Cardiology最新文献

{"title":"The Safety Profile of Ticagrelor among Older Adults (Age ≥75 years): A Pharmacovigilance Analysis.","authors":"Inbar Yacoby-Halevi, Boris Kruchin, Chen Gadot, Dmitri Guz, Assaf Rotmensh, Yonatan Shaleve, Hila Sharon, Noam Greenberg, Boris Fishman, Edward Itelman, Aviad Rotholz, Keren Skalsky, Katia Orvin, Alon Eisen, Ran Kornowski, Tsahi T Lerman, Amos Levi","doi":"10.1159/000552641","DOIUrl":"10.1159/000552641","url":null,"abstract":"<p><strong>Introduction: </strong>Ticagrelor is a widely used potent P2Y12 inhibitor in patients aged ≥75 years with acute coronary syndromes. Despite its widespread use, data on ticagrelor's safety in older adults remain limited.</p><p><strong>Methods: </strong>We performed a retrospective pharmacovigilance analysis using the FDA Adverse Event Reporting System from 2010 to 2024. Disproportionality analysis compared ticagrelor with clopidogrel, assessing predefined adverse events in adults (<75 years) and older adults (≥75 years). For each group, reporting odds ratios (RORs) with 95% confidence intervals (CIs) were calculated, and differences between age groups were evaluated using interaction analysis.</p><p><strong>Results: </strong>A total of 6,476 ticagrelor-related adverse event reports were included: 4,795 (74%) adults and 1,681 (26%) older adults. In older adults, ticagrelor was not associated with increased reporting of dyspnea, intracranial hemorrhage, complete atrioventricular block, or gout. Acute kidney injury (AKI) was the only event reported more frequently in older adults (ROR 2.3 [95% CI: 1.5-3.6] vs. 0.6 [95% CI: 0.4-0.9]; p < 0.001). Ticagrelor was associated with lower reporting of gastrointestinal bleeding, hematuria, hemoptysis, and anemia in both age subgroups. Bradycardia and syncope were reported more frequently among adults (p = 0.002 and p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Ticagrelor appears generally safe in older adults (≥75 years), with no excess reporting of major adverse events compared to younger adults, aside from a higher reporting of AKI.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-9"},"PeriodicalIF":1.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13423310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210211","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}

{"title":"Transcatheter versus Surgical Aortic Valve Replacement in Patients Aged 50-65 Years: A Propensity Score-Matched 5-Year Study.","authors":"Mohamed Doma, Mahmoud Ismayl, Adham Ramadan, Ibrahim Kamel, Pedro A Villablanca, Ashequl M Islam, Andrew M Goldsweig","doi":"10.1159/000552949","DOIUrl":"10.1159/000552949","url":null,"abstract":"<p><strong>Introduction: </strong>Comparative long-term outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in younger patients remain incompletely defined, particularly beyond early follow-up. This study evaluated short-, mid-, and long-term outcomes between TAVR and SAVR in patients aged 50-65 years using a multicenter retrospective cohort.</p><p><strong>Methods: </strong>Patients with aortic stenosis aged 50-65 years undergoing TAVR or SAVR were identified using the TriNetX database. Patients were matched 1:1 using propensity score matching (PSM). Outcomes were assessed at 30 days, 1 year, and 5 years. The primary endpoint was a composite of all-cause mortality or stroke; secondary endpoints included hospitalization, major bleeding, acute kidney injury (AKI), cardiogenic shock, and valve dysfunction. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to estimate the overall effect size.</p><p><strong>Results: </strong>PSM yielded 1,041 well-balanced pairs. At 30 days, TAVR was associated with a lower risk of the primary composite endpoint (3.0% vs. 5.6%; HR 0.53; 95% CI: 0.34-0.82; p = 0.004), all-cause mortality (HR 0.50; p = 0.03), major bleeding (HR 0.29; p < 0.001), AKI (HR 0.39; p < 0.001), and cardiogenic shock (HR 0.28; p < 0.001). At 1 year, the composite endpoint, mortality, and stroke did not differ significantly between groups; major bleeding remained lower with TAVR (HR 0.50; p < 0.001). At 5 years, TAVR was associated with higher risks of the primary composite endpoint (18.6% vs. 15.5%; HR 1.27; 95% CI: 1.03-1.57; p = 0.02) and all-cause mortality (13.7% vs. 8.3%; HR 1.81; 95% CI: 1.39-2.37; p < 0.001), while major bleeding remained lower (HR 0.65; p < 0.001).</p><p><strong>Conclusion: </strong>TAVR demonstrated early safety but a higher long-term risk of mortality and composite adverse outcomes at 5 years compared with SAVR.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-7"},"PeriodicalIF":1.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210195","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":"Real-World Promise of Cilostazol in Refractory Vasospastic Angina: The Need for Multicentre Collaboration.","authors":"Adnan Duha Cömert, Ercan Taştan","doi":"10.1159/000552955","DOIUrl":"10.1159/000552955","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210186","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":"Predictive Value of N-Terminal Pro-Brain Natriuretic Peptide Combined with High-Sensitivity Troponin-I for Progression to High-Risk Status in Acute Pulmonary Embolism.","authors":"Yangyi Lin, Xinyun Wang, Xiongying Lin, Tongqing Yao, Xian Jin","doi":"10.1159/000552873","DOIUrl":"10.1159/000552873","url":null,"abstract":"<p><strong>Introduction: </strong>Despite significant advances in the diagnosis and treatment of acute pulmonary embolism (APE), mortality remains high among high-risk APE patients. Timely identification of APE patients at risk of progression to high-risk status may enable intensified monitoring and timely treatment escalation, thereby potentially improving prognosis. The current guideline stratification system has a limited ability to distinguish patients likely to progress to high-risk status. This study aimed to evaluate the predictive value of combined N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin-I (hs-cTnI) for clinical deterioration to high-risk states in APE patients.</p><p><strong>Methods: </strong>A retrospective study included patients with APE who were diagnosed by computed tomography pulmonary angiography from January 2022 to July 2024. Patients were classified according to the presence or absence of progression to high-risk status.</p><p><strong>Results: </strong>A total of 569 patients were enrolled, of whom 23 progressed to high-risk status and 546 did not. Both NT-proBNP and hs-cTnI were significant predictors of progression to high-risk status: NT-proBNP (odds ratio [OR]: 1.019, 95% confidence interval [CI]: 1.007-1.032, p = 0.002) and hs-cTnI (OR: 7.241, 95% CI: 2.916-17.983, p < 0.001). The area under the receiver operating characteristic curve for the NT-proBNP and hs-cTnI combination in predicting progression to high-risk status was 0.852. Patients with elevated levels of both NT-proBNP (≥1,860 pg/mL) and hs-cTnI (≥0.03 ng/mL) had a significantly higher rate of progression to high-risk status (25.9%), especially among intermediate-high-risk patients (31.7%).</p><p><strong>Conclusions: </strong>The combination of NT-proBNP and hs-cTnI provides clinically useful prediction of impending deterioration to high-risk status in APE, particularly among intermediate-high-risk patients.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204162","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":"C-Reactive Protein and Long-Term Risk of Death in Patients with Myocardial Infarction.","authors":"Julie Borchsenius, Kristian H Kragholm, Deepak L Bhatt, Martin Bødtker Mortensen, Alexander Egeberg, Carlo Alberto Barcella, Christoffer Polcwiartek, Maria Dons, Ditte Vesterlev, Adam Femerling Langhoff, Caroline Espersen, Majid Afzal, Johanna Frary, Christina Byrne, Monija Mrgan, Roxana Mihaela Popescu, Arman Qamar, Michael Hecht Olsen, Lars Valeur Køber, Christian Torp-Pedersen, Gunnar Gislason, Muthiah Vaduganathan, Brittany Weber, Tor Biering-Sørensen, Manan Pareek","doi":"10.1159/000551869","DOIUrl":"10.1159/000551869","url":null,"abstract":"<p><strong>Introduction: </strong>The long-term prognostic value of standard C-reactive protein (CRP) in patients with myocardial infarction is unknown.</p><p><strong>Methods: </strong>Using Danish nationwide registries, we identified patients with a diagnosis of myocardial infarction from 2013 through 2020, who had a CRP measurement ≤24 h of index hospitalization. The primary outcome was death from any cause, and the secondary outcome was hospitalization or outpatient contact for new-onset heart failure. Absolute and relative risks for outcomes according to CRP quartiles at days 0-30 and 31-365 were calculated using multivariable Cox regression with average treatment effect modeling, adjusted for demographics and clinical features, including high-sensitivity troponin concentrations.</p><p><strong>Results: </strong>A total of 29,035 patients with myocardial infarction were included. Median CRP was 4 mg/L, and quartile intervals were quartile 1: <2.9 mg/L, quartile 2: 2.9 to <4 mg/L, quartile 3: 4 to <12 mg/L, and quartile 4: ≥12 mg/L. At 0-30 days, 1,660 patients had died, and 1,861 died between days 31 and 365. The standardized absolute risk of death at both 0-30 and 31-365 days was lowest among patients in quartile 1 (0-30 days: 2.8%, 31-365 days: 4.1%) and highest among patients in quartile 4 (0-30 days: 9.7%, 31-365 days: 9.5%). The standardized relative risks of death increased in a stepwise fashion from quartile 2 to quartile 4 when using quartile 1 as the comparator. Similar findings were observed for heart failure.</p><p><strong>Conclusion: </strong>Among patients with myocardial infarction, higher CRP concentrations were significantly associated with a higher risk of death and incident heart failure.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052437","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":"Safety and Efficacy of Double-Effect Kissing Balloon Technique in Left Main Bifurcation Percutaneous Coronary Intervention: Design and Rationale of Japanese Coronary Intervention Using Drug-Eluting and Perfusion Therapy for Left Main Disease Registry.","authors":"Takayuki Warisawa, Shuhei Odagiri, Masanobu Ishii, Toshiyuki Nagai, Taku Asano, Yohei Sotomi, Mamoru Nanasato, Kazuya Kawai, Hitoshi Matsuo, Shigeru Saito","doi":"10.1159/000552600","DOIUrl":"10.1159/000552600","url":null,"abstract":"<p><strong>Introduction: </strong>The Japanese Coronary Intervention Using Drug-Eluting and Perfusion Therapy for Left Main Disease Registry (JDEPTH-LM Registry) is a prospective, multicenter observational study in 32 Japanese institutions evaluating the double-effect kissing balloon technique (W-KBT) as a novel strategy for left main trunk percutaneous coronary intervention (LM-PCI). This approach combines provisional crossover stenting, proximal optimization technique, KBT, and prolonged (≥30 s) KBT using a perfusion balloon for the left anterior descending artery and a drug-coated balloon for the left circumflex (LCx) ostium.</p><p><strong>Methods: </strong>A total of 280 patients with stable/unstable angina or non-ST-elevation myocardial infarction and LCx ostial involvement will be enrolled. The co-primary endpoints are procedural success and major adverse cardiovascular events at 12 months. The JDEPTH-LM Registry will provide clinical data on the safety and efficacy of W-KBT, which may enhance outcomes in LM-PCI involving the LCx ostial lesion.</p><p><strong>Conclusion: </strong>These findings could contribute to the optimization of complex LM-PCI strategies in clinical practice.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004466","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}

{"title":"Graded Severity of Aortic Valve Sclerosis as an Independent Clinical Marker of Systemic Disease, Diastolic Dysfunction, and Mortality Risk: A Large Echocardiographic Cohort Study.","authors":"Israel Gotsman, Ariel Verbner, Donna R Zwas, Elisha Ouzan, Offer Amir, David Leibowitz","doi":"10.1159/000552614","DOIUrl":"10.1159/000552614","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic valve sclerosis (AVS) is highly prevalent in the elderly. However, the prognostic implications of different degrees of echocardiographic AVS severity, and its association with comorbidities, myocardial remodeling, and heart failure phenotypes remains incompletely defined.</p><p><strong>Methods: </strong>We studied 42,959 participants from a large institutional echocardiographic database. AVS severity was classified as Normal (69%), Thickened (16%), Calcified (13%), or Severely Calcified (2%). Subjects with aortic stenosis greater than mild were excluded.</p><p><strong>Results: </strong>Increasing AVS severity was consistently associated with a higher burden of systemic comorbidities: hypertension, diabetes mellitus, atherosclerotic cardiovascular disease, heart failure, atrial fibrillation and renal disease. It was also associated with concentric left ventricular (LV) geometry, reflected by increased relative wall thickness and LV mass index. Worsening diastolic dysfunction was evident with increasing degrees of AVS, including reduced mitral annular e' velocity, an elevated E/e' ratio, increased left atrial volume index, and higher tricuspid regurgitation gradient. A rising prevalence of clinical heart failure with preserved ejection fraction (HFpEF) was observed. After multivariable adjustment including diastolic parameters, AVS severity demonstrated a strong, dose-dependent, independent association with all-cause mortality. Patients with severe calcification demonstrated the highest risk, with a hazard increase exceeding 60%. AVS severity was also a predictor of the composite endpoint of death and cardiovascular hospitalization.</p><p><strong>Conclusions: </strong>AVS severity assessed on echocardiography demonstrates strong, dose-dependent associations with systemic comorbidities, concentric LV geometry, and HFpEF, and carries substantial prognostic significance. These findings highlight the clinical relevance of AVS severity as an early stage of the aortic valve disease spectrum, underscoring the need for proactive management of the systemic disease continuum.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980797","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}

{"title":"Commentary Chasing the Pathophysiological Footprint in Hypertrophic Cardiomyopathy: Beyond Global Strain.","authors":"Anatoli Kiotsekoglou, Aasha S Gopal, Adnan Rahman, Samir K Saha","doi":"10.1159/000551606","DOIUrl":"https://doi.org/10.1159/000551606","url":null,"abstract":"","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970328","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":"Cardiogenic Shock: Outcome Patterns Across the Body Mass Spectrum and Renal Vulnerability.","authors":"Priyanka Boettger, Vincent Groesser, Karolis Macius, Shahed Al Zoghool, Hassan Hassan, Joerg Yogarajah, Jamschid Sedighi, Utku Bayram, Matthias Janusch, Pascal Bauer, Henning Lemm, Samuel Sossalla, Michael Buerke","doi":"10.1159/000552535","DOIUrl":"10.1159/000552535","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between body mass index (BMI) and acute kidney injury (AKI) and mortality in infarction-related cardiogenic shock (CS) remains uncertain. We investigated the association between BMI and renal and short-term clinical outcomes in patients with infarction-related CS.</p><p><strong>Methods: </strong>In this retrospective single-center cohort study, 369 consecutive patients with infarction-related CS were included. BMI was analyzed as the exposure variable and modeled both continuously and according to World Health Organization categories. AKI within 96 h, defined according to Kidney Disease: Improving Global Outcomes creatinine-based criteria, and in-hospital mortality were the primary outcomes; renal replacement therapy (RRT) was a secondary outcome. Associations were assessed using multivariable logistic regression adjusted for prespecified confounders, including age, sex, diabetes mellitus, chronic kidney disease, and baseline estimated glomerular filtration rate. Nonlinear relationships were explored using restricted cubic spline analyses.</p><p><strong>Results: </strong>AKI occurred in 158 patients (42.8%). Higher BMI, modeled as a continuous variable, was associated with an increased risk of AKI (adjusted OR 1.34 per 5 kg/m2; 95% CI, 1.06-1.69; p = 0.012). RRT was more frequently required in patients with obesity than in those with normal weight (18.5% vs. 8.6%; p = 0.018). When analyzed categorically, overweight (BMI 25.0-29.9 kg/m2) was associated with lower in-hospital mortality compared with normal weight (adjusted OR 0.66; 95% CI, 0.45-0.95; p = 0.028), whereas obesity was not independently associated with mortality. Nonlinear modeling suggested a U-shaped relationship between BMI and both AKI and in-hospital mortality, with the lowest estimated risk at intermediate BMI levels.</p><p><strong>Conclusion: </strong>In patients with infarction-related CS, BMI was associated with both renal outcomes and in-hospital mortality. Higher BMI was linked to increased renal vulnerability, whereas overweight was associated with lower mortality. These findings should be interpreted cautiously given the observational design and the potential for residual confounding and reverse causation, particularly at lower BMI levels.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-15"},"PeriodicalIF":1.9,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970344","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}

{"title":"A Risk Score without a Window: The Clinical Timing Problem of Observatoire Régional Breton sur l'Infarctus Risk Score.","authors":"Sarah Louise Duus Holle, Helle Søholm, Martin Frydland, Mikkel Bjerg Andersen, Yusuf Abdi Isse, Joakim Bo Kunkel, Anika Klein, Lene Holmvang, Jacob Eifer Møller, Christian Hassager, Rasmus Paulin Beske","doi":"10.1159/000552034","DOIUrl":"10.1159/000552034","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiogenic shock (CS) is a main cause of mortality in ST-elevation myocardial infarction (STEMI). The ORBI risk score estimates in-hospital CS risk using pre- and post-procedural angiographic variables. The study aimed to prospectively validate the ORBI risk score for predicting in-hospital CS and to assess its ability to identify post-procedural CS, when all score components are available.</p><p><strong>Methods: </strong>Consecutive adult STEMI patients without CS at admission were prospectively registered at a tertiary hospital during 2022-2025. Discrimination and calibration were evaluated in all patients and among patients with post-procedural CS after leaving the catheterization laboratory.</p><p><strong>Results: </strong>Among 2,713 adult patients (median age 64 years; 24% female), the median ORBI score was 4 (IQR 2-7), and 103 patients (3.8%) developed in-hospital CS. Among all patients, 80% were low risk (ORBI ≤7) with 1.0% developing in-hospital CS; 13% were low-to-intermediate risk (ORBI 8-10) with 5.6% developing CS; 3.1% were intermediate-to-high risk (ORBI 11-12) with 23% developing CS; and 3.9% were high risk (ORBI ≥13), of whom 40% developed in-hospital CS. The score demonstrated strong discrimination (area under the receiver operating characteristic curve [AUC] 0.89; 95% CI: 0.87-0.94) for in-hospital CS and for post-procedural CS (AUC 0.87; 95% CI: 0.83-0.95). In patients with in-hospital CS, 68% developed peri-procedural CS. Among patients with post-procedural, CS the score substantially overestimated CS risk.</p><p><strong>Conclusions: </strong>The ORBI risk score performed well at predicting in-hospital CS but markedly overestimated post-procedural CS risk. As post-procedural CS is the clinically relevant endpoint for a model incorporating post-procedural variables, the ORBI score requires recalibration before it can be used to guide post-PCI decisions.</p>","PeriodicalId":9391,"journal":{"name":"Cardiology","volume":" ","pages":"1-12"},"PeriodicalIF":1.9,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970320","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}