JACC. Heart failure最新文献

{"title":"Global Burden of Pulmonary Arterial Hypertension and Associated Heart Failure: Global Burden of Disease 2021 Analysis.","authors":"Haoquan Huang, Chuwen Hu, Rong Zhang, Hui Xu, Minghui Cao, Yanni Fu","doi":"10.1016/j.jchf.2024.12.005","DOIUrl":"10.1016/j.jchf.2024.12.005","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary arterial hypertension (PAH) and associated heart failure (HF) are emerging global health challenges.</p><p><strong>Objectives: </strong>This study aimed to analyze the global, regional, and national burden of PAH and PAH-related HF from 1990 to 2021 with the use of GBD (Global Burden of Disease) 2021 estimates, to observe temporal trends, and to predict future patterns through 2050.</p><p><strong>Methods: </strong>Data on prevalence, incidence, disability-adjusted life years (DALYs), and deaths were derived from GBD 2021. Joinpoint regression was adopted for analyzing trends and changes, decomposition analysis for quantifying impacts of age structure, population growth, and epidemiologic changes, and the Bayesian age-period-cohort model for predictions.</p><p><strong>Results: </strong>In 2021, global PAH prevalence was 2.28 per 100,000, slightly down from 1990 (average annual percent change [AAPC]: -0.03; 95% CI: -0.05 to -0.01), and incidence rose to 0.52 per 100,000 (AAPC: 0.10; 95% CI: 0.10-0.11). DALYs fell to 8.24 per 100,000 (AAPC: -1.52; 95% CI: -1.64 to -1.40), and deaths dropped to 0.27 per 100,000 (AAPC: -0.82; 95% CI: -0.95 to -0.68). Increased PAH deaths from aging and growth. Women had higher PAH prevalence and incidence, and by 2021 surpassed men in DALYs and deaths rates. For PAH-related HF, prevalence rose to 191,808 cases and years lived with disability rose from 9,788 to 17,765, although rates declined. These trends are projected to persist through 2050, with cases and deaths rising but rates stable from 2019 to 2021.</p><p><strong>Conclusions: </strong>The burden of PAH persists due to aging and population growth, despite declining age-standardized rates. Future interventions should address regional and sex disparities in PAH.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567152","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":"Influence of Obesity on Invasive Hemodynamics and Prognosis in Patients With Heart Failure.","authors":"Benjamin Lautrup Hansen, Tania Deis, Johan E Larsson, Mads Ersbøll, Kasper Rossing, Morten Schou, Hoong Sern Lim, Finn Gustafsson","doi":"10.1016/j.jchf.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.12.009","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested that obesity may cause heart failure with preserved left ventricular ejection and report strong association between body mass index (BMI) and invasive hemodynamics. However, sparse information exists in patients who have heart failure with reduced ejection fraction (HFrEF).</p><p><strong>Objectives: </strong>This study aimed to investigate associations between BMI and invasive hemodynamics in patients with HFrEF and the influence of obesity on clinical outcomes.</p><p><strong>Methods: </strong>Referred patients with HFrEF evaluated for advanced heart failure were studied. All patients had right heart catheterization performed. Obesity was defined as BMI ≥30 kg/m². Clinical events included death, heart transplantation, and durable left ventricular assist device implantation.</p><p><strong>Results: </strong>The study population comprises 578 patients with a mean age of 52 ± 13 years and BMI of 26 ± 5 kg/m². Patients with obesity (BMI range: 30-45 kg/m²) counted 126 (22%) and had significantly higher cardiac output and slightly higher central venous pressure compared to patients without obesity. Cardiac output increased by 89 mL/min per 1-U increase in BMI. Vascular resistances were significantly inversely related to BMI. Pulmonary arterial pressure and pulmonary capillary wedge pressure were not associated with BMI. In patients with obesity, symptoms seem to be dissociated from filling pressures and cardiac index, whereas a clear association is observed in patients without. Obesity did not predict survival over a median follow-up of 5.9 years (Q1-Q3: 2.0-10.1 years).</p><p><strong>Conclusions: </strong>In patients with HFrEF, BMI and CO correlate significantly. Symptoms and hemodynamics appear dissociated in patients with obesity. Finally, survival in patients with obesity did not differ from those without.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673239","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":"Long-Term Response of Obstructive Hypertrophic Cardiomyopathy Patients to Mavacamten Based on Sex: Insights From the VALOR-HCM Trial.","authors":"Milind Y Desai, Sara Saberi, Jeffrey B Geske, Andrew Wang, Paul Cremer, David R Fermin, Mark A Zenker, Neal K Lakdawala, Albree Tower-Rader, Srihari S Naidu, Kathy Lampl, Anjali Owens","doi":"10.1016/j.jchf.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.jchf.2025.02.005","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657183","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":"Glucagon-Like Peptide 1 Receptor Agonist Is Associated With Improved Survival in Overweight Heart Failure Patients.","authors":"Patric Karlström, Aldina Pivodic, Michael Fu","doi":"10.1016/j.jchf.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have shown improved symptomatic relieving and functional capacity in patients with heart failure (HF) with preserved ejection fraction and obesity.</p><p><strong>Objectives: </strong>The purpose of this study was to evaluate the effect of GLP-1RA on outcome in patients with HF.</p><p><strong>Methods: </strong>A retrospective analysis was performed based on the Swedish HF Registry since 2007 among patients with a body mass index (BMI) >25 kg/m² to assess whether GLP-1RA treatment was associated with reduced mortality in patients with HF.</p><p><strong>Results: </strong>In the overall cohort, 34,247 patients were not treated with GLP-1RA, and 808 patients were. In patients treated with GLP-1RA, 96.3% had diabetes mellitus. Treatment with GLP-1RA showed a statistically significant association with reduced all-cause (adjusted HR [aHR]: 0.75 [95% CI: 0.60-0.94]; P = 0.013) and cardiovascular (CV) mortality (aHR: 0.52 [95% CI: 0.35-0.77]; P = 0.0010) compared with those not receiving GLP-1RA within 2 years after index registration. In a 1:1 propensity score matched cohort, there was no significant association between GLP-1RA and all-cause mortality (aHR: 0.79 [95% CI: 0.59-1.06]; P = 0.11), but there was with CV mortality (aHR: 0.53 [95% CI: 0.32-0.87]; P = 0.012). GLP-1RA-associated risk reduction in CV death was more pronounced in patients with a BMI >30 kg/m² and appears to be greater in individuals with an ejection fraction ≤40% compared with >40%.</p><p><strong>Conclusions: </strong>This nationwide real-world study shows that patients with HF who received GLP-1RA have a significant reduction in CV mortality, which is particularly pronounced in overweight and obese patients with reduced ejection fraction.</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633807","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":"Heart Failure Specialist Care and Long-Term Outcomes for Patients Admitted With Acute Heart Failure","authors":"Antonio Cannata MD ,&nbsp;Mehrdad A. Mizani PhD ,&nbsp;Daniel I. Bromage PhD ,&nbsp;Susan E. Piper MD ,&nbsp;Suzanna M.C. Hardman PhD ,&nbsp;Cathie Sudlow PhD ,&nbsp;Mark de Belder MD ,&nbsp;Paul A. Scott MD ,&nbsp;John Deanfield FRCP ,&nbsp;Roy S. Gardner MD ,&nbsp;Andrew L. Clark MD ,&nbsp;John G.F. Cleland MD ,&nbsp;Theresa A. McDonagh MD ,&nbsp;CVD-COVID-UK/COVID-IMPACT Consortium","doi":"10.1016/j.jchf.2024.06.013","DOIUrl":"10.1016/j.jchf.2024.06.013","url":null,"abstract":"<div><h3>Background</h3><div>For patients with acute heart failure (HF), specialist HF care during admission improves diagnosis and treatments.</div></div><div><h3>Objectives</h3><div>The authors aimed to investigate the association of HF specialist care with in-hospital and longer term prognosis.</div></div><div><h3>Methods</h3><div>The authors used data from the National Heart Failure Audit from January 1, 2018, to December 31, 2022, linked to electronic records for hospitalization and deaths. All-cause mortality was the primary outcome measure and in-hospital mortality the secondary outcome measure.</div></div><div><h3>Results</h3><div>Data for 227,170 patients admitted to hospital with HF (median age: 81 years; IQR: 72-88 years), were analyzed. Approximately 80% of acute HF admissions received support from HF specialists. Thirty-nine percent of patients (n = 70,720) were seen by a multidisciplinary team (HF physicians and heart failure specialist nurses [HFSNs]), 22% (n = 40,330) were seen by HFSNs alone, and the remaining 39% (n = 71,700) were seen exclusively by specialist HF physicians. At discharge, more patients who received HF specialist care were prescribed medical therapy for HF and had specialized follow-up. Conversely, diuretic agents were prescribed to fewer patients. HF specialist care was independently associated with a higher rate of prescribing HF therapies at discharge and a lower likelihood of receiving diuretic therapy (OR: 0.90 [95% CI: 0.86-0.95]; <em>P &lt;</em> 0.001). HF specialist care was associated with better long-term survival (HR: 0.89 [95% CI: 0.87-0.90]; <em>P &lt;</em> 0.001) and lower in-hospital mortality (OR: 0.92 [95% CI: 0.0.88-0.97]; <em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Receiving HF specialist care during admission for HF is associated with a higher rate of implementation of medical therapy, fewer discharges on diuretic therapy, and lower in-hospital and long-term mortality across the left ventricular ejection fraction spectrum, especially for patients with heart failure with reduced ejection fraction.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 402-413"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901790","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":"Donor Selection for Heart Transplantation in 2025","authors":"Rashmi Jain MD ,&nbsp;Evan P. Kransdorf MD, PhD ,&nbsp;Jennifer Cowger MD ,&nbsp;Valluvan Jeevanandam MD ,&nbsp;Jon A. Kobashigawa MD","doi":"10.1016/j.jchf.2024.09.016","DOIUrl":"10.1016/j.jchf.2024.09.016","url":null,"abstract":"<div><div>The number of candidates on the waiting list for heart transplantation (HT) continues to far outweigh the number of available organs, and the donor heart nonuse rate in the United States remains significantly higher than that of other regions such as Europe. Although predicting outcomes in HT remains challenging, our overall understanding of the factors that play a role in post-HT outcomes continues to grow. We observe that many donor risk factors that are deemed “high-risk” do not necessarily always adversely affect post-HT outcomes, but are in fact nuanced and interact with other donor and recipient risk factors. The field of HT continues to evolve, with ongoing development of technologies for organ preservation during transport, expansion of the practice of donation after circulatory death, and proposed changes to organ allocation policy. As such, the field must continue to refine its processes for donor selection and risk prediction in HT.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 389-401"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681998","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":"Wet and Sent Home From Heart Failure Hospitalization","authors":"Sean P. Collins MD, MSC ,&nbsp;Hasan K. Siddiqi MD, MSCR ,&nbsp;Lynne Warner Stevenson MD","doi":"10.1016/j.jchf.2025.01.006","DOIUrl":"10.1016/j.jchf.2025.01.006","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 430-434"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548169","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":"Disparities Among Immigrants and Native Patients in Denmark With New-Onset Heart Failure With Reduced Ejection Fraction","authors":"Sam Aiyad Ali MD ,&nbsp;Naja Emborg Vinding MD ,&nbsp;Jawad H. Butt MD ,&nbsp;Johanna Krøll MD ,&nbsp;Johan E. Larsson MD ,&nbsp;Morten Schou MD, PhD ,&nbsp;Emil L. Fosbøl MD, PhD ,&nbsp;Brian B. Løgstrup MD, PhD, DMsc ,&nbsp;Inge Schjødt RN, PhD ,&nbsp;Pardeep S. Jhund MD ,&nbsp;Lars Køber MD, DMSc ,&nbsp;Finn Gustafsson MD, DMSc ,&nbsp;Naveed Sattar MBChB, PhD ,&nbsp;John J.V. McMurray MD ,&nbsp;Søren Lund Kristensen MD, PhD","doi":"10.1016/j.jchf.2024.11.008","DOIUrl":"10.1016/j.jchf.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Worldwide, major health care variations exist in patients with heart failure (HF).</div></div><div><h3>Objectives</h3><div>In this study, the authors sought to examine and compare immigrants grouped by region of origin and native Danish patients presenting with new-onset heart failure with reduced ejection fraction (HFrEF).</div></div><div><h3>Methods</h3><div>The authors used data from the Danish Heart Failure Registry and administrative registries comprising information on medication, comorbidity, vital status, income level, and education. The co-primary outcomes were uptitration of guideline-directed medical therapy (GDMT) and a composite of HF hospitalization and all-cause death.</div></div><div><h3>Results</h3><div>Overall, 55,918 patients were included, of whom 94.8% were native Danish patients, 3.0% originated from Europe/Central Asia, 1.1% from the Middle East/North Africa, 0.6% from South Asia, and 0.5% from other regions. Patients from the non-Western areas were around 10 years younger (median age 62 vs 72 years) and had more diabetes (38%-50% vs 20%) and ischemic heart disease (67%-74% vs 48%) and less atrial fibrillation (9%-15% vs 32%) compared with Danish patients (all <em>P</em> &lt; 0.001). At 12 months’ follow-up, no major differences in attainment of ≥50% target daily doses of GDMT were observed across groups. The crude 3-year cumulative risk of HF hospitalization or all-cause death ranged from 25% to 37% and was lowest for non-Western immigrants, although this difference does not persist in age- and sex-matched analyses.</div></div><div><h3>Conclusions</h3><div>Patients in Denmark with HFrEF originating from non-Western parts of the world were younger and had more ischemic heart disease and diabetes and less atrial fibrillation compared with native Danish patients. The likelihood of GDMT uptitration at 12 months was similar to that of native Danish patients, whereas their risk of HF hospitalization or all-cause death was lower, although the difference between the 2 groups diminished in age- and sex-matched analyses.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 483-493"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364881","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":"Decongestion and Outcomes in Patients Hospitalized for Acute Heart Failure","authors":"Matteo Pagnesi MD, PhD ,&nbsp;Laura Staal PhD ,&nbsp;Jozine M. ter Maaten MD, PhD ,&nbsp;Iris E. Beldhuis MD ,&nbsp;Gad Cotter MD ,&nbsp;Beth A. Davison PhD ,&nbsp;Niels Jongs PhD ,&nbsp;G. Michael Felker MD, MHS ,&nbsp;Gerasimos Filippatos MD ,&nbsp;Barry H. Greenberg MD ,&nbsp;Peter S. Pang MD ,&nbsp;Piotr Ponikowski MD, PhD ,&nbsp;Carlo Mario Lombardi MD ,&nbsp;Marianna Adamo MD, PhD ,&nbsp;Thomas Severin MD ,&nbsp;Claudio Gimpelewicz MD ,&nbsp;Adriaan A. Voors MD, PhD ,&nbsp;John R. Teerlink MD ,&nbsp;Marco Metra MD","doi":"10.1016/j.jchf.2024.09.013","DOIUrl":"10.1016/j.jchf.2024.09.013","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic importance of residual congestion after acute heart failure (AHF) hospitalization is still debated.</div></div><div><h3>Objectives</h3><div>The authors aimed to assess the impact of residual congestion in a large cohort of patients with AHF enrolled in the RELAX-AHF-2 (Efficacy, Safety and Tolerability of Serelaxin When Added to Standard Therapy in AHF) trial.</div></div><div><h3>Methods</h3><div>Residual congestion was assessed at day 5 after admission among hospitalized patients using an established composite congestion score (CCS) based on the presence of orthopnea, peripheral edema, and increased jugular venous pressure, ranging from 0 to 8 points. The primary endpoint was a composite of cardiovascular death or rehospitalization for heart failure or renal failure at 180 days.</div></div><div><h3>Results</h3><div>Among the 5,900 AHF patients included in this analysis, 3,380 (57.3%) had at least 1 sign of congestion (ie, CCS ≥1) and 1,066 (18.1%) had a CCS ≥3 at day 5 after admission. Patients with residual congestion at day 5 were more symptomatic, had more comorbidities, received higher doses of loop diuretic agents in-hospital, albeit with lower diuretic response, were less likely to have hemoconcentration, and were more likely to have worsening renal function at day 5. After multivariable adjustment for clinically meaningful variables, any sign of residual congestion and CCS ≥3 at day 5 were both independently associated with a higher risk of the primary endpoint (adjusted HR: 1.32 [95% CI: 1.15-1.51]; <em>P &lt;</em> 0.001 and adjusted HR: 1.62 [95% CI: 1.39-1.88]; both <em>P &lt;</em> 0.001).</div></div><div><h3>Conclusions</h3><div>Among patients with AHF who were still hospitalized at day 5, residual congestion was common and independently associated with worse outcome. (Efficacy, Safety and Tolerability of Serelaxin When Added to Standard Therapy in AHF [RELAX-AHF-2]; <span><span>NCT01870778</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 414-429"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768939","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":"Clinical and Proteomic Risk Profiles of New-Onset Heart Failure in Men and Women","authors":"Hailun Qin MD ,&nbsp;Jasper Tromp MD, PhD ,&nbsp;Jozine M. ter Maaten MD, PhD ,&nbsp;Geert H.D. Voordes MD ,&nbsp;Bart J. van Essen MD ,&nbsp;Mark André de la Rambelje MSc ,&nbsp;Camilla C.S. van der Hoef MD ,&nbsp;Bernadet T. Santema MD, PhD ,&nbsp;Carolyn S.P. Lam MD, PhD ,&nbsp;Adriaan A. Voors MD, PhD","doi":"10.1016/j.jchf.2024.09.022","DOIUrl":"10.1016/j.jchf.2024.09.022","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have examined clinical predictors of incident heart failure (HF) in men and women. However, potential mechanisms through which these clinical predictors relate to the onset of HF remain to be established.</div></div><div><h3>Objectives</h3><div>The authors studied the association between clinical and proteomic risk profiles of new-onset HF in men and women.</div></div><div><h3>Methods</h3><div>Incident HF was studied in 478,479 participants from the UK Biobank. The association between new-onset HF and 8 common modifiable traditional risk factors, including obesity, smoking status, socioeconomic status, atrial fibrillation, type 2 diabetes, hypertension, hyperlipidemia, and history of myocardial infarction, was assessed in men and women. Proteomics data (2,923 unique proteins, Olink) was available in 22,695 men and 27,421 women. Pathway over-representation analyses were performed to identify biological pathways in men and women with and without new-onset HF. Principal component analyses were performed to extract weighted scores for each pathway. Subsequently, weighted scores were used in mediation analyses to investigate how the pathways mediated the association between risk factors and new-onset HF.</div></div><div><h3>Results</h3><div>During a median follow-up time of 12 years, HF incident rate was 3.60 per 1,000 person-years in men and 1.72 per 1,000 person-years in women (<em>P &lt;</em> 0.001). The strongest risk factor for future HF was a history of myocardial infarction (HR: 2.61; 95% CI: 2.46-2.77) in men and atrial fibrillation (HR: 4.10; 95% CI: 3.58-4.71) in women. When a risk factor was present in women, it conferred a higher risk of new-onset HF compared with the presence of the same risk factor in men. Both in men and women, the population-attributable risk was highest for hypertension (25% in men, 29% in women) and obesity (16% in men, 21% in women). Pathway analyses of protein profiles indicated several inflammatory pathways, and neutrophil degranulation in particular, to be activated both in men and women who developed HF. These inflammatory pathways modestly (22% in men and 24% in women) contributed to the association between hypertension and new-onset HF, but showed a stronger contribution (33% in men and 47% in women) to the association between obesity and new-onset HF.</div></div><div><h3>Conclusions</h3><div>In men and women, the most prominent risk factors for new-onset HF were hypertension and obesity, but they conferred a greater risk of new-onset HF in women. New-onset HF in both men and women was associated with pathophysiological pathways related to neutrophil degranulation and immunomodulation; and these pathways partly mediated the association between hypertension, obesity, and new-onset HF.</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 435-449"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872111","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}