{"title":"Genetic Association of the Ins/Del Variant of ACE and Risk of Cardiomyopathy: A Case-Control Study and Updated Meta-Analysis.","authors":"Shikha Bharti, Amrit Sudershan, Dharminder Kumar, Mohd Younis, Meenakshi Bhagat, Ishan Behlam, Surbhi Pathania, Mayushi Gupta, Sheetal Bhagat, Rakesh K Panjalyia, Ashiq Hussain Mir, Najitha Banu, Parvinder Kumar","doi":"10.1159/000542278","DOIUrl":"10.1159/000542278","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiomyopathy is a complex condition influenced by multiple genes and environmental factors. It has been suspected that cardiomyopathy is affected by the ACE gene's I/D polymorphism. Our study aimed to evaluate the association between this polymorphism and cardiomyopathy risk in the Jammu population of North India, alongside a meta-analysis to determine the specific risks associated with different types of cardiomyopathy.</p><p><strong>Method: </strong>In the case-control study, we opted for a convenient sampling technique to gather patients from hospitals. Meanwhile, for the meta-analysis registered under PROSPERO with CRD42024519763, and in line with PRISMA guidelines, we accessed online databases and applied predefined inclusion criteria. Data extraction and quality assessment were performed using the Newcastle-Ottawa scale. Statistical analysis included genotypic frequencies, Hardy-Weinberg equilibrium testing, logistic regression models, and assessments for heterogeneity and publication bias.</p><p><strong>Result: </strong>The case-control study revealed a significant association between the ACE I/D risk variant and cardiomyopathy risk in the Jammu population (odds ratio [OR]: 1.30, confidence interval [CI] [1.04-1.63], p value = 0.021). Furthermore, a total of 34 studies were fund-eligible for the meta-analysis and demonstrated a significant association between the risk variant and both dilated (OR: 1.25, CI [1.03-1.50], p value = 0.022) and hypertrophic (OR: 1.31, CI [1.0876-1.5776], p value = 0.004446) cardiomyopathy.</p><p><strong>Conclusion: </strong>Our study found a significant association between the I/D polymorphism and cardiomyopathy risk in the Jammu population. Further, the meta-analysis strengthens the findings by consistently linking the ACE I/D polymorphism to both dilated and hypertrophic cardiomyopathy. These results underscore the importance of genetic factors in cardiomyopathy risk assessment and further research is needed to understand the underlying mechanisms and potential therapeutic implications.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-24"},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-11-06DOI: 10.1159/000542399
Bo Eun Park, Byungeun Shon, Jungrae Cho, Min-Su Jung, Jong Sung Park, Myeong Seop Kim, Eunkyu Lee, Hyohun Choi, Hyuk Kyoon Park, Yoon Jung Park, Hong Nyun Kim, Namkyun Kim, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Sungmoon Jeong, Se Yong Jang
{"title":"Signal-Guided Multitask Learning for Myocardial Infarction Classification Using Images of Electrocardiogram.","authors":"Bo Eun Park, Byungeun Shon, Jungrae Cho, Min-Su Jung, Jong Sung Park, Myeong Seop Kim, Eunkyu Lee, Hyohun Choi, Hyuk Kyoon Park, Yoon Jung Park, Hong Nyun Kim, Namkyun Kim, Myung Hwan Bae, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Sungmoon Jeong, Se Yong Jang","doi":"10.1159/000542399","DOIUrl":"10.1159/000542399","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of myocardial infarction (MI) needs to be swift and accurate, but definitively diagnosing it based on the first test encountered in clinical practice, the electrocardiogram (ECG), is not an easy task. The purpose of the study was to develop a deep learning (DL) algorithm using multitask learning method to differentiate patients experiencing MI from those without coronary artery disease using image-based ECG data.</p><p><strong>Methods: </strong>A DL model was developed based on 11,227 ECG images. We developed a new ECG interpretation algorithm through signal-guided multitask learning, building on a previously published single-task algorithm. The utility of this model was evaluated by testing 51 physicians in interpreting ECGs with and without the assistance of the DL model.</p><p><strong>Results: </strong>The proposed model demonstrated superior performance, achieving 90.56% accuracy, 83.82% sensitivity, 93.02% specificity, 81.44% precision, and an F1 score of 82.61% in discriminating MI ECG. Overall, the median accuracy of ECG interpretation improved from 62% to 68% with the DL algorithm. Trainees and specialists in internal medicine experienced significant accuracy increases (60-66% for trainees, 72-80% for specialists). In the MI group, NSTEMI accuracy was notably lower than STEMI (33% vs. 80%, p < 0.001), but the DL algorithm improved interpretative capabilities in both NSTEMI and STEMI.</p><p><strong>Conclusions: </strong>Signal-guided multitask DL algorithm demonstrated superior performance compared with previous single-task algorithm. The DL algorithm supports the physicians' decision discriminating MI ECGs from non-MI ECGs. The improvement was consistent in subgroups of STEMI and NSTEMI.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-11-04DOI: 10.1159/000542197
Victor Gurewich, David Segarnick
{"title":"Fibrinolysis Was Replaced before It Was Understood.","authors":"Victor Gurewich, David Segarnick","doi":"10.1159/000542197","DOIUrl":"10.1159/000542197","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-11-02DOI: 10.1159/000542317
Erwan Donal, Adrien Al Wazzan
{"title":"The Need for New Data on Left Ventricular Remodeling and the Crucial Role of Ejection Time for Our Daily Clinical Practice.","authors":"Erwan Donal, Adrien Al Wazzan","doi":"10.1159/000542317","DOIUrl":"10.1159/000542317","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-10-30DOI: 10.1159/000542238
Wen Bo Tian, Wei Sen Zhang, Chao Qiang Jiang, Xiang Yi Liu, Feng Zhu, Ya Li Jin, Tong Zhu, Tai Hing Lam, Kar Keung Cheng, Lin Xu
{"title":"Optimal QT Correction Formula for Older Chinese: Guangzhou Biobank Cohort Study.","authors":"Wen Bo Tian, Wei Sen Zhang, Chao Qiang Jiang, Xiang Yi Liu, Feng Zhu, Ya Li Jin, Tong Zhu, Tai Hing Lam, Kar Keung Cheng, Lin Xu","doi":"10.1159/000542238","DOIUrl":"10.1159/000542238","url":null,"abstract":"<p><strong>Introduction: </strong>To identify the optimal QT correction formula for generating corrected QT (QTc) and cutoffs for prolonged QTc, and examine the associations with mortality and cardiovascular disease (CVD) in older Chinese.</p><p><strong>Methods: </strong>A prospective study included 24,611 Chinese aged 50+ years and without CVD at 2003-2008 from Guangzhou Biobank Cohort Study. QT interval was corrected by Bazett, Fridericia, Framingham and Hodges formulas. The slope and R2 of the QTc and heart rate regression were used to determine the optimal correction formula. The 95th percentile of QTc was used to defined prolonged QTc. Cox regression was used to examine associations of prolonged QTc with mortality and CVD. The net reclassification index was calculated to assess risk reclassification.</p><p><strong>Results: </strong>During an average follow-up of 15.3 years, 5,261 deaths and 5,539 CVD occurred. Optimal heart correction was observed for the Hodges formula, and Bazett formula performed the worst. Prolonged QTc corrected by Fridericia, Framingham and Hodges formulas had similar association strength with all-cause mortality, CVD mortality and incident CVD (especially coronary heart disease, myocardial infarction and ischemic stroke), with hazard ratios approximately being 1.25, 1.40, and 1.15, respectively. They also improved risk reclassification for all-cause mortality, CVD mortality and incident CVD by approximately 5%, 10%, and 6%, respectively. However, prolonged QTc corrected by Bazett formula was not associated with incident CVD and did not improve risk reclassification.</p><p><strong>Conclusions: </strong>Hodges formula outperformed other formulas for heart rate correction. Fridericia, Framingham, and Hodges formulas can be used for death and cardiovascular risk prediction.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-10-28DOI: 10.1159/000542318
Hinpetch Daungsupawong, Viroj Wiwanitkit
{"title":"Deep Learning-Based Method for Rapid 3D Whole-Heart Modeling in Congenital Heart Disease: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1159/000542318","DOIUrl":"10.1159/000542318","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-10-16DOI: 10.1159/000541907
Thomas Gilhofer, Victoria Bokemeyer, Victor Schweiger, Mario Gehler, Jonathan Michel, Mi Chen, Alessandro Candreva, Linn Ryberg, Christian Templin, Barbara Stähli, Julia Stehli, Alexander Gotschy, Philipp Jakob, Frank Ruschitzka, Stefanie Aeschbacher, Philipp Krisai, Leo H Bonati, Moa Lina Haller, Nicolas Rodondi, Juerg Beer, Peter Ammann, Giorgio Moschovitis, Elia Rigamonti, Stefan Osswald, David Conen, Fabian Nietlispach, Ronald Karl Binder, Tobias Reichlin, Michael Kühne, Albert Markus Kasel
{"title":"Long-Term Outcome of Patients with Atrial Fibrillation and High Risk of Stroke Treated with Oral Anticoagulation or Left Atrial Appendage Occlusion: A Cardinality Matched Analysis.","authors":"Thomas Gilhofer, Victoria Bokemeyer, Victor Schweiger, Mario Gehler, Jonathan Michel, Mi Chen, Alessandro Candreva, Linn Ryberg, Christian Templin, Barbara Stähli, Julia Stehli, Alexander Gotschy, Philipp Jakob, Frank Ruschitzka, Stefanie Aeschbacher, Philipp Krisai, Leo H Bonati, Moa Lina Haller, Nicolas Rodondi, Juerg Beer, Peter Ammann, Giorgio Moschovitis, Elia Rigamonti, Stefan Osswald, David Conen, Fabian Nietlispach, Ronald Karl Binder, Tobias Reichlin, Michael Kühne, Albert Markus Kasel","doi":"10.1159/000541907","DOIUrl":"10.1159/000541907","url":null,"abstract":"<p><strong>Introduction: </strong>Atrial fibrillation (AF) poses a significant risk of stroke. Left atrial appendage occlusion (LAAO) is an alternative for patients with contraindications to oral anticoagulation (OAC) or with high risk of bleeding. This study aims to compare the outcomes of LAAO versus conventional stroke prevention in high-risk AF-patients.</p><p><strong>Methods: </strong>This secondary analysis incorporates data from the prospective Swiss-AF and Beat-AF cohorts, and the Zurich LAAO Registry. Cardinality matching was performed to create two comparable cohorts: conventional treatment (92% OAC) and LAAO. The primary endpoint was a composite of stroke, cardiovascular (CV) death, and clinically relevant bleeding. Kaplan-Meier method with competing risk analysis was used.</p><p><strong>Results: </strong>Each group included 468 patients (age 76.4 [70.5, 82.0] years, 33% female). The LAAO group exhibited higher baseline bleeding risk (HAS BLED 2.0 [1.0-3.0] versus 3.0 [3.0-4.0]; p < 0.001). Median follow-up time: 6.0 (4.7-7.0) years in conventional treatment group and 4.0 (1.5-6.1) in LAAO group. No significant difference in the primary composite endpoint (HR 0.87, 95% CI: 0.72-1.06, p = 0.18), stroke risk (HR 1.14, 95% CI: 0.66-1.97, p = 0.64), or CV mortality (HR 1.08, 95% CI: 0.82-1.42, p = 0.60) was observed between groups. LAAO correlated with a significantly lower risk of clinically relevant bleeding (HR 0.61, 95% CI: 0.47-0.80, p < 0.001).</p><p><strong>Conclusion: </strong>In this cardinality matched analysis with long-term follow-up, LAAO showed similar stroke and CV death rates but lower clinically relevant bleeding risk compared to conventional therapy in high-risk AF-patients.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-10-01DOI: 10.1159/000541725
Lee A Goeddel, Sergio Navarrete, Natalie Waldron, Anjali D'Amiano, Nauder Faraday, Joao A C Lima, Chirag R Parikh, Karen Bandeen-Roche, Allison G Hays, Charles Brown Iv
{"title":"Association between Left Ventricular Geometry, Systolic Ejection Time, and Estimated Glomerular Filtration Rate in Ambulatory Patients with Preserved Left Ventricular Ejection Fraction.","authors":"Lee A Goeddel, Sergio Navarrete, Natalie Waldron, Anjali D'Amiano, Nauder Faraday, Joao A C Lima, Chirag R Parikh, Karen Bandeen-Roche, Allison G Hays, Charles Brown Iv","doi":"10.1159/000541725","DOIUrl":"10.1159/000541725","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac function is important to quantify for risk stratification. Although left ventricular ejection fraction (LVEF) is commonly used, and identifies patients with poor systolic function, other easily acquired measures of cardiac function are needed, particularly to stratify patients with relatively preserved LVEF. LV relative wall thickness (RWT) has been associated with adverse clinical outcomes in patients with preserved LVEF, but the clinical relevance of this observation is not known. The purpose of this study was to assess whether increased RWT is a marker of subclinical cardiac dysfunction as measured by a surrogate of LV dysfunction and left ventricular ejection time (LVET) and if increased RWT is independently associated with chronic kidney disease (CKD), an important clinical outcome and cardiovascular disease risk equivalent.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled ambulatory patients 18 years and older undergoing routine transthoracic echocardiography (TTE) at Johns Hopkins Hospital from January 2017 to January 2018. Patients with LVEF <50%, severe valvular disease, or liver failure were excluded. Multivariable regression evaluated the relationship between RWT, LVET, and CKD adjusted for demographics, comorbidities, and vital signs.</p><p><strong>Results: </strong>We analyzed data from 375 patients with mean age (±SD) 52.2 ± 15.3 years of whom 58% were female. Mean ± SD of RWT was 0.45 ± 0.10, while mean ± SD of LVET was 270 ms ± 33. In multivariable linear regression adjusted for demographics, comorbidities, vital signs, and left ventricular mass, each 0.1 increase in RWT was associated with a decrease of 4.6 ms in LVET, indicating worse cardiac function (β, ± 95% CI) (-4.60, -7.37 to -1.48, p = 0.004). Of those with serum creatinine available 1 month before or after TTE, 20% (50/247) had stage 3 or greater CKD. In logistic regression (adjusted for sex, comorbidities, and medications), each 0.1 unit increase in RWT was associated with an 61% increased odds of CKD (aOR = 1.61, 1.03-2.53, p = 0.037). In multivariable ordinal regression adjusted for the same covariates, each 0.1 unit increase in RWT was associated with a 44% increased odds of higher CKD stage (aOR = 1.44, 1.03-2.02, p = 0.035). There was a trend but no statistically significant relationship between RWT and change in estimated glomerular filtration rate at 1 year.</p><p><strong>Conclusion: </strong>In an outpatient cohort undergoing TTE, increased RWT was independently associated with a surrogate of subclinical systolic dysfunction (LVET) and CKD. This suggests that RWT, an easily derived measure of LV geometry on TTE, may identify clinically relevant subclinical systolic dysfunction and patients with worse kidney function. Additional investigation to further clarify the relationships between RWT, systolic function, and kidney dysfunction over time and how this information may guide clinical intervent","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-07-22DOI: 10.1159/000540240
Errol Aarnink, Domenico Della Rocca, Pedro Cepas-Guillen, Tomás Benito-González, Amin Polzin, Luca Branca, Daniel Spoon, Marianna Adamo, Xavier Freixa, Andrea Natale, Lucas V A Boersma
{"title":"The Association of Hematological Markers with Occurrence of Thrombotic and Bleeding Events following Left Atrial Appendage Occlusion.","authors":"Errol Aarnink, Domenico Della Rocca, Pedro Cepas-Guillen, Tomás Benito-González, Amin Polzin, Luca Branca, Daniel Spoon, Marianna Adamo, Xavier Freixa, Andrea Natale, Lucas V A Boersma","doi":"10.1159/000540240","DOIUrl":"10.1159/000540240","url":null,"abstract":"<p><strong>Introduction: </strong>Patients undergoing left atrial appendage occlusion (LAAO) are at increased risk for bleeding or thromboembolic events. Concurrently, biomarkers are of growing importance in risk stratification for atrial fibrillation patients. We aimed to evaluate the association of hematological markers and clinical characteristics with the occurrence of thromboembolic and bleeding events following LAAO.</p><p><strong>Methods: </strong>Seven implanting centers retrospectively gathered data on hematological markers (i.e., platelet count [PC], mean platelet volume [MPV], and fibrinogen) prior to LAAO. Prespecified thromboembolic and major bleeding outcomes were collected and the association with pre-procedural hematological markers and clinical characteristics was evaluated using Cox regression analysis.</p><p><strong>Results: </strong>In total, 1,315 patients were included (74 ± 9 years, 36% female, CHA2DS2-VASc 4.3 ± 1.5, HAS-BLED 3.3 ± 1.1). Over a total follow-up duration of 2,682 patient years, 77 thromboembolic events and 107 major bleeding events occurred after LAAO. Baseline PC was the only biomarker showing a signal for a relation to thromboembolic events (HR 1.18, 95% CI: 1.00-1.39) per 50*109 increment, p = 0.056). Thrombotic event rates, including device-related thrombus, increased within higher PC quartiles. Thromboembolism was associated with age (HR 1.05, 95% CI: 1.00-1.10, per year increase) and prior thromboembolism (HR 2.08, 95% CI: 1.07-4.03), but with none of the biomarkers in multivariate analysis. No association of any of the hematological markers with major bleeding was observed. Major bleeding following LAAO was associated with prior major bleeding (HR 5.27, 95% CI: 2.71-10.22), renal disease (HR 1.93, 95% CI: 1.17-3.18), and discharge on dual antiplatelet therapy (DAPT) (HR 1.71, 95% CI: 1.05-2.77).</p><p><strong>Conclusion: </strong>Most thrombotic events occurred in the highest PC quartile, but no association of any of the hematological markers with thromboembolism or major bleeding was observed in our analysis. In multivariate analysis, older age and prior thromboembolism were associated with thromboembolism. Prior major bleeding, renal disease and discharge on DAPT were multivariate predictors of major bleeding after LAAO.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CardiologyPub Date : 2024-01-01Epub Date: 2024-02-13DOI: 10.1159/000537682
Jasmeet Kalsi, John M Suffredini, Stephanie Koh, Jing Liu, Mirza U Khalid, Ali Denktas, Mahboob Alam, Waleed Kayani, Xiaoming Jia
{"title":"Intravascular Ultrasound-Guided versus Angiography-Guided Percutaneous Coronary Intervention for Stent Thrombosis Elevation Myocardial Infarction: An Updated Systematic Review and Meta-Analysis.","authors":"Jasmeet Kalsi, John M Suffredini, Stephanie Koh, Jing Liu, Mirza U Khalid, Ali Denktas, Mahboob Alam, Waleed Kayani, Xiaoming Jia","doi":"10.1159/000537682","DOIUrl":"10.1159/000537682","url":null,"abstract":"<p><strong>Introduction: </strong>Intravascular ultrasound (IVUS) provides intra-procedural guidance in optimizing percutaneous coronary interventions (PCI) and has been shown to improve clinical outcomes in stent implantation. However, current data on the benefit of IVUS during PCI in ST-elevation myocardial infarction (STEMI) patients is mixed. We performed meta-analysis pooling available data assessing IVUS-guided versus angiography-guided PCI in STEMI patients.</p><p><strong>Methods: </strong>We conducted a systematic search on PubMed and Embase for studies comparing IVUS versus angiography-guided PCI in STEMI. Mantel-Haenszel random effects model was used to calculate risk ratios (RRs) with 95% confidence intervals (CIs) for outcomes of major adverse cardiovascular events (MACEs), death, myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST) and in-hospital mortality.</p><p><strong>Results: </strong>A total of 8 studies including 336,649 individuals presenting with STEMI were included for the meta-analysis. Follow-up ranged from 11 to 60 months. We found significant association between IVUS-guided PCI with lower risk for MACE (RR 0.82, 95% CI 0.76-0.90) compared with angiography-guided PCI. We also found significant association between IVUS-guided PCI with lower risk for death, MI, TVR, and in-hospital mortality but not ST.</p><p><strong>Conclusion: </strong>In our meta-analysis, IVUS-guided compared with angiography-guided PCI was associated with improved long-term and short-term clinical outcomes in STEMI patients.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"196-204"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}