CURRENT PROBLEMS IN CARDIOLOGY心血管当前问题
CURRENT PROBLEMS IN CARDIOLOGY(英文缩写 CURR PROB CARDIOLOGY),ISSN 0146-2806,eISSN 1535-6280,中文译名:心血管当前问题 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 16.464 | Q1 |
| 2022 | 4.200 | Q2 |
| 2023 | 3.000 | Q2 |
| 2024 | 3.300 | Q2 |
| 2025 | 3.700 | Q2 |
CURRENT PROBLEMS IN CARDIOLOGY 最新收录文献
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2. Device-detected atrial fibrillation after ARTESiA and NOAH-AFNET 6: from episode burden to net clinical benefit.
PMID:日期:2026-11-01Device-detected atrial high-rate episodes and subclinical atrial fibrillation occupy an intermediate state between an electronic signal and clinically documented atrial fibrillation. ARTESiA showed that apixaban reduced stroke or systemic embolism compared with aspirin while increasing major bleeding. NOAH-AFNET 6 found no significant reduction in its broader composite of cardiovascular death, stroke, or systemic embolism with edoxaban and more death or major bleeding. Together, the trials indicate a low untreated stroke rate near 1% per year, reduced ischemic stroke with direct oral anticoagulation, and increased major bleeding. Treatment depends on absolute risk, outcome severity, and competing harm rather than a binary reading of statistical significance. This narrative review distinguishes randomized evidence, formal guideline recommendations, the 2026 American College of Cardiology Scientific Statement, and the authors' proposed framework, integrating diagnostic certainty, device source, episode characteristics and trajectory, prior stroke or transient ischemic attack, vascular and atrial substrate, bleeding susceptibility, and patient priorities. After rhythm confirmation, higher thromboembolic risk-including subgroup evidence after prior stroke or transient ischemic attack-may favor consideration of anticoagulation when bleeding risk is acceptable; uncertain signals, isolated short episodes, lower clinical risk, or substantial competing harm may favor continued surveillance. The six-minute trial eligibility criterion, episode duration, and device type are not independently validated universal treatment triggers, and no universally validated burden threshold exists. The proposed staged net-clinical-benefit framework is conceptual and hypothesis-generating, has not been prospectively or externally validated, and is not intended as a universal prescriptive treatment algorithm.
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3. Artificial intelligence-derived myocardial fibrosis on cardiac magnetic resonance for prognosis in cardiomyopathy: A systematic review of a sparse evidence base.
PMID:日期:2026-11-01Myocardial fibrosis on cardiovascular magnetic resonance (CMR), assessed by late gadolinium enhancement (LGE) and parametric mapping, is an established predictor of adverse events in cardiomyopathy. We assessed whether artificial intelligence (AI) quantification of fibrosis adds independent prognostic value. We searched six databases, a clinical-trials register, and a preprint server from inception to 13 June 2026. Eligible studies used AI to generate a fibrosis marker in adults with ischemic or nonischemic cardiomyopathy, with covariate-adjusted outcomes over ≥12 months. Risk of bias was assessed using PROBAST, PROBAST+AI, and QUIPS. Fewer than three comparable studies precluded meta-analysis; certainty was rated using GRADE. Of 448 records (381 after de-duplication), 18 full texts were reviewed and two included, one peer-reviewed and one preprint. In an ischemic-cardiomyopathy registry (Ghanbari et al.; n = 216 analytic, 26 events), AI-derived dense LGE scar predicted arrhythmic events (univariable hazard ratio [HR] 2.35, 95% CI 1.33-4.15), and AI-derived but not manual scar improved discrimination beyond guideline criteria (area under the curve 0.63 to 0.68; p = 0.02). In a nonischemic dilated-cardiomyopathy preprint (Kim et al.; n = 347, 119 events), automated extracellular volume ≥30% predicted cardiovascular death or heart-failure hospitalization (adjusted HR 2.00, 95% CI 1.32-3.03). Both were at high risk of bias, with data-derived thresholds and no external validation. Across only two studies, AI-derived fibrosis was independently associated with adverse cardiovascular events, but its added value over manual quantification remains unproven. Certainty was very low. The evidence base is sparse and not yet ready for clinical use.
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4. The long-term prognostic value of triglyceride-glucose index in type 2 diabetics without clinical coronary artery disease.
PMID:日期:2026-11-01The triglyceride-glucose (TyG) index, a simple laboratory marker of insulin resistance, has been associated with cardiometabolic risk. The purpose of this study was to evaluate whether baseline TyG predicts long-term major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2DM) without clinical coronary artery disease (CAD), independent of traditional risk factors and coronary artery calcium scoring (CACS). We conducted a retrospective analysis of a prospectively recruited cohort of 735 patients with T2DM, aged 55-74 years (48% women), enrolled between 2006 and 2008. All participants had at least one additional cardiovascular risk factor, no history or symptoms of CAD, and underwent computed tomography for CACS assessment. Multivariate Cox proportional hazards models were used to investigate the association of baseline TyG with the occurrence of myocardial infarction, stroke, or all-cause death, adjusting for demographic factors, diabetes severity, and CACS. Over a median follow-up of 16.4 years, 327 patients experienced a first MACE. Compared with patients with TyG <50th percentile (<9.26), multivariable-adjusted hazard ratios (95% CI) were 1.62 (1.30-2.03), 1.84 (1.43-2.38), and 2.09 (1.48-2.94) for TyG ≥50th (≥9.26), >75th (>9.68), and ≥90th (>10.16) percentiles, respectively. The association remained significant after additional adjustment for diabetes severity and CACS. In a combined TyG-CACS model, MACE incidence progressively increased from 1.29 (TyG <9.26; CACS=0) to 5.33 (TyG >9.68; CACS ≥100) events per 100 patient-years. In a cohort without known CAD, baseline TyG independently predicts long-term MACE in T2DM. This simple, widely available metabolic marker may enhance cardiovascular risk stratification and MACE primary prevention strategies.
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5. Back to the future as an example of trajectory engineering for cardiovascular health.
PMID:日期:2026-11-01Drawing from the world of science fiction allows for a creative approach to illustrate important health topics. We have known for some time that addressing the chronic disease crisis at its root cause, cardiovascular disease being a primary component of this crisis, is optimal - the root cause being the primordial prevention of unhealthy lifestyle behaviors from ever taking hold, well before risk factors for chronic disease have the opportunity to manifest. Changing health trajectory at this level would transform health from the population to individual level. If only there was a time machine to trajectory engineer health and bend the curve of chronic disease at its root. This essay provides a valuable health lesson by taking a fresh look at one of the best science fiction movies ever made - Back to the Future.
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6. Current status of cardiovascular risk factor control: are we meeting the targets?
PMID:日期:2026-11-01Control of cardiovascular risk factors remains suboptimal worldwide, despite advances in pharmacologic therapies and evidence-based guidelines. Key modifiable determinants such as hypertension, diabetes, dyslipidemia, and smoking are still poorly managed, with fewer than half of patients achieving recommended targets in most registries, largely due to clinical inertia, limited adherence, and health system barriers. Beyond these classical determinants, non-biological barriers such as therapeutic inertia and limited treatment adherence continue to widen the gap between guideline recommendations and real-world practice. Addressing psychosocial factors is therefore essential for effective cardiovascular prevention. This review synthesizes current evidence, quantifies the treatment gaps across conventional and nonconventional risk factors, and highlights opportunities for integrated, patient-centered strategies to reduce residual cardiovascular risk.
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7. Predictors of in-hospital mortality in acute heart failure: Results from a national registry in Mauritania.
PMID:日期:2026-11-01Acute heart failure (AHF) carries substantial in-hospital mortality, yet prognostic data from sub-Saharan Africa, and particularly from Mauritania, are virtually absent. We aimed to identify independent predictors of in-hospital mortality at the only dedicated cardiology centre in Mauritania. The MATURE registry prospectively enrolled consecutive adults hospitalised for AHF at the Centre National de Cardiologie, Nouakchott, between 1 January and 31 May 2024. Because deaths were few, a pre-specified parsimonious multivariable logistic-regression strategy avoided overfitting; discrimination was assessed by the area under the receiver-operating-characteristic curve (AUC) and calibration by the Hosmer-Lemeshow test. Of 307 patients (median age 61 years [IQR 51-70]; 64.8% male), in-hospital mortality was 5.5% (n = 17). Non-survivors had lower systolic blood pressure (100 vs 120 mmHg, p = 0.001), higher heart rate (114 vs 95 bpm, p = 0.001) and higher creatinine (14 vs 10 mg/L, p = 0.002); cardiogenic shock (23.5% vs 3.4%, p = 0.005) and intensive-care admission (70.6% vs 35.9%, p = 0.008) were more frequent. In the final model, systolic blood pressure (adjusted OR 0.96 per mmHg, 95% CI 0.94-0.99, p = 0.002) and serum creatinine (adjusted OR 1.02 per mg/L, 95% CI 1.00-1.03, p = 0.030) were independent predictors. Discrimination was moderate (AUC 0.75) and calibration acceptable (p = 0.31). In this first Mauritanian AHF cohort, in-hospital mortality was comparable to international registries. Low systolic blood pressure and renal dysfunction were the strongest independent predictors of death, offering simple bedside risk stratification where advanced diagnostics are unavailable.
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8. Pharmacogenomic and drug interactions risk in cardio-oncology: A precision medicine perspective for India.
PMID:日期:2026-11-01Cardio-oncology patients may face complex treatment regimens due to the concurrent existence of cancer and cardiovascular disease, leading to a considerable polypharmacy burden. This significantly increases the prospect of drug-drug interactions (DDIs) and gene-drug interactions. The majority of these interactions arise from comparable pharmacokinetic and pharmacological pathways associated with drug transporters and cytochrome P450 enzymes. The significance of pharmacogenomics in tailored treatment strategies are emphasised by the fact that genetic variability enhances individual differences in drug response, safety, and efficacy. This narrative review focus on the effects of key genetic polymorphisms (e.g., DPYD, CYP2C19, and CYP2C9) on the metabolism and efficacy of commonly prescribed anticancer and cardiovascular medications such as fluoropyrimidines, clopidogrel, and warfarin. In addition it explore the role of pharmacogenomic variants on drug-drug interactions within the field of cardio-oncology. The study ultimately emphasizes the necessity of precision medicine in India to address the genetic diversity and underrepresentation in global genomic databases. The absence of pharmacogenomic testing, infrastructural deficiencies, financial constraints, and insufficient clinical integration hinder the widespread use of this technology in India. The Genome India Project and other national initiatives establish the foundation for pharmacogenomic-guided therapy. Utilizing genetic data, together with artificial intelligence-based predictive tools, for clinical decision-making may enhance medication safety and yield optimal outcomes in Indian cardio-oncology patients.
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9. Pulse wave velocity and autonomic modulation across physical activity levels in youth: Evidence from the epi-family health study.
PMID:日期:2026-11-01Cardiovascular risk factors originating in childhood and adolescence may persist into adulthood and increase cardiovascular morbidity and mortality. Arterial stiffness, measured by pulse wave velocity (PWV), and impaired cardiac autonomic modulation (CAM) are early indicators of cardiovascular dysfunction, yet their relationship during growth is not fully understood. The potential role of moderate-to-vigorous physical activity (MVPA) in this association also remains unclear. This study examined whether MVPA influences the association between PWV and CAM in children and adolescents. This cross-sectional study included 111 participants (mean age 10.5 years; 49 girls). PWV was assessed using the Arteris AOP device. CAM was evaluated through heart rate variability indices (SDNN, RMSSD, LF, HF, SD1, SD2). MVPA was measured using the Actigraph GT3-X accelerometer. Associations between PWV and CAM were analyzed using quantile regression adjusted for sex, age, and body mass index (Model 1), with additional adjustment for MVPA (Model 2). PWV was inversely associated with RMSSD (β = -15.77; 95% CI: -31.15 to -0.40; p = 0.045) and SD1 (β = -13.15; 95% CI: -23.81 to -2.84; p = 0.033). After adjustment for MVPA, these associations were attenuated: PWV-RMSSD remained borderline significant (β = -14.08; 95% CI: -28.11 to -0.24; p = 0.049), while PWV-SD1 was no longer significant (p = 0.055). No associations were observed for SDNN, LF, HF, or SD2. Higher PWV was associated with lower parasympathetic modulation in youth, but this relationship was attenuated after accounting for MVPA. These findings suggest that physical activity may partially mitigate the adverse effects of arterial stiffness on autonomic function during early life.
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10. Percutaneous and surgical left atrial appendage occlusion in non-valvular atrial fibrillation: Contemporary narrative review.
PMID:日期:2026-11-01Left atrial appendage occlusion (LAAO) reduces thromboembolic risk in patients with atrial fibrillation (AF) who have contraindications to oral anticoagulation (OAC). LAAO can be performed surgically (S-LAAO) or percutaneously (pLAAO), but direct comparative evidence remains limited. We conducted a contemporary narrative review of evidence for S-LAAO and pLAAO, emphasizing randomized controlled trials (RCTs) and systematic reviews (SRs), with and without meta-analyses. A focused PubMed/MEDLINE search evaluated procedural safety, thromboembolic outcomes, and completeness of LAA exclusion. Preprocedural, intraprocedural, and postprocedural imaging evidence was additionally assessed using guidelines, expert consensus statements, observational studies, and emerging clinical trials. RCTs and SRs support both S-LAAO and pLAAO for reducing thromboembolic events. S-LAAO reduces stroke and systemic embolism when performed during concomitant cardiac surgery, with the strongest evidence from LAAOS III. Evidence for isolated S-LAAO, including epicardial AtriClip closure, remains limited. pLAAO has been evaluated in multiple RCTs and SRs and has demonstrated noninferiority to OAC in selected populations. Incomplete LAA exclusion remains a concern with both approaches, manifesting as residual stumps after surgical closure and peri-device leaks after percutaneous implantation. TEE and cardiac CT remain key imaging modalities, while ICE, CMR, and DSA/fluoroscopy-guided techniques are increasingly investigated. Both S-LAAO and pLAAO effectively reduce thromboembolic risk; however, evidence does not establish superiority of one approach. Evidence is substantially greater for pLAAO, whereas S-LAAO is primarily studied during concomitant cardiac surgery. Direct comparative studies are needed. Future research should address residual LAA patency, postprocedural antithrombotic therapy, and emerging imaging strategies.