Circulation reports最新文献

{"title":"Admission Renal Dysfunction Severity as a Prognostic Factor in Older Patients With Acute Heart Failure.","authors":"Kazuya Kito, Masakazu Saitoh, Yuji Mori, Keita Fujiyama, Masahiro Toda, Kotaro Iwatsu, Tomoyuki Morisawa, Tetsuya Takahashi, Michitaka Kato","doi":"10.1253/circrep.CR-25-0274","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0274","url":null,"abstract":"<p><strong>Background: </strong>Renal dysfunction (RD) is common at admission for acute heart failure (AHF), but there is limited evidence focusing on older adults and considering the influence of physical function. We evaluated the prognostic significance of admission RD severity as a risk factor for adverse outcomes in older patients with AHF, while considering the potential modifying effect of physical function.</p><p><strong>Methods and results: </strong>This multicenter prospective cohort study enrolled 710 patients aged ≥65 years with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². Admission RD was stratified into 4 severity classes: mild RD (eGFR 45-59), moderate RD (eGFR 30-44), severe RD (eGFR 15-29), and kidney failure (eGFR <15). The primary outcome was a composite of HF readmission and all-cause death within 1 year post-discharge. Subgroup analyses assessed potential effect modification by physical function and other variables. After multivariable adjustment, severe RD or kidney failure was significantly associated with a higher risk of the composite outcome compared with mild RD (adjusted hazard ratio: 1.529; 95% confidence interval: 1.005-2.326). A possible interaction was observed between moderate RD and the Short Physical Performance Battery score at discharge (P for interaction=0.093).</p><p><strong>Conclusions: </strong>Severe RD or kidney failure at admission independently predicted 1-year HF readmission and all-cause death. In moderate RD, physical function may modify RD prognostic impact.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"616-625"},"PeriodicalIF":1.1,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679884","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":"Risk Factors for Venous Thromboembolism in Advanced Non-Small Cell Lung Cancer: A Nationwide Administrative Database Study.","authors":"Tetsuya Kimura, Yugo Yamashita, Yasutaka Ihara, Megumi Mizutani, Ryota Kawai, Ayumi Shintani","doi":"10.1253/circrep.CR-25-0167","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0167","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is associated with a high risk of venous thromboembolism (VTE). However, data on specific risk factors for VTE in patients with advanced NSCLC remain limited.</p><p><strong>Methods and results: </strong>Using a Japanese nationwide administrative database, we analyzed 20,206 patients aged ≥18 years with advanced NSCLC who received first-line chemotherapy between January 2016 and January 2023. VTE events were identified through International Classification of Diseases, Tenth Revision codes and imaging studies. Risk factors were evaluated using Cox proportional hazards models with time-dependent covariates. The cumulative incidence of VTE was 4.2% and 6.1% at 365 and 730 days after the first date of chemotherapy for NSCLC, respectively. Several significant risk factors for VTE were identified, including female sex (hazard ratio [HR] 1.374; 95% confidence interval [CI] 1.157-1.631), higher body mass index (HR 1.029 per 1-kg/m² increase; 95% CI 1.009-1.048), previous VTE (HR 2.707; 95% CI 1.907-3.843), platinum-based chemotherapy (HR 1.217; 95% CI 1.051-1.410), anti-vascular endothelial growth factor agent (HR 1.763; 95% CI 1.458-2.132), heart failure (HR 1.677; 95% CI 1.432-1.965), and stroke/transient ischemic attack (HR 1.296; 95% CI 1.055-1.593).</p><p><strong>Conclusions: </strong>This large-scale study identified several significant risk factors for VTE in patients with advanced NSCLC. The findings suggest the need for risk-stratified monitoring and prophylactic strategies to reduce VTE-related complications in high-risk patients.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"634-641"},"PeriodicalIF":1.1,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679780","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":"Sex-Based Differences in the Effect of Short Dual Antiplatelet Therapy Followed by Prasugrel Monotherapy in High-Bleeding-Risk Patients After Percutaneous Coronary Intervention.","authors":"Norihiro Kogame, Yoshihisa Nakagawa, Ken Kozuma, Raisuke Iijima, Anna Tsutsui, Yoshitaka Murakami, Masayuki Fukuzawa, Satoru Abe, Go Kato, Masato Nakamura","doi":"10.1253/circrep.CR-25-0298","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0298","url":null,"abstract":"<p><strong>Background: </strong>In patients at high bleeding risk (HBR), short dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) reduces bleeding without increasing ischemic events. However, the sex-based differences in the effects of short DAPT strategy followed by prasugrel monotherapy compared with conventional DAPT strategy remain unclear.</p><p><strong>Methods and results: </strong>The 24-month outcomes from 2 multicenter, non-interventional, prospective registries, PENDULUM mono (n=872; short DAPT strategy followed by prasugrel monotherapy) and an HBR subset of the PENDULUM registry (n=1,553; conventional DAPT strategy), were analyzed using the inverse probability of treatment weighting method. Primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE) and clinically relevant bleeding (CRB: Bleeding Academic Research Consortium [BARC] types 2, 3, and 5). In women, short DAPT strategy was associated with numerically lower rates of MACCE (8.2% vs. 12.3%; hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.42-1.20; P=0.197) and CRB (4.7% vs. 7.0%; HR 0.68, 95% CI 0.35-1.32; P=0.258). In men, similar trends were observed for MACCE (8.8% vs. 11.0%; HR 0.86, 95% CI 0.62-1.21; P=0.388) and CRB (7.0% vs. 8.1%; HR 0.87, 95% CI 0.60-1.26; P=0.460). No significant interaction between treatment and sex was found for MACCE (P=0.599) or CRB (P=0.537).</p><p><strong>Conclusions: </strong>In HBR patients undergoing PCI, a short DAPT strategy followed by prasugrel monotherapy had numerically fewer ischemic and bleeding events than conventional DAPT strategy, without evidence of sex-based heterogeneity.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"554-563"},"PeriodicalIF":1.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679825","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":"Significance of Prehospital 12-Lead Electrocardiogram Transmission　- Trial Utilizing an Established Smartphone Communication Application for Acute Stroke Management.","authors":"Koji Yamaguchi, Yutaka Kawabata, Takayuki Ise, Masataka Sata","doi":"10.1253/circrep.CR-25-0319","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0319","url":null,"abstract":"<p><strong>Background: </strong>The Japanese Resuscitation Council's 2020 Guidelines recommend transmitting a prehospital 12-lead electrocardiogram (PH-ECG) for adult patients suspected of having ST-elevation myocardial infarction (STEMI). Nationwide, the primary methods of ECG transmission are either prefecture-specific emergency transport systems or cloud-based services. However, prefectural systems often lack convenience, while cloud-based services are associated with substantial implementation costs.</p><p><strong>Methods and results: </strong>A smartphone application (JOIN^®), which enables ambulance information-sharing with receiving hospital physicians, has been widely adopted across Japan. Leveraging its photo function to transmit ECGs, we initiated prehospital ECG transmission from ambulances without incurring additional costs. Over the past year, the system has been utilized in approximately 20 cases at our hospital. Analysis of transport times by shift period (weekday daytime vs. non-shift hours [weekday nighttime and weekends/holidays]) revealed no significant difference during daytime shifts. However, during non-shift hours, the ECG transmission group demonstrated a tendency for shorter door-to-catheterization laboratory time (25±5.0 vs. 51±18 min).</p><p><strong>Conclusions: </strong>Obtaining a 12-lead ECG prior to hospital arrival reduces waiting times for catheter-based treatment. When ambulances and receiving hospitals are connected via a smartphone application, the photo function can facilitate prehospital ECG transmission without additional implementation costs. This approach may represent a novel strategy to improve outcomes for STEMI patients.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 3","pages":"515-520"},"PeriodicalIF":1.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438833","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 Between Symptom Characteristics, Knowledge Sources, and Patient Interpretation of Acute Coronary Syndrome: Insights From the Japanese Circulation Society Chest Pain Registry.","authors":"Masato Uchida, Satoshi Yoshimura, Kanna Arimoto, Hirotoshi Nishikita, Yohei Fushimura, Hirokazu Yokoi, Takuya Taniguchi, Chika Nishiyama, Yasunori Ueda, Taku Iwami","doi":"10.1253/circrep.CR-25-0301","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0301","url":null,"abstract":"<p><strong>Background: </strong>The associations between symptom characteristics and patients' interpretations and sources of knowledge about acute coronary syndrome (ACS) remains unclear.</p><p><strong>Methods and results: </strong>We enrolled 81 patients with ACS. Patients who misinterpreted their symptoms more frequently reported atypical features such as tenderness (13.3% vs 0%; P=0.028) and syncope (11.8% vs 0%; P=0.011). Common knowledge sources among patients who correctly interpreted their symptoms included television, healthcare professionals, and the internet without social media.</p><p><strong>Conclusions: </strong>Patients experiencing atypical symptoms often misinterpret them. Most knowledge sources for those who interpreted correctly were traditional.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"668-669"},"PeriodicalIF":1.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679899","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 Geographical Distance and Residential Population Density With Clinical Outcomes in Acute Decompensated Heart Failure: Insights From the Kyoto Congestive Heart Failure (KCHF) Registry.","authors":"Erika Yamamoto, Takao Kato, Takeshi Morimoto, Hidenori Yaku, Yasutaka Inuzuka, Yodo Tamaki, Neiko Ozasa, Yusuke Yoshikawa, Takeshi Kitai, Ryoji Taniguchi, Moritake Iguchi, Kazuya Nagao, Ryusuke Nishikawa, Kazushige Kadota, Yutaka Furukawa, Kenji Ando, Yukihito Sato, Koichiro Kuwahara, Takeshi Kimura, Koh Ono","doi":"10.1253/circrep.CR-25-0316","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0316","url":null,"abstract":"<p><strong>Background: </strong>The residential environment may influence access to care and prognosis in patients with heart failure (HF). Evidence on the impact of geographic factors in Japan is limited. We investigated the association of home-to-hospital distance and residential population density with 1-year clinical outcomes in patients hospitalized for acute decompensated HF.</p><p><strong>Methods and results: </strong>We used the Kyoto Congestive Heart Failure registry to analyze 3,616 patients who were discharged alive after their first hospitalization. Home-to-hospital distance was calculated using road travel distance and dichotomized by the median (8.0 km). Residential density was classified as urban (densely inhabited districts [DID]) or suburban (non-DID). The primary outcome was all-cause death at 1 year, assessed using hospital-stratified Cox proportional hazards models. The median home-to-hospital distance was 8.0 km (interquartile range 4.1-14.5 km); 1,797 (49.7%) patients were in the long-distance group. The long-distance group had a higher risk of all-cause death than the short-distance group (adjusted hazard ratio [HR] 1.19; 95% confidence interval [CI] 1.02, 1.39; P=0.02). As a continuous variable, each doubling of distance was associated with increased all-cause death (HR 1.06; 95% CI 1.02, 1.10). Suburban residence was not significantly associated with the primary outcome compared with urban residence (adjusted HR 1.18; 95% CI 0.99, 1.44; P=0.06).</p><p><strong>Conclusions: </strong>In Japanese patients hospitalized for acute decompensated HF, longer home-to-hospital distance, but not residential population density, was associated with a higher risk of 1-year all-cause death.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"603-615"},"PeriodicalIF":1.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Plaque Morphology on Drug-Coated Balloon Treatment Outcomes for Coronary Calcified Lesions: An Optical Coherence Tomography Analysis.","authors":"Masahiro Koide, Kan Zen, Tomotsugu Seki, Kento Fukui, Kazuaki Takamatsu, Jun Shiraishi, Satoaki Matoba","doi":"10.1253/circrep.CR-25-0219","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0219","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) for calcified coronary lesions without stent implantation remains a challenging therapeutic strategy. The efficacy of drug-coated balloon (DCB) therapy in relation to specific calcified plaque morphologies has not been previously investigated.</p><p><strong>Methods and results: </strong>We conducted a retrospective analysis of 150 lesions (136 patients) who underwent optical coherence tomography (OCT)-guided PCI using DCB for angiographically moderate-to-severe calcified lesions. Based on the OCT findings, target lesions were categorized into 3 groups: superficial calcific sheet (SC) group; calcific protrusion (CP) group; and eruptive calcified nodule (eCN) group. Long-term clinical outcomes, including clinically driven target lesion revascularization (CD-TLR), myocardial infarction (MI), cardiac death, and the composite endpoint of major adverse cardiovascular events (MACE), were assessed over a median follow up of 2.6 years. No significant differences in rates of CD-TLR, MI, cardiac death, or MACE were observed between the SC and CP groups. In contrast, the eCN group showed significantly higher incidences of MI (P<0.01 vs. SC; P<0.05 vs. CP), cardiac death (P<0.01 vs. SC and CP), and MACE (P<0.01 vs. SC and CP) compared with the other 2 groups.</p><p><strong>Conclusions: </strong>In moderate-to-severe calcified lesions where adequate vessel preparation was achieved, DCB therapy was associated with favorable outcomes in lesions with SC or CP morphologies. In contrast, lesions involving eCN were linked to significantly worse clinical outcomes.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"544-553"},"PeriodicalIF":1.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679928","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":"Initial Outcomes After Trans-Right Subclavian Transcatheter Aortic Valve Implantation: Analysis of Device Coaxiality.","authors":"Ryusuke Hamada, Kyohei Onishi, Masakazu Yasuda, Kosuke Fujita, Naoko Soejima, Tatsuya Miyoshi, Koichiro Matsumura, Shinsuke Kotani, Atsunori Okamura, Yoshitaka Iwanaga, Genichi Sakaguchi, Gaku Nakazawa","doi":"10.1253/circrep.CR-25-0243","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0243","url":null,"abstract":"<p><strong>Background: </strong>Trans-subclavian access transcatheter aortic valve implantation (TAVI), typically from the left side, is feasible. However, right subclavian artery access is technically challenging because of the anatomical orientation, resulting in malalignment of the transcatheter heart valve within the aortic annular plane.</p><p><strong>Methods and results: </strong>We aimed to evaluate procedural outcomes, device-annulus alignment, and clinical efficacy of right trans-subclavian (RtTS) TAVI. Of a consecutive 423 patients who underwent TAVI, 32 cases performed via right and left subclavian access were analyzed. Implanted device depth and angle were analyzed angiographically. The device-annulus angle was measured angiographically. Fifteen of 22 patients were treated with a balloon-expandable valve, and 7 patients received a self-expanding valve, via RtTS. Procedural success was achieved in all cases. Compared with femoral and left subclavian approaches, RtTS led to a significantly larger device-annulus angle (6.0° vs. 8.7°; P<0.05), with deep left coronary cusp implantation (2.4 vs. 4.4 mm; P=0.05). Post-procedural transcatheter heart valve function was comparable across the groups, and no patients had greater than moderate paravalvular leakage. However, the incidence of symptomatic stroke occurred in 2 patients in the RtTS group (9.1%; P=0.21).</p><p><strong>Conclusions: </strong>RtTS TAVI is a feasible alternative access route, with comparable procedural and clinical outcomes to those of conventional approaches, albeit with a higher risk of stroke.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"650-656"},"PeriodicalIF":1.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679565","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":"Japanese Nationwide Survey of New Heart Failure Drug Prescriptions by Pediatric Cardiologists.","authors":"Jun Muneuchi","doi":"10.1253/circrep.CR-25-0282","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0282","url":null,"abstract":"<p><strong>Background: </strong>This nationwide survey investigated new heart failure drug prescriptions by Japanese pediatric cardiologists.</p><p><strong>Methods and results: </strong>Among 97 responding institutions, 357 patients received sodium-glucose cotransporter-2 inhibitors (SGLT-2i; n=189), angiotensin receptor-neprilysin inhibitors (ARNI; n=89), selective hyperpolarization-activated cyclic nucleotide-gated channel (HCN) blockers (n=76), or soluble guanylate cyclase (sGC) stimulators (n=3). SGLT-2i were predominantly prescribed in post-Fontan patients (45%), with one-third being children under 18 years. ARNI were commonly used for biventricular congenital heart disease (CHD) and cardiomyopathy (47% and 29%), with 40% under 18 years.</p><p><strong>Conclusions: </strong>Pediatric-specific clinical trials and appropriate usage guidelines are urgently needed.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 3","pages":"504-506"},"PeriodicalIF":1.1,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Preoperative Malnutrition and Sarcopenia on Clinical Outcomes After Transcatheter Aortic Valve Replacement.","authors":"Kanna Nakamura, Tomohiko Taniguchi, Aoi Omori, Hirotoshi Nishi, Gakuto Bando, Makoto Idouji, Tsukasa Motoyoshi, Madoka Sano, Yuta Azumi, Ryosuke Murai, Junichi Ooka, Taiji Okada, Toshiaki Toyota, Yasuhiro Sasaki, Kitae Kim, Atsushi Kobori, Natsuhiko Ehara, Makoto Kinoshita, Yutaka Furukawa","doi":"10.1253/circrep.CR-25-0281","DOIUrl":"https://doi.org/10.1253/circrep.CR-25-0281","url":null,"abstract":"<p><strong>Background: </strong>The impact of coexisting malnutrition and sarcopenia on survival after transcatheter aortic valve replacement (TAVR) has not been fully studied.</p><p><strong>Methods and results: </strong>Among 513 consecutive patients undergoing TAVR between February 2014 and June 2023, 340 with available preoperative Geriatric after Nutritional Risk Index (GNRI) and Short Physical Performance Battery (SPPB) data were categorized into 4 groups based on malnutrition (GNRI <98) and sarcopenia (SPPB ≤9) status: malnutrition and sarcopenia (N=98); malnutrition without sarcopenia (N=69); no malnutrition with sarcopenia (N=83); neither malnutrition nor sarcopenia (N=90, reference). The primary outcome measure was all-cause death. Patients with both malnutrition and sarcopenia were older and had a higher prevalence of anemia compared with the reference group. The cumulative 5-year mortality rate was significantly higher in this group. After adjusting for confounders, coexistence of malnutrition and sarcopenia had a significantly higher risk for all-cause death (hazard ratio [HR] 3.15; 95% confidence interval [CI]: 1.68-5.89; P<0.001). In contrast, malnutrition without sarcopenia (HR 1.36; 95% CI 0.64-2.90; P=0.42) and no malnutrition with sarcopenia (HR 1.86; 95% CI 0.92-3.79; P=0.08) were not associated with increased mortality.</p><p><strong>Conclusions: </strong>The coexistence of malnutrition and sarcopenia significantly increased mortality risk after TAVR, which highlights the importance of integrating both nutritional and sarcopenia assessments into preoperative risk stratification to optimize outcomes in patients undergoing TAVR.</p>","PeriodicalId":94305,"journal":{"name":"Circulation reports","volume":"8 4","pages":"642-649"},"PeriodicalIF":1.1,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679067","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}