"abstract":"<div><div>Many individuals transiently reduce their road exposure (kilometers or hours of driving per month) after receiving an implantable cardioverter-defibrillator (ICD). This markedly influences interpretation of monthly crash risks, but very few studies describe real-world road exposure after ICD implantation. We obtained 18 years of population-based health and driving data for drivers undergoing ICD implantation in British Columbia, Canada. We estimated drivers’ monthly \"road exposure relative to baseline\" (RERB) after ICD implantation (0 = complete cessation of driving; 1 = road exposure unchanged), using clinical data to infer the duration of compulsory driving restrictions, and using published data to account for incomplete adherence to restrictions and voluntary reductions in road exposure by month since implantation. We then used estimated RERB to calculate exposure-adjusted crash risks. Among 3,454 primary prevention ICD recipients, RERB-adjusted crash rate in the first month after implantation was not significantly different than among matched controls (mean recipient RERB = 0.29; adjusted incidence rate ratio [aIRR] = 2.22, 95% CI 0.72 to 6.87), but sensitivity analyses suggested that crash rate adjusted for a plausible lower-bound RERB estimate was ∼5-fold higher than among controls. Among 3,070 secondary prevention ICD recipients, RERB-adjusted crash rate in the first 6 months after implantation was not significantly different than among matched controls (mean recipient RERB = 0.50; aIRR = 1.11, 95% CI 0.77 to 1.61), but sensitivity analyses indicated that crash rate in the first 3 months after implantation adjusted for a plausible lower-bound RERB estimate was ∼2-fold higher than among controls. In conclusion, the substantial transient reductions in road exposure after ICD implantation should inform interpretation of monthly crash risks.</div></div>","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 18-25"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627878","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":"GLP-1 Receptor Agonists in Patients With Diabetes and Peripheral Artery Disease: In Pursuit of Excellence","authors":"Stanislav Henkin MD, MPH ,&nbsp;Gregory Piazza MD, MS","doi":"10.1016/j.amjcard.2025.10.008","DOIUrl":"10.1016/j.amjcard.2025.10.008","url":null,"abstract":"","PeriodicalId":7705,"journal":{"name":"American Journal of Cardiology","volume":"260 ","pages":"Pages 94-95"},"PeriodicalIF":2.1,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312193","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}