European heart journal open最新文献

{"title":"Correction to: Impact of foetal growth restriction and being born small for gestational age on newborn echo- and electrocardiographic measurements-a Copenhagen baby heart study.","authors":"","doi":"10.1093/ehjopen/oeag129","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag129","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjopen/oeaf177.].</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 4","pages":"oeag129"},"PeriodicalIF":4.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13496325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803559","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":"Prediction of left atrial appendage dysfunction by atrial strain imaging in patients with rheumatic mitral stenosis in sinus rhythm.","authors":"Jamal Yusuf, Gaurav Sharma, Ankit Bansal, Vimal Mehta, Ankur Gautam, Lovedeep Singh, Mohit D Gupta, Rajat Chaudhary, Vishal Batra, Girish M Palleda, Safal Safal, Arima Nigam, Sumod Kurian, Partho P Sengupta","doi":"10.1093/ehjopen/oeag130","DOIUrl":"10.1093/ehjopen/oeag130","url":null,"abstract":"<p><strong>Aims: </strong>In severe rheumatic mitral stenosis (MS) with sinus rhythm, left atrial appendage (LAA) dysfunction increases thromboembolic risk, yet clinical guidelines provide no recommendations, and its assessment via transoesophageal echocardiography is not feasible for routine or repeated use. This study assessed whether left atrial (LA) strain imaging could non-invasively predict LAA contractile dysfunction.</p><p><strong>Methods and results: </strong>We prospectively enrolled 138 patients with severe rheumatic MS in sinus rhythm who underwent transthoracic and transoesophageal echocardiography. Left atrial appendage inactivity was defined as LAA emptying velocity < 25 cm/s. Left atrial reservoir strain (LASr), conduit, and contractile strain were quantified using speckle-tracking echocardiography. Multivariable logistic regression and receiver operating characteristic analyses were performed to evaluate predictors of LAA inactivity. Left atrial appendage inactivity was observed in 108 patients (78.2%), and LAA thrombus was detected in eight patients (5.8%)-all in sinus rhythm. In multivariate analysis, LASr was the strongest independent predictor of LAA inactivity [odds ratio: 0.61 per 1% increase; 95% confidence interval (CI): 0.50-0.75; <i>P</i> < 0.0001]. Left atrial reservoir strain yielded an area under the ROC curve of 0.950 (95% CI: 0.911-0.989), with a threshold of ≤22.95% showing a sensitivity of 93.5% and specificity of 90% for predicting LAA inactivity. Impaired LA strain identified patients with elevated fibrinogen, D-dimer, and the presence of LAA thrombus.</p><p><strong>Conclusion: </strong>Left atrial strain imaging provides a robust non-invasive predictor of LAA dysfunction in severe rheumatic MS patients in sinus rhythm. These findings support the potential clinical utility of LA strain in improving risk stratification and guiding anticoagulation decisions in this under-recognized high-risk population.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag130"},"PeriodicalIF":4.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13574500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972699","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":"Angiographic characteristics of older patients with non-ST elevation myocardial infarction undergoing invasive strategy: A pre-specified analysis from the SENIOR-RITA trial.","authors":"Graziella Pompei, Francesca Rubino, Kenny Jenkins, Hanna Ratcovich, David Austin, Shrilla Banerjee, Gill Louise Buchanan, Shahid Junejo, Abdul Nasser, Nehal Hussein, Jolanta Sobolewska, Timothy Williams, Stuart Hood, Awsan Noman, Akhlaque Uddin, Manas Sinha, Robert Butler, John Irving, Robert F Storey, David E Newby, Keith A A Fox, Stuart Pocock, Vijay Kunadian","doi":"10.1093/ehjopen/oeag131","DOIUrl":"10.1093/ehjopen/oeag131","url":null,"abstract":"<p><strong>Aims: </strong>In the SENIOR-RITA trial, among older adults with non-ST-elevation myocardial infarction (NSTEMI), an invasive strategy did not reduce the composite outcome of cardiovascular death or non-fatal myocardial infarction compared with a conservative strategy over a median follow-up of 4.1 years.</p><p><strong>Objectives: </strong>To describe the angiographic characteristics of patients randomized to the invasive arm.</p><p><strong>Methods and results: </strong>SENIOR-RITA was a prospective, multicentre, randomized controlled trial recruiting NSTEMI patients aged ≥75 years. From November 2016 to March 2023, 1518 patients from 48 UK sites were randomized 1:1 to an invasive or conservative strategy. Procedural data were collected, and angiographic data were analysed using quantitative coronary angiography at the Newcastle University angiographic core laboratory using QAngio® XA Medis. Of 680 patients undergoing angiography, quantitative coronary angiography analysis was performed in 667 participants. Obstructive coronary artery disease was found in 76.8%, and 13% had prior coronary surgical revascularization. A total of 1173 lesions were identified. Most lesions (29.5%) were classified as type B2 according to the ACC/AHA classification. Lesions in patients not receiving percutaneous coronary intervention (PCI) were angiographically more complex than those treated with PCI, with a higher prevalence of type C lesions, bifurcation, ostial lesions, and the presence of collaterals. Overall, 330 patients (49.5%) underwent PCI, which was successful in 96.5% with minimal complications.</p><p><strong>Conclusion: </strong>The SENIOR-RITA angiography sub-study is the largest subgroup analysis to date in older NSTEMI adults, providing important insights into the angiographic characteristics and emphasizing the importance of a holistic, patient-centred care for older adults.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag131"},"PeriodicalIF":4.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993260","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":"Genotype status and arrhythmic risk in sport participants with hypertrophic cardiomyopathy.","authors":"Frédéric Myon, Mathilde Delatour, Nathalie Behar, François Carré, Erwan Donal, Frédéric Schnell","doi":"10.1093/ehjopen/oeag127","DOIUrl":"10.1093/ehjopen/oeag127","url":null,"abstract":"<p><strong>Aims: </strong>The impact of genotype on arrhythmic risk in sports-active hypertrophic cardiomyopathy (HCM) patients remains unclear. We compared outcomes between genotype-positive (G+) and genotype-negative (G-) athletes with HCM.</p><p><strong>Methods and results: </strong>In this retrospective study, HCM patients actively engaged in sports underwent standardized baseline evaluation and follow-up. The primary endpoint included sudden cardiac death (SCD)/sudden cardiac arrest, appropriate implantable cardioverter-defibrillator (ICD) therapy, sustained ventricular tachycardia/non-sustained ventricular tachycardia (NSVT). Secondary outcomes included a composite of ventricular arrhythmias, atrial fibrillation, ischaemic stroke, and heart-failure hospitalization. Fifty-nine patients [age 40 years (23.2-50.0)] were followed for 6.3 years (3.0-12.6). Twenty-nine participants (49.2%) carried a likely pathogenic or pathogenic variant, most commonly MYBPC3 (44.8%), MYH7 (24.1%), and TNNT2 (17.2%). At inclusion, median sport practice was 6.0 (3.0-10.0) hours per week, with 67.8% of competitors. At last follow-up, 88.1% remained active in sports. The ESC 5-year SCD risk score was slightly higher in G+ compared with G- patients [1.87% (1.47-3.67) vs. 1.54% (1.24-2.20), <i>P</i> = 0.048], but most of the participants were classified as low risk. Ventricular arrhythmias occurred in 20.7% of G+ and 23.3% of G- patients (<i>P</i> = 0.807), with similar event-free survival (<i>P</i> = 0.685). Most ventricular arrhythmias were isolated NSVT (84.6%). Hard ventricular arrhythmic events were limited to two ICD-terminated ventricular fibrillations in G+ patients, one at rest and one during low-intensity exercise. The incidence of the composite secondary cardiovascular outcome was comparable between groups (31.0% vs. 33.3%, <i>P</i> = 0.850).</p><p><strong>Conclusion: </strong>In this exploratory cohort of sports-active HCM patients, ventricular arrhythmic and cardiovascular event rates were similar between G+ and G- participants during follow-up.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 4","pages":"oeag127"},"PeriodicalIF":4.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13520929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842539","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":"Discontinuation of oral anticoagulants is common after catheter ablation in older patients with atrial fibrillation.","authors":"Xiaojuan Liu, Daniel E Singer, E Kevin Heist, Kueiyu Joshua Lin","doi":"10.1093/ehjopen/oeag128","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag128","url":null,"abstract":"<p><strong>Aims: </strong>Guidelines recommend continuing oral anticoagulation (OAC) after atrial fibrillation (AF) ablation based on stroke risk, yet real-world post-procedural OAC management remains poorly characterized. We aimed to evaluate contemporary patterns of OAC use after AF ablation and identify predictors of OAC discontinuation.</p><p><strong>Methods and results: </strong>Using Medicare claims from 2013-2022, we established a cohort of patients undergoing a first AF ablation and assessed patterns of OAC discontinuation during the subsequent year. We defined OAC discontinuation as a dispensing gap ≥60 days. Baseline characteristics were evaluated as predictors of discontinuation using least absolute shrinkage and selection operator Cox regression. Among 208 232 AF patients (mean age 74.5, 47% women) undergoing ablation, 58% were taking OAC following ablation, 24% discontinued between 3 and 12 months, 8% discontinued within 3 months, and 10% did not use OAC within 3 months. Apixaban was the most commonly used OAC agent, while the use of warfarin declined over time. The overall rate of repeated ablation was 26%. We found that 44% of patients with CHA₂DS₂-VASc score ≥3 discontinued OAC within 1 year after ablation. Higher CHA₂DS₂-VASc scores and longer pre-ablation OAC use were associated with lower discontinuation, whereas pre-ablation major bleeding, frailty, and use of warfarin (vs. direct OACs) increased the likelihood of discontinuation.</p><p><strong>Conclusion: </strong>OAC discontinuation after AF ablation is common, including among patients at elevated stroke risk despite guideline recommendations for continued therapy. More data are needed on the clinical consequences of post-ablation OAC discontinuation.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag128"},"PeriodicalIF":4.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168114","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":"Vasoactive intensity predicts mortality beyond SCAI staging in cardiogenic shock.","authors":"Christophe Beyls, Nicolas Mollet, Nathan Helstroffer, Osama Abou-Arab, Yazine Mahjoub, Bélaïd Bouhemad, François Roubille, Pierre-Grégoire Guinot","doi":"10.1093/ehjopen/oeag126","DOIUrl":"10.1093/ehjopen/oeag126","url":null,"abstract":"<p><strong>Aims: </strong>Cardiogenic shock (CS) remains associated with high mortality. Severity is traditionally stratified by the Society for Cardiovascular Angiography and Interventions (SCAI) staging system despite substantial heterogeneity within stages. Whether vasoactive therapy intensity or combination provides additional prognostic information beyond SCAI staging remains unknown. This study assessed whether vasoactive support intensity, quantified by the vasoactive-inotropic score (VIS), improves mortality prediction beyond SCAI staging.</p><p><strong>Methods and results: </strong>In this retrospective bicentric cohort, consecutive adults admitted for CS between 2018 and 2023 were included. The VIS was calculated. The primary outcome was 90-day mortality. Multivariable logistic regression models adjusted for baseline severity assessed interactions with SCAI stage and the incremental prognostic value of VIS using nested models. Among 1167 patients, 90-day mortality increased across SCAI stages C, D, and E (20.1%, 27.4%, and 45.6%; <i>P</i> < 0.001, respectively), with substantial heterogeneity within stages. In stage C, dobutamine alone was associated with lower mortality than norepinephrine alone [OR = 0.25 (0.09-0.74); <i>P</i> = 0.009]; in stage E, dobutamine plus norepinephrine was associated with higher mortality [OR = 2.39 (1.07-5.36); <i>P</i> = 0.028]. The number of vasoactive agents was associated with mortality (OR = 1.27 per additional agent; <i>P</i> = 0.041) but proved a crude marker, providing only marginal incremental discrimination (<i>R</i> ² = 0.233; Δ = +0.011), with its prognostic information fully captured by VIS (<i>R</i> ² = 0.286 vs. 0.287 with and without number of agents). Adding SCAI stage minimally improved discrimination (<i>R</i> ² = 0.222-0.226; Δ = +0.004), whereas VIS substantially improved model performance (<i>R</i> ² = 0.286; Δ = +0.060; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Vasoactive intensity quantified by the VIS improved 90-day mortality prediction beyond SCAI staging and the simple count of vasoactive drugs, providing incremental prognostic information beyond SCAI staging.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag126"},"PeriodicalIF":4.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914761","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":"Circulating anti-Ro/Sjögren's syndrome-related antigen A antibodies and risk of heart rate-corrected QT interval prolongation: a meta-analysis.","authors":"Pietro Enea Lazzerini, Mark Markovich Melamud, Evgeny Alexandrovich Ermakov, Vadim Vyacheslavovich Konkov, Valentina Nikolaevna Buneva, Riccardo Accioli, Alessandra Cartocci, Anna Cantore, Viola Salvini, Decoroso Verrengia, Maurizio Acampa, Pier Leopoldo Capecchi, Mohamed Boutjdir","doi":"10.1093/ehjopen/oeag123","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag123","url":null,"abstract":"<p><strong>Aims: </strong>Accumulating evidence indicates that anti-Ro/Sjögren's syndrome-related antigen A (SSA) antibodies, specifically the anti-Ro/SSA-52kD subtype, can promote heart rate-corrected QT interval (QTc) prolongation by inhibiting the hERG-K⁺ channel. However, the numerous clinical studies published over the past two decades yielded conflicting results. This meta-analysis aims at pooling the available data to provide clarity on this clinically relevant issue.</p><p><strong>Methods and results: </strong>A systematic review was performed for clinical studies comparing QTc in anti-Ro/SSA-positive vs. -negative subjects. Standardized mean differences (SMDs) and odds ratios (ORs) were compared using random effects models. The risk of bias was assessed using RoBANS2, Egger's test and contour-enhanced funnel plots. Twenty-five studies were included, pooling 2122 anti-Ro/SSA-positive and 8865 anti-Ro/SSA-negative subjects. Overall, anti-Ro/SSA-positivity is associated with a longer QTc [SMD = 0.36 (0.18-0.53), <i>P</i> < 0.001], and a more than two times higher risk of QTc prolongation [OR = 2.24 (1.54-3.27), <i>P</i> < 0.001]. Several sub-analyses supported and refined these findings. Specifically, in anti-Ro/SSA-positive patients with unselected connective tissue disease, QTc absolute values are higher [SMD = 0.56 (0.20-0.93), <i>P</i> = 0.0026] and QTc prolongation occurs more frequently [OR = 6.99 (2.35-20.75), <i>P</i> < 0.001] than in negative patients; furthermore, QTc prolongation is also more common in systemic lupus erythematosus patients with circulating anti-Ro/SSA-antibodies than in those without [OR = 1.86 (1.19-2.90), <i>P</i> = 0.006]. Finally, in anti-Ro/SSA-52kD-positive subjects, the QTc is longer compared to the negative ones [SMD = 0.43 (0.15-0.71), <i>P</i> = 0.002].</p><p><strong>Conclusion: </strong>This meta-analysis supports the conclusion that circulating anti-Ro/SSA-antibodies <i>per se</i> represents a significant risk factor for QTc prolongation. However, the presence of several conflicting studies suggests that a more accurate investigation of specific factors, such as the impact of individual antibody subtype levels (anti-52kD/anti-60kD), will be critical to fully clarify the topic and its implications in clinical practice.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag123"},"PeriodicalIF":4.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198570","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":"Permanent LEft ventricular septAl Pacing vs. right ventricular pacing in patients with atrioventricular conduction disorders-a randomized trial: rationale and design of the LEAP trial.","authors":"Jesse H J Rijks, Johan van Koll, Haran Burri, Karol Curila, Vincent F van Dijk, Arnaud Hauer, Jurren M van Opstal, Jan de Pooter, Leonard M Rademakers, Stefan A J Timmer, Wouter Wieringa, Brigitte A B Essers, Sander M J van Kuijk, Hans-Peter Brunner-La Rocca, Kevin Vernooy, Justin Luermans","doi":"10.1093/ehjopen/oeag108","DOIUrl":"10.1093/ehjopen/oeag108","url":null,"abstract":"<p><p>Permanent cardiac pacing is the only available therapy in patients with atrioventricular (AV) conduction disorders and can be lifesaving. However, conventional right ventricular pacing (RVP) causes dyssynchronous electrical and mechanical activation of the ventricles, possibly resulting in pacing-induced cardiomyopathy and heart failure. Left bundle branch area pacing (LBBAP) might overcome these adverse effects of RVP, but evidence to support this assumption is lacking. The LEAP trial is a multi-centre investigator-initiated, prospective, randomized controlled, open-label, blinded endpoint evaluation (PROBE) study, designed to test the hypothesis that in patients with an indication for pacemaker implantation due to AV conduction disorders with an expected ventricular pacing percentage ≥20%. LBBAP is superior to RVP in preventing the composite primary endpoint of (1) all-cause mortality, (2) hospitalization for heart failure, and (3) a more than 10% point decrease in left ventricular ejection fraction (LVEF) leading to an LVEF below 50%. The LEAP trial randomizes 470 patients 1:1 to the index LBBAP or RVP control arm. The primary endpoint will be determined at 1-year follow-up. This article describes the design and analytic plan for the trial.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 4","pages":"oeag108"},"PeriodicalIF":4.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148715112","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":"Correction to: Estriol attenuates visceral adiposity and pulmonary artery smooth muscle cell proliferation via ERα-mediated signalling.","authors":"","doi":"10.1093/ehjopen/oeag122","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag122","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjopen/oeag001.].</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 4","pages":"oeag122"},"PeriodicalIF":4.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708937","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":"SARS-CoV-2 infection and long-term risk of cardiovascular and renal morbidity.","authors":"Heather A Boyd, Thor Grønborg Junker, Tor Biering-Sørensen, Jan Wohlfahrt, Anders Hviid","doi":"10.1093/ehjopen/oeag121","DOIUrl":"10.1093/ehjopen/oeag121","url":null,"abstract":"<p><strong>Aims: </strong>Cardiovascular and renal consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been studied intensively in high-risk groups, but the consequences of mild infection for the general population, particularly beyond the acute phase of infection, remain unclear. We examined long-term associations between SARS-CoV-2 infection and cardiovascular disease (CVD) and kidney disease (KD) in the general population, with emphasis on age and vaccination status at the time of infection, mild infection, and SARS-CoV-2 variant.</p><p><strong>Methods and results: </strong>We conducted a register-based cohort study in Denmark that included all Danish residents with ≥1 PCR test for SARS-CoV-2 infection in the period March 2020-December 2022. We defined exposure as a positive PCR test for SARS-CoV-2 infection and used Cox regression to estimate hazard ratios for 15 CVD outcomes and six KD outcomes, comparing persons testing positive for SARS-CoV-2 infection and persons who only ever tested negative for infection. The cohort for CVD analyses included 4 508 489 persons without pre-existing CVD [median follow-up 25.2 months/person, interquartile range (IQR) 21.7-27.5 months]; 2 698 261 persons (59.8%) tested positive for SARS-CoV-2 infection during the study period. The cohort for the KD analyses included 5 150 480 persons without pre-existing KD (median follow-up 25.1 months, IQR 21.7-27.4 months), 2 983 233 (57.9%) of whom tested positive for infection. SARS-CoV-2 infection was associated with slight increases in the risks of pulmonary embolism, venous embolism/thrombosis, arrhythmias, chronic renal failure, unspecified renal failure, and other/unspecified KD up to a year after infection; infection was not associated with the other disease groups tested. The strongest associations between SARS-CoV-2 infection and CVD and KD were observed among unvaccinated persons and persons infected with earlier (pre-omicron) variants.</p><p><strong>Conclusion: </strong>We found little evidence that infection with SARS-CoV-2 was associated with increased long-term risks of CVD or KD in the general population. Increased CVD risks associated with SARS-CoV-2 infection appeared limited to three outcomes (pulmonary embolism, venous embolism/thrombosis, arrhythmias), and the potential increases in risk were small. Our KD results also suggested that any persistent risks associated with SARS-CoV-2 infection were minimal; however, these findings need to be confirmed in other populations. Most importantly, in a largely vaccinated population, long-term CVD and KD risks differed little for omicron-infected and uninfected persons.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 5","pages":"oeag121"},"PeriodicalIF":4.3,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042880","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}