Cardiology Research最新文献

{"title":"Sardjito Cardiovascular Intensive Care Score as an Alternative to Mayo Cardiac Admission Risk Score for Predicting Mortality in Cardiovascular Intensive Care Patients.","authors":"Nadia Luthfia Adani, Hendry Purnasidha Bagaswoto, Irsad Andi Arso","doi":"10.14740/cr2199","DOIUrl":"10.14740/cr2199","url":null,"abstract":"<p><strong>Background: </strong>The cardiovascular intensive care unit (CICU) has evolved into a multidisciplinary unit managing critically ill patients with high mortality rates. In 2022, the Sardjito Cardiovascular Intensive Care (SCIENCE) score introduced seven simple parameters assessed within the first 24 h to predict CICU mortality. The Mayo Cardiac Admission Risk Score (M-CARS) is a well-established tool for predicting CICU mortality but requires specialized laboratory tests. This study compared the predictive performance of the SCIENCE score and M-CARS and validated SCIENCE at its development site.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted between February 2022 and September 2024 and included CICU patients at Sardjito Hospital. Outcomes assessed were CICU and in-hospital mortality. Predictive performance was evaluated by accuracy, discrimination, and calibration (Hosmer-Lemeshow test).</p><p><strong>Results: </strong>Over 50% of the initial participants were excluded due to missing M-CARS data (particularly the anion gap), leaving 1,503 eligible patients. M-CARS showed good predictive performance for CICU mortality (accuracy 70.9%, area under the curve (AUC) 0.804, P = 0.685) and in-hospital mortality (accuracy 72.2%, AUC 0.797, P = 0.303). The SCIENCE score also showed good predictive performance for CICU mortality (accuracy 63.7%, AUC 0.775, P = 0.059) and in-hospital mortality (accuracy 65.8%, AUC 0.767, P = 0.352). Acute stroke (hemorrhagic and non-hemorrhagic) was associated with higher CICU and in-hospital mortality (P < 0.05).</p><p><strong>Conclusion: </strong>Both the SCIENCE score and M-CARS provide acceptable predictive performance for CICU patients. However, as M-CARS has limited applicability in some settings, the SCIENCE score may serve as a more practical alternative.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"170-180"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293480","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":"Holter-Derived Mean Heart Rate as a Predictor of Short-Term Clinical Risk in Patients Hospitalized With Acute Heart Failure.","authors":"Vu Manh Tan, Pham Xuan Hung, Tran Vuong The Vinh, Nguyen Thi Van Khanh, Vo Thai Duy","doi":"10.14740/cr2189","DOIUrl":"10.14740/cr2189","url":null,"abstract":"<p><strong>Background: </strong>Heart rate (HR) is a key marker of autonomic and hemodynamic stress in acute heart failure (AHF). Whether 24-h Holter-derived mean HR provides incremental prognostic value for short-term clinical outcomes during hospitalization remains unclear. This study evaluated the association between Holter-derived mean HR and short-term clinical outcomes in patients hospitalized with AHF.</p><p><strong>Methods: </strong>The study enrolled consecutive adults hospitalized with AHF at a tertiary hospital between October 2020 and June 2021. All participants underwent 24-h Holter monitoring during early hospitalization. Mean HR was categorized as < 70, 70-100, or > 100 beats per minute (bpm). Outcomes included in-hospital mortality, and all-cause mortality and readmission at 30, 60, and 90 days post-discharge. Two cardiologists blinded to outcomes interpreted Holter data. Statistical analyses were conducted to evaluate associations between mean HR categories and short-term clinical outcomes.</p><p><strong>Results: </strong>Ninety-four patients were included (mean age 66 ± 16.2 years; 56.4% female). In-hospital mortality was strongly associated with mean HR (4.8% for < 70 bpm vs. 31.3% for > 100 bpm; P = 0.023). A HR threshold > 100 bpm significantly increased in-hospital mortality (P = 0.012). In contrast, admission HR alone did not predict mortality (P = 0.573). Post-discharge mortality (1.1-4.3%) and readmission rates (5.3-13.8%) did not differ across HR categories.</p><p><strong>Conclusions: </strong>Holter-derived mean HR was a robust predictor of in-hospital mortality in patients hospitalized with AHF, outperforming single-time HR measurements. These findings may have potential relevance to perioperative risk assessment in patients with AHF, although prospective studies including surgical cohorts are required.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"164-169"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293560","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":"Association of Circulating Brain-Derived Neurotrophic Factor With Coronary Risk Factors and Coronary Artery Disease in Patients Who Have Undergone Coronary Computed Tomography Angiography.","authors":"Tetsuro Tachibana, Yuhei Shiga, Erika Miura-Takahashi, Kohei Tashiro, Riku Tsudome, Yuto Kawahira, Takashi Kuwano, Makoto Sugihara, Satoshi Imaizumi, Shin-Ichiro Miura","doi":"10.14740/cr2201","DOIUrl":"10.14740/cr2201","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have reported low circulating brain-derived neurotrophic factor (BDNF) concentrations in patients with coronary artery disease (CAD), but findings have been inconsistent and may be influenced by platelet-related factors. This study evaluated the association between plasma BDNF and CAD in patients undergoing coronary computed tomography angiography (CCTA).</p><p><strong>Methods: </strong>We prospectively enrolled 402 consecutive patients who underwent CCTA for CAD screening at Fukuoka University Hospital and who were either clinically suspected of having CAD or had at least one cardiovascular risk factor. CAD was defined as coronary artery stenosis of 50% or greater. Plasma BDNF was measured and its association with CAD and clinical variables was examined using multivariate linear regression and logistic regression. The effect of covariate adjustment on the association between BDNF and CAD was assessed using the change-in-estimate method.</p><p><strong>Results: </strong>Patients with CAD (n = 186) had lower plasma BDNF levels compared with patients without CAD (n = 216) (5.73 ± 3.16 vs. 6.41 ± 3.42 ng/mL, P = 0.039). Multivariate linear regression analysis revealed that platelet count was the strongest determinant of plasma BDNF levels (β = 0.027, P < 0.001). Unadjusted logistic regression analysis showed that higher BDNF levels were associated with a lower prevalence of CAD (odds ratio (OR) 0.94, 95% confidence interval (CI) 0.88-1.00, P = 0.039). However, after adjusting for platelet count, this association weakened and became non-significant (OR 0.976, 95% CI 0.909-1.05, P = 0.49). Further adjustment for age and coronary artery calcification score did not significantly alter the results.</p><p><strong>Conclusions: </strong>In a cohort undergoing CCTA with a relatively intermediate pre-test probability of CAD, plasma BDNF levels were lower in patients with CAD, but this crude correlation was primarily explained by platelet-related confounding factors. Platelet count should be considered when evaluating BDNF as a cardiovascular biomarker in patients with intermediate cardiovascular risks.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"156-163"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293538","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":"Comparison of Single-Freezing Temperature-Guided and Conventional Time-to-Isolation-Guided Protocols of Cryoballoon in Atrial Fibrillation Ablation.","authors":"Xiao Yu Liu, Jie Zheng, Ku Lin Li, Hua Yan You, Shi Peng Dang, Yu Fei Dai, Hai Wei Geng, Yun Lai Gao, Ru Xing Wang","doi":"10.14740/cr2202","DOIUrl":"10.14740/cr2202","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to compare the efficacy and safety of simplified single-freezing protocol with achieving -40 °C within 60 s of freezing as the observation index and the conventional time-to-isolation (TTI)-guided double-freezing protocol using second-generation cryoballoon in the treatment of atrial fibrillation (AF).</p><p><strong>Methods: </strong>A retrospective analysis was performed. After propensity score matching, 146 patients who underwent conventional TTI-guided protocol freezing (conventional group) and 146 patients who underwent single-freezing temperature-guided protocol freezing (simplified group) using second-generation cryoballoon were included. Procedure time, X-ray time and dose, complications, success rate, and recurrence rate during follow-up were analyzed.</p><p><strong>Results: </strong>Compared with the conventional group, the simplified group showed a significant reduction in procedure time (98.8 ± 16.3 vs. 79.4 ± 12.7 min, P < 0.001), and X-ray time (24.3 ± 6.8 vs. 17.8 ± 4.9 min, P < 0.001) and dose (681.1 ± 337.8 vs. 540.1 ± 343.7 mGy, P < 0.001). There was no significant difference in the success rate of acute pulmonary vein isolation between the two groups of patients (145/146 vs. 146/146, P = 0.975) and the proportion of maintaining sinus rhythm during follow-up (114/146 vs. 109/146, P = 0.842). Cox regression analysis showed that simplified protocol is not a predictive factor for recurrence in AF cryoablation.</p><p><strong>Conclusions: </strong>In summary, the single-freezing temperature-guided protocol demonstrates comparable efficacy and safety to conventional TTI-guided protocol of second-generation cryoballoon in the AF ablation with the advantages of reducing procedure time and radiation exposure.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"205-213"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293530","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 High-Mobility Group Box 1/Toll-Like Receptor 4 in Pericardial Fibrosis and Postoperative Low Cardiac Output Syndrome in Constrictive Pericarditis.","authors":"Li Kui Fang, Tian Xiang Wang, Fang Ming Zhong, Guo Can Yu, Wei Hua Li","doi":"10.14740/cr2228","DOIUrl":"10.14740/cr2228","url":null,"abstract":"<p><strong>Background: </strong>It has remained unclear about the factors that are involved in the pericardial fibrotic process and the occurrence of postoperative low cardiac output syndrome (LCOS) in constrictive pericarditis. This study aimed to analyze the role of toll-like receptor 4 (TLR4) and high-mobility group box 1 (HMGB1) in pericardial fibrosis, and their impact on the development of postoperative LCOS in patients with constrictive pericarditis.</p><p><strong>Methods: </strong>This retrospective study enrolled 24 constrictive pericarditis patients who underwent isolated pericardiectomy at our department from May 2023 to April 2025. Pericardial tissues were subjected to immunohistochemistry to detect the expression of TLR4, HMGB1, α-smooth muscle actin (α-SMA) and collagen III. Mean optical density (MOD) was used for quantitative analysis of immunohistochemical staining. Pearson correlation analysis was performed to assess associations between TLR4, HMGB1 and fibrotic markers, while receiver operating characteristic (ROC) curves were used to evaluate their potential predictive value for postoperative LCOS.</p><p><strong>Results: </strong>Of the 24 patients, seven (29.2%) patients developed postoperative LCOS. TLR4 was expressed in 21 (87.5%) specimens, and HMGB1 was expressed in all specimens. Pearson correlation analysis showed positive correlations between TLR4 and α-SMA (r = 0.529, P = 0.008), HMGB1 and α-SMA (r = 0.516, P = 0.010), and TLR4 and HMGB1 (r = 0.844, P < 0.001). MOD values of TLR4 and HMGB1 were significantly higher in patients with postoperative LCOS (P = 0.028 and P < 0.001, respectively). ROC curve suggested that TLR4 (area under the curve (AUC) = 0.790, 95% confidence interval (CI), 0.516-1.000) and HMGB1 (AUC = 0.941, 95% CI, 0.853-1.000) had potential predictive value for postoperative LCOS.</p><p><strong>Conclusions: </strong>TLR4 and HMGB1 were involved in the pericardial fibrosis and were significantly associated with the occurrence of postoperative LCOS in constrictive pericarditis.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"239-247"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293472","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":"Nonvalvular Atrial Fibrillation and Anticoagulation in the Elderly: A Retrospective Cohort Study.","authors":"Kaiyu Jia, Elizabeth Rimsky, Joaquim Noguer, Aysan Sattarzadeh, Sabina Shah, Maryam Arooba Sherani, Omar Khayat, Bahy Abofrekha, Un Jung Lee, Suzanne El-Sayegh","doi":"10.14740/cr2219","DOIUrl":"10.14740/cr2219","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is associated with a substantially increased risk of ischemic stroke and systemic embolism particularly in elderly patients. Understanding real-world patterns of anticoagulation (AC) use in elderly population is critical.</p><p><strong>Methods: </strong>This is a retrospective, single-center, chart review study that included patients who had nonvalvular AF between 2021 and 2024. Patients were divided into two groups according to age: 50-75 years old and 76-89 years old. Primary endpoint was AC underutilization, which was defined by the presence of all the following conditions: 1) CHA₂DS₂-VASc score > 2; 2) Outcomes Registry for Better Informed Treatment (ORBIT) score ≥ 3; 3) without AC. Secondary endpoint was AC appropriateness, which is defined by the presence of all the following conditions: 1) CHA₂DS₂-VASc > 2; 2) ORBIT < 3; 3) with AC.</p><p><strong>Results: </strong>A total of 6,386 patients were included. Among them, 3,306 patients were 50-75 years old, and 3,080 patients were 76-89 years old. Patients in age group 76-89 had a 4.547-fold higher odds ratio (OR = 4.547; 95% confidence interval (CI), 3.827-5.403) to have AC underutilization than those in age group 50-75. Patients in age group 76-89 were 108% (OR = 2.077; 95% CI, 1.818-2.374) more likely to have AC appropriateness than those in age group 50-75. History of bleeding (OR = 10.582; 95% CI, 6.467-17.315; P < 0.001) and glomerular filtration rate (GFR) (OR = 0.985; 95% CI, 0.982-0.988; P < 0.001) were independent predictors of appropriateness. Similar, history of bleeding (OR = 2.402; 95% CI, 1.666-3.462; P < 0.001) and GFR (OR = 1.006; 95% CI, 1.001-1.010; P = 0.0185) were also independent predictors of underutilization.</p><p><strong>Conclusions: </strong>Patients in age group 76-89 were more likely to have AC underutilization than patients in age group 50-75. History of bleeding and GFR were independent predictors of appropriateness and underutilization. These findings highlight the ongoing challenge of balancing stroke prevention and bleeding risk in elderly AF patients and underscore the importance of guideline-directed, individualized AC strategies.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"149-155"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293518","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":"Strong Adherence to Cardiac Rehabilitation Program Improves Exercise Tolerance in Outpatients With Cardiovascular Disease.","authors":"Kakeru Bando, Yasunori Suematsu, Takuro Matsuda, Yuiko Yano, Kai Tsukahara, Takashi Maruo, Hiroyuki Fukuda, Chie Matsushita, Etsumi Nakamura, Reiko Teshima, Hinata Oda, Kanta Fujimi, Shin-Ichiro Miura","doi":"10.14740/cr2213","DOIUrl":"10.14740/cr2213","url":null,"abstract":"<p><strong>Background: </strong>Exercise-based cardiac rehabilitation (CR) programs are recommended in outpatients at least three times a week, but high-frequency visits can be difficult due to patients' work schedules. The association between the frequency of exercise-based CR and the increase in exercise tolerance is not well known. We evaluated the effect of CR once a week or more for improving exercise tolerance.</p><p><strong>Methods: </strong>This is a retrospective observational study. From February 2011 to January 2020, 110 outpatients who participated in CR and performed a cardiopulmonary exercise test (CPET) two times (initially and within 6 months) were registered. We divided the patients into those who participated in CR once a week or more (n = 75) and less than once a week (n = 35) and compared the changes in the results of CPET.</p><p><strong>Results: </strong>Overall, the median patient age was 68.5 (59-74) years, 69.1% were males, and the body mass index was 23.8 (20.2-27.4) kg/m². The average frequency of CR was 1.54 (0.93-1.89) times per week. While patients who participated in CR once a week or more showed improvements in oxygen uptake, ventilatory equivalent, ventilatory efficiency, and oxygen uptake per heart rate, those who participated in CR less than once a week showed only small improvements. The ratio of oxygen uptake to work rate in patients who participated in CR once a week or more also improved significantly.</p><p><strong>Conclusions: </strong>Patients who participated in a CR program once a week or more showed improved exercise tolerance.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"181-189"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293476","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":"Predictive Value of the Pulmonary Artery Pulsatility Index in Pulmonary Arterial Hypertension: REVEAL Analysis.","authors":"Nicole F Ruopp, Harrison W Farber, Mohammad Rahman, Navin K Kapur, Zeenat Safdar","doi":"10.14740/cr2225","DOIUrl":"10.14740/cr2225","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest in developing risk assessment tools/metrics to improve treatment, management, and outcomes for pulmonary arterial hypertension (PAH). This study investigated the association of the pulmonary artery pulsatility index (PAPi) with patient characteristics, hospitalization, and mortality.</p><p><strong>Methods: </strong>Data collected from the US-based Registry to Evaluate Early and Long-Term PAH Disease Management were stratified/analyzed according to baseline PAPi quartiles (36-month follow-up).</p><p><strong>Results: </strong>In total, 2,711 patients were included. Baseline demographic/clinical characteristics were similar; however, the lowest quartiles (< 3.55; ≥ 3.55 to < 5.5) had higher New York Heart Association/World Health Organization functional class, while those in the highest quartiles (≥ 5.5 to < 9.0; ≥ 9.0) had longer 6-min walk distance. Of 2,414 patients assessed for hospitalization, 1,326 (54.9%) were hospitalized. Lower PAPi correlated with increasing hospitalization probability (≥ 9.0 quartile, n = 291 (48.0%); ≥ 5.5 to < 9.0 quartile, n = 333 (54.8%); ≥ 3.55 to < 5.5 quartile, n = 340 (57.2%); and < 3.55 quartile, n = 362 (59.7%)). Of 681 (28.1%) patients who died, 150 (24.1%) were in the ≥ 9.0 quartile, 154 (25.5%) the ≥ 5.5 to < 9.0 quartile, 157 (26.7%) the ≥ 3.55 to < 5.5 quartile, and 220 (35.9%) the < 3.55 quartile (P < 0.001). Compared with the < 3.55 quartile, there was a 35.6%, 25.8%, and 23.3% reduction in mortality in the ≥ 9.0, ≥ 5.5 to < 9.0, and ≥ 3.55 to < 5.5 quartiles, respectively.</p><p><strong>Conclusions: </strong>PAPi may be a useful prognostic tool and long-term predictor of clinical events in PAH.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"214-226"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293511","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":"Role of Intracoronary Imaging in Percutaneous Coronary Intervention for In-Stent Restenosis: A Prospective Observational Study.","authors":"Ramya Das Nageri Kunnath, Pulugundla Varun, Sharath Nagesh, Harikrishnan Sivadasanpillai, Bijulal Sasidharan, Sreevilasam P Abhilash","doi":"10.14740/cr2224","DOIUrl":"10.14740/cr2224","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in contemporary stent technology and procedural techniques, in-stent restenosis (ISR) remains a clinically significant cause of repeat revascularization. Coronary angiography, although the standard diagnostic modality, has limited ability to identify the underlying mechanism of ISR. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) may improve mechanism-based decision-making and procedural optimization. This study aimed to evaluate the impact of intracoronary imaging on ISR mechanism identification and treatment strategy during ISR percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This prospective observational study included 34 patients with 40 ISR lesions (60 previously implanted stents) undergoing IVUS- or OCT-guided PCI at a tertiary care center. Patients underwent detailed assessment of cardiovascular risk factors, angiographic classification of ISR, and systematic intracoronary imaging analysis. ISR lesions were classified as mechanically driven or tissue-proliferative based on imaging findings. The primary objective was to assess the impact of imaging on lesion preparation and definitive treatment strategy.</p><p><strong>Results: </strong>The mean age was 63 years, and 82.4% were male. Diffuse ISR was present in 57.5% of lesions. Intracoronary imaging identified mechanical and tissue-proliferative ISR in equal proportions (50% each). Mechanical ISR was more frequently associated with earlier presentation and structural complexity, including multisegment involvement and stent overlap zones. Intravascular imaging led to escalation of lesion modification strategies in 50% of lesions. Before imaging, drug-eluting balloon (DEB) therapy was planned in 55% and drug-eluting stent (DES) implantation in 15% of cases. Following imaging, DES implantation was performed in 50% of lesions, representing a significant shift in treatment strategy (McNemar test, P = 0.021).</p><p><strong>Conclusion: </strong>Both mechanical and tissue-proliferative mechanisms contributed substantially to ISR. Intracoronary imaging clarified the dominant ISR mechanism, guided lesion preparation, and modified definitive treatment strategy. These findings suggest a mechanism-based role for IVUS/OCT in lesion assessment and procedural planning during ISR PCI. Larger comparative studies with longer follow-up are required to determine whether imaging-guided ISR PCI improves clinical outcomes.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"227-238"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293506","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":"Analytical Evaluation of a Point-of-Care Platform for Glycated Hemoglobin and N-Terminal Pro-B-Type Natriuretic Peptide Testing in Cardiometabolic Care.","authors":"Perrin Ngougni Pokem, Ali Khatib, Iman Azariouh Kaddouri, Damien Gruson","doi":"10.14740/cr2220","DOIUrl":"10.14740/cr2220","url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a frequent complication of diabetes, highlighting the importance of integrated cardiometabolic assessment. Glycated hemoglobin (HbA1c) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) represent complementary biomarkers reflecting glycemic control and myocardial stress. Point-of-care testing (POCT) platforms may facilitate decentralized diagnostics and shorten analytical turnaround time. The aim of this study was to evaluate the analytical performance of the AFIAS-3 point-of-care fluorescence immunoassay platform for HbA1c and NT-proBNP measurements in comparison with established central laboratory methods.</p><p><strong>Methods: </strong>This single-center verification study included 50 patient samples for each analyte. HbA1c measurements obtained using AFIAS-3 were compared with Tosoh G8 high-performance liquid chromatography (HPLC), while NT-proBNP measurements were compared with the cobas 8000 electrochemiluminescence immunoassay. Analytical precision and accuracy were assessed using manufacturer quality control materials. Method comparison was performed using Passing-Bablok regression, Bland-Altman analysis, and Spearman correlation. Agreement at clinical thresholds was evaluated using Cohen's kappa statistics.</p><p><strong>Results: </strong>For HbA1c, analytical precision was excellent, with coefficients of variation of 1.9% and 1.8%. Correlation with the reference method was strong (r = 0.98), and the mean bias was minimal (-0.03%). Agreement at the diagnostic threshold of 6.5% was excellent (κ = 0.92). For NT-proBNP, coefficients of variation were 5.3% and 15.4%. Correlation with the central laboratory method was very high (r = 0.99), although proportional bias was observed at higher concentrations (slope 1.24). Agreement at clinically relevant thresholds remained substantial.</p><p><strong>Conclusions: </strong>The AFIAS-3 POCT platform demonstrated excellent analytical agreement for HbA1c and acceptable agreement for NT-proBNP at clinically relevant thresholds. Dual biomarker POCT may support decentralized cardiometabolic diagnostics, although NT-proBNP values at higher concentrations should be interpreted cautiously.</p>","PeriodicalId":9424,"journal":{"name":"Cardiology Research","volume":"17 3","pages":"190-196"},"PeriodicalIF":1.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13278697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293532","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}