The following science will be presented at ACC.25 in Chicago, IL, and was simultaneously published in JACC, JACC: CardioOncology, JACC: Heart Failure, JACC: Advances and JACC: Case Reports. Access all JACC Journals' simultaneous publications on the JACC Journals at ACC.25 page.

JACC

FINE-HEART: Finerenone Reduces New-Onset AFib Across the Spectrum of Cardio-Kidney-Metabolism
In a pooled analysis of three large clinical trials, Maria A. Pabon, MD, et al., found that finerenone, a nonsteroidal mineralocorticoid receptor antagonist, reduced the risk of new-onset atrial fibrillation (AFib) or flutter, with 4.3% of finerenone group participants vs. 3.9% of placebo participants developing new-onset AFib or flutter over 2.9 years median follow up. Risk reduction was consistent regardless of number of cardio-kidney-metabolic conditions or by trial. Read on.

Impact of Vutrisiran on Functional Capacity and Quality of Life in ATTR-CM
More patients with transthyretin amyloidosis with cardiomyopathy (ATTR-CM) treated with vutrisiran experienced improvements in functional capacity, health status and quality of life when compared to those taking a placebo at 30 months in the HELIOS-B trial. Farooq H. Sheikh, MD, FACC, et al., looked at a total of 654 patients and used 6-minute walk test and Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary scores to analyze the efficacy of vutrisiran. Read on.

Impact of HF Severity on Vutrisiran Efficacy in ATTR-CM
Mathew S. Maurer, MD, FACC, et al., investigated the effect of vutrisiran on all-cause mortality and recurrent cardiovascular events in HELIOS-B patients of varying heart failure (HF) severities. Stratifying the trial participants by NYHA classes, the authors found the treatment demonstrated evidence of benefit across the range of HF severities included in the trial, with greatest benefit noted among patients with less severe disease. Read on.

Effect of Targeting apoC-III With Plozasiran on Lipoprotein Particle Size and Number in Hypertriglyceridemia
In 403 patients with severe hypertriglyceridemia (SHASTA-2 study) and mixed hyperlipidemia (MUIR study), plozasiran reduced apoC-III, decreased triglyceride-rich lipoprotein particles by about 50%, shifted LDL to larger particles, and slightly increased HDL particle concentration, suggesting potential for the treatment to reduce cardiovascular risk. Christie M. Ballantyne, MD, FACC, et al., used nuclear magnetic resonance to conduct comprehensive lipoprotein profiling after subcutaneous doses of plozasiran were administered at baseline and 12 weeks. Read on.

JACC: CardioOncology

Rechallenge After Severe ICI Myocarditis
Guillaume Bailly, MD, et al., present the clinical case of a 73-year-old man diagnosed with metastatic squamous call carcinoma of unknown primary previously treated for immune checkpoint inhibitor (ICI) myocarditis. Despite current guideline recommendations, the patient was rechallenged as a last therapeutic option following cancer recurrence. "Although myotoxicity recurred, a strategy of active monitoring and prompt treatment led to a favorable outcome and, ultimately, cancer remission," note the authors. Read on.

ICI-Related Myocarditis With or Without Concomitant Myopathy
In their analysis of 101 patients with ICI-induced immune-related myocarditis, Osnat Itzhaki Ben Zadok, MD, MSc; Meabh J. O'Hare, MBBCH; and Anju Nohria, MD, MSc, identified distinct biomarker profiles and cardiovascular complications for those with isolated myocarditis vs. those with concomitant immune-related myopathy. Of note, patients with concomitant myopathy had higher high-sensitivity troponin T and creatinine kinase levels and were more likely to present with significant arrythmias while patients with isolated myocarditis had higher N-terminal prohormone of brain natriuretic peptide levels, lower LVEFs and greater risk of acute decompensated HF. Read on.

JACC: Heart Failure

Long-Term Response of Obstructive HCM Patients to Mavacamten Based on Sex
In a study seeking to determine sex-associated differences from the VALOR-HCM trial, Milind Y. Desai, MD, et al., found that women with symptomatic obstructive hypertrophic cardiomyopathy (HCM) experienced similar and sustained long-term benefit from mavacamten when compared to men. Similar improvements were noted for both women and men in NYHA functional class, KCCQ 23-item Clinical Summary scores, reduced long-term need for septal reduction therapy, and improvement in biomarkers and markers of favorable cardiac remodeling. Read on.

JACC: Advances

Pericardial Effusion Associated With DOAC Use
In a single-center investigation assessing the incidence, characteristics and predisposing factors of pericardial effusion associated with direct oral anticoagulants (DOACs), Jessica Song, PharmD, et al., identified a total of 456 patients with pericardial effusion from 2013 to 2023. Annual incidence was 0.069% for DOACs, 0.047% for warfarin and 0.001% for no anticoagulation. Among pericardial effusion cases in patients on DOACs, 50% were moderately large or large. DOAC, warfarin, concurrent use of amiodarone and presence of solid tumor were all factors associated with moderately large or large pericardial effusion. Read on.

JACC: Case Reports

• Complex Management of Thromboembolism in Double-Outlet Right Ventricle
  Pranav Bhargava, MD, et al.
• Myocarditis: A Rare Cardiac Manifestation of Antiphospholipid Syndrome
  Alexander C. Sacher, DO, et al.
• Complete Heart Block Triggered by Nirmatrelvir-Ritonavir and Verapamil
  Evan Offord, MD, et al.
• Conservative Management of Left Atrial Dissection and Associated Complete Heart Block Following Cardiac Surgery
  Drew Bidmead, BS, et al.
• Vitamin C Deficiency as a Readily Reversible Cause of Pulmonary HTN
  Liam S. Flanagan, MD, BS, et al.
• Transcatheter Mechanical Aspiration of a Large Right Ventricle Lead Vegetation
  Emmanuel Daniel, MD, et al.
• Symptomatic Tricuspid Valve Obstruction Due to Intravenous Leiomyomatosis
  Logan D. Cho, MD, et al.
• Missed Kawasaki Disease Presenting as a Giant Coronary Aneurysm Mimicking an Intracardiac Mass
  Khalid Shakfeh, MD, et al.