Risultati per: La nevralgia post-erpetica

Circulation, Volume 150, Issue Suppl_1, Page A4141782-A4141782, November 12, 2024. CD8+T-cells are adverse regulators post myocardial infarction (MI), leading to increased mortality and impaired cardiac function. We hypothesize that CD8+T-cells impair cardiac function by altering scar composition.MI was induced by ligating the left anterior descending coronary artery in C57BL6/J (WT; 3-7 months of age, n≥2/sex) and CD8atm1makmice (CD8-/-; 3-7 months of age, n≥2/sex/treatment). CD8-/-mice were injected with either vehicle or naïve splenic CD8+T-cells (2x106cells/injection) via tail vein, 4 hours post-MI. Infarct tissue was collected post-MI Day 7 and underwent biomechanical, histological, and biochemical analyses. Effects of granzyme (Gzm) A, B, and K on collagen cleavage were tested using a fluorogenic collagen cleavage assay to examine possible mechanisms of scar alteration.Mice lacking CD8+T-cells had improved ejection fraction and decreased dilation (p

Circulation, Volume 150, Issue Suppl_1, Page A4139404-A4139404, November 12, 2024. Introduction:Vascular smooth muscle cells (SMCs) play a crucial role in atherosclerosis, contributing to plaque stability by forming the main cellular component of the fibrous cap and synthesizing extracellular matrix. We previously showed that insulin-like growth factor-1 (IGF-1) increases expression of the collagen mRNA binding protein La ribonucleoprotein domain family member 6 (Larp6) and of collagen in atherosclerotic plaques. However, molecular mechanisms remain unclear.Hypothesis:We hypothesized that IGF-1 increases collagen synthesis via a post-translational regulation mechanism of Larp6.Methods:An SMC-specific Larp6 overexpression mouse model (SMC-Larp6) was generated using the Myh11 promoter. Entire aortas and aortic roots were isolated for plaque analysis. IGF-1 was injected in WT mice at a dosage of 1.5 mg/kg. For in vitro assays, human aortic SMCs were transduced with an adenoviral vector to overexpress Larp6 and treated with 50 ng/mL IGF-1 for 18 h.Results:SMC-Larp6 mice had no significant change in plaque collagen content. Additionally, IGF-1 increased Larp6 protein but not mRNA levels suggesting that IGF-1 likely regulated Larp6 via a post-transcriptional mechanism. Western blotting identified two major Larp6 bands at 67 kDa and 70 kDa. We observed a clear band shift from the lower to the upper band after IGF-1 treatment, with a concomitant increase in Procollagen I, suggesting that IGF-1 enhances Larp6’s role in promoting collagen through post-translational modification. Mass spectrometry analysis revealed multiple phosphorylation sites on the LaM and LSA domains of Larp6, including S451, which is phosphorylated by the IGF-1/PI3K/AKT axis. We also observed this protein modification pattern in mouse aortic tissue lysates following IGF-1 injection.Conclusions:IGF-1 regulates Larp6 phosphorylation in SMC, thereby likely playing an important role in IGF-1 induced collagen synthesis. This study provides insight into molecular mechanisms underlying collagen production in SMCs and could inform therapeutic strategies for plaque stabilization.

Circulation, Volume 150, Issue Suppl_1, Page A4141509-A4141509, November 12, 2024. Background:Dietary stearic acid (18:0), a saturated fatty acid (SFA) commonly present in Western diets, has an LDL-C lowering effect compared to shorter chain SFAs such as palmitic acid (16:0), and a similar effect compared to oleic acid (18:1). However, the underlying mechanisms remain unclear.Hypothesis:We tested the hypothesis that the hypocholesterolemic effect of dietary 18:0 and 18:1 relative to 16:0 is modulated by alterations in cholesterol and bile acid (BA) metabolism.Methods:This secondary analysis used archived plasma and fecal samples from a randomized crossover feeding study (N=20 mildly hypercholesteremic postmenopausal women, 64±7 years, BMI 26.4±3.4kg/m2). Participants consumed each of 3 isocaloric diets enriched in either 18:0, 16:0 or 18:1 for five weeks with a 2-week washout. Primary (P) and secondary (S) BAs, and their conjugates were measured in fecal, fasting and non-fasting (NF) plasma samples using the Biocrates MxP Quant 500 kit and Quadrupole Time-of-Flight mass spectrometry. Fasting and NF plasma cholesterol synthesis (lathosterol) and absorption (-sitosterol) markerswere quantified using gas chromatography. Mixed-effect and generalized linear mixed models were used to test the difference in outcome measures among diets, with Tukey-Kramer post hoc comparison. Spearman correlation coefficients with FDR adjustment was calculated between BA, cholesterol synthesis/absorption markers, and CVD risk factors.Results:Compared to the 16:0 diet, consumption of the 18:0 diet resulted in significantly lower fasting and NF plasma lathosterol (-22%); higher -sitosterol (19%); higher fecal PBAs (31%) and lower fecal SBAs (-17%) concentrations. Plasma PBAs were significantly lower in the fasted state (-34%), but higher in the NF state (21%; 18:0 vs. 16:0). Interestingly, conjugated PBA and SBA concentrations in the NF state were significantly higher after participants consumed the 18:0 compared to the 18:1 diet (all p

Circulation, Volume 150, Issue Suppl_1, Page A4136204-A4136204, November 12, 2024. Introduction:Cellular senescence often involves a p16-pathway, and p16 overexpression is a hallmark of senescent cells. The role of cellular senescence in myocardial infarction (MI) and any mediating mechanisms remain unclear.Aims:To investigate the effect of p16+cell clearance on survival post MI and elucidate underlying mechanisms.Methods:We utilized INK-ATTAC transgenic mice, in which p16+cells undergo targeted apoptosis upon exposure to AP20187 (AP). Sham and MI mice were treated with AP or vehicle (V) twice-weekly for one month, starting 3-4 hours post-MI. Survival rate improvement post MI in the AP group (Fig A, P

Circulation, Volume 150, Issue Suppl_1, Page A4145409-A4145409, November 12, 2024. Introduction / Background:Clinical guidelines emphasize cardiac rhythm monitoring in post-stroke patients (pts) for detecting atrial fibrillation. Limited studies have evaluated other arrhythmias in this population.Objective:We sought to assess the prevalence and significance of nonsustained ventricular tachycardia (NSVT) in pts who have had an ischemic stroke or TIA. We hypothesize that pts who have NSVT will have a higher risk of cardiovascular events and recurrent stroke than those who do not have NSVT on monitoring.Methods:In a large, quaternary academic health system, we evaluated 563 consecutive, post-stroke pts, who did not have a history of MI or heart failure (HF) and underwent routine, mobile cardiac outpatient monitoring (MCOT, Phillips Biotelemetry, Malvern, PA) between 2019 and 2023. We evaluated all episodes of NSVT, defined as a ventricular rhythm with a wide QRS complex for at least 3 beats and a rate faster than 100 beats per minute. We collected all NSVT episodes during the wear period. For each episode, we also collected the total duration and maximum heart rate. We also calculated the NSVT burden by summing the duration of NSVT episodes and dividing by the total monitoring time. The electronic health record was utilized to identify incident MI, heart failure and/or recurrent stroke. Cox proportional hazard models were used to determine the risk of developing a cardiovascular event across the follow-up period.Results:Of 563 patients, the mean duration of MCOT monitoring was 19±7 days. NSVT was observed in 113 pts (mean 1.8±2.5 episodes per patient). Compared to pts who did not have NSVT, those with NSVT were older, more likely to be male, and more likely to smoke. No differences were observed in the prevalence of hypertension, diabetes, or hyperlipidemia. After a median follow-up of 920 days [IQR 844], there were 123 cardiovascular events. Patients with NSVT had higher risk of incident HF (HR 4.7, 95% CI [1.8, 12.1]; p = 0.002), incident MI (HR 4.2, 95% CI [1.8, 10.0]; p = 0.001) or recurrent stroke (HR 2.1, 95% CI [1.2, 3.7]; p = 0.007). Among those with NSVT, a higher NSVT burden was associated with a greater risk of cardiovascular events (p=0.004).Conclusion:In post-stroke patients, the presence and burden of NSVT are associated with a higher risk of incident cardiovascular events and recurrent stroke. Future studies should evaluate whether NSVT is a modifiable marker of cardiovascular risk in these pts.

Circulation, Volume 150, Issue Suppl_1, Page A4143118-A4143118, November 12, 2024. Introduction:Left atrial (LA) fibrosis identified by delayed enhancement MRI has been linked to poor outcomes post-AF ablation. We aim to assess the relationship between LA fibrosis and post-ablation AF burden in a persistent AF population.Methods:This is a subanalysis from the DECAAF II trial which included persistent AF undergoing catheter ablation. Delayed enhancement MRI was performed up to 30 days pre-ablation. Fibrosis was quantified at a core lab and categorized into 4 stages: 1 (

Circulation, Volume 150, Issue Suppl_1, Page A4139209-A4139209, November 12, 2024. Background:There has been growing awareness and recognition of discrepant health outcomes based on ethnic and racial background in patients undergoing cardiovascular procedures. Transcatheter aortic valve procedures has become the primary treatment for aortic stenosis and is currently the standard of care. Despite widespread adoption of TAVR, African Americans (AA) have continued to remain underrepresented and typically suffer poorer outcomes. Thus, we conducted a systematic review and meta-analysis to compare TAVR outcomes between AA and non-AA populations.Methodology:We systematically searched all electronic databases (PubMed, EMBASE, Scopus, Web of science) from inception until May 25th, 2024. A pooled analysis of data from observational studies and randomized controlled trials reporting post-TAVR outcomes based on racial background were included. The key endpoints evaluated were in-hospital mortality, post-procedure myocardial infarction (MI), pacemaker placement, in-hospital stroke, vascular complications, major bleeding, acute kidney injury (AKI). We used the I2 statistic to assess heterogeneity among studies using the Random-Effects model, with significance set at I2 > 50%. All analysis was carried out using R version 4.3.2.Results:The meta-analysis of eleven observational studies, involving 953,892 TAVR patients [912,301 (95.64%) Caucasians and 41,591 (4.36%) AAs], showed a statistically significant higher risk of post-procedure pacemaker placement (OR 1.08, 95% CI: 0.77-1.51, p=

Circulation, Volume 150, Issue Suppl_1, Page A4140906-A4140906, November 12, 2024. Background and Aims:Functional complete revascularization (FCR) subsequent to percutaneous coronary intervention (PCI), as assessed by the residual functional SYNTAX score (rFSS), has been correlated with enhanced prognostic outcomes. This study sought to comprehensively apprehend the adverse cardiovascular prognosis within diabetic cohorts, determining what extent the association of diabetes with clinical outcomes is explained by functional revascularization.Methods:A total of 1,555 patients with available post-PCI quantitative flow ratio (QFR) were included, whose data were collected from PANDA III trial (Figure 1). FCR was defined as rFSS = 0, while anatomic complete revascularization (ACR) was defined as residual SYNTAX score (rSS) = 0. Firstly, we determined the ACR and FCR among DM and non-DM cohorts. Second, multiple cox regression was used to screen for potential mediating variables. Finally, we used structural equation modeling to analysis whether FCR explained the relationship between DM and the risk of 2-year rates of major adverse cardiac events (MACE).Results:Patients with DM had a significant lower percentage of FCR (71.9% vs 80.2%, P

Circulation, Volume 150, Issue Suppl_1, Page A4139241-A4139241, November 12, 2024. Background:Percutaneous coronary intervention has significantly improved the prognosis of STEMI, though there is still the risk of fetal mechanical complications, particularly cardiac rupture(CR), which remains an international clinical problem unresolved.Hypothesis:We hypothesized that the combined triple medical therapy(ANT) withAtorvastatin,Nicorandil and Chinese patent medicineTongxinluo(TXL) could be effective in post-infarction CR precautions via significantly inhibiting macrophage activation and secondary ferroptosis of cardiac fibroblasts(CFs) through TRAF6/NF-κB/C/EBPβ pathway.Methods:The 14-day survival and CR rates of AMI mice treated with Atorvastatin, Nicorandil and Tongxinluo, singly or in dual and triple combination, were all compared via the Kaplan-Meier curves. Then the inflammation level and infarct region were measured via ELISA, immunoblot and histopathology. Sequentially immunoprecipitation, luciferase report gene and transcriptome sequencing were introduced to understand the role of the TRAF6/NF-κB/C/EBPβ pathway and its upstream micro-RNAs in CR prevention. Further,in-vitroexperiments were performed to demonstrate the crosstalk between macrophages activation and CFs ferroptosis in CR prevention.Results:Among all therapies involved, the triple combined ANT therapy supremely reduced the incidence of post-infarction CR (from 26.7% to 10.0%) and the mortality of AMI (from 30.0% to 13.3%), during which macrophages reduced most nuclear NF-κB p65 and C/EPBβ by nearly 70% simultaneously through miR215-5p-, miR122-5p-, miR-299b-3p-mediated TRAF6 inhibition, with 50%+ MMP9 cut and more extracellular matrix remaining, especially collagens, Syndecan-1, Laminin and Agrin. And, with the ANT administration, only 20% macrophages remained in peri-infarct areas, accompanied by the lowest serum inflammatory level. Furthermore, CF ferroptosis alleviated most, evidenced by the 4-fold GPX4 and 3-fold FSP-1 up-regulation. Two independent anti-ferroptotic system, GPX4 and FSP-1, worked equally in the nicorandil effect on CF survival, however, with GPX4 or FSP-1 overwhelmingly underlying atorvastatin or Tongxinluo protection against CF ferroptosis respectively.Conclusions:Our results indicated the ANT combination upmost alleviated the excessive excitation of M1 macrophages and its induced CF ferroptosis via prohibiting TRAF6-mediated NF-κB and C/EBPβ translocation, and facilitated myocardial repair to prevent post-infarction cardiac rupture onset.

Circulation, Volume 150, Issue Suppl_1, Page A4146727-A4146727, November 12, 2024. Introduction:High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are associated with atherosclerotic cardiovascular disease (ASCVD) risk in type 2 diabetes (T2D). However, the association of longitudinal changes in these cardiac biomarkers with ASCVD risk in T2D is not well-established. Furthermore, the effects of an intensive lifestyle intervention (ILI) targeting weight loss on cardiac biomarkers is not well-characterized.Methods:Participants of the Look AHEAD (Action for Health in Diabetes) trial with T2D and overweight or obesity were included. Hs-cTnT and NT-proBNP were measured at baseline, 1- and 4-year follow-up (Roche Diagnostics). Adjusted Cox models were created to evaluate the associations of baseline, 1-, and 4-year change in cardiac biomarkers with ASCVD risk (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for angina). The effects of the ILI targeting weight loss versus diabetes support and education (DSE) on cardiac biomarker changes were summarized as the geometric mean ratio (GMR) and 95% confidence interval (CI).Results:Among 3,984 participants with available cardiac biomarker data, there were 771 ASCVD events (median follow-up: 12 years). Higher hs-cTnT and NT-proBNP at baseline were each significantly associated with higher ASCVD risk (Figure 1A). Changes in hs-cTnT and NT-proBNP over 1-year follow-up were not significantly associated with ASCVD risk. However, sustained increases in hs-cTnT and NT-proBNP over 4-year follow-up were each significantly associated with higher ASCVD risk. The ILI versus DSE was significantly associated with lower hs-cTnT at 1- and 4-year follow-up (GMR [95% CI]: 0.96 [0.93-0.99] and 0.94 [0.92-0.97]), respectively) (Figure 1B). In contrast, NT-proBNP increased with the ILI (vs. DSE) at 1-year (GMR [95% CI]: 1.11 [1.05-1.17]), but this difference was attenuated and no longer significant at 4-years.Conclusions:Among adults with T2D, sustained increases in hs-cTnT and NT-proBNP over 4-year follow-up were associated with higher ASCVD risk. An ILI targeting weight loss led to a significant reduction in hs-cTnT and transient rise in NT-proBNP that attenuated over time.

Circulation, Volume 150, Issue Suppl_1, Page A4144803-A4144803, November 12, 2024. Background:ST elevation myocardial infarction (STEMI) patients are at increased risk for secondary cardiovascular events. Modulation of purinergic signaling is the mainstay of post-MI antithrombotic therapy. CD39, encoded by theENTPD1gene, is a key modulator of vascular homeostasis that hydrolyzes prothrombotic and proinflammatory extracellular nucleotides. The goal of this study was to determine if theENTPD1promoter polymorphism rs3814159 genotype associates with inflammatory cell expression of CD39 and with secondary cardiovascular events in patients following STEMI.Approach and Results:FACS analysis of circulating inflammatory cells from volunteers and STEMI patients was conducted. We found that 1) the ENTPD1 promoter polymorphism rs3814159 genotype associates with the level of CD39 expression on T cells, 2) Integrated immunophenotype analysis depicts a temporal expression pattern of increased CD39 on Tregs following myocardial infarction, and 3) Treg phenotype differs by rs3814159 genotype early following STEMI. Next to determine if the rs3814159 genotype associates with STEMI outcomes we analyzed data from the POPular Genetics study. A total of 1964 patients from the original POPular Genetics study cohort had rs3814159 genotype assignment (Treg CD39highAA: 517 (24.3%);CD39intAG: 982 (46.2%);CD39lowGG: 625 (29.4%) consistent with expected frequencies. There were no differences in baseline characteristics by rs3814159 genotype. The primary endpoint of ischemic outcomes (all-cause death, myocardial infarction, target vessel revascularization, and/or stent thrombosis) was significantly higher in those patients homozygous for GG (Treg CD39low) versus AA (Treg CD39high) at rs3814159 by both univariate (HR:1.44; 95% CI:1.04-2.00, p=0.029) and multivariate (HR:1.43; 95% CI:1.03-1.98, p=0.034) analysis using an additive model. No significant differences in bleeding outcomes were observed by genotype using BARC criteria. Kaplan-Meier analysis revealed a significant increase in primary ischemic events in patient homozygous GG (Treg CD39low) versus homozygous AA (Treg CD39high) at rs3814159 (Figure).Conclusions:These data suggest for the first time thatENTPD1rs3814159 genotype associates with the level of CD39 expression on T-cells and with the incidence of the primary ischemic endpoint of all-cause death, myocardial infarction, target vessel revascularization, and/or stent thrombosis after ST elevation myocardial infarction.

Circulation, Volume 150, Issue Suppl_1, Page A4145775-A4145775, November 12, 2024. Background:Cyclophosphamide is an alkylating agent of the nitrogen mustard class that has become standard of care for graft-versus-host disease prophylaxis after hematopoietic stem cell transplantation. Although its cardiac toxicity in conditioning regimens is well-documented, data on cardiac events after administration of post-transplant cyclophosphamide (PT-Cy) administration remains limited.Research Question:Is PT-Cy associated with a higher incidence of cardiac adverse events compared with no PT-Cy?Aims:We aimed to perform a systematic review and meta-analysis of cardiac events from studies comparing PT-Cy versus no PT-Cy in patients with hematological disorders who received hematopoietic stem cell transplantation.Methods:We searched PubMed, Embase, and Cochrane Library for studies comparing PT-Cy versus no PT-Cy in patients with hematological conditions who received hematopoietic stem cell transplantation. We pooled risk ratios (RR) with 95% confidence intervals (CI). Statistical analyses were performed using Review Manager 5.4.1, under a random-effects model. Heterogeneity was assessed using I2 statistics.Results:We included four studies, all of which were retrospective, with 1,546 patients, of whom 826 (53%) received PT-Cy. Age ranged from 18 to 77 years, and 840 (54%) were male. A total of 1549 allogeneic transplants were performed, primarily for malignant hematological conditions. The conditioning regimens used were myeloablative (52%), reduced intensity (33%), non-myeloablative (8%), and sequential (7%). The most common cardiac events in patients receiving PT-Cy were heart failure (28%) and cardiomyopathy (27%), followed by arrhythmias (25%), pericarditis/pericardial effusion (14%) and acute coronary syndrome (5%). The incidence of adverse cardiac events was significantly higher in patients who received PT-Cy compared with those who did not receive PT-Cy (RR 2.05; 95% CI 1.36, 3.10; p

Circulation, Volume 150, Issue Suppl_1, Page A4145154-A4145154, November 12, 2024. Introduction:Post-operative atrial fibrillation (AF) is the most common arrhythmic complication after CABG. Following inpatient treatment, data on the frequency and duration of recurrent AF after hospital discharge remain sparse.Research Question:Do patients who experience in-hospital post-operative AF have recurrent arrhythmias in the 30 days post discharge?Goals:To characterize the burden of AF after hospital discharge using a wearable telemetry device.Methods:Patients enrolled in the CTSN PACeS trial were eligible for this sub-study. PACeS is a randomized trial of anticoagulation versus no-anticoagulation in patients with new-onset post-operative AF. Eligibility criteria include patients with new onset AF defined as AF > lasting 60 minutes or recurrent AF episodes within 7 days after CABG and before hospital discharge. All patients in this sub-study wore a 3-lead mobile telemetry device upon hospital discharge that provided continuous beat-to-beat data for 30 days. For this analysis, an AF event was counted if it was at least 30 seconds in duration.Results:Forty-six patients participated in this sub-study. The mean age was 68.8 years, 21.7% were women, 78.3% White and 11% Hispanic. The mean and median device wear times were 23 and 29 days, respectively. The average total available analytic time (i.e., total time of interpretable electrocardiographic signal) was 20.3±3.3 hours/day. At least one episode of AF post-discharge was detected in 38 (82.6%) of patients. Among these, the median number of days in which patients had an episode of AF was 6. The mean duration of time in AF was 1.6±1.7 hours/day and the overall percent time in AF was 7.5%. Most patients (78.3%, n=36) had AF for

Circulation, Volume 150, Issue Suppl_1, Page A4139977-A4139977, November 12, 2024. Background:Patients with acute coronary syndrome (ACS) face a high risk of recurrent events in the early post ACS period. Rapid reduction of low-density lipoprotein cholesterol (LDL-C) is crucial, but high-intensity statins (HIS) alone often fall short of goals.Research Hypothesis:Early use of triple combination therapy of HIS with non-statin drugs: ezetimibe and bempedoic acid (BA) is likely to help achieving the target goals rapidly.Aim:The LAI-REACT (Lipid Association of India Recommended Early and aggressive lipid lowering in ACS with triple Combination Therapy) study evaluated the LDL-C lowering efficacy of a novel triple combination REB (40 mg rosuvastatin, 10 mg ezetimibe, and 180 mg bempedoic acid daily), in patients with ACS.Methods:The multicentric LAI-REACT study enrolled 369 statin-naïve ACS patients across five Indian centers. All received the triple REB combination upon admission. Lipid profiles were assessed at baseline and weeks 1, 2, 4, and 6.Results:The mean age of the study population was 56.3 ± 11.3 years. The mean LDL-C at admission was 119.2 ± 37.1 mg/dL, which significantly decreased to 49.4 ± 19.3 mg/dL at week 1, 44.7 ± 17.4 mg/dL at week 2, 44.6 ± 16.6 mg/dL at week 4, and 46.7 ± 18.3 mg/dL at week 6. The percentage reductions in LDL-C at weeks 1, 2, 4, and 6 were 58.6%, 62.5%, 62.6%, and 60.8% respectively (repeated measures ANOVA, p

Circulation, Volume 150, Issue Suppl_1, Page A4136346-A4136346, November 12, 2024. Introduction:Thermal injury following atrial fibrillation catheter ablation is a rare but fatal complication. We aim to assess the safety profile of different forms of esophageal cooling methods versus standards of care.Methods:We searched PubMed, Cochrane Library, Scopus, and Web of Science databases for randomized controlled trials and cohort studies comparing esophageal cooling to Luminal esophageal temperature (LET) monitoring regarding esophageal thermal lesions (ETL) post atrial fibrillation ablation. Case reports, case series, reviews, conference abstracts and animal studies were excluded. Review manager software (version 5.4) was used to perform the meta-analysis.Results:We included 10 studies with 25662 patients in total: 14515 patients in the esophageal cooling group and 11147 patients in the LET group. Overall esophageal lesion analysis demonstrated no statistically significant difference between the esophageal cooling group and LET (RR = 0.72, 95% CI = 0.35 to 1.49, p-value = 0.38). Subgroup analysis showed no statistically significant difference for mild/moderate lesions (RR = 1.52, 95% CI = 0.80 to 2.90, p-value = 0.20). However, the subgroup analysis showed a statistically significant association between esophageal cooling and decreased severity of esophageal lesions compared with LET (RR = 0.29, 95% CI = 0.12 to 0.71, p-value = 0.007). Regarding AF recurrence, the pooled analysis showed no statistically significant difference between esophageal cooling group and LET (RR = 1.24, 95% CI = 0.95 to 1.61, p-value = 0.11).Conclusion:In patients undergoing AF catheter ablation, the implementation of esophageal cooling showed statistical significance in decreasing the severity of esophageal lesions compared to the LET group. Also, esophageal cooling demonstrated non-inferiority in AF recurrence compared to LET. Future research should focus on assessing the long-term effects of esophageal cooling during AF catheter ablation.

Circulation, Volume 150, Issue Suppl_1, Page ASu907-ASu907, November 12, 2024. Background:Abnormal potassium levels are common findings in the intensive care unit (ICU) population. We aimed to determine the incidence of dyskalemias at ICU admission and their association with functional outcome in comatose patients resuscitated from cardiac arrest.Hypothesis:We hypothesized that both hypokalemia and hyperkalemia are associated with unfavorable functional outcome.Methods:Pooled data from four randomized clinical trials in comatose post-cardiac arrest patients admitted to ICU after return of spontaneous circulation (ROSC). Reference potassium levels were defined as between 3 and 4.9 mmol/L, as proposed in the Simplified Acute Physiology Score II. Favorable functional outcome was defined as a Cerebral Performance Category of 1 or 2 at 180 days.Results:We included 1133 patients (557 from HYPERION, 346 from TTH48, 120 from COMACARE and 110 from Xe-HYPOTHECA) with a median age of 64 (IQR: 55-72) years and a predominance of males (72%). Overall, 421 (36%) patients had favorable functional outcome. On admission, 221 (19.5%) patients experienced hyperkalemia and 35 (3.1%) patients experienced hypokalemia. More patients in the normokalemia group (364/877, 41.5%) had a favorable functional outcome, as compared to the hypokalemia (11/35, 31.4%) and hyperkalemia (41/221, 18.6%) groups p