Cardiology最新文献

{"title":"The Impact of Cilostazol in Refractory Vasospastic Angina.","authors":"Richard Z Lin, Rosanna Tavella, Sepehr Shakib, John F Beltrame","doi":"10.1159/000544943","DOIUrl":"10.1159/000544943","url":null,"abstract":"<p><strong>Introduction: </strong>Refractory vasospastic angina (VSA) includes patients with disabling angina despite maximally tolerated calcium channel blocker and nitrate therapy. Randomised clinical trial evidence confirms the efficacy of cilostazol in refractory VSA, yet its use in real-world clinical practice is limited. This study evaluated the impact of cilostazol therapy on patient-reported outcomes in patients with refractory VSA.</p><p><strong>Methods: </strong>Between June 2016 and May 2022, 15 consecutive refractory VSA patients were initiated on cilostazol (50 mg twice daily), with baseline and 3-month responses assessed via the Seattle Angina Questionnaire (SAQ). The primary outcome was a clinically significant reduction in angina frequency (i.e., >10-point improvement in SAQ angina frequency score) at 3 months.</p><p><strong>Results: </strong>A clinically significant reduction in angina frequency was reported in 13 patients (86%) at 3 months, with 3 (20%) becoming angina free. Moreover, over 3 months, median SAQ scores improved for angina frequency (25 [IQR 15, 46] to 75 [30, 82]), physical limitation (53 [44, 67] to 83 [56, 92]), and quality of life (17 [4, 29] to 50 [35, 58]). Additionally, a 54% reduction in angina-related emergency department presentations and 50% reduction in angina-related hospital admissions were noted. Minor medication-related adverse effects were experienced by 3 patients, with no serious adverse effects noted. Cilostazol was continued in 14 patients (93%) beyond the 3-month follow-up period.</p><p><strong>Conclusions: </strong>In patients with refractory VSA, cilostazol is well tolerated, improves patient-reported outcomes, reduces healthcare utilisation, and thus is an effective therapy in real-world clinical practice.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-6"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522474","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}

{"title":"Development of a Core Confounder Set for Real-World Essential Hypertension Studies.","authors":"Jianrong Chen, Xu Zhou, Rong Chen, Sheng Xu, Shuqing Li, Jiancheng Wang","doi":"10.1159/000544860","DOIUrl":"10.1159/000544860","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to establish a core set of confounders for real-world essential hypertension studies to improve the reasonable control of confounding bias.</p><p><strong>Methods: </strong>Controlled clinical studies of essential hypertension published between January 2001 and June 2020 were retrieved from PubMed. Matched or adjusted confounders from these studies were compiled to form a pool of potential candidates. The importance of each confounder was assessed through Delphi expert consultation, considering its statistical significance for impacting the prognosis of essential hypertension in published studies and its applicability in real-world essential hypertension studies. The most essential confounders were ultimately selected to constitute the core confounder set.</p><p><strong>Results: </strong>Following a comprehensive literature review and group discussion, a total of 50 confounders were included in the Delphi questionnaire. Twenty-nine cardiologists from across China were invited to participate in the Delphi consultation, and consensus was reached after two rounds of consultation. As a result, a core set of 13 confounders was established comprising three confounders in the demographic characteristic and lifestyle domain, four in the baseline hypertension status domain, three in the comorbidity domain, one in the cointervention domain, and two in the common factor domain (study center and time). Additionally, a recommendation regarding the prioritization of controlling these confounders was formulated.</p><p><strong>Conclusion: </strong>This study established a core set of confounders for real-world essential hypertension studies that can effectively control confounding bias and are readily accessible. These findings can serve as valuable references for protocol design and data analysis in real-world essential hypertension studies.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499122","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}

{"title":"Age-Related Outcomes of Transcatheter Aortic Valve Replacement in Patients with Pure Severe Aortic Regurgitation.","authors":"Jianing Fan, Dawei Lin, Jiaxin Miao, Zilong Weng, Yiming Qi, Zhi Zhan, Mingfei Li, Shasha Chen, Yuliang Long, Nanchao Hong, Yuhao Li, Xiaochun Zhang, Wenzhi Pan, Daxin Zhou, Junbo Ge","doi":"10.1159/000543567","DOIUrl":"10.1159/000543567","url":null,"abstract":"<p><strong>Introduction: </strong>Transcatheter aortic valve replacement (TAVR) is increasingly used, especially in older and high-risk surgical patients with pure severe aortic regurgitation (PSAR). However, the efficacy of TAVR in younger patients with aortic regurgitation (AR) remains unclear. This study explored the therapeutic efficacy and safety of TAVR in these two groups and compared their outcomes.</p><p><strong>Methods: </strong>Patients with AR who underwent TAVR at Zhongshan Hospital between June 2021 and September 2023 were included and categorized into younger and older age groups based on whether they were less than 75 years old. The baseline characteristics, clinical test information, and follow-up data of the patients were collected.</p><p><strong>Results: </strong>A total of 82 patients were included in this study (72.7 ± 7.6 years old, 52 [63.4%] male). The younger and older age groups each comprised 41 patients. Young patients had better clinical conditions (diabetes mellitus [0% vs. 17.1%, p = 0.006], symptoms [29.3% vs. 70.7%, p = 0.025], and permanent pacemaker implantation [0% vs. 9.8%, p = 0.040]). Significant improvements in AR as well as left and right heart functions were observed in both groups. A reduced occurrence rate of mild perivalvular leaks (PVL) was observed in the younger age group at the 1-month follow-up visit (2.4% vs. 14.6%; p = 0.048).</p><p><strong>Conclusion: </strong>TAVR is safe and effective for both younger and older patients undergoing PSAR. Younger patients who underwent AR-TAVR experienced fewer PVL compared to those experienced by older patients. Therefore, TAVR may be an alternative for younger patients with PSAR. Further large-scale multicenter prospective studies are needed to validate our findings.</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":"143499101","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}

{"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}

{"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}

{"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}

{"title":"Unravelling ATTR Cardiac Amyloidosis in Iceland: A Nationwide Epidemiological Study.","authors":"Hekla María Bergmann, Ævar Örn Úlfarsson, Hafsteinn Einarsson, Helena Xiang Jóhannsdóttir, Gunnar Thór Gunnarsson, Thórdís Jóna Hrafnkelsdóttir, Karl Andersen, Inga Jóna Ingimarsdóttir","doi":"10.1159/000543750","DOIUrl":"https://doi.org/10.1159/000543750","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiac amyloidosis (CA) arises from the deposition of misfolded amyloid proteins in the heart's extracellular matrix, leading to significant cardiac disease. Recent data suggest that CA is under-recognised, and advances in treatment have increased focus on this condition with the intention of implementing treatment earlier to improve prognosis. There is limited knowledge regarding the prevalence of transthyretin CA (ATTR-CA) on a national level, particularly in Iceland. Therefore, this study represents the first nationwide effort to evaluate the baseline characteristics, diagnostics, and treatment of ATTR-CA in Iceland.</p><p><strong>Methods: </strong>A retrospective study of all patients diagnosed with ATTR-CA in Iceland from 6 May 2013 to 11 March 2024 was identified in the Icelandic Cardiac Amyloid Registry (ICE-CAR) created in 2023 by heart failure (HF) specialists at Landspitali University Hospital in Reykjavik, Iceland. Diagnosis was based on different combinations of transthoracic echocardiography, an elevated Perugini score on bone scintigraphy and heart biopsies, as well measurements of free light chains, M-component measurements in blood and urine. Patients were grouped according to the National Amyloidosis Centre (NAC) prognostic staging system for ATTR-CA.</p><p><strong>Results: </strong>In total, 65 patients with ATTR-CA were identified (males n = 60, females n = 5, median age 81.4 years [IQR 75.5-85.5 years]), all wild-type and no mutant variant. Diagnosis was made with myocardial biopsy in 7 cases. Upon diagnosis, 83% of the patients had an interventricular septum thickness of ≥15 mm and 92% showed a posterior wall thickness of ≥12 mm. Approximately 57% of patients belonged to New York Heart Association (NYHA) functional class I-II. The HF phenotypes according to left ventricular ejection fraction (LVEF) were distributed as follows: reduced (HFrEF) n = 24 (37%), mildly reduced (HFmrEF) n = 9 (14%), preserved (HFpEF) n = 29 (44.5%), and unknown LVEF n = 3 (4.5%). A total of 54 patients had reported NAC stage: stage I 23 (35.4%), stage II 20 (30.8%), stage III 11 (16.9%). Around 32% received disease-modifying treatment.</p><p><strong>Conclusion: </strong>Despite the low NYHA class observed in the study population, our findings in Iceland's nationwide assessment of ATTR-CA indicate more advanced age and lower LVEF at diagnosis compared to other studies. This highlights the critical need for early detection and appropriate therapeutic interventions in managing ATTR-CA.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975133","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}

{"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}

{"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}

{"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}