JAMA cardiology最新文献

{"title":"Comment on Aspirin Avoidance in Patients With LVADs-Reply.","authors":"Finn Gustafsson,Mandeep R Mehra","doi":"10.1001/jamacardio.2025.2347","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2347","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"1 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684375","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":"Trajectories of Physical Activity Before and After Cardiovascular Disease Events in CARDIA Participants.","authors":"Yariv Gerber,Kelley Pettee Gabriel,David R Jacobs,Nashira I Brown,Jared P Reis,Joseph J Shearer,Cora E Lewis,Mercedes R Carnethon,Stephen Sidney,Véronique L Roger","doi":"10.1001/jamacardio.2025.2282","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2282","url":null,"abstract":"ImportanceModerate to vigorous-intensity physical activity (MVPA) is essential for primary and secondary prevention of cardiovascular disease (CVD), but long-term patterns around CVD events remain underexplored.ObjectiveTo evaluate MVPA trajectories across adulthood, pre-CVD and post-CVD changes, and demographic variations.Design, Setting, and ParticipantsData were drawn from CARDIA (Coronary Artery Risk Development in Young Adults), a prospective study initiated in 1985-1986 with up to 10 MVPA assessments through 2020-2022. Cohort analysis examined long-term MVPA trajectories across adulthood, while a nested case-control analysis assessed pre-CVD and post-CVD MVPA trajectories. The CARDIA study was conducted in 4 US cities. Data analysis for this study was completed from September 2024 to February 2025.ExposuresMVPA (measured via exercise units [EU]; 300 EU = approximately 150 minutes/week of MVPA), self-reported using a validated questionnaire.Main Outcomes and MeasuresThe primary outcome was CVD events, including coronary heart disease, stroke, and heart failure. MVPA trajectories were analyzed across adulthood and relative to CVD using smoothed regression. Odds ratios (ORs) for low MVPA (<300 EU) post-CVD were estimated via generalized estimating equations.ResultsThe cohort analysis included 3068 participants, among whom mean (SD) age at baseline was 25.2 (3.6) years, and 1743 participants (56.8%) were female. Race was self-reported; the sample included 529 Black men, 834 Black women, 796 White men, and 909 White women. The nested case-control analysis included 236 incident CVD cases, each matched 1:1 to control participants by age, sex, and race. MVPA decreased steadily from young adulthood into middle age, stabilizing in later years. Black men had a more sustained decline, while Black women consistently reported the lowest MVPA. In the nested analysis, MVPA in case participants began declining approximately 12 years before CVD, with accelerated declines within 2 years of the event. Post-CVD, the case-control gap persisted. MVPA trajectories by type of CVD revealed steeper pre-CVD declines in heart failure and consistently low post-CVD levels across all types. Adjusting for pre-CVD MVPA, cases were more likely than controls to exhibit low MVPA post-CVD (OR, 1.78; 95% CI, 1.26-2.50), with the highest risk in Black women (OR, 4.52; 95% CI, 2.29-8.89).Conclusions and RelevanceIn this cohort and nested case-control study among CARDIA participants, MVPA declined from early adulthood to midlife then plateaued, with notable demographic differences; cases experienced steep declines before CVD, and gaps compared to controls persisted afterward. Black women had the lowest MVPA across adulthood and the highest risk of low MVPA post-CVD, underscoring the need to support lifelong physical activity and address group differences.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"1 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684357","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":"Comment on Aspirin Avoidance in Patients With LVADs.","authors":"Xiaoping Wang","doi":"10.1001/jamacardio.2025.2344","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2344","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"90 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684360","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":"Time to Implement a Polypill-Based Public Health Service.","authors":"Nicholas Wald","doi":"10.1001/jamacardio.2025.2255","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2255","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"8 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640195","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":"Time to Implement a Polypill-Based Public Health Service-Reply.","authors":"Ciaran N Kohli-Lynch,Thomas J Wang,Brandon K Bellows","doi":"10.1001/jamacardio.2025.2258","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2258","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"3 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640090","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":"Temporal Patterns in Out-of-Hospital Cardiac Arrest Incidence and Outcome.","authors":"Owen McBride,Amy Poel,Catherine R Counts,Megin Parayil,Camilla Osborne,Chris Drucker,Mickey Eisenberg,David Murphy,Peter Kudenchuk,Michael Sayre,Thomas Rea","doi":"10.1001/jamacardio.2025.2247","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2247","url":null,"abstract":"ImportanceIncidence and outcome of out-of-hospital cardiac arrest (OHCA) have implications for public health and community strategies to reduce risk and improve resuscitation.ObjectiveTo examine temporal patterns in OHCA incidence and outcome.Design, Setting, and ParticipantsThis was a retrospective cohort investigation conducted in King County, Washington, between 2001 and 2020. Adults with OHCA treated by emergency medical services (EMS) were included in the analysis. Study data were analyzed from May 2024 to April 2025.ExposuresIncidence and clinical outcome of OHCA.Main Outcomes and MeasuresAnnual incidence was calculated per 100 000 person-years and stratified by sex, age group (&lt;65 years and ≥65 years), and initial rhythm (shockable, nonshockable) with change estimated as average annualized change (AAC) percentage. Resuscitation was assessed according to 5-year groups. Temporal trends were evaluated using Poisson regression for incidence and survival to hospital discharge.ResultsThere were 25 118 individuals (median [IQR] age, 65 [53-78] years; 15 994 male [63.7%]) with OHCA treated by EMS during 30 884 504 person-years; survival was 17.7%. Overall incidence was 81.3 per 100 000 person-years, 20.9 for shockable and 59.8 for nonshockable OHCA. There was no evidence of linear temporal change in overall incidence: 88.7 in 2001, 82.1 in 2020 (AAC, -0.5%; 95% CI, -0.9% to 0%). However, temporal patterns depended on rhythm and demographic characteristics. For example, shockable rhythm incidence declined (28.6 in 2001 and 17.9 in 2020; AAC, -2.3%; 95% CI, -2.9% to -1.5%), but change was null among nonshockable arrest (59.8 in 2001 and 63.7 in 2020; AAC, 0.3%; 95% CI, -0.1% to 0.8%). Overall survival to hospital discharge improved over time: 14.7% (859 of 5847 individuals; 2001-2005), 17.4% (1024 of 5885 individuals; 2006-2010), 19.3% (1232 of 6376 individuals; 2011-2015), and 18.9% (1322 of 7010; 2016-2020; P &lt; .001 test for trend). Survival increased from 35% (591 of 1689 individuals) during the 2001 to 2005 period to 47.5% (768 of 1617 individuals) during the 2016 to 2020 period among shockable OHCA and from 6.4% (265 of 4135 individuals) during the 2001 to 2005 period to 10.1% (536 of 5323 individuals) during the 2016 to 2020 period among nonshockable OHCA (P &lt; .001 tests for trend). Temporal improvement was observed in prehospital resuscitation (survival to hospital admission) and in-hospital survival (discharge among those admitted to hospital; P &lt; .001 tests for trend). Outcome improvements corresponded to temporal increase in bystander cardiopulmonary resuscitation (55.5% in 2001-2005 to 73.9% in 2016-2020) and early automated external defibrillator application by non-EMS personnel (2.2% in 2001-2005 to 10.9% in 2016-2020; P &lt; .001 tests for trend).Conclusions and RelevanceResults suggest that the overall OHCA incidence did not change over time, although there were differential temporal patterns among clinical subgroups. Survival improved o","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"666 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640089","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":"Medication Adherence in Hypertension: A Cluster Randomized Clinical Trial.","authors":"Saul Blecker,Devin M Mann,Tiffany R Martinez,Hayley M Belli,Yunan Zhao,Aamina Ahmed,Cassidy Fitchett,Christina Wong,Harris R Bearnot,Corrine I Voils,Antoinette M Schoenthaler","doi":"10.1001/jamacardio.2025.2155","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2155","url":null,"abstract":"ImportanceMedication nonadherence is present in nearly half of patients with hypertension but is underrecognized in clinical care. Data linkages between electronic health records and pharmacies have created opportunities for scalable assessment of medication adherence at the point of care.ObjectiveTo test the effectiveness of a multicomponent intervention that identified patients with uncontrolled hypertension and medication nonadherence using linked electronic health record-pharmacy data combined with team-based care to address adherence barriers.Design, Setting, and ParticipantsTEAMLET (Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence) was a pragmatic, 2-arm, cluster randomized clinical trial conducted between October 2022 and November 2024 in 10 primary care sites in New York. The study included adults with uncontrolled hypertension and low medication adherence, defined as proportion of days covered (PDC) less than 80%. Data analysis was performed from November 2024 to January 2025.InterventionThe intervention consisted of the following: (1) automated identification of patients with medication nonadherence at the time of the visit; (2) prompting of medical assistants to screen for barriers to adherence; (3) clinical decision support alerting the primary care physicians and nurse practitioners to barriers to adherence; and (4) adherence discussion between the primary care physician or nurse practitioner and the patient. The comparator was usual care.Main Outcomes and MeasuresThe primary outcome was change in PDC from baseline to 12 months.ResultsAmong 1726 patients (mean [SD] age, 67.2 [13.9] years; 887 [51.4%] female), the mean (SD) baseline PDC was 33.2% (30.5%) overall (32.4% [30.4%] in the intervention group and 34.0% [30.6%] in the control group). The mean (SD) PDC at 12 months was 51.1% (39.5%) for the intervention group and 53.1% (39.6%) for the control group. No difference was found in the change in PDC from baseline to 12 months between the intervention and control groups (mean [SD] absolute change in PDC, 18.5 [41.1] vs 18.2 [40.9] percentage points, respectively; adjusted difference, -0.15 percentage point; 95% CI, -4.06 to 3.76 percentage points). Change in systolic blood pressure and patients who became adherent (PDC ≥80%) at 12 months were also similar between groups.Conclusions and RelevanceIn this pragmatic trial, an intervention that combined team-based primary care with automated identification of patients with antihypertensive medication nonadherence did not lead to improvements in adherence or blood pressure.Trial RegistrationClinicalTrials.gov Identifier: NCT05349422.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"13 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586687","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":"Sodium-Glucose Cotransporter 2 Inhibitor Use for Heart Failure in US Ambulatory Cardiovascular Care.","authors":"Abdelghani El Rafei,Kensey Gosch,Evan S Manning,Alireza Ghajar,Sridharan Raghavan,Thomas M Maddox,Pamela N Peterson,Lisa Fleming,Suzanne V Arnold,Paul S Chan,Stephen J Greene,Gregg C Fonarow,Philip G Jones,Larry A Allen,Paul L Hess","doi":"10.1001/jamacardio.2025.2145","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2145","url":null,"abstract":"ImportanceSodium-glucose cotransporter 2 inhibitor (SGLT2i) therapy reduces risk of heart failure (HF) events and cardiovascular death among individuals with HF. Trends of SGLT2i use in cardiovascular ambulatory care in the US remain unknown.ObjectiveTo evaluate the rate of SGLT2i use among patients with HF in the cardiovascular ambulatory care setting.Design, Setting, and ParticipantsThis was a retrospective cohort study conducted from July 1, 2019, through June 30, 2023. Included for analysis were patients with HF enrolled in the National Cardiovascular Data Registry (NCDR) Practice Innovation and Clinical Excellence (PINNACLE) registry, a national ambulatory cardiovascular care quality improvement registry. Study data were analyzed from February 15, 2024, through January 15, 2025.Main Outcomes and MeasuresPatient-level and practice-level prescription of SGLT2i therapy.ResultsOf 759 915 patients (mean [SD] age, 70 [14] years; 359 270 women [47.3%]; 49 252 Black individuals [14.6%]; 278 303 White individuals [82.7%]) with HF at 191 US sites, 76 927 (10.1%) were prescribed SGLT2i. Among patients with available ejection fraction (EF) data, 20 544 (17.9%) with HF with reduced EF (HFrEF) and 36 615 (8.9%) with HF with mildly reduced EF (HFmrEF) or HF with preserved EF (HFpEF) were prescribed SGLT2i. Rates of SGLT2i use for all patients with HF increased from 4.6% in the third quarter of 2019 to 16.2% in the second quarter of 2023, from 5.1% to 28.5% for those with HFrEF, and from 4.5% to 12.8% for those with HFmrEF or HFpEF (P for trend <.001). SGLT2i was less commonly used for older persons (IQR age, 80 years vs 63 years; OR, 0.76; 95% CI, 0.75-0.77), female sex (OR, 0.79; 95% CI, 0.77-0.81), and higher systolic blood pressure (OR, 0.78; 95% CI, 0.77-0.79), whereas history of type 2 diabetes was associated with markedly higher use (OR, 3.21; 95% CI, 3.15-3.28). After adjustment for patient- and practice-level characteristics, significant variation in SGLT2i use across sites was present (90th vs 10th percentile risk practice, adjusted OR, 4.40; 95% CI, 3.76-5.52).Conclusions and RelevanceAlthough this study found that SGLT2i use had increased among ambulatory patients with HF during the study period, the majority of eligible patients did not receive this therapy. Older age, female sex, and higher blood pressures were associated with lower SGLT2i use with significant unexplained variation in use across practices. Systematic efforts to improve SGLT2i therapy use are warranted.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"97 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586563","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":"Error in Abstract and Methods.","authors":"","doi":"10.1001/jamacardio.2025.2405","DOIUrl":"10.1001/jamacardio.2025.2405","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591267","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":"Prognostic Implications of Type and Location of LMNA Cardiomyopathy Genetic Variants.","authors":"Sadiya S Khan,Lisa M Castillo,Sharlene M Day","doi":"10.1001/jamacardio.2025.2068","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2068","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"39 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144533510","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}