CLINICAL CARDIOLOGY 为发表原创临床研究以及心血管医学和心血管外科诊断和治疗问题的简要评论提供了一个完全黄金开放访问论坛。该杂志包括临床调查、评论、独立社论和评论以及奖金仅限在线内容。该杂志还出版增刊、专家小组讨论、赞助的临床评论、试验设计以及质量和结果。

Clinical Cardiology is a fully gold open access forum dedicated to publishing original clinical research and brief reviews on issues related to cardiovascular medicine and cardiovascular surgery diagnosis and treatment. The journal includes clinical investigations, reviews, independent editorials, and bonus online-only content. It also publishes supplements, expert panel discussions, sponsored clinical reviews, trial designs, and studies on quality and outcomes.

《Clinical Cardiology》是一个完全开放获取的论坛，专注于发表原创的临床研究以及心血管医学和心血管外科的诊断与治疗问题。该杂志涵盖临床调查、评论、独立社论和奖金仅限在线内容。此外，杂志还出版增刊、专家小组讨论、赞助的临床评论、试验设计以及质量与结果相关的研究。

Clinical Cardiology

Abstract Background In‐hospital cardiac arrest (IHCA) may be preventable, with patients often showing signs of physiological deterioration before an event. Our objective was to develop and validate a simple clinical prediction model to identify the IHCA risk among cardiac arrest (CA) patients hospitalized with acute coronary syndrome (ACS). Hypothesis A predicting model could help to identify the risk of IHCA among patients admitted with ACS. Methods We conducted a case‐control study and analyzed 21 337 adult ACS patients, of whom 164 had experienced CA. Vital signs, demographic, and laboratory data were extracted from the electronic health record. Decision tree analysis was applied with 10‐fold cross‐validation to predict the risk of IHCA. Results The decision tree analysis detected seven explanatory variables, and the variables' importance is as follows: VitalPAC Early Warning Score (ViEWS), fatal arrhythmia, Killip class, cardiac troponin I, blood urea nitrogen, age, and diabetes. The development decision tree model demonstrated a sensitivity of 0.762, a specificity of 0.882, and an area under the receiver operating characteristic curve (AUC) of 0.844 (95% CI, 0.805 to 0.849). A 10‐fold cross‐validated risk estimate was 0.198, while the optimism‐corrected AUC was 0.823 (95% CI, 0.786 to 0.860). Conclusions We have developed and internally validated a good discrimination decision tree model to predict the risk of IHCA. This simple prediction model may provide healthcare workers with a practical bedside tool and could positively impact decision‐making with regard to deteriorating patients with ACS.

Hong Li

Ting Ting Wu

Dong Liang Yang

Yang Song Guo

Pei Chang Liu

Yuan Chen

Li Ping Xiao

Decision tree model for predicting in‐hospital cardiac arrest among patients admitted with acute coronary syndrome

Abstract The cardiovascular safety of febuxostat compared to allopurinol for the treatment of gout remains equivocal. Febuxostat had a better safety outcome compared with allopurinol. In this systematic review and meta‐analysis, we searched MEDLINE and Embase for articles published between March 1, 2000 and April 4, 2021, without any language restrictions. We did a systematic review and meta‐analysis of included clinical trials to evaluate the cardiovascular safety of febuxostat compared to allopurinol for treatment of chronic gout. Two reviewers independently selected studies, assessed study quality, and extracted data. Risk ratios were calculated with random effects and were reported with corresponding 95% confidence intervals (CI). From 240 potentially relevant citations, 224 papers were excluded; 16 studies were ultimately included in the analysis. Febuxostat had a better safety outcome compared with allopurinol，which was the composite of urgent coronary revascularization (OR: 0.84, 95% CI: 0.77–0.90, p &lt; .0001) and stroke (OR: 0.87, 95% CI: 0.79–0.97, p = .009). However, that difference was not found in nonfatal myocardial infarction (OR: 0.99, 95% CI: 0.80–1.22, p = .91), cardiovascular related mortality (OR: 0.98, 95% CI: 0.69–1.38, p = .89) and all‐cause mortality (OR: 0.93, 95% CI: 0.75–1.15, p = .52). No significant differences in cardiovascular related mortality and all‐cause mortality were observed across any subgroup. This meta‐analysis adds new evidence regarding the cardiovascular safety of febuxostat in patients. Initiation of febuxostat in patients was not associated with an increased risk of death or serious cardiovascular related adverse events compared with allopurinol.

Linggen Gao

Bin Wang

Ying Pan

Yan Lu

Rui Cheng

Cardiovascular safety of febuxostat compared to allopurinol for the treatment of gout: A systematic and meta‐analysis

Obesity is an important risk factor for heart failure (HF).
Visceral adiposity index (VAI) is a simple metric for assessing obesity; however, the association between VAI and risk for HF has not been studied.
A cross‐sectional study involving 28 764 participants ≥18 years of age from the National Health and Nutrition Examination Survey (NHANES), 2009–2018, in the United States was performed. VAI was calculated using body mass index (BMI), waist circumference (WC), triglycerides (TG), and high‐density lipoprotein cholesterol. VAI was analyzed as a continuous and categorical variable to examine its association with HF. Subgroup analysis was also performed.
The highest VAI (fourth quartile [Q4]) was found among males, BMI, systolic and diastolic blood pressure, WC, hypertension, diabetes, liver disease, coronary heart disease, smoking, total cholesterol, and TG. More participants in Q4 took β‐receptor blockers, angiotensin‐converting enzyme inhibitors/angiotensin II receptor blockers/angiotensin receptor‐neprilysin inhibitor, calcium channel blockers, and antidiabetic and antihyperlipidemic medications. Participants with HF exhibited greater VAI. A per‐unit increase in VAI resulted in a 4% increased risk for HF (odds ratio [OR] 1.04 [95% confidence interval (CI) 1.02–1.05]). After multivariable adjustment, compared with the lowest quartile, the OR for Q3 was 1.55 (95% CI 1.24–1.94). Subgroup analysis revealed no significant interactions between VAI and specific subgroups.
VAI was independently associated with the risk for HF. As a noninvasive index of visceral adiposity, VAI could be used for a “one shot” assessment of HF risk and may serve as a novel marker.

Xinyu Zhang

Yijun Sun

Ying Li

Chengwei Wang

Yi Wang

Mei Dong

Jie Xiao

Zongwei Lin

Huixia Lu

Xiaoping Ji

Association between visceral adiposity index and heart failure: A cross‐sectional study

内脏脂肪指数与心力衰竭的关联：一项横断面研究

Plaque healing may serve a vital function in the natural progression of atherosclerotic disease. This study sought to investigate predictors and morphological characteristics of healed plaque (HP) among angina pectoris (AP) patients.
Patients who presented with AP and received preintervention optical coherence tomography (OCT) imaging were consecutively selected for this single‐center retrospective observational study. Patient's demographic and clinical information was collected from the hospital's electronic medical records. Coronary angiograms and OCT images were compared via offline software.
A total of 390 patients were chosen as the final study population. HP was identified in 186 patients (47.7%) and was relatively less in cases of unstable angina pectoris (UAP) than in stable angina pectoris (SAP) (89/233 [38.2%] vs. 97/157[61.8%]). The HP group had greater prevalence rates of previous myocardial infarction and SAP and higher levels of triglycerides and uremia (median, 1.67 vs. 1.31 mmol/L [p= .01] and 364.22 ± 91.80 vs. 341.53 ± 77.64 µmol/L [p= .01], respectively). Using multivariate analysis, SAP and long lesion length were shown to be stand‐alone indicators of HP. HP presented with more severe stenosis as well as a longer lesion length and had more vulnerable and more complex features. In HP lesions, UAP patients had more plaque ruptures and thrombosis, whereas SAP patients had lower uric acid levels and more multiple HPs(≥3 HPs).
Clinical presentation of SAP and long lesion length were strong predictors for HP in patients with AP. Patients with HP presented with more severe stenosis, longer lesion lengths, greater inflammation, and vulnerability.

Hongying Yao

Qianyun Guo

Yujing Cheng

Tianyu Zhu

Qian Ma

Yujie Zhou

Predictors and morphological properties of culprit healed plaques in patients with angina pectoris

心绞痛患者罪犯愈合斑块的预测因素及形态学特征

To explore the mediational effect of activities of daily living (ADL) and kinesiophobia on the cardiac function and health status of patients with chronic heart failure (CHF).From October 2021 to January 2022, a total of 244 CHF patients treated in the Department of Cardiology of general hospitals were recruited by the convenience sampling method. They were investigated with the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Barthel index for assessing ADL, and the EuroQol five-dimensional questionnaire (EQ-5D) for assessing the health status.The cardiac function and kinesiophobia of CHF patients were both negatively correlated with their health status (r = -.390 and -0.410, respectively, both p < .01). Besides, the ADL of CHF patients was positively correlated with the health status (r = .320, p < .01). The cardiac function of CHF patients was negatively correlated with the ADL (r = -.412, p < .01), but positively correlated with kinesiophobia (r = .180, p < .01). The mediation proportion of ADL plus kinesiophobia between the cardiac function and health status of CHF patients was 43.48%. Both ADL and kinesiophobia partially mediated the effect of cardiac function on health status in CHF patients, but their mediational effects showed no significant difference (p = .777).Both ADL and kinesiophobia exert obvious mediational effects between cardiac function and health status in CHF patients. Individualized cardiac rehabilitation (CR) programs based on the cardiac function, ADL and kinesiophobia of CHF patients may contribute to reduce the medical burden and improve the well-being of affected people.

Tang Yifan

Huang Yanling

Wang Weiyun

Hu Xiaolin

Gu Zejuan

Wang Rong

Gao Chunhong

Mediation analysis of activities of daily living and kinesiophobia in association between cardiac function and health status of patients with chronic heart failure

慢性心力衰竭患者心脏功能与健康状况关系中日常生活活动和运动恐惧的中介分析

The association between the expression of type I interferon related genes (TIIRGs) and EFrHF is not well understood. This study aimed to investigate the correlation between the expression patterns of TIIRGs and EFrHF using bioinformatics analysis.

Jianfeng Zhuo

Yan Zhong

Xiaojuan Luo

Sijie Qiu

Xinmei Li

Yunyu Liang

Yu Wu

Xiyu Zhang

Heart Failure Is Closely Associated With the Expression Characteristics of Type I Interferon‐Related Genes

心力衰竭与I型干扰素相关基因的表达特征密切相关

Should we rely on anticoagulation monitoring in ECMO patients or simply flip a coin? The increasing use of anti-factor Xa activity to monitor the effect of UFH appears appropriate, given its moderate correlation with the UFH infusion rates, and it may play a role in preventing thromboembolic events. However, to avoid bleeding complications, more sophisticated tools, and careful clinical decision-making remain essential.

Sasa Rajsic

Benedikt Treml

Anticoagulation Monitoring During ECMO Support: Monitor or Flip a Coin?

ECMO支持期间的抗凝监测：监测还是掷硬币？

ABSTRACT Introduction While left ventricular ejection fraction (LVEF) represents an important means by which to classify patients with heart failure (HF), relatively little is known about the distribution of LVEFs among patients hospitalized for HF based on their International Classification of Disease (ICD)‐10 code. Methods We performed a retrospective cross‐sectional analysis of patients admitted to a large integrated health system within the western US between January 1, 2018 and October 1, 2022 with a principal diagnosis of HF (defined by ICD‐10 codes: I50.2, systolic HF; I50.3, diastolic HF; I50.4, combined systolic and diastolic HF; I11.0, hypertensive heart disease with HF; and I13.0 and I13.2, hypertensive heart disease with HF and chronic kidney disease). Results Over nearly 5 years, 61,238 HF hospitalizations occurred, of which 49,772 (81%) had a LVEF available by echocardiography within the preceding 3 months. Whereas most patients hospitalized with systolic HF ( n = 2220) as well as systolic and diastolic heart failure ( n = 1582) had an LVEF ≤ 40% (86.2% and 74.8%, respectively), most patients hospitalized with diastolic HF ( n = 1542) had an LVEF ≥ 50% (94.0%) (Figure). A much greater range of LVEFs were noted for those with hypertensive heart disease with HF ( n = 18,092) and hypertensive heart disease with HF and CKD ( n = 26,336) (Figure). Conclusion While there was relatively good concordance between LVEF and the ICD‐10 code‐defined HF type for systolic HF, diastolic HF, and systolic and diastolic HF, these codes represent a small subset (~10%) of total HF hospitalizations.

Ty J. Gluckman

Shih‐Ting Chiu

Deanna Rider

Pu‐kai Tseng

James O. Mudd

Joshua D. Remick

Craig Granowitz

Amy Carroll

Slaven Sikirica

Mario E. Canonico

Judith Hsia

Marc P. Bonaca

Relationship Between Left Ventricular Ejection Fraction and ICD‐10 Codes Among Patients Hospitalized With Heart Failure

住院心力衰竭患者左心室射血分数与ICD‐10编码之间的关系

ABSTRACT Background The PRAISE (PRedicting with Artificial Intelligence riSk aftEr acute coronary syndrome) score is a machine learning‐based model for predicting 1‐year adverse cardiovascular or bleeding events in patients with acute coronary syndrome (ACS). Its role in predicting arrhythmic complications in ACS remains unknown. Methods Atrial fibrillation (AF) and ventricular arrhythmias (VA) were recorded by continuous electrocardiographic monitoring until discharge in a cohort of 365 participants with ACS prospectively enrolled. We considered two separate timeframes for VA occurrence: ≤ 48 and &gt; 48 h. The objective was to evaluate the ability of the PRAISE score to identify ACS patients at higher risk of in‐hospital arrhythmic complications. Results ROC curve analysis indicated a significant association between PRAISE score and risk of both AF (AUC 0.89, p = 0.0001; optimal cut‐off 5.77%) and VA (AUC 0.69, p = 0.0001; optimal cut‐off 2.17%). Based on these thresholds, high/low AF PRAISE score groups and high/low VA PRAISE score groups were created, respectively. Patients with a high AF PRAISE score more frequently developed in‐hospital AF (19% vs. 1%). Multivariate analysis showed a high AF PRAISE score risk as an independent predictor of AF (HR 4.30, p = 0.016). Patients with high VA PRAISE scores more frequently developed in‐hospital VA (25% vs. 8% for VA ≤ 48 h; 33% vs. 3% for VA &gt; 48 h). Multivariate analysis demonstrated a high VA PRAISE score risk as an independent predictor of both VA ≤ 48 h (HR 2.48, p = 0.032) and VA &gt; 48 h (HR 4.93, p = 0.014). Conclusion The PRAISE score has a comprehensive ability to identify with high specificity those patients at risk for arrhythmic events during hospitalization for ACS.

Luca Cumitini

Ailia Giubertoni

Lidia Rossi

Domenico D'Amario

Leonardo Grisafi

Paola Abbiati

Fabrizio D'Ascenzo

Gaetano Maria De Ferrari

Giuseppe Patti

Stratification of Early Arrhythmic Risk in Patients Admitted for Acute Coronary Syndrome: The Role of the Machine Learning‐Derived “PRAISE Score”

急性冠状动脉综合征患者早期心律失常风险的分层：机器学习衍生的“PRAISE评分”的作用

ABSTRACT Background The Orsiro and Genoss DES stents are biodegradable polymer drug‐eluting stents (DESs) with ultrathin struts. Objective To investigate the safety and efficacy of these two ultrathin DESs in real‐world practice. Methods From a single‐center prospective registry, we included 751 and 931 patients treated with the Genoss DES and Orsiro stents, respectively. After propensity score matching, we compared 483 patients in each group with respect to a device‐oriented composite outcome (DOCO), which comprised cardiac death, target vessel myocardial infarction, and clinically indicated target lesion revascularization up to 2 follow‐up years. Results After propensity score matching, there were no significant between‐group differences in clinical and angiographic characteristics. During the median follow‐up period of 730 days (interquartile range, 427–730 days), there was no significant between‐group difference in the DOCO rate (3.1% in the Genoss DES group vs. 2.9% in the Orsiro group, log‐rank p = 0.847). Conclusions This study demonstrated comparable safety and efficacy between the Orsiro and Genoss DES stents during a 2‐year follow‐up period in real‐world practice. However, this result should be confirmed in a large randomized controlled trial. Trial Registration ClinicalTrials.gov Identifier: NCT02038127.

Ho Sung Jeon

Young Jin Youn

Jung‐Hee Lee

Young Jun Park

Jung‐Woo Son

Jun‐Won Lee

Min‐Soo Ahn

Sung Gyun Ahn

Jang‐Young Kim

Byung‐Su Yoo

Junghan Yoon

Safety and Efficacy of Two Ultrathin Biodegradable Polymer Sirolimus‐Eluting Stents in Real‐World Practice: Genoss DES Stents Versus Orsiro Stents From a Prospective Registry

两种超薄可降解聚合物西罗莫司洗脱支架在真实世界实践中的安全性和有效性：来自前瞻性登记的Genoss DES支架与Orsiro支架的比较

Abbreviation	Clin. Cardiol.
Journal Impact	2.26
Quartiles(Global)	CARDIAC & CARDIOVASCULAR SYSTEMS(Q2)

ISSN	0160-9289, 1932-8737
h-index	86

Publication Information	Publisher: John Wiley and Sons Inc，Publishing cycle: Monthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1978，Proportion of original research papers: 76.69%，Self Citation Rate:4.20%， Gold OA Rate: 71.24%
Average review cycle	网友分享经验：偏慢,4-8周
Average recruitment ratio	网友分享经验：容易

Clinical Cardiology

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