JACC

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.

JACC: Advances

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.

JACC: CardioOncology

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.