{"title":"Challenges Addressing Prognosis in Advanced Heart Failure","authors":"Larry A. Allen MD, MHS , Lynne W. Stevenson MD","doi":"10.1016/j.jchf.2025.01.002","DOIUrl":"10.1016/j.jchf.2025.01.002","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 525-529"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548164","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}
Janice Y. Chyou MD , Wan Ting Tay MAppStat , Jasper Tromp MD, PhD , Wouter Ouwerkerk PhD , Kai Hang Yiu MD, PhD , John G.F. Cleland MD , Sean P. Collins MD , Christiane E. Angermann MD , Georg Ertl MD , Ulf Dahlström MD, PhD , Kenneth Dickstein MD, PhD , Sergio V. Perrone MD , Mathieu Ghadanfar MD , Anja Schweizer PhD , Achim Obergfell MD , Gerasimos Filippatos MD , Carolyn S.P. Lam MBBS, PhD
{"title":"Prognostic Implications and Global Perspectives of Atrial Fibrillation in Patients Hospitalized for Heart Failure","authors":"Janice Y. Chyou MD , Wan Ting Tay MAppStat , Jasper Tromp MD, PhD , Wouter Ouwerkerk PhD , Kai Hang Yiu MD, PhD , John G.F. Cleland MD , Sean P. Collins MD , Christiane E. Angermann MD , Georg Ertl MD , Ulf Dahlström MD, PhD , Kenneth Dickstein MD, PhD , Sergio V. Perrone MD , Mathieu Ghadanfar MD , Anja Schweizer PhD , Achim Obergfell MD , Gerasimos Filippatos MD , Carolyn S.P. Lam MBBS, PhD","doi":"10.1016/j.jchf.2024.11.009","DOIUrl":"10.1016/j.jchf.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) and heart failure (HF) each contributes to global disease burden and can coexist. The interplay of prior HF, prior AF, and presenting rhythm have not previously been jointly considered in prognostic implication.</div></div><div><h3>Objectives</h3><div>The authors sought to assess 1-year all-cause mortality according to permutations of prior HF, prior AF, and AF as presenting rhythm, in a global cohort of patients hospitalized for HF.</div></div><div><h3>Methods</h3><div>REPORT-HF enrolled patients during hospitalization for acute HF from 44 countries over 6 continents. Cox proportional hazard models were used to compute HRs for the primary outcome of 1-year all-cause mortality.</div></div><div><h3>Results</h3><div>Of 13,401 participants (median age 67 years, 61% men), 58% had prior HF. AF prevalence (prior or newly detected) at HF admission was 39%, varying by left ventricular ejection fraction and race subgroups. Compared with patients with no prior HF, no prior AF, and presenting in sinus rhythm, 1-year all-cause mortality was elevated in patients with prior HF, prior AF, and presenting in AF (adjusted HR: 1.54 [95% CI: 1.34-1.78]; <em>P</em> < 0.001) and in patients with prior HF, no prior AF, and presenting in AF (adjusted HR: 1.51 [95% CI: 1.20-1.90]; <em>P</em> < 0.001), but not in patients with no prior HF and with prior AF or presenting in AF. These results were conserved across left ventricular ejection fraction and race subgroups.</div></div><div><h3>Conclusions</h3><div>In a global cohort of patients hospitalized for HF, permutations of prior HF, prior AF, and AF as presenting rhythm differentiate outcome. History of prior HF influences the prognostic implications of AF in patients hospitalized for HF. (Global Noninterventional Heart Failure Disease Registry [REPORT-HF]; <span><span>NCT02595814</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 453-464"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364449","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}
Gracia Fahed MD , John Isaiah Jimenez BS , Marina I. Adrianzen Fonseca MD , Jonathan Hu BS , Gabriela Spencer-Bonilla MD , Francois Haddad MD , Jesus E. Pino Moreno MD , Ronald M. Witteles MD , Kevin M. Alexander MD
{"title":"The Impact of Social Determinants of Health on Timely Detection in Transthyretin Cardiac Amyloidosis","authors":"Gracia Fahed MD , John Isaiah Jimenez BS , Marina I. Adrianzen Fonseca MD , Jonathan Hu BS , Gabriela Spencer-Bonilla MD , Francois Haddad MD , Jesus E. Pino Moreno MD , Ronald M. Witteles MD , Kevin M. Alexander MD","doi":"10.1016/j.jchf.2024.11.022","DOIUrl":"10.1016/j.jchf.2024.11.022","url":null,"abstract":"","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":"13 3","pages":"Pages 530-532"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548165","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}
Toru Kondo, Pardeep S Jhund, Inder S Anand, Brian L Claggett, Akshay S Desai, Kieran F Docherty, Carolyn S P Lam, Martin P Lefkowitz, Aldo P Maggioni, Felipe A Martinez, Margaret M Redfield, Jean L Rouleau, Dirk J Van Veldhuisen, Faiez Zannad, Michael R Zile, Milton Packer, Scott D Solomon, John J V McMurray
{"title":"Effects of Sacubitril/Valsartan According to Natriuretic Peptide Levels in Patients Enrolled in PARADIGM-HF and PARAGON-HF.","authors":"Toru Kondo, Pardeep S Jhund, Inder S Anand, Brian L Claggett, Akshay S Desai, Kieran F Docherty, Carolyn S P Lam, Martin P Lefkowitz, Aldo P Maggioni, Felipe A Martinez, Margaret M Redfield, Jean L Rouleau, Dirk J Van Veldhuisen, Faiez Zannad, Michael R Zile, Milton Packer, Scott D Solomon, John J V McMurray","doi":"10.1016/j.jchf.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.jchf.2024.12.010","url":null,"abstract":"<p><strong>Background: </strong>Recent trials of new heart failure (HF) treatments suggest the effect of therapy may vary by N-terminal pro-B type natriuretic peptide (NT-proBNP) level.</p><p><strong>Objectives: </strong>The authors examined the efficacy of sacubitril/valsartan according to NT-proBNP levels in patients with reduced, mildly reduced, and preserved left ventricular ejection fraction (LVEF) enrolled in PARADIGM-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor with Angiotensin-Converting-Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial) and PARAGON-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor with Angiotensin-Receptor Blockers Global Outcomes in HF with Preserved Ejection Fraction).</p><p><strong>Methods: </strong>Individual patient data from PARADIGM-HF and PARAGON-HF were pooled and participants were divided into categories defined by quintiles of NT-proBNP level. The primary outcome examined was the composite of HF hospitalization or cardiovascular death.</p><p><strong>Results: </strong>Among the 13,195 patients enrolled in both trials, 13,142 (99.6%) had a baseline NT-proBNP level measured. The rate of the primary outcome (per 100 person-years) increased with NT-proBNP levels: quintile 1, 5.9 (95% CI: 5.3-6.5); quintile 2, 7.5 (95% CI: 6.9-8.2); quintile 3, 9.0 (95% CI: 8.2-9.7); quintile 4, 12.0 (95% CI: 11.1-12.9); and quintile 5, 20.8 (95% CI: 19.6-22.2). The relative risk reduction in the primary outcome with sacubitril/valsartan was consistent across NT-proBNP levels: the HR in quintile 1 was 0.79 (95% CI: 0.65-0.96); quintile 2, 0.87 (95% CI: 0.72-1.04); quintile 3, 0.79 (95% CI: 0.66-0.93); quintile 4, 0.85 (95% CI: 0.73-0.99); and quintile 5, 0.86 (95% CI: 0.76-0.97; P for interaction = 0.86). The absolute risk reduction was greatest in NT-proBNP quintile 5; the number needed to treat for the primary outcome over the median follow-up of 31 months was 16 in quintile 5 vs 37 in quintile 1.</p><p><strong>Conclusions: </strong>The relative risk reductions with sacubitril/valsartan were consistent irrespective of NT-proBNP level in HF patients across the range of LVEF. Consequently, the absolute risk reductions were greatest in patients with higher NT-proBNP levels. (PARADIGM-HF; NCT01035255; and PARAGON-HF; NCT01920711).</p>","PeriodicalId":14687,"journal":{"name":"JACC. Heart failure","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633639","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}
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