European heart journal open最新文献

{"title":"Bridging the gaps in interventional cardiology disparities-socioeconomic, geographic, and political inequalities.","authors":"Marta Kaluzna-Oleksy, Giulia Massiero, Salvatore De Rosa, Marta Bujak, Rania Hammami, Omeir Kadri, Mila Kovacevic, Rita Caldeira de Rocha, José Luis Leiva Pons, Marie-Claude Morice, Alaide Chieffo","doi":"10.1093/ehjopen/oeaf151","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf151","url":null,"abstract":"<p><p>Despite significant advancements in interventional cardiology, including PCI, TAVI, and other structural heart interventions, access to these life-saving procedures remains uneven across the globe. This viewpoint highlights how socioeconomic, geographic, and political disparities impact clinical decision-making, outcomes, and professional well-being. Drawing from real-world experience and health systems analysis, the article explores the multifaceted barriers that hinder equitable care-ranging from health literacy and rural access to workforce shortages and regulatory or reimbursement challenges. It further discusses the psychological burden on clinicians caused by moral distress and limited resources. Potential solutions, including telemedicine, decentralized training, public awareness campaigns, and policy advocacy, are proposed to bridge the gap and promote a more just and inclusive landscape in interventional cardiology.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf151"},"PeriodicalIF":0.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644044","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":"Associated mortality and time spent in hospital following mitral valve intervention for mitral regurgitation according to frailty status: a nationwide Danish study.","authors":"Lauge Østergaard, Jeppe K Petersen, Christian L Carranza, Simon Melchior, Liv Borum Schöps, Sofie Truong, Kamillia Baker, Jarl Emanuel Strange, Lars Køber, Emil Fosbøl","doi":"10.1093/ehjopen/oeaf152","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf152","url":null,"abstract":"<p><strong>Aims: </strong>Little is known about how patient frailty affects mortality and hospitalization following mitral valve intervention for mitral regurgitation (MR).</p><p><strong>Methods and results: </strong>Using Danish nationwide registries, we identified patients undergoing first-time mitral valve intervention for MR during the period 1996-2022. Patients were categorized as frail or non-frail based on the Hospital Frailty Risk Score. We assessed 1 year mortality with the reverse Kaplan-Meier estimator, and adjusted comparisons were computed using multivariable-adjusted Cox regression analysis. A composite outcome of death or time in hospital >14 days within 1 year was examined using multivariable-adjusted logistic regression analysis. A total of 7000 patients (90.0%) were considered non-frail (median age 67.0 years, 66.3% male) and 782 (10.0%) were considered frail (median age 71.0 years, 56.3% male). One year mortality was 8.2% among non-frail patients and 13.4% among frail patients (<i>P</i>-value <0.0001), but no statistically significant difference was observed [hazard ratio = 1.16, 95% confidence interval (CI): 0.88-1.54, reference: non-frail patients] in the adjusted analysis. Within the first year after mitral valve intervention, 42.8% of non-frail patients were never admitted, 42.1% were admitted for 1-14 days, 6.2% for 14-28 days, and 5.1% for >28 days. Among frail patients, the corresponding proportions were 26.6%, 46.3%, 9.1%, and 9.8%. In the adjusted analysis, frail patients were associated with higher odds of the composite outcome [odds ratio = 1.65 (95% CI: 1.37-2.00)].</p><p><strong>Conclusion: </strong>Frail patients were associated with more time spent in hospital within the first year following surgery compared with non-frail patients, but no statistically significant difference was found in the 1 year mortality according to frailty status in adjusted analysis.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf152"},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644054","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":"Impact of socio-demographic and ethnic determinants in guideline-directed medical therapy implementation during heart failure hospitalization.","authors":"Renzo Laborante, Agni Delvinioti, Federica Tomassini, Donato Antonio Paglianiti, Gaetano Rizzo, Giuseppe Ciliberti, Attilio Restivo, Jacopo Lenkowicz, Antonio Iaconelli, Stefano Patarnello, Giuseppe Patti, Francesco Canonico, Antonio Gasbarrini, Vincenzo Valentini, Alfredo Cesario, Giovanni Arcuri, Gianluigi Savarese, Filippo Crea, Stefania Boccia, Domenico D'Amario","doi":"10.1093/ehjopen/oeaf149","DOIUrl":"10.1093/ehjopen/oeaf149","url":null,"abstract":"<p><strong>Aims: </strong>To assess for the first time the impact of socio-demographic variables on prescription of guideline-directed medical therapy (GDMT) after an episode of heart failure (HF) decompensation in the Italian healthcare system.</p><p><strong>Methods and results: </strong>Utilizing 'GENERATOR-HF DataMart', a cross-sectional analysis was performed. We included patients with HF and reduced ejection fraction discharged between January 2019 and July 2024. The degree of GDMT implementation across the different socio-demographic variables (i.e. patient's age, sex, marital status, nationality, place of residence, and educational level) was evaluated through the modified optimal medical therapy (mOMT) score (i.e. a ratio between the number of pillars actually prescribed and the number of pillars that could be prescribed on the basis of each specific contraindication). A multivariable logistic regression model was also fitted to assess the association between the socio-demographic variables and the prescription of each pillar and loop diuretics. 1730 patients (median age: 72 years; 24% females) were included. The mOMT score was significantly lower in elderly patients, but comparable across other pre-specified socio-demographic categories. In multivariable regression analysis, older age was the only independent socio-demographic predictor of under-prescription both overall and for ACEi/ARB/ARNI (OR0.70; 95% CI 0.55-0.89), beta-blockers (OR0.59; 95% CI 0.41-0.84) and SGLT2i (OR0.66, 95% CI 0.47-0.93), while also associated with a loop diuretics use (OR1.56; 95% CI 1.13-2.17). A higher mOMT score was significantly associated with a reduced incidence of early adverse events (i.e. 30-day all-cause death and urgent re-admissions) (4.1% vs. 8.5%; <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Older age was the only independent predictor of under-prescription of GDMT and enhanced use of loop diuretics, whereas no discrepancies were found across the other socio-demographic subgroups.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf149"},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727282","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":"Relative efficacy of tafamidis, acoramidis, patisiran and vutrisiran in patients with transthyretin cardiac amyloidosis: a network meta-analysis.","authors":"Alberto Aimo, Vincenzo Castiglione, Michele Emdin, Valentina Lorenzoni, Giuseppe Vergaro","doi":"10.1093/ehjopen/oeaf147","DOIUrl":"10.1093/ehjopen/oeaf147","url":null,"abstract":"<p><strong>Aims: </strong>Transthyretin cardiac amyloidosis (ATTR-CA) is an important cause of heart failure (HF). Several therapies demonstrated an efficacy in reducing hard and surrogate endpoints. We compared the relative efficacy of therapies evaluated in completed phase III trials.</p><p><strong>Methods and results: </strong>We conducted a network meta-analysis using data from ATTR-ACT, ATTRIBUTE-CM, APOLLO-B, and HELIOS-B. The primary endpoint was a composite of all-cause mortality and cardiovascular hospitalizations. Secondary endpoints were changes in the 6-minute walk distance (6MWD) and Kansas City Cardiomyopathy Questionnaire-Overall Summary (KCCQ-OS) scores. For the primary endpoint, tafamidis and vutrisiran demonstrated a significant survival benefit over placebo; acoramidis approached significance. In indirect comparisons, there was no clear evidence of a larger absolute risk reduction for any drug. Tafamidis was associated with the lowest risk for the primary endpoint (surface under the cumulative ranking, SUCRA 82%), followed by vutrisiran monotherapy (70%). Regarding changes in 6MWD, tafamidis and acoramidis had the highest SUCRA curve values (97% and 69%, respectively). For KCCQ-OS changes, tafamidis also had the highest SUCRA (87%), followed by acoramidis (79%) and vutrisiran monotherapy (67%). When the ATTR-ACT trial was excluded from the analysis, vutrisiran monotherapy consistently showed the highest probability of being ranked better than other treatments in terms of primary end-point.</p><p><strong>Conclusion: </strong>Although differences in trial design and study populations complicate direct efficacy comparisons, tafamidis demonstrated the highest efficacy in improving survival, reducing cardiovascular hospitalizations, and enhancing functional capacity and quality of life in patients with ATTR-CA, but also vutrisiran and acoramidis emerged as viable options.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf147"},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12637029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590483","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":"Impact of ablation energy on mortality after oesophageal fistula and injury complicating atrial fibrillation ablation procedures: results from a worldwide FDA database, the POTTER-AF 2 study.","authors":"Roland R Tilz, Sorin S Popescu, Helmut Pürerfellner, Karl-H Kuck, Kun Xiang, Ekin C Uzunoglu, Christian-H Heeger, Julia Vogler, Harikrishna Tandri, Fabrizio Assis, Ghanshyam Shantha, José L Merino, John N Catanzaro","doi":"10.1093/ehjopen/oeaf146","DOIUrl":"10.1093/ehjopen/oeaf146","url":null,"abstract":"<p><strong>Aims: </strong>Oesophageal fistulas (OF) and injuries (OI) are rare, but life-threatening complications following catheter ablation for atrial fibrillation (AF). Data about their incidence, management, and outcome are scarce. This study investigates the clinical characteristics and outcomes of OF and OI following AF ablation.</p><p><strong>Methods and results: </strong>All OF and OI reported between August 2009 and August 2019 in the Manufacturer and User Facility Device Experience (MAUDE) database of the Food and Drug Administration were analysed. A total of 1274 device adverse events following AF/atrial flutter (AFL) ablation were reported in the MAUDE database. Of them, 60 (4.7%) represented patients with OF or OI. A total of 47 patients exhibited OF, while 13 OI without perforation. A total of 35 (58.3%) patients underwent radiofrequency (RF)-based ablation, 20 (33.3%) cryoballoon (CB)-based PVI, and 5 (8.3%) a laser-based PVI. The mortality was 63.3%, but significantly higher in the OF group as compared to the OI group (76.6% vs. 15.4%; <i>P</i> < 0.001). When analysing only the patients exhibiting OF, the mortality was 71.0% among the RF patients, 86.7% among the CB patients, and 100% among those receiving laser ablations (<i>P</i> = 0.427). Among patients exhibiting OF only, the mortality was 80% for those treated surgically, 80% for those treated exclusively endoscopically, and 100% for those treated conservatively.</p><p><strong>Conclusion: </strong>Almost one-third of the patients developing OF underwent CB-based ablation. More than three-fourths of the patients died, without significant difference between the ablation energy used. All patients with OF treated conservatively died. OF may occur despite oesophageal temperature monitoring.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf146"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12659787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650616","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":"Intravascular ultrasound-guided percutaneous coronary intervention in acute coronary syndrome stratified by the TVF-ACS risk score: the IVUS-ACS trial.","authors":"Jing Kan, Ziwei Xi, Xiaojuan Zhang, Dandan Cai, Nailiang Tian, Xiaobo Li, Zhizhong Liu, Muhammed Anjum, Ping Xie, Xiang Chen, Hamid Sharif Khan, Xiaomei Guo, Tahir Saghir, Jing Chen, Badar Ul Ahad Gill, Ning Guo, Imad Sheiban, Fei Ye, Junjie Zhang, Feng Chen, Yongyue Wei, Gregg W Stone, Shao-Liang Chen","doi":"10.1093/ehjopen/oeaf145","DOIUrl":"10.1093/ehjopen/oeaf145","url":null,"abstract":"<p><strong>Aims: </strong>The IVUS-ACS trial demonstrated that intravascular ultrasound (IVUS) guidance reduces target-vessel failure (TVF) in patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI). Whether this benefit applies to all ACS patients across the spectrum of risk is unknown. We sought to develop a new risk score for 1-year TVF after PCI in ACS and determine whether IVUS guidance compared with angiography guidance improves outcomes in both high- and low-risk patients.</p><p><strong>Methods and results: </strong>From the angiography-guided group of the IVUS-ACS trial (<i>n</i> = 1743), the TVF-ACS risk score was developed using the least absolute shrinkage and selection operator method in a derivation group (<i>n</i> = 1288), and its robustness was assessed in an internal validation group (<i>n</i> = 455). External validation was then performed separately in the IVUS-XPL and ULTIMATE trials. Outcomes in high- and low-risk patients randomized to IVUS guidance vs. angiography guidance were then examined. Ten readily available clinical, laboratory, and angiographic variables were selected for inclusion in the TVF-ACS risk score. A cut-off value of 15.64 discriminated angiography-guided PCI patients at high-risk vs. low risk [area under the curve (AUC) 0.715, 95% confidence interval (CI) 0.653-0.777]. The AUC was similar in the validation group [0.709 (95% CI 0.630-0.788)]. High-risk patients exhibited a higher 1-year rate of TVF compared with low-risk patients [19.8 vs. 5.7%, hazard ratio (HR) 3.81, 95% CI 2.06-7.02, <i>P</i> = 0.00002]. Among 3486 randomized patients, IVUS guidance compared with angiography guidance reduced 1-year TVF in high-risk patients (6.9 vs. 17.6%; HR 0.38, 95% CI 0.24-0.59) with a lesser effect in low-risk patients (3.2 vs. 4.3%; HR 0.75, 95% CI 0.51-1.11; <i>P</i> _interaction = 0.02). External validation in the IVUS-XPL and ULTIMATE trials confirmed these benefits but with consistent effects in high- and low-risk patients (<i>P</i> _interactions = 0.49 and 0.92, respectively).</p><p><strong>Conclusion: </strong>The TVF-ACS risk score reliably stratifies ACS patients undergoing PCI into high- and low-risk groups. The benefits of IVUS guidance during PCI are most pronounced in high-risk ACS patients, although all ACS patients are likely to benefit.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf145"},"PeriodicalIF":0.0,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12625814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558853","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":"Development of three-step holistic care pathways to detect and manage comorbidities in patients with atrial fibrillation: the Horizon 2020 EHRA-PATHS consortium.","authors":"Rana Önder, Lien Desteghe, Johan Vijgen, Rónán Collins, Rafal Dabrowski, Michal Miroslaw Farkowski, Marcio Jansen de Oliveira Figueiredo, Maartje J M Hereijgers, Daniel Hofer, Chu-Pak Lau, Geraldine Lee, Dominik Linz, Michelle Lobeek, Teresa Lopez, Christine McAuliffe, Jose Luis Merino, Tatjana Potpara, Prashanthan Sanders, Alireza Sepehri Shamloo, Maciej Sterliński, Emma Svennberg, Colinda van Deutekom, Isabelle Van Gelder, Michiel Rienstra, Hein Heidbuchel","doi":"10.1093/ehjopen/oeaf120","DOIUrl":"10.1093/ehjopen/oeaf120","url":null,"abstract":"<p><strong>Aims: </strong>Older patients with AF (≥65 years) have on average four additional comorbidities. Comorbidity management requires a systematic approach for identification, and interdisciplinary care, often lacking in clinical practice. The EHRA-PATHS project's overall aim is to create an approach to systematically address multimorbidity in older patients with AF.</p><p><strong>Methods and results: </strong>This project involves a consortium of 14 partners from 11 European countries. The comorbidity care pathways were developed using a stepwise approach. (i) A literature study. (ii) Online meetings/discussions to create structured care pathways. (iii) A two-round Delphi study for consensus on the final pathways (agreement ≥80%) and to rank the comorbidities for priority. (iv) Selection of comorbidities for evaluation in the planned randomized controlled trial (RCT). Development of care pathways for 23 comorbidities or special clinical settings was obtained and agreed upon. The Delphi surveys were sent to 37 consortium experts. After round 1 (28 responses), 13 pathways reached an agreement ≥80%. Twelve adjusted pathways were presented in round 2 (27 responses), of which 8 received an agreement ≥80%. The last four pathways were finalized after expert consensus. Hypertension, heart failure, and overweight were ranked as the most important comorbidities.</p><p><strong>Conclusion: </strong>A structured process of expert meetings and two Delphi rounds led to the development and ranking of 23 concise care pathways to identify and manage comorbidities in patients with AF. All pathways will be combined into a software tool, providing clinicians with a systematic approach to comorbidity management, which will be tested in the RCT of EHRA-PATHS.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 5","pages":"oeaf120"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12555002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423640","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 complexity of tackling multimorbidity in atrial fibrillation: how European projects are reshaping our approach to comorbidities.","authors":"Giulio Francesco Romiti, Tze-Fan Chao, Gregory Y H Lip","doi":"10.1093/ehjopen/oeaf132","DOIUrl":"10.1093/ehjopen/oeaf132","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 5","pages":"oeaf132"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12555000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395863","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":"Mitral Transcatheter edge-to-edge repair rivals surgery for survival despite less complete correction: a systematic review and metanalysis of randomized and propensity score matching studies.","authors":"Gianluca Di Pietro, Riccardo Improta, Antonio Lattanzio, Alessandro Roscioli, Lucia Ilaria Birtolo, Marco Tocci, Riccardo Colantonio, Gennaro Sardella, Silvio Fedele, Natalia Pavone, Wael Saade, Fabio Miraldi, Massimo Mancone","doi":"10.1093/ehjopen/oeaf135","DOIUrl":"10.1093/ehjopen/oeaf135","url":null,"abstract":"<p><strong>Aims: </strong>To compare outcomes of patients with severe mitral regurgitation (MR) after m-TEER and surgery.</p><p><strong>Methods and results: </strong>PubMed, Scopus, and Google Scholar databases were searched for randomized controlled trials and propensity score matching studies comparing mid-term outcomes of m-TEER vs. surgical valve repair. All-cause of death, rehospitalization for heart failure, mitral reintervention, NYHA class at clinical follow-up and grade ≥ 3 at echocardiographic follow-up were the outcomes of interest. Additional sensitivity analyses were performed to account for heterogeneity. Nine studies (2 RCT and 7 propensity score matching studies) with a total of 23 825 patients (m-TEER group = 11 970; surgery group = 11 855) were included. Surgery and m-TEER were associated with comparable rates of all-cause mortality at a median follow-up of 18 months (RR 1.02, 95%CI 0.77-1.37, <i>P</i>-value 0.87). Surgical repair was associated with a reduced risk of rehospitalization for heart failure (RR 1.70, 95%CI 1.47-1.98, <i>P</i> value < 0.01) and mitral reintervention (RR 3.27, 95%CI 2.49-4.30, <i>P</i> value < 0.01), due to a reduced at least moderate residual MR (RR 6.35, 95%CI 1.43-28.22, <i>P</i> value 0.02).</p><p><strong>Conclusion: </strong>In patients with severe MR, m-TEER resulted in comparable outcomes for all-cause deaths compared to surgery, although the latter was associated with reductions in heart failure rehospitalization, reintervention and MR residual rates at a median 18-month follow-up.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf135"},"PeriodicalIF":0.0,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12604465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508588","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":"Effect of previous stroke on quality of inpatient care and long-term mortality risk of non-ST-segment myocardial infarction.","authors":"Andrew Cole, Nicholas Weight, Mustafa Al-Jarshawi, Muhammad Rashid, Mamas A Mamas","doi":"10.1093/ehjopen/oeaf143","DOIUrl":"10.1093/ehjopen/oeaf143","url":null,"abstract":"<p><strong>Aims: </strong>Individuals with a previous stroke face an increased risk of Non-ST-segment myocardial infarction (NSTEMI) and may have a higher associated mortality. However, the impact of inpatient care quality during the NSTEMI admission on long-term outcomes remains unclear. To assess whether there were disparities in care and NSTEMI clinical outcomes between individuals with and without a previous stroke.</p><p><strong>Methods and results: </strong>We analysed 425 274 adults hospitalized between January 2005 and March 2019, with NSTEMI from the UK Myocardial Ischaemia National Audit Project (MINAP) registry, linked with Office for National Statistics mortality reporting. We examined long-term outcomes by previous stroke status and inpatient care quality for patients that survived to discharge using the opportunity-based quality-indicator score (OBQI) score, categorized as 'poor', 'fair', 'good' or 'excellent'. Individuals with previous stroke were older (median age 79 vs. 72 years) and underwent revascularization by PCI (22% vs. 37%) less frequently than those without a previous stroke. The adjusted mortality risk for those with a previous stroke was higher at 30 days (aHR 1.14, 95% CI 1.10, 1.18), 1 year (aHR 1.20, 95% CI 1.17, 1.22) and 10 years (aHR 1.27, 95% CI 1.26 1.29) with higher quality inpatient care associated with lower mortality rates compared with poor care (good: HR 0.86, 95% CI 0.80, 0.92; excellent: HR 0.76, 95% CI 0.71, 0.81).</p><p><strong>Conclusion: </strong>Individuals with a previous stroke, experience disparities during inpatient care following NSTEMI and have a higher risk of long-term mortality. Higher quality inpatient care may lead to better long-term survival.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 6","pages":"oeaf143"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12637201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590541","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}