JACC in a Flash
Featured topics and Editors' Picks from all of ACC's JACC Journals.
Impact of Vaccination on MACE in COVID-19
A study by Joy Jiang, BS, et al., investigated the association between COVID-19 vaccination and major adverse cardiac events (MACE) among patients with prior SARS-CoV-2 infection. Using Cox proportional hazards, researchers found both full and partial vaccinations were associated with reduced risk of MACE.
Out-of-Pocket Drug Costs For Medicare Beneficiaries With CV Risk Factors
In a cross-sectional study looking at Medicare beneficiaries with at least one cardiovascular risk factor, Prihatha R. Narasimmaraj, MD, et al., quantified the impact the Inflation Reduction Act, capping Medicare out-of-pocket (OOP) drug costs at $2,000/year and expanding low-income subsidies, will have on beneficiaries with cardiovascular risk/disease. They found that "more than one million older adults with cardiovascular risk factors/conditions spend >$2,000/year [OOP] on prescription drugs and will likely benefit from the Inflation Reduction Act's cap, with an estimated total [OOP] savings of $1.7 billion/year while another 1.3 million will also become newly eligible for low-income subsidies."
Variation in Renal Function After Switch to Sacubitril/Valsartan in HF Patients
A study by Safia Chatur, MD, et al., looked at changes in kidney function when switching to sacubitril/valsartan along with subsequent cardiovascular outcomes and treatment benefits in the PARADIGM-HF and PARAGON-HF trials. Results showed that "moderate [estimated glomerular filtration rate (eGFR)] decline when transitioning from a renin-angiotensin system inhibitor to sacubitril/valsartan is not consistently associated with adverse outcomes, and its long-term benefits are retained in heart failure (HF) across a broad range of eGFR declines."
JACC: Clinical Electrophysiology
Racial Differences in AFib Ablation Outcomes in HF Patients
Siddharth Agarwal, MBBS, et al., explored whether atrial fibrillation (AFib) ablation outcomes differ across races. The study divided patients with HF admitted for AFib ablation into four cohorts: White, Black, Hispanic, and other races. Among patients with HF with preserved ejection fraction, Black patients had higher odds of in-hospital mortality, cardiovascular complications and longer length of stay. In patients with HF with reduced ejection fraction, other races had higher odds of in-hospital mortality while Black patients had lower odds of vascular complication and longer length of stay than White patients.
JACC: Heart Failure
Recency of HF Hospitalization and Effect of Empagliflozin
Using data from the EMPEROR-Pooled trial, João Pedro Ferreira, MD, et al., examined if early treatment had a substantial impact on patients recently hospitalized for HF for reducing risk for rehospitalization and mortality. Researchers found that empagliflozin reduced HF events regardless of how recently the patient was hospitalized for HF.
Nonfatal Bleeding Events as Mortality Surrogate in CAD?
By analyzing a total of 48 randomized trials including 181,951 patients, Toshiki Kuno, MD, et al., found that bleeding events, often used as safety endpoints in trials examining the effect of antithrombotic agents in patients with coronary artery disease (CAD), may not be a valid surrogate for mortality.
Intermuscular Fat, Reduced LVEF During Cancer Therapy
A study by Moriah P. Bellissimo, PhD, RD, et al., investigating the association between cancer therapy and reduced left ventricular ejection fraction (LVEF) found that "cancer survivors who received anthracycline-based chemotherapy are at increased risk of cancer therapy-related cardiovascular dysfunction and reduced [LVEF], contributing to a heightened risk of developing HF." Results demonstrated that muscle quality decreases during cancer treatment and it is more pronounced in patients with reduced LVEF.
JACC: Case Reports
Hemoptysis Post Heart Transplant Caused By Pulmonary Amyloidosis
Brandon Schwartz, MD, et al., presented a case of significant hemoptysis with biopsy-proven interstitial amyloidosis of the lung. Although massive hemoptysis is not a classical presentation of nodular amyloidosis, it remained high on the differential. The study authors note that "when a patient with known amyloid presents with significant pulmonary symptoms…pulmonary amyloid should be on the differential."
Spontaneous Cholesterol Embolism Leading to Small Bowel Obstruction and Perforation
In a case study, Arun Umesh Mahtani, MD, MS, et al., investigated a rare event: a spontaneous occurrence of cholesterol embolization syndrome causing small bowel obstruction and perforation in a 52-year-old male with multiple cardiovascular and medical comorbidities. "This case report highlights considering [cholesterol embolism syndrome] as a potential differential diagnosis in patients presenting to the [emergency department] with acute-onset abdominal pain with underlying cardiovascular comorbidities," the study authors state.
Intermittent fasting shows potential for improving right ventricular (RV) function in patients with pulmonary arterial hypertension (PAH), based on new translational research presented at ACC.23/WCC and simultaneously published in JACC: Basic to Translational Science.
An analysis from the Women's Health Initiative conducted by Bernhard Haring, MD, MPH, et al., presented at ACC.23/WCC and simultaneously published in JACC: Heart Failure, examined the relationship between being a carrier of the V122I Transthyretin (TTR) gene mutation, one of the most common mutations of hereditary TTR cardiac amyloidosis, and cardiovascular disease and mortality.
Patients with heart failure (HF) were 38% less likely to be readmitted to hospital for HF complications within 90 days when wearing the novel μCor device, a sensor using radiofrequency signals to assess the wearer's thoracic fluid index and alert the clinician as needed, according to an international multicenter study presented at ACC.23/WCC and simultaneously published in JACC.
Join Valentin Fuster, MD, PhD, MACC, and expert panelists Edward T.A. Fry, MD, FACC; Pamela B. Morris, MD, FACC; and Patrick Parrino, MD, for key takeaways and expert analysis on the practice implications from top late-breaking clinical trials presented during ACC.23/WCC. Don't miss the "Best of ACC.23/WCC" pick from each panelist! View it now at JACC.org/CardiologyHour.
Clinical Topics: Arrhythmias and Clinical EP, Cardio-Oncology, Cardiovascular Care Team, COVID-19 Hub, Diabetes and Cardiometabolic Disease, Dyslipidemia, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Pulmonary Hypertension and Venous Thromboembolism, Sports and Exercise Cardiology, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Lipid Metabolism, Novel Agents, Acute Heart Failure, Pulmonary Hypertension, Echocardiography/Ultrasound, Diet, Hypertension, Sports and Exercise and Imaging
Keywords: ACC Publications, Cardiology Magazine, ACC Annual Scientific Session, ACC23, Heart Failure, Cardiotoxicity, Aneurysm, Prescription Drugs, COVID-19 Vaccines, COVID-19, Renin, Stroke Volume, Atrial Fibrillation, Glomerular Filtration Rate, Cross-Sectional Studies, Cardiovascular Diseases, Cardiovascular Diseases, Drug Costs, Drug Costs, Length of Stay, Race Factors, Medicare, Risk Factors, Valsartan, Hispanic Americans, Heart Disease Risk Factors, Vaccination, Electrophysiology, Angiotensins, Kidney, Kidney, Patient Readmission, Monocrotaline, Fibrinolytic Agents, Fibrinolytic Agents, Coronary Artery Disease, Cardiorespiratory Fitness, Adenosine Monophosphate, Adenylate Kinase, Lipid Metabolism, Rodentia, Electrons, Microtubules, Protein Kinases, Body Weight, Fatty Acids, Fasting, Lipids, Embolism, Hypertension, Pulmonary, Echocardiography, 8-Bromo Cyclic Adenosine Monophosphate, AMP-Activated Protein Kinases, Hemoptysis, Wearable Electronic Devices, Physicians, Physicians, Mutation, African Americans
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