Cardiology in Review最新文献

{"title":"Albuminuria in Heart Failure: A Cardiorenal Integration Biomarker Beyond Chronic Kidney Disease.","authors":"Abhishesh Wagle, Bishal Bharati, Ioanna Yglesias I Dimadi, Nidhi Varma","doi":"10.1097/CRD.0000000000001430","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001430","url":null,"abstract":"<p><p>While traditionally albuminuria has been considered a marker of glomerular injury and chronic kidney disease, recent evidence establishes it as a cardiorenal integration biomarker; a signal of systemic congestion, endothelial activation, and inadequate therapeutic control that may help identify patients who could benefit from intensive cardiorenal protective therapy, pending prospective validation. Initial management usually targets the achievement of euvolemia to address the albumin leakage caused by the increase in intraglomerular pressure due to increased central and renal venous pressures. Further management focuses on renin-angiotensin-aldosterone system inhibition and sodium-glucose cotransporter 2 inhibitors for the restoration of tubuloglomerular feedback and reduction of intraglomerular pressure. Urinary albumin is a readily accessible biomarker that enhances risk stratification and may guide the optimization of cardiorenal protective therapies in heart failure patients. Integration of routine urinary albumin-to-creatinine ratio monitoring into heart failure management is a promising frontier that requires validation.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Atrial Strain Impairment in Embolic Stroke of Undetermined Source: A Systematic Review and Meta-Analysis.","authors":"Sangharsha Thapa, Sangam Shah, Pratik Fnu, Mariam Ahmed, Amaara Wahid, Nishitha Bujala, Anish Thapa, Swati Chand, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001434","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001434","url":null,"abstract":"<p><p>Embolic stroke of undetermined source (ESUS) accounts for approximately one-third of all ischemic strokes. Atrial cardiomyopathy, independent of paroxysmal atrial fibrillation, is an increasingly recognized embolic substrate. Left atrial (LA) strain assessed by speckle-tracking echocardiography or cardiac magnetic resonance provides a sensitive, noninvasive measure of subclinical atrial mechanical dysfunction that precedes chamber enlargement. This systematic review and meta-analysis synthesizes evidence on all 3 LA strain phases in ESUS through July 2026. Seven studies met the inclusion criteria; 5 provided extractable quantitative data for meta-analysis (n = 656, n = 40, n = 56, n = 82, and n = 459; total N = 1293). ESUS patients demonstrated significantly reduced LA reservoir strain [mean difference (MD) = -4.43%, 95% confidence interval (CI), -6.77 to -2.09; I2 = 82.25%; P = 0.0002], LA conduit strain (LAScd) (MD = -1.69%, 95% CI, -2.20 to -1.18; I2 = 0.00%; P < 0.0001), and LA contractile strain (MD = -2.24%, 95% CI, -3.34 to -1.14; I2 = 69.92%; P < 0.0001). LAScd I2 = 0.00% indicates remarkably consistent conduit impairment across all 5 studies. All 5 meta-analytic studies achieved a Newcastle-Ottawa Scale score of ≥7. All 3 LA strain phases are consistently and significantly impaired in ESUS patients versus controls. Near-zero LAScd heterogeneity identifies conduit strain as the most reproducible marker of atrial cardiomyopathy in ESUS. These findings support subclinical atrial cardiomyopathy as an embolic substrate independent of atrial fibrillation. Large, prospective, standardized multicenter studies are required before clinical translation.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning for Mortality Prediction in Infective Endocarditis: A Systematic Review and Meta-Analysis.","authors":"Vatsalya Choudhary, Muskan Jain, Farhana Tamanna, Raj Gohil, Navya Mandalapu, Sirisha Gara, Mounika Reddy Vadiyala, Giorgi Chilingarashvili, Apurva Popat, Rupak Desai, Saurabh Sharma","doi":"10.1097/CRD.0000000000001463","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001463","url":null,"abstract":"<p><p>Infective endocarditis (IE) continues to be an often fatal condition despite improvements in cardiac surgical procedures and antibiotic therapy, and conventional scoring tools show poor generalizability. Machine learning (ML) addresses these limitations by capturing complex, nonlinear clinical relationships, outperforming conventional scores in predictive accuracy, though prior ML work in IE has focused on diagnosis. A PRISMA-compliant systematic review and meta-analysis of PubMed (Supplemental Digital Content, https://links.lww.com/CIR/A251) and Scopus (through April 2026) evaluated supervised ML models predicting all-cause mortality in adult IE patients; study quality and reporting were appraised using PROBAST and TRIPOD. Eight studies (5503 patients, mean age 53.85) were included in qualitative synthesis, of which 5 contributed area under the receiver operating characteristic curve (AUC) or C-index estimates for pooling via random-effects models, stratified into in-hospital/early and 6-month mortality subgroups. Seven studies were retrospective, and 1 was prospective. ML models, especially ensemble approaches such as Random Forest and gradient boosting, demonstrated strong discriminative performance across all cohorts, with AUC reflecting the ability to distinguish patients who died from those who survived, and outperformed conventional models. Pooled AUC was 0.85 (95% confidence interval [CI], 0.81-0.89) for in-hospital/early mortality (I2 = 35.3%) and 0.85 (95% CI, 0.82-0.88) for 6-month mortality (I2 = 0%). Dominant predictor domains varied by clinical context; multisystem physiologic markers characterized general IE cohorts, dynamic and laboratory variables enhanced intensive care unit-based predictions, and procedural and anatomical factors defined surgical and transcatheter aortic valve replacement model performance. Risk of bias was identified in 4 studies. ML models showed strong discriminative performance for IE mortality prediction, with ensemble methods outperforming conventional approaches by capturing its multivariate heterogeneity. Clinical adoption remains limited; future efforts should prioritize multicenter prospective validation, longitudinal data integration, and development of interpretable frameworks for bedside adoption.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Patent Ductus Arteriosus in the Adult Population.","authors":"Anthony J Kaywood, Alishah Ahmadi, William H Frishman","doi":"10.1097/CRD.0000000000001470","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001470","url":null,"abstract":"<p><p>Patent ductus arteriosus (PDA) is defined as a persistent communication between the pulmonary artery and the aorta that normally closes before birth. While the ductus arteriosus is an essential vascular shunt for a developing fetus, its failure to close can become pathologic. Most PDAs are repaired during infancy; however, some remain patent into adulthood, with presentations varying in clinical severity. Untreated PDA can lead to significant morbidity, with complications including left-heart volume overload, arrhythmia, pulmonary hypertension, and possible Eisenmenger syndrome. This review covers the management of PDA in adults, highlighting the pathophysiology, morphological classification, clinical presentation, and current approaches to closure. Transcatheter closure is currently the preferred approach, although surgical methods may be used in patients with distinct anatomy or other concomitant intracardiac pathology. While both methods come with different risk profiles, closure in adults has proven to be effective, resulting in considerable hemodynamic and clinical improvements.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uric Acid and Cardiovascular Disease.","authors":"Antonis A Manolis, Theodora A Manolis, Apostolos Vouliotis, Antonis S Manolis","doi":"10.1097/CRD.0000000000001460","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001460","url":null,"abstract":"<p><p>Hyperuricemia, a major metabolic abnormality following hyperglycemia, hypertension, and hyperlipidemia, represents a significant global public health issue. Complex pathological mechanisms can lead to hyperuricemia, which not only directly triggers gout but it is also closely involved with various chronic diseases, such as cardiovascular disease (CVD), diabetes, and chronic kidney disease, presenting a systemic risk to individual general and CV health. This metabolic disorder arises mainly from excessive uric acid (UA) production or compromised excretion that results in abnormal elevation of UA in extracellular fluids and tissues, leading to the emergence of gout, kidney diseases, and CV disorders. It may reflect residual risk in CVD patients, conferring a poor prognosis in these patients even when they attain control of the low-density lipoprotein cholesterol levels by receiving statins. Thus, hyperuricemia is not a benign biochemical finding and should be recognized as a relevant CV and renal risk factor. Serum urate measurement can improve risk stratification in selected high-risk populations. Although routine treatment of asymptomatic hyperuricemia is not advised, targeted urate-lowering strategies may be needed in patients with high CV risk, symptomatic disease, or very high serum UA levels. Importantly, nutrient intake and diet quality need significant improvement in individuals with hyperuricemia, as it has been shown to lack behind in terms of balanced macronutrient intake, quality and sources of macronutrients, and healthy eating. Data from future randomized trials are needed to determine whether urate-lowering treatment can improve hard CV and renal outcomes in these patient groups.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorenal Syndrome Reimagined: From Hemodynamic Failure to a Multisystem Cardio-Renal-Metabolic-Inflammatory Network in the SGLT2 Era.","authors":"Hamna Shahid, Afia Shafaqat, Faiqa Nasar, Muhammad Saad, Zaryab Naseer, Muhammad Faizan Tariq, Samreen, Laiba Munawar","doi":"10.1097/CRD.0000000000001445","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001445","url":null,"abstract":"<p><p>Cardiorenal syndrome (CRS) has traditionally been conceptualized as a hemodynamic disorder characterized by bidirectional dysfunction between the heart and kidneys. However, recent advances have expanded this paradigm into a complex multisystem disorder involving intertwined cardiovascular, renal, metabolic, inflammatory, neurohormonal, and immunologic pathways. The emergence of sodium-glucose cotransporter-2 (SGLT2) inhibitors has accelerated this conceptual transformation by demonstrating profound cardiovascular and renal benefits extending beyond glycemic control. Contemporary evidence suggests that CRS is not solely driven by impaired perfusion and venous congestion but also by maladaptive neurohormonal activation, mitochondrial dysfunction, oxidative stress, endothelial injury, fibrosis, metabolic derangements, gut microbiota dysbiosis, and chronic low-grade inflammation. This evolving framework aligns closely with the newly proposed cardiovascular-kidney-metabolic syndrome model, emphasizing systemic pathophysiological interconnectedness. SGLT2 inhibitors have emerged as disease-modifying therapies capable of targeting multiple mechanistic pathways simultaneously through natriuresis, restoration of tubuloglomerular feedback, reduction of intraglomerular hypertension, attenuation of inflammatory signaling, improvement in myocardial energetics, modulation of sympathetic activity, and mitigation of oxidative stress. Landmark clinical trials have consistently demonstrated reductions in heart failure hospitalization, chronic kidney disease progression, and cardiovascular mortality across diabetic and non-diabetic populations. In this narrative review, we re-examine CRS through a modern multidimensional lens, highlighting evolving molecular mechanisms, novel biomarkers, inflammatory-metabolic interactions, and the transformative therapeutic implications of SGLT2 inhibitors. We further explore future directions, including precision medicine, multi-omics profiling, artificial intelligence-assisted phenotyping, and emerging cardiorenal therapeutics that may redefine CRS management in the coming decade.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Efficacy and Safety of Shockwave Intravascular lithotripsy in Patients of Acute Coronary Syndrome: Narrative Review.","authors":"Ashhad Moaarij, Akshit Bhambri, Anchit Chauhan, Anirudh Anirudh, Dhruv Gehlot, Hritvik Jain","doi":"10.1097/CRD.0000000000001380","DOIUrl":"10.1097/CRD.0000000000001380","url":null,"abstract":"<p><p>The increasing global burden of coronary artery disease is complicated by advanced multivessel disease and severe coronary artery calcification. Extensive coronary calcification reduces arterial compliance and predisposes to stent under expansion, malapposition, restenosis, and procedural complications during percutaneous coronary intervention. While traditional debulking techniques like atherectomy exist, they rely on mechanical abrasion or high-pressure barotrauma. Intravascular lithotripsy (IVL) has emerged as a novel, energy-mediated alternative that uses localized acoustic pressure waves to fracture superficial and deep coronary calcium, increase vessel compliance, and facilitate safe stent expansion. This narrative review synthesizes clinical trial data, multicenter registries, intravascular imaging substudies, and device development reports to define the contemporary role, procedural outcomes, safety profile, and limitations of coronary IVL. Across pivotal trials and real-world registries, including the sisrupt coronary artery disease studies, IVL-facilitated percutaneous coronary intervention yields high device success (92.4-98%) and low device-related complication rates (about 1%), with short-term major adverse cardiovascular event rates typically in the single digits and 1-year event rates varying between 9% and 13% in high-risk cohorts. IVL represents a safe and effective strategy for modifying coronary calcification and facilitating optimal stent deployment in complex percutaneous coronary intervention. While current data are robust, further randomized head-to-head trials against atherectomy and long-term surveillance beyond 2 years are required to define its definitive role in complex scenarios, such as acute coronary syndromes.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Myocarditis: Contemporary Insights Into Viral and Immune-Mediated Pathobiology, Precision Diagnostics, Advanced Multimodality Imaging, Risk Stratification, and Evolving Therapeutic Strategies.","authors":"Haram Fatima, Mashal Aziz Rana, Tehreem Asghar, Muhammad Bilal Akram, Areena Fatima, Mashaaal Murtaza, Rimsha Khan, Sidra Ashraf","doi":"10.1097/CRD.0000000000001451","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001451","url":null,"abstract":"<p><p>Pediatric myocarditis is an important cause of acute and chronic myocardial dysfunction, accounting for a substantial proportion of dilated cardiomyopathy, heart failure, malignant arrhythmias, and sudden cardiac death in children. Although historically considered a predominantly viral disease, contemporary evidence indicates that pediatric myocarditis represents a heterogeneous spectrum of disorders characterized by complex interactions between infectious triggers, innate and adaptive immune responses, host genetic susceptibility, and myocardial repair mechanisms. The emergence of multisystem inflammatory syndrome in children and vaccine-associated myocarditis has further expanded the clinical spectrum while emphasizing the importance of accurate etiologic classification. Diagnosis remains challenging because clinical manifestations range from mild chest discomfort to fulminant cardiogenic shock. Advances in high-sensitivity cardiac troponin assays, cardiac magnetic resonance imaging with multiparametric tissue characterization, molecular pathogen detection, and selective endomyocardial biopsy have substantially improved diagnostic accuracy. Risk stratification increasingly integrates clinical presentation, ventricular function, biomarker profiles, arrhythmic burden, and imaging findings to identify patients at risk for adverse outcomes and guide therapeutic intensity. Contemporary management combines evidence-based heart failure therapy with individualized immunomodulatory treatment, mechanical circulatory support for refractory cardiogenic shock, and multidisciplinary long-term surveillance. Although survival has improved significantly with advances in pediatric intensive care and ventricular assist devices, important uncertainties remain regarding optimal immunotherapy, biomarker-guided management, and precision medicine approaches. This narrative review summarizes current understanding of viral and immune-mediated pathobiology, discusses evolving diagnostic strategies and multimodality imaging, reviews contemporary risk stratification models, and highlights emerging therapeutic approaches aimed at improving outcomes in children with myocarditis.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Glycemic Efficacy of Perioperative Liraglutide in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Ibrahim Gamal, Mohamed Hamouda Elkasaby, Osama Ewidat, Nuha Riyad, Zahra Sadin, Angad Singh Gill, Mahmoud Nassar, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001465","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001465","url":null,"abstract":"<p><p>Perioperative hyperglycemia in cardiac surgery is associated with wound infection, acute kidney injury, and death, yet the intravenous insulin used to treat it is itself coupled to hypoglycemia. Glucagon-like peptide-1 receptor agonists lower glucose only when glucose is elevated and might therefore separate glycemic control from hypoglycemic risk. We searched PubMed/MEDLINE, Scopus, Web of Science, and CENTRAL through September 2025 for randomized controlled trials of perioperative subcutaneous liraglutide versus placebo or insulin-based usual care in adults undergoing cardiac surgery. Two reviewers screened, extracted data, and applied the Cochrane Risk of Bias 2 tool independently; certainty was graded using GRADE. Effects were pooled by inverse variance, fixed-effect when I2 was below 50%. Seven reports of 4 trials, enrolling 446 randomized patients, were eligible. Liraglutide did not alter 30-day mortality (1/161 vs 3/160; risk ratio [RR] 0.42, 95% confidence interval [CI], 0.06-2.81), the composite of any postoperative complication (68/129 vs 76/132; RR 0.92; 95% CI, 0.74-1.14), cardiac adverse events (RR 1.08; 95% CI, 0.83-1.40), hypoglycemia (8/165 vs 9/166; RR 0.85; 95% CI, 0.34-2.13), or postoperative nausea and vomiting (RR 3.01; 95% CI, 0.26-35.27).</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Coronary Intervention in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis With Reconstructed Individual Patient Data and GRADE Assessment.","authors":"Mazen Negmeldin Yassin, Karim Elfeqi, Ahmed Abdelmaksoud, Fouad Hanna, Abdelrahman El-Helbawy, Mohamed Hamouda Elkasaby, Amr Mohsen, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001467","DOIUrl":"10.1097/CRD.0000000000001467","url":null,"abstract":"<p><p>Coronary artery disease coexists in approximately 50% of transcatheter aortic valve implantation candidates, yet the role of percutaneous coronary intervention (PCI) remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing PCI with conservative management or deferral in transcatheter aortic valve implantation candidates with coronary artery disease. We searched 4 databases from inception to June 19, 2026. Odds ratios (ORs) were pooled using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp-Sidik-Jonkman adjustment. Individual patient data were reconstructed from published Kaplan-Meier curves. Risk of bias and certainty of evidence were assessed. Three randomized controlled trials (n = 1156 patients) were included. PCI showed no significant reductions in all-cause death (OR 0.88; 95% confidence interval [CI], 0.62-1.25; I2 = 0%), cardiovascular death (OR 0.72; 95% CI, 0.40-1.29; I2 = 0%), or myocardial infarction (OR 0.85; 95% CI, 0.17-4.18; I2 = 51.8%). Stroke was significantly reduced with PCI (OR 0.68; 95% CI, 0.48-0.95; I2 = 0%). PCI was associated with a trend toward increased any bleeding (OR 2.26; 95% CI, 0.81-6.29; I2 = 69.8%) and major bleeding (OR 1.70; 95% CI, 0.63-4.60; I2 = 35.9%).</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}