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Prognostic Impact of Coronary Calcifications in Patients with Recently Diagnosed Prostate Cancer.
IF 1.9 4区 医学
Cardiology Pub Date : 2025-02-25 DOI: 10.1159/000543735
Nina Stødkilde-Jørgensen, Andreas Bugge Tinggaard, Simon Winther, Andreas Sjoeholm-Christensen, June Anita Ejlersen, Jørgen Bjerggaard Jensen, Morten Böttcher
{"title":"Prognostic Impact of Coronary Calcifications in Patients with Recently Diagnosed Prostate Cancer.","authors":"Nina Stødkilde-Jørgensen, Andreas Bugge Tinggaard, Simon Winther, Andreas Sjoeholm-Christensen, June Anita Ejlersen, Jørgen Bjerggaard Jensen, Morten Böttcher","doi":"10.1159/000543735","DOIUrl":"10.1159/000543735","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with prostate cancer are at increased risk of cardiovascular events. A non-electrocardiogram gated CT scan of the thorax is part of the diagnostic workup, allowing for assessment of coronary calcifications. However, the prognostic impact of a coronary artery calcium score (CACS) obtained from such CT scans is uncertain. This study aimed to investigate the association between CACS and a combined endpoint of all-cause death, myocardial infarction, or stroke in patients with recently diagnosed prostate cancer.</p><p><strong>Methods: </strong>The primary analysis included patients (N = 571) with recently diagnosed prostate cancer and without known coronary artery disease undergoing prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT). Patients were stratified into four CACS groups. Cox proportional hazard models adjusted for risk factors were used to examine the association between CACS and the combined endpoint.</p><p><strong>Results: </strong>Patients were distributed in the four CACS groups as follows: CACS 0-10 (26%), 11-99 (21%), 100-399 (24%), and ≥400 (29%). An increased risk of the combined endpoint was found with increasing CACS. Compared with CACS 0-10, the hazard ratios for CACS 11-99, 100-399 and ≥400 were 0.95 (95% confidence interval [CI]: 0.37-2.42), 2.39 (95% CI: 1.13-5.09) and 3.14 (95% CI: 1.52-6.48), respectively. Only 53% of patients in the CACS ≥400 group received statins.</p><p><strong>Conclusion: </strong>In patients with prostate cancer, assessment of a CACS from the initial PET/CT scan allows for the identification of patients with a threefold higher risk of death, myocardial infarction, or stroke. Initiation of preventive statin treatment in these patients could reduce cardiovascular events.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499065","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}
引用次数: 0
Transvalvular Flow Rates in Patients with Moderate-To-Severe and Severe Aortic Stenosis: Clinical Usefulness and Risk Stratification.
IF 1.9 4区 医学
Cardiology Pub Date : 2025-02-17 DOI: 10.1159/000544784
Hyungseop Kim, In-Cheol Kim, Hee-Jeong Lee
{"title":"Transvalvular Flow Rates in Patients with Moderate-To-Severe and Severe Aortic Stenosis: Clinical Usefulness and Risk Stratification.","authors":"Hyungseop Kim, In-Cheol Kim, Hee-Jeong Lee","doi":"10.1159/000544784","DOIUrl":"10.1159/000544784","url":null,"abstract":"<p><strong>Introduction: </strong>The definition of low-flow/low-gradient aortic stenosis (AS) using the stroke volume index (SVI) alone overlooks factors like vascular resistance and valve stiffness. Consequently, an SVI indicating a normal flow might indicate a low flow when used with the transvalvular flow rate (TFR), which incorporates ejection time. We compared the SVI (35 mL/m2) and TFR (250 mL/m2) and analyzed the outcomes for patients with and without aortic valve replacement (AVR).</p><p><strong>Methods: </strong>From 2013 to 2016, we retrospectively evaluated the clinical data of patients with moderate-to-severe and severe AS, defined as a maximum aortic valve velocity ≥3.5 m/s or a valve area ≤1.3 cm2. Patients were categorized into AVR and non-AVR groups. The non-AVR group was further classified by a TFR above or below 250 mL/m2. Moreover, we compared the SVIs with TFRs. We examined the rates of all-cause mortality and heart failure hospitalizations.</p><p><strong>Results: </strong>Among 135 patients, 42 (31%) had mismatched SVIs and TFRs; 41 had a high SVI and a low TFR, whereas one had a low SVI and a high TFR. Among the 59 non-AVR patients, 25 (71.4%) of the 35 patients with a low TFR died, whereas 4 (16.7%) of the 24 patients with a high TFR died. The TFR in the 76 AVR patients was similar to that in the non-AVR patients, 3 of whom died (3.9%). The Kaplan-Meier analysis revealed that non-AVR patients with a low TFR had worse outcomes and the AVR patients fared best. The SVI was significantly less suitable than the TFR for risk stratification.</p><p><strong>Conclusion: </strong>This study highlights that a high TFR, rather than a high SVI, is associated with a better prognosis, even among non-AVR patients, suggesting that the TFR is better for risk assessment and complements the SVI.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440244","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}
引用次数: 0
Long-Term Prognosis in Takotsubo Syndrome: A Comprehensive Approach.
IF 1.9 4区 医学
Cardiology Pub Date : 2025-02-12 DOI: 10.1159/000544168
Francesco Santoro, Natale Daniele Brunetti
{"title":"Long-Term Prognosis in Takotsubo Syndrome: A Comprehensive Approach.","authors":"Francesco Santoro, Natale Daniele Brunetti","doi":"10.1159/000544168","DOIUrl":"10.1159/000544168","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405729","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}
引用次数: 0
Additive Predictive Value of Left Ventricular End-Diastolic Volume Index to the Development of Persistent Atrial Fibrillation in Nonobstructive Hypertrophic Cardiomyopathy.
IF 1.9 4区 医学
Cardiology Pub Date : 2025-02-10 DOI: 10.1159/000544032
Yajie Tang, Pan Yang, Minghu Xiao, Lei Song, Minjie Lu, Zhe Zheng
{"title":"Additive Predictive Value of Left Ventricular End-Diastolic Volume Index to the Development of Persistent Atrial Fibrillation in Nonobstructive Hypertrophic Cardiomyopathy.","authors":"Yajie Tang, Pan Yang, Minghu Xiao, Lei Song, Minjie Lu, Zhe Zheng","doi":"10.1159/000544032","DOIUrl":"10.1159/000544032","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the association between left ventricular end-diastolic volume index (LVEDVi) and the risk of persistent or long-standing persistent atrial fibrillation (perAF) in nonobstructive hypertrophic cardiomyopathy (NOHCM) patients.</p><p><strong>Methods: </strong>Forty-nine NOHCM patients with perAF were selected as the case group (NOHCMAF group). A control group comprised 98 NOHCM patients without atrial fibrillation (AF) history.</p><p><strong>Results: </strong>Compared to the control group, patients in the NOHCMAF group were associated with higher CHA2DS2-VASc score (3.0 ± 1.7 vs. 2.2 ± 1.1, p = 0.003), higher grade of diastolic dysfunction (II/III) (43.3% vs. 19.4%, p < 0.001). Meanwhile, they were associated with a larger left atrial diameter (LAD) (46.8 ± 4.7 vs. 39.3 ± 4.5 mm, p < 0.001) and a smaller LVEDVi (63.88 ± 15.07 mL/m2 vs. 78.86 ± 12.26 mL/m2, p < 0.001). Multivariate logistic analysis indicated the independent predictive factor of LVEDVi (odds ratio: 0.908, confidence interval: 0.861-0.957, p < 0.001). The multivariable models revealed the additive discrimination for perAF by the LVEDVi with a higher C-statistic of 0.945 in combination with age at diagnosis and LAD. The LVEDVi cutoff for predicting perAF was 71 mL/m2.</p><p><strong>Conclusions: </strong>LVEDVi was independently associated with the occurrence of perAF in NOHCM patients, demonstrating an incremental value compared to conventional LA parameters. Increased cardiac rhythm monitoring is recommended for patients with LVEDVi ≤71 mL/m2.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390161","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}
引用次数: 0
Prognostic Value of Measuring Body Surface Area in Patients with Acute Coronary Syndrome.
IF 1.9 4区 医学
Cardiology Pub Date : 2025-02-03 DOI: 10.1159/000543736
Udaya S Tantry, Sahib Singh, Paul A Gurbel
{"title":"Prognostic Value of Measuring Body Surface Area in Patients with Acute Coronary Syndrome.","authors":"Udaya S Tantry, Sahib Singh, Paul A Gurbel","doi":"10.1159/000543736","DOIUrl":"10.1159/000543736","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-3"},"PeriodicalIF":1.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122255","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}
引用次数: 0
Endomyocardial Biopsy: Short- and Long-Term Safety in Myocarditis Patients.
IF 1.9 4区 医学
Cardiology Pub Date : 2025-01-22 DOI: 10.1159/000543593
Ze-Ping Li, Guang-Ling Li, Ya-Nan Wang, Hong Yang, Lu-Yun Wang, Guang-Lin Cui, Kun Miao, Jian-Gang Jiang
{"title":"Endomyocardial Biopsy: Short- and Long-Term Safety in Myocarditis Patients.","authors":"Ze-Ping Li, Guang-Ling Li, Ya-Nan Wang, Hong Yang, Lu-Yun Wang, Guang-Lin Cui, Kun Miao, Jian-Gang Jiang","doi":"10.1159/000543593","DOIUrl":"10.1159/000543593","url":null,"abstract":"<p><strong>Introduction: </strong>Aims of the study were to assess the short-term and long-term outcomes of percutaneous endomyocardial biopsy (EMB) in patients with myocarditis and to identify the risk factors for EMB-related complications in this patient population.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 294 hospitalized patients with clinically suspected myocarditis at Tongji Hospital from October 2019 to October 2023, with a median follow-up duration of 18 months. Patients were divided into an EMB group (n = 151) and a non-EMB group (n = 143) based on whether they underwent EMB procedure. The incidence of endpoints was compared between the two groups, and the Kaplan-Meier survival curve was used to assess the survival rate without endpoints. Endpoints included major adverse cardiovascular events (MACE), ventricular enlargement, and decline in cardiac function. Multivariate logistic regression analysis was employed to evaluate the risk factors for EMB-related complications.</p><p><strong>Results: </strong>The incidence of major short-term complications following EMB was 2.0% (3/151), while the incidence of minor complications was 9.3% (14/151). Multivariate risk regression analysis revealed that operative duration (OR: 1.101, 95% CI: 1.02-1.079, p < 0.05) and BNP levels (OR: 1.083, 95% CI: 0.931-1.26, p < 0.05) were associated with short-term complications following EMB. Compared to the non-EMB group, the EMB group had no significant increase in hospital stay (10 [8, 15] vs. 9 [7, 16], p = 0.27) and no significant decline in cardiac function. Long-term follow-up results showed that 8 patients (5.3%) in the EMB group experienced MACE, 14 patients (9.3%) had left ventricular enlargement, and 18 patients (11.9%) had a decline in left ventricular ejection fraction (LVEF) after discharge; in the non-EMB group, 12 patients (8.4%) experienced MACE, 30 patients (19.9%) had left ventricular enlargement, and 18 patients (11.9%) had a decline in LVEF after discharge. The Kaplan-Meier curve revealed a lower incidence of endpoint events in the EMB group (p < 0.05).</p><p><strong>Conclusion: </strong>In patients with myocarditis, EMB is associated with a risk of short-term complications, with higher levels of BNP and operative duration being independent risk factors for EMB-related complications. However, EMB does not adversely affect cardiac function or hospital stay during the inpatient period and may contribute to the improvement of long-term outcomes in patients with myocarditis.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-14"},"PeriodicalIF":1.9,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022374","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}
引用次数: 0
High-Sensitivity Troponin I Measurement in a Large Contemporary Cohort: Implications for Clinical Care. 高灵敏度肌钙蛋白I测量在一个大的当代队列:对临床护理的意义。
IF 1.9 4区 医学
Cardiology Pub Date : 2025-01-17 DOI: 10.1159/000543403
Daniel Esau, Peter Nord, Beth L Abramson
{"title":"High-Sensitivity Troponin I Measurement in a Large Contemporary Cohort: Implications for Clinical Care.","authors":"Daniel Esau, Peter Nord, Beth L Abramson","doi":"10.1159/000543403","DOIUrl":"10.1159/000543403","url":null,"abstract":"<p><strong>Introduction: </strong>Contemporary methods of cardiovascular (CV) risk stratification are frequently inaccurate. Biomarkers such as high-sensitivity troponin I (hsTnI) have the potential to improve risk stratification. However, uncertainties exist regarding factors that determine hsTnI concentration. Our aim was to investigate the prevalence of elevated hsTnI in a large contemporary Canadian cohort and describe the effect of comorbidities on hsTnI concentration.</p><p><strong>Methods: </strong>We report a large dataset of 41,602 visits in which hsTnI was measured routinely in ambulatory outpatients. hsTnI was remeasured in 28% of patients, with a mean time between measurements of 387 days (IQR 364-441). Low-, medium-, and high-risk categories were created based on hsTnI cutoffs for each sex. Laboratory data, blood pressure, and anthropomorphic measures were extracted from the electronic medical record.</p><p><strong>Results: </strong>Remeasurement of hsTnI did not change risk category in 92.7% of cases. Male sex, higher HDL-C, higher Hgb A1c, decreasing eGFR, and increasing systolic blood pressure were significant predictors of increased hsTnI. High non-HDL-C and the use of statins were associated with lower hsTnI. The inverse relationship between hsTnI and non-HDL-C was partially corrected when the confounding effect of statin therapy was considered. Model fit was poor (adjusted R-squared = 0.0091).</p><p><strong>Conclusion: </strong>Traditional CV risk factors were predictors of serum hsTnI levels; however, a significant amount of the variance in hsTnI cannot be explained by these factors alone. This suggests that hsTnI adds additional information that is not provided by traditional risk stratification methods and supports ongoing study of hsTnI as a biomarker for CV risk stratification.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-8"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000864","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}
引用次数: 0
Nourishment of Nerves and Innervation: A Novel Approach for the Treatment of Myocardial Infarction. 神经营养与神经支配:治疗心肌梗塞的新方法。
IF 1.9 4区 医学
Cardiology Pub Date : 2025-01-17 DOI: 10.1159/000543513
Xiaorui Yin, Dan Cai, Zhimin Song, Chunli Song
{"title":"Nourishment of Nerves and Innervation: A Novel Approach for the Treatment of Myocardial Infarction.","authors":"Xiaorui Yin, Dan Cai, Zhimin Song, Chunli Song","doi":"10.1159/000543513","DOIUrl":"10.1159/000543513","url":null,"abstract":"<p><strong>Background: </strong>Autonomic innervation of the heart plays a pivotal role not only in regulating the heart rate but also in modulating the cardiac cell microenvironment via cell-cell interactions and influencing the heart's repair capabilities. Currently, the primary clinical approach for treating myocardial infarction (MI) is percutaneous coronary intervention. However, the myocardial salvage rate remains low for patients with advanced disease. MI is recognized as an autonomic nervous system disorder, marked by sympathetic hyperactivity and the loss of parasympathetic nerves. Following MI, ventricular sympathetic nerve sprouting occurs, leading to an increase in ventricular sympathetic innervation and, consequently, an increased risk of ventricular arrhythmia, which is the primary cause of sudden cardiac death in patients with a history of MI. The vagus nerve positively regulates cardiomyocyte proliferation and regeneration, enhancing ventricular remodeling and cardiac function post-MI. This process is highly significant in the treatment and rehabilitation of MI. Cardiac autonomic nerves are influenced by factors such as inflammation, immunity, intercellular communication, metabolism, genetics, epigenetics, and cytokine secretion related to cardiac mesenchymal nerves. In recent years, significant advancements have been made regarding treatment for MI, specifically in the fields of autonomic nervous system therapies, stem cell and extracellular vesicle treatments, traditional Chinese medicine acupuncture and moxibustion, and peripheral electrophysiological stimulation and bioengineering materials.</p><p><strong>Summary: </strong>The balance of dominance between the sympathetic and parasympathetic nervous systems in the heart affects tissue regeneration and cardiac remodeling after MI. The secretion of neurons regulates the microenvironment of cardiac repair. The neural therapy of MI involves multiple fields such as traditional Chinese medicine, biomaterials, stem cell therapy, and drug research and development and has broad development prospects.</p><p><strong>Key messages: </strong>The regulation exerted by the cardiac autonomic nervous system on the heart significantly influences the prognosis of MI. This involves nervous system modulation of inflammation and heart rate and complex interactions between neurons and cardiomyocytes, immune cells, fibroblasts, adipocytes, stem cells, and other cellular components. Genetic and epigenetic modifications, as well as shifts in energy metabolism, also play crucial roles.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-23"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000865","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}
引用次数: 0
Dynamic Arterial Lactate Values Are Associated with 30-Day Mortality in Patients with Acute Myocardial Infarction and Cardiogenic Shock on Intra-Aortic Balloon Pump Circulatory Support. 动态动脉乳酸值与主动脉内球囊泵循环支持下急性心肌梗死和心源性休克患者30天死亡率相关。
IF 1.9 4区 医学
Cardiology Pub Date : 2025-01-17 DOI: 10.1159/000543495
Aurelia Georgeta Solomonean, Mihaela Ioana Dregoesc, Mihnea Istrate, Victor Ștefan Buiga, Dan Ion Bindea, Adrian Ștef, Cătălin Botiș, Adrian Corneliu Iancu
{"title":"Dynamic Arterial Lactate Values Are Associated with 30-Day Mortality in Patients with Acute Myocardial Infarction and Cardiogenic Shock on Intra-Aortic Balloon Pump Circulatory Support.","authors":"Aurelia Georgeta Solomonean, Mihaela Ioana Dregoesc, Mihnea Istrate, Victor Ștefan Buiga, Dan Ion Bindea, Adrian Ștef, Cătălin Botiș, Adrian Corneliu Iancu","doi":"10.1159/000543495","DOIUrl":"10.1159/000543495","url":null,"abstract":"<p><strong>Introduction: </strong>In patients with acute myocardial infarction and cardiogenic shock (AMICS), the intra-aortic balloon pump (IABP) remains the most commonly used form of mechanical circulatory support. However, information on the characteristics of nonresponders is limited. This study evaluated the risk factors associated with 30-day mortality in a cohort of patients with AMICS, on IABP support.</p><p><strong>Methods: </strong>The medical records of patients admitted for AMICS, who underwent IABP insertion over a period of 5 years, were extracted from the electronic database of a tertiary cardiovascular disease center. The primary endpoint was 30-day all-cause mortality.</p><p><strong>Results: </strong>A cohort of 62 patients was included in the analysis. Mechanical complications were diagnosed in 54.8% of the patients. At 30-day follow-up, mortality reached 69.3%. High arterial lactate at the time of IABP insertion (OR: 1.04; 95% CI: 1.01-1.09; p = 0.04), high arterial lactate after 24 h of circulatory support (OR: 1.07; 95% CI: 1.02-1.17; p = 0.03), and low lactate clearance at 24 h (OR: 0.51; 95% CI: 0.22-0.83; p = 0.03) were associated with 30-day mortality independent of infarct type, mechanical complications, baseline SCAI stage, creatinine, and bicarbonate value at the time of support initiation. Lactate at the time of IABP insertion and lactate at 24 h predicted 30-day mortality at a cutoff value >50 mg/dL and >27 mg/dL, respectively.</p><p><strong>Conclusion: </strong>In a cohort of patients with AMICS who underwent IABP therapy, dynamic arterial lactate values both pre- and post-IABP insertion were independently associated with increased 30-day all-cause mortality. The dynamic changes in arterial lactate could help establish the optimal timing of circulatory support initiation and guide treatment escalation in patients at risk for adverse outcomes.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000793","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}
引用次数: 0
Role of Bailout Gene-Silencing Therapy in Plaque Lipid Reduction: Intravascular Imaging Study. 救助基因沉默治疗在斑块脂质降低中的作用:血管内影像学研究。
IF 1.9 4区 医学
Cardiology Pub Date : 2025-01-17 DOI: 10.1159/000543463
Karlis Trusinskis, Baiba Kokina, Maris Lapsovs, Mairita Karantajere, Evija Kanasniece, Laima Caunite, Sanda Jegere, Inga Narbute, Dace Sondore, Alona Grave, Indulis Kumsars, Andrejs Erglis
{"title":"Role of Bailout Gene-Silencing Therapy in Plaque Lipid Reduction: Intravascular Imaging Study.","authors":"Karlis Trusinskis, Baiba Kokina, Maris Lapsovs, Mairita Karantajere, Evija Kanasniece, Laima Caunite, Sanda Jegere, Inga Narbute, Dace Sondore, Alona Grave, Indulis Kumsars, Andrejs Erglis","doi":"10.1159/000543463","DOIUrl":"10.1159/000543463","url":null,"abstract":"<p><strong>Introduction: </strong>Insufficient statin/ezetimibe effectiveness for low-density lipoprotein cholesterol (LDL-C) reduction is not uncommon. A novel gene-silencing medication inclisiran has been introduced. Near-infrared spectroscopy (NIRS) allows to assess the dynamics of plaque lipid content in the context of optimal lipid-lowering pharmacotherapy. The aim of this study was to evaluate the impact of optimal hypolipidaemic pharmacotherapy, including add-on inclisiran, on the plasma lipid profile and plaque lipid content.</p><p><strong>Methods: </strong>This study enrolled patients with stable coronary artery disease, admitted for elective percutaneous coronary intervention (PCI). NIRS of the segment of interest was performed during index PCI and 15 months later. Patients having LDL-C >1.8 mmol/L after 4-6 weeks of maximum tolerated statin/ezetimibe therapy received add-on inclisiran. Lipid profile changes within 15 months were also evaluated.</p><p><strong>Results: </strong>Among 42 included patients, 24 drug-resistant hypercholesterolaemia participants were assigned to inclisiran therapy. After 15 months, a significant LDL-C decrease of 26.42% was established (p = 0.006), with 12 participants reaching the LDL-C goal of <1.8 mmol/L. Average 15-month LDL-C reduction was 36.03%. NIRS data demonstrated a significant reduction in maximum lipid-core burden index within 4 mm (maxLCBI4 mm) in the inclisiran group (-117.64, p = 0.004) and statin/ezetimibe group (-141.88, p = 0.004), with no significant difference between the groups (p = 0.213).</p><p><strong>Conclusion: </strong>Results demonstrate an association between better LDL-C control and coronary plaque lipid burden reduction. Addition of inclisiran leads to remarkable LDL-C reduction in patients who have run out of statin and ezetimibe treatment options.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000866","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}
引用次数: 0
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