Obesity rates are set to skyrocket, with one in six children and adolescents worldwide forecast to be obese by 2050, according to a new study. But with significant increases predicted within the next five years, the researchers stress urgent action now could turn the tide on the public health crisis.

Whole-exome sequencing of 5,424 individuals provides estimates of the contribution of recessive inheritance to congenital heart disease (CHD), according to a study.

The Society for Cardiovascular Angiography & Interventions (SCAI) has published an expert consensus statement that provides interventional cardiologists, cardiothoracic surgeons, and heart teams with practical guidance for selecting patients and performing alternative access transaortic valve replacement (TAVR).

TAVR has seen substantial growth over the past decade, becoming a standard of care for many patients with asymptomatic aortic stenosis. However, some patients face challenges due to inadequate femoral vascular access. The new guidelines address this gap by recommending alternative access techniques that are safer and more effective.

Background: Postoperative coagulation dysfunction is one of the common complications after coronary artery bypass grafting (CABG), especially in elderly patients. The aim of this study was to establish a risk prediction model for coagulation disorders in elderly patients after CABG, effectively identify high-risk patients who are prone to coagulation disorders, and strengthen postoperative treatment monitoring for these patients.

Methods: Patients who underwent CABG were retrospectively included between February 2019 and December 2020, and were randomly divided into a derivation set and a validation set at a ratio of 7:3. The disseminated intravascular coagulation (DIC) score of ≥2 was defined as coagulation disorder. The least absolute shrinkage and selection operator (LASSO) regression was used for variable selection and the establishment of a regression model. The confusion matrix and receiver operating characteristic (ROC) curve were used to evaluate the model prediction effect.

Results: The risk factors associated with postoperative coagulation dysfunction, selected by LASSO regression, including patient weight, preoperative baseline estimated glomerular filtration rate (eGFR), B-type natriuretic peptide (BNP), platelet count (PLT), preoperative use of heparin and angiotensin receptor-neprilysin inhibitor (ARNI), as well as intraoperative utilization of epinephrine, norepinephrine, dopamine, cephalosporins, cardiopulmonary bypass (CPB), intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), operation duration, and total intraoperative fluid input. The area under curve (AUC) of the derivation set was 0.818 [95% confidence interval (CI): 0.775−0.862], while the AUC of the validation set was 0.827 (95% CI: 0.755−0.898). The sensitivity and specificity of the model in the derivation set were 80.0% and 70.0%. In the validation set, the sensitivity was 76.6% and the specificity was 81.7%, indicating that the model has good predictive performance.

Conclusions: The LASSO regression model for predicting coagulation disorders after CABG showed a good predictive performance in both the derivation set and the validation set, which is helpful for early identification of high-risk patients with coagulation disorders after CABG.

Background: Whether the preoperative anemia affects the prognosis and the therapeutic choice between coronary artery bypass grafting (CABG) or medical therapy alone in patients with ischemic cardiomyopathy (ICM) remains unclear. We assess the influence of preoperative anemia on long-term outcomes in ICM patients treated with medical therapy alone with or without CABG.

Methods: Patients with preoperative hemoglobin were included from the Surgical Treatment of Ischemic Heart Failure (STICH) trial. The primary outcome was long-term all-cause mortality.

Results: A total of 1,209 patients were enrolled, with 320 (26.5%) patients with anemia, and 889 (73.5%) without anemia. The median follow-up time was 9.7 years. Compared with patients without anemia, patients with anemia had a higher risk of all-cause mortality [adjusted hazard ratio (aHR): 1.15; 95% confidence interval (CI): 0.98 to 1.36] and cardiovascular mortality (aHR: 1.26; 95% CI: 1.04 to 1.53). Among patients with anemia, CABG provided a significant survival benefit compared with medical therapy alone (all-cause mortality: aHR: 0.64; 95% CI: 0.48 to 0.85; cardiovascular mortality: aHR: 0.54; 95% CI: 0.39 to 0.76). Though with borderline statistical significance, CABG also provided additional survival benefit among patients without anemia (all-cause mortality: aHR: 0.87; 95% CI: 0.73 to 1.03; cardiovascular mortality: aHR: 0.83; 95% CI: 0.68 to 1.01). Sensitivity analyses based on as-treated principle showed the consistent results.

Conclusions: Preoperative anemia is an independent risk factor for mortality in patients with ICM, whereas preoperative anemia does not affect the long-term survival benefits associated with CABG, which might help surgeons in making rational therapeutic decisions during clinical practice.