European heart journal. Quality of care & clinical outcomes最新文献

{"title":"Patient-physician sex concordance in cardiovascular care: context matters.","authors":"Ilias Kyriopoulos, Elias Mossialos","doi":"10.1093/ehjqcco/qcag077","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag077","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics, management and outcomes of enterococcal infective endocarditis: an ancillary study from the ESC-EORP EURO-ENDO registry.","authors":"Mary Philip, Robinson Gravier Dumonceau, Rodolfo Citro, Bernard Cosyns, Erwan Donal, Paola Anna Erba, Frédérique Gouriet, Bernard Iung, William K F Kong, Patrizio Lancellotti, Aldo Maggioni, Julien Mancini, Bogdan A Popescu, Bernard Prendergast, Antonia Sambola, Shantanu P Sengupta, Ana Timoteo, Christophe Tribouilloy, Joost P van Melle, Roch Giorgi, Gilbert Habib","doi":"10.1093/ehjqcco/qcaf145","DOIUrl":"10.1093/ehjqcco/qcaf145","url":null,"abstract":"<p><strong>Aims: </strong>Enterococcal infective endocarditis (EIE) represents a growing proportion of infective endocarditis (IE) cases, particularly among elderly and comorbid patients. EIE poses diagnostic and therapeutic challenges, notably regarding optimal antimicrobial therapy and surgical decision-making. We aimed to compare the clinical characteristics, management, and outcomes of EIE vs. non-enterococcal IE (NEIE) in the ESC-EORP EURO-ENDO registry.</p><p><strong>Methods and results: </strong>This ancillary analysis of the prospective EURO-ENDO registry included adult patients with definite or possible IE enrolled between January 2016 and March 2018. Patients with monomicrobial EIE were compared with those with NEIE. Clinical, microbiological, imaging, and therapeutic data were analysed. Multivariable logistic regression including EuroSCORE II and valve status identified independent predictors of in-hospital mortality. Among 3083 patients, 365 (12%) had monomicrobial EIE. Compared with NEIE, EIE patients were older (mean 68 vs. 58 years), had more comorbidities, and more frequent prosthetic valve involvement (41% vs. 26%). Aortic valve localization and colonic uptake on PET/CT were also more common. In-hospital mortality was similar (16% vs. 17%). After adjustment for EuroSCORE II and valve status, EIE was not independently associated with higher in-hospital mortality (adjusted OR 0.67 [95% confidence interval 0.42-1.04]; P = 0.083). Among 195 EIE patients with 1-year follow-up, recurrence occurred in 6%. Healthcare-associated acquisition, prosthetic valve infection, and recurrence were associated with worse outcomes and lower surgical rates.</p><p><strong>Conclusion: </strong>EIE affects older, high-risk patients. After adjustment for operative risk, mortality was comparable to other aetiologies, highlighting the need for tailored diagnostic and therapeutic strategies.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"308-321"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness and budget-impact analysis of Acetazolamide in decompensated heart failure patients with volume overload in the German health care system.","authors":"Bent Estler, Hanna Fröhlich, Tobias Täger, Norbert Frey, Lutz Frankenstein","doi":"10.1093/ehjqcco/qcaf140","DOIUrl":"10.1093/ehjqcco/qcaf140","url":null,"abstract":"<p><strong>Aims: </strong>Acute decompensated heart failure (ADHF) represents a major clinical and economic burden in Germany, primarily due to the frequent need for hospitalizations and high rehospitalization rates. Acetazolamide, a carbonic anhydrase inhibitor, has been shown in the ADVOR trial to improve early decongestion when added to loop diuretics. However, its economic impact within the German healthcare system has not yet been evaluated.</p><p><strong>Methods and results: </strong>We developed a decision-analytic cost-effectiveness model using a 3-month time horizon to evaluate the addition of acetazolamide to standard diuretic therapy in hospitalized ADHF patients, based on data from the ADVOR trial. The analysis was conducted from the perspective of the German statutory health insurance (GKV). Model inputs included clinical probabilities, utilities from German heart failure populations, and healthcare costs (2025 values). Both deterministic and probabilistic sensitivity analyses were performed. A complementary budget impact analysis (BIA) estimated national-level financial implications under various adoption scenarios. In the base-case analysis, acetazolamide was technically dominant, incurring lower cost (4495€ vs. 4959€ per patient) and slightly higher quality-adjusted life years (QALYs: 0.132287 vs. 0.127710, difference 0.00458 ≈ 1.7 quality-adjusted days over 3 months) resulting in an ICER of -101 449€ per QALY. In a scenario using arm-specific outcomes from ADVOR, acetazolamide remained cost-saving with a minimal QALY decrement (-0.00024). The BIA estimated annual savings of €11-217 million depending on uptake and patient eligibility, with €39 million under full uptake when ADVOR exclusion criteria are applied.</p><p><strong>Conclusion: </strong>Acetazolamide appears to be a cost-effective and potentially cost-saving adjunct to standard care in patients hospitalized with ADHF in Germany. Broad adoption of acetazolamide could reduce inpatient costs for ADHF, with potential annual savings ranging from tens to hundreds of millions of euros depending on eligibility and uptake.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"296-304"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GLP-1 receptor agonists and clinical outcomes in patients with type 2 diabetes undergoing transcatheter aortic valve implantation.","authors":"Hoang Nhat Pham, Ramzi Ibrahim, Mahmoud Abdelnabi, George Bcharah, Ahmed K Mahmoud, Mohamed Allam, Juan Farina, Justin Z Lee, Amitoj Singh, Chadi Ayoub, Said Alsidawi, Kristen A Sell-Dottin, Anwar Chahal, Dan Sorajja, Kwan Lee, Mohamad Alkhouli, Reza Arsanjani","doi":"10.1093/ehjqcco/qcaf135","DOIUrl":"10.1093/ehjqcco/qcaf135","url":null,"abstract":"<p><strong>Aims: </strong>We evaluated clinical outcomes with GLP-1 RA use post-TAVI in patients with T2D. GLP-1 receptor agonists (GLP1-RAs) lower cardiovascular risk in type 2 diabetes (T2D), but their impact in patients with valvular heart disease, including those undergoing transcatheter aortic-valve implantation (TAVI), remained unexplored.</p><p><strong>Methods and results: </strong>We conducted a retrospective cohort study using the TriNetX network, including 25 184 adults (≥18 years) with T2D who underwent TAVI (2015-2023). Patients were stratified based on GLP1-RA initiation within 14 days post-TAVI. Baseline characteristics, comorbidities, medications, and laboratory data were balanced using 1:1 propensity score matching (PSM). Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for events from one-month post-TAVI until the most recent follow-up. PSM yielded 1101 patients per group, with a mean age of 73 years and 39% female. Mean follow-up duration was 2.2 ± 1.1 and 2.6 ± 1.8 years for GLP1-RA users and non-users, respectively. GLP1-RA use was also associated higher survival probability (HR: 0.708 [95% CI: 0.583-0.859]), and lower rates of all-cause hospitalization (HR: 0.790 [95% CI, 0.706-0.885]), major cardiovascular events (HR: 0.849 [95% CI: 0.749-0.963]), and acute heart failure exacerbation (HR: 0.785 [95% CI: 0.677-0.909]), acute kidney injury (HR: 0.843 [95% CI: 0.719-0.988]), and major kidney events (HR: 0.665 [95% CI: 0.510-0.866]). No differences were observed in acute myocardial infarction, cerebral infarction, or cardiac arrest.</p><p><strong>Conclusion: </strong>In patients with T2D undergoing TAVI, GLP1-RA use is associated with significant survival benefits and improved cardiorenal outcomes. However, these findings are limited by the observational design, high comorbidity burden, lack of data on medication compliance, and specific cause of death. Prospective trials are warranted to confirm these benefits.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"405-418"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetazolamide for acute heart failure: rethinking clinical and economic value in a field of narrow gains.","authors":"Vincenzo Castiglione, Francesco Gentile, Michele Emdin","doi":"10.1093/ehjqcco/qcag013","DOIUrl":"https://doi.org/10.1093/ehjqcco/qcag013","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":"12 3","pages":"305-307"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From composite events to clinical action: disentangling arrhythmia risk in a new Fabry CMR prognostic score.","authors":"Xiao Liang, Ting Huang, Rong Li","doi":"10.1093/ehjqcco/qcag019","DOIUrl":"10.1093/ehjqcco/qcag019","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"355"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RNA-targeted therapeutics in arterial hypertension.","authors":"Egidio Imbalzano, Riccardo M Inciardi, Luana Orlando, Francesca Amati, Flavio D'Ascenzi, Riccardo Liga, Anna Vittoria Mattioli, Marianna Gigliotti De Fazio, Maria Concetta Pastore, Andrea Rinaldi, Pietro Scicchitano, Matteo Cameli","doi":"10.1093/ehjqcco/qcaf127","DOIUrl":"10.1093/ehjqcco/qcaf127","url":null,"abstract":"<p><p>Hypertension is a common and serious medical condition affecting millions of people worldwide. While existing treatments are effective for many hypertensive patients, up to one-third fail to achieve adequate blood pressure control-often due to poor adherence, complex polypharmacy, or true pharmacological resistance. In this context, novel precision medicine approaches such as RNA-targeted therapeutics may represent tailored, long-acting alternatives particularly beneficial for patients with resistant hypertension, poor compliance, or multiple comorbidities. Small interfering RNAs (siRNAs) and antisense oligonucleotides (ASOs) have shown promising results as potential treatments for hypertension. On the one hand, zilebesiran (formerly ALN-AGT01) is currently in phase 2 clinical trials and targets the hepatic synthesis of angiotensinogen through a novel mechanism of action. On the other hand, IONIS-AGT-LRX is a hepatocyte-directed antisense oligonucleotide designed to target AGT mRNA in hepatocytes, thereby reducing angiotensinogen synthesis and circulating plasma levels. Furthermore, literature show sparse trials on RNA-targeted nucleic acid therapeutics as potential hypertension treatment, in preclinical and clinical phases, in animal and human targets, analyzed in this review in their safety and efficacy. RNA-based drugs, administered as subcutaneous injections, offer several advantages over traditional antihypertensive agents, including greater target specificity and prolonged duration of action, potentially improving adherence and long-term blood pressure control. However, these therapies are not suitable for the acute management of hypertensive emergencies or urgencies, and evidence regarding their effects on cardiovascular outcomes, target organ protection, and mortality is still lacking. Further studies are warranted to define their role in clinical practice.</p>","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"358-365"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of vutrisiran, tafamidis, and their combination in amyloid transthyretin cardiomyopathy.","authors":"Alberto Aimo, Valentina Lorenzoni, Vincenzo Castiglione, Giuseppe Vergaro, Michele Emdin","doi":"10.1093/ehjqcco/qcaf152","DOIUrl":"10.1093/ehjqcco/qcaf152","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"422-424"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"POAF after CABG: early risk, landmark bias, and the case for selective anticoagulation.","authors":"Gianluca Pagnoni, Aurora Vicenzi, Francesca Coppi","doi":"10.1093/ehjqcco/qcaf149","DOIUrl":"10.1093/ehjqcco/qcaf149","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"402"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Listening to what matters: a quality-of-care-centred perspective in adults with congenital heart disease and heart failure.","authors":"Egle Incalcaterra","doi":"10.1093/ehjqcco/qcag007","DOIUrl":"10.1093/ehjqcco/qcag007","url":null,"abstract":"","PeriodicalId":520616,"journal":{"name":"European heart journal. Quality of care & clinical outcomes","volume":" ","pages":"342-343"},"PeriodicalIF":4.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}