Journal of cardiology最新文献

{"title":"Clinical implications of malnutrition on 30-day adverse events in patients with Takotsubo syndrome.","authors":"Kyohei Onishi, Koichiro Matsumura, Eijiro Yagi, Nobuhiro Yamada, Yohei Funauchi, Kazuyoshi Kakehi, Ayano Yoshida, Kosuke Fujita, Takayuki Kawamura, Hiroki Matsuzoe, Masafumi Ueno, Gaku Nakazawa","doi":"10.1016/j.jjcc.2025.03.004","DOIUrl":"10.1016/j.jjcc.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>The impact of malnutrition on clinical outcomes in patients with takotsubo syndrome (TTS) is poorly understood. The purpose of this study was to investigate the relationship between malnutrition on admission and 30-day adverse events in patients with TTS.</p><p><strong>Methods: </strong>We retrospectively evaluated 124 consecutive patients admitted for TTS at our hospital from April 2013 to July 2023. Malnutrition was assessed at admission using the Geriatric Nutritional Risk Index (GNRI), which is an objective and simple nutritional assessment method. Malnutrition was defined as GNRI <92. We defined 30-day adverse events as the composite of all-cause death, acute heart failure, cardiogenic shock, life-threatening arrhythmia, thrombotic events, and stroke. The primary endpoint was the comparison of the 30-day adverse event rates between patients with and without malnutrition.</p><p><strong>Results: </strong>The median age was 78.0 (70.0-83.0) years, and 77 % of the patients were women. The median GNRI was 90.8 (81.5-98.0) and 55 % had malnutrition. The 30-day adverse events were shown in 64 patients. Compared with patients without malnutrition, the 30-day adverse event rate was significantly higher in those with malnutrition (32 % vs. 68 %, respectively; log-rank test p = 0.0001). The multivariable Cox proportional hazards model revealed that malnutrition was independently associated with high 30-day adverse event rates adjusted by age, female sex, malignancy, B-type natriuretic peptide, and high-sensitivity C-reactive protein (hazard ratio: 1.97, 95 % confidence interval: 1.08-3.58; p = 0.02).</p><p><strong>Conclusions: </strong>Malnutrition at admission was associated with high 30-day adverse event rates. Early identification and a considered treatment strategy for malnutrition are important in patients with TTS.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances and clinical implications of intravascular imaging.","authors":"Masahiko Noguchi, Tomotaka Dohi","doi":"10.1016/j.jjcc.2025.03.001","DOIUrl":"10.1016/j.jjcc.2025.03.001","url":null,"abstract":"<p><p>Coronary artery disease (CAD) remains a major contributor to the global mortality rate. Accurate and detailed evaluation of atherosclerotic plaque characteristics is essential for effective risk assessment and treatment planning. Although conventional coronary angiography excels at quantifying luminal stenosis, information on plaque composition and structure remains limited. Recent advances in intravascular imaging (IVI) have bridged this gap by enabling high-resolution visualization of the vessel wall and plaque morphology, thereby enhancing treatment strategies and facilitating comprehensive risk stratification. Among the principal IVI modalities, intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near-infrared spectroscopy (NIRS) provide distinct benefits. IVUS accurately measures vessel diameter and plaque burden, offering critical guidance for managing complex lesions and left main artery disease. The extremely high spatial resolution of OCT allows precise identification of high-risk plaque features, such as thin fibrous caps. NIRS complements these techniques by quantitatively assessing lipid components within plaques, making it particularly useful in predicting future cardiovascular events. In this review, we summarize the latest evidence on applying IVI modalities to the evaluation and treatment of CAD. We focus on the assessment of plaque morphology, identification of high-risk lesions, and the role of IVI-guided percutaneous coronary intervention (PCI). The continued development of hybrid imaging systems and artificial intelligence-based image analysis may produce more precise and safer PCI approaches. Consequently, IVI is poised to become indispensable in managing CAD, paving the way for more personalized treatment strategies tailored to the specific lesion characteristics of each patient.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply.","authors":"Hiroki Matsushita, Keita Saku","doi":"10.1016/j.jjcc.2025.02.020","DOIUrl":"10.1016/j.jjcc.2025.02.020","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of left atrium posterior wall isolation in patients undergoing catheter ablation for atrial fibrillation","authors":"Zheng-Qi Song MD ,&nbsp;Xin-Yu Lu MD ,&nbsp;Yu-Peng Xu MD ,&nbsp;Hui Lin MD ,&nbsp;Yi-He Chen MD, PhD","doi":"10.1016/j.jjcc.2024.09.008","DOIUrl":"10.1016/j.jjcc.2024.09.008","url":null,"abstract":"<div><div>The posterior left atrium (LAPW) is an important substrate for initiation and maintenance of atrial fibrillation (AF). While it has been proposed as a potential target for preventing recurrence of atrial tachyarrhythmias, it remains unclear whether electrical silence of LAPW offers additional benefits over pulmonary vein isolation (PVI) alone. We conducted a systematic review of PubMed, Medline, Embase, and Cochrane databases and identified 21 eligible studies, encompassing 1514 patients assigned to PVI + posterior wall isolation (PWI) group and 1629 patients assigned to PVI group. Over a median follow-up of 12 months, adjunctive PWI significantly improved the atrial tachyarrhythmia-free survival by 14 % in comparison to PVI alone [relative risk (RR): 1.14, 95 % confidence interval (CI): 1.04 to 1.25, <em>p</em> = 0.004]. This improvement was mainly attributed to a pronounced benefit for patients with persistent AF. In addition, patients undergoing PVI + PWI had a longer procedure time [weighted mean difference (WMD): 23.85, 95 % CI: 12.68 to 35.01, <em>p</em> &lt; 0.001], ablation time (WMD: 9.27, 95 % CI: 5.19 to 13.54, <em>p</em> &lt; 0.001), and a nearly negligible increase in fluoroscopic exposure (WMD: 2.69, 95 % CI: −0.23 to 5.62, <em>p</em> = 0.071). There was no increased risk of procedure-related complications between these approaches (RR: 1.06, 95 % CI: 0.71 to 1.57, <em>p</em> = 0.787). Compared with PVI alone, PWI adjunctive to PVI exhibited a higher procedure success of sinus rhythm maintenance in persistent AF during an index catheter ablation. Meanwhile, elongated procedure time and ablation time did not compromise the safety of extensive ablation strategy with additional PWI.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 213-219"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of cardiac allograft vasculopathy using splenic switch-off on myocardial PET","authors":"Atsushi Yamamoto MD, PhD ,&nbsp;Michinobu Nagao MD, PhD ,&nbsp;Michiru Nomoto MD, PhD ,&nbsp;Akihiro Inoue MD ,&nbsp;Risa Imakado MD ,&nbsp;Risako Nakao MD, PhD ,&nbsp;Yuka Matsuo MD, PhD ,&nbsp;Akiko Sakai MD, PhD ,&nbsp;Hidetoshi Hattori MD, PhD ,&nbsp;Noriko Kikuchi MD, PhD ,&nbsp;Shinichi Nunoda MD, PhD ,&nbsp;Koichiro Kaneko MD, PhD ,&nbsp;Mitsuru Momose MD, PhD ,&nbsp;Shuji Sakai MD, PhD ,&nbsp;Junichi Yamaguchi MD, PhD","doi":"10.1016/j.jjcc.2024.06.010","DOIUrl":"10.1016/j.jjcc.2024.06.010","url":null,"abstract":"<div><h3>Background</h3><div><span>Heart transplantation<span><span> (HTx) is a definitive therapy for refractory heart failure. Cardiac allograft vasculopathy (CAV), characterized by diffuse </span>arteriopathy<span> involving the epicardial coronary arteries and microvasculature, is the major cause of death for patients with HTx. </span></span></span>¹³<span>N-ammonia positron emission tomography (NH</span>₃<span>-PET) can offer diagnostic and prognostic utility for CAV. The splenic switch-off (SSO) detected in NH3-PET is a hemodynamic<span><span> indicator of favorable response to adenosine. We hypothesized that both CAV and SSO reflected a pathology that progresses in parallel with systemic vascular endothelial dysfunction. Therefore, we quantitatively evaluated splenic adenosine reactivity measured using NH3-PET as an index of </span>endothelial function, and examined its predictability for CAV.</span></span></div></div><div><h3>Methods</h3><div>Forty-eight patients who underwent NH₃<span>-PET after HTx were analyzed. The spleen ratio was calculated as the mean standardized uptake value, measured by placing an ROI on the spleen, at stress divided by that at rest. SSO was defined by a cutoff determined using receiver operating characteristic (ROC) analysis for the spleen ratio. The endpoint was appearance or progression of CAV. Predictability of SSO was analyzed using Kaplan–Meier analysis.</span></div></div><div><h3>Results</h3><div>The endpoint occurred in 9 patients during a mean follow-up of 45 ± 17 months. ROC curve analysis demonstrated a cutoff of 0.94 for spleen ratio. Patients without SSO displayed a significantly higher CAV rate than those with SSO (<em>p</em> = 0.022).</div></div><div><h3>Conclusions</h3><div>SSO reflects the endothelial function of systemic blood vessels and was a predictor of CAV in patients with HTx.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 260-262"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of surgical ablation and left atrial appendage occlusion in patients with AF undergoing coronary artery bypass grafting: A network meta-analysis","authors":"Ahmed K. Awad MD ,&nbsp;Mohammed A. Elbahloul MD ,&nbsp;Aliaa Gamal MD ,&nbsp;Amir N. Attia MD ,&nbsp;Sarah M. Hamed MD ,&nbsp;Ahmed I. Elsekhary MD ,&nbsp;Michel Pompeu Sá MD, MSc, MHBA, PhD","doi":"10.1016/j.jjcc.2025.01.011","DOIUrl":"10.1016/j.jjcc.2025.01.011","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is a prevalent cardiac arrhythmia that greatly elevates the risk of stroke. This risk increases both during and after cardiac procedures, such as coronary artery bypass grafting (CABG). There is an increasing interest in non-pharmacological treatments such as left atrial appendage occlusion (LAAO) and surgical ablation, intending to enhance both immediate and long-term postoperative results.</div></div><div><h3>Objective</h3><div>To investigate the efficacy of surgical ablation (SA), LAAO, or both in patients with AF undergoing CABG.</div></div><div><h3>Methods</h3><div>We searched four electronic databases: PubMed, Scopus, Cochrane Library, and WOS. We analyzed data using R language and “netmeta” and “netrank” packages of meta-insight software. Pooled outcomes were reported as mean difference or risk ratio (RR) with 95 % confidence interval (CI) in a random effect method.</div></div><div><h3>Results</h3><div>A total of 16 studies were included with 594,312 patients included. The 30-day mortality showed a non-statistically significant difference between CABG-LAAO compared to CABG alone and CABG-SA with RR of 1.70 (95%CI 0.38–7.61) and 0.62 (95%CI 0.10–3.94). However, compared to CABG alone, CABG-SA + LAAO, CABG-LAAO, and CABG-SA had significantly lower risk of long-term mortality with RR 0.75 (95%CI 0.57–0.98), 0.78 (95%CI 0.65–0.94), and 0.73 (95%CI 0.61–0.88), respectively. CABG-SA + LAAO, CABG-LAAO, and CABG-SA reduced the risk of short-term stroke compared to CABG alone with RR of 0.73 (95%CI 0.43–1.24), 0.93 (95%CI 0.78–1.11), and 1.01 (95%CI 0.75–1.36), respectively. Moreover, only CABG-SA + LAAO and CABG-LAAO showed a statistically significant reduction in long term stroke and hospitalization due to heart failure while CABG-SA showed no statistically significant difference. Furthermore, there was no statistically significant difference between our interventions in terms of 30-day rehospitalization, intra-aortic balloon pump support, and risk of hemorrhage.</div></div><div><h3>Conclusion</h3><div>Among patients with AF undergoing CABG, whether undergoing SA alone or LAAO alone or both showed significant clinical outcomes such as reduced risk of both short- and long-term mortality and short-term stroke.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 177-185"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of new-onset atrial fibrillation in the setting of acute coronary syndrome","authors":"George Bazoukis MD, MSc, PhD ,&nbsp;Jeremy Man Ho Hui MD ,&nbsp;Athanasios Saplaouras MD ,&nbsp;Polyxeni Efthymiou MD ,&nbsp;Alexandros Vassiliades MD ,&nbsp;Varnavas Dimitriades MD ,&nbsp;Chloe Tsz Ching Hui MD ,&nbsp;Siyuan Simon Li MD ,&nbsp;Ahmed Osama Jamjoom MD ,&nbsp;Tong Liu MD, PhD ,&nbsp;Konstantinos P. Letsas MD, PhD ,&nbsp;Michael Efremidis MD, PhD ,&nbsp;Gary Tse MD, PhD","doi":"10.1016/j.jjcc.2024.12.007","DOIUrl":"10.1016/j.jjcc.2024.12.007","url":null,"abstract":"<div><div>Approximately 10 % of patients who have suffered from myocardial infarction develop new-onset atrial fibrillation (AF). Coronary artery disease implicating atrial branches has been associated with AF. The following variables have been associated with new-onset AF in the setting of acute coronary syndrome: older age, history of hypertension, history of angina, history of stroke, chronic renal failure, body mass index, no statin use, worse nutritional status, worse Killip class, admission heart rate ≥ 85 bpm, complete atrioventricular block, Glasgow prognostic score, Syntax score, C₂HEST score &gt; 3, PRECISE-DAPT score ≥ 25, left ventricular ejection fraction ≤40 %, increased left atrial diameter, E/E′ ratio &gt; 12, epicardial fat tissue thickness, and thrombolysis in myocardial infarction flow &lt; 3. Regarding laboratory variables, elevated D-dimer levels, C-reactive protein levels, N-terminal pro-B-type natriuretic peptide, creatine kinase-MB, high-sensitivity troponin T at baseline, midregional pro–atrial natriuretic peptide, and cholesterol levels have been proposed as potential predictors of AF in this setting. Regarding the impact of new-onset AF on clinical outcomes, it has been associated with an increased risk of stroke, higher mortality rates, heart failure, cardiogenic shock, higher odds of ventricular arrhythmias and major adverse cardiac events. New-onset AF is an indicator of worse in-hospital prognosis compared to patients with a previous history of AF. New-onset AF, as well as previous AF, were strong predictors of ischemic stroke, and therefore, patients with new-onset AF should be anticoagulated according to the CHA₂DS₂-VASc score. Cardioversion to sinus rhythm, if possible, is advised before the discharge as it may be related to better outcomes.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 186-203"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early vs. late transcatheter aortic valve replacement in acute heart failure hospitalizations: A comparative nationwide analysis","authors":"Anas Hashem MD ,&nbsp;Amani Khalouf MD ,&nbsp;Mohamed Salah Mohamed MD ,&nbsp;Saryia Adra MD ,&nbsp;Deya Alkhatib MD ,&nbsp;Mahmoud Ismayl MD ,&nbsp;Anthony Kashou MD ,&nbsp;Devesh Rai MD ,&nbsp;Jeremiah P. Depta MD ,&nbsp;Samian Sulaiman MD ,&nbsp;Andrew M. Goldsweig MD, MS ,&nbsp;Sudarshan Balla MD","doi":"10.1016/j.jjcc.2024.08.007","DOIUrl":"10.1016/j.jjcc.2024.08.007","url":null,"abstract":"<div><h3>Background</h3><div>Severe aortic stenosis (AS) is the most common valvular disease in the USA. Patients undergoing urgent or emergent transcatheter aortic valve replacement (TAVR) have worse clinical outcomes than those undergoing non-urgent procedures. No studies have examined the impact of procedural TAVR timing on outcomes in AS complicated by acute heart failure (AHF).</div></div><div><h3>Aims</h3><div>We aimed to evaluate differences in in-hospital mortality and clinical outcomes between early (&lt;48 h) vs. late (≥48 h) TAVR in patients hospitalized with AHF using a real-world US database.</div></div><div><h3>Methods</h3><div>We queried the National Inpatient Sample database to identify hospitalizations with a diagnosis of AHF, aortic valve disease, and a TAVR procedure (2015–2020). The associations between TAVR timing and clinical outcomes were examined using logistic regression model.</div></div><div><h3>Results</h3><div>A total of 25,290 weighted AHF hospitalizations were identified, of which 6855 patients (27.1 %) underwent early TAVR, and 18,435 (72.9 %) late TAVR. Late TAVR patients had higher in-hospital mortality rate (2.2 % vs. 2.8 %, <em>p</em> &lt; 0.01) on unadjusted analysis but no significant difference following adjustment for demographic, clinical, and hospital characteristics [aOR 1.00 (0.82–1.23)]. Late TAVR was associated with higher odds of cardiac arrest (aOR 1.50, 95 % CI: 1.18–1.90) and use of mechanical circulatory support (aOR 2.05, 95 % CI: 1.68–2.51). Late TAVR was associated with longer hospital stay (11 days vs. 4 days, <em>p</em> &lt; 0.01) and higher costs ($72,851 vs. $53,209, <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Early TAVR was conducted in approximately 25 % of the AS patients admitted with AHF, showing improved in-hospital outcomes before adjustment, with no significant differences observed after adjustment.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 248-256"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 patients from older community hospitalized for heart failure in guideline-directed medical therapy era: Insights from the COMPASS-HF registry","authors":"Daisuke Sueta MD, PhD ,&nbsp;Satoshi Araki MD, PhD ,&nbsp;Hiroki Usuku MD, PhD, FJCC ,&nbsp;Tomohiro Fujisaki MD ,&nbsp;Takuya Kiyama MD, PhD ,&nbsp;Masanobu Ishii MD, MPH, PhD ,&nbsp;Noriaki Tabata MD, PhD ,&nbsp;Koichiro Fujisue MD, PhD ,&nbsp;Hiroaki Kusaka MD, PhD ,&nbsp;Shinsuke Hanatani MD, PhD ,&nbsp;Eiichiro Yamamoto MD, PhD, FJCC ,&nbsp;Hiroshi Haruguchi MD ,&nbsp;Hiroshi Takamori MD, PhD ,&nbsp;Kenichi Tsujita MD, PhD, FJCC","doi":"10.1016/j.jjcc.2024.09.006","DOIUrl":"10.1016/j.jjcc.2024.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Despite strong recommendations in the latest guidelines for implementing guideline-directed medical therapy (GDMT) before discharge, there is a lack of data on the clinical characteristics and outcomes of older patients with heart failure (HF). Therefore, this study aimed to investigate the clinical characteristics and outcomes of patients with HF in a super-aging society during the GDMT era.</div></div><div><h3>Methods and Results</h3><div>In the COMPASS-HF study including 305 consecutive hospitalized patients, 177 with acute HF were identified through a medical record review. The mean age of the enrolled patients was 86.2 years, and 46.3 % were men. The mean simple GDMT score, which is recognized as a useful prognostic tool for Japanese patients with HF, was 5.0. The incidences of all-cause death and HF hospitalization were 46.5 % and 19.4 %, respectively. The incidences of all-cause death and cardiovascular death were significantly lower in the high simple GDMT score group (≥5 points) than in the low simple GDMT score group (≤4 points) (<em>p</em> = 0.049 and <em>p</em> = 0.044, respectively). However, no significant differences were noted in HF hospitalization and composite events (cardiovascular death and HF hospitalization) between the groups (<em>p</em> = 0.564 and <em>p</em> = 0.086, respectively).</div></div><div><h3>Conclusions</h3><div>While GDMT was well-implemented in the older community, the mortality rate among hospitalized patients with HF remained high. Although GDMT appears to have reduced the HF hospitalization rate, further validation and development of an optimal predictive model for elderly patients with HF are essential.</div></div><div><h3>X (formerly Twitter)</h3><div>In the older community, although the short- and long-term mortality of hospitalized patients with HF is still high even in the GDMT era, the HF hospitalization rate is suppressed, probably due to GDMT. A simple GDMT score may also be useful for stratifying the prognosis of older patients with HF. #HeartFailure#Mortality#GDMT#Fantastic4.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 257-259"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and risk factors of hypotension-related adverse events among Japanese patients with heart failure receiving sacubitril/valsartan or enalapril: Results from the PARALLEL-HF study","authors":"Hiroyuki Tsutsui MD, PhD, FJCC ,&nbsp;Shin-ichi Momomura MD, PhD, FJCC ,&nbsp;Yoshihiko Saito MD, PhD, FJCC ,&nbsp;Hiroshi Ito MD, PhD FJCC ,&nbsp;Kazuhiro Yamamoto MD, PhD FJCC ,&nbsp;Yasushi Sakata MD, PhD, FJCC ,&nbsp;Tomomi Ohishi ,&nbsp;Takayuki Iimori ,&nbsp;Toshihito Kitamura ,&nbsp;PARALLEL-HF Investigators","doi":"10.1016/j.jjcc.2024.09.002","DOIUrl":"10.1016/j.jjcc.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><div>The PARALLEL-HF trial showed that treatment with sacubitril/valsartan resulted in more symptomatic hypotension versus enalapril in Japanese patients with heart failure (HF) and reduced ejection fraction, similar to PARADIGM-HF. Use of sacubitril/valsartan in these patients may be limited by concerns regarding hypotension.</div></div><div><h3>Methods</h3><div>This post-hoc analysis characterized hypotension-related adverse events (AEs) and their effects on efficacy using data from PARALLEL-HF, in which patients received sacubitril/valsartan 200 mg twice daily or enalapril 10 mg twice daily.</div></div><div><h3>Results</h3><div>Of 223 patients, 28.2 % experienced hypotension-related AEs and incidence was higher with sacubitril/valsartan versus enalapril (hazard ratio, 2.2; 95 % CI, 1.3–3.8; <em>p</em> = 0.0027). However, reduction in mean systolic blood pressure from baseline to study end did not significantly differ (sacubitril/valsartan: −2.2 mmHg vs enalapril: −1.3 mmHg; <em>p</em> = 0.6895). Patients who experienced hypotension-related AEs had lower mean body mass index, higher median N-terminal pro-brain natriuretic peptide at randomization, and more frequent history of stroke. Hypotension-related AEs leading to treatment discontinuation were not significantly different for sacubitril/valsartan versus enalapril (3.4 % vs 6.9 %, <em>p</em> = 0.5957). Reduction in risk of cardiovascular death or HF hospitalization was similar with sacubitril/valsartan versus enalapril in patients with or without hypotension-related AEs.</div></div><div><h3>Conclusions</h3><div>Incidence of hypotension-related AEs was higher in the sacubitril/valsartan versus enalapril group but did not affect risk of cardiovascular death or HF hospitalization, which was similar between treatment groups.</div></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":"85 3","pages":"Pages 241-247"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}