European heart journal open最新文献

{"title":"Energetics of flow restoration after premature ventricular contractions depends on microvascular vasodilation capacity: Insights from wave intensity analysis.","authors":"Ahmet Tas, Fevzi Alp Findik, Yaren Alan, Ilke Kara Tas, Tim P van de Hoef, Kim H Parker, Murat Sezer, Jan J Piek","doi":"10.1093/ehjopen/oeaf041","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf041","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf041"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031794","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":"Individually designed ablation of low-voltage areas in persistent atrial fibrillation-a randomized controlled trial (IDEAL-AF): study design and rationale.","authors":"Astrid Paul Nordin, Mats Jensen-Urstad, Emmanouil Charitakis, Finn Åkerström, Henrik Almroth, Csaba Herczku, Jari Tapanainen, Niklas Höglund, Nikola Drca","doi":"10.1093/ehjopen/oeaf037","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf037","url":null,"abstract":"<p><strong>Aims: </strong>Voltage-based ablation is a promising catheter ablation strategy for atrial fibrillation (AF) in which low-voltage zones (LVZs) are targeted as a complement to pulmonary vein isolation (PVI). In a randomized setting, we intend to investigate whether PVI plus ablation of LVZs, compared to PVI-only, decreases the incidence of arrhythmia recurrence and improves health-related quality of life (HRQoL) in patients with persistent AF and LVZs.</p><p><strong>Methods and results: </strong>Individually designed ablation of low-voltage areas in persistent atrial fibrillation trial (IDEAL-AF; NCT04377594) is a multi-centre, randomized, controlled clinical trial. Patients with persistent AF and LVZs ≥ 3.0 cm² outside the PVI ablation lines will be randomized in a 1:1 ratio to either PVI or PVI plus LVZ ablation. The primary outcome will be the recurrence of atrial arrhythmias off anti-arrhythmic drugs during 12 months of follow-up after one to two ablation procedures within 6 months. A 3-month blanking period will be applied after the first procedure. Patients will be monitored using a smart phone-based ECG recording device throughout the follow-up period. With an anticipated enrolment of 936 patients, this study has 80% power to detect a 20% absolute risk reduction in the primary endpoint. Additionally, HRQoL improvement will be assessed using three questionnaires.</p><p><strong>Conclusion: </strong>IDEAL-AF is a multi-centre, randomized, controlled clinical trial investigating whether ablation of LVZs in addition to PVI reduces the recurrence rate of atrial arrhythmias and improves HRQoL compared to PVI-only in patients with persistent AF and LVZs. This study has the potential to modify recommendations regarding ablation techniques for this specific patient cohort.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf037"},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060966","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":"Modulation of cell fate by shock wave therapy in ischaemic heart disease.","authors":"Michael Graber, Can Gollmann-Tepeköylü, Victor Schweiger, Jakob Hirsch, Leo Pölzl, Felix Nägele, Daniela Lener, Hubert Hackl, Sieghart Sopper, Elke Kirchmair, Sophia Mair, Jakob Voelkl, Christina Plattner, Felix Eichin, Zlatko Trajanoski, Anne Krogsdam, Jonas Eder, Manuel Fiegl, Dominik Hau, Ivan Tancevski, Michael Grimm, John P Cooke, Johannes Holfeld","doi":"10.1093/ehjopen/oeaf011","DOIUrl":"10.1093/ehjopen/oeaf011","url":null,"abstract":"<p><strong>Aims: </strong>Cardiac shockwave therapy (SWT) improves left ventricular (LV) function in patients with ischaemic cardiomyopathy. Shockwave therapy activates Toll-like receptor 3 (TLR3), a receptor-inducing chromatin remodelling and nuclear reprogramming of cardiac cells. We hypothesized that mechanical activation of TLR3 facilitates reprogramming of fibroblasts towards endothelial cells restoring myocardial perfusion and function.</p><p><strong>Methods and results: </strong>Human cardiac fibroblasts were treated by mechanical stimulation via SWT or TLR3 agonist Poly(I:C) in the presence of endothelial induction medium. A lineage tracing experiment was performed in a transgenic mouse model of Fsp1-Cre/LacZ mice after coronary occlusion. Left ventricular function and scarring were assessed. Single-cell sequencing including RNA trajectory analysis was performed. Chromatin remodelling and epigenetic plasticity were evaluated via western blot and Assay for Transposase-Accessible Chromatin sequencing. Mechanical stimulation of human fibroblasts with SWT activated TLR3 signalling and enhanced the expression of endothelial genes in a TLR3-dependent fashion. The induced endothelial cells (ECs) resembled genuine ECs in that they produced endothelial nitric oxide and formed tube-like structures in Matrigel. In a lineage tracing experiment in Fsp1-Cre/LacZ mice, shockwave treatment increased LacZ/CD31-positive cells (indicating transdifferentiation) after coronary occlusion. Furthermore, SWT reduced myocardial scar size and improved LV function. Single-cell RNA-seq and RNA trajectory analyses revealed that SWT induced an endothelial fibroblast cluster and mechanical stimulation induced significant changes in chromatin organization, with chromatin being more accessible after both treatments in 1705 genomic regions.</p><p><strong>Conclusion: </strong>Shockwave therapy enhances DNA accessibility via TLR3 activation and facilitates the transdifferentiation of fibroblasts towards endothelial cells in ischaemic myocardium.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf011"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813249","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 relation between delayed reperfusion treatment and reduced left ventricular ejection fraction in patients with ST-segment elevation myocardial infarction: a national prospective cohort study.","authors":"Bård Uleberg, Kaare Harald Bønaa, Kari Krizak Halle, Bjarne K Jacobsen, Beate Hauglann, Eva Stensland, Olav Helge Førde","doi":"10.1093/ehjopen/oeaf034","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf034","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this nationwide study of patients with acute ST-segment elevation myocardial infarction (STEMI) was to investigate the relation between delayed reperfusion and mildly to moderately reduced and severely reduced left ventricular ejection fraction (LVEF).</p><p><strong>Methods and results: </strong>In this national population-based cohort study, log-binominal and modified Poisson regression models were applied to examine the associations between delayed reperfusion (i.e. fibrinolysis > 30 min or primary percutaneous coronary intervention > 120 min after first medical contact) and reduced LVEF, adjusted for reperfusion strategy, and patient characteristics. A total of 6567 Norwegian patients with STEMI registered in the Norwegian Registry of Myocardial Infarction during 2015-2018 were included in the analyses. Among them, 57% had normal LVEF (≥50%), 39% had mildly to moderately reduced LVEF (31-49%), and 4% had severely reduced LVEF (≤30%), measured during the acute admission. The adjusted relative risk of having a mildly to moderately reduced LVEF was 1.11 [95% confidence interval (CI) 1.04-1.18] for patients receiving delayed vs. timely reperfusion, and the adjusted relative risk of having severely reduced LVEF was 1.76 (95% CI 1.37-2.25) for patients receiving delayed vs. timely reperfusion. Reperfusion strategy, either primary percutaneous coronary intervention (pPCI) or a pharmacoinvasive strategy (PI), was not a significant determinant for reduced LVEF in any of the analyses.</p><p><strong>Conclusion: </strong>Delayed reperfusion treatment in STEMI increases the risk of mildly to moderately reduced LVEF, and the risk of severely reduced LVEF substantially, compared with timely reperfusion. The risk of reduced LVEF did not differ between patients treated with pPCI or PI.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf034"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061235","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":"Post-cardiac surgery atrial fibrillation and sex differences in clinical outcomes: a systematic review and meta-analysis.","authors":"Faith Michael, Travis Quevillon, Suzanne Betteridge-LeBlanc, Mustafa Alzahran, Rafael Shehata, Cynthia A Jackevicius, Rony Atoui, Bindu Bittira, Tina Baykaner, Paula Harvey, Ratika Parkash, Jeff S Healey, Dennis T Ko, Mohammed Shurrab","doi":"10.1093/ehjopen/oeaf033","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf033","url":null,"abstract":"<p><p>There is conflicting literature on sex differences and clinical outcomes in patients who develop atrial fibrillation (AF) post-cardiac surgery. Our aim was to compare clinical outcomes between females and males with post-cardiac surgery AF. A systematic search was conducted for studies published until 27 September 2024 in MEDLINE, Embase, and CENTRAL. Included studies compared mortality and stroke in females vs. males who developed AF after cardiac surgery. Outcomes of interest were mortality and stroke. Pooled prevalence was used to compare comorbidities. Raw event rates were used to calculate odds ratios (ORs), which were pooled with a fixed-effects model. 10 422 studies were identified and 5 studies met inclusion criteria. 14 970 patients who developed AF after cardiac surgery were included, of whom 3748 were females. The length of follow-up was up to 10 years. The weighted average age was 70.4 ± 2.9 years in females and 66.7 ± 2.4 years in males (<i>P</i> = 0.32). At baseline, females had a higher prevalence of hypertension, diabetes, dyslipidemia, stroke, and peripheral vascular disease. The odds of in-hospital mortality among females were higher compared to males (5.5 vs. 3.0%; OR 2.04, 95% CI 1.42-2.91, <i>P</i> < 0.001, <i>I</i> ² = 57%). There were no significant differences in post-discharge mortality (45.6 vs. 42.9%; OR 1.05, 95% CI 0.97-1.15, <i>P</i> = 0.23, <i>I</i> ² = 0%) or in-hospital stroke (2.5 vs. 1.9%; OR 1.30, 95% CI 0.79-2.13, <i>P</i> = 0.30, <i>I</i> ² = 57%) in females vs. males. In conclusion, females with post-cardiac surgery AF had a higher prevalence of comorbidities at baseline. The odds of in-hospital mortality were twice as high among females. There were no significant differences in post-discharge mortality or in-hospital stroke. Future studies are warranted to understand the mechanisms of increased in-hospital mortality in females and to develop effective monitoring strategies and interventions.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf033"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028993","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 Cardiovascular Disease Journals in Reporting Sex and Gender in Research.","authors":"C Noel Bairey Merz, Robert O Bonow, Mercedes Carnethon, Filippo Crea, Joseph A Hill, Harlan M Krumholz, Roxana Mehran, Erica S Spatz","doi":"10.1093/ehjopen/oeaf029","DOIUrl":"10.1093/ehjopen/oeaf029","url":null,"abstract":"","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf029"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756811","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":"Edoxaban treatment in routine clinical practice is highly concordant with the 2020 European Society of Cardiology atrial fibrillation guidelines: results from the noninterventional Global ETNA-AF programme.","authors":"Doralisa Morrone, Leon Dinshaw, José Antonio Gordillo de Souza, Cathy Chen, Paulus Kirchhof, Yukihiro Koretsune, Ladislav Pecen, Chun-Chieh Wang, Takeshi Yamashita, Martin Unverdorben, Raffaele De Caterina","doi":"10.1093/ehjopen/oeaf004","DOIUrl":"10.1093/ehjopen/oeaf004","url":null,"abstract":"<p><strong>Aims: </strong>The 2020 European Society of Cardiology (ESC)-atrial fibrillation (AF) guidelines recommend a risk-based approach to oral anticoagulation (OAC) therapy in patients with AF; however, it is unknown if current practice aligns with these recommendations. This study assessed the associated effectiveness and safety of edoxaban in patients with AF according to the 2020 ESC-AF guidelines and the approved label in routine clinical care.</p><p><strong>Methods and results: </strong>The Global ETNA-AF programme is a large prospective, noninterventional programme evaluating safety and effectiveness of edoxaban. Baseline characteristics and 2-year clinical event data were analysed in subgroups, defined by ESC-AF guidelines indication of OAC therapy according to CHA₂DS₂-VASc score [no OAC to be considered, OAC should be considered (2 for females/1 for males), and OAC recommended (≥3 for females/≥2 for males)] and modified HAS-BLED score [(≥3 (bleeding risk high) vs. <3 (bleeding risk low)]. Of 19 960 patients included, 16 912 (84.7%) were categorized as OAC recommended and 2501 (12.5%) as OAC should be considered; 547 (2.7%) were in the no OAC to be considered group. In the OAC recommended group, 12 006 (71.0%) had high bleeding risk. Clinical event rates were <5%/year across all risk groups, even in the OAC recommended and high bleeding risk groups. In the OAC recommended and high bleeding risk groups, patients had low ischaemic stroke and bleeding event rates, regardless of receiving the 30 or 60 mg dose.</p><p><strong>Conclusion: </strong>This study demonstrated that edoxaban use in patients with AF largely aligns with 2020 ESC-AF guidelines, while maintaining low clinical event rates.</p><p><strong>Registration: </strong>Europe (NCT02944019), Japan (UMIN000017011), and Korea/Taiwan (NCT02951039).</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf004"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756803","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":"Decreased peak atrial longitudinal strain and left atrial contraction strain rate values may predict atrial fibrillation in patients in sinus rhythm at baseline: a systematic review and meta-analysis.","authors":"Henriette Mészáros, Rita Nagy, Péter Fehérvári, Péter Hegyi, Enikő Pomozi, Zsombor Simon, Andrea Ágnes Molnár, Sándor Nardai, Béla Péter Merkely, Pál Ábrahám","doi":"10.1093/ehjopen/oeaf024","DOIUrl":"10.1093/ehjopen/oeaf024","url":null,"abstract":"<p><p>Despite the broadening spectrum of heart rhythm-monitoring techniques, the most appropriate modality and duration to detect atrial fibrillation (AF) are not consensual. Two-dimensional speckle tracking for left atrial strain analysis seems feasible to detect atrial cardiomyopathy, which represents a substrate for AF. We aimed to perform a systematic review and meta-analysis on peak atrial longitudinal strain (PALS) and contraction strain rate (pLAct) differences as primary outcomes measured in sinus rhythm (SR) between patients with and without future AF during follow-up (FU). Random-effect model was used. For continuous outcomes, we calculated weighted mean differences (WMD) to compare the two groups We identified eight eligible articles consisting of 1230 patients. Six articles were eligible for quantitative PALS analysis, while three were eligible regarding pLAct. The baseline parameters of the future AF and SR patients were comparable in most of the papers. The PALS value in patients developing future AF was significantly lower compared to patients with no AF (WMD: -5.55% 95% CI -7.06 to -4.03%). Pooled WMD of pLAct between the groups was -0.44 1/s, 95% CI: -0.56 to -0.33 1/s. Baseline PALS and pLAct values of future AF patients were significantly lower than those who remained in SR during FU. PALS and pLAct seem to be sensitive parameters which can be implemented in a predictive model for AF enabling us to find patients who need prolonged heart rhythm-monitoringand it can be also a guidance for oral anticoagulation indication setting.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 3","pages":"oeaf024"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181479","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":"Insulin-like growth factor binding protein-3 (IGFBP-3): a biomarker of coronary artery disease induced myocardial ischaemia.","authors":"Jacqui A Lee, Jessika Wise, Sara D Raudsepp, Louise N Paton, Jan Powell, Kieran Jina, Sally Aldous, Richard W Troughton, Philip D Adamson, A Mark Richards, W Frank Peacock, James L Januzzi, Noah Erceg, Luca Koechlin, Jasper Boeddinghaus, Pedro Lopez-Ayala, Christian Mueller, Martin P Than, John W Pickering, Chris J Pemberton","doi":"10.1093/ehjopen/oeaf028","DOIUrl":"10.1093/ehjopen/oeaf028","url":null,"abstract":"<p><strong>Aims: </strong>Among individuals presenting to the emergency department (ED) with chest pain, clinical uncertainty surrounds the appropriate identification of non-myocardial infarction (MI) individuals who would most benefit from objective functional/anatomical testing (e.g. imaging). We applied a proteomic biomarker discovery approach to identify novel candidates reflecting coronary artery disease (CAD) induced ischaemia that could translate to measurement in clinical samples.</p><p><strong>Methods and results: </strong>Mass spectroscopy (MS) of perfusate from an isolated rat heart model of cardiac ischaemia identified >100 novel protein biomarkers. A prominent candidate, insulin-like growth factor binding protein (IGFBP-3), was then interrogated for its ability to identify CAD-related ischaemia (e.g. positive cardiac stress test; unstable angina pectoris, UAP; arterial stenosis >70% on angiography) in multiple patient sample sets [cardiac stress testing, <i>n</i> = 12; septal alcohol ablation (SAA), <i>n</i> = 12; ED chest pain, <i>n</i> = 2977]. In cardiac stress testing, a significant delta IGFBP-3 (ΔIGFBP-3) between 0 and 150 min was seen in positive, but not negative, tests (<i>P</i> = 0.03). In SAA, peripheral IGFBP-3 levels did not change over 24 h (<i>P</i> = 0.57). In ED patients, ΔIGFBP-3 between 0 and 2 h (i) identified more 365-day low-risk major adverse cardiac event cases (27-30%), (ii) provided 7% improvement in positive predictive value over a clinical model for the identification of unstable angina (<i>P</i> = 0.01), and (iii) was a significant, independent predictor of >70% stenosis on angiography, improving indeterminate risk prediction by 9% (95% CI 3-15%).</p><p><strong>Conclusion: </strong>Our discovery approach has translated IGFBP-3 as a potential biomarker to identify significant CAD/ischaemia in patients who do not meet diagnostic thresholds for MI.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf028"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775101","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":"Spontaneous coronary artery dissection in regions of non-Western populations: a systematic literature search and scoping review.","authors":"Rasha Kaddoura, Ashraf Ahmed, Mohammed Al-Hijji, Fathima Aaysha Cader, Mirvat Alasnag, David Adlam","doi":"10.1093/ehjopen/oeaf022","DOIUrl":"https://doi.org/10.1093/ehjopen/oeaf022","url":null,"abstract":"<p><p>Current data on spontaneous coronary artery dissection (SCAD) predominantly originate from Europe or Caucasians with limited information about other ethnicities. This scoping review presents the evidence on SCAD in non-Western countries. The prevalence of SCAD diagnosis was 1.0% [95% confidence interval (95% CI): 0.0-3.0, <i>I</i> ² = 99%] among patients presenting with myocardial infarction, increasing to 5.0% (95% CI: 1.0-16.0, <i>I</i> ² = 99%) among females. The mean age was 51.3 years with females accounting for 54.0% of patients. A conservative revascularization management was reported in 48.0% (95% CI: 32.0-65.0, <i>I</i> ² = 85%) of patients. Antiplatelet therapy was reported as dual (68.0%, 95% CI: 37.0-89.0, <i>I</i> ² = 90%) in only three studies. A death rate (3.0%) was similar during hospitalization and at mean follow-up of 23.42 months. In conclusion, there is a marked variability in the clinical course of patients with SCAD as well heterogeneity among the included studies. This review identified knowledge gaps in our understanding of SCAD in non-Western countries that should be addressed in future prospective studies.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":"5 2","pages":"oeaf022"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055582","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}