European heart journal open最新文献

{"title":"Risk prediction of death and heart transplantation in adult patients with myocarditis.","authors":"Anna Baritussio, Andrea Silvio Giordani, Chiara Merola, Giulia Lorenzoni, Cristina Vicenzetto, Federico Scognamiglio, Cristina Basso, Stefania Rizzo, Monica De Gaspari, Elisa Carturan, Giuseppe Tarantini, Sabino Iliceto, Renzo Marcolongo, Dario Gregori, Alida Linda Patrizia Caforio","doi":"10.1093/ehjopen/oeag104","DOIUrl":"10.1093/ehjopen/oeag104","url":null,"abstract":"<p><strong>Aims: </strong>Identifying early risk predictors in myocarditis is clinically relevant, as patients' outcomes may be very diverse. We aimed to explore predictors of death and heart transplant (HTx) in a large single-centre cohort of adult patients with myocarditis using a machine learning (ML) technique.</p><p><strong>Methods and results: </strong>We retrospectively enrolled consecutive adult patients with biopsy-proven or clinically suspected myocarditis, collecting clinical, laboratory, and imaging data, both at diagnosis and during follow-up. A predictive model of death/HTx was developed using random forest (RF), ranking covariates according to their predictive accuracy. We included 938 patients (median age 36 years, 69% male) with clinically suspected (<i>n</i> = 549) or biopsy-proven (<i>n</i> = 389) myocarditis. During follow-up, 35 patients died, and 26 underwent HTx. The most important variables in predicting survival were NYHA class (variable importance, VIMP, 10%) LVEF (3.6%) and clinical presentation (2.5%) at diagnosis, histological type of myocarditis on endomyocardial biopsy (EMB)(2.9%), anti-endothelial cell antibodies (0.6%), and anti-nuclear antibodies (0.4%) positivity. Overall, the predictive accuracy of our RF model was good (89.2%, 95% C.I. 86.1-92.3).</p><p><strong>Conclusion: </strong>Based on a ML approach, we found, with good predictive accuracy, that advanced NYHA class, reduced LVEF and heart failure at diagnosis, and giant cell myocarditis on EMB are predictors of worse prognosis in adult patients with myocarditis.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 3","pages":"oeag104"},"PeriodicalIF":4.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335049","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":"Systemic blood pressure changes following coronary revascularization: towards a coronary baroreflex?","authors":"Pierre Lantelme, Sophie Lampert, Brahim Harbaoui, Pierre-Yves Courand","doi":"10.1093/ehjopen/oeag106","DOIUrl":"10.1093/ehjopen/oeag106","url":null,"abstract":"<p><p>Graphical AbstractFor image description, please refer to the figure legend and surrounding text.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 3","pages":"oeag106"},"PeriodicalIF":4.3,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13285985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310897","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":"Relationship between early use of tocilizumab during chimeric antigen receptor T-cell therapy for multiple myeloma and cardiovascular risk and progression-free survival.","authors":"Sophia Golec, Weijia Fu, Erin Moshier, Ariel Peleg, Brunna Pileggi, Adriana Rossi, Gagan Sahni","doi":"10.1093/ehjopen/oeag097","DOIUrl":"10.1093/ehjopen/oeag097","url":null,"abstract":"<p><strong>Background: </strong>Chimeric antigen receptor-T-cell (CAR-T) therapies are approved for refractory and relapsed multiple myeloma (MM). Patients with MM have high cardiovascular disease burden due to age and cardiotoxic treatments. Retrospective studies in patients who develop severe grades of cytokine release syndrome (CRS) demonstrated a 20-30% major cardiovascular adverse event (MACE) rate. Early use of an interleukin-6 receptor antagonist, tocilizumab, to reverse CRS may lower rates of MACE.</p><p><strong>Aims: </strong>This observational study sought to examine the relationship between early use of tocilizumab and the development of MACE.</p><p><strong>Methods: </strong>We performed a retrospective chart review of adults undergoing CAR-T therapy for MM between 2017 and 2023 at a single medical center. Major cardiovascular adverse event was defined as a composite of myocardial injury, heart failure, stroke, arrhythmias, and cardiovascular death over a median period of 12 months. The secondary outcomes were progression-free survival (PFS) and overall survival (OS). Major cardiovascular adverse event incidence was estimated using the cumulative incidence function with non-cardiovascular death as a competing risk and compared by Gray's test, and PFS/OS were analysed using Kaplan-Meier methods with log-rank tests.</p><p><strong>Results: </strong>Of the 145 patients studied, CRS occurred in 120 patients (82%). Of those with CRS, 107 (89%) received tocilizumab within 24 h. Within 1 year of therapy, 14 patients (9.7%) experienced MACE. Only patients with CRS developed MACE. The incidence of MACE was 8% [95% confidence interval (CI): 5%, 14%] at 6 months and 11% (95% CI: 7%, 19%) at 12 months. Progression-free survival at 12 months was 58% (95% CI: 50%, 68%).</p><p><strong>Conclusions: </strong>Progression-free survival and OS did not differ significantly based on incidence on CRS.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 3","pages":"oeag097"},"PeriodicalIF":4.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348011","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":"Weight change and long-term cardiovascular outcomes in overweight and obese patients after acute coronary syndromes.","authors":"Louise Artels, Cédric Follonier, Stéphanie Baggio, David Carballo, David Nanchen, Kostantinos Koskinas, Christian M Matter, Lorenz Räber, Olivier Muller, Nicolas Rodondi, François Mach, Baris Gencer","doi":"10.1093/ehjopen/oeag105","DOIUrl":"10.1093/ehjopen/oeag105","url":null,"abstract":"<p><strong>Aims: </strong>Overweight and obesity are common among patients with acute coronary syndromes (ACS), yet the long-term cardiovascular consequences of post-ACS weight change remain uncertain. We investigated the association between 1-year weight change after ACS and 5-year clinical outcomes in overweight and obese patients.</p><p><strong>Methods and results: </strong>We analysed 1473 overweight and obese ACS participants from the Swiss ELIPS cohort with available weight measurements. Hazard ratios (HRs) were estimated per 1% and 5% weight change for the 5-year risk of major adverse cardiovascular events (MACE), defined as cardiovascular death, non-fatal myocardial infarction, coronary revascularization, stroke, or transient ischaemic attack. Models were adjusted for age, sex, body mass index (BMI), smoking, total cholesterol, hypertension, diabetes, and estimated glomerular filtration rate. Predefined subgroups included BMI ≥ 27 kg/m² vs. 25-27 kg/m². Among the participants (15.1% women, mean age 61.5 years), the median BMI was 28.1 kg/m² (67% BMI ≥ 27 kg/m²). Median 1-year weight change was 0%; 47.5% lost weight and 18.7% achieved >5% weight loss. Patient characteristics associated with weight loss were older age, higher BMI, non-smoking status, and participation in cardiac rehabilitation. During follow-up, 278 MACE events occurred. Weight loss was associated with a lower risk of MACE [multivariate-adjusted HR per 5%: 0.90, 95% confidence interval (CI): 0.82-1.00, <i>P</i> = 0.04]. The association was stronger in patients with BMI ≥ 27 kg/m² (adj HR per 5% 0.87, 95% CI: 0.77-0.97) compared to those with BMI 25-27 kg/m² (adj HR per 5% 1.01, 95% CI: 0.85-1.20, interaction <i>P</i> = 0.16).</p><p><strong>Conclusion: </strong>Overweight and obese ACS patients who lose weight may have a lower risk of cardiovascular events.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 3","pages":"oeag105"},"PeriodicalIF":4.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335062","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":"Admission ferritin in STEMI predicts long-term major adverse cardiovascular outcomes.","authors":"David Alberto Brenes-Castro, Jorge Arturo Ortega-Hernández, Ximena Latapi-Ruíz Esparza, Jorge Daniel Sierra-Lara Martínez, José Luis Briseno-De La Cruz, Héctor González-Pacheco, Rodrigo Gopar-Nieto, Alexandra Arias-Mendoza, Diego Araiza-Garaygordobil","doi":"10.1093/ehjopen/oeag092","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag092","url":null,"abstract":"<p><strong>Aims: </strong>Inflammation is a key driver of atherosclerosis and acute coronary syndromes (ACS). Despite the prognostic relevance of inflammatory biomarkers in STEMI, the role of serum ferritin, an inflammation-sensitive marker of iron metabolism, remains unclear. The purpose of this study is to evaluate the association between elevated ferritin (≥300 ng/mL) and long-term major adverse cardiovascular events (MACE) in patients with STEMI.</p><p><strong>Methods and results: </strong>This is a substudy of the PHASE-MX registry, a prospective cohort of STEMI patients treated at our institution (2018-2021). Patients ≥18 years old with ferritin measurement at admission were included. The primary outcome was MACE [all-cause mortality, cardiogenic shock, recurrent myocardial infarction, and new-onset congestive heart failure (CHF)]. A total of 477 patients were included with a follow-up of 4.5 years (median of 533 days, IQR 338-1137). Median age was 59, 45.4% had hypertension, and 34.9% had diabetes. No differences in baseline characteristics were found among groups. Ferritin ≥300 ng/mL was present in 29.9% of patients and was associated with a higher risk of MACE (HR 1.43, 95% CI 1.06-1.94; <i>P</i> = 0.01), driven by all-cause mortality (HR 2.00, 95% CI 1.09-3.69) and new CHF (HR 1.46, 95% CI 1.05-2.04). This association remained significant after adjustment for inflammatory markers and GRACE score (aHR 1.48, 95% CI 1.04-2.10; <i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>Elevated ferritin (≥300 ng/mL) is an independent predictor of long-term MACE in STEMI, supporting its potential role as a prognostic biomarker in ACS.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 4","pages":"oeag092"},"PeriodicalIF":4.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763597","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":"Predicting common cardiovascular and non-cardiovascular outcomes after new-onset atrial fibrillation: an analysis from a UK nationwide primary-secondary care linkage dataset.","authors":"Hiroyuki Yoshimura, A Floriaan Schmidt, Gregory Y H Lip, Rui Providencia","doi":"10.1093/ehjopen/oeag103","DOIUrl":"10.1093/ehjopen/oeag103","url":null,"abstract":"<p><strong>Aims: </strong>Atrial fibrillation (AF) increases the risk of major cardiovascular and neurological complications. Utilization of risk schemes for identifying patients at risk for stroke has improved outcomes for patients with AF.</p><p><strong>Objectives: </strong>Using linked UK primary and secondary care data, we identified risk predictors and develop risk models for heart failure (HF) hospitalization, myocardial infarction (MI) hospitalization, vascular dementia, sepsis, sudden cardiac death (SCD), and all-cause death in the AF population.</p><p><strong>Methods and results: </strong>We included 198 995 patients diagnosed with AF between January 1998 and May 2016. We developed multivariable Cox regression models to predict outcome incidence after AF diagnosis, using 70% of the data for derivation and 30% for validation. Model performance was assessed using Harrell's c-index. Predictor variables were selected based on their availability in routine clinical practice. Among the assessed predictors, excessive alcohol intake, HF, MI, sepsis, and stroke showed the strongest associations with adverse outcomes. The prediction models demonstrated fair to moderate discrimination, with c-index values of 0.70 (95% CI 0.70-0.71) for HF hospitalization, 0.64 (95% CI 0.63-0.65) for MI hospitalization, 0.76 (95% CI 0.75-0.77) for vascular dementia, 0.66 (95% CI 0.65-0.67) for sepsis, 0.65 (95% CI 0.62-0.68) for SCD, and 0.71 (95% CI 0.71-0.71) for all-cause death.</p><p><strong>Conclusion: </strong>In patients with AF, we developed prediction models that demonstrate fair to good performance. Our models, based on variables easily obtainable in routine clinical care, may facilitate patient risk stratification and guide further diagnostic or preventive interventions.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 3","pages":"oeag103"},"PeriodicalIF":4.3,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297912","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":"Narrowing sex differences in pharmacotherapy following invasive angiography for coronary artery disease between 2017 and 2024.","authors":"Andrew J Sullivan, Zin Tun, Margaret Siu, Manisha Rai, Gloria Antoun, Nandini Rawat, Rebecca Walker, Alexandros Kythreotis, Abdelmajid Al Jariri, Asad Shabbir, Shane Cashin, Anthony Mathur, Daniel A Jones, Ajay Gupta, Krishnaraj S Rathod, Amrita Ahluwalia","doi":"10.1093/ehjopen/oeag099","DOIUrl":"10.1093/ehjopen/oeag099","url":null,"abstract":"<p><strong>Introduction: </strong>Women who experience myocardial infarction (MI) and undergo invasive angiography, experience higher morbidity and mortality compared to age-matched male counterparts. The prognostic benefit of optimal medical therapy (OMT) following MI is well established; however, treatment bias has been evidenced historically between the sexes. We explored sex differences in prescribing trends of OMT following invasive angiography for obstructive CAD at a high throughput regional cardiac centre.</p><p><strong>Methods: </strong>We determined discharge medication received by females and males undergoing invasive angiography in 2017, 2019, 2022, and 2024 with obstructive CAD (angiographic lesion ≥50% luminal diameter). Logistic regression was used to determine differences in the main cohort and in subgroups by clinical diagnosis (ACS, STEMI, NSTEMI, stable angina) and age (<55 or ≥55 years). This latter age cut-off to explore pre- and post-menopause trends, respectively.</p><p><strong>Results: </strong>10 591 patient attendances (22.3% female, <i>n</i> = 2360) were included in the analysis. In the overall cohort, women were less likely to receive β-blockers (<i>P</i> = 0.002), ACE-I/ARB (<i>P</i> = 0.002), and high potency P2Y₁₂ inhibitors (<i>P</i> < 0.001) compared to males. In ACS, similar patterns were observed for β-blockers and high potency P2Y₁₂ inhibitors, women ≥55 years were less likely to receive high intensity statin (HIS). However, we show significant improvements in the prescribing of β-blockers (<i>P</i> = 0.018) in women over time, and a trend towards improved prescribing of high potency P2Y₁₂ inhibitors (<i>P</i> = 0.085) in ACS.</p><p><strong>Conclusion: </strong>These findings demonstrate welcome improvements in equitable prescribing practices for OMT post angiography and highlight the importance of reviewing prescribing practices to ensure evidencing of success in implementing best practice guidelines.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 4","pages":"oeag099"},"PeriodicalIF":4.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427557","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: Outcomes of catheter ablation for ventricular tachycardia in structural heart disease: a meta-analysis and quality appraisal of trials.","authors":"","doi":"10.1093/ehjopen/oeag096","DOIUrl":"https://doi.org/10.1093/ehjopen/oeag096","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ehjopen/oeaf171.].</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 3","pages":"oeag096"},"PeriodicalIF":0.0,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229817","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":"Reperfusion injury from a haemodynamic standpoint and role of pressure-controlled reperfusion in avoiding reperfusion injury.","authors":"Murat Sezer, Ahmet Tas, Yaren Alan, Ilke Kara Tas, Alp Ozcan, Divaka Perera, Irem Sezer, Sayan Sen, Jan J Piek, Sabahattin Umman","doi":"10.1093/ehjopen/oeag098","DOIUrl":"10.1093/ehjopen/oeag098","url":null,"abstract":"<p><p>Currently, there is no established treatment for post-ischaemic reperfusion-related injury, namely reperfusion injury (RI), which paradoxically exacerbates microvascular and tissue damage in any reperfused ischaemic organ territory. During the ischaemic phase, the autoregulatory apparatus in a subtended organ region temporarily loses its pressure-regulating function because of the combined effects of drastically increased oxygen demand and ischaemic insult. Therefore, it cannot protect the hypoxically injured distal capillary bed from the detrimental effect of the sudden and uncontrolled pressure rise that occurs during the initial phase of reperfusion. This acute capillary barotrauma caused by abruptly initiated reperfusion at systemic pressure can be regarded as an iatrogenic trigger for subsequent damage in the reperfused organ territory. From this haemodynamic perspective, RI can be redefined as a 'capillary hyperpressurization syndrome', dictated by the 'initial reperfusion pressure'. Accordingly, initiating reperfusion gently at lower pressures [pressure-controlled reperfusion (PCR)] and maintaining it at that level until protective autoregulatory myogenic control mechanisms recover may provide substantial benefit in limiting the progressive damage caused by post-ischaemic abrupt and full-pressure reperfusion. In this review, we revisit RI from this haemodynamic perspective and suggest that the same pathomechanism-namely, acute exposure of ischaemically injured microvascular endothelium to an uncontrolled pressure rise during the initial reperfusion phase-predominantly dictates post-reperfusion damage in the heart and in other organ ischaemia-reperfusion settings, where PCR techniques may help limit post-reperfusion damage.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 4","pages":"oeag098"},"PeriodicalIF":4.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393039","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":"Atrial fibrillation risk in athletes: it's not the sport, it's the mileage.","authors":"Marius Myrstad, Eirik Mølmshaug, Kristoffer Robin Johansen","doi":"10.1093/ehjopen/oeag090","DOIUrl":"10.1093/ehjopen/oeag090","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"6 3","pages":"oeag090"},"PeriodicalIF":4.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347918","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}