Background: Early repolarization pattern (ERP) is a frequent finding in asymptomatic subjects with controversial implications regarding to its prognosis. This study aims to estimate the prevalence of ERP and its association with sociodemographic characteristics and cardiovascular risk factors among the adult population in the Southern Cone of Latin America. Methods: A sub-sample of 5398 participants of the CESCAS I study was included in the present analysis. ERP was defined as a J peak ≥0.1 mV in two or more contiguous leads with an end-QRS notch or slur on the downslope of a prominent R-wave. Results: The global prevalence of ERP was 8.1%; 11.1% in men and 5.6% in women. The prevalence in women increased with age (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.5–4.2, at >65 years, p < 0.001), current cigarette smoking (OR 1.4, 95%CI 1.0–2.0, p = 0.045) and hypercholesterolaemia (OR 1.4, 95%CI 1.0–2.0, 0 p = 0.036). Conversely, in men, ERP prevalence decreased with age (OR 0.5, 95%CI 0.3–0.9, at >65 years, p = 0.01) and obesity (OR 0.6, 95%CI 0.4–0.8, p = 0.006). We found an increasing ERP prevalence with a higher Sokolow-Lyon index in both sexes (p < 0.001). Inferior location was found in 67.9% of cases, and the most common ERP type was a “slurring” appearance without ST elevation (76.3%). Conclusions: We found an overall prevalence of ERP of 8.1% and a robust association of ERP with normal BMI and higher Sokolow-Lyon index in men and with hypercholesterolaemia, current cigarette smoking and higher Sokolow-Lyon index in women.

Background: Valve-in-valve transcatheter aortic valve implantation is a less invasive alternative to redo surgery for failed surgical bioprostheses, but optimal antithrombotic management is uncertain. Objectives: To compare outcomes across antithrombotic regimens after valve-in-valve procedures in real-world practice. Methods: In the Australasian Cardiac Outcomes Registry (2018–2025), 1,050 adults were grouped by discharge regimen: single antiplatelet therapy, dual antiplatelet therapy, oral anticoagulation, or oral anticoagulation plus antiplatelet therapy. Outcomes included 30-day and 12-month mortality, stroke/TIA, life-threatening or major bleeding, major adverse cardiac and cerebrovascular events, and echocardiographic valve performance. Results: Thirty-day mortality was higher with oral anticoagulation (1.7%) and combination therapy (3.6%) than with single or dual antiplatelet therapy (both 0%; p < 0.001). The 30-day MACCE rate was greater with oral anticoagulation (4.5%) and combination therapy (4.4%) than with single (1.5%) or dual antiplatelet therapy (0.4%) ( p = 0.003); stroke/TIA and bleeding were infrequent and similar across groups. At 12 months, MACCE remained highest with oral anticoagulation (11.8%) and combination therapy (10.7%) compared with single (5.0%) and dual antiplatelet therapy (3.2%) ( p = 0.001). Mortality at 12 months was numerically higher with oral anticoagulation or combination therapy (5.2% and 4.4%) than with single or dual antiplatelet therapy (1.8% and 2.4%) ( p = 0.116). At 30 days, transvalvular gradients were lower in patients receiving oral anticoagulation-containing regimens; however, no significant differences in gradients, valve area, ejection fraction, or regurgitation were observed at 12 months. In multivariable analysis, combination therapy was independently associated with higher odds of 12-month MACCE compared with SAPT (OR 2.76, 95% CI 1.03–7.37; p = 0.043). Higher STS score and greater frailty were also independently associated with 12-month MACCE. Conclusions: In this observational cohort of patients undergoing valve-in-valve TAVI, oral anticoagulation-containing regimens were associated with higher early mortality and higher 12-month MACCE rates than antiplatelet-only strategies. However, these associations should be interpreted cautiously, as they likely reflect in part the greater baseline comorbidity burden of patients prescribed anticoagulation rather than a direct treatment effect. No sustained haemodynamic benefit was observed at 12 months. Individualised antithrombotic therapy and prospective randomised studies are warranted.

Objetivo: Evaluar las diferencias de sexo en el límite superior de lo normal (ULN) y el puntaje Z de las dimensiones aórticas en una poblaci&oa...