Journal of Cardiac Failure最新文献

{"title":"Effectiveness of Virtual Care Team Guided Management of Hospitalized Patients with HFrEF by Ethnicity.","authors":"John H Bertot, Anubodh S Varshney, Alea Moscone, Brian L Claggett, Zi Michael Miao, Muhammad Akash, Maria Pabon, Jonathan W Cunningham, Tracy Makuvire, Scott D Solomon, Dale S Adler, Muthiah Vaduganathan, Ankeet S Bhatt","doi":"10.1016/j.cardfail.2024.11.018","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.018","url":null,"abstract":"<p><strong>Background: </strong>IMPLEMENT-HF demonstrated a virtual team-based care strategy was safe and improved prescription of guideline directed medical therapy (GDMT) in hospitalized patients with heart failure and reduced ejection fraction (HFrEF). We evaluated differences in efficacy and safety outcomes by ethnicity in IMPLEMENT-HF.</p><p><strong>Methods: </strong>IMPLEMENT-HF evaluated a provider-facing virtual team-based care strategy vs. usual care in hospitalized patients with HFrEF from October 2021 to June 2022. The primary outcome was change in a guideline directed medical therapy (GDMT) optimization score from hospital admission to discharge, with positive changes reflecting net optimization. In this post-hoc analysis, we assessed heterogeneity in treatment effects by ethnicity (Hispanic vs. non-Hispanic). Outcomes included prespecified primary and secondary effectiveness outcomes and adjudicated safety events.</p><p><strong>Results: </strong>Of 808 screened patient admissions, 252 (31%) from 198 unique patients met inclusion criteria. Hispanic patients (n=43) were more likely to have diabetes and end-stage kidney disease than non-Hispanics; 70% spoke Spanish as a primary language. GDMT optimization score was lower among Hispanic vs. non-Hispanic patients (-0.44, 95% CI: -1.88 to 0.99 vs. +1.62, 95% CI: +1.02 to +2.21; p-value of interaction by ethnicity= 0.002). Allocation to the virtual care team intervention vs. usual care increased the proportion of patients experiencing >1 new initiation or dose up-titration among non-Hispanic patients but did not among Hispanic patients (absolute difference non-Hispanic vs. Hispanic: +31% vs. -19%; p-value of interaction = 0.003). Similar trends were seen among individual HF therapy and for the proportion of patients with optimization score >0 (absolute difference non-Hispanic vs. Hispanic: +29% vs. -20%; p-value of interaction = 0.005). Safety outcomes were similar among Hispanic and non-Hispanic patients.</p><p><strong>Conclusion: </strong>A provider-facing, virtual care team guided strategy for HFrEF GDMT optimization was less effective in Hispanic patients. Efforts to identify and reduce bias contributing to this observed difference and more diverse implementation studies are needed.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864210","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":"Performance of Clinical Scoring Systems in the Diagnosis of Transthyretin Amyloid Cardiomyopathy in a Diverse Patient Cohort.","authors":"Garred S Greenberg, Chinwendu Onuegbu, Carlos Espiche, Andrea Scotti, Paul Ippolito, Henry Dwaah, Jake Gilman, James Tauras, Aldo L Schenone, Piotr J Slomka, Michelle M Kittleson, Marcelo F Di Carli, Mario J Garcia, Mark Travin, Leandro Slipczuk","doi":"10.1016/j.cardfail.2024.11.016","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.016","url":null,"abstract":"<p><strong>Background: </strong>Two diagnostic clinical scoring systems, the ATTR-CM Score and the T-AMYLO Score, have been proposed but not validated in diverse populations, despite Black race being an important risk factor for transthyretin amyloid cardiomyopathy (ATTR-CM). The aim of this study was to evaluate their performance in diagnosing ATTR-CM in a diverse patient cohort.</p><p><strong>Methods: </strong>This retrospective single-center study analyzed patients who underwent a 99mTc-pyrophosphate single photon emission computed tomography scan (Tc-PYP) for workup of suspected ATTR-CM. ATTR-CM was considered present in those exhibiting Perugini scores of 2 or 3, confirmed by myocardial radiotracer uptake via single photon emission computed tomography. The diagnostic performance of a multivariate regression model and the two scoring systems was tested against Tc-PYP as the gold standard.</p><p><strong>Results: </strong>Our cohort included 476 patients, of which 308 (65%) were non-Hispanic Black, 93 (20%) were Hispanic, and 215 (45%) were female. A total of 164 (34%) had a positive Tc-PYP. Age ≥74 years, male sex, history of carpal tunnel, LVEF <55%, posterior wall thickness over 12mm, and relative wall thickness over 0.57 were independent predictors of positive Tc-PYP in our cohort, and hemoglobin <10 mg/dL, glomerular filtration rate <30 ml/min/1.73m², and coronary artery disease were independent predictors of negative Tc-PYP. The multivariate model had an area under the curve (AUC) of 0.92 (95% CI, 0.90-0.95). The ATTR-CM Score (AUC, 0.86; 95% CI, 0.83-0.90) had better diagnostic accuracy than the T-AMYLO Score (AUC, 0.75; 95% CI, 0.71-0.80) (P < 0.001).</p><p><strong>Conclusions: </strong>Two simple clinical scoring systems, derived to identify patients at high risk of having ATTR-CM necessitating further diagnostic evaluation, showed good predictive accuracy in our diverse patient cohort. The ATTR-CM Score was superior to the T-AMYLO Score in our cohort.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864213","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":"Where's the remote? Failure to report clinical workflows in heart failure remote monitoring studies.","authors":"Elise L Shalowitz, Pardeep Jhund, Mitchell Psotka, Abhinav Sharma, Matt Dimond, Trejeeve Martyn, Richard Nkulikiyinka, Mona Fiuzat, David P Kao","doi":"10.1016/j.cardfail.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.012","url":null,"abstract":"<p><strong>Background: </strong>Remote patient monitoring (RPM) clinical trials have reported mixed results in improving outcomes for patients with chronic heart failure (HF). The impact of clinical workflows that could impact RPM effectiveness is often overlooked. We sought to characterize workflows and response protocols that could impact outcomes in studies of non-invasive RPM in HF.</p><p><strong>Methods: </strong>We reviewed studies (1999-2024) assessing non-invasive RPM interventions for adults with HF. We collected 24 aspects of workflows describing education, physiological and symptomatic data collection, transmission and review, clinical escalation protocols, and response time. We attempted to perform a meta-analysis to identify associations between workflow components and outcomes of death and hospitalization.</p><p><strong>Results: </strong>We identified 63 studies (57.1% randomized controlled, 23.8% pilot/feasibility, 19.1% other) comprising 16,699 subjects. Despite a large number of studies and subjects, workflow reporting was insufficient to perform our intended meta-analysis regarding key workflow components. RPM clinical workflows were diverse in configuration, with high variability in component description ranging from always- to never-reported. Specifics of monitoring devices and related training were well-reported as expected based on most trial hypotheses. However, elements of clinical data response such as frequency of data review, clinical escalation criteria, and provider response time were often underreported or not reported at all (48%, 24%, and 97%, respectively), hindering study replication and evidence-based implementation.</p><p><strong>Conclusions: </strong>Clinical workflows are poorly described in non-invasive RPM studies, preventing systematic assessment, device comparison, and replication. A standardized approach to reporting HF RPM workflows is vital to evaluate effectiveness and guide evidence-based clinical implementation.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854119","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":"Rationale and Design of the Personalized Therapy Study: Evaluating Real-World Performance of Two Automated Defibrillation Therapy Algorithms.","authors":"Raymond Yee, Charles J Love, Daniel W Kaiser, Ulrika Birgersdotter-Green, Yong-Mei Cha, Jagmeet P Singh, Shufeng Liu, Yan Zhang, Eugene S Chung","doi":"10.1016/j.cardfail.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.011","url":null,"abstract":"<p><strong>Background: </strong>Barriers to maximizing patient benefit with implantable defibrillation devices include limited ability to tailor antitachycardia pacing (ATP) therapy in real-time and identify patients at risk of heart failure (HF) events early on. The Personalized Therapy study aims to evaluate the performance of two algorithms, intrinsic ATP^TM (iATP) and TriageHF^TM, to address these barriers in routine clinical practice.</p><p><strong>Methods and results: </strong>The Personalized Therapy Study was designed as a prospective, multicenter, post-market registry study expected to enroll approximately 2,200 patients meeting the following criteria: (1) implanted with a study-eligible device regardless of procedure type; (2) Medtronic CareLink® Network enrolled; (3) TriageHF enabled within CareLink and High Risk Alert notifications turned ON; and (4) iATP enabled. The primary study objectives are to demonstrate iATP effectiveness in the fast ventricular tachycardia zone and estimate the positive predictive value of TriageHF high-risk status for worsening HF. Additionally, objectives include characterizing iATP effectiveness in all ventricular detection zones and characterizing TriageHF based clinical actions and related HF-hospitalizations.</p><p><strong>Conclusion: </strong>This study is expected to generate real-world evidence on the performance of the iATP and TriageHF algorithms, which aim to improve clinical practice by tailoring arrhythmia and HF therapies to individual patient disease state.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854112","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":"Knowledge of Illness Trajectory and Symptoms of Heart Failure in Patients with Acute Coronary Syndrome.","authors":"Momoko Masuda, Kazuki Tobita, Ayumi Goda, Daisuke Fujisawa, Shinsuke Takeuchi, Kohei Koyama, Syoichi Tashiro, Shin Yamada, Kyoko Soejima, Takashi Kohno","doi":"10.1016/j.cardfail.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.013","url":null,"abstract":"<p><strong>Background: </strong>Preventive management of heart failure (HF) should involve strategies to increase awareness of HF in patients with pre-HF and those at risk of HF. However, the perception of HF in patients with acute coronary syndrome (ACS) remains unclear. This study aimed to assess patient understanding of the definition of HF for the public (i.e., its illness trajectory [intermittent decline], impact on life expectancy [HF would limit life expectancy], and symptoms [shortness of breath, swelling]) that was introduced by the Japanese Circulation Society.</p><p><strong>Methods: </strong>This cross-sectional questionnaire-based study enrolled 209 emergently admitted patients with ACS who underwent a cardiac rehabilitation program at a single university-based hospital. We identified the clinical characteristics of patients who understood HF definition.</p><p><strong>Results: </strong>Among the enrolled patients (median age, 69 years; males, 81.3%; 59.8% with ST-elevation myocardial infarction), 64.0% and 53.1% chose the correct answers regarding HF illness trajectory and impact on life expectancy, respectively. While 92.3% of the patients correctly chose shortness of breath as a HF symptom, 56.7% correctly chose swelling. Patient understanding of the definition of HF was associated with younger age, but not with HF risk (i.e., hypertension, diabetes, higher natriuretic peptide levels, lower left ventricular ejection fraction) and history of symptomatic HF.</p><p><strong>Conclusions: </strong>Among patients with ACS who participated in the cardiac rehabilitation program in this cohort, patient understanding of HF definition was suboptimal. Effective measures to improve their understanding should be considered to enhance the prevention of HF.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836503","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":"Medically tailored meals in heart failure: a systematic review of the literature 2013-2023.","authors":"Nathalie McIntosh, Hayley Bilingsley, Scott L Hummel, Whitney L Mills","doi":"10.1016/j.cardfail.2024.10.446","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.10.446","url":null,"abstract":"<p><strong>Background: </strong>Dietary interventions have potential to improve symptoms and outcomes in patients with heart failure (HF), but there are barriers to eating nutrient-dense diets. One strategy to address challenges is to provide medically-tailored meals (MTMs), fully-prepared meals that align with an individual's nutritional needs. In this systemic review, we examined clinical outcomes of studies that provided MTMs to patients with HF.</p><p><strong>Methods and results: </strong>We searched CINAH, EBSCO/MEDLINE, EMBASE, PUBMED and the Cochrane Central Register of Controlled Trials to identify MTM interventions published between 2013 and 2023. We included six studies. Five studies involved sodium-restriction. Four of these were randomized control trials and one was a matched cohort study. Sample sizes ranged from 31 to 641. Patient populations included individuals who had heart failure, acute decompensated heart failure and heart failure with preserved ejection fraction. One study involved energy-restriction in patients with heart failure with preserved ejection fraction and obesity. This was a randomized control study and had a sample size of 100. Sodium-restriction interventions, when aligned with Dietary Approaches to Stop Hypertension goals, reduced 90-day HF readmissions in one study and trended towards improving 30-day and 12-week HF readmissions in another. The energy-restriction intervention reduced diastolic blood pressure, weight and inflammatory biomarkers, and improved quality of life (QoL) and cardiorespiratory fitness. Neither intervention had an impact on mortality.</p><p><strong>Conclusions: </strong>Provision of sodium-restricted MTMs to HF patients may reduce the risk of rehospitalization. Provision of energy-restricted MTMs to HF patients with obesity can improve symptoms, weight loss, QoL and cardiorespiratory fitness. Adequately powered randomized controlled trials are needed to confirm these effects and investigate underlying mechanisms.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824227","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":"Practice Variation in Temporary Mechanical Circulatory Support for Cardiogenic Shock.","authors":"Song Li, Arjun Bahl, Boyangzi K Li, Manreet K Kanwar, Borui Li, Shashank S Sinha, Jaime Hernandez-Montfort, Qiuyue Kong, Paavni Sangal, Robert W Yeh, Daniel Burkhoff, Claudius Mahr, Navin K Kapur","doi":"10.1016/j.cardfail.2024.10.447","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.10.447","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824229","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":"Prognostic impact of thyroid function in patients with incident heart failure: a nationwide study.","authors":"Jeppe Kofoed Petersen, Christian Selmer, Søren Lund Kristensen, Rasmus Rørth, Adelina Yafasova, Lucas Grove Bager Vejlstrup, Sam Aiyad Ali, Morten Schou, Lars Køber, Emil Loldrup Fosbøl, Lauge Østergaard","doi":"10.1016/j.cardfail.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.010","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of data on the prognostic impact of thyroid dysfunction in patients with heart failure (HF). We aimed to examine the association between these two conditions in a nationwide cohort of patients with HF.</p><p><strong>Methods: </strong>This Danish cohort study evaluated the thyroid function of patients diagnosed with first-time HF from 2000-2021. Patients were categorized according to laboratory-based thyroid function values (euthyroid, overt/subclinical hypothyroidism, or hyperthyroidism) recorded within one year before the HF diagnosis. The primary outcome was a composite of mortality and hospitalization for HF, examined using the cumulative incidence function. Cox proportional hazard analysis adjusted for major comorbidities was performed to investigate differences in outcomes among groups.</p><p><strong>Results: </strong>Of the 58,067 individuals included in this study (43.9% female, median age 75.7 years [p25-p75:66.4-83.5]), 54,319 (93.6%) were euthyroid, 1,669 (2.9%) had subclinical hypothyroidism, 239 (0.4%) had overt hypothyroidism, 1,633 (2.8%) had subclinical hyperthyroidism, and 207 (0.4%) had overt hyperthyroidism. Compared with euthyroid patients, the adjusted one-year HR of the composite outcome was 1.11 (95% CI, 1.02-1.20) in patients with subclinical hypothyroidism, 1.24 (95% CI, 1.02-1.51) in patients with overt hypothyroidism, 1.06 (95% CI, 0.98-1.15) in patients with subclinical hyperthyroidism, and 1.27 (95% CI, 1.00-1.60) in patients with overt hyperthyroidism. This positive association was mainly driven by the increased mortality rates.</p><p><strong>Conclusion: </strong>In patients with incident HF, the presence of both hypo- and hyperthyroidism up to one year prior to HF diagnosis was associated with increased risk of the composite of mortality and hospitalization for HF. Our results demonstrate a high-risk group of patients in need of increased clinical awareness.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822194","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":"Patient Focus: How can food choices help treat heart failure? An explanation of \"Medically tailored meals in heart failure: a systematic review of the literature 2013-2023\".","authors":"Nicholas S Hendren, Jennifer T Thibodeau","doi":"10.1016/j.cardfail.2024.11.009","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.11.009","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818058","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":"GLP-1 Receptor Agonist in Non-obese Patients with Type-2 Diabetes Mellitus and Heart Failure with Preserved Ejection Fraction.","authors":"Sumanth Khadke, Ashish Kumar, Ammar Bhatti, Sourbha S Dani, Sadeer Al-Kindi, Khurram Nasir, Salim S Virani, Jagriti Upadhyay, Dinamarie C Garcia-Banigan, Sonu Abraham, Raya Husami, Yixin Kong, Sherif Labib, David Venesy, Sachin Shah, Daniel Lenihan, Muthiah Vaduganathan, Anita Deswal, Gregg C Fonarow, Javed Butler, Anju Nohria, Mikhail N Kosiborod, Sarju Ganatra","doi":"10.1016/j.cardfail.2024.10.448","DOIUrl":"https://doi.org/10.1016/j.cardfail.2024.10.448","url":null,"abstract":"<p><strong>Background: </strong>Glucagon like peptide-1 receptor agonists (GLP-1RA) promote weight loss and improve heart failure-related symptoms, quality of life, and functional capacity in patients with obesity and heart failure with preserved ejection fraction (HFpEF). However, their clinical effectiveness in non-obese patients with diabetes and HFpEF is understudied.</p><p><strong>Methods: </strong>The TriNetX research network was used to identify adult patients (≥18 years) with type 2 diabetes mellitus (T2DM), Heart failure with preserved ejection fraction ((Left ventricular ejection fraction ≥45%), elevated brain natriuretic peptide (≥150pg/mL) or N-terminal pro-B-type natriuretic peptide(≥450pg/mL) and a body mass index (BMI) <30 kg/m2 on or before August 31, 2022. Patients were divided into two groups based on GLP-1RA use. After propensity score matching, Cox proportional Hazard Ratios (HRs) were used to compare outcomes over a 12-month follow-up period.</p><p><strong>Results: </strong>The study included 84,990 patients (n= 42,495 per group, mean age 64 years, 49% females, 65% white). Patients on GLP-1RA were associated with lower incidence of heart failure exacerbation events (HR 0.60, 95% CI 0.58-0.62, p<0.001) and all-cause emergency room visits or hospitalizations (HR 0.67, 95% CI 0.66-0.69, p<0.001) compared to those not on GLP-1RA. Other outcomes including acute myocardial infarction, atrial fibrillation, ischemic stroke, pulmonary hypertension, C-reactive protein ≥5mg/L, acute kidney injury, and the need for renal replacement therapy, were also significantly less frequent in the GLP-1RA group. These associated benefits persisted even among patients on sodium-glucose cotransporter-2 inhibitors (SGLT2i).</p><p><strong>Conclusion: </strong>GLP-1RA use is associated with improved cardiovascular outcomes in non-obese patients with T2DM and HFpEF and has an associated incremental benefit even among patients on SGLT2i.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818056","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}