Heart最新文献

{"title":"Shaping the future of cardiovascular medicine: advancing morphological atlases.","authors":"Kenya Kusunose","doi":"10.1136/heartjnl-2024-325612","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-325612","url":null,"abstract":"","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulants or antiplatelets for secondary prevention of cryptogenic stroke: an updated systematic review and meta-analysis.","authors":"Kuan-Yu Chi, Talal El Zarif, Dimitrios Varrias, Pei-Lun Lee, Yu-Cheng Chang, Junmin Song, Anita Osabutey, Pawel Borkowski, Cho-Han Chiang, Yu Chang, Yu-Shiuan Lin, Michele Nanna, Michael G Nanna","doi":"10.1136/heartjnl-2024-325288","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-325288","url":null,"abstract":"<p><strong>Background: </strong>Patients with cryptogenic stroke or embolic stroke of undetermined source (ESUS) face a high risk of recurrent ischaemic stroke, but the optimal antithrombotic strategy remains unclear. This systematic review and meta-analysis compared the effectiveness and safety of oral anticoagulants (OACs) versus antiplatelets in these populations, with a focus on subgroup effects by key clinical characteristics.</p><p><strong>Methods: </strong>Six databases were searched through March 2024 to identify randomised controlled trials (RCTs) comparing OACs and antiplatelets in patients with cryptogenic stroke or ESUS. The primary outcome was recurrent ischaemic stroke. Subgroup analyses evaluated treatment effects based on supracardiac atherosclerosis risk, presence of patent foramen ovale (PFO) and signs or risk factors for atrial cardiopathy. Meta-regression with interaction p values was employed to assess differences in treatment effects between subgroups.</p><p><strong>Results: </strong>Nine RCTs comprising 15 451 participants were included. In the overall population, there was no significant difference in recurrent ischaemic stroke risk between OACs and antiplatelets (relative risk (RR) 0.90, 95% CI 0.79 to 1.02; I²=0%). Subgroup analyses showed that OACs reduced ischaemic stroke risk in patients with low-risk supracardiac atherosclerosis (RR 0.53, 95% CI 0.35 to 0.80; I²=0%) compared with those with high-risk supracardiac atherosclerosis (RR 0.91, 95% CI 0.78 to 1.06; I²=0%) and evidence of supracardiac atherosclerosis (RR 1.13, 95% CI 0.84 to 1.53; I²=0%) (p interaction=0.0002). Similarly, OACs were more effective in patients with signs or risk factors for atrial cardiopathy (RR 0.84, 95% CI 0.70 to 0.99; I²=0%) than in those without atrial cardiopathy (RR 1.05, 95% CI 0.85 to 1.30; I²=0%) (p interaction=0.02). There was no significant interaction by PFO status (p interaction=0.28). While the risk of major bleeding risk was comparable between groups (RR 1.34, 95% CI 0.73 to 2.44; I²=65%), a significantly higher risk of major bleeding other than intracerebral haemorrhage was observed in patients taking OACs compared with antiplatelets (RR 1.69, 95% CI 1.18 to 2.43; I²=0%).</p><p><strong>Conclusions: </strong>OACs are more effective than antiplatelets for preventing ischaemic stroke in patients who had a cryptogenic stroke or ESUS with low-risk supracardiac atherosclerosis or atrial cardiopathy. The findings highlight the need for personalised treatment strategies and further trials in these subgroups.</p><p><strong>Prospero registration number: </strong>CRD42024518903.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of frailty on the effectiveness of intensive blood pressure control for patients with type 2 diabetes: a secondary analysis of a randomised controlled trial.","authors":"Li Wenjie, Zhiyan Wang, Mingxiao Li, Chao Jiang, Chang Hua, Yangyang Tang, Hao Zhang, Xinru Liu, Shiyue Zheng, Hang Guo, Manlin Zhao, Yu Feng Wang, Mingyang Gao, Qiang Lv, Jianzeng Dong, Chang-Sheng Ma, Xin Du","doi":"10.1136/heartjnl-2024-324360","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-324360","url":null,"abstract":"<p><strong>Background: </strong>Frailty is an independent risk factor for cardiovascular events. It is uncertain whether frailty modifies the efficacy of intensive blood pressure (BP) control among participants with type 2 diabetes mellitus(T2DM).</p><p><strong>Methods: </strong>The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD BP) trial, a two-by-two factorial trial, examined the effects of systolic BP (<120 vs <140 mm Hg) and glycaemic control on cardiovascular events in T2DM. We constructed a frailty index using the Rockwood cumulative deficit approach. Cox proportional hazard models were used to estimate the effectiveness of intensive BP treatment according to frailty status. The primary composite outcome was non-fatal myocardial infarction, non-fatal stroke or death from cardiovascular causes.</p><p><strong>Results: </strong>There were 4733 participants (mean age: 62.7 years; 39.9% frailty). The mean average number of antihypertensive medications was higher in frail patients compared with non-frail patients in both the standard (2.2 vs 1.7) and intensive (3.1 vs 2.7) treatment groups. In the standard glycaemic arm, intensive BP treatment reduced the risk of the primary outcome (HR 0.75, 95% CI 0.58 to 0.97) regardless of frailty status (p value for interaction=0.86). The benefits of intensive BP intervention were consistent across the spectrum of the frailty index (p value for interaction=0.96) in the standard glycaemic arm. However, no benefits of intensive BP treatment (HR 1.08, 95% CI 0.82 to 1.43) were observed in the intensive glycaemic arm.</p><p><strong>Conclusions: </strong>In the ACCORD BP study, the benefit of intensive BP treatment was consistent regardless of frailty in the setting of standard glycaemic control. Frailty should not be a barrier to intensive BP control in patients with T2DM treated with guideline-recommended standard glycaemic control.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Echocardiographic cardiac damage classification and clinical outcomes in atrial functional mitral regurgitation.","authors":"Taiji Okada, Nobuyuki Kagiyama, Tomohiro Kaneko, Masashi Amano, Yukio Sato, Yohei Ohno, Masaru Obokata, Kimi Sato, Kojiro Morita, Tomoko Machino-Ohtsuka, Yukio Abe, Yutaka Furukawa","doi":"10.1136/heartjnl-2024-325240","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-325240","url":null,"abstract":"<p><strong>Background: </strong>Atrial functional mitral regurgitation (AFMR) arises from left atrial (LA) dilation, commonly associated with atrial fibrillation, and leads to progressive cardiac damage. This study evaluated the prognostic value of a novel echocardiographic cardiac damage classification system for patients with moderate or severe AFMR.</p><p><strong>Methods: </strong>In a retrospective multicentre study, 1007 patients with AFMR were stratified into four groups based on echocardiographic findings: group 1, LA damage (dilation); group 2, left ventricular damage (reduced ejection fraction and/or dilation); group 3, right heart damage (tricuspid regurgitation and/or pulmonary hypertension); and group 4, combined left and right heart damage. The primary outcome was a composite of all-cause death, heart failure hospitalisations and mitral valve (MV) interventions over a median follow-up of 3.0 years.</p><p><strong>Results: </strong>The cohort's mean age was 78±10 years, with 56% female. Event rates for the primary outcome were progressively higher across groups 1-4 (31.0%, 38.0%, 46.3% and 57.2%, respectively; p<0.001). After multivariable adjustment, group 4 was associated with a significantly higher risk of the primary outcome compared with group 1 (HR 1.65, 95% CI 1.29 to 2.11, p<0.001). This classification consistently stratified risks for individual components of the composite endpoint, particularly in patients without MV intervention.</p><p><strong>Conclusions: </strong>A cardiac damage classification system based on echocardiographic parameters provides prognostic insights in patients with AFMR, identifying subgroups at higher risk of adverse outcomes. Future studies are needed to validate its use in guiding therapeutic decisions.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clot-in-transit and pulmonary embolism: an urgent call for awareness and action.","authors":"Mario Di Marino, Vincenzo Cicchitti, Umberto Ianni, Fabrizio Ricci, Cesare Mantini, Giampaolo Niccoli, Francesco Pelliccia, Sabina Gallina, Raffaele De Caterina, Juan-Carlos Kaski, Mamas A Mamas, Marco Zimarino","doi":"10.1136/heartjnl-2024-324747","DOIUrl":"10.1136/heartjnl-2024-324747","url":null,"abstract":"<p><p>Patients with acute pulmonary embolism (PE) have a wide spectrum of clinical presentations, from incidental findings to sudden cardiac death. Management and treatment recommendations in currently available guidelines vary according to patient risk and haemodynamic profile. A clot-in-transit (CiT) in the right heart chambers may be occasionally identified and is, therefore, an under-recognised but challenging condition, often preceding an abrupt clinical deterioration, and associated with increased mortality. Data on the detection of a CiT are sparse but consistent in attributing negative prognostic relevance, and therefore the presence of CiT should be systematically investigated and recorded in the setting of PE.In this review, the challenges related to the identification of a CiT are highlighted. Here, we propose an algorithm where the role of the Pulmonary Embolism Response Team (PERT) is reinforced. The PERT should convene once the CiT is suspected, to define the timeline for the diagnostic steps and subsequent management on a case-by-case basis. A patient with PE and CiT requires close bedside monitoring and rapid escalation therapy in case of clinical deterioration. Beyond anticoagulation alone, more aggressive strategies can be considered, including systemic thrombolysis, surgical pulmonary embolectomy and the currently emerging catheter-directed therapies. PROSPERO registration number: CRD42024493303.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"151-158"},"PeriodicalIF":5.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New wearable cardiac acoustic monitoring technology for evaluation of subclinical leaflet thrombosis after transcatheter aortic valve replacement.","authors":"Ran Liu, Zhaolin Fu, Yunfeng Yan, Meng Xie, Yang Li, Jing Yao, Xiaowei Yan, Zhinan Lu, Chun Zhang, Lei Xu, Guangyuan Song","doi":"10.1136/heartjnl-2024-324698","DOIUrl":"10.1136/heartjnl-2024-324698","url":null,"abstract":"<p><strong>Background: </strong>Subclinical leaflet thrombosis (SLT) is a common complication after transcatheter aortic valve replacement (TAVR). Multidimensional CT (MDCT) is the main imaging mortality for the diagnosis of SLT but it enhances the risk of contrast-induced nephropathy. Our study aimed to use an innovative wearable acoustic cardiography (ACG) device to diagnose SLT as an alternative option.</p><p><strong>Methods: </strong>This prospective cohort study consecutively enrolled patients with severe symptomatic aortic stenosis who underwent successful TAVR. We collected and analysed clinical data including ACG measurements and imaging results. Discrimination capability analysis (ie, area under the curve (AUC), sensitivity, specificity) of a composite feature from ACG readings in predicting SLT during follow-up was performed. Based on the severity of SLT, patients were categorised into three groups: Group 1 (no SLT), Group 2 (mild SLT) and Group 3 (moderate-to-severe SLT).</p><p><strong>Results: </strong>116 patients consented and enrolled in the stud<u>y</u>. At the 1-month follow-up, MDCT revealed a 25% prevalence of SLT with 11.2% classified as moderate-to-severe. ACG analysis revealed distinctive patterns of early systolic, baseless and high-energy murmurs exclusively in patients in Group 3 but not in group 2. The diagnostic performance of ACG for moderate-to-severe SLT showed a sensitivity of 84.62%, specificity of 91.26% and AUC of 0.920 (95% CI: 0.855 to 0.962, p<0.001). At 6 months, both MDCT and ACG indicated that nine (70%) patients in Group 3 who received anticoagulant therapy achieved complete resolution of SLT.</p><p><strong>Conclusion: </strong>ACG can be considered as an effective tool to assist in the diagnosis of SLT based on deterioration of transvalvular haemodynamics post-TAVR. Further studies are required to confirm its utility as a valuable non-invasive diagnostic and monitoring tool.</p><p><strong>Trial registration number: </strong>ChiCTR2300072300.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"180-189"},"PeriodicalIF":5.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification and exercise recommendations in cardiomyopathies and channelopathies: a practical guide for the multidisciplinary team.","authors":"Joyee Basu, Hamish MacLachlan, Raghav Bhatia, Helen Alexander, Robert Cooper, Nabeel Sheikh","doi":"10.1136/heartjnl-2024-324318","DOIUrl":"https://doi.org/10.1136/heartjnl-2024-324318","url":null,"abstract":"<p><p>Exercise offers a plethora of health benefits. However, certain genetic and acquired diseases such as cardiomyopathies and channelopathies are associated with sudden cardiac death during exercise. Several factors complicate exercise prescription in individuals living with these conditions. The lack of high-quality evidence supporting exercise recommendations, variation in the clinical phenotypes within the same condition and sparse physician education around exercise prescription all leads to a reluctance to provide specific guidance on how to engage in physical activity.This article aims to summarise the latest evidence underpinning risk stratification and current guideline recommendations for physical activity in individuals with cardiomyopathies and channelopathies wishing to engage in exercise. It also aims to provide a basic practical approach to exercise prescription for health professionals involved in the care of these patients. This approach may then serve as a foundation that can be easily personalised. Since risk can never be completely eliminated, all decisions regarding exercise participation should be taken following shared dialogue between the physician, patient and wider stake holders where appropriate.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and relevance of H558R in the efficacy and toxicity of flecainide in patients with atrial fibrillation: a cohort study.","authors":"Mauro Trincado Ave, Maria Brion, Alejandro Blanco-Verea, Carlos Tilves, Martin Pérez Hermilla, Carlos Minguito Carazo, Javier Garcia Seara, Jose Ramon González-Juanatey, Moisés Rodriguez-Mañero","doi":"10.1136/heartjnl-2024-324506","DOIUrl":"10.1136/heartjnl-2024-324506","url":null,"abstract":"<p><strong>Background: </strong>The SCN5A gene polymorphism histidine-558-to-arginine (H558R) has been associated with atrial fibrillation (AF) and may affect the therapeutic effects of flecainide. This study aimed to assess the prevalence of the H558R polymorphism in a European cohort of patients with AF and examine its association with flecainide's effects on AF recurrence and toxicity.</p><p><strong>Methods: </strong>This cohort study included patients diagnosed with AF and prescribed flecainide between 2017 and 2021 in a regional health area. Patients without the polymorphism (H558R-/-) were compared with heterozygous patients (H558R+/-) for a primary outcome of combined 6-month AF recurrence or toxicity. Secondary analyses evaluated the long-term outcomes and compared the prevalence of H558R in the AF cohort to a general population sample (n=3401).</p><p><strong>Results: </strong>A total of 104 patients were enrolled, with 57% H558R-/-, 37% H558R+/- and 6% H558R+/+. The prevalence of the H558R polymorphism was significantly higher in the AF cohort than in the general population (43.27% vs 24.37%, prevalence ratio 1.78, 95% CI 1.41 to 2.23, p<0.01). H558R+/- patients had a significantly lower risk of 6-month AF recurrence or toxicity (p=0.023, risk ratio 0.423, 95% CI 0.189 to 0.947), corresponding to an absolute risk difference of 21.5%. These findings were similar in the multivariable analysis. In long-term follow-up, H558R+/- patients continued to demonstrate a lower risk of AF recurrence or toxicity (p=0.039, HR 0.53, 95% CI 0.276 to 0.999).</p><p><strong>Conclusions: </strong>The H558R polymorphism is more prevalent in patients with AF compared with the general population and its presence is associated with a more favourable response to flecainide treatment.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"159-165"},"PeriodicalIF":5.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating bone morphogenetic protein 10 as a novel marker of atrial stress and remodelling in heart failure.","authors":"Daan C H Ceelen, Valentina Bracun, Bart J van Essen, Adriaan A Voors, Rudolf A de Boer, Jozine M Ter Maaten, Serge Masson, Peter Kastner, Chim C Lang, Navin Suthahar","doi":"10.1136/heartjnl-2024-324486","DOIUrl":"10.1136/heartjnl-2024-324486","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the potential of circulating bone morphogenetic protein 10 (BMP10) as a biomarker for atrial stress and remodelling in patients with heart failure (HF), in comparison to N-terminal pro-B-type natriuretic peptide (NT-proBNP). We also assessed the predictive value of BMP10 for adverse clinical outcomes.</p><p><strong>Methods: </strong>BMP10 levels were quantified in 2085 chronic HF patients from the European BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) cohort and in 1487 patients from the Scottish validation cohort. Multivariable linear regression identified independent associates of BMP10. Proteomic analysis of 6369 proteins with subsequent gene set enrichment analysis was used to explore biological pathways associated with elevated BMP10. Cox proportional hazards models adjusting for established risk factors were used to associate BMP10 levels with clinical outcomes, including all-cause mortality and HF hospitalisation.</p><p><strong>Results: </strong>In a multivariable model including clinical and echocardiographic parameters, log-transformed and standardised BMP10 levels were significantly associated with a history of atrial fibrillation (Sβ=0.419; p<0.001), and with echocardiographic features reflecting atrial stress, such as increased left atrial diameter (Sβ=0.075; p=0.048). By contrast, these were not among the strongest associates of NT-proBNP levels. Gene set enrichment analysis showed significant overrepresentation in pathways of muscle contraction and extracellular matrix organisation. Higher log-transformed and standardised BMP10 levels predicted a combined outcome of 2-year all-cause mortality and HF rehospitalisation (HR=1.10, 95% CI=1.02-1.19), with the validation cohort yielding comparable results.</p><p><strong>Conclusion: </strong>BMP10 emerges as a novel biomarker reflecting atrial stress and remodelling in chronic HF patients. Its additional predictive value for adverse outcomes underscores its potential utility in enhancing risk stratification and guiding therapeutic interventions in HF management.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"172-179"},"PeriodicalIF":5.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Industry marketing payments to physicians and prescription patterns for sacubitril/valsartan in the USA.","authors":"Anju Murayama","doi":"10.1136/heartjnl-2024-324453","DOIUrl":"10.1136/heartjnl-2024-324453","url":null,"abstract":"<p><strong>Objectives: </strong>Although financial interactions between physicians and pharmaceutical and medical device companies could be potential conflicts of interest, in certain instances, industry promotion targeted at physicians may facilitate the early adoption of effective, novel care for patients such as sacubitril/valsartan in the USA. This study aims to evaluate associations between industry-sponsored meal payments to physicians and their prescribing patterns for sacubitril/valsartan in the USA.</p><p><strong>Methods: </strong>Using the publicly accessible Centers for Medicare and Medicaid Services Medicare Part D database and the Open Payments Database, this study assessed associations between industry-sponsored meal payments to physician prescribers and total amounts of Medicare claims and spending for sacubitril/valsartan between 2015 and 2021.</p><p><strong>Results: </strong>Among 220 147 eligible physician prescribers, 60 568 (27.5%) received at least one meal payment related to sacubitril/valsartan from the manufacturer, totaling US$13.9 million. The receipt of meal payments was significantly associated with a higher proportion of sacubitril/valsartan prescriptions to all sacubitril/valsartan, angiotensin receptor blocker and angiotensin-converting enzyme inhibitor prescriptions, with an OR of 2.04 (95% CI: 1.98 to 2.10, p<0.001). Moreover, a 10% increase in the annual number of meal payments was associated with a 2.6% (95% CI: 2.5% to 2.6%, p<0.001) increase in the annual number of Medicare claims and a 7.3% (95% CI: 7.1% to 7.5%, p<0.001) increase in annual Medicare spending per physician.</p><p><strong>Conclusions: </strong>Given the underprescription of sacubitril/valsartan in the USA, the positive associations between meal payments and physicians' prescribing patterns suggest that industry-sponsored meals may contribute to the early adoption of this cost-effective, novel heart failure drug among US Medicare beneficiaries.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":" ","pages":"147-150"},"PeriodicalIF":5.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}