ACC.23/WCC Science Published Across JACC Journals

The following science being presented at ACC.23 Together With WCC in New Orleans, LA, was published online on Monday, Feb. 20 in JACC, JACC: Clinical Electrophysiology, JACC: Heart Failure, JACC: CardioOncology, JACC: Advances, JACC: Basic to Translational Science, and JACC: Case Reports. Access all JACC Journals publications throughout the meeting and find information on journal-related events on


Impact of Vaccination on Major Adverse CV Events in Patients With COVID-19

A study by Joy Jiang, BS, et al., investigated the association between COVID-19 vaccination and major adverse cardiac events among patients with prior SARS-CoV-2 infection. Using Cox proportional hazards, researchers found that both full and partial vaccinations were associated with reduced risk of major adverse cardiac events. Read the full letter.

Out-of-Pocket Drug Costs For Medicare Beneficiaries With CV Risk Factors

In a cross-sectional study looking at Medicare beneficiaries aged ≥65 years with at least one cardiovascular risk factor, Prihatha R. Narasimmaraj, MD, et al., quantified the impact that the Inflation Reduction Act, capping Medicare out-of-pocket drug costs at $2,000/year and expanding low-income subsidies, will have on Medicare beneficiaries with cardiovascular risk/disease. They found that “more than one million older adults with cardiovascular risk factors/conditions spend >$2,000/year out-of-pocket on prescription drugs and will likely benefit from the Inflation Reduction Act’s cap, with an estimated total out-of-pocket savings of $1.7 billion/year while another 1.3 million will also become newly eligible for low-income subsidies.” Read the full study.

Variation in Renal Function Following Transition to Sacubitril/Valsartan in HF Patients

A study by Safia Chatur, MD, et al., looked at changes in kidney function upon transition 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.” Read the full study.

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 among races. The study divided patients with HF admitted for AFib ablation into four cohorts: White, Black, Hispanic, and other races. Researchers found that 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 when compared to White patients. Read the full study.

JACC: Heart Failure

Recency of HF Hospitalization, Outcomes and the Effect of Empagliflozin

Using data from the EMPEROR-Pooled trial, João Pedro Ferreira, MD, et al., looked to see if early treatment had a substantial impact on patients recently hospitalized for HF when it came to reducing risk for rehospitalization and mortality. Researchers found that treating HF patients with empagliflozin reduced HF events regardless of how recently the patient was hospitalized for HF. Read the full study.

JACC: CardioOncology

Intermuscular Fat Changes Are Related to 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. Read the full letter.

JACC: Advances

Assessment of Nonfatal Bleeding Events as Surrogate For Mortality in CAD

By analyzing a total of 48 randomized control 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. Read the full study.

JACC: Basic to Translational Science

Intermittent Fasting Activates AMP-Kinase to Restructure Right Ventricular Lipid Metabolism and Microtubules

Using two rodent models of pulmonary artery hypertension-mediated right ventricular failure (monocrotaline and Sugenhypoxia), Felipe Kazmirczak, MD, et al., showed that intermittent fasting “activates [adenosine monophosphate-activated protein kinase (AMP-Kinase)], which restructures fatty acid metabolism, microtubules, and [electron transport chain] regulation.” This consistent observation suggests potential as a nonpharmacological intervention for patients with right ventricular failure. Read the full study. In an accompanying editorial comment, Hayley Billingsley, RDN; Stefano Toldo, PhD; and Antonio Abbate, MD, FACC, conclude: “…a randomized control trial of intermittent fasting in patients with [pulmonary artery hypertension] seems reasonable, measuring not only the effects on pulmonary artery pressures and right ventricular function but also monitoring the effects of intermittent fasting on body weight, lean mass, and, most importantly, on cardiorespiratory fitness as a final common measure of impact.” Read the full editorial comment.

JACC: Case Reports

Hemoptysis After Heart Transplantation Caused by Pulmonary Amyloidosis

Brandon Schwartz, MD, et al., present 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. Other proposed diagnoses included infections, arteriovenous malformation, malignancy, and diffuse alveolar hemorrhage. The study authors note that “when a patient with known amyloid presents with significant pulmonary symptoms…pulmonary amyloid should be on the differential.” Read the full case study.

Spontaneous Cholesterol Embolism Leading to Small Bowel Obstruction and Perforation

In a case study, Arun Umesh Mahtani, MD, MS, et al., investigate 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. Read the full case study.

Clinical Topics: Arrhythmias and Clinical EP, Cardio-Oncology, Cardiovascular Care Team, COVID-19 Hub, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Sports and Exercise Cardiology, Atherosclerotic Disease (CAD/PAD), Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Lipid Metabolism, Novel Agents, Diet

Keywords: ACC Annual Scientific Session, ACC23, Lipids, Kidney, Fasting, Survivors, Embolism, Fatty Acids, Body Weight, Angiotensins, Protein Kinases, Electrophysiology, Microtubules, Vaccination, Heart Disease Risk Factors, Biopsy, Amyloidosis, Valsartan, COVID-19, Medicare, Risk Factors, Race Factors, Length of Stay, Electrons, Drug Costs, Rodentia, Cardiovascular Diseases, Lipid Metabolism, Adenylate Kinase, Cross-Sectional Studies, Adenosine Monophosphate, Coronary Artery Disease, Cardiorespiratory Fitness, Glomerular Filtration Rate, Hemoptysis, Anthracyclines, Ventricular Function, Left, Renin, COVID-19 Vaccines, Prescription Drugs, Fibrinolytic Agents, Monocrotaline, Patient Readmission, Atrial Fibrillation, Stroke Volume

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