Journal of the American College of Cardiology最新文献

{"title":"Reflections on Binary Thresholds for Hypercholesterolemia and Hypertension","authors":"Cian P. McCarthy, John W. McEvoy","doi":"10.1016/j.jacc.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.05.002","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Funding Support and Author Disclosures</h2>Dr McCarthy is supported by a National Heart, Lung, And Blood Institute Career Development Award (K23HL167659); and has received consulting fees/honorarium from Roche Diagnostic, Abbott Laboratories, New Amsterdam Pharma, and Heartflow, Inc. Dr McEvoy has reported that he has no relationships relevant to the contents of this paper to disclose.</section></section>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"12 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144260228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-Evaluating Recurrent Events in Heart Failure Trials","authors":"Audinga-Dea Hazewinkel PhD ,&nbsp;John Gregson PhD ,&nbsp;Stuart J. Pocock PhD ,&nbsp;John McMurray MD ,&nbsp;Scott D. Solomon MD ,&nbsp;Brian Claggett PhD ,&nbsp;Milton Packer MD ,&nbsp;Stefan D. Anker MD, PhD ,&nbsp;João P. Ferreira MD, PhD ,&nbsp;Kieran Docherty MBChB, MD ,&nbsp;Alasdair Henderson PhD ,&nbsp;Pardeep Jhund MBChB, MSc, PhD ,&nbsp;Ulrica Wilderäng PhD ,&nbsp;David Wright PhD","doi":"10.1016/j.jacc.2025.03.543","DOIUrl":"10.1016/j.jacc.2025.03.543","url":null,"abstract":"<div><div>Analyses using repeat hospitalizations (HFHs) are common in heart failure trials and typically assume that such repeat events occur randomly over time. Also, many think that using repeat events enhances statistical power. This article challenges those assumptions, using data from 4 heart failure trials of sodium-glucose cotransporter 2 inhibitors. We found marked within-patient time clustering of repeat events: risks of subsequent HFH and cardiovascular death are markedly elevated following a hospitalization, especially early on. The Lin-Wei-Yang-Ying and negative binomial models do not account for this. Alternative approaches using area under the curve and win ratio methods for the composite of cardiovascular death and all HFHs strengthened the treatment effect. But still, time-to-first event analyses tended to give the strongest evidence. Overall, some commonly used repeat event analyses appear not to be the best. It is time to rethink how best to use repeat events data in heart failure trials.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Pages 2304-2323"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Management of Patients Taking Factor XI Inhibitors","authors":"James D. Douketis MD ,&nbsp;P. Gabriel Steg MD ,&nbsp;Suzanne C. Cannegieter MD, PhD ,&nbsp;Alex C. Spyropoulos MD","doi":"10.1016/j.jacc.2025.04.026","DOIUrl":"10.1016/j.jacc.2025.04.026","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Pages 2299-2301"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less Heart Failure But No Improvement in Quality of Life in FINEARTS-HF","authors":"Gad Cotter MD ,&nbsp;Beth A. Davison PhD ,&nbsp;Deepak L. Bhatt MD, MPH, MBA","doi":"10.1016/j.jacc.2025.04.022","DOIUrl":"10.1016/j.jacc.2025.04.022","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Pages 2333-2336"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"10-Year and 30-Year Risks of Cardiovascular Disease in the U.S. Population","authors":"Kamil F. Faridi MD, MSc ,&nbsp;Devesh Malik BS ,&nbsp;Mohammed Essa MD ,&nbsp;Huanhuan Yang PhD ,&nbsp;Erica S. Spatz MD, MHS ,&nbsp;Harlan M. Krumholz MD, SM ,&nbsp;Yuan Lu ScD","doi":"10.1016/j.jacc.2025.03.546","DOIUrl":"10.1016/j.jacc.2025.03.546","url":null,"abstract":"<div><h3>Background</h3><div>The American Heart Association PREVENT (Predicting Risk of Cardiovascular Disease Events) equations were recently developed to estimate risk of total cardiovascular disease (CVD), which includes both atherosclerotic CVD (ASCVD) and heart failure (HF). Long-term risks of total CVD in the U.S. population are unknown.</div></div><div><h3>Objectives</h3><div>This study sought to determine the long-term risks of CVD in the U.S. population.</div></div><div><h3>Methods</h3><div>Using data on U.S. adults aged 30 to 79 years from the National Health and Nutrition Examination Survey between 2011 and 2020, we determined 10- and 30-year risks of total CVD, ASCVD, and HF based on the PREVENT equations. Age-standardized and survey-weighted risk prevalence was determined with further stratification according to age, sex, race, and ethnicity.</div></div><div><h3>Results</h3><div>The study population included 14,184 participants aged 30 to 79 years, representing 160.6 million U.S. adults with and without CVD. The prevalence of existing CVD was 9.6%, including 26.8% among adults aged 65 to 79 years. Survey-weighted prevalence of having elevated (≥7.5%) 10-year predicted risk of developing CVD was 20.2%, although only 10.7% were considered at risk for ASCVD and 12.7% at risk for HF. Prevalence of having elevated 10-year risk of developing CVD was 1.0% in adults aged 30 to 44 years, 18.3% in adults aged 45 to 64 years, and 66.3% in adults aged 65 to 79 years. Due to underlying risk factor profiles, men as well as Black and Hispanic adults had higher 10-year risks of total CVD, ASCVD, and HF. Mean 10-year risks of total CVD, ASCVD, and HF modestly increased over time. For 30-year risks, 66.7% of adults aged 30 to 59 years were without CVD but had elevated total CVD risk, including 89.7% of adults aged 45 to 59 years. Men and Black adults had higher 30-year risks of ASCVD and HF.</div></div><div><h3>Conclusions</h3><div>Three in 10 U.S. adults aged 30 to 79 years have existing CVD or an elevated 10-year predicted risk of CVD, including &gt;90% of adults aged &gt;65 years. Two-thirds of middle-aged adults are without CVD but have an elevated 30-year CVD risk. Men and Black and Hispanic adults are higher risk. These findings emphasize the need for intensive efforts to prevent CVD in the United States.</div></div>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Pages 2239-2249"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audio Summary","authors":"","doi":"10.1016/S0735-1097(25)06507-6","DOIUrl":"10.1016/S0735-1097(25)06507-6","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Page e195"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure Care and Outcomes After Private Equity Acquisition of U.S. Hospitals","authors":"Daniel Y. Johnson, Michael Liu, Victoria L. Bartlett, ZhaoNian Zheng, Andrew S. Oseran, Rishi K. Wadhera","doi":"10.1016/j.jacc.2025.05.037","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.05.037","url":null,"abstract":"<h3>Background</h3>Private equity firms have rapidly acquired U.S. hospitals and increasingly invested in cardiology over the past decade. However, little is known about how private equity acquisition of hospitals affects care and outcomes for patients with heart failure.<h3>Objectives</h3>The purpose of this study was to evaluate whether clinical care and outcomes changed for patients with heart failure after the acquisition of U.S. hospitals by private equity firms compared with matched control hospitals.<h3>Methods</h3>This study identified U.S. hospitals acquired by private equity firms and matched control hospitals from 2012 through 2019. A quasiexperimental difference-in-differences analysis was used to evaluate changes in clinical outcomes, the case mix of admissions and transfers, as well as cardiac procedure utilization among Medicare fee-for-service beneficiaries aged 65 years or older with heart failure.<h3>Results</h3>There were 41 private equity-acquired hospitals and 192 matched control hospitals. After private equity acquisition of hospitals, there was no change in 30-day mortality rates (difference-in-differences [DiD] +0.7 percentage points [95% CI: −0.4 to 1.8]) or 30-day hospital revisit rates (DiD −0.2 percentage points [95% CI: −0.9 to 0.5]), despite a significant decrease in the clinical risk of patients with heart failure when compared with those at matched control (nonacquired) hospitals. Overall hospital transfer rates did not change, but Black patients were significantly more likely to be transferred out to another site after private equity acquisition (DiD +7.1 percentage points [95% CI: 0.7-13.4]), a change not observed across other racial groups. In addition, there was a significant increase in cardiac catheterization rates (DiD estimate, +0.7 percentage points [95% CI: 0.1-1.2]) among heart failure patients at private equity-acquired vs control hospitals.<h3>Conclusions</h3>These findings suggest that private equity acquisitions of U.S. hospitals do not improve outcomes among older adults with heart failure, despite a decrease in the clinical risk of patients admitted to these sites.","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"20 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144252551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Balloon Angioplasty","authors":"Jane A. Leopold MD ,&nbsp;Eric A. Secemsky MD, MS","doi":"10.1016/j.jacc.2025.04.052","DOIUrl":"10.1016/j.jacc.2025.04.052","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Pages 2285-2287"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Long Road Ahead in Cardiovascular Disease Prevention Using the PREVENT Equations","authors":"Sadiya S. Khan MD, MSc","doi":"10.1016/j.jacc.2025.04.041","DOIUrl":"10.1016/j.jacc.2025.04.041","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Pages 2250-2252"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factor XI Inhibition for Prevention of Thromboembolism","authors":"Behnood Bikdeli MD, MS","doi":"10.1016/j.jacc.2025.05.004","DOIUrl":"10.1016/j.jacc.2025.05.004","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 23","pages":"Pages 2302-2303"},"PeriodicalIF":21.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144237823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}