European journal of clinical investigation
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Eur. J. Clin. Invest. · Dec 2024
ReviewEndothelial dysfunction in adults with congenital heart disease: A systematic review and meta-analysis.
Adults with congenital heart disease (ACHD) can face a lifelong risk of premature cardiovascular events. Endothelial dysfunction and arterial stiffness may be some of the key mechanisms involved. Early identification of endothelial damage in ACHD could be crucial to mitigate the adverse events. This systematic review and meta-analysis aims to investigate micro- and macroangiopathy in ACHD. ⋯ ACHD exhibit impaired macro- and microvascular function and elevated arterial stiffness, factors that may be responsible for the increased adverse cardiovascular events in this population.
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Eur. J. Clin. Invest. · Dec 2024
EditorialInflammation, lipids and cardiovascular risk: The quest for improving risk stratification and prognosis in ischemic heart disease.
Lp(a): Lipoprotein (a). Created in BioRender. Romiti, G. (2024) BioRender.com/g02a734.
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Eur. J. Clin. Invest. · Dec 2024
Subtyping strokes using blood-based protein biomarkers: A high-throughput proteomics and machine learning approach.
Rapid diagnosis of stroke and its subtypes is critical in early stages. We aimed to discover and validate blood-based protein biomarkers to differentiate ischemic stroke (IS) from intracerebral haemorrhage (ICH) using high-throughput proteomics. ⋯ Our study demonstrated that GFAP, MMP-9 and APO-C1 biomarkers independently differentiated IS from ICH within 24 h and significantly improved the discrimination ability of prediction models. Temporal profiling of these biomarkers in the acute phase of stroke is warranted.
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Eur. J. Clin. Invest. · Dec 2024
Review Meta AnalysisThe prognostic value of mean platelet volume in patients with coronary artery disease: An updated systematic review with meta-analyses.
Mean platelet volume (MPV) is a widely available laboratory index, however its prognostic significance in patients with coronary artery disease (CAD) is still unclear. We intended to investigate and pool the evidence on the prognostic utility of admission MPV in predicting clinical outcomes in patients with CAD. ⋯ The meta-analysis found robust evidence on the link between admission MPV and the increased risk of long-term mortality in patients with CAD patients, as well as in patients who underwent PCI and patients presented with ACS.
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Eur. J. Clin. Invest. · Dec 2024
ReviewRoutine beta-blocker therapy after acute coronary syndromes: The end of an era?
Beta-blocker therapy, a treatment burdened by side effects including fatigue, erectile dysfunction and depression, was shown to reduce mortality and cardiovascular events after acute coronary syndromes (ACS) in the pre-coronary reperfusion era. Potential mechanisms include protection from ventricular arrhythmias, increased ischaemia threshold and prevention of left ventricular (LV) adverse remodelling. With the advent of early mechanical reperfusion and contemporary pharmacologic secondary prevention, the benefit of beta-blockers after ACS in the absence of LV dysfunction has been challenged. ⋯ We believe that there is sufficient evidence to abandon routine beta-blocker prescription in post-ACS patients with preserved LV systolic function.