bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of cangrelor and transition to oral P2Y12 inhibitors in patients undergoing percutaneous coronary intervention: the ARCANGELO study
Authors: De Luca Leonardo , Calabrò Paolo , Capranzano Piera , Di Mario Carlo , Chirillo Fabio , Rolfo Cristina , Menozzi Alberto , Menichelli Maurizio , Bolognese Leonardo , Musumeci Giuseppe 
Published: August 2023

Abstract

Aims
Cangrelor is the only intravenous P2Y12 inhibitor available. Safety, efficacy, and transitioning from cangrelor to oral P2Y12 inhibitors were recorded in patients with acute coronary syndrome (ACS). The ARCANGELO study aims to assess the safety of cangrelor on bleeding and the effects of the transition to oral P2Y12 inhibitors in a real-world setting according to the European Medical Agency’s requirement.

Methods and results
Adult patients with ACS undergoing percutaneous coronary intervention (PCI) receiving cangrelor were included in the study. Patients were followed for 30 days. Incidence of bleeding events, major adverse cardiac events, and transition strategy to oral P2Y12 were recorded. Among 1004 ACS patients undergoing PCI, 995 (99.1%) were eligible for the analysis; 597 (60.0%) of them had ST-segment elevation myocardial infarction. A total of 925 (93.1%) patients underwent PCI by radial catheter access, and 972 (97.2%) received drug-eluting stents. All eligible patients received bolus and cangrelor infusion between 2 and 4 h in 95% of the cases. A total of 730 patients (73.4%) received ticagrelor, 127 (12.8%) prasugrel, and 138 (13.9%) clopidogrel as transition therapy. Bleeding, according to Bleeding Academic Research Consortium (BARC) criteria, within 30 days post-PCI occurred in 5.2% of patients (95% confidence interval: 3.9–6.8%); 0.5% experienced a moderate (BARC 3), and all others mild (BARC 1–2) bleeding events. Major adverse cardiac events occurred in 14 (1.4%) patients, principally all-cause mortality (n = 6 patients) and myocardial infarction (n = 7 patients).

Conclusion
The use of cangrelor in ACS patients undergoing PCI and the transition strategy to P2Y12 inhibitors are confirmed as safe and effective in daily practice.
Aortic flow is associated with aging and exercise capacity
Authors: Zhao Xiaodan , Garg Pankaj , Assadi Hosamadin , Tan Ru-San , Chai Ping , Yeo Tee Joo , Matthews Gareth , Mehmood Zia , Leng Shuang , Bryant Jennifer Ann , Teo Lynette L S , Ong Ching Ching , Yip James W , Tan Ju Le , van der Geest Rob J , Zhong Liang 
Published: August 2023

Abstract

Aims
Increased blood flow eccentricity in the aorta has been associated with aortic (AO) pathology, however, its association with exercise capacity has not been investigated. This study aimed to assess the relationships between flow eccentricity parameters derived from 2-dimensional (2D) phase-contrast (PC) cardiovascular magnetic resonance (CMR) imaging and aging and cardiopulmonary exercise test (CPET) in a cohort of healthy subjects.

Methods and Results
One hundred and sixty-nine healthy subjects (age 44 ± 13 years, M/F: 96/73) free of cardiovascular disease were recruited in a prospective study (NCT03217240) and underwent CMR, including 2D PC at an orthogonal plane just above the sinotubular junction, and CPET (cycle ergometer) within one week. The following AO flow parameters were derived: AO forward and backward flow indexed to body surface area (FFi, BFi), average flow displacement during systole (FDsavg), late systole (FDlsavg), diastole (FDdavg), systolic retrograde flow (SRF), systolic flow reversal ratio (sFRR), and pulse wave velocity (PWV). Exercise capacity was assessed by peak oxygen uptake (PVO2) from CPET. The mean values of FDsavg, FDlsavg, FDdavg, SRF, sFRR, and PWV were 17 ± 6%, 19 ± 8%, 29 ± 7%, 4.4 ± 4.2 mL, 5.9 ± 5.1%, and 4.3 ± 1.6 m/s, respectively. They all increased with age (r = 0.623, 0.628, 0.353, 0.590, 0.649, 0.598, all P &lt; 0.0001), and decreased with PVO2 (r = −0.302, −0.270, −0.253, −0.149, −0.219, −0.161, all P &lt; 0.05). A stepwise multivariable linear regression analysis using left ventricular ejection fraction (LVEF), FFi, and FDsavg showed an area under the curve of 0.769 in differentiating healthy subjects with high-risk exercise capacity (PVO2 ≤ 14 mL/kg/min).

Conclusion
AO flow haemodynamics change with aging and predict exercise capacity.

Registration
NCT03217240
Prognostic implication of liver fibrosis scores in patients with non-ischemic dilated cardiomyopathy
Authors: Liu Yupeng , Song Jingjing , Wang Wenyao , Tang Yi-Da 
Published: August 2023

Abstract

Aims
Liver fibrosis was associated with adverse outcomes in various cardiovascular diseases. The current risk stratification of non-ischemic dilated cardiomyopathy (NIDCM) still largely depends on the left ventricular ejection fraction (LVEF). At present, the relationship between liver fibrosis and prognosis in patients with NIDCM remains blank.

Methods and results
A total of 433 NIDCM patients were analysed in this study. Liver fibrosis was assessed by three liver fibrosis scores (LFS), including aspartate aminotransferase to platelet ratio index (APRI), aspartate aminotransferase/alanine aminotransferase ratio (AST/ALT ratio), and gamma-glutamyltransferase to platelet ratio (GPR). The primary endpoint was defined as all-cause mortality or heart transplantation (ACM/HTx). During a median follow-up period of 1.7 years, 140 ACM/HTx events occurred. Positive associations were observed between LFS and ACM/HTx. Patients with elevated APRI, AST/ALT ratio, and GPR scores exhibited increased ACM/HTx (all P &lt; 0.05). Intermediate-to-high APRI [hazard ratio (HR) 1.66, 95%CI 1.06–2.61, P = 0.027], AST/ALT ratio (HR 1.59, 95%CI 1.07–2.36, P = 0.021), and GPR (HR 1.64, 95%CI 1.11–2.42, P = 0.013) were independently associated with increased risk of ACM/HTx, even after adjusting for LVEF and other covariates. The positive relationship remains consistent across different subgroups, including those with diabetes and obesity.

Conclusions
Elevated liver fibrosis scores were associated with a worse outcome beyond LVEF in patients with NIDCM, which may provide additional prognostic value in the management of NIDCM.
Prevalence and determinants of dilated ascending aorta in a Swedish population: a case–control study
Authors: Swahn Eva , Lekedal Hanna , Engvall Jan , Nyström Fredrik H , Jonasson Lena 
Published: August 2023

Abstract

Aims
Dilation of the ascending aorta (AA) is often asymptomatic until a life-threatening dissection or rupture occurs. An overall increase in the use of thoracic imaging has enabled early and sometimes incidental identification of AA dilation. Still, the prevalence and determinants of AA dilation remain to be clarified. The aim was to identify and characterize persons with AA dilation in a middle-aged Swedish population.

Methods and results
We used the Swedish CardioPulmonary BioImage Study Linköping (n = 5058, age 50–65 years) to identify cases with AA diameter ≥ 40 mm on coronary computed tomography angiography (CCTA) or chest computed tomography. Age- and gender-matched individuals with AA diameter &lt; 40 mm served as controls. Echocardiography, blood pressure (BP) measurements (office and home), pulse wave velocity (PWV), coronary artery calcification (CAC), CCTA-detected coronary atherosclerosis, and carotid ultrasound were used to characterize these subjects. We identified 70 cases (mean AA diameter 44 mm, 77% men) and matched these to 146 controls (mean AA diameter 34 mm). Bicuspid aortic valve and aortic valve dysfunction were more common in cases than in controls (8% vs. 0% and 39% vs. 11%, respectively). Both office and home BP levels were significantly higher among cases. Also, high PWV (&gt;10 m/s) levels were more common in cases (33% vs. 17%). Neither CAC scores nor prevalence or burden of atherosclerosis in coronary and carotid arteries differed between groups.

Conclusion
The prevalence of dilated AA was 1.4% and showed positive associations with male gender, aortic valve pathology, and diastolic BP, though not with subclinical atherosclerosis.
Bone changes post-sleeve gastrectomy in relation to body mass and hormonal changes
Authors: Kaur Snimarjot , Nimmala Supritha , Singhal Vibha , Mitchell Deborah M , Pedreira Clarissa C , Lauze Meghan , Lee Hang , Stanford Fatima Cody , Bouxsein Mary L , Bredella Miriam A , Misra Madhusmita 
Published: August 2023

Abstract

Objective
To determine mechanisms contributing to impaired bone health in youth 24 months following sleeve gastrectomy (SG).

Design
Twenty-four-month longitudinal observational study.

Methods
Participants included 23 youth undergoing SG and 30 non-surgical controls (NS) 13-25 years old with moderate-to-severe obesity. Subjects underwent fasting labs for bone turnover markers (N-terminal propeptide of type 1 procollagen, C-telopeptide (CTX)), sex hormones, sex hormone binding globulin (SHBG), and enteric peptides, DXA for areal bone mineral density (aBMD) and body composition, high-resolution peripheral quantitative CT for volumetric BMD (vBMD) at the distal radius and tibia, and microfinite element analysis for strength estimates.

Results
Groups did not differ for mean age or BMI z-scores. Over 24 months, compared to NS, SG had greater reductions in BMI z-scores, and spine, hip, and femoral neck aBMD Z-scores (P ≤ .012), greater increases in serum CTX and SHBG (P ≤ .039), and greater decreases in estrone and ghrelin (P ≤ .021). Among females, estrone and free androgen index (FAI) decreased (P ≤ .022) in SG vs NS groups. After controlling for age and sex, decreases in BMI and lean mass were associated with decreases in total hip and femoral neck aBMD Z-scores, and decreases in radial total and trabecular vBMD and failure load, and tibial total and trabecular vBMD. Among females, after controlling for age, decreases in estrone were associated with decreases in spine aBMD Z-scores and radial total and trabecular vBMD, and decrease in FAI with decreases in radial failure load.

Conclusion
Reductions in BMI, lean mass, and sex steroids over 24 months post-SG are associated with bone loss and could be targeted for preventative or therapeutic interventions.
Clinical trial registration number: The study is registered in ClinicalTrials.gov (NCT02557438).
2022 Joint ESC/EACTS review of the 2018 guideline recommendations on the revascularization of left main coronary artery disease in patients at low surgical risk and anatomy suitable for PCI or CABG
Authors: Byrne Robert A , Fremes Stephen , Capodanno Davide , Czerny Martin , Doenst Torsten , Emberson Jonathan R , Falk Volkmar , Gaudino Mario , McMurray John J V , Mehran Roxana , Milojevic Milan , Sousa Uva Miguel 
Published: August 2023

Abstract
In October 2021, the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) jointly agreed to establish a Task Force (TF) to review recommendations of the 2018 ESC/EACTS Guidelines on myocardial revascularization as they apply to patients with left main (LM) disease with low-to-intermediate SYNTAX score (0–32). This followed the withdrawal of support by the EACTS in 2019 for the recommendations about the management of LM disease of the previous guideline. The TF was asked to review all new relevant data since the 2018 guidelines including updated aggregated data from the four randomized trials comparing percutaneous coronary intervention (PCI) with drug-eluting stents vs. coronary artery bypass grafting (CABG) in patients with LM disease. This document represents a summary of the work of the TF; suggested updated recommendations for the choice of revascularization modality in patients undergoing myocardial revascularization for LM disease are included. In stable patients with an indication for revascularization for LM disease, with coronary anatomy suitable for both procedures and a low predicted surgical mortality, the TF concludes that both treatment options are clinically reasonable based on patient preference, available expertise, and local operator volumes. The suggested recommendations for revascularization with CABG are Class I, Level of Evidence A. The recommendations for PCI are Class IIa, Level of Evidence A. The TF recognized several important gaps in knowledge related to revascularization in patients with LM disease and recognizes that aggregated data from the four randomized trials were still only large enough to exclude large differences in mortality.
Dipeptidyl peptidase 3 plasma levels predict cardiogenic shock and mortality in acute coronary syndromes
Authors: Wenzl Florian A , Bruno Francesco , Kraler Simon , Klingenberg Roland , Akhmedov Alexander , Ministrini Stefano , Santos Karine , Godly Konstantin , Godly Julia , Niederseer David , Manka Robert , Bergmann Andreas , Camici Giovanni G , von Eckardstein Arnold , Stähli Barbara , Muller Olivier , Roffi Marco , Räber Lorenz , Lüscher Thomas F 
Published: August 2023

AbstractBackground and AimsDipeptidyl peptidase 3 (DPP3) is a protease involved in the degradation of angiotensin II which disturbs peripheral blood pressure regulation and compromises left ventricular function. This study examined the relationship of circulating DPP3 (cDPP3) with cardiogenic shock (CS) and mortality in patients presenting with acute coronary syndromes (ACS).MethodsPlasma cDPP3 levels were assessed at baseline and 12–24 h after presentation in patients with ACS prospectively enrolled into the multi-centre SPUM-ACS study (n = 4787).ResultsCirculating DPP3 levels were associated with in-hospital CS when accounting for established risk factors including the ORBI risk score [per log-2 increase, hazard ratio (HR) 1.38, 95% confidence interval (CI) 1.05–1.82, P = .021]. High cDPP3 was an independent predictor of mortality at 30 days (HR 1.87, 95% CI 1.36–2.58, P &lt; .001) and at one year (HR 1.61, 95% CI 1.28–2.02, P &lt; .001) after adjustment for established risk factors and the GRACE 2.0 score. Compared to values within the normal range, persistently elevated cDPP3 levels at 12–24 h were associated with 13.4-fold increased 30-day mortality risk (HR 13.42, 95% CI 4.86–37.09, P &lt; .001) and 5.8-fold increased 1-year mortality risk (HR 5.79, 95% CI 2.70–12.42, P &lt; .001). Results were consistent across various patient subgroups.ConclusionsThis study identifies cDPP3 as a novel marker of CS and increased mortality in patients with ACS. Circulating DPP3 offers prognostic information beyond established risk factors and improves early risk assessment.
Significance of lipids, lipoproteins, and apolipoproteins during the first 14–16 months of life
Authors: Taageby Nielsen Sofie , Mohr Lytsen Rikke , Strandkjær Nina , Juul Rasmussen Ida , Sillesen Anne-Sophie , Vøgg R Ottilia B , Axelsson Raja Anna , Nordestgaard Børge G , Kamstrup Pia R , Iversen Kasper , Bundgaard Henning , Tybjærg-Hansen Anne , Frikke-Schmidt Ruth 
Published: August 2023

Abstract

Background and Aims
The aims of this study were to investigate lipid parameters during the first 14–16 months of life, to identify influential factors, and to test whether high concentrations at birth predict high concentrations at 2- and 14–16 months.

Methods
The Copenhagen Baby Heart Study, including 13,354 umbilical cord blood samples and parallel venous blood samples from children and parents at birth (n = 444), 2 months (n = 364), and 14–16 months (n = 168), was used.

Results
Concentrations of lipids, lipoproteins, and apolipoproteins in umbilical cord blood samples correlated highly with venous blood samples from newborns. Concentrations of low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (HDL) cholesterol, apolipoprotein B, and lipoprotein(a) increased stepwise from birth to 2 months to 14–16 months. Linear mixed models showed that concentrations of LDL cholesterol, non-HDL cholesterol, and lipoprotein(a) above the 80th percentile at birth were associated with significantly higher concentrations at 2 and 14–16 months. Finally, lipid concentrations differed according to sex, gestational age, birth weight, breastfeeding, and parental lipid concentrations.

Conclusions
Lipid parameters changed during the first 14–16 months of life, and sex, gestational age, birth weight, breastfeeding, and high parental concentrations influenced concentrations. Children with high concentrations of atherogenic lipid traits at birth had higher concentrations at 2 and 14–16 months. These findings increase our knowledge of how lipid traits develop over the first 14–16 months of life and may help in deciding the optimal child age for universal familial hypercholesterolaemia screening.
Heart failure medical therapy prior to mitral transcatheter edge-to-edge repair: the STS/ACC Transcatheter Valve Therapy Registry
Authors: Varshney Anubodh S , Shah Miloni , Vemulapalli Sreekanth , Kosinski Andrzej , Bhatt Ankeet S , Sandhu Alexander T , Hirji Sameer , DeFilippis Ersilia M , Shah Pinak B , Fiuzat Mona , O’Gara Patrick T , Bhatt Deepak L , Kaneko Tsuyoshi , Givertz Michael M , Vaduganathan Muthiah 
Published: August 2023

Abstract

Background and Aims
Guideline-directed medical therapy (GDMT) is recommended before mitral valve transcatheter edge-to-edge repair (MTEER) in patients with heart failure (HF) and severe functional mitral regurgitation (FMR). Whether MTEER is being performed on the background of optimal GDMT in clinical practice is unknown.

Methods
Patients with left ventricular ejection fraction (LVEF) &lt; 50% who underwent MTEER for FMR from 23 July 2019 to 31 March 2022 in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry were identified. Pre-procedure GDMT utilization was assessed. Cox proportional hazards models were constructed to evaluate associations between pre-MTEER therapy (no/single, double, or triple therapy) and risk of 1-year mortality or HF hospitalization (HFH).

Results
Among 4199 patients across 449 sites, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, mineralocorticoid receptor antagonists, and angiotensin receptor–neprilysin inhibitors were used in 85.1%, 44.4%, 28.6%, and 19.9% before MTEER, respectively. Triple therapy was prescribed for 19.2%, double therapy for 38.2%, single therapy for 36.0%, and 6.5% were on no GDMT. Significant centre-level variation in the proportion of patients on pre-intervention triple therapy was observed (0%–61%; adjusted median odds ratio 1.48 [95% confidence interval (CI) 1.25–3.88]; P &lt; .001). In patients eligible for 1-year follow-up (n = 2014; 341 sites), the composite rate of 1-year mortality or HFH was lowest in patients prescribed triple therapy (23.0%) compared with double (24.8%), single (35.7%), and no (41.1%) therapy (P &lt; .01 comparing across groups). Associations persisted after accounting for relevant clinical characteristics, with lower risk in patients prescribed triple therapy [adjusted hazard ratio (aHR) 0.73, 95% CI .55–.97] and double therapy (aHR 0.69, 95% CI .56–.86) before MTEER compared with no/single therapy.

Conclusions
Under one-fifth of patients with LVEF &lt;50% who underwent MTEER for FMR in this US nationwide registry were prescribed comprehensive GDMT, with substantial variation across sites. Compared with no/single therapy, triple and double therapy before MTEER were independently associated with reduced risk of mortality or HFH 1 year after intervention.
Efficacy of ferric carboxymaltose in heart failure with iron deficiency: an individual patient data meta-analysis
Authors: Ponikowski Piotr , Mentz Robert J , Hernandez Adrian F , Butler Javed , Khan Muhammad Shahzeb , van Veldhuisen Dirk J , Roubert Bernard , Blackman Nicole , Friede Tim , Jankowska Ewa A , Anker Stefan D 
Published: August 2023

Abstract

Background and Aims
Whereas a beneficial effect of intravenous ferric carboxymaltose (FCM) on symptoms and exercise capacity among patients with iron deficiency and heart failure (HF) has been consistently demonstrated, the effects of treatment on clinical events remain the subject of research. This meta-analysis aimed to characterize the effects of FCM therapy on hospitalizations and mortality.

Methods
Patient-level data from randomized, placebo-controlled FCM trials including adults with HF and iron deficiency with ≥52 weeks follow-up were analysed. The co-primary efficacy endpoints were (i) composite of total/recurrent cardiovascular hospitalizations and cardiovascular death and (ii) composite of total HF hospitalizations and cardiovascular death, through 52 weeks. Key secondary endpoints included individual composite endpoint components. Event rates were analysed using a negative binomial model. Treatment-emergent adverse events were also examined.

Results
Three FCM trials with a total of 4501 patients were included. Ferric carboxymaltose was associated with a significantly reduced risk of co-primary endpoint 1 (rate ratio 0.86; 95% confidence interval 0.75–0.98; P = .029; Cochran Q: 0.008), with a trend towards a reduction of co-primary endpoint 2 (rate ratio 0.87; 95% confidence interval 0.75–1.01; P = .076; Cochran Q: 0.024). Treatment effects appeared to result from reduced hospitalization rates, not improved survival. Treatment appeared to have a good safety profile and was well tolerated.

Conclusions
In iron-deficient patients with HF with reduced left ventricular ejection fraction, intravenous FCM was associated with significantly reduced risk of hospital admissions for HF and cardiovascular causes, with no apparent effect on mortality.
Upgrade of right ventricular pacing to cardiac resynchronization therapy in heart failure: a randomized trial
Authors: Merkely Béla , Hatala Robert , Wranicz Jerzy K , Duray Gábor , Földesi Csaba , Som Zoltán , Németh Marianna , Goscinska-Bis Kinga , Gellér László , Zima Endre , Osztheimer István , Molnár Levente , Karády Júlia , Hindricks Gerhard , Goldenberg Ilan , Klein Helmut , Szigeti Mátyás , Solomon Scott D , Kutyifa Valentina , Kovács Attila , Kosztin Annamária 
Published: August 2023

Abstract

Background and Aims
De novo implanted cardiac resynchronization therapy with defibrillator (CRT-D) reduces the risk of morbidity and mortality in patients with left bundle branch block, heart failure and reduced ejection fraction (HFrEF). However, among HFrEF patients with right ventricular pacing (RVP), the efficacy of CRT-D upgrade is uncertain.

Methods
In this multicentre, randomized, controlled trial, 360 symptomatic (New York Heart Association Classes II–IVa) HFrEF patients with a pacemaker or implantable cardioverter defibrillator (ICD), high RVP burden ≥ 20%, and a wide paced QRS complex duration ≥ 150 ms were randomly assigned to receive CRT-D upgrade (n = 215) or ICD (n = 145) in a 3:2 ratio. The primary outcome was the composite of all-cause mortality, heart failure hospitalization, or &lt;15% reduction of left ventricular end-systolic volume assessed at 12 months. Secondary outcomes included all-cause mortality or heart failure hospitalization.

Results
Over a median follow-up of 12.4 months, the primary outcome occurred in 58/179 (32.4%) in the CRT-D arm vs. 101/128 (78.9%) in the ICD arm (odds ratio 0.11; 95% confidence interval 0.06–0.19; P &lt; .001). All-cause mortality or heart failure hospitalization occurred in 22/215 (10%) in the CRT-D arm vs. 46/145 (32%) in the ICD arm (hazard ratio 0.27; 95% confidence interval 0.16–0.47; P &lt; .001). The incidence of procedure- or device-related complications was similar between the two arms [CRT-D group 25/211 (12.3%) vs. ICD group 11/142 (7.8%)].

Conclusions
In pacemaker or ICD patients with significant RVP burden and reduced ejection fraction, upgrade to CRT-D compared with ICD therapy reduced the combined risk of all-cause mortality, heart failure hospitalization, or absence of reverse remodelling.