bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brugada phenocopy in fulminant eosinophilic myocarditis: a case series
Authors: Kawauchi Dai , Yunoki Kei , Yoshino Tomohiro , Oka Takefumi 
Published: December 2024

Abstract

Background
Brugada phenocopy (BrP) is a condition that induces reversible Brugada-like electrocardiographic (ECG) changes in patients without true Brugada syndrome. We present two cases of fulminant eosinophilic myocarditis that showed Type 1 Brugada ECG changes in the early phase of the clinical course.

Case summary
Case 1 was a 76-year-old man who developed fulminant eosinophilic myocarditis with ventricular tachycardia while hospitalized for heart failure. Case 2 was a 60-year-old man who presented with cardiogenic shock and was diagnosed with fulminant eosinophilic myocarditis. Both patients showed a Type 1 Brugada ECG at onset, and their ventricular function was greatly reduced. Regarding mechanical circulatory support, Case 1 was treated with venous-arterial extracorporeal membrane oxygenation and intra-aortic balloon pumping. Case 2 had venous-arterial extracorporeal membrane oxygenation and Impella CP insertion. Steroid therapy was introduced in both cases. In Case 1, the Type 1 Brugada ECG took 7 days to improve. Left ventricular function improved with time but right heart function was poor and right heart enlargement remained. In Case 2, the Type 1 Brugada ECG improved on the second day, and left and right heart function improved over time.

Discussion
We report two cases of fulminant eosinophilic myocarditis with Brugada-like ECG and severe right heart dysfunction. BrP in acute myocarditis may be an indicator of right heart failure and an important ECG marker in determining the indication for mechanical circulatory support and improvement of right heart function.
Optimal site of pacemaker lead implantation for persistent atrial standstill guided by electroanatomical mapping following a cox-maze procedure: a case report
Authors: Ujiro Sae , Yamashita Soichiro , Takemoto Makoto , Okuda Masanori 
Published: December 2024

Abstract

Background
Atrial standstill is characterized by the absence of atrial activity. We report a case of a patient with extensive atrial fibrosis who underwent electrophysiologic study (EPS) and electroanatomical mapping (EAM) to identify surviving atrial sites amenable for pacemaker lead implantation.

Case summary
A 72-year-old man with persistent atrial fibrillation (AF) and atrial functional mitral regurgitation/tricuspid regurgitation (MR/TR) underwent a Cox-Maze surgery, mitral and tricuspid valve repair, and biatrial plication. He was referred because of post-operative presyncope symptoms. Electrocardiography revealed atrial standstill and junctional rhythm (JR); however, EAM revealed that both atria were almost entirely scarred and isolated fibrillation in left pulmonary veins and coronary sinus. Junctional rhythm retrogradely conducted around an atrioventricular (AV) node and pacing at this area could conduct to the ventricle through the AV node. An atrial pacing lead was implanted at this area, which yielded a QRS wave similar to the own beat. However, the atrial lead voltage was quite low; hence, ventricular pacing lead was implanted to avoid a future occurrence of pacing failure.

Discussion
This report demonstrates the benefits of EPS and EAM in informing optimal pacemaker implantation for patients with extensive scar in atrium.
Effect of SGLT2i on kidney outcomes of individuals with type 2 diabetes according to body mass index: nationwide cohort study
Authors: Jimba Takahiro , Kaneko Hidehiro , Suzuki Yuta , Okada Akira , Azegami Tatsuhiko , Ko Toshiyuki , Fujiu Katsuhito , Morita Hiroyuki , Takeda Norifumi , Hayashi Kaori , Yokoo Takashi , Node Koichi , Komuro Issei , Yasunaga Hideo , Nangaku Masaomi , Takeda Norihiko 
Published: December 2024

Abstract

Aims
To investigate the clinical significance of the modification of the kidney protective effects of sodium-glucose cotransporter-2 (SGLT2) inhibitors by baseline body mass index (BMI).

Methods and results
We included individuals with SGLT2 inhibitors or dipeptidyl peptidase-4 (DPP4) inhibitors newly prescribed for type 2 diabetes using a nationwide epidemiological cohort and performed propensity score matching (1:2). The primary outcome was the annual eGFR decline, assessed using a linear mixed-effects model, compared between individuals with SGLT2 inhibitors and DPP4 inhibitors. We investigated the interaction effect of BMI at the time of prescription using a three-knot restricted cubic spline model. We analysed 2165 individuals with SGLT2 inhibitor prescriptions and 4330 individuals with DPP4 inhibitor prescriptions. Overall, the annual decline in eGFR was less pronounced in the group treated with SGLT2 inhibitors than in those treated with DPP4 inhibitors (−1.34 mL/min/1.73 m2 vs. −1.49 mL/min/1.73 m2). The advantage of SGLT2 inhibitors in mitigating eGFR decline was augmented in the individuals with higher BMI (P-value for interaction 0.0017). Furthermore, even upon adjusting the definition of outcomes to encompass a 30 or 40% reduction in eGFR, the potential advantages of SGLT2 inhibitors over DPP4 inhibitors persisted, with a trend of augmented effects with higher BMI. This interaction effect was evident in the individuals with preserved kidney function.

Conclusion
Our nationwide epidemiological study substantiated the improved kidney outcomes in the SGLT2 inhibitor users compared with the DPP4 inhibitor users across a wide range of BMI, which was pronounced for individuals with higher BMI.
Causes of death in patients with atrial fibrillation in the UK: a nationwide electronic health record study
Authors: Lai Yongtong , Yoshimura Hiroyuki , Zakkak Nadine , Marijon Eloi , Chahal Anwar , Lip Gregory Y H , Schmidt Floriaan , Providencia Rui 
Published: December 2024

Abstract

Aims
Causes of death remain largely unexplored in the atrial fibrillation (AF) population. We aimed to (i) thoroughly assess causes of death in patients with AF, especially those associated with sudden cardiac death (SCD) and (ii) evaluate the potential association between AF and SCD.

Methods and results
Linked primary and secondary care United Kingdom Clinical Practice Research Datalink dataset comprising 6 529 382 individuals aged ≥18. We identified 214 222 patients with newly diagnosed AF, and an equivalent number of non-AF patients matched for age, sex and primary care practice. The underlying primary cause of death for each patient was assessed in the form of International Classification of Diseases Tenth Revision (ICD-10) codes and also as part of broader disease categories (i.e. ICD-10 chapters).

Findings
Over a median follow-up of 2.7 (interquartile range: 0.7–6.0) years, 124 781 (58.25%) patients with AF died. Sudden cardiac death occurred in 13 923 patients with AF [6.50% patients with AF vs. 2.01% non-AF patients; odds ratio (OR) = 3.38, 95% confidence interval (CI): 3.27–3.50, P &lt; 0.0001], contributing to 11.05% of all AF mortality. Diseases of the circulatory system, neoplasms and respiratory diseases explained 45% of AF mortality. Sudden cardiac death occurred more frequently in males (OR = 1.87, 95% CI: 1.80–1.93, P &lt; 0.0001), and females with AF died more often of diseases of the circulatory, respiratory, digestive, and genitourinary system and less often of neoplastic disorders.

Interpretation
Conditions of the circulatory system are the main driver of mortality in the AF population. Females with AF experience higher cardiovascular and respiratory mortality but die less frequently of neoplasms. The risk of SCD is higher in the AF population, occurring more frequently in males.
Supraventricular ectopic activity predicts postoperative atrial fibrillation, new onset atrial fibrillation and worse survival in obstructive hypertrophic cardiomyopathy
Authors: Nie Changrong , Zhu Changsheng , Xiao Minghu , Wu Zining , Yang Qiulan , Lu Zhengyang , Lu Tao , Meng Yanhai , Wang Shuiyun 
Published: December 2024

Abstract

Background
Supraventricular ectopic activity (SVEA) is a marker of foci that may initiate atrial fibrillation (AF) and is associated with worse survival. The types and frequencies of SVEA for predicting postoperative AF (POAF), new-onset AF, and clinical outcomes in obstructive hypertrophic cardiomyopathy(oHCM) remain unknown.

Method
Our study consecutively recruited 961 patients with oHCM. All patients underwent a 24-hour Holter monitor before surgery.

Results
POAF incidence was 20.7% and increased with the burden of premature atrial contractions (PACs). Multivariable analysis showed that supraventricular tachycardia (SVT) was independently associated with POAF, with the model including SVT yielding the largest area under the curve (AUC) [0.710, 95%CI 0.670-0.750] for predicting POAF. During a median follow-up of 2.9 years, 12 deaths, 60 new-onset AF, and 139 composite endpoints were observed. A Spearman correlation indicated a linear relationship between the incidence of new-onset AF and composite endpoints with PAC frequency. The Kaplan-Meier survival curves demonstrated that patients with PACs &gt;200 beats/day had significantly higher cumulative rates of new-onset AF[HR 3.13, (95%CI 1.74-5.62), p&lt;0.001] and composite endpoints [HR 2.00, (95%CI 1.30-3.06), p=0.002] than their counterparts. Adding PACs &gt;200 beats/day to the multivariable model significantly improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) for predicting new-onset AF (NRI=0.264, IDI=0.033) and composite endpoints (NRI=0.233, IDI=0.014).

Conclusion
The incidence of POAF was 20.7%, increasing with PACs severity. Furthermore, PACs burden was positively associated with a higher incidence of adverse events. Specially, PACs&gt;200 beats/day may best predict a higher incidence of new-onset AF and worse survival.
Relationship between hospital mortality and readmission rates after transcatheter aortic valve replacement
Authors: Kolte Dhaval , Tale Archana , Song Yang , Yeh Robert W 
Published: December 2024

Abstract

Background
There is substantial hospital-level variation in 30-day risk-standardized mortality rate (RSMR) and risk-standardized readmission rate (RSRR) after transcatheter aortic valve replacement (TAVR). However, the relationship between hospital RSMRs and RSRRs has not been well characterized.

Methods and results
We analysed data on 141 905 Medicare fee-for-service beneficiaries who underwent TAVR across 512 hospitals between 1 October 2015 and 31 December 2020. The primary and secondary outcomes of interest were 30-day all-cause mortality and 30-day all-cause readmissions, respectively. Hierarchical logistic regression models with random hospital-level intercepts were used to estimate RSMRs and RSRRs for each hospital. We used Pearson correlation coefficient (r) and restricted cubic spline regression to determine the relationship between RSMR and RSRR in the overall cohort and within subgroups based on hospital characteristics. The median [interquartile range (IQR)] hospital-level 30-day RSMR was 2.2% (2.1–2.4%), ranging from 1.3 to 3.5%. Similarly, the median (IQR) hospital-level 30-day RSRR was 13.2% (12.7–13.8%), ranging from 10.6 to 16.8%. In the overall cohort, there was weak correlation between 30-day RSMR and RSRR after TAVR (r = 0.25, 95% CI 0.17–0.33, P &lt; 0.001). Subgroup analyses by hospital characteristics demonstrated the weakest correlation between RSMR and RSRR for non-JCAHO accredited hospitals (r = 0.07), hospitals in the Midwest (r = 0.12), and West (r = 0.14), and hospitals with low TAVR volume (r = 0.15).

Conclusion
Risk-standardized mortality and readmission rates after TAVR are weakly correlated, suggesting that hospital practices and processes of care influencing mortality are likely different from those influencing readmissions after TAVR, thereby necessitating measurement of both outcomes and developing specific interventions to decrease mortality and readmissions.
Performance of the ARC-HBR criteria in ST-elevation myocardial infarction. Significance of smoking as an additional bleeding risk factor
Authors: Kesti Henri , Mattila Kalle , Jaakkola Samuli , Lehto Joonas , Söderblom Nea , Kalliovalkama Kalle , Porela Pekka 
Published: December 2024

Abstract

Background and aims
The Academic Research Consortium for High Bleeding Risk criteria (ARC-HBR) are recommended by guidelines for bleeding risk assessment in ST-elevation myocardial infarction (STEMI). The aim of this study was to identify possible other risk factors and adjust the original ARC-HBR criteria for confounders.

Methods and results
All consecutive STEMI patients managed in a Finnish tertiary hospital between 2016 and 2022 were identified using a database search. Data collection was done by reviewing electronic patient records. Bleeding risk was assessed according to the ARC-HBR criteria. The primary endpoint was non-access site bleeding academic research consortium (BARC) type 3 or 5 bleeding during 1-year follow-up. A total of 1548 STEMI patients were analysed. HBR criteria was fulfilled in 661 (42.7%). Multivariable competing risk analysis identified only 4 individual ARC-HBR criteria as independent risk factors for bleeding. Smoking status was identified as a novel bleeding risk factor. Current and former smokers had increased bleeding risk compared with never smokers [hazard ratio (HR) 3.01, 95% confidence interval (CI) 1.62–5.61 and HR 1.99, CI 1.19–3.34]. In those not meeting any ARC-HBR criteria, cumulative BARC 3 or 5 incidence of current smoking was 3.40% and intracranial haemorrhage (ICH) 1.36%. Thus, exceeding ARC-HBR definition for a major criterion. In the non-HBR group the prevalence of current smoking was 40.4% (n = 358).

Conclusion
Current and former smoking predicts major bleeding complications after STEMI. Current smoking is highly prevalent among those classified as non-HBR according to the ARC-HBR criteria.
Enhanced recovery after minimally invasive cardiac surgery following a zero ICU concept—a propensity score-matched analysis
Authors: Pitts Leonard , Dini Martina , Goecke Simon , Kofler Markus , Ott Sascha , Stoppe Christian , O’Brien Benjamin , Jacobs Stephan , Falk Volkmar , Hommel Matthias , Kempfert Jörg 
Published: December 2024

Abstract

OBJECTIVES
This study investigates our enhanced recovery after minimally invasive cardiac surgery program “enhanced recovery after minimally invasive cardiac surgery” (ERMICS) following a ‘Zero ICU’ concept compared to standard-of-care treatment in terms of safety and clinical efficacy.

METHODS
All patients who underwent minimally invasive mitral valve surgery for primary severe mitral valve regurgitation between 2021 and 2023 were included. Propensity score matching (2:1) was performed between patients who received standard-of-care treatment and those who underwent ERMICS. Patients treated with the ERMICS approach were transferred to the peripheral ward instead of the intensive care unit on the day of surgery (Zero ICU). Separate primary end-points were safety (mortality, stroke), postoperative ventilation time and hospital length of stay.

RESULTS
A total of 611 patients (566 standard of care vs 45 ERMICS) were included in the study. After 2:1 matching, the cohort comprised 135 patients (90 standard of care vs 45 ERMICS) and were well balanced in terms of pre- and intraoperative variables. Thirty-day mortality was 0% in both groups. Postoperative ventilation time [P = 0.018, odds ratio (OR) &lt; 0.01, confidence interval (CI) &lt; 0.001], postoperative pain (P = 0.005, OR = 0.36, CI 0.18–0.74) and hospital length of stay (P = 0.049, OR = 0.28, CI 0.08–0.98) was significantly lower in ERMICS patients, while postoperative complications did not differ.

CONCLUSIONS
Our ERMICS ‘Zero ICU’ concept is safe and leads to significantly shorter postoperative ventilation time and hospital length of stay for patients undergoing minimally invasive mitral valve surgery for primary severe mitral valve regurgitation.
Preoperative planning programme in minimally invasive lung surgery reduces intraoperative adverse events
Authors: Epailly Julien , Braggio Cesare , Vasse Matthieu , Todesco Alban , Pauly Vanessa , D’Journo Xavier-Benoit , Thomas Pascal Alexandre , Fourdrain Alex 
Published: December 2024

Abstract

OBJECTIVES
While minimally invasive surgery (MIS) is the preferred approach in patients with early-stage lung cancer, intraoperative adverse events (IOAE) may still occur. The objective of this study was to assess the impact of a dedicated preoperative planning program on adverse event occurrence.

METHODS
A single-centre cross-sectional comparative study was conducted, including all patients with proven/suspected lung cancer undergoing curative MIS, prior (September 2021–October 2022) and after (November 2022–January 2024) the implementation of a preoperative planning program. The preoperative planning program consisted of a weekly assessment of upcoming surgical cases, evaluating surgical strategy, anatomical variations and anticipating surgical difficulties. Data were prospectively collected. The primary outcome was the rate of IOAE. Secondary outcomes were conversion rate, healthcare-associated adverse events and postoperative morbi-mortality.

RESULTS
We included 553 patients, 290 without preoperative planning and 263 undergoing a preoperative planning program. The overall IOAE rate was 11.4%, significantly lower after preoperative planning (7.6% vs 14.8%, P = 0.008). The overall healthcare-associated adverse events rate was 23.2%, significantly lower after preoperative planning (17.1% vs 28.6%, P = 0.0014). There were no statistical differences before and after preoperative planning for conversion rate (8.37% vs 10.7%, P = 0.354), complication rate (33.1% vs 34.5%, P = 0.73) and 90-day mortality (0.38% vs 2.07%, P = 0.126). Preoperative planning program impacted surgical strategy in 61/263 patients (23.2%) including a change in the extent of resection in 25/263 patients (9.5%).

CONCLUSIONS
Implementation of a systematic preoperative planning program in MIS for lung cancer decreases IOAE enabling an improvement in surgical safety.
Immigration, segregation, and attitudes toward immigrants: a longitudinal multiscalar analysis across egohoods
Authors: Laurence James , Goebel Jan 
Published: December 2024

Abstract
Evidence on how proximity to ethnic outgroups shapes attitudes toward immigration remains inconclusive. We suggest this may be driven, in part, by the fact that studies rarely account for the role of residential segregation. We argue that how the minority-share in an environment affects majority-group attitudes will depend on how segregated groups are from one another. To explore this, we undertake fixed-effects modelling of nationally representative German panel data and contextual data (2005–2013), and generate bespoke, home-centred egohoods for respondents across 12 spatial scales (500–10,000 metres radius). Findings show that how egohood minority-share is related to immigration-attitudes is conditional on egohood segregation: only egohoods becoming ethnically diverse and segregated see anti-immigrant sentiment increase; egohoods becoming ethnically diverse and integrated actually see anti-immigrant sentiment decrease. This conditioning-relationship exhibits a (broadly monotonic) bell-curve relationship across egohood-scales, peaking around a 3500/4000 metres radius.
Cross-national variation in the skills trap: illuminating the heterogeneous economic returns to high cognitive skills
Authors: Araki Satoshi 
Published: December 2024

Abstract
Research argues possessing high skills is crucial for economic success. While such arguments are often evidenced by the average skills effect, we know little about its heterogeneity. From a comparative perspective, this article examines the heterogeneous effects of cognitive skills on earnings using the standardized dataset for Britain, the Czech Republic, France, Korea, Norway, and the United States. Propensity score (PS) matching analysis first shows skills generally contribute to higher earnings. However, the effect size varies across PS strata, including the negative selection trend with low-PS groups (i.e. individuals who are least likely to acquire high skills) gaining more from such traits (Norway); U-shaped patterns with mid-PS being penalized (Britain and USA); homogeneous effects (Czech Republic); and their mixtures (France and Korea). Subpopulation PS models further reveal these heterogeneities comprise unequal returns across gender and parental education in a way that either intensifies or mitigates existing social inequalities. The results suggest (i) the ‘skills trap’ operates in structurally devaluing high skills among certain groups of people whilst rewarding others; and (ii) this trap works variously across societies in accordance with their socio-economic and educational systems. Methodologically, these findings also underscore the importance of investigating effect heterogeneity across both composite PS and its components.
Alcohol-attributed disease burden and formal alcohol policies in the Nordic countries (1990–2019): an analysis using the Global Burden of Disease Study 2019
Authors: van der Velde Lode , Shabaan Ahmed Nabil , Månsson Anastasia , Wennberg Peter , Allebeck Peter , Karlsson Thomas G , Flodin Pär , Eikemo Terje Andreas , Skrindo Knudsen Ann Kristin , de Soysa Indra , Skogen Jens Christoffer ,   GBD 2019 Nordic Alcohol Collaborators, Abolhassani Hassan , Ärnlöv Johan , Arumugam Ashokan , Asaduzzaman Muhammad , Baker Jennifer L , Dalal Koustuv , Deuba Keshab , Edvardsson David , Fereshtehnejad Seyed-Mohammad , Havmöller Rasmus J , Hay Simon I , Juel Knud , Kauppila Joonas H , Kiadaliri Ali , Kisa Adnan , Kisa Sezer , Kivimäki Mika , Lallukka Tea , Larsson Anders O , Leinsalu Mall , Meretoja Atte , Meretoja Tuomo J , Jonasson Junmei Miao , Murray Christopher J L , Neupane Subas , Ngwa Che Henry , Pereira Gavin , Sagoe Dominic , Shiri Rahman , Truelsen Thomas Clement , Vasankari Tommi Juhani , Gissler Mika , McGrath John J , Sigfusdottir Inga Dora , Sigurvinsdottir Rannveig , Pasovic Maja , Danielsson Anna-Karin , Agardh Emilie E 
Published: December 2024

Abstract
It is still unclear how changes in alcohol control policies may have contributed to changes in overall levels of alcohol-attributed harm between and within the Nordic countries. We modified and applied the Bridging the Gap (BtG)-scale to measure the restrictiveness of a set of alcohol control policies for each Nordic country and each year between 1990 and 2019. Alcohol-attributed harm was measured as total and sex-specific alcohol-attributed disease burden by age-standardized years of life losts (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) per 100 000 population from the Global Burden of Disease Study (GBD). Longitudinal cross-country comparisons with random effects regression analysis were employed to explore associations, within and across countries, differentiated by sex and the time to first effect. Overall, alcohol-attributed YLLs, YLDs, and DALYs decreased over the study period in all countries, except in Iceland. The burden was lower in those countries with restrictive national policies, apart from Finland, and higher in Denmark which had the least restrictive policies. Changes in restrictiveness were negatively associated with DALYs for causes with a longer time to effect, although this effect was stronger for males and varied between countries. The low alcohol attributed disease burden in Sweden, Norway, and Iceland, compared to Denmark, points towards the success of upholding lower levels of harm with strict alcohol policies. However, sex, location and cause-specific associations indicate that the role of formal alcohol policies is highly context dependent and that other factors might influence harm as well.