Circulation-Cardiovascular Quality and Outcomes最新文献

{"title":"Response by Fauchier et al to Letter Regarding Article, \"Incidence, Prevalence, and Trends in Mortality and Stroke Among Medicare Beneficiaries With Atrial Fibrillation: 2013 to 2019\".","authors":"Nichole M Rogovoy, Stephen Kearing, Weiping Zhou, James V Freeman, Jonathan P Piccini, Sana M Al-Khatib, Emily P Zeitler","doi":"10.1161/CIRCOUTCOMES.125.012691","DOIUrl":"https://doi.org/10.1161/CIRCOUTCOMES.125.012691","url":null,"abstract":"","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012691"},"PeriodicalIF":6.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253443","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":"Disrupting the Status Quo: Reimagining How We Use Troponin for Diagnosing Myocardial Infarction.","authors":"Lori B Daniels, W Frank Peacock, Bertil Lindahl, James A de Lemos","doi":"10.1161/CIRCOUTCOMES.125.012131","DOIUrl":"10.1161/CIRCOUTCOMES.125.012131","url":null,"abstract":"","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012131"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975940","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":"Outcomes of Endovascular Revascularization for Chronic Limb-Threatening Ischemia in Medicare Advantage and Medicare Fee-For-Service Beneficiaries.","authors":"Katerina Dangas, Joseph M Kim, Siling Li, Yang Song, Andrew S Oseran, Robert W Yeh, Rishi K Wadhera, Eric A Secemsky","doi":"10.1161/CIRCOUTCOMES.125.012099","DOIUrl":"10.1161/CIRCOUTCOMES.125.012099","url":null,"abstract":"","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012099"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976031","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":"Trends in Health Care Services Use and Mortality in Adults With Cardiometabolic Diseases During the First Year of the Pandemic in Ontario, Canada.","authors":"Tetyana Kendzerska, Mouaz Saymeh, Michael Pugliese, Marcus Povitz, Brandon Robinson, Jodi D Edwards, Teresa To, Andrea S Gershon","doi":"10.1161/CIRCOUTCOMES.125.011996","DOIUrl":"10.1161/CIRCOUTCOMES.125.011996","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic disrupted health services, particularly affecting individuals with cardiometabolic diseases. This study compared health care use and mortality trends in adults with cardiometabolic diseases during the first pandemic year. It also examined associations between changes in outpatient visits and diagnostic tests with acute health care utilization and mortality.</p><p><strong>Methods: </strong>Using health administrative databases, we conducted a retrospective population-based study using an open-cohort sampling on adult (≥18 years of age) Ontario residents with a prior diagnosis of angina, congestive heart failure, hypertension, or diabetes between January 2016 and March 2021. During the pandemic's first year (March 2020-March 2021), observed (per 100 000 at-risk) versus projected event rates were compared for all-cause outpatient visits, diagnostic testing, emergency department visits, hospitalizations and mortality across the 4 time periods. Auto-regressive integrated moving-average models were used to calculate projected rates from observed monthly rates from similar periods pre-COVID (January 2016-December 2019). Quasi-Poisson models examined interactions between care access and acute outcomes.</p><p><strong>Results: </strong>In the first pandemic quarter, rates of outpatient visits, diagnostic testing, emergency department visits, and hospitalizations for adults with cardiometabolic diseases decreased. By year-end, outpatient visits exceeded projections for angina, congestive heart failure, and diabetes, while most diagnostic test rates remained below projections. Mortality was as projected, except in adults with hypertension during the first quarter (observed 54 964 versus projected, 50 134 [95% CI, 46 686-53 840]). In adults with diabetes and hypertension, fewer cardiac investigations and echocardiograms were associated with greater mortality than prepandemic (interaction <i>P</i><0.01). Unlike other populations, diabetes and hypertension patients showed reduced emergency department visits, hospitalizations, and mortality during months with the highest virtual care use (<i>P</i><0.02).</p><p><strong>Conclusions: </strong>The pandemic impacted health care utilization and mortality for adults with cardiometabolic diseases. Access to diagnostic testing is critical, particularly for those with diabetes and hypertension. Virtual care may benefit frequent health care users.</p>","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e011996"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132330","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":"What Is the Value of Routine Cardiovascular Care? Potential Lessons From the COVID-19 Pandemic.","authors":"Joseph S Wallins, Vinay Kini","doi":"10.1161/CIRCOUTCOMES.125.012788","DOIUrl":"10.1161/CIRCOUTCOMES.125.012788","url":null,"abstract":"","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012788"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253399","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 and Physician Perspectives on Cardiovascular Risk: A Multicenter Survey of Communication Gaps Among Hospitalized Patients in Spain.","authors":"Juan Górriz-Magaña, Ramon Maruri-Sánchez, Ane Elorriaga, Nahikari Salterain-González, Alicia Prieto-Lobato, Raúl Gascueña Rubia, Isabel Monedero Sánchez, Ana Elvira-Laffond, Miguel Lapena Reguero, Amanda Leandro Barros, Cristina Villabona Rivas, Alejandro Gutiérrez-Fernández, César Jiménez-Méndez, Silvia Prieto-González, María Melendo-Viu, Blanca Alcón Durán, Emilio Blanco López, Clara Bonanad Lozano, Alejandro Durante-López, Anna Carrasquer, Pedro Martínez-Losas, Teresa Alvarado Casas, Pedro Pájaro Merino, Victor Juárez-Olmos, Javier Lopez-Pais, Michelle M Kittleson, Pablo Díez-Villanueva, Jordi Bañeras","doi":"10.1161/CIRCOUTCOMES.124.011837","DOIUrl":"10.1161/CIRCOUTCOMES.124.011837","url":null,"abstract":"<p><strong>Background: </strong>Effective risk communication is essential in managing cardiovascular disease, the leading cause of global mortality. Clear communication between patients and physicians supports informed decision-making, yet comprehension gaps persist. We aimed to assess the quality of risk communication during hospital admissions for cardiovascular events, from patient and physician perspectives, and identify discrepancies in risk perception and associated factors.</p><p><strong>Methods: </strong>The HARIPA study (Heart Risk Perception and Communication Inpatient) by the Spanish Society of Cardiology was a multicenter, cross-sectional analysis conducted in 28 hospitals across Spain from October 2022 to March 2023. It included consecutive cardiology inpatients (urgent or scheduled), aged ≥18 years, who could complete structured questionnaires. Participating physicians also completed parallel questionnaires. These assessed admission diagnosis, perceptions of future cardiovascular risk, and communication about potential procedural complications. Agreement between responses was evaluated using kappa indices (weighted for ordinal variables), and multivariable logistic regression was used to examine the impact of demographic and clinical factors (odds ratios with 95% CIs).</p><p><strong>Results: </strong>We included 943 patients (mean age, 68.2 years; 29.4% women). The most frequent reason for admission was ischemic heart disease (41.3%). Responses resulted in a substantial agreement, with a kappa index of 0.72. Concordance between patients and physicians regarding future cardiovascular risk was low (weighted kappa: 0.29), with patients often underestimating their risk. And for assessment about procedural potential complications was moderate (kappa: 0.34). Although 76.9% of patients reported feeling adequately informed about procedural risks, 69.3% of those who experienced complications (n=208) stated they had not been warned about them.</p><p><strong>Conclusions: </strong>This study reveals significant gaps in risk communication in cardiovascular care, particularly regarding future risks and complications. As well-informed patients are more likely to adhere to preventive therapies, tailoring communication strategies to individual patient characteristics could improve understanding and align perceptions with clinical realities, enhancing health outcomes.</p>","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e011837"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016605","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":"Resuming the Decline in Cardiovascular Deaths: Urgent Federal Policy Actions.","authors":"Anand K Parekh, Rinky Bhatia","doi":"10.1161/CIRCOUTCOMES.125.012625","DOIUrl":"10.1161/CIRCOUTCOMES.125.012625","url":null,"abstract":"","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012625"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024682","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":"Temporal Trends, Patient Characteristics, and Outcomes of Type 2 Versus Type 1 Myocardial Infarction Among Medicare Beneficiaries.","authors":"Amgad Mentias, Neil Keshvani, Milind Y Desai, Samir R Kapadia, Khaled M Ziada, Cian P McCarthy, Hurst M Hall, Ki Park, Dharam J Kumbhani, A Michael Lincoff, James L Januzzi, Ambarish Pandey","doi":"10.1161/CIRCOUTCOMES.125.012136","DOIUrl":"10.1161/CIRCOUTCOMES.125.012136","url":null,"abstract":"<p><strong>Background: </strong>Type 2 myocardial infarction (MI) is common among older adults and is associated with adverse outcomes in single-center studies. We aimed to examine temporal trends and compare outcomes between type 1 and type 2 MI in Medicare beneficiaries.</p><p><strong>Methods: </strong>Medicare beneficiaries with type 1 or type 2 MI were identified using <i>International Classification of Diseases, Tenth Revision</i> codes from Medicare Provider Analysis and Review 100% inpatient files. Temporal trends were assessed from 2018 to 2021. Patients with type 2 MI were matched 1:1 to type 1 MI by age, sex, race, and year. Outcomes included all-cause mortality, recurrent MI, heart failure hospitalization (HFH), and stroke. Time-to-event analyses used Cox models for mortality and Fine-Gray models for hospitalization outcomes, with short-term (≤30 days) and long-term (>30 days) outcomes assessed using landmark analysis.</p><p><strong>Results: </strong>Among 1 816 926 Medicare beneficiaries, the proportion of type 2 MI increased from 19.4% in 2018 to 26.8% in 2021 (<i>P</i>_trend<0.001). In propensity-matched analyses of 94 132 patients (mean age 77.3±11 years, 53.3% male), patients with type 2 (versus type 1) MI had lower short-term all-cause mortality (hazard ratio, 0.61 [95% CI, 0.59-0.63]), recurrent MI (subdistribution hazard ratio [sHR], 0.56 [95% CI, 0.54-0.59]), HFH (sHR, 0.56 [95% CI, 0.47-0.67]), and similar risk of stroke (sHR, 1.04 [95% CI, 0.90-1.21]). In long-term, patients with type 2 (versus type 1) MI had higher risk of all-cause mortality (hazard ratio, 1.23 [95% CI, 1.20-1.26]) and stroke (sHR, 1.20 [95% CI, 1.10-1.31]). The risk of recurrent MI and HFH associated with type 2 (versus type 1) MI in long-term follow-up was lower but considerably attenuated in magnitude compared with short-term risk (recurrent MI: sHR, 0.89 [95% CI, 0.86-0.94]; HFH; sHR, 0.73 [95% CI, 0.66-0.81]).</p><p><strong>Conclusions: </strong>Type 2 MI now accounts for over one-quarter of all MIs and is increasingly diagnosed. While patients with type 1 MI had higher short-term all-cause mortality risk, those with type 2 MI demonstrated higher long-term all-cause mortality and stroke risk, with lower risk of recurrent MI and HFH. These results highlight an urgent need for evidence-based strategies in this high-risk population.</p>","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012136"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126328","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":"Developing a Toolkit to Reduce Infections Following Durable LVAD Implantation in the United States Using a Multistage Mixed Methods Design.","authors":"P Paul Chandanabhumma, Sriram Swaminathan, Lourdes M Cabrera, Shiwei Zhou, Carol E Chenoweth, Hechuan Hou, Sarah Comstock, Preeti N Malani, Keith D Aaronson, Francis D Pagani, Donald S Likosky","doi":"10.1161/CIRCOUTCOMES.125.012073","DOIUrl":"10.1161/CIRCOUTCOMES.125.012073","url":null,"abstract":"<p><strong>Background: </strong>Infections following durable left ventricular assist device (dLVAD) implantation are common and associated with increased morbidity and mortality. Despite documented interhospital variability, few studies have identified strategies to mitigate their occurrence. This national study uses a multistage mixed methods design to develop a customizable and deployable toolkit of expert-guided recommendations to reduce infections post-dLVAD.</p><p><strong>Methods: </strong>Using purposeful sampling, participants (eg, clinical and operational ventricular assist device [VAD] team members) from low, medium, and high-performance hospitals (based on their risk-adjusted, 90-day post-implantation infection rates) across the United States were interviewed to assess factors contributing to postdLVAD infections. Draft toolkit recommendations were iteratively developed after integrating thematically analyzed qualitative and quantitative data from a merged national registry with Medicare and hospital survey data. A national advisory team of VAD subject matter experts provided mixed methods input to refine the toolkit's content and structure.</p><p><strong>Results: </strong>Seventy-three clinical and operational VAD team members across 8 US hospitals were interviewed, spanning low (n=4), medium (n=1) and high (n=3) performance groups. Fourteen subject matter experts provided stakeholder feedback to refine the toolkit. The resulting toolkit contains 39 infection prevention recommendations that address VAD program care processes (eg, real-time provider communication), clinicians (eg, multidisciplinary protocol development), patients and caregivers (eg, engaging patient advisors in patient education), and VAD leadership (eg, unit and service level data reporting). Accompanying resources (eg, team-based exercises, data collection worksheets) support implementing and evaluating site-specific strategies.</p><p><strong>Conclusions: </strong>Using mixed methods approaches, an infection prevention toolkit was developed to enhance care coordination among VAD team members and mitigate postdLVAD infections. Future work should evaluate the effectiveness of implementing this infection prevention toolkit within the dLVAD setting.</p>","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012073"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187371","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":"National Patterns of Remote Patient Monitoring Service Availability at US Hospitals.","authors":"Aline F Pedroso, Zhenqiu Lin, Joseph S Ross, Rohan Khera","doi":"10.1161/CIRCOUTCOMES.125.012034","DOIUrl":"10.1161/CIRCOUTCOMES.125.012034","url":null,"abstract":"<p><strong>Background: </strong>Digital remote patient monitoring (RPM), such as home-based blood pressure, heart rate, or weight monitoring, enables longitudinal care outside traditional health care settings, especially in the vulnerable period after hospitalizations, with broad coverage of the service by payers. We sought to evaluate patterns of RPM service availability at US hospitals and the characteristics of hospitals and the counties they serve that are associated with the availability of these services.</p><p><strong>Methods: </strong>We used national data from the American Hospital Association Annual Survey from 2018 to 2022 to ascertain US hospitals offering RPM services for postdischarge or chronic care. We linked hospitals with their census-based county-level data to define the characteristics of the counties they serve, including sociodemographic features such as age distribution, racial/ethnic composition, median household income, education level, and disability status. We used multivariable logistic regression to assess associations between hospital- and county-level characteristics and RPM availability, adjusting for hospital size, region, teaching status, and ownership.</p><p><strong>Results: </strong>The study included 5644 hospitals. Over 5 years of study, there was a 40.3% increase in the number of hospitals offering RPM services, rising from 1364 (33.0%) hospitals in 2018 to 1797 (46.3%) in 2022. In 2022, hospitals with >300 beds had 3.7-fold odds of offering RPM compared with those with <100 beds (adjusted odds ratio, 3.71 [95% CI, 2.90-4.74]). Nonteaching hospitals had lower odds of RPM availability than teaching hospitals (adjusted odds ratio, 0.29 [95% CI, 0.19-0.44]), and rural hospitals had lower odds than urban hospitals (adjusted odds ratio, 0.49 [95% CI, 0.32-0.77]).</p><p><strong>Conclusions: </strong>In this national study of US hospitals, there has been a large increase in the availability of RPM services but with large variation among hospitals, with lower availability in hospitals serving low-income and rural counties.</p>","PeriodicalId":49221,"journal":{"name":"Circulation-Cardiovascular Quality and Outcomes","volume":" ","pages":"e012034"},"PeriodicalIF":6.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}