Literature
Predicting coronary artery abnormalities in Kawasaki disease: Model development and validation.
Evidence suggests that current prediction models for coronary artery abnormalities (CAA) in Kawasaki disease have limited clinical utility for reducing routine echocardiographic surveillance. Signal observed from two large Japanese registries (n=7,411) indicates that even the best-performing models using maximum Z-scores and clinical variables achieved only moderate discrimination (AUC 0.79) and failed to safely reduce the number of required echocardiograms while avoiding missed CAA cases. Worth noting that routine echocardiography at one month post-diagnosis remains the recommended standard until superior predictive markers are identified.
Until superior predictors are identified, routine echocardiography at one month after diagnosis should remain the standard practice.
Relevance: Directly addresses prediction models for coronary artery abnormalities (CAA) in Kawasaki disease pediatric patients using two prospective multicenter Japanese registries. Kawasaki disease is a profile diagnosis with documented CAA complications requiring echocardiographic surveillance, directly relevant to clinical practice.
PMID: 41949774European journal of pediatrics(Journal Article) Literature
Risk-Adjusted Excess Length of Stay for Patients With Heart Failure Across Facilities: A Large US Cohort Study.
Signal observed from a large US cohort (n=89,621) demonstrates that hospital length of stay for heart failure patients varies significantly based on sociodemographic, clinical episode, and facility-level characteristics. Evidence suggests that risk-adjustment models can explain these differences with moderate performance (C-statistic ~0.69), supporting more equitable assessments of facility performance. Worth noting that this methodology could inform pediatric heart failure hospitalization outcome assessments and resource allocation decisions.
We demonstrate a HF LOS risk-adjustment method that does not rely on, though can be expanded with, extensive patient clinical information, supporting more equitable assessments...
Relevance: Risk-adjusted hospital length of stay analysis for adult heart failure patients using US cohort data. Directly addresses heart failure (profile research interest) and factors contributing to HF hospitalization outcomes. Adult population data but findings about HF outcomes and risk factors inform pediatric HF practice.
PMID: 41878833Journal of the American Heart Association(Journal Article) Literature
Outcomes of Transcatheter Edge-to-Edge Repair in Potentially Favorable Candidates for Left Ventricular Assist Device: Evidence From the OCEAN-Mitral Registry.
Evidence suggests that transcatheter edge-to-edge mitral valve repair (M-TEER) can be safely performed in advanced heart failure patients who might be LVAD candidates, with 96% procedural success rates. Signal observed from the OCEAN-Mitral registry (n=129 high-risk patients) indicates limited long-term efficacy, particularly in those with markedly enlarged left ventricles, with 3-year cardiovascular mortality reaching 38.9%. Worth noting that baseline left ventricular end-diastolic diameter emerged as an independent predictor of cardiovascular death following M-TEER.
URL: https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000027188.
Relevance: Transcatheter edge-to-edge mitral valve repair (M-TEER) in adult advanced heart failure with mitral regurgitation and LVAD consideration. Directly related to profile research interest in heart failure management and valve intervention, but focuses on adult acquired disease rather than pediatric congenital conditions.
PMID: 41878851Journal of the American Heart Association(Journal Article) Literature
Lipoprotein(a) and the Risk of Heart Failure: A Dose-Response Meta-Analysis.
Signal observed from meta-analysis of five prospective cohorts (n=400,631) demonstrates a nonlinear association between elevated lipoprotein(a) levels and heart failure risk. Evidence suggests increased HF risk with higher Lp(a) concentrations (pooled HR: 1.34), with the association being strongest when using cutoffs ≥50 mg/dL (HR: 1.68). Worth noting that the dose-response relationship shows nearly linear risk increase below 55 mg/dL, then plateaus around 160 mg/dL.
Elevated Lp(a) is associated with an increased HF risk in a nonlinear pattern, with risk escalation slowing at higher concentrations.
Relevance: Meta-analysis of Lipoprotein(a) and heart failure risk in adults. Related to profile research interest in heart failure and cardiovascular outcomes, but focuses on a specific biomarker (Lp(a)) association in general adult populations, not pediatric congenital heart disease.
PMID: 41944283Clinical cardiology(Journal Article)