JAMA cardiology最新文献

{"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":"864"},"PeriodicalIF":14.1,"publicationDate":"2025-08-01","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":"Error in Additional Contributions.","authors":"","doi":"10.1001/jamacardio.2025.2039","DOIUrl":"10.1001/jamacardio.2025.2039","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"864"},"PeriodicalIF":14.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325730","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":"AHA PREVENT Equations and Lipoprotein(a) for Cardiovascular Disease Risk : Insights From MESA and the UK Biobank.","authors":"Harpreet S Bhatia, Matthew Ambrosio, Alexander C Razavi, Pamela L Alebna, Calvin Yeang, Jared A Spitz, Jaideep Patel, Michael Y Tsai, Laurence Sperling, Michael D Shapiro, Sotirios Tsimikas, Anurag Mehta","doi":"10.1001/jamacardio.2025.1603","DOIUrl":"10.1001/jamacardio.2025.1603","url":null,"abstract":"<p><strong>Importance: </strong>Lipoprotein(a) [Lp(a)] is independently associated with atherosclerotic cardiovascular disease (ASCVD) risk but is not included in the new American Heart Association Predicting Risk of Cardiovascular Disease Events (PREVENT) equations for CVD risk assessment.</p><p><strong>Objective: </strong>To evaluate the performance of these equations in individuals with elevated Lp(a).</p><p><strong>Design, setting, and participants: </strong>Cohort study involving 314 783 participants from the multicenter Multi-Ethnic Study of Atherosclerosis (MESA, 2000-2018; n = 6670) and the population-based UK Biobank (UKB, 2006-2022; n = 308 113) without known cardiovascular disease with available Lp(a) measurements. Analyses were conducted March 25, 2025.</p><p><strong>Exposure: </strong>Elevated Lp(a) level of 125 nmol/L or higher.</p><p><strong>Main outcomes and measures: </strong>Coronary heart disease (CHD), ASCVD, heart failure (HF), and total CVD. Participants were categorized as low (<5%), borderline (5% to <7.5%) intermediate (7.5% to <20%), and high (≥20%) risk of each outcome. Ten-year observed event rates were calculated, and the association between elevated Lp(a) and outcomes overall and by risk category was evaluated in age- and sex-adjusted Cox proportional hazards models. Improvement in risk prediction with the addition of elevated Lp(a) was evaluated using continuous and categorical net reclassification improvement (NRI) (using the above cut points).</p><p><strong>Results: </strong>Among the 314 783 participants (mean [SD] age, 62.1 [10.2] years and 3523 females [53%] in MESA; mean [SD] age, 56.3 [8.1] years; 169 648 females [55%] in the UKB), observed 10-year ASCVD event rates generally fell within the bounds of predicted risk categories regardless of Lp(a) level, although participants with elevated Lp(a) had higher event rates than did those with nonelevated Lp(a) (hazard ratio [HR], 1.30; 95% CI, 1.22-1.38) with similar results for CHD, HF, and total CVD. For CHD, the strongest association was among low-risk individuals (P for interaction = .31). The addition of elevated Lp(a) values to PREVENT modestly improved ASCVD risk prediction (category-free NRI, 0.058; 95% CI, 0.043-0.065; categorical NRI, 0.006, 95% CI, 0.004-0.011) with the greatest improvement in borderline-risk; when Lp(a) was evaluated continuously, the greatest improvement in prediction was among individuals at low risk. For CHD, the greatest improvement in prediction was in low- and high-risk individuals.</p><p><strong>Conclusions and relevance: </strong>In this analysis of 2 cohort studies, the novel PREVENT equations performed well for risk prediction overall, including among individuals with elevated Lp(a). However, Lp(a) values remain independently associated with higher risk, and Lp(a) may improve personalized risk assessment, particularly among specific subgroups.</p>","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":"810-818"},"PeriodicalIF":14.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215827","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":"Direct Stellate Ganglion or Vertebral Vein Stimulation?","authors":"Adi Lador,Miguel Valderrábano","doi":"10.1001/jamacardio.2025.2435","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2435","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"722 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737236","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":"Older Than You Think-The Psychology of Comparison.","authors":"Mohammad Al Mouslmani,Abdulla A Damluji,Michael G Nanna","doi":"10.1001/jamacardio.2025.2404","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2404","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"143 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747952","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":"Preserving and Promoting Clinical Trial Representativeness: A Review of Existing Strategies and the Path Forward.","authors":"Francesca Maria Di Muro,Katerina Dangas,Rebecca Ortega,Birgit Vogel,Wayne B Batchelor,Pamela S Douglas,Roxana Mehran","doi":"10.1001/jamacardio.2025.2421","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2421","url":null,"abstract":"ImportanceDespite major advancements in cardiovascular clinical research, underrepresentation in cardiovascular clinical trials persists, limiting generalizability, access to novel therapies, and equitable care.ObservationsPolicymakers, funding bodies, researchers, and professional societies have increasingly acknowledged the scientific importance of representation of the intended use population in cardiovascular clinical trials through policies and incentives, yet significant challenges remain. Achieving meaningful representation requires more than meeting enrollment targets, it demands the integration of best practices into trial design, including tailored recruitment strategies, diverse leadership, standardized demographic data collection, and clear accountability metrics.Conclusions and RelevanceThis review synthesizes the latest policies and initiatives concerning representation in clinical research and provides a strategic framework to ensure scientific validity of clinical trials by operationalizing broad representation at all levels. A coordinated approach among stakeholders is needed to address the scientific value of trial representation of the intended use population.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"712 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737357","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":"PREVENT Risk Age Equations and Population Distribution in US Adults.","authors":"Vaishnavi Krishnan,Xiaoning Huang,Amanda M Perak,Josef Coresh,Chiadi E Ndumele,Philip Greenland,Donald M Lloyd-Jones,Sadiya S Khan","doi":"10.1001/jamacardio.2025.2427","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2427","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"57 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747953","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":"Direct Stellate Ganglion or Vertebral Vein Stimulation?-Reply.","authors":"Timothy M Markman,Francis Marchlinski,Saman Nazarian","doi":"10.1001/jamacardio.2025.2438","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2438","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"27 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737181","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":"Diabetes and Obesity and Treatment Effect of Early Rhythm Control vs Usual Care in Patients With Atrial Fibrillation","authors":"Andreas Metzner, Stephan Willems, Katrin Borof, Guenther Breithardt, A. John Camm, Harry J. G. M. Crijns, Lars Eckardt, Larissa Fabritz, Nele Gessler, Andreas Goette, Bruno Reissmann, Renate B. Schnabel, Ulrich Schotten, Antonia Zapf, Andreas Rillig, Paulus Kirchhof","doi":"10.1001/jamacardio.2025.2374","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.2374","url":null,"abstract":"ImportanceThe EAST-AFNET 4 randomized clinical trial demonstrated that early rhythm control therapy added to anticoagulation therapy and therapy of concomitant conditions reduces the primary composite outcome of cardiovascular death, stroke, hospitalization because of heart failure, or acute coronary syndrome compared to usual care. However, the impact of body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) and diabetes on outcomes in EAST-AFNET 4 is not known.ObjectiveTo assess the effects of BMI and diabetes on outcomes in EAST-AFNET 4.Design, Setting, and ParticipantsEAST-AFNET 4 is an international, investigator-initiated, parallel-group, open, blinded outcome assessment randomized clinical trial conducted in 11 European countries. Patients who had early atrial fibrillation (AF, diagnosed ≤1 year before enrollment) and cardiovascular conditions were eligible for inclusion. The current analysis is a prespecified secondary analysis of the EAST-AFNET 4 trial performed in the final, locked dataset assigning patients to therapy group on the basis of randomization (intention-to-treat population). EAST-AFNET 4 was conducted from June 2010 to May 2020, and this secondary analysis of the final locked data base was performed in 2024.InterventionEAST-AFNET 4 randomly assigned patients to either early rhythm control or usual care.Main Outcomes and MeasureThe primary outcome of this analysis and the EAST-AFNET 4 trial is a composite of cardiovascular death, stroke, hospitalization because of heart failure, or acute coronary syndrome.ResultsThere were 1086 patients with obesity (BMI ≥30; mean [SD] BMI 34.5 [4.2]) and 1690 patients without obesity (BMI &amp;amp;lt;30; mean [SD] BMI 25.9 [2.6]). Overall mean patient age was 70 years, and 1293 patients (46.6%) were female. Patients with obesity were younger (mean [SD] age, 68 [8.6] vs 72 [7.7] years) and had more frequently nonparoxysmal AF patterns (31% vs 24%) than patients without obesity. There was no difference in mean (SD) CHA&lt;jats:sub&gt;2&lt;/jats:sub&gt;DS&lt;jats:sub&gt;2&lt;/jats:sub&gt;-VASc score (3.4 [1.3] vs 3.3 [1.3]). Obesity did not change the effect of early rhythm control therapy on the first primary outcome (hazard rate point estimates: BMI &amp;amp;lt;30, 0.84; BMI ≥30, 0.69; &lt;jats:italic&gt;P&lt;/jats:italic&gt; for interaction = .22). Patients with diabetes were younger (mean [SD] age, 69 [8.6] vs 71 [8.2] years; &lt;jats:italic&gt;P&lt;/jats:italic&gt; = .001) and had a higher mean CHA&lt;jats:sub&gt;2&lt;/jats:sub&gt;DS&lt;jats:sub&gt;2&lt;/jats:sub&gt;-VASC score (4.06 vs 3.11; &lt;jats:italic&gt;P&lt;/jats:italic&gt; &amp;amp;lt; .001). Diabetes did not interact with the treatment effect of early rhythm control (diabetes: hazard ratio [HR], 0.77; 95% CI, 0.57-1.05 vs no diabetes: HR, 0.78; 95% CI, 0.64-0.96; &lt;jats:italic&gt;P&lt;/jats:italic&gt; for interaction = .93). There was no difference in safety outcomes between patients with and without diabetes (64 of 351 patients [18.2%] vs 167 of 1039 patients [16.1%]; &lt;jats:italic&gt;P","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"92 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737593","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-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}