European heart journal open最新文献

{"title":"Prevalence of albuminuria and its association with left atrial remodelling in patients with atrial fibrillation.","authors":"Koki Nakanishi, Masao Daimon, Katsuhito Fujiu, Kentaro Iwama, Kazutoshi Hirose, Yuriko Yoshida, Yasuhiro Mukai, Hikari Seki, Yuko Yamamoto, Megumi Hirokawa, Tomoko Nakao, Tsukasa Oshima, Takumi Matsubara, Yu Shimizu, Gaku Oguri, Toshiya Kojima, Eriko Hasumi, Hiroyuki Morita, Makoto Kurano, Norihiko Takeda","doi":"10.1093/ehjopen/oeaf054","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf054","url":null,"abstract":"<p><strong>Aims: </strong>Although recent epidemiological studies identified albuminuria as an independent risk for atrial fibrillation (AF), even in individuals with a preserved or mildly reduced estimated glomerular filtration rate (eGFR), the prevalence of albuminuria and its association with left atrial (LA) remodelling in patients with AF remains unknown. This study aimed to investigate the association of albuminuria with LA structure and mechanics before and after catheter ablation (CA) in AF patients.</p><p><strong>Methods and results: </strong>We examined 133 AF patients with an eGFR ≥60 mL/min/1.73 m² who underwent first CA. Conventional and speckle-tracking echocardiography was performed before and 6 months after CA to assess the LA volume index, LA reservoir strain, and LA stiffness. The median eGFR was 70 mL/min/1.73m², and 21 (15.8%) patients had albuminuria. The difference between the eGFR values of patients with and without albuminuria was not significant (<i>P</i>  <i>=</i> 0.709). Patients with albuminuria had a larger LA volume index, reduced LA reservoir strain and increased LA stiffness compared with patients without albuminuria (all <i>P</i> < 0.001). The presence of albuminuria was associated with reduced LA reservoir strain and increased LA stiffness, independent of age, AF type, and AF risk factors. After CA, there was significant improvement in LA size and function in both groups, while albuminuria group still had a larger LA volume index and increased LA stiffness (both <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Approximately 16% of AF patients with preserved or mildly reduced eGFR had albuminuria. The presence of albuminuria was related to unfavourable LA remodelling and its persistence even after restoration of sinus rhythm.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf054"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin does not modify cardiovascular event risk in endometriosis in the California Teachers Study.","authors":"Alison Seitz, Cenai Zhang, Leslie Bull, Hooman Kamel, Halina White, Babak B Navi, Ja Hyun Shin, Jill Berkin, Jed H Kaiser, Vanessa Liao, Ava L Liberman","doi":"10.1093/ehjopen/oeaf023","DOIUrl":"10.1093/ehjopen/oeaf023","url":null,"abstract":"<p><strong>Aims: </strong>Endometriosis frequently affects reproductive aged females and is associated with increased cardiovascular disease risk. The aims of this study were (i) to confirm the relationship between cardiovascular disease and endometriosis and (ii) to test whether aspirin modified the effect of endometriosis on cardiovascular disease risk.</p><p><strong>Methods and results: </strong>A longitudinal cohort study was conducted using data from the California Teachers Study from enrolment (1995-1996) through the current administrative end follow-up (31 December 2020). Primary outcome was any incident major adverse cardiovascular event (MACE) defined using validated ICD-9/ICD-10 codes for stroke, myocardial infarction, and coronary heart disease. Inverse probability (IP) weights were used to estimate the causal effect of self-reported endometriosis on cardiovascular events. Of the included 120 435 participants, 13 754 (11.4%) reported history of endometriosis. There were 2159 admissions for MACE in the endometriosis group vs. 16 632 in the non-endometriosis group. After controlling for demographics and vascular comorbidities, risk of MACE was higher in the endometriosis group than in the non-endometriosis group [IP-weighted hazard ratio (HR) 1.10, confidence interval (CI) 1.04-1.15], particularly in participants < 40 years of age (IP-weighted HR 1.48, CI 1.08-2.02). Aspirin use did not modify the effect of endometriosis on MACE (<i>P</i> interaction = 0.467). Among participants taking aspirin, the adjusted HR for endometriosis was 1.07 (95% CI, 0.96-1.19) whereas among participants not taking aspirin, adjusted HR was 1.10 (95% CI, 1.04-1.17).</p><p><strong>Conclusion: </strong>In a large American cohort, endometriosis was associated with increased risk of adverse cardiovascular events, especially in younger participants. Aspirin did not modify this risk. Research to determine how to best reduce cardiovascular risk in endometriosis is warranted.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf023"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-glucose cotransporter-2 inhibitors and ketoacidosis in heart failure: analysis of US Adverse Event Reporting System (FAERS).","authors":"Samantha L Yeung, Mengxi Wang, Mimi Lou, Tien M H Ng","doi":"10.1093/ehjopen/oeaf056","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf056","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf056"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of high microvascular resistance on coronary wave energetics depends on coronary microvascular functionality.","authors":"Ahmet Tas, Yaren Alan, Ilke Kara Tas, Sabahattin Umman, Kim H Parker, Tim P van de Hoef, Murat Sezer, Jan J Piek","doi":"10.1093/ehjopen/oeaf050","DOIUrl":"10.1093/ehjopen/oeaf050","url":null,"abstract":"<p><strong>Aims: </strong>The pathophysiological relevance of high hyperemic microvascular resistance (hMR) in stable coronary artery disease is controversial. Using wave intensity analysis (WIA, defined as the product of the time derivatives of the coronary pressure and velocity), we aim to compare the impact of high hMR on coronary wave energetics with respect to coronary microvascular dysfunction (CMD), defined as reduced coronary flow reserve (CFR < 2.5), in unobstructed arteries.</p><p><strong>Methods and results: </strong>The study population (<i>n</i> = 258, mean age = 68 ± 10 years, 73% male) had a high cardiovascular risk profile including dyslipidemia (88%), hypertension (70%), smoking (55%) and diabetes (28%). The mean fractional flow reserve was 0.89 ± 0.05. Vessels (<i>n</i> = 312) were divided into four endotypes: no CMD-low hMR (CFR ≥ 2.5, hMR < 2.5 mmHg.s.cm^-1), Functional CMD (CFR < 2.5, hMR < 2.5 mmHg.s.cm^-1), Structural CMD (CFR < 2.5, hMR ≥ 2.5 mmHg.s.cm^-1), and no CMD-high hMR (CFR ≥ 2.5, hMR ≥ 2.5 mmHg.s.cm^-1). The no CMD-high hMR endotype had the lowest mean resting velocity (bAPV = 10 ± 3 cm.s^-1  <i>P</i> < 0.001), highest mean basal microvascular resistance (bMR = 9 ± 2 mmHg/cm.s^-1  <i>P</i> < 0.001) amongst all endotypes, yet, it had reference-level CFR, microvascular resistance reserve and resistive reserve ratio (<i>P</i> > 0.05 for all compared to no CMD-low hMR), unlike CMD endotypes (<i>P</i> < 0.05 compared to CMD endotypes). The no CMD-high hMR endotype exhibited the highest hyperemic increase in the accelerating wave energy proportion (AEP) (13% ± 13%, <i>P</i> = 0.042), indicating an intact autoregulatory response. Only in the CMD endotypes, high hMR was associated with reduced AEP (<i>r</i> = -0.229, <i>P</i> < 0.001), unlike no CMD endotypes (<i>P</i> = 0.383).</p><p><strong>Conclusion: </strong>High hMR alone is not a definitive CMD marker. In line with the adaptive high hMR hypothesis, increased hMR does not necessarily limit augmentation of AEP, and is associated with robust autoregulatory capacity in vessels with preserved CFR. Cardiologists should be alert to a potential adaptive no CMD-high hMR endotype to avoid misdiagnosis.</p><p><strong>Registration: </strong>NCT02328820.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf050"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of sphingolipids in heart failure.","authors":"Rana Hamouche, Scott A Summers, William L Holland, Sutip Navankasattusas, Stavros G Drakos, Eleni Tseliou","doi":"10.1093/ehjopen/oeaf035","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf035","url":null,"abstract":"<p><p>Advanced heart failure (HF) is characterized by changes in the structure, function, and metabolism of cardiac muscle. As the disease progresses, cardiomyocytes shift their ATP production from fatty acid oxidation to glycolysis. This shift results in an accumulation of lipid metabolites, particularly sphingolipids, which can disrupt normal cellular function and contribute to cardiac dysfunction. In animal models of obesity, accumulation of toxic sphingolipid metabolites in the heart has been described as cardiac lipotoxicity. In humans, HF is classified into two groups based on ejection fraction (EF): HF with reduced EF of less than 40% (HFrEF) and HF with preserved EF of greater than 50% (HFpEF). Despite shared risk factors and comorbidities, the structural and cellular differences between HFrEF and HFpEF distinguish them as separate conditions. Ceramides (Cer), a type of sphingolipid, have gained significant attention for their involvement in the development and prognosis of atherosclerotic disease and myocardial infarction, while sphingosine-1-phosphate, a downstream product of Cer, has shown cardioprotective properties. The aim of this review is to describe the role of sphingolipids in HF with reduced and preserved EF. By understanding the role of sphingolipids through animal and human studies, this review aims to pave the way for developing strategies that target abnormal signalling pathways in the failing heart, ultimately bridging the gap between scientific research and clinical applications.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf035"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular magnetic resonance imaging markers of ageing: a multi-centre, cross-sectional cohort study.","authors":"Hosamadin S Assadi, Xiaodan Zhao, Gareth Matthews, Rui Li, Jordi Broncano Cabrero, Bahman Kasmai, Samer Alabed, Javier Royuela Del Val, Hilmar Spohr, Yashoda Gurung-Koney, Nay Aung, Sunil Nair, Andrew J Swift, Vassilios S Vassiliou, Liang Zhong, Abdallah Al-Mohammad, Rob J van der Geest, Peter P Swoboda, Sven Plein, Pankaj Garg","doi":"10.1093/ehjopen/oeaf032","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf032","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac ageing involves a series of anatomical and physiological changes contributing to a decline in overall performance. Cardiac magnetic resonance (CMR) provides comprehensive structural and functional assessment for detecting age-related cardiovascular remodelling. We aimed to develop a fully automated CMR model to predict functional heart age.</p><p><strong>Methods and results: </strong>This international, multi-centre, retrospective observational study enrolled 191 healthy individuals with normal body mass index (BMI), free of metabolic, cardiovascular, and respiratory disease as the derivation cohort. Left atrial (LA) end-systolic volume and LA ejection fraction were selected for the final model. The model was validated on 366 patients with BMI >25 kg/m² and one or more comorbidities [hypertension, diabetes mellitus (DM), atrial fibrillation (AF), and obesity]. In healthy individuals [median age: 34 years, 105 (55%) female], CMR-derived functional heart age was similar to the chronological age [bias: 0.05%, 95% confidence interval (CI): 9.56-9.67%, <i>P</i> = 0.993]. In the validation cohort [median age: 53 years, 157 (43%) female], CMR-derived functional heart age was 4.6 years higher than chronological age (95% CI: 1.6-7.6 years, <i>P</i> = 0.003). Cardiac magnetic resonance-derived functional heart age was significantly higher in patients with hypertension (<i>P</i> < 0.001), DM (<i>P</i> < 0.001), and AF (<i>P</i> < 0.001) than age-matched healthy controls. Moreover, CMR-derived functional heart age was higher than the chronological age in obesity Class I (<i>P</i> = 0.07), obesity Class II (<i>P</i> = 0.11), and obesity Class III (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This study highlights the time course of structural and physiological changes in the heart during healthy and unhealthy ageing. We propose simple equations that should help communicate subtle changes in heart assessment with ageing.</p><p><strong>Registration: </strong>ClinicalTrials.gov: NCT05114785.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf032"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12045662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanistic classification of isolated severe aortic regurgitation in a contemporary cohort of patients.","authors":"Rudy R Unni, Munir Boodhwani, Ibrahim Jelaidan, David T Harnett, Samia Massalha, Calvin Liang, Graeme Prosperi-Porta, David Glineur, Ian G Burwash, Kwan-Leung Chan, Thais Coutinho, Angel Fu, Nadav Willner, David Messika-Zeitoun, Luc Beauchesne","doi":"10.1093/ehjopen/oeaf042","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf042","url":null,"abstract":"<p><strong>Aims: </strong>Aortic regurgitation (AR) arises from leaflet disease and/or dilatation of the functional aortic annulus complex. Understanding the mechanisms of AR informs surgical planning of valve and aorta repair. This study investigates the mechanisms, aetiologies, and outcomes of isolated native severe AR in a consecutive cohort of patients.</p><p><strong>Methods and results: </strong>Patients with moderate-to-severe (3+)/severe (4+) native valve AR, identified from our institutional echocardiography database (2014-2018), were included. Exclusions were significant concomitant valve disease, endocarditis, or aortic dissection. AR was classified per the El-Khoury system: Type I (normal leaflet motion: Ia-ascending aorta/sinotubular junction dilatation, Ib-aortic root dilation, Ic-aortic annular dilation), Type II (leaflet prolapse), and Type III (leaflet restriction). Valve anatomy and clinical outcomes, including mortality and surgical intervention, were analyzed. Of 282 patients (77.3% male), 58.5% had multiple AR mechanisms. Type II (leaflet prolapse) was most common (48.6%), followed by Type III (36.2%). Bicuspid aortic valve (BAV) represented 35.5% of the population, with leaflet prolapse observed in 72%. Multiple mechanisms were more frequent in BAV (77% vs. 48%, <i>P</i> < 0.001). After a median follow-up of 4.7 years (available for 97.5% of patients), 158 (57.5%) underwent an intervention with 48.7% having an aortic valve repair or valve-sparing aortic root replacement.</p><p><strong>Conclusion: </strong>Although leaflet prolapse (Type II) was the pre-dominant AR mechanism, multiple contributing mechanisms were often present, particularly in BAV patients. Aortic valve repair accounted for nearly half of surgical interventions, underscoring the importance of mechanism identification to optimize repair and avoid valve replacement.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf042"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12076401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined association of lipoprotein(a) and European Society of Cardiology Systematic COronary Risk Evaluation 2 (SCORE2) with 10-year major adverse cardiovascular events: evidence from a single tertiary hospital including 9979 patients.","authors":"Kyuwoong Kim, Minkyoung Kim, Jiye Han, Tae Joon Jun, Young-Hak Kim","doi":"10.1093/ehjopen/oeaf048","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf048","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf048"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in out-of-hospital cardiac arrest.","authors":"Nertila Zylyftari, Mads Wissenberg, Filip Gnesin, Amalie Lykkemark Møller, Elisabeth Helen Anna Mills, Sidsel G Møller, Britta Jensen, Kristian Bundgaard Ringgren, Hanno L Tan, Fredrik Folke, Gunnar Gislason, Christian Torp- Pedersen, Christina Ji-Young Lee","doi":"10.1093/ehjopen/oeaf047","DOIUrl":"10.1093/ehjopen/oeaf047","url":null,"abstract":"<p><strong>Aims: </strong>The impact of resuscitation care initiatives on sex-differences in out-of-hospital cardiac arrest (OHCA) survival remains unclear. We aim to examine sex-differences in characteristics and survival.</p><p><strong>Methods and results: </strong>This Danish register-based study (2001-2020) included adult patients with a presumed cardiac cause of arrest. Temporal trends in survival were stratified by sex and subgroups: (i) bystander-witnessed status; (ii) bystander cardiopulmonary resuscitation (CPR); (iii) initial shockable heart rhythm; and age groups of <50, 50-75, and >75 years. To examine the association between sex and survival, we conducted adjusted logistic regression analyses. Among 50 066 OHCAs, women represented 34%. Women were older, had more chronic obstructive pulmonary disease, and lower prevalence of cardiovascular and cardiometabolic conditions than men. Women also had more OHCA at home (83.4 vs. 74.1%), fewer witnessed arrests (48.1 vs. 52.9%), half the probability of initial shockable heart rhythm (13.6 vs. 27.6%), and similar rates of receiving bystander-CPR. Survival rates improved over time for both sexes, but men had higher 30-day survival than women, even in subgroup and adjusted analyses [odds ratios (OR): 1.29; 95% confidence intervals (CI): 1.15-1.45, <i>P</i> < 0.001]. Sex-differences in survival were larger among those aged 50-75 years (in absolute and relative rates) and bystander witnessed arrests, while differences were smaller in those with initial shockable heart rhythms.</p><p><strong>Conclusion: </strong>Despite increases in 30-day survival for both sexes, women consistently had lower survival rates than men. Sex-differences were larger among those aged 50-75 years or with bystander witnessed arrests, but smaller in the subset of patients with an initial shockable heart rhythm.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf047"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardioprotective drugs and heart failure/cardiomyopathy incidence in chemotherapy-treated cancer survivors of breast cancer and non-Hodgkin lymphoma: a retrospective cohort study in England.","authors":"Pooja Hindocha, Alexander R Lyon, Krishnan Bhaskaran, Helen Strongman","doi":"10.1093/ehjopen/oeaf039","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf039","url":null,"abstract":"<p><strong>Aims: </strong>Evidence for the use of beta-blockers, angiotensin II receptor blockers (ARB), or angiotensin-converting enzyme inhibitors (ACEi) to mitigate chemotherapy-induced cardiotoxicity is inconclusive. The objectives are to investigate associations between prescription of ARBs, ACEis, and/or beta-blockers in the year following cancer diagnosis and subsequent risk of heart failure/cardiomyopathy (HF/CM) in chemotherapy-treated breast cancer and non-Hodgkin lymphoma (NHL) survivors.</p><p><strong>Methods and results: </strong>This cohort study used linked English electronic healthcare records from 9875 adult (≥18 years) breast cancer and NHL survivors who received chemotherapy. Cox regression was used to estimate the association between primary care-prescribed beta-blocker, ARB, and ACEi use in the year following cancer diagnosis, and subsequent HF/CM incidence, adjusting for potential confounders. Likelihood ratio tests were used to assess effect modification. The mean follow-up duration was 4.9 years (maximum 21.4). After adjusting for age, the risk of HF/CM was higher in the exposed group [hazard ratio (HR): 1.69, 95% confidence interval (CI): 1.34-2.14], but further adjustment for gender, comorbidities, and other medications reduced the association to close to null (HR: 1.07, 95% CI: 0.68-1.69). There was no evidence that the association differed by cancer site, age, radiotherapy, prior cardiovascular disease, or years since cancer diagnosis.</p><p><strong>Conclusion: </strong>We found no evidence that general practitioner prescribed beta-blocker, ARB, or ACEi use was associated with a reduced incidence of HF/CM in this population of chemotherapy-treated breast cancer and NHL survivors. This might be because the drug dosage and timing were not optimized to prevent chemotherapy-related cardiac damage; residual confounding by indication may also have obscured any treatment benefit.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf039"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}