Cardiology Research And Practice[JOURNAL]
Sun
200 papers
Impact of nutritional status on outcome of patients of acute coronary syndrome.
Joy BA, Khaled MFI, Majumder D … +6 more , Saha SK, Asha SS, Joarder AI, Adhikary DK, Haque SA, Shimul MMH
Am Heart J Plus · 2026 Feb · PMID 41624398 · Full text
BACKGROUND: Acute Coronary Syndrome (ACS) remains a leading cause of mortality in Bangladesh, where malnutrition is prevalent but often overlooked in clinical care. Malnourished ACS patients may experience worse outcomes...
BACKGROUND: Acute Coronary Syndrome (ACS) remains a leading cause of mortality in Bangladesh, where malnutrition is prevalent but often overlooked in clinical care. Malnourished ACS patients may experience worse outcomes, yet nutritional assessment is rarely routine. This study evaluates the impact of nutritional status on short-term outcomes using CONUT scoring. METHODS: This prospective cohort study was conducted at the Department of Cardiology, Bangladesh Medical University, Dhaka, Bangladesh, over 18 months. A total of 100 adult ACS patients were included in the final analysis and stratified into nutritional status categories using the Controlling Nutritional Status (CONUT) scoring system. Key outcomes included in-hospital mortality and length of stay. Statistical analyses were performed using SPSS version 29.0.2.0, employing ANOVA, Fisher's exact test, and regression models to examine associations between nutritional status and clinical outcomes. RESULTS: Among the patients, 43% had mild malnutrition, 24% had moderate malnutrition, and 33% had no malnutrition. Nutritional status was significantly associated with both duration of hospital stay ( < .001) and mortality ( = .003). Patients with moderate malnutrition had significantly longer hospital stays (β = 4.388, < .001) and higher mortality odds (β = 0.167, p < .001) compared to those without malnutrition. CONCLUSION: Nutritional status, particularly moderate malnutrition as assessed by CONUT scoring, is a significant predictor of adverse clinical outcomes in ACS patients. Integrating nutritional assessment in ACS management protocols may improve prognosis and reduce healthcare burdens.
Can magnetocardiography decrease ED overcrowding, increase hospital bed capacity, and save hospitals money?
Pena ME, Mace SE, Bleecker G … +4 more , Girard KK, Mital P, Suri P, Takla RE
Am Heart J Plus · 2026 Feb · PMID 41624397 · Full text
OBJECTIVES: The objectives of this study are to demonstrate the time and cost savings of magnetocardiography (MCG) compared to other noninvasive cardiac imaging (NCI) tests, specifically in regard to time, number of skil...
OBJECTIVES: The objectives of this study are to demonstrate the time and cost savings of magnetocardiography (MCG) compared to other noninvasive cardiac imaging (NCI) tests, specifically in regard to time, number of skilled healthcare personnel (HCP), and cost of skilled HCP, medications and supplies, including contrast agents and radiotracers required to perform each test. DESIGN: This is a multicenter study comparing the time, skilled HCP, and costs needed to perform MCG and other NCI from four urban and community hospitals. OUTCOME MEASURES: Time needed to perform each test, the number of skilled HCP required, and costs for labor, supplies/drugs and contrast agents/radiotracers. RESULTS: Median time in minutes for obtaining ETT 60, SE 75, DSE 75, MPI-SPECT 225, MPI-PET 180, cMRI 90, and cCTA 75, MCG 15. Median number of skilled HCP required for performing the NCI were ETT 1.5, SE 2.5, DSE 2.5, MPI-SPECT 3.0, MPI-PET 3.0, cMRI 2.5, cCTA 2, and MCG 1. Median skilled HCP and their costs was ETT $71.23, SE $150.43, DSE $153.91, MPI-SPECT $625.18, MPI-PET $403.62, cMRI $95.41, cCTA $138.03, and MCG $8.75. CONCLUSION: There is a time, skilled HCP and cost savings by using MCG versus other NCI for the evaluation of chest pain. Further studies are needed to validate MCG as an alternative to other NCI so these benefits can be realized.
SGLT2 inhibitor therapy and clinical outcomes in HIV-related cardiomyopathy.
Sheashaa H, Ibrahim R, Pham HN … +7 more , Awad K, Scalia IG, Farina JM, Tamarappoo B, Holloway C, Arsanjani R, Ayoub C
Am Heart J Plus · 2026 Feb · PMID 41608154 · Full text
BACKGROUND: HIV cardiomyopathy (HIV-CM) is associated with significant morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have benefits in heart failure (HF), but their role in the specialized po...
BACKGROUND: HIV cardiomyopathy (HIV-CM) is associated with significant morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have benefits in heart failure (HF), but their role in the specialized population of HIV-CM is poorly understood. METHODS: Patients in the TriNetX Network with HIV-CM and SGLT2i therapy were compared to a propensity matched control group of patients with HIV-CM without SGLT2i use. The primary endpoint was all-cause mortality, secondary endpoints included all-cause hospitalizations, acute HF, stroke, acute myocardial infarction (MI), cardiac arrest, atrial fibrillation and ventricular tachycardia. RESULTS: In the total of 2606 included patients, SGLT2i therapy was associated with significant reduction in all-cause mortality (HR 0.475, 95%CI 0.337-0.671), all-cause hospitalization (HR 0.725, 95%CI 0.646-0.814). No significant differences were observed in the individual outcomes of acute HF, MI, stroke, or cardiac arrest. CONCLUSION: SGLT2i use was associated with significant reductions in all-cause mortality and hospitalizations in patients with HIV-CM.
Association of caffeine levels with myocardial perfusion during pharmacological stress cardiac magnetic resonance imaging.
Iribarren A, Obrutu O, Maughan J … +6 more , Cook-Wiens G, Bairey Merz CN, Li D, Berman DS, Kwan AC, Wei J
Am Heart J Plus · 2026 Feb · PMID 41586338 · Full text
BACKGROUND: Caffeine, a nonselective adenosine A2 receptor antagonist, blunts adenosine-induced coronary hyperemia. Despite recommended abstinence before adenosine stress cardiac magnetic resonance imaging (CMRi), residu...
BACKGROUND: Caffeine, a nonselective adenosine A2 receptor antagonist, blunts adenosine-induced coronary hyperemia. Despite recommended abstinence before adenosine stress cardiac magnetic resonance imaging (CMRi), residual caffeine may affect myocardial perfusion reserve index (MPRI), a marker of coronary microvascular dysfunction. METHODS: Symptomatic patients without obstructive coronary artery disease underwent adenosine stress-rest CMRi after 48-h abstinence from caffeine and vasoactive medications. Plasma caffeine was measured pre-scan and subjects were categorized into 2 groups according to caffeine levels (<1 mg/L and ≥ 1 mg/L). Hemodynamics, MPRI and splenic switch-off were compared to assess adequate adenosine stress response during imaging. RESULTS: Of 109 patients studied, 15 (14 %) had detectable caffeine level. Other than sex, there were no significant differences between the two groups. Transmyocardial MPRI did not correlate with caffeine level ≥ 1 mg/L ( = 0.12, = 0.66). CONCLUSION: Mildly elevated plasma levels of caffeine did not affect measures of adequacy of response to adenosine during stress CMRi.
Magnetocardiography for noninvasive surveillance of rejection and cardiac allograft vasculopathy in heart transplant recipients.
Eskander C, Peters M, Gupta D … +2 more , Bruno KA, Vilaro JR
Am Heart J Plus · 2026 Feb · PMID 41586337 · Full text
Heart transplantation is the definitive treatment for end-stage heart failure, yet long-term graft survival is hindered by two major complications: acute/chronic rejection (cellular or antibody mediated) and cardiac allo...
Heart transplantation is the definitive treatment for end-stage heart failure, yet long-term graft survival is hindered by two major complications: acute/chronic rejection (cellular or antibody mediated) and cardiac allograft vasculopathy (CAV). Standard surveillance is performed to screen for these issues and predominantly consists of cardiac catheterization with hemodynamics, endomyocardial biopsy and invasive coronary angiography, with intravascular ultrasound (IVUS) and coronary flow reserve. The use of IVUS increases the sensitivity for CAV detection. Overall, these procedures have associated morbidities, need anesthesia and have associated patient discomfort and substantial cost. Magnetocardiography (MCG), a noninvasive modality that measures cardiac magnetic fields, has emerged as a potential tool for early detection of complications in post-transplant patients. Unlike electrocardiography, MCG provides spatially resolved data on depolarization and repolarization, independent of body habitus or tissue conductivity. Early studies suggest that MCG can identify electrophysiologic abnormalities associated with both acute rejection and CAV, in some cases preceding histologic or angiographic confirmation. Rejection is reflected by alterations in magnetic dipole strength and repolarization heterogeneity, while CAV correlates with repolarization dispersion indices such as QTc heterogeneity and Magnetic Dispersion Velocity. Despite promising pilot data, MCG remains underutilized, largely due to small study sizes, lack of standardized interpretation, and limited availability of equipment. This review synthesizes the existing evidence, highlights potential advantages and limitations, and outlines future directions for integrating MCG into standard post-transplant surveillance protocols.
Beta-blocker therapy after myocardial infarction with preserved LVEF (≥50%): a systematic review and Bayesian meta-analysis with time-to-event reconstruction.
Al-Shammari AS, Kurmasha YH, Islam MR … +10 more , Hammadeh BM, Khaleel NI, Hamed BM, Altaii H, Jena N, Gerdes J, Sokos G, Daggubati R, Sattar Y, Refaat M
Am Heart J Plus · 2026 Feb · PMID 41586336 · Full text
BACKGROUND: The role of β-blockers in MI with preserved LVEF (≥50%) remains unclear. This Bayesian meta-analysis assessed their effect on mortality and major cardiovascular outcomes. METHODS: A systematic search was perf...
BACKGROUND: The role of β-blockers in MI with preserved LVEF (≥50%) remains unclear. This Bayesian meta-analysis assessed their effect on mortality and major cardiovascular outcomes. METHODS: A systematic search was performed in PubMed, Embase, and Scopus from database inception to September 2025 for studies assessing BB use in post-MI patients with preserved LVEF. All-cause mortality was the primary outcome. A Bayesian random-effects model was applied using the bayesmeta package in RStudio, with effect sizes expressed as risk ratios (RRs) and 95% credible intervals (CrIs). Between-study heterogeneity was assessed through posterior τ estimates. Time-to-event outcomes were analyzed using reconstructed individual patient data from published Kaplan-Meier curves. RESULTS: Six studies, including 17,068 patients, met the inclusion criteria. BB therapy was associated with a posterior risk ratio (RR 0.79; 95% CrI 0.55-1.06) suggesting a possible reduction in all-cause mortality; however, the credible interval included the null, indicating uncertainty in the magnitude or direction of effect. The posterior estimates for cardiovascular death (RR 0.84; 95% CrI 0.55-1.23), stroke (RR 0.92; 95% CrI 0.58-1.49), myocardial infarction (RR 1.04; 95% CrI 0.80-1.40), heart failure (RR 0.84; 95% CrI 0.55-1.23), MACE (RR 1.09; 95% CrI 0.76-1.51), and unplanned revascularization (RR 1.06; 95% CrI 0.75-1.48) also showed wide credible intervals overlapping 1.0, reflecting uncertainty in potential treatment effects. Heterogeneity across outcomes was generally low to moderate. In time-to-event analyses, the frequentist stratified model showed a statistically significant survival benefit with β-blockers (HR 0.87; 95% CI 0.81-0.92), whereas the Bayesian model indicated a similar trend, but the credible interval (HR 0.60; 95% CrI 0.26-1.41) included the null, suggesting no strong evidence of effect. CONCLUSION: β-blockers were not associated with a clear reduction in all-cause mortality or other outcomes, as credible intervals included the null. Large, randomized trials are needed to define their long-term role in this population.
Three different indications for left ventricular unloading in one patient with severe heart failure.
Gausepohl T, Flierl U, Garcheva V … +5 more , Ricklefs M, Schwedhelm B, Bauersachs J, Pfeffer TJ, Schäfer A
Am Heart J Plus · 2026 Feb · PMID 41586335 · Full text
BACKGROUND: The percutaneous microaxial flow pump (mAFP) is an established mechanical circulatory support (MCS) device for cardiogenic shock (CS) and can also stabilize hemodynamics during cardiac and noncardiac procedur...
BACKGROUND: The percutaneous microaxial flow pump (mAFP) is an established mechanical circulatory support (MCS) device for cardiogenic shock (CS) and can also stabilize hemodynamics during cardiac and noncardiac procedures. This case series describes the safety and feasibility of repeated mAFP use for three indications in a single patient. METHODS: We retrospectively reviewed three consecutive mAFP deployments in one patient enrolled in the Hannover-Cardiac-Unloading-REgistry between October 2021 and August 2023. Indications included acute myocardial infarction-related CS (AMI-CS), ventricular tachycardia (VT) ablation one year later, and elective thyroidectomy for amiodarone-induced hyperthyroidism another year later. RESULTS: A 62-year-old patient with ischemic cardiomyopathy (initial LVEF 34%) achieved hemodynamic stabilisation during AMI-CS, successful protected VT ablation without compromise, and stable perioperative support during thyroidectomy. No major adverse events occurred. CONCLUSIONS: Repeated mAFP use for AMI-CS, VT ablation, and high-risk surgery was feasible and safe, supporting its versatility in complex clinical care.
Initiation, titration, and safety of vericiguat for treatment of heart failure in United States clinical practice.
Greene SJ, Michel A, Lecomte C … +3 more , Manca P, Holl K, Senni M
Am Heart J Plus · 2026 Feb · PMID 41586334 · Full text
STUDY OBJECTIVE: To evaluate the following among new users of vericiguat: up-titration patterns, factors associated with up-titration, occurrence of hypotension/syncope, predictors of hypotension/syncope. DESIGN: Retrosp...
STUDY OBJECTIVE: To evaluate the following among new users of vericiguat: up-titration patterns, factors associated with up-titration, occurrence of hypotension/syncope, predictors of hypotension/syncope. DESIGN: Retrospective cohort study (linked claims and electronic health record data). SETTING: US clinical practice. PARTICIPANTS: 1361 new users of vericiguat. INTERVENTIONS: N/A. MAIN OUTCOME MEASURES: Vericiguat starting dose, up-titration patterns and predictors, occurrence and predictors of hypotension/syncope, over a 3-month follow-up period. RESULTS: Among 1361 new users of vericiguat, 770 (57%) initiated a starting dose of 2.5 mg/day, 330 (24%) initiated a dose of 5 mg/day, and 261 (19%) initiated a dose of 10 mg/day. Over 3-month follow-up, the 10 mg target dose was reached by 349 (26%) patients. Among these patients, the median time to reach the 10 mg dose was 60 days among 2.5 mg/day starters, and 41 days among 5 mg/day starters. Among the 2.5 mg starters, 68% had no up-titration. Among patients initiating either the 2.5 mg/day or 5 mg/day dose, a starting dose of 5 mg (vs. 2.5 mg) was the only significant predictor for reaching the 10 mg dose; adjusted hazard ratio 2.89 (95% CI: 1.86, 4.49, < 0.0001). Overall, 130 patients (9.6%) had a hypotension event and 67 patients (4.9%) had a syncope event. History of hypotension was the strongest independent predictor of hypotension/syncope events (adj. HR 2.85, 95% CI: 1.96, 4.13, < 0.0001). A > 2.5 mg/day vericiguat starting dose was not associated with the occurrence of hypotension/syncope (vs. 2.5 mg/day); adj. HR 0.82, 95% C.I. (0.58, 1.16). CONCLUSION: Vericiguat users initiated on the 5 mg/day dose were considerably more likely to reach the target dose of 10 mg/day vs. those started on the recommended 2.5 mg/day dose, without excess risk of hypotension or syncope.
A risk model to predict atrial fibrillation in diabetes using machine learning: The ACCORD study.
Offerman EJ, Phan J, Harirforoosh S … +3 more , Fan W, Wong ND, Donaldson DM
Am Heart J Plus · 2026 Feb · PMID 41568239 · Full text
BACKGROUND: Machine learning (ML) may improve prediction of atrial fibrillation (AF), but its value compared with traditional models such as Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE-AF) in pat...
BACKGROUND: Machine learning (ML) may improve prediction of atrial fibrillation (AF), but its value compared with traditional models such as Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE-AF) in patients with diabetes remains unclear. METHODS: Among 9,307 patients in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) with type 2 diabetes and no prior AF, a random forest (RF) classifier using clinical and metabolic variables was compared with a CHARGE-AF Cox model. Discrimination was assessed by five-fold cross-validated area under receiver operating curve (AUC). RESULTS: Over 6.26 years, 175 patients developed AF. The RF model (AUC = 0.731) performed comparably to CHARGE-AF (AUC = 0.756; = 0.18). Age, waist circumference, race, total cholesterol, and estimated glomerular filtration rate were the top predictors. CONCLUSION: ML matched CHARGE-AF performance and revealed distinct predictors supporting personalized AF risk prevention.
Symptom phenotypes and coronary microvascular function in non-obstructive coronary artery disease: Insights beyond epicardial ischemia.
Matsumoto K, Otsuka K, Kagawa S … +14 more , Yamaura H, Miura T, Sugioka K, Saitoh W, Okamoto A, Kajio G, Fujisawa N, Yamaguchi T, Shimada T, Hayashi Y, Shibata A, Ito A, Yamazaki T, Fukuda D
Am Heart J Plus · 2026 Feb · PMID 41568238 · Full text
STUDY OBJECTIVE: To examine the relationship between coronary microvascular dysfunction (CMD) indices and chest pain presentation in patients with non-obstructive coronary artery disease (NOCA). DESIGN AND SETTING: Retro...
STUDY OBJECTIVE: To examine the relationship between coronary microvascular dysfunction (CMD) indices and chest pain presentation in patients with non-obstructive coronary artery disease (NOCA). DESIGN AND SETTING: Retrospective, single-center observational study. PARTICIPANTS: Patients with angiographically intermediate left anterior descending artery (LAD) stenosis and preserved epicardial physiology (fraction flow reserve, FFR >0.80), with no significant stenosis in vessels other than the LAD. INTERVENTIONS: Invasive CMD assessment using coronary flow reserve (CFR), index of microcirculatory resistance (IMR), and myocardial resistance reserve (MRR). MAIN OUTCOME MEASURES: Associations between symptom phenotypes and physiological indices, and the diagnostic performance of symptom-based assessment for detecting CMD. RESULTS: Among 59 patients (mean age 69.2 years; 71 % male), CFR and MRR differed significantly across symptom phenotypes (both < 0.001), whereas IMR did not. Patients with typical angina exhibited the lowest CFR and MRR, indicating impaired microvascular vasodilatory reserve despite preserved epicardial physiology. Conversely, patients with atypical symptoms had the highest CFR and MRR, whereas asymptomatic patients had intermediate values. FFR was comparable across groups (median 0.89, = 0.21). In age-adjusted analyses, symptom severity was inversely associated with CFR (β = -1.085, = 0.004) and MRR (β = -1.062, = 0.003), but not with IMR. Symptom-based assessment showed higher specificity than sensitivity across CMD definitions and performed best for impaired MRR (sensitivity 60.9 %, specificity 80.6 %). Functional CMD was observed even in asymptomatic patients. CONCLUSION: In patients with NOCA, coronary microvascular vasodilatory reserve varies according to symptom phenotype, highlighting the limited reliability of symptom assessment alone and underscoring the importance of objective physiological evaluation for characterizing CMD.
Short dual antiplatelet therapy after PCI with Resolute Onyx drug-eluting stents in high bleeding risk patients: One-year outcomes from a South Asian cohort.
Jariwala P, Vallapuri GS, Konda BKR … +1 more , Jangam SK
Am Heart J Plus · 2026 Feb · PMID 41561403 · Full text
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) in patients with high bleeding risk (HBR) remains unclear. This study evaluated the safety and effic...
BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) in patients with high bleeding risk (HBR) remains unclear. This study evaluated the safety and efficacy of a shortened DAPT strategy (3-month DAPT followed by ticagrelor monotherapy) in patients with HBR receiving Resolute Onyx zotarolimus-eluting stents (ZES). METHODS: This retrospective observational study was conducted at the Yashoda Hospitals in Hyderabad. A total of 150 HBR patients who underwent PCI with Resolute Onyx ZES between June 2023 and June 2024 were included in the study. All patients received DAPT (aspirin 75 mg + ticagrelor 90 mg BID) for three months, followed by ticagrelor monotherapy for nine months. The primary outcome was a composite of cardiac death or MI from three months to one year. The secondary endpoints included stent thrombosis, target lesion failure (TLF), target lesion revascularization (TLR), stroke, and bleeding events (BARC classification). RESULTS: The mean age was 75.5 years, and 42.3 % were female. Diabetes was observed in 33.5 % of patients, prior revascularization in 46.4 %, and acute coronary syndrome in 58.3 %. Most lesions were calcified (60.8 %) or complex (88.2 % B2/C lesions). The patients met an average of 1.9 HBR criteria, and 54.6 % met at least two criteria. The primary composite endpoint occurred in 5.7 % of the patients (cardiac death-2.3 %; MI-3.4 %). Definite/probable stent thrombosis occurred in 0.3 %, TLF in 3.0 %, clinically driven TLR in 1.7 %, stroke in 0.6 %, and BARC 1-3 bleeding in 2.1 %. No BARC 3-5 bleeding events were recorded. CONCLUSION: In this real-world HBR cohort treated with Resolute Onyx ZES, a strategy of 3-month DAPT followed by ticagrelor monotherapy was associated with low rates of ischemic events and the absence of major bleeding at one year. These findings suggest a favorable safety-efficacy balance for DAPT de-escalation in carefully selected patients; however, this requires confirmation in larger, prospective studies.
Coronary artery disease in patients undergoing transcatheter aortic valve replacement: Current evidence and future directions.
Wehbeh BED, Al Sakan M, Francis J … +3 more , Ghazal R, Alam S, Sawaya F
Am Heart J Plus · 2026 Feb · PMID 41561402 · Full text
Coronary artery disease (CAD) coexists frequently with aortic stenosis (AS), and the optimal management of CAD in patients undergoing transcatheter aortic valve replacement (TAVR) remains incompletely defined due to limi...
Coronary artery disease (CAD) coexists frequently with aortic stenosis (AS), and the optimal management of CAD in patients undergoing transcatheter aortic valve replacement (TAVR) remains incompletely defined due to limited and heterogeneous evidence. This review aims to integrate the current evidence on the epidemiology and shared pathophysiology of CAD and AS, summarize the diagnostic algorithms for CAD in the TAVR population, and evaluates revascularization strategies with a focus on the timing of percutaneous coronary intervention relative to valve replacement. Current evidence suggests that while routine PCI in TAVR candidates for stable CAD may offer limited benefit, revascularization in patients with complex CAD or high anatomical burden may improve outcomes. This review further characterizes the incidence, proposed mechanisms, and prognostic significance of post-TAVR coronary events and outlines emerging strategies to optimize ischemic and procedural outcomes in this high-risk cohort.
Coronary artery calcium score of zero does not rule out obstructive CAD in young adults.
Smettei O, Abazid RM, Romsa JG … +10 more , Akincioglu C, Warrington JC, Alshaar TB, Teefy PJ, De S, Tzemos N, Zareardalan R, Badreddine M, Bureau Y, Vezina WC
Am Heart J Plus · 2026 Feb · PMID 41561401 · Full text
PURPOSE: Young adults are more likely to have non-calcified coronary plaques. Purpose to assess the predictive value of a zero-coronary artery calcium (CAC) score in young adults and to determine which clinical character...
PURPOSE: Young adults are more likely to have non-calcified coronary plaques. Purpose to assess the predictive value of a zero-coronary artery calcium (CAC) score in young adults and to determine which clinical characteristics are associated with obstructive coronary heart disease. METHODS: 6775 patients were prospectively entered a registry. They all had a CAC. Mean age 63 +/- 18 years. 56.2 % males. 3525 patients underwent coronary CT angiography (CCTA). 3250 patients underwent single photon emission tomography (SPECT). SPECT patients were mainly outpatients. CCTA patients also were almost exclusively outpatients. Thus, the population was generally a low-risk population. RESULTS: Among the CCTA patients, 1888 had a 0 CAC score. 175/1888 (9 %) had less than 70 % stenosis, while 41/1888 (2.2 %) had ≥70 % stenosis. Patients with ≥70 % stenosis: were younger 45 ± 12 yr versus 59 ± 11 yr, predominantly males versus had a slightly greater prevalence of family history of CAD (58.5 % vs 57.9 % = 0.04), smoking history (68.3 % VS.44.6 % < 0.001), hypertension (61 % versus 39.2 % = 0.004), dyslipidemia (56.1 % versus 36.2 % p < 0.001), and obesity (70.7 % VS 11.7 % p < 0.001). 3250 patients had CAC and SPECT. Of these, 1161 had a zero CAC score. Of these 42 patients had significant ischemia >10 % of LV, Patients with ischemia >10 % of LV mass, and they were younger 44 ± 10 yr versus 60 ± 12 yr, had a slightly greater prevalence of family history of CAD 61 % versus 57 % = 0.07, smoking history (64.3 % versus 48.5 % = 0.045), hypertension (69 % versus 45.5 % = 0.003), obesity 19 % versus 11.7 %, and diabetes (35.7 % versus 14.5 % < 0.001). CONCLUSIONS: A zero CAC does not rule out significant CAD in young adults with chest pain with CAD risk factors. These patients may need further investigations.
Unraveling the genetic blueprint of coronary artery disease: The role of polygenic risk scores in risk prediction.
El Ghazawi A, Fahed AC, Fawaz N … +3 more , Fakih Y, Alam S, Refaat M
Am Heart J Plus · 2026 Feb · PMID 41561400 · Full text
Cardiovascular diseases, and most notably coronary artery disease (CAD), carry a large burden of mortality and morbidity, highlighting the need for better risk prediction and prevention. Several risk scoring tools for CA...
Cardiovascular diseases, and most notably coronary artery disease (CAD), carry a large burden of mortality and morbidity, highlighting the need for better risk prediction and prevention. Several risk scoring tools for CAD have been developed to improve early detection, reduce the risk of acute cardiac events, and ensure adequate monitoring and follow-up of high-risk individuals. One that seized attention, especially with the groundbreaking advancements in disease's genetic buildup, was the polygenic risk score (PRS) for CAD. It was developed for potentially improving risk prediction at an early age, with individualized patient care. Our review aims to review the latest advances in this field of polygenic risk prediction, highlighting background information about PRS, current evidence supporting the utility of PRS for CAD, challenges associated with its implementation, and its complementary role with the coronary artery calcium score (CAC). Our review demonstrates that PRS could be a strong predictive indicator of CAD, especially when combined with other clinical factors. However, concerns remain regarding its applicability to genetically diverse populations, the ethical and psychological challenges, and practical feasibility. Lastly, PRS can augment and predict CAC in terms of risk discrimination and reclassification. In conclusion, PRS is a valuable tool that is upscaling with wider adoption. This requires a proper handling of its associated challenges to better shape the future of individualized care.
New recommendations for rhythm control-What has changed in the 2023 ACC/AHA/ACCP/HRS and 2024 ESC guidelines for atrial fibrillation, and where does dronedarone fit in?
Naccarelli GV, Rackley J, Boriani G
Am Heart J Plus · 2025 Dec · PMID 41552718 · Full text
In recent years, the importance of early rhythm control to delay the progression of atrial fibrillation (AF) has been recognized, as have the benefits of catheter ablation and antiarrhythmic drugs (AADs) as first-line th...
In recent years, the importance of early rhythm control to delay the progression of atrial fibrillation (AF) has been recognized, as have the benefits of catheter ablation and antiarrhythmic drugs (AADs) as first-line therapy for rhythm control. Selecting the most appropriate AAD according to its safety profile as well as individual patient characteristics is of key importance. To inform decision-making, up-to-date guidelines are paramount. The American College of Cardiology (ACC)/American Heart Association (AHA)/American College of Clinical Pharmacy (ACCP)/Heart Rhythm Society (HRS) guidelines for AF were updated in 2023, while the European Society of Cardiology (ESC) guidelines for AF were updated in 2024. Dronedarone is an AAD indicated in the US to reduce the risk of hospitalization for AF in patients in sinus rhythm with a history of paroxysmal or persistent AF. In Europe, it is indicated for the maintenance of sinus rhythm after successful cardioversion in clinically stable adults with paroxysmal or persistent AF. Since the last major review of the efficacy and safety of dronedarone (published in 2019), multiple real-world evidence (RWE) studies and post hoc analyses of key dronedarone randomized controlled trials have been performed. This review discusses the findings of these RWE studies and post hoc analyses in the context of the 2023 ACC/AHA/ACCP/HRS and 2024 ESC guidelines for AF with a focus on dronedarone as a treatment option for early rhythm control, its use after catheter ablation, and its use in people with heart failure and a mildly reduced or preserved ejection fraction.
Comparison of all-cause and cause-specific mortality after myocardial infarction - a Hungarian registry study.
Ferenci T, Jánosi A
Am Heart J Plus · 2025 Dec · PMID 41552717 · Full text
STUDY OBJECTIVE: Despite advances, myocardial infarction remains a significant public health concern, with survival being a crucial outcome measure. While all-cause mortality is well-studied, less is known about causes o...
STUDY OBJECTIVE: Despite advances, myocardial infarction remains a significant public health concern, with survival being a crucial outcome measure. While all-cause mortality is well-studied, less is known about causes of death following an infarction. This study aimed to analyse cause-specific mortality after myocardial infarction and to compare it with the analysis of all-cause mortality. DESIGN: Data from a nationwide Hungarian myocardial infarction registry from January 2020 to June 2022 were linked with official cause of death information. Cumulative incidence functions and multivariable modelling of subdistribution hazard were used for cause-specific survival analysis, accounting for competing risks. Standard all-cause survival analysis (Cox proportional hazards model) was also carried out as a comparison. RESULTS: Among 27,965 patients with acute myocardial infarction, 25.0 % died during follow-up (of a median of 661 days). Myocardial infarction was the primary cause of death in 38.6 % of cases, followed by other cardiovascular causes (37.5 %). Factors associated with higher cause-specific mortality for infarction included older age, male sex, ST-elevation infarction, diabetes, prior stroke, peripheral artery disease, and heart failure. Percutaneous coronary intervention and hypertension was associated with lower hazard. Results largely matched all-cause survival analysis, except for ST-elevation, where hazard was much higher in cause-specific analysis. CONCLUSIONS: While overall and cause-specific analyses aligned in this large registry study, a notable difference was observed for ST-elevation infarction, where hazard was substantially higher in the cause-specific analysis. This highlights the potential relevance of distinguishing between causes of death for a more precise understanding of outcomes.
Establishment and Validation of Nomogram Model Based on Neutrophil Lymphocyte Ratio for Prognosis of Patients With Congestive Heart Failure.
Shi F, Wang L, Wang E … +1 more , Fang C
Cardiol Res Pract · 2026 · PMID 41536841 · Full text
OBJECTIVE: Based on the NLR, we aim to investigate the prognostic factors of CHF and establish a nomogram model to predict the OS of CHF patients. METHODS: We selected 566 CHF patients from the NHANES database surveyed b...
OBJECTIVE: Based on the NLR, we aim to investigate the prognostic factors of CHF and establish a nomogram model to predict the OS of CHF patients. METHODS: We selected 566 CHF patients from the NHANES database surveyed between 1999 and 2018 as the study population and randomly divided the data into training and validation sets in a 7:3 ratio. We used multivariate Cox regression analysis to determine the factors affecting the prognosis of CHF patients. Additionally, we evaluated the stratification of the NLR and the nomogram total risk score using the Kaplan-Meier survival curves and log-rank tests. To evaluate the predictive accuracy of the nomogram, we used the area under the ROC and the calibration curve method. Finally, we used decision curve analysis to explore the value of the nomogram in clinical applications. RESULTS: Multivariate Cox regression analysis revealed that the NLR, age, and gender were risk factors affecting the OS of CHF patients, whereas hemoglobin and platelets were protective factors. We established a nomogram based on NLR, age, gender, hemoglobin, and platelets and calculated the area under the survival rate curve for 3, 5, and 10 years in both the training and validation sets, indicating good predictive capacity of the model (training set AUCs were 0.822, 0.82, and 0.803, respectively; validation set AUCs were 0.726, 0.769, and 0.775, respectively). Calibration curves and decision curve analysis indicated the model's accuracy and clinical applicability. The risk stratification was performed using NLR and the nomogram total score, and the Kaplan-Meier survival curves and log-rank tests showed that CHF patients with higher NLR had worse prognosis and those with lower nomogram total score had better prognosis than those in high-risk groups. There was a significant difference in OS between the high- and low-risk groups ( < 0.001). CONCLUSION: This study found that NLR, age, gender, hemoglobin, and platelets are closely related to the prognosis of CHF patients. We successfully constructed a nomogram model based on these factors, which can accurately predict the prognosis of CHF patients.
Multidetector Computed Tomography Findings of Myocardial Bridge and Its Relationship With Coronary Calcification.
Dursun A, Doğan N, Başel MC … +1 more , Boğan M
Cardiol Res Pract · 2026 · PMID 41502454 · Full text
OBJECTIVES: This study aimed to evaluate the prevalence and anatomical characteristics of myocardial bridge (MB) using multidetector computed tomography (MDCT) and to investigate its relationship with coronary artery cal...
OBJECTIVES: This study aimed to evaluate the prevalence and anatomical characteristics of myocardial bridge (MB) using multidetector computed tomography (MDCT) and to investigate its relationship with coronary artery calcification and atherosclerotic burden. METHODS: We retrospectively analyzed 7024 patients who underwent MDCT for cardiac complaints between November 2010 and December 2020. The length and thickness of MBs were measured, and coronary calcification was quantified using the Agatston score. Patients were categorized according to the degree of coronary stenosis (< 50% or ≥ 50%) to assess the association between MB and calcification severity. RESULTS: The prevalence of MB was 7.7% (542 patients). The most common complaints in patients with MB were atypical chest pain (76%) and stable angina (24%). MB was most commonly detected in the middle segment of the LAD artery (65.68%). Mild atherosclerotic plaque (31%), moderate atherosclerotic plaque (13%), and severe atherosclerotic plaque and stenosis (5%) were present in 51% of patients with MB. Significant calcification was found in 23% of MB patients, who had higher calcification scores, particularly those with coronary artery stenosis greater than 50%. CONCLUSIONS: MDCT serves as an effective noninvasive method not only for detecting MB but also for evaluating concomitant coronary calcification and early atherosclerotic changes. Early identification of calcification in MB patients may guide individualized cardiovascular assessment, focusing on noninvasive imaging, risk factor control, and preventive therapy similar to standard protocols for atherosclerosis management.
Educational innovation in cardiovascular care: Developing a curriculum for women's cardiovascular health.
Borgarelli G, Singulane CC, Montana P … +10 more , Lefbom L, Karra H, Watts K, Harrison K, Choffel JM, Ennen CS, Sharma AM, Wingerter KE, Soukoulis V, Rodriguez-Lozano PF
Am Heart J Plus · 2026 Jan · PMID 41492447 · Full text
Cardiovascular disease (CVD) is the leading cause of death among women in the United States, with significant knowledge gaps in sex-specific care among providers. To address this, we developed and implemented a structure...
Cardiovascular disease (CVD) is the leading cause of death among women in the United States, with significant knowledge gaps in sex-specific care among providers. To address this, we developed and implemented a structured, multidisciplinary women's cardiovascular health (CVH) curriculum within the cardiovascular fellowship program at the University of Virginia. The curriculum focused on women-specific cardiovascular health, including cardio-obstetrics, spontaneous coronary artery dissection (SCAD) and coronary microvascular disease (CMD), and encompassed didactic lectures and unique experiential learning through clinical work, research, and community outreach. This multidisciplinary approach enhances individualized care and prepares trainees to recognize and treat the unique cardiovascular needs of women. Continued development of such curricula is crucial for reducing morbidity and mortality disparities in CVD.
Predictive value of abnormal coronary computed tomography angiography in patients with Normal single-photon emission computed tomography scan.
Abazid RM, Almohideb MA, Barry MA … +8 more , Smettie O, Asad N, Sallam YT, Abdelrazek M, Akincioglu C, Warrington J, Romsa JG, Vezina WC
Am Heart J Plus · 2026 Jan · PMID 41492446 · Full text
BACKGROUND: The aim of this study was to assess the prognostic value of abnormal coronary computed tomography angiography (CCTA) in patients with normal single-photon emission computed tomography (SPECT) study. METHODS:...
BACKGROUND: The aim of this study was to assess the prognostic value of abnormal coronary computed tomography angiography (CCTA) in patients with normal single-photon emission computed tomography (SPECT) study. METHODS: We retrospectively enrolled patients with normal SPECT scans and abnormal CCTA studies, who were categorized according to CCTA findings into obstructive with ≥50 %, and non-obstructive CAD <50 % coronary artery stenosis. Major adverse cardiac events (MACE) was defined as cardiovascular death and non-fatal myocardial infarction. RESULTS: Among 1558 eligible patients, there were 1356 (87.1 %) patients with non-obstructive CAD and 202 (12.9 %) patients with obstructive CAD. Over a median follow-up of 10.4 ± 5.1 years, a total of 87 MACEs were reported. Patients with obstructive CAD were older (67.4 ± 8 vs. 60.3 ± 10 years, < 0.001), more often male (75.0 % vs. 54.6 %, p < 0.001), and had a higher prevalence of diabetes mellitus (26.7 % vs. 17.2 %, = 0.008) compared with those with non-obstructive disease. Despite normal SPECT findings, patients with obstructive CAD had significantly higher rates of MACE compared with those with non-obstructive CAD [25/202 (12.4 %) vs. 62/1356 (4.8 %), < 0.001]. Multivariable Cox regression confirmed age (HR 1.21, = 0.04), diabetes (HR 1.35, = 0.03), higher coronary calcium score (HR 1.49, = 0.01), and the presence of obstructive CAD (HR 2.57, < 0.001) are independent predictors of mortality. CONCLUSION: Obstructive CAD on CCTA is associated with significantly higher long-term risk of MACE in comparison to non-obstructive CAD in patients with normal SPECT.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe