Open Heart

BackgroundAmong patients with ST segment elevation myocardial infarction (STEMI), higher concentrations of high sensitivity troponin T (hs-cTnT) are associated with larger MI size and predict a worse prognosis. In the 2467 patient CELEBRATE trial, a single subcutaneous injection of the short-acting glycoprotein IIb/IIIa receptor blocker antagonist zalunfiban at first medical contact significantly improved the primary outcome including clinical endpoints. In this study, we assessed the impact of ...

BackgroundIn patients with atrial fibrillation (AF) and stable coronary artery disease beyond 1 year after percutaneous coronary intervention (PCI), oral anticoagulant monotherapy is guideline-recommended; however, its efficacy and safety in patients with complex PCI remain uncertain. MethodsWe conducted a post-hoc analysis of the randomized ADAPT AF-DES trial comparing NOAC monotherapy versus NOAC plus clopidogrel in AF patients [≥]12 months after second- or third-generation drug-eluting st...

BackgroundHypertension is a major modifiable risk factor for cardiovascular disease, yet blood pressure (BP) control remain suboptimal, particularly in socially disadvantaged communities. Guidelines recommend initiating single-pill combination (SPC) therapy to improve adherence and BP control, but uptake in primary care is limited. ObjectivesTo evaluate the SOLO care improvement project, promoting SPC initiation among general practitioners (GPs) in Amsterdam Zuidoost, a disadvantaged, multi-eth...

BackgroundEmbolic stroke of undetermined source (ESUS) is associated with a high risk of recurrence. However, randomized trials have not shown superiority of anticoagulation over aspirin in unselected patients. Atrial cardiomyopathy (AtCM) may identify a high-risk ESUS phenotype. We investigated whether multimodal AtCM markers distinguish ESUS from controls and predict adverse clinical outcomes. MethodsIn this prospective single-center study, consecutive ESUS patients and age- and sex-matched c...

BackgroundThere is uncertainty among physicians regarding the optimal clinical application of the novel high-sensitivity cardiac troponin I (hs-cTnI)-VITROS assay within the widely implemented upper reference limit (URL)-based ESC 0/3h-algorithm. MethodsThis prospective, international, multicenter study aimed to validate and compare different modifications of the URL-based ESC 0/3h-algorithm among adult patients presenting with suspected acute myocardial infarction (AMI) to the emergency depart...

Background and AimsDespite advances in reperfusion and medical therapy, survivors of acute myocardial infarction (AMI) remain at risk for adverse left ventricular remodeling (LVR), a precursor to heart failure. Building on prior work outlining 12-month biomarker trajectories linked to early ventricular dysfunction, we aimed to assess whether these circulating biomarkers predict long-term adverse LVR. MethodsWe prospectively enrolled 155 patients experiencing their first AMI. Clinical, biochemic...

Whether the cumulative evidence for remote patient monitoring (RPM) in heart failure (HF) has reached a definitive threshold -- and whether benefits extend to geographically underserved populations -- remains uncertain. We conducted a systematic review, meta-analysis, and trial sequential analysis (TSA) of 65 RCTs (59 poolable; [~]23,000 participants) across four databases through February 2026, encompassing structured telephone support (15 trials), non-invasive telemonitoring (33), and invasive...

IntroductionAtrial fibrillation (AF), a common arrhythmia, is associated with impaired quality of life (QoL) and increased stroke risk and mortality. Clinical guidelines recommend leveraging digital technologies to support patient education and AF self-management. Conversational artificial intelligence (AI) technologies may support patient engagement with self-management by enabling human-like conversations. This study aims to evaluate the effectiveness of a conversational AI intervention (Conve...

PurposeDespite strong evidence, real-world adoption of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) remains suboptimal. The Get With The Guidelines-Heart Failure (GWTG-HF) program was designed to close gaps in care. We evaluated whether hospital participation in GWTG-HF is associated with greater GDMT intensity and improved outcomes. MethodsWe conducted a retrospective analysis (2013-2021) of Medicare beneficiaries with Part A and Part D hos...

ObjectivesVisit-to-visit blood pressure variability (VVV BPV) is an underutilised risk factor for cardiovascular disease (CVD). This study aims to determine the minimum number of BP measurements needed and to identify cut-off values for the standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) of systolic and diastolic VVV BPV to predict CVD risk in primary care. MethodsWe analysed data from the electronic practice-based research network (ePBRN) in Southwest...

PurposeThe objective of this study was to identify predictors of statin adherence in the primary and secondary prevention of CVD among patients in the first two years after the date of first prescription using real-world data. MethodsThe Electronic Practice Based Research Network Linked Dataset was used in this study. Statin adherence was calculated using a modified proportion of days covered (PDC) formula. Individuals with PDC [≥] 80% during the two years of observation period were consider...

ObjectiveThe objective of this study was to explore the predictors of statin intolerance in the primary and secondary prevention of CVD among patients in the first two years after the date of first prescription using real-world data. MethodsThis study used the Electronic Practice Based Research Network Linked Dataset. An algorithm, which considered the muscle symptoms and creatinine kinase of patients, was used to identify statin intolerant patients. The R software was used for all analyses. De...

BackgroundKetone bodies have shown potential to improve cardiac metabolism and function in patients with heart failure (HF). ObjectiveTo evaluate the effects of exogenous ketone-based interventions on cardiac function in patients with HF or related cardiometabolic risk factors. MethodsWe conducted a systematic review based on a search of MEDLINE, EMBASE, CINAHL, Cochrane Library, and Scopus from inception to January 2025. Eligible studies included randomized controlled trials evaluating exogen...

Background-Blockers (ABs) are the most commonly prescribed medications for benign prostatic hyperplasia (BPH), a highly prevalent condition. Although the ALLHAT raised concerns about cardiovascular (CV) safety of nonselective ABs for the treatment of hypertension, the comparative CV risk profile of selective 1A-adrenergic receptor (1A-AR) antagonists for BPH remains unclear. MethodsWe conducted a retrospective cohort study using the TriNetX federated research network (158 million patients acros...

ObjectiveTo validate case number correctness and time interval agreement in the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) for out-of-hospital cardiac arrest (OHCA) by linkage to Emergency Medical Dispatch Centre (EMDC) data between 2015 and 2024. MethodsIn this retrospective validation study, OHCA records reported to the SCRC were linked with EMDC-indexed OHCA for validation and correction of EMS case numbers. We quantified the proportion of correct EMS case numbers reported as a...

Structured AbstractO_ST_ABSBackgroundC_ST_ABSGuideline recommendations for infective endocarditis (IE) prophylaxis have narrowed significantly over the past decade. However, these recommendations are derived from adult data and may not adequately account for the unique risk factors for IE in pediatric and congenital heart disease (CHD) patients with cardiac implantable electronic devices (CIEDs). ObjectiveTo characterize contemporary IE cases and prophylaxis practices among members of the Pedia...

We performed a systematic review and meta-analysis of randomized controlled trials evaluating glucagon-like peptide-1 receptor agonists (GLP-1 RAs) versus placebo in adults with heart failure (HF), searching PubMed, Cochrane CENTRAL, and ClinicalTrials.gov through February 2026. The primary outcome was the composite of cardiovascular death and first HF hospitalization. Random-effects meta-analysis used restricted maximum likelihood estimation with Hartung-Knapp-Sidik-Jonkman adjustment. We inclu...

The objective of this systematic review and meta-analysis was to identify the interventions used to manage intolerance in patients receiving statins for primary prevention of CVD and to determine the effectiveness of these interventions. This study was conducted according to the PRISMA checklist. The electronic databases MEDLINE (PubMed), SCOPUS, EMBASE, and CINAHL were searched for studies published until June 2025. Based on the NLA definition of statin intolerance, the outcomes were split into...

BackgroundGenerative artificial intelligence (AI) systems are increasingly used to produce medical illustrations for education; however, their anatomical accuracy in complex domains such as congenital heart disease (CHD) remains insufficiently validated. MethodsIn an assessor-blinded comparative study, we evaluated AI-generated CHD illustrations from two contemporary text-to-image platforms (ChatGPT-5/ChatGPT-Images and Gemini NanoBanana) against human-modified educational images. Twenty differ...

BackgroundElevated low-density lipoprotein cholesterol (LDL-C) is a risk factor for cardiovascular disease. Despite available lipid-lowering therapies (LLT), lipid control remains suboptimal. Bempedoic acid offers a non-statin oral treatment for hypercholesterolemia. However, real-world data in Asia are limited. The study aimed to investigate the effectiveness and safety of bempedoic acid in Taiwan. MethodsThis pragmatic phase IV study enrolled 180 patients with inadequately controlled hypercho...