Journal of Cardiac Failure最新文献

{"title":"Optimized Or Maximized Dose Of Mineralocorticoid Receptor Antagonists Among Patients Initiating Outpatient Sodium Zirconium Cyclosilicate Therapy","authors":"Abiy Agiro ,&nbsp;Connie Rhee ,&nbsp;Erin Cook ,&nbsp;Manasvi Sundar ,&nbsp;Alexandra Greatsinger ,&nbsp;Fan Mu ,&nbsp;Jingyi Chen ,&nbsp;Ellen Colman ,&nbsp;Arun Malhotra","doi":"10.1016/j.cardfail.2024.10.066","DOIUrl":"10.1016/j.cardfail.2024.10.066","url":null,"abstract":"<div><h3>Introduction</h3><div>Renin-angiotensin-aldosterone system inhibitor (RAASi) use can exacerbate hyperkalemia, especially in patients with cardiorenal conditions. Sodium zirconium cyclosilicate (SZC) has been previously shown to enable patients with hyperkalemia to continue RAASi; however, the level of dose optimization or maximization of RAASi after the initiation of outpatient SZC therapy is not well described, particularly among patients receiving mineralocorticoid receptor antagonists (MRA).</div></div><div><h3>Methods</h3><div>Using data from a large US insurance claims database from 7/2018-12/2022, adults who initiated SZC in the outpatient setting with a ≥7 day overlap with a RAASi (index) and ≥1 MRA fill in the 6-month follow-up period were selected. MRA optimization (≥50% of target dose) or maximization (≥100% of target dose) per guidelines were described during follow-up. The target dose for both spironolactone and eplerenone was 50 mg daily. Predictors of MRA optimization and maximization were assessed using separate multivariable logistic regression models.</div></div><div><h3>Results</h3><div>A total of 395 patients with MRA use after SZC initiation met the inclusion criteria, of whom 341 (86%) had an optimized MRA dose and 129 (33%) had a maximized MRA dose during follow-up. Patients had a mean age of 66 years and 63% of the sample was male. Common comorbidities included hypertension (91%), stage 1-4 or unspecified stage chronic kidney disease (CKD; 81%), diabetes (72%), and heart failure (53%). Predictors of MRA optimization included any vasodilator use (Figure 1). Predictors of MRA maximization included liver disease, stage 3 or stage 4 CKD vs. no CKD, and the absence of heart failure (Figure 2).</div></div><div><h3>Conclusions</h3><div>Among this real-world sample of patients taking a RAASi, most patients with hyperkalemia optimized their MRA dose and one-third maximized their MRA dose after initiating SZC in the outpatient setting. Certain clinical characteristics are significant predictors of the optimization and maximization of MRA dose.</div></div><div><h3>Funding</h3><div>AstraZeneca</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 205-206"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142050","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":"Beating to your Own Rhythm: An explanation of “Characteristics of Patients Hospitalized for Acute Heart Failure who Develop Atrial Fibrillation or Convert to Sinus Rhythm”","authors":"ANAS JAWAID MD,&nbsp;JENNIFER T. THIBODEAU MD, MSCS","doi":"10.1016/j.cardfail.2024.07.005","DOIUrl":"10.1016/j.cardfail.2024.07.005","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 14-15"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758896","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":"On Hurricanes and Resilience","authors":"G. Michael Felker MD, MHS, FHFSA","doi":"10.1016/j.cardfail.2024.12.004","DOIUrl":"10.1016/j.cardfail.2024.12.004","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 176-177"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006010","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":"Clinical Outcomes Of Cardiogenic Shock In Patients With Cardiac Sarcoidosis- A National Inpatient Database Study","authors":"Ambica Vivek Nair ,&nbsp;Sai Prasad Ramachandran ,&nbsp;Olayiwola Bolaji ,&nbsp;Blanche Echari ,&nbsp;Arthur Dilibe ,&nbsp;Osejie Fidelis Oriaifo ,&nbsp;Pramil Cheriyath ,&nbsp;Rajendra Shah ,&nbsp;Arthur Okere","doi":"10.1016/j.cardfail.2024.10.049","DOIUrl":"10.1016/j.cardfail.2024.10.049","url":null,"abstract":"<div><h3>Introduction</h3><div>The clinical manifestations of cardiac sarcoidosis vary greatly from asymptomatic presentation to significant life threatening arrhythmias . While severe heart failure and resultant cardiogenic shock are rare manifestations of cardiac sarcoidosis, prompt intervention is imperative. This retrospective study investigates the outcomes of cardiogenic shock in patients with cardiac sarcoidosis.</div></div><div><h3>Methodology</h3><div>National Inpatient Sample (2015-2020) was queried to identify all patients hospitalized for cardiogenic shock . They were classified into those with cardiac sarcoidosis and those without based on 10-CM codes. We applied discharge weight (DISCWT) provided in the database to generate the national estimates. Pearson Chi-square test for categorical variables and Student's t-tests/one-way ANOVA for continuous variables were applied to compare the baseline demographics and hospital characteristics. The categorical and continuous variables were expressed in percentages and median ± IQR respectively. Multivariable logistic regression model was used to assess the independent association of sarcoidosis with in-hospital outcomes of cardiogenic shock after adjusting for confounders .</div></div><div><h3>Results</h3><div>Of 599,260 patients admitted for cardiogenic shock, 0.49% (n=2,955) had sarcoidosis. Sarcoidosis patients, with a median age of 61 years compared to 67 in non-sarcoid patients, had higher African American (48.60% vs 14.45%, P&lt;.001)ethnicity .They also had higher prevalence of comorbidities such as COPD, hypertension, CHF, and CKD, while obesity, hyperlipidemia, and prior MI were more common in non-sarcoid patients . Sarcoidosis was associated with higher incidence of ventricular tachycardia (aOR 1.219, 95% CI 1.115-1.332, P&lt;0.001) and heart transplantations(aOR-2.22,95%c CI 1.84-2.67,P&lt;0.001). Conversely, sarcoidosis was associated with lower odds of multiorgan failure, cardiac arrest, PCI and CABG .No significant difference was observed in in-hospital mortality, AKI requiring dialysis and utilization of ECMO between sarcoid and non-sarcoid patients. Sarcoidosis patients were more likely to be discharged to home health care and experienced longer hospital stays (median 9 days vs 7 days) with higher total hospitalisation costs ($36,841.47 vs $31,605.32).</div></div><div><h3>Conclusion</h3><div>Patients admitted for cardiogenic shock from cardiac sarcoidosis had no difference in mortality rates when compared to their counterparts without cardiac sarcoidosis. However, the increased prevalence of ventricular arrhythmias among individuals with sarcoidosis warrants heightened vigilance and specialized management strategies for this patient population.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 198-199"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142291","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":"Predictive Model Of The Sustainability Of Favorable Response After LVAD Weaning In HF Patients: A VAD Wean Registry Analysis","authors":"Eleni Maneta ,&nbsp;Christos Kyriakopoulos ,&nbsp;Elizabeth Dranow ,&nbsp;Thomas Hanff ,&nbsp;Josef Stehlik ,&nbsp;Omar Wever-Pinzon ,&nbsp;Evgenij Potapov ,&nbsp;Jan Schmitto ,&nbsp;Palak Shah ,&nbsp;Maria Papathanasiou ,&nbsp;Filio Billia ,&nbsp;Craig Selzman ,&nbsp;Snehal Patel ,&nbsp;Stavros Drakos","doi":"10.1016/j.cardfail.2024.10.050","DOIUrl":"10.1016/j.cardfail.2024.10.050","url":null,"abstract":"<div><h3>Introduction</h3><div>During left ventricular assist device (LVAD) support, a subset of heart failure (HF) patients can experience myocardial structural and functional improvement that can lead to device weaning.</div></div><div><h3>Hypothesis</h3><div>We sought to derive a predictive model for the durability of favorable response after LVAD weaning.</div></div><div><h3>Methods</h3><div>We studied 400 HF patients enrolled in the international multicenter VAD Wean Registry who received a durable continuous-flow LVAD from 2002 to 2019 and underwent device support weaning (Figure). Indications for LVAD weaning included: (a) structural and functional myocardial improvement meeting institutional criteria for “myocardial recovery” (i.e. responders) or (b) LVAD-related complications accompanied by variable degrees of cardiac improvement (i.e. partial responders). We obtained clinical data before and during LVAD support as well as after LVAD weaning. The primary outcome was 3-year freedom from death, transplant or LVAD re-implantation. Bootstrap imputation and LASSO variable selection techniques were used to derive a predictive model which was then internally validated.</div></div><div><h3>Results</h3><div>Patients were predominantly White race (71%), Male sex (63%), with an average age of 42±14 years. At 3-years, 78% patients survived without the need for transplant or LVAD re-implantation. Out of 37 variables, we identified four that were included in a multivariate model achieving a C-statistic of 0.70 (95% CI: 0.64-0.76), (Table): indication for LVAD weaning, age, HF duration, and presence of implantable cardioverter-defibrillator (ICD).</div></div><div><h3>Conclusions</h3><div>Using routine clinical data from a multicenter registry we developed an internally validated risk tool to predict the sustainability of favorable response for 3 years after LVAD weaning. This model could aid clinical discussions related to the long-term management and prognosis of HF patients on LVAD support.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Page 199"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142292","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":"Incidence Of Ventricular Tachycardia And Fibrillation Detected By An Insertable Cardiac Monitor In Patients With Symptomatic Heart Failure With Reduced And Preserved Ejection Fraction","authors":"Rami Kahwash ,&nbsp;Michael Zile ,&nbsp;Muhammad S Khan ,&nbsp;Prasad Chalasani ,&nbsp;Barry Bertolet ,&nbsp;Laura Gravelin ,&nbsp;Brian Van Dorn ,&nbsp;Shantanu Sarkar ,&nbsp;Verla Laager ,&nbsp;Noreli Franco ,&nbsp;Nirav Patel ,&nbsp;Javed Butler","doi":"10.1016/j.cardfail.2024.10.031","DOIUrl":"10.1016/j.cardfail.2024.10.031","url":null,"abstract":"<div><h3>Introduction</h3><div>Subcutaneous insertable cardiac monitors (ICM) have the capability to detect tachycardia episodes which mostly includes supraventricular tachycardias (SVT) and occasionally ventricular tachycardia and fibrillation (VT/VF).</div></div><div><h3>Hypothesis</h3><div>We investigated the incidence of spontaneous VT/VF in NYHA class II/III heart failure (HF) patients with reduced and preserved ejection fraction using cardiac arrhythmia diagnostics measured by an ICM.</div></div><div><h3>Methods</h3><div>Patients with a recent history of HF events were implanted with an ICM equipped with tachycardia detection capability in the LINQ-HF and ALLEVIATE-HF phase-1 studies. ICMs detect tachycardia if 30 of 40 recent intervals are shorter than 260 ms or if 16 consecutive intervals are shorter than the tachycardia interval (nominally 340 ms) which is adjusted with age. Episodes are rejected if there is a large amount of baseline noise using a noise rejection algorithm. Tachycardia episodes that were detected by the ICM were first classified as VT/VF, SVT, or oversensing using an artificial intelligence (AI) model that was pre-trained using over 50,000 manually adjudicated ICM detected tachycardia episodes. If the AI model output probability for VT/VF was greater than 0.2, then those episodes were manually adjudicated for true incidence of non-induced spontaneous VT/VF. The Kaplan-Meier incidence curves for VT/VF incidence are reported as a function of reduced vs. preserved ejection fraction.</div></div><div><h3>Results</h3><div>The two studies had a combined 163 patients implanted with an ICM and followed for an average of 14.7±8.3 months. The baseline characteristics include average age of 67.2±11.2 years, 62.6% males, 55.2% with LVEF ≥ 50% (143 patients had LVEF measurements prior to implant), 16.6%% class-II and 83.4% class-III, and 55.2% with a clinical history of AF. There were 13 deaths and 14 device upgrades in the studies. There were 4 spontaneous polymorphic VT/VF episodes in 3 patients and 52 sustained monomorphic VT episodes in another 9 patients. The Kaplan-Meier incidence of VT/VF in the overall patient cohort was estimated to be 14% at 24 months. Patients with reduced and preserved EF had estimated incidence of 20% and 10%, respectively, at 24 months (Figure).</div></div><div><h3>Conclusion</h3><div>Incidence of VT/VF, as detected by an ICM and after manual adjudication of episodes after screening by an AI model over 2 years of follow-up, was estimated to be more than 14% in Class II/III HF patients with a history of HF events. VT/VF incidence was higher in HF patients with reduced vs. preserved LVEF in these study cohorts.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 189-190"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142615","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":"Glucagon-Like Peptide-1 Receptor Agonists in Heart Failure with Reduced Ejection Fraction: Time for a Trial","authors":"John W. Ostrominski MD ,&nbsp;Muthiah Vaduganathan MD, MPH","doi":"10.1016/j.cardfail.2024.07.002","DOIUrl":"10.1016/j.cardfail.2024.07.002","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 166-168"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734185","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":"Heart Transplantation: Effective Communication During Time Of Offer Acceptance To Post-operative Sign Out","authors":"Megan Dierks","doi":"10.1016/j.cardfail.2024.10.017","DOIUrl":"10.1016/j.cardfail.2024.10.017","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Our team acknowledges the many different members of the team who need to be actively involved in real time communication updates after a heart offer from UNOS has been accepted, in order to have a thorough, well delineated plan for transplant. Program wide initiation was launched to promote changes in the coordination for improved communication and universal, standardized patient care treatments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Hypothesis&lt;/h3&gt;&lt;div&gt;The best way to improve communication is to widen inclusivity and engage all members in the transplant phase. We felt that we needed to optimize each transplant and create a standardization across the board.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a group randomized assessment and invited all members of the team to participate in an online survey. This survey was launched prior to interventions. The survey identified lapses in effective communication styles and streamlining of care universally. From the feedback from the poll, we then implanted several key structural changes into our transplant coordination. After the interventions were in place, we launched a repeat survey poll one year later, to the same audience.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;One of the first interventions put into motion was the inclusivity of our pre-transplant conference call. Several hours before our agreed upon OR time, we typically met as a team to discuss the planning of the transplant. Many team members voiced they would like to be involved in this, so we opened up the invitation to all members of the patients' immediate care team. Updated medication sheet for pre, intra, and post op. Enhanced conference call to include all team members. New e-record changes; phoenix, progress notes with listings, email with alert of offer acceptance, conference time - streamlined appropriate duties and specified contacts for who to call with questions. updated the transplant coordinators duty and worksheet they manage the coordination from to be all-inclusive task-oriented checklist.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;63% of team worked for the program for over 3 yrs. Despite having tenure within our department, at the beginning of this process many felt they did not understand their role. One year later we have improved our 1 year survival rates. We have standardized our conference call to where it is a 15 min presentation. We have transplanted a record number of patients at our institution; 40 total for the 2023 calendar year, a 83% increase from the year prior.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Preoperative communication is standardized with little variation. Preoperative communication is organized and efficient. It is now agreed it is clear with whom team members should contact with questions about the plan of care. We have identified each team member, ensuring all necessary players are involved and present for the pre-transplant conference calls.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;We","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 183-184"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141352","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":"Clinical Outcome Of Hospitalized Patients Undergoing Left Ventricular Assist Device Implantation With Comorbid Protein-energy Malnutrition: A Study Utilizing The Nationwide Inpatient Sample (NIS) Database","authors":"Phuuwadith Wattanachayakul ,&nbsp;Pongprueth Rujirachun ,&nbsp;Evan Isaacs ,&nbsp;Natchaya Polpichai ,&nbsp;Sakditad Saowapa ,&nbsp;Thitiphan Srikulmontri ,&nbsp;Narathorn Kulthamrongsri ,&nbsp;Bruce Adrian Casipit ,&nbsp;Aman Amanullah","doi":"10.1016/j.cardfail.2024.10.075","DOIUrl":"10.1016/j.cardfail.2024.10.075","url":null,"abstract":"<div><h3>Background</h3><div>Patients with advanced heart failure are often at risk of malnutrition, which correlates with poor long-term outcomes such as increased heart failure hospitalizations, overall mortality, and heightened risk of complications. However, the impact of protein-energy malnutrition (PEM) on patients that specifically hospitalized for left ventricular assist device (LVAD) implantation remains unclear. Thus, our study aims to investigate this relationship.</div></div><div><h3>Methods</h3><div>We analyzed the 2020 U.S. National Inpatient Sample (NIS) to investigate the impact of concurrent diagnosis of PEM on the hospital outcome of patients admitted for LVAD implantation. Participants aged above 18 years were included using relevant ICD-10 CM codes. Multivariable logistic and linear regression analyses were employed to calculate adjusted odds ratios (aORs) for specific in-hospital outcomes.</div></div><div><h3>Results</h3><div>Among 3,645 patients admitted for LVAD implantation, the mean age was 56±13 years, with 25.3% female. Ethnicities comprised Caucasians (55%), Blacks (32%), Mexican Americans (6%), Asians (2%), and others (4%). Of these, 34.6% (1,270/3,645) had concurrent PEM diagnosis. Overall, the in-hospital mortality rate was 10.9%. In a multivariable regression model adjusting for patient and hospital factors, patients with PEM had a prolonged stay (45 days vs. 34 days, Beta_LOS 9.9, 95% CI 5.4 to 14.4, p &lt; 0.001) and had a 1.57-fold higher risk of mechanical ventilation use than those without PEM (aOR 1.57, 95% CI 1.03 to 2.41, p = 0.038). However, there was no statistically significant increase in the risk of in-hospital mortality (aOR 1.96, 95%CI 0.59 to 1.93, p = 0.835), acute kidney injury (aOR 1.42, 95% CI 0.91 to 2.20, p = 0.121), post-procedural bleeding (aOR 1.28, 95% CI 0.85 to 1.92, p = 0.243), or renal replacement therapy utilization (aOR 1.33, 95% CI 0.68 to 2.61, p = 0.405).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that concurrent PEM is associated with longer hospital stays and an increased risk of requiring mechanical ventilation. Future longitudinal cohort studies are needed to understand these connections better.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Page 209"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141406","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":"Sex Differences In Clinical Outcomes Among Patients With Stress-induced Cardiomyopathy Complicated By Cardiogenic Shock: A Retrospective Multi-center Cohort Study","authors":"Gina C Josey ,&nbsp;Usman Hasnie ,&nbsp;Vibhu Parcha ,&nbsp;Ahmed Saleh ,&nbsp;Ammar Hasnie ,&nbsp;Samuel McElwee ,&nbsp;Stephen Clarkson","doi":"10.1016/j.cardfail.2024.10.047","DOIUrl":"10.1016/j.cardfail.2024.10.047","url":null,"abstract":"<div><h3>Introduction</h3><div>Stress-Induced cardiomyopathy, which disproportionately impacts post-menopausal females, may be complicated by cardiogenic shock. However, sex-specific clinical outcomes among patients with stress-induced cardiomyopathy complicated by cardiogenic shock remains relatively understudied.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study using an EHR-based data platform from large academic medical centers across the United States (TriNetX, Inc.). We identified a study population of patients diagnosed with cardiogenic shock secondary to stress-induced cardiomyopathy from January 2012 through January 2024. Baseline demographics, clinical characteristics, medication use, and outcomes were defined using standardized ICD-10 codes. We stratified patients by sex, with the primary outcome of all-cause mortality at 6 months. Secondary outcomes included cardiac arrest, acute kidney injury (AKI), atrial fibrillation, and ventricular tachycardia/fibrillation (VT/VF). Propensity score matching (1:1), incorporating demographic factors, comorbidities, and medication usage, was employed to compare the risk of primary and secondary outcomes between groups.</div></div><div><h3>Results</h3><div>A total of 4,519 individuals were identified as having cardiogenic shock secondary to stress-induced cardiomyopathy. After propensity-score matching, there were 1,476 individuals in each group (<strong>Table</strong>). Females had a lower risk of all-cause mortality compared with their male counterparts (33.2% vs. 40.7%, HR: 0.78, 95% CI: 0.69-0.88). The females had lower risk of AKI (HR: 0.73, 95% CI: 0.66-0.80), cardiac arrest (HR: 0.86, 95% CI: 0.73-1.00), and VT/VF (HR: 0.76, 95% CI: 0.63-0.92). The risk of atrial fibrillation was similar between males and females (HR: 0.90, 95% CI: 0.76-1.06).</div></div><div><h3>Conclusion</h3><div>This study unveils a sex-based disparity in clinical outcomes among individuals with stress cardiomyopathy complicated by cardiogenic shock, underscoring the potential influence of sex-specific factors in the pathophysiology of this condition. Further investigations are warranted into the mechanistic underpinnings of sex-associated disparities and for tailoring therapeutic strategies to optimize clinical outcomes.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Page 197"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142289","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}