Hemelrijk KI, Broeze GM, Aarts HM
… +22 more, Garcia EM, Tchétché D, de Brito FS, Barbanti M, Kornowski R, Latib A, Onofrio A, Ribichini F, Cid B, Dumonteil N, Abizaid A, Sartori S, Errigo P, Tarantini G, Vigo CF, Orvin K, Pagnesi M, Valle-Fernandez RD, Dangas G, Mehran R, van Nieuwkerk AC, Delewi R
Am J Cardiol
· 2026 Jun · PMID 42362006
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Transcatheter aortic valve replacement (TAVR) is a widely accepted treatment option for patients with severe aortic valve stenosis. However, approximately one-third of patients undergoing TAVR present with a small aortic...Transcatheter aortic valve replacement (TAVR) is a widely accepted treatment option for patients with severe aortic valve stenosis. However, approximately one-third of patients undergoing TAVR present with a small aortic annulus, which is associated with impaired valve performance. The primary objective of this study was to evaluate 2 year mortality after transfemoral TAVR in patients with a small aortic annulus (valve size ≤23 mm for balloon-expandable valves and ≤26 mm for self-expanding valves), comparing balloon-expandable with self-expanding valves. The CENTER2-study includes data from 25,771 patients undergoing TVR. Patients were propensity score-matched and compared on clinical outcomes. A total of 8,827 (37.2%) patients had a small aortic annulus. Mean age was 81.9±6.3 years, 76.9% were female, and the median STS-PROM score was 4.8% (IQR 2.3-5.6). In the matched cohort of 2,692 patient pairs, patients receiving a balloon-expandable valve had higher rates of life-threatening bleeding at 30 days (3.6% vs 2.4%, p=0.01) and two-year mortality (19.1% vs 15.3%, HR 1.23, 95% CI 1.07-1.43, p=0.004). However, permanent pacemaker implantation was more frequent in patients receiving a self-expanding valve (21.6% vs 8.7%, p<0.001). In conclusion, this large real-world cohort of patients undergoing transfemoral TAVR, more than a third of patients had a small aortic annulus. Patients with a small aortic annulus receiving a balloon-expandable valve had higher 2-year mortality rates. Patients receiving a self-expanding valve had higher rates of permanent pacemaker implantation.
Suruagy-Motta RFO, da Silva LD, Rosa CR
… +12 more, Barbosa GLV, Silva LFP, Fayyat TC, Rehman T, Carvalho PE, Dall'Orto C, Pileggi B, Filho EM, Kumar S, Azzalini L, Gibson CM, Brilakis ES
Am J Cardiol
· 2026 Jun · PMID 42349533
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Severely calcified coronary lesions are associated with increased risk of procedural complications, stent underexpansion, and restenosis. While atherectomy prepares vessels for treatment, drug-eluting stents (DES) are tr...Severely calcified coronary lesions are associated with increased risk of procedural complications, stent underexpansion, and restenosis. While atherectomy prepares vessels for treatment, drug-eluting stents (DES) are traditionally preferred over drug-coated balloons (DCB). DCBs offer a stent-free alternative that may improve vessel remodeling and may require shorter antiplatelet therapy. However, for severely calcified lesions, it remains unclear whether DCB or DES are more effective. Following PRISMA guidelines, a systematic search of PubMed, Embase, Web of Science, Scopus, and Cochrane Central identified randomized controlled trials and adjusted observational studies comparing DCB versus DES following atherectomy. The study endpoints included major adverse cardiovascular events (MACE), all-cause death, myocardial infarction (MI), target lesion revascularization (TLR), and major bleeding. Random-effects models were used to estimate pooled risk ratios (RRs) and 95% confidence intervals (CIs). Eight observational studies comprising a pooled total of 1,968 patients (698 DCB and 1,270 DES) met the inclusion criteria. There was no statistically significant difference between the DCB and DES strategies regarding MACE (RR 1.12; 95% CI 0.85-1.47; I = 0%), myocardial infarction (RR 1.11; 95% CI 0.40-3.04; I = 0%), major bleeding (RR 1.11; 95% CI 0.36-3.37; I = 0%), all-cause mortality (RR 1.18; 95% CI 0.78-1.79; I = 0%), or cardiac death (RR 0.67; 95% CI 0.34-1.32; I = 0%). However, DES was associated with a significantly lower risk of target lesion revascularization in the pooled analysis (RR 1.82; 95% CI 1.14-2.91; I = 37.4%) and in the Kaplan-Meier curve (HR=1.64, 95% Cl, 1.11-2.42, p=0.014). In conclusion, following mechanical atherectomy for calcified lesions, both DCB and DES demonstrate favorable MACE, mortality, and safety profiles. However, DES exhibits a consistent association with lower target lesion revascularization. Given the observational nature and inherent selection biases of the data, these findings cannot establish definitive causal relationships and require caution.
Inutsuka K, Shibahashi E, Otsuki H
… +13 more, Arashi H, Kamishima K, Jujo K, Oka T, Mori F, Tanaka H, Sakamoto T, Ishii Y, Terajima Y, Fujii S, Takagi A, Haruta S, Yamaguchi J
Am J Cardiol
· 2026 Jun · PMID 42349532
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Whether prehospital statin therapy is associated with better outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) remains unclear. We evaluated...Whether prehospital statin therapy is associated with better outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) remains unclear. We evaluated the association between prior statin use and lower 1-year cardiovascular event rates in this population. We analyzed data from 827 consecutive patients with STEMI undergoing primary PCI from a multicenter registry and classified them into a prior statin group (n = 510, 62%) and a non-prior statin group (n = 317, 38%). The primary endpoint was 1-year major adverse cardiovascular events (MACE), defined as cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Inverse probability of treatment weighting (IPTW) was the primary analytic approach. After IPTW adjustment, the prior statin group had a lower weighted 1-year MACE incidence than the non-prior statin group (3.1% vs. 7.6%; hazard ratio, 0.31; 95% confidence interval, 0.17-0.57). The association between prior statin therapy and lower MACE risk was consistent in multivariable Cox regression and sensitivity analyses using modified IPTW approaches. In conclusion, statin therapy before STEMI onset was associated with lower 1-year cardiovascular event rates after primary PCI, a finding mainly driven by lower mortality.
Ceravolo R, Lucà F, Gulizia MM
… +3 more, Nardi F, Grimaldi M, Gelsomino S
Am J Cardiol
· 2026 Jun · PMID 42342009
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Obesity-related heart failure with preserved ejection fraction (HFpEF) represents an increasingly prevalent clinical phenotype characterized by exercise intolerance, systemic inflammation, and limited therapeutic options...Obesity-related heart failure with preserved ejection fraction (HFpEF) represents an increasingly prevalent clinical phenotype characterized by exercise intolerance, systemic inflammation, and limited therapeutic options. Semaglutide, a glucagon-like peptide-1 receptor agonist approved for obesity management, has shown favorable effects on symptoms and cardiometabolic markers in patients with HFpEF and obesity, but the overall clinical profile of semaglutide across randomized trials and its relevance within the broader HFpEF therapeutic landscape remain incompletely defined. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating semaglutide versus placebo in adults with HFpEF and obesity. MEDLINE, Embase, and CENTRAL were searched through February 2025. Six randomized trials (n = 4,216 participants) met inclusion criteria. Primary outcomes included changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP), Kansas City Cardiomyopathy Questionnaire (KCCQ) score, and heart-failure hospitalization. Random-effects models were used for pooled analyses. Semaglutide significantly reduced NT-proBNP levels (mean difference -119.7 pg/mL; 95% CI -144.4 to -95.1; P < 0.001) and improved KCCQ scores in trials enrolling HFpEF populations (mean difference +8.27 points; 95% CI 6.04-10.50; P < 0.001). Semaglutide was also associated with a lower risk of heart-failure hospitalization (odds ratio 0.81; 95% CI 0.75-0.88; P < 0.001). Between-study heterogeneity was low for primary outcomes, and sensitivity analyses confirmed the robustness of the pooled estimates, while meta-regression analyses did not identify significant modification of treatment effects by baseline C-reactive protein levels. In conclusion, semaglutide therapy in obesity-related HFpEF was associated with improvements in biomarkers, symptoms, and heart-failure hospitalization across randomized trials, providing a quantitative synthesis of emerging evidence supporting metabolic-targeted strategies in this increasingly recognized HFpEF phenotype.
Nishimiya K, Yosofi B, Dimitriu-Leen AC
… +14 more, Volleberg RHJA, Focks JJ, van Helden G, Jansen TPJ, Camaro C, Cate TCT, van Wely M, van Nunen LX, Thannhauser J, Elias-Smale S, van Geuns RJ, van Royen N, Nijveldt R, Damman P
Am J Cardiol
· 2026 Jun · PMID 42342008
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BACKGROUND: Current guidelines recommend a structured diagnostic protocol to determine the underlying final diagnosis for myocardial infarction with non-obstructive coronary arteries (MINOCA). Yet, a comprehensive diagno...BACKGROUND: Current guidelines recommend a structured diagnostic protocol to determine the underlying final diagnosis for myocardial infarction with non-obstructive coronary arteries (MINOCA). Yet, a comprehensive diagnostic workup is often hindered by economic and time constraints, and real-world data is scarce. OBJECTIVES: This study thus aimed to examine the diagnostic strategy of a structured protocol beyond initial invasive coronary angiography (ICA) for MINOCA. METHODS: This prospective multicenter cohort study enrolled MINOCA patients who underwent ICA between December 2020 and June 2024. The protocol with a stepwise approach recommended ad-hoc optical coherence tomography (OCT) for culprit lesion identification. Left ventricular angiography (LVA) or echocardiography were indicated for screening takotsubo syndrome (TTS). In case that no overt diagnosis was found, cardiac magnetic resonance (CMR) was performed to distinguish focal myocardial infarction from other diagnoses, including myocarditis, TTS, and other non-ischemic cardiomyopathy. Coronary functional testing (CFT) was considered in case of persistent angina. RESULTS: A total of 183 patients (60% female) were enrolled. The diagnostic yield per test was 19% with OCT (21/112), 29% with LVA and/or echocardiography (32/112), 62% with CMR (64/104), and 50% (1/2) with CFT. An incremental diagnostic yield in 183 patients was observed by combining modalities (11% with OCT alone versus 29% with OCT and LVA/echocardiography versus 58% with OCT, LVA/echocardiography and CMR versus 59% by adding CFT to all the imaging, P<0.01). CONCLUSIONS: In conclusion, a structured diagnostic protocol with multiple diagnostic tests increases the diagnostic yield in the work-up of MINOCA, resulting in an identified final diagnosis in 59%.
Nakata Y, Shibahashi E, Otsuki H
… +13 more, Arashi H, Kamishima K, Jujo K, Oka T, Mori F, Tanaka H, Sakamoto T, Ishii Y, Terajima Y, Fujii S, Takagi A, Haruta S, Yamaguchi J
Am J Cardiol
· 2026 Jun · PMID 42336345
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BACKGROUND: A complex high-risk indicated percutaneous coronary intervention (CHIP) score was recently developed from the British Cardiovascular Intervention Society (BCIS) database, and its prognostic value has been rep...BACKGROUND: A complex high-risk indicated percutaneous coronary intervention (CHIP) score was recently developed from the British Cardiovascular Intervention Society (BCIS) database, and its prognostic value has been reported. However, its utility remains non-validated in imaging-guided percutaneous coronary intervention (PCI), which has a favorable prognostic association with CHIP. We investigated the usefulness of the BCIS-CHIP score under imaging-guided PCI. METHODS: This multicenter prospective observational study included patients who underwent imaging-guided PCI. Patients were evaluated and categorized into four groups based on BCIS-CHIP scores (0, 1-2, 3-4, ≥5), for which we assessed the incidence of 1-year major adverse cardiac or cerebrovascular events (MACCE), including all-cause death, nonfatal myocardial infarction, and nonfatal stroke. Secondary outcomes were individual MACCE components, target vessel revascularization, and heart failure events. RESULTS: In total, 1218 patients were included. MACCE at 1 year occurred in 1.8%, 3.4%, 7.3%, and 11.7% of patients with BCIS-CHIP scores 0, 1-2, 3-4, and ≥5, respectively (p<0.001). The incidence of a primary endpoint in groups 3-4 (HR: 4.2, 95% CI: 1.48-12.2) and ≥5 (HR: 7.4, 95% CI: 2.59-21.37) was significantly higher than those in group 0. CONCLUSIONS: The BCIS-CHIP score is useful for predicting cardiovascular events in patients who have undergone imaging-guided PCI and could simplify risk stratification of patients with CHIP.
Am J Cardiol
· 2026 Jun · PMID 42336344
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Troponin is prognostic in acute pulmonary embolism (PE), but whether prior coronary artery disease (CAD) modifies troponin levels, kinetics, or prognostic value is unclear. We conducted a retrospective cohort study using...Troponin is prognostic in acute pulmonary embolism (PE), but whether prior coronary artery disease (CAD) modifies troponin levels, kinetics, or prognostic value is unclear. We conducted a retrospective cohort study using the Medical Information Mart for Intensive Care IV database (2008-2022) in adults with primary acute PE and ≥1 conventional troponin within 72 hours, excluding those with concurrent STEMI or NSTEMI so that troponin elevation reflected PE rather than acute coronary syndrome. CTEPH was also excluded. Prior CAD was defined as documented chronic ischemic heart disease, prior coronary revascularization, or remote myocardial infarction. Troponin-outcome models compared first troponin, peak, delta, and time-to-peak by prior CAD status. Clinical-outcome models tested first troponin, prior CAD, and their interaction across mortality, hemodynamic decompensation, advanced PE therapy, discharge home, length of stay, and peak lactate. All models adjusted for demographics, comorbidities, creatinine, and the simplified Pulmonary Embolism Severity Index. Among 1,942 patients (17.9% prior CAD), first troponin did not differ by CAD status after adjustment (β = 0.13 per 0.1 ng/mL [-0.04, 0.30], p = 0.145), and no kinetic outcome differed (all p > 0.4). Higher first troponin was associated with higher mortality and worse outcomes overall (five of six measures, all p ≤ 0.048). Prior CAD did not modify these associations (interaction p ≥ 0.129), except for lactate (β = 0.32 mmol/L, p < 0.001). In conclusion, troponin elevation in acute PE is not altered by underlying coronary disease and carries the same prognostic value regardless of prior CAD.
Am J Cardiol
· 2026 Jun · PMID 42331127
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The role of ypertensive heart disease (HHD) in the pathogenesis of heart failure with preserved ejection fraction (HFpEF) is recently reviewed by Ono and Falcão. While hypertension and are consistently associated with ad...The role of ypertensive heart disease (HHD) in the pathogenesis of heart failure with preserved ejection fraction (HFpEF) is recently reviewed by Ono and Falcão. While hypertension and are consistently associated with adverse cardiovascular outcomes and future heart failure (HF), the distinction between association and causation remains incompletely resolved. Current evidence supports the hypothesis that HHD may contribute to the development of HF; however, direct longitudinal demonstration that isolated hypertensive remodeling progresses to overt HF remains limited. We argue that much of the available evidence supports epidemiological association rather than a validated causal pathway. In conclusion, whether isolated HHD represents a myocardial disease intrinsically prone to HF acute decompensation remains an open question, with important implications for HF phenotyping and disease classification.
Gonda Y, Asami M, Horiuchi Y
… +29 more, Tanaka J, Taniwaki M, Yuzawa H, Komiyama K, Tanabe K, Yamamoto M, Shimura T, Sugiura A, Kubo S, Saji M, Izumi Y, Enta Y, Shirai S, Izumo M, Mizuno S, Watanabe Y, Amaki M, Kodama K, Yamaguchi J, Naganuma T, Bota H, Ohno Y, Hachinohe D, Yamawaki M, Ueno H, Nakazawa G, Otsuka T, Hayashida K, OCEAN-Mitral investigators
Am J Cardiol
· 2026 Jun · PMID 42331126
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Patients undergoing hemodialysis (HD) have poor outcomes after transcatheter edge-to-edge repair (TEER). However, the prognostic significance of postprocedural transmitral pressure gradient (TMPG) and residual mitral reg...Patients undergoing hemodialysis (HD) have poor outcomes after transcatheter edge-to-edge repair (TEER). However, the prognostic significance of postprocedural transmitral pressure gradient (TMPG) and residual mitral regurgitation (MR) in this population remains unclear. In the prospective, multicenter Optimized CathEter vAlvular iNtervention (OCEAN)-Mitral registry, we analyzed 3,515 patients with immediate postprocedural TMPG and MR data, including 224 (6.4%) on HD and 3,291 (93.6%) not on HD. The primary outcome was all-cause mortality at 2 years. During a median follow-up of 434 days, 624 deaths (17.8%) occurred. All-cause mortality was significantly higher in HD patients than in non-HD patients (33.0% vs. 16.7%, p <0.001). Non-cardiovascular death accounted for a greater proportion of deaths in HD patients than in non-HD patients (17.9% vs. 6.6%, p <0.001). In non-HD patients, a postprocedural TMPG ≥5 mmHg was associated with increased mortality (adjusted hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.18-2.03, p = 0.002), whereas this association was not statistically significant in HD patients (adjusted HR 1.68, 95% CI 0.83-3.38, p = 0.147). Similarly, residual MR ≥2+ was associated with higher mortality in non-HD patients (adjusted HR 1.26, 95% CI 1.01-1.58, p = 0.043), whereas no statistically significant association was demonstrated in HD patients (adjusted HR 1.47, 95% CI 0.70-3.08, p = 0.307). In conclusion, elevated postprocedural TMPG and residual MR were associated with higher mortality in non-HD patients, whereas no statistically robust associations were demonstrated in HD patients.
Abbas OF, Emara A, Almarfadi A
… +5 more, Haddad R, Atta K, Elbenawi H, Zordok M, Elgendy IY
Am J Cardiol
· 2026 Jun · PMID 42323984
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Coronary artery bypass grafting (CABG) is traditionally guided by coronary angiography, although angiographic severity may not accurately reflect the physiological significance of coronary lesions. Fractional flow reserv...Coronary artery bypass grafting (CABG) is traditionally guided by coronary angiography, although angiographic severity may not accurately reflect the physiological significance of coronary lesions. Fractional flow reserve (FFR) improves outcomes in percutaneous coronary intervention, but its role in guiding CABG remains uncertain. We conducted a meta-analysis of randomized controlled trials (RCTs) comparing FFR-guided versus angiography-guided CABG. Electronic databases were systematically searched from inception to April 2026. Outcomes included all-cause death, myocardial infarction (MI), and stroke. Random-effects models were used to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Three RCTs including 1,061 patients were analyzed, with 533 patients assigned to FFR-guided CABG. During a mean follow-up of 15 months, FFR-guided CABG was associated with a significantly lower risk of MI compared with angiography-guided CABG (RR 0.48, 95% CI 0.26-0.89; P=0.01; I²=0%). There were no statistically significant differences in all-cause death (RR 0.74, 95% CI 0.52-1.07; P=0.10; I²=0%) or stroke (RR 1.60, 95% CI 0.94-2.74; P=0.08; I²=0%). Risk of bias was low across all included trials. In conclusion, FFR-guided CABG was associated with a reduced incidence of MI compared with angiography-guided CABG, without significant differences in all-cause death or stroke. Larger trials with longer follow-up are needed to further define the role of physiology-guided surgical revascularization.
Beesley H, Galvani E, Akinmolayemi O
… +5 more, Manyak G, Prakash Y, Sharma SK, Kini A, Lerakis S
Am J Cardiol
· 2026 Jun · PMID 42323153
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Low-flow severe aortic stenosis (LFSAS) is a high-risk phenotype associated with increased mortality after transcatheter aortic valve replacement (TAVR). The prognostic value of postprocedural normalization of stroke vol...Low-flow severe aortic stenosis (LFSAS) is a high-risk phenotype associated with increased mortality after transcatheter aortic valve replacement (TAVR). The prognostic value of postprocedural normalization of stroke volume index (SVi), and its variation across valve types, remain uncertain. To evaluate the association between post-TAVR flow state and 1-year clinical outcomes among patients with LFSAS, and to determine whether this association differs between balloon-expandable valves (BEV) and self-expanding valves (SEV). We retrospectively analyzed consecutive patients with LFSAS (SVi ≤ 35 ml/m²) who underwent TAVR at a single quaternary center from 2019 to 2022 The primary endpoint was a composite of all-cause mortality or heart failure hospitalization at 1-year follow-up. Predictors of flow change post-TAVR were also assessed. Of 567 patients included, 54.9% received BEV and 45.1% SEV; 42.2% achieved flow normalization post-TAVR. The primary endpoint occurred in 13.8% of the normalized flow group and 17.4% of the maintained flow group (adjusted HR 0.82, 95% CI 0.51 to 1.30; p = 0.40). There was no statistically significant interaction between valve type (BEV vs SEV) and flow normalization status in the primary endpoint (p = 0.31). In multivariable analysis, post-TAVR flow normalization was not independently associated with improved 1-year outcome in patients with LFSAS. The findings suggest that underlying myocardial and systemic factors may drive prognosis more strongly than procedural flow changes.
Am J Cardiol
· 2026 Jun · PMID 42323152
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Sixth-generation high-sensitivity cardiac troponin T (hs-cTnT Gen 6) represents a significant analytical advance in the evaluation of patients with acute chest pain. Improved precision at low concentrations, revised 99th...Sixth-generation high-sensitivity cardiac troponin T (hs-cTnT Gen 6) represents a significant analytical advance in the evaluation of patients with acute chest pain. Improved precision at low concentrations, revised 99th-percentile thresholds, and enhanced robustness may expand the applicability of accelerated rule-out strategies. However, troponin interpretation remains inherently dependent on clinical context, including pretest probability, serial electrocardiographic findings, and competing causes of myocardial injury. Increasing assay sensitivity highlights the limitations of categorical interpretation and supports a shift toward continuous, context-dependent models. Absolute delta changes appear to provide greater diagnostic clarity at lower baseline concentrations although this advantage may diminish at higher values. As biomarker performance improves, reliance on simplified risk scores may decrease, while the importance of integrated approaches combining clinical assessment, ECG dynamics, and assay-specific troponin kinetics may increase. Such frameworks may better reflect the complexity of contemporary acute coronary syndrome evaluation. In this setting, there is an increasing role for integrated, algorithm-based approaches to support clinical decision-making in patients with acute chest pain.
Am J Cardiol
· 2026 Jun · PMID 42320613
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Cardiovascular diseases (CVDs) continue to be a significant public health burden and public health emergency in the world, underscoring the importance of early and easily accessible cardiovascular risk prediction strateg...Cardiovascular diseases (CVDs) continue to be a significant public health burden and public health emergency in the world, underscoring the importance of early and easily accessible cardiovascular risk prediction strategies. While systemic clinical and biochemical markers have been the mainstay of traditional risk assessment models, there is growing evidence that microvascular dysfunction is an early marker of vascular injury that is present prior to the onset of overt cardiovascular disease. The retinal microvasculature offers a unique non-invasive window into systemic vascular health, given its structural and physiological similarities with the coronary and cerebral circulation. Microvascular retinal changes such as changes in vascular caliber, tortuosity, branching and patterns of perfusion, are associated with hypertension, diabetes mellitus, stroke, coronary artery disease and heart failure. Advanced retinal imaging techniques like optical coherence tomography angiography (OCT-A) also allow to analyse the architecture of retinal vessels and microcirculatory function in detail. In addition, emerging molecular evidence shows shared pathways of endothelial dysfunction, inflammation, oxidative stress, and activation of the renin-angiotensin system, that link retinal vascular remodeling to cardiovascular pathology. Over the past few years, the use of artificial intelligence (AI) and deep learning (DL) has dramatically increased the capability of retinal imaging for translation, leading to automated acquisition of high dimensional vascular features and prediction of cardiovascular risk from retinal photographs. Retinal imaging biomarkers could complement clinical and molecular parameters to enhance risk stratification for cardiovascular disease in an individual basis. Overall, retinal microvascular phenotyping is a promising tool for early cardiovascular risk assessment, scalable, and non-invasive, and could play a role in future precision cardiology and preventive cardiovascular care strategies.
Verma BR, Sadeghpour A, Hani FB
… +12 more, Ahmed S, Waksman O, Sawant V, Rappaport H, Al Arguli A, Galo J, Cellamare M, Thakkar Y, Satler L, Ben-Dor I, Rogers T, Waksman R
Am J Cardiol
· 2026 Jun · PMID 42314921
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The clinical impact of performing transcatheter aortic valve replacement (TAVR) in patients with chronic inflammatory systemic diseases (CIDs) is not well reported. Hence, we designed this study to evaluate whether coexi...The clinical impact of performing transcatheter aortic valve replacement (TAVR) in patients with chronic inflammatory systemic diseases (CIDs) is not well reported. Hence, we designed this study to evaluate whether coexistence of CIDs in TAVR patients leads to worse clinical outcomes. We retrospectively studied TAVR patients at our institution between November 21, 2011 and March 29, 2024. Patients diagnosed with chronic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE), scleroderma, Sjögren's syndrome, inflammatory bowel disease, or other related diseases were identified using International Classification of Diseases codes. Clinical outcomes during inpatient and at 1-year were compared between CIDs and no-CID patients. Our study included 2,880 TAVR patients with mean age of 79 ± 9 years, 45% were female, and 78% were Caucasian. CIDs patients comprised 6.4% (n = 185) of the total cohort. The CIDs cohort had a higher proportion of females (61.6 vs 43.9%, p <0.001), immunosuppressive therapy (5.9 vs 2.9%, p = 0.02), NYHA class III or IV symptoms (51.9 vs 40%, p = 0.04), and higher STS score (4.1 vs 3.4; p = 0.04). In-hospital mortality (0.0 vs 1.7%; p = 0.08) was similar between the CIDs and no-CIDs groups; however, vascular complications (10.3% vs 6.1%, p = 0.036) and unplanned vascular interventions (5.4 vs 1.9%; p = 0.003) were more common in CIDs patients. Survival analysis showed no difference in 1-year mortality (8.9 vs 8.91%, log-rank p = 0.73) between the 2 groups. In conclusion, TAVR in CIDs patients is safe and has comparable immediate and 1-year adverse outcomes compared to non-CIDs patients; however, these patients are more prone to vascular access complications and may require more unplanned vascular interventions.
Am J Cardiol
· 2026 Jun · PMID 42285456
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Combined beneficial effect of CRF and ESBP in population with and without CV risk factors on all-cause, CHD, and CV mortality are discussed.Combined beneficial effect of CRF and ESBP in population with and without CV risk factors on all-cause, CHD, and CV mortality are discussed.