Adithya K Yadalam, Apoorva Gangavelli, Alexander C Razavi, Yi-An Ko, Ayman Alkhoder, Nisreen Haroun, Rafia Lodhi, Ahmed Eldaidamouni, Mahmoud Al Kasem, Arshed A Quyyumi
{"title":"Lipoprotein(a) Levels and Adverse Outcomes in Heart Failure.","authors":"Adithya K Yadalam, Apoorva Gangavelli, Alexander C Razavi, Yi-An Ko, Ayman Alkhoder, Nisreen Haroun, Rafia Lodhi, Ahmed Eldaidamouni, Mahmoud Al Kasem, Arshed A Quyyumi","doi":"10.1016/j.cardfail.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.cardfail.2025.03.016","url":null,"abstract":"<p><strong>Background: </strong>Although lipoprotein(a) [Lp(a)] level elevation is associated with new-onset heart failure (HF), it is unclear if elevated Lp(a) levels predict cardiovascular events in patients with chronic HF. Thus, we examined the association between Lp(a) levels and adverse cardiovascular outcomes in patients with HF.</p><p><strong>Methods & results: </strong>A total of 1,088 patients with HF undergoing cardiac catheterization at Emory-affiliated hospitals from 2004 to 2022 were divided into low (<30 mg/dL), intermediate (30-49 mg/dL), and high (≥50 mg/dL) Lp(a) groups. The primary outcome was the composite of cardiovascular death and HF hospitalization. Outcomes were assessed by Lp(a) group with competing-risk modeling accounting for non-cardiovascular death after adjustment for demographics, traditional cardiovascular risk factors, ejection fraction (EF), ischemic HF etiology, and NT-proBNP. Sensitivity analyses were performed to explore for heterogeneity of effect. The median age was 67, 34% were women, 18% were Black, 74% with ischemic HF, and 60% with EF ≤40%. During a median follow-up time of 4.3 years, 474 (44%) composite events occurred. When compared to participants with Lp(a) <30 mg/dL after multivariable adjustment, those with Lp(a) 30-49 mg/dL (sHR 1.35, 95% CI 1.04-1.76, P=0.025) and Lp(a) ≥50 mg/dL (sHR 1.38, 95% CI 1.11-1.72, P=0.004) had a significantly higher risk of cardiovascular death or HF hospitalization. This relationship appeared to diminish over time and was nominally stronger in those with ischemic versus nonischemic HF (P-interaction=0.06) but did not meet significance after adjustment for multiple hypothesis testing.</p><p><strong>Conclusion: </strong>In patients with HF, Lp(a) ≥30 mg/dL independently predicts the risk of cardiovascular death or HF hospitalization.</p>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795562","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}
SHELLI FEDER PhD, APRN, FNP-C, ACHPN, FPCN, FAHA , LYNNE IANNONE MA , DORA LENDVAI PhD, RN , YAN ZHAN MBA, RN , KATHLEEN AKGÜN MD, MS , MARY ERSEK PhD, RN, FPCN , CAROL LUHRS MD , LARRY A. ALLEN MD, MHS , DAVID B. BEKELMAN MD, MPH , NATHAN GOLDSTEIN MD , DIO KAVALIERATOS PhD, FAAHPM
{"title":"Clinician Insights into Effective Components, Delivery Characteristics and Implementation Strategies of Ambulatory Palliative Care for People with Heart Failure: A Qualitative Analysis","authors":"SHELLI FEDER PhD, APRN, FNP-C, ACHPN, FPCN, FAHA , LYNNE IANNONE MA , DORA LENDVAI PhD, RN , YAN ZHAN MBA, RN , KATHLEEN AKGÜN MD, MS , MARY ERSEK PhD, RN, FPCN , CAROL LUHRS MD , LARRY A. ALLEN MD, MHS , DAVID B. BEKELMAN MD, MPH , NATHAN GOLDSTEIN MD , DIO KAVALIERATOS PhD, FAAHPM","doi":"10.1016/j.cardfail.2024.07.009","DOIUrl":"10.1016/j.cardfail.2024.07.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To elicit perspectives from specialist palliative care (SPC) and cardiology clinicians concerning the necessary components, delivery characteristics and implementation strategies of successful ambulatory SPC for people with heart failure (HF).</div></div><div><h3>Background</h3><div>Palliative care is a recommended component of guideline-directed care for people with HF. However, optimal strategies to implement SPC within ambulatory settings are unknown.</div></div><div><h3>Methods</h3><div>We conducted a qualitative descriptive study composed of semistructured interviews with SPC and cardiology clinicians at Veterans Affairs Medical Centers (VAMCs) with the highest number of ambulatory SPC consultations within the VA system among people with HF between 2021 and 2022. Clinicians were asked how they provided ambulatory SPC and what they felt were the necessary components, delivery characteristics and implementation strategies of care delivery. Interviews were analyzed using directed content analysis.</div></div><div><h3>Results</h3><div>We interviewed 14 SPC clinicians and 9 cardiology clinicians at 7 national VAMCs; 43% were physicians, and 48% were advanced-practice registered nurses/physician associates. Essential components of ambulatory SPC encompassed discussion of goals of care (eg, prognosis, advance directives) and connecting patients/caregivers to resources (eg, home care). Preferred delivery characteristics included integrated (ie, embedded) approaches to SPC delivery, standardized patient selection and referral procedures, and formalized procedures for handoffs to and from SPC. Strategies that addressed SPC implementation included deploying palliative champions, educating non-SPC clinicians on the value of ambulatory SPC for people with HF and developing ambulatory models through leadership support.</div></div><div><h3>Conclusions/Implications</h3><div>Facilitating the broader adoption of ambulatory SPC among people with HF may be achieved by prioritizing these mutually valued and necessary features of SPC delivery.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 611-620"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889346","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}
JESSICA R. GOLBUS MD, MS , TREJEEVE MARTYN MD, MSc
{"title":"Weighing the Benefits of Wearable Devices in Heart Failure Trials","authors":"JESSICA R. GOLBUS MD, MS , TREJEEVE MARTYN MD, MSc","doi":"10.1016/j.cardfail.2025.03.001","DOIUrl":"10.1016/j.cardfail.2025.03.001","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 704-707"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585770","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}
SARAH GODFREY MD, MPH , JENNIFER NIXON MSW , MARK H. DRAZNER MD, MSc , MARYJANE FARR MD, MSc
{"title":"The Impact of Kinlessness on Older Adults with Advanced Heart Failure","authors":"SARAH GODFREY MD, MPH , JENNIFER NIXON MSW , MARK H. DRAZNER MD, MSc , MARYJANE FARR MD, MSc","doi":"10.1016/j.cardfail.2024.06.012","DOIUrl":"10.1016/j.cardfail.2024.06.012","url":null,"abstract":"<div><div>Markers of social health, including kinlessness, social isolation and loneliness, have important implications for quality of life and health for older adults. As the population ages, there is a growing cohort of kinless older adults without living partners or children, particularly among disadvantaged groups. Kinlessness has been associated with worse mental and physical health, significant unmet care needs, increased risk of dementia, higher rates of long-term placement, and higher mortality rates than those for patients with kin. Although other markers of social health have been studied in patients with heart failure, little is known about kinlessness in this population of patients. This review outlines the data on kinlessness and its impact on patients’ outcomes, and it proposes novel interventions to mitigate its effects.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 708-714"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889347","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":"Weighing the Future: A Novel Tool to Manage Patients With Heart Failure","authors":"ANJAN TIBREWALA MD, MS, JANE E. WILCOX MD, MSCI","doi":"10.1016/j.cardfail.2025.02.009","DOIUrl":"10.1016/j.cardfail.2025.02.009","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 676-678"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492026","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}
AVERY C. BECHTHOLD PhD, BSN, RN , MARTHA ABSHIRESAYLOR PhD, RN , RACHEL D. WELLS PhD, RN
{"title":"Lessons Learned From 2 Research Studies Enrolling Underrepresented Patients With Ventricular Assist Devices and Their Family Caregivers","authors":"AVERY C. BECHTHOLD PhD, BSN, RN , MARTHA ABSHIRESAYLOR PhD, RN , RACHEL D. WELLS PhD, RN","doi":"10.1016/j.cardfail.2025.01.026","DOIUrl":"10.1016/j.cardfail.2025.01.026","url":null,"abstract":"<div><div>Given the continued challenges of and barriers to recruiting and retaining underrepresented groups in cardiovascular studies, this study aimed to describe successful recruitment strategies used by 2 related ventricular assist device (VAD) studies. The 2 exemplar studies focused on understanding how adults with a VAD and their family caregivers discuss, reflect upon and act on their personal values. To recruit a more representative and diverse sample reflective of the substantial Black population receiving care at the local academic hospital outpatient clinic, we developed multipronged recruitment strategies for a convergent mixed-methods study (Study 1) and a sequential explanatory mixed-methods study (Study 2). Two underlying principles guided recruitment strategies: (1) clinician-scientist collaboration, and (2) personalized participant interactions. This article reflects on lessons learned by an early career investigator and her mentors from 2 studies, which will support ongoing inclusive recruitment in future projects.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 748-752"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585710","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}
Shashank S. Sinha MD , Robert J. Mentz MD , Anuradha Lala MD
{"title":"In Search of Truth: Why You Think You're Right Even When You're Wrong","authors":"Shashank S. Sinha MD , Robert J. Mentz MD , Anuradha Lala MD","doi":"10.1016/j.cardfail.2025.03.003","DOIUrl":"10.1016/j.cardfail.2025.03.003","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 609-610"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792247","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}
ARDEN O'DONNELL PhD, MPH, LICSW, APHSW-C , LAURA P. GELFMAN MD, MPH,
{"title":"Extending the Reach: Ambulatory Specialty Palliative Care for People With Heart Failure","authors":"ARDEN O'DONNELL PhD, MPH, LICSW, APHSW-C , LAURA P. GELFMAN MD, MPH,","doi":"10.1016/j.cardfail.2025.02.010","DOIUrl":"10.1016/j.cardfail.2025.02.010","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 4","pages":"Pages 621-623"},"PeriodicalIF":6.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537194","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}