Circulation最新文献

{"title":"Second- and Third-Generation BCR-ABL Tyrosine Kinase Inhibitors and the Risk of Pulmonary Arterial Hypertension: A Prevalent New-User Design.","authors":"Clément Jambon-Barbara, Samy Suissa, Sophie Dell'Aniello, Alex Hlavaty, Jean-Luc Cracowski, Marie-Camille Chaumais, Marc Humbert, David Montani, Charles Khouri","doi":"10.1161/CIRCULATIONAHA.125.077764","DOIUrl":"10.1161/CIRCULATIONAHA.125.077764","url":null,"abstract":"<p><strong>Background: </strong>BCR-ABL (fusion between the Abelson [Abl] tyrosine kinase gene at chromosome 9 and the break point cluster [Bcr] gene at chromosome 22) tyrosine kinase inhibitors (TKIs) have been increasingly linked to pulmonary arterial hypertension (PAH) since 2009, although supporting evidence is limited. Our objective was to evaluate the risk of PAH associated with second- and third-generation BCR-ABL TKIs compared with imatinib in adults.</p><p><strong>Methods: </strong>We employed a prevalent new-user design that emulates a randomized trial within the French national health care database population between 2008 and 2024. Thus, subjects initiating a second- and third-generation BCR-ABL TKI were matched on time and propensity score with users of the first-generation BCR-ABL TKI, imatinib. Patients were followed to occurrence of the primary outcome (ie, new onset of PAH), switch to another BCR-ABL TKI, death from any cause, end of registration within the database, or end of the study period, whichever came first. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards regression models, and incidence rates and corresponding 95% CIs were calculated using the Poisson distribution.</p><p><strong>Results: </strong>Six thousand six hundred twenty-five dasatinib (age 59.7±15.2 years, 44.0% women), 5205 nilotinib (age 55.4±15.0 years, 44.2% women), 2421 bosutinib (age 63.8±14.2 years, 42.1% women),1358 ponatinib (age 57.3±14.9 years, 46.1% women), and 922 asciminib (age 64.3±13.8 years, 43.7% female) new users were each matched with the maximum of available imatinib users on time-conditional propensity score and on duration of prior imatinib use (prevalent users). Dasatinib use was associated with a 9-fold increased risk of PAH compared with imatinib (1829 versus 43 events per million persons per year; HR=8.89 [95% CI, 5.30-14.92]). Bosutinib and ponatinib were associated with HRs of 10.76 (95% CI, 4.68-24.73) and 7.74 (95% CI, 2.33-25.70) respectively, with most cases occurring in patients previously exposed to dasatinib. Nilotinib and asciminib were not associated with an increased risk of PAH.</p><p><strong>Conclusions: </strong>This study, designed to emulate a randomized trial, suggests that, in French patients with chronic myeloid leukemia treated with BCR-ABL TKIs, dasatinib use is associated with a higher risk of PAH compared with imatinib, while bosutinib and ponatinib exposure may aggravate or trigger a recurrence of PAH in patients with preexisting dasatinib exposure. Whether bosutinib and ponatinib could induce PAH without preexposure to dasatinib remains to be explored.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":"967-979"},"PeriodicalIF":38.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Alcohol Use and Cardiovascular Disease: A Scientific Statement From the American Heart Association.","authors":"Mariann R Piano, Gregory M Marcus, Dawn M Aycock, Jennifer Buckman, Chueh-Lung Hwang, Susanna C Larsson, Kenneth J Mukamal, Michael Roerecke","doi":"10.1161/CIR.0000000000001430","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001430","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"153 13","pages":"e1106"},"PeriodicalIF":38.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forecasting the Burden of Cardiovascular Disease and Stroke in Women in the United States Through 2050: A Scientific Statement From the American Heart Association.","authors":"Karen E Joynt Maddox, Harmony R Reynolds, Demilade Adedinsewo, Cheryl Bushnell, Holli A DeVon, Holly C Gooding, Virginia J Howard, Rina Mauricio, Eliza C Miller, Garima Sharma, R J Waken","doi":"10.1161/CIR.0000000000001406","DOIUrl":"10.1161/CIR.0000000000001406","url":null,"abstract":"<p><strong>Background: </strong>Forecasts for the future prevalence of cardiovascular disease and stroke are crucial to guide efforts to improve health outcomes across the life course for women.</p><p><strong>Methods: </strong>Using historical trends from the 2015 to 2020 National Health and Nutrition Examination Survey, 2015 to 2019 Medical Expenditure Panel Survey, and census estimates for population growth, we estimated trends in prevalence through 2050 for cardiovascular risk factors based on suboptimal levels of Life's Essential 8 and clinical cardiovascular disease and stroke, overall and by age and race and ethnicity.</p><p><strong>Results: </strong>Among adult women overall, the prevalence of hypertension is estimated to increase from 48.6% in 2020 to 59.1% in 2050. Diabetes (14.9% to 25.3%) and obesity (43.9% to 61.2%) will increase, whereas hypercholesterolemia will decline (42.1% to 22.3%). Prevalences of suboptimal diet, inadequate physical activity, and smoking will decline over time, and inadequate sleep will increase. Prevalences of coronary disease (6.85% to 8.21%), heart failure (2.45% to 3.60%), stroke (4.14% to 6.74%), atrial fibrillation (1.58% to 2.31%), and total cardiovascular disease and stroke (10.7% to 14.4%) will rise. Similar trends are projected in girls 2 to 19 years of age, with an increase from 19.6% to 32.0% projected in obesity. Most adverse trends are projected to be more pronounced among women and girls identifying as American Indian/Alaska Native or multiracial, Black, or Hispanic.</p><p><strong>Conclusions: </strong>The prevalence of cardiovascular risk factors and disease in women and girls will increase over the next 30 years. Focused clinical and public health interventions are needed across the life course to address these adverse trends.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":"e1061-e1077"},"PeriodicalIF":38.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association.","authors":"Amanda R Vest, Robert J DiDomenico, Lily Lichtenstein, Tammy Slater, Eson Ekpo, Abdulla A Damluji, Erin Bohula, Carlos L Alviar","doi":"10.1161/CIR.0000000000001405","DOIUrl":"10.1161/CIR.0000000000001405","url":null,"abstract":"<p><p>Malnutrition can affect patients with various acute cardiovascular disease conditions, including acute coronary syndromes, arrhythmias, or valvular disease; however, most of the literature has focused on patients with heart failure. Malnutrition prevalence estimates range from 20% to 60% for hospitalized patients. Use of Global Leadership Initiative on Malnutrition criteria for malnutrition diagnosis for patients with cardiovascular disease has confirmed prognostic value, correlating with poorer physical function and higher mortality. Nutritional support plays a key role for inpatients, particularly in the cardiac intensive care unit, and includes initiation of feeding within 48 hours of hospitalization, preferably through enteral nutrition. Enteral nutrition is more cost-effective compared with parenteral nutrition and can decrease mortality and shorten lengths of stay. Parenteral nutrition is reserved for patients with severe gastrointestinal dysfunction or to supplement nutrition when enteral nutrition is contraindicated, for example, during high pressor doses that preclude adequate intestinal perfusion or when achieving <70% of nutritional targets after the first week. The optimal protein intake for patients with cardiogenic shock is an area of ongoing research, with higher protein approaches not appearing beneficial in recent critical care trials.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":"e1078-e1105"},"PeriodicalIF":38.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2026 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association.","authors":"Alice H Lichtenstein, Amit Khera, Cheryl A M Anderson, Lawrence J Appel, Dana M DeSilva, Christopher Gardner, Frank B Hu, Daniel W Jones, Kristina S Petersen","doi":"10.1161/CIR.0000000000001435","DOIUrl":"https://doi.org/10.1161/CIR.0000000000001435","url":null,"abstract":"<p><p>Poor diet quality is strongly associated with elevated cardiovascular disease morbidity and mortality risk. This American Heart Association scientific statement for food-based cardiovascular health optimization and cardiovascular disease risk reduction guidance summarizes available evidence and provides contextual guidance for the key features of heart-healthy dietary patterns. It enumerates collateral benefits of adopting a heart-healthy dietary pattern in terms of nutrient intake adequacy and compatibility with other chronic disease risk reduction guidance. The features of a heart-healthy dietary pattern include (1) adjusting energy intake and expenditure to achieve and maintain a healthy body weight; (2) eating plenty of vegetables and fruits and choosing a wide variety; (3) choosing foods made mostly with whole grains rather than refined grains; (4) choosing healthy sources of protein; (5) choosing sources of unsaturated fats in place of sources of saturated fat; (6) choosing minimally processed foods instead of ultraprocessed foods; (7) minimizing intake of added sugars in beverages and foods; (8) reducing sodium intake by choosing foods low in sodium and preparing foods with minimal or no salt; and (9) if alcohol is not consumed, do not start; if alcohol is consumed, limit intake.</p>","PeriodicalId":10331,"journal":{"name":"Circulation","volume":" ","pages":""},"PeriodicalIF":38.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MR-ProADM Predicts Mortality and Heart Failure Events in ATTR Cardiac Amyloidosis.","authors":"Belén Peiró-Aventín,Elena Revuelta-Lopez,Mariana Brandao,Julio Nuñez,Manuel A Fernández-Rojo,Rosa M Carmona,Borja Montejo,Alejandro Ferrando-Muñoz,Aránzazu Martín-García,Esther Gonzalez-Lopez,Fernando Dominguez,Andrea Camblor,María Ruiz-Cueto,Josep Lupon,Sergio Teryua,Dimitrios Bampatsias,Israt Jahan,Ana Royuela,Ahmad Masri,Mathew S Maurer,Antoni Bayes-Genis,Pablo Garcia-Pavia","doi":"10.1161/circulationaha.125.077833","DOIUrl":"https://doi.org/10.1161/circulationaha.125.077833","url":null,"abstract":"BACKGROUNDWith the increasing diagnosis of transthyretin amyloid cardiomyopathy (ATTR-CM) at earlier stages and new therapies, there is a rising demand for tools to stratify risk and prognosis. We evaluated the prognostic value of multiple circulating biomarkers for predicting outcomes in ATTR-CM.METHODSWe evaluated 12 different circulating biomarkers (N-terminal pro-B-type natriuretic peptide [NT-proBNP], high-sensitivity troponin I [hsTnI], mid-regional pro-adrenomedullin [MR-proADM], carbohydrate antigen 125 [CA125], soluble suppressor of tumorigenicity 2 [sST2], cluster of differentiation antigen 146 [CD146], growth/differentiation factor-15 [GDF-15], alpha-klotho, fibroblast growth factor 23 [FGF-23], galectin-3, insulin-like growth factor-binding protein 7 [IGFBP-7], and estimated glomerular filtration rate [eGFR]) in 337 ATTR-CM patients from Spain. Cox models were employed to determine their predictive abilities. Findings were validated in 2 independent external cohorts of 210 patients from the United States and 416 patients from the ATTR-ACT trial, respectively.RESULTSOver a median follow-up of 19.7 months (IQR, 6.5-42.3), 67 patients (19.9%) died/underwent heart transplantation, and 81 (24%) had heart failure events. MR-proADM was the biomarker with the strongest prognostic performance, with a C-index of 0.788 (95% CI, 0.723-0.851) for all-cause mortality and 0.721 (95% CI, 0.669-0.772) for the composite endpoint of death and heart failure events. MR-proADM was associated with multiple parameters of ATTR-CM severity and was independently associated with mortality, heart failure events, and the composite endpoint. MR-proADM ≥1.1 nmol/L was identified as the optimal prognostic threshold, and it improved prediction of mortality when added to the National Amyloid Center (area under the curve [AUC], 0.682 versus 0.737; P<0.001), Mayo (AUC, 0.659 versus 0.749; P<0.001), and the Columbia staging systems (AUC, 0.699 versus 0.768; P<0.001). In both validation cohorts, patients with MR-proADM ≥1.1 nmol/L had worse outcomes (P<0.001). This association was also confirmed in patients receiving tafamidis.CONCLUSIONSIn patients with ATTR-CM, MR-proADM levels are associated with disease severity and worse prognosis. MR-proADM improves prediction of all-cause mortality and captures heart failure events.","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"16 1","pages":""},"PeriodicalIF":37.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter by Wu et al Regarding Article, \"G Protein-Coupled Receptor Kinase 3 Exacerbates Diabetic Heart Injuries Through Direct Phosphorylation of Cannabinoid Receptor 2 in Humans and Mice\".","authors":"Di Wu,Jing Zhang,Jian Yang","doi":"10.1161/circulationaha.125.077325","DOIUrl":"https://doi.org/10.1161/circulationaha.125.077325","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"33 1","pages":"e1055-e1056"},"PeriodicalIF":37.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response by Xiong and Zhang to Letter Regarding Article, \"An Aberrant Resurgence of Endogenous Retroviruses Prompts Myocarditis and Heart Failure\".","authors":"Junhao Xiong,Bing Zhang","doi":"10.1161/circulationaha.125.079058","DOIUrl":"https://doi.org/10.1161/circulationaha.125.079058","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"18 1","pages":"e1059-e1060"},"PeriodicalIF":37.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response by Gao et al to Letter Regarding Article, \"G Protein-Coupled Receptor Kinase 3 Exacerbates Diabetic Heart Injuries Through Direct Phosphorylation of Cannabinoid Receptor 2 in Humans and Mice\".","authors":"Pan Gao,Liliang Li,Yunzeng Zou","doi":"10.1161/circulationaha.125.079055","DOIUrl":"https://doi.org/10.1161/circulationaha.125.079055","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"229 1","pages":"e1057"},"PeriodicalIF":37.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response by Hundemer and Vaidya to Letter Regarding Article, \"Subclinical Primary Aldosteronism and Major Adverse Cardiovascular Events: A Longitudinal Population-Based Cohort Study\".","authors":"Gregory L Hundemer,Anand Vaidya","doi":"10.1161/circulationaha.125.079057","DOIUrl":"https://doi.org/10.1161/circulationaha.125.079057","url":null,"abstract":"","PeriodicalId":10331,"journal":{"name":"Circulation","volume":"21 1","pages":"e1053-e1054"},"PeriodicalIF":37.8,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147578008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}