JACC advances最新文献

{"title":"Polygenic Inheritance for Common Comorbidities Associated With Congenital Heart Disease","authors":"Jamie-Lee M. Thompson PhD , Ingrid S. Tarr BSc , Emma M. Rath PhD , Michael Troup BSCT , Eddie K.K. Ip PhD , Gillian M. Blue PhD , David S. Winlaw MBBS, MD , Sally L. Dunwoodie PhD , Eleni Giannoulatou DPhil","doi":"10.1016/j.jacadv.2025.101673","DOIUrl":"10.1016/j.jacadv.2025.101673","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101673"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apixaban Dose in Patients With Atrial Fibrillation and Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary Intervention","authors":"Marat Fudim MD, MHS ,&nbsp;Renato D. Lopes MD, PhD ,&nbsp;Daniel M. Wojdyla MS ,&nbsp;Roxana Mehran MD ,&nbsp;Muhammad Shahzeb Khan MD, MSc ,&nbsp;Christopher B. Granger MD ,&nbsp;Shaun G. Goodman MD ,&nbsp;Ronald Aronson MD ,&nbsp;Stephan Windecker MD ,&nbsp;John H. Alexander MD, MHS","doi":"10.1016/j.jacadv.2025.101665","DOIUrl":"10.1016/j.jacadv.2025.101665","url":null,"abstract":"<div><h3>Background</h3><div>Studies have demonstrated the safety and efficacy of reducing the dose of apixaban from 5.0 mg to 2.5 mg twice daily in patients with atrial fibrillation (AF) and ≥2 dose-reduction criteria (age ≥80 years, body weight ≤60 kg, serum creatinine ≥1.5 mg/dL). However, data on reduced dose apixaban in patients with AF and acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) are limited.</div></div><div><h3>Objectives</h3><div>The authors aimed to assess clinical outcomes, including bleeding and death/ischemic events, according to apixaban dose in AUGUSTUS.</div></div><div><h3>Methods</h3><div>In AUGUSTUS, 4,614 patients with AF and/or recent ACS or PCI on a P2Y12 inhibitor were randomized to open-label apixaban or vitamin K antagonist (VKA) and blinded aspirin or placebo for 6 months. Apixaban dose was determined by investigators following the apixaban label. We assessed outcomes, including major/clinically relevant nonmajor bleeding and death/ischemic events, among patients who appropriately received reduced dose apixaban, inappropriately received reduced dose apixaban, and appropriately received standard dose apixaban compared with VKA.</div></div><div><h3>Results</h3><div>Of 2,290 patients assigned apixaban, 229 (10%) received reduced dose apixaban and 98 (43%) of those met dose-reduction criteria. Among patients receiving appropriately reduced, inappropriately reduced, and standard dose apixaban, rates of major/clinically relevant nonmajor bleeding were 13.7%, 10.5%, and 11.0%; rates of death or ischemic events were 12.2%, 12.3%, and 5.7%. When comparing the risk of clinical outcomes in the 3 groups (appropriately reduced, inappropriately reduced, and standard dose apixaban) vs matched patients receiving VKA, we found that patients receiving apixaban had more favorable outcomes than those receiving VKA, without significant interaction (<em>P</em> &gt; 0.2 across all 3 groups and all outcomes).</div></div><div><h3>Conclusions</h3><div>Of the ∼10% of patients in AUGUSTUS who received reduced dose apixaban, less than half met the dose-reduction criteria. In patients with AF and recent ACS or PCI, appropriately reduced dose apixaban was associated with a lower risk of bleeding and similar rates of ischemic outcomes compared with VKA, similar results were found with standard dose apixaban. (A Study of Apixaban in Patients With Atrial Fibrillation, Not Caused by a Heart Valve Problem, Who Are at Risk for Thrombosis [Blood Clots] Due to Having Had a Recent Coronary Event, Such as a Heart Attack or a Procedure to Open the Vessels of the Heart; <span><span>NCT02415400</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101665"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Real Estate the Main Driver of Additional Costs for Cardiology Consultations in France?","authors":"Benjamin Marchandot MD ,&nbsp;Adrien Carmona MD ,&nbsp;Olivier Morel MD, PhD","doi":"10.1016/j.jacadv.2025.101657","DOIUrl":"10.1016/j.jacadv.2025.101657","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101657"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Permanent Cardiac Pacing in the Fontan Population","authors":"Bret L. Pinsker MD ,&nbsp;Jeremy P. Moore MD, MS ,&nbsp;Thomas M. Bashore MD ,&nbsp;Richard A. Krasuski MD","doi":"10.1016/j.jacadv.2025.101667","DOIUrl":"10.1016/j.jacadv.2025.101667","url":null,"abstract":"<div><div>Following the Fontan operation, electrophysiologic abnormalities requiring pacemaker implantation are common, consisting of sinus node dysfunction, complete atrioventricular block, and electromechanical dyssynchrony. Pacemaker implantation in this population can be challenging, as transvenous access to the cardiac chambers is often limited and may increase the risk of thromboembolism. Consequently, epicardial lead placement continues to be the default approach at most centers. Furthermore, permanent cardiac pacing has been associated with poor outcomes in this population (including an increased need for cardiac transplantation and death), even though it may be, depending on the approach, of great benefit for many individuals. Fortunately, improved understanding of the differential effects of cardiac pacing and novel approaches related to implantation have been developed and have increased their application to a growing number of patients. This review highlights the indications for pacing, methods to facilitate lead implantation, and associated outcomes in Fontan patients requiring permanent cardiac pacing.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101667"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Metals and Nonmetals in Drinking Water, Cardiovascular Events, and Diet","authors":"Hanxu Shi PhD ,&nbsp;Mintao Su MPH ,&nbsp;Peng Shen BA ,&nbsp;Junxiong Ma PhD ,&nbsp;Qinfeng Zhou PhD ,&nbsp;Zongming Yang PhD ,&nbsp;Pengfei Chai BA ,&nbsp;Shengzhi Sun PhD ,&nbsp;Hongbo Lin BA ,&nbsp;Liming Shui MPH ,&nbsp;Zhisheng Liang MPH ,&nbsp;Shuyu Huang MPH ,&nbsp;Na Zhang PhD ,&nbsp;Jianbing Wang PhD ,&nbsp;Kun Chen MD ,&nbsp;Zhenyu Zhang PhD","doi":"10.1016/j.jacadv.2025.101669","DOIUrl":"10.1016/j.jacadv.2025.101669","url":null,"abstract":"<div><h3>Background</h3><div>Metals and nonmetals in drinking water could potentially influence cardiovascular health. The relationship between poor-quality drinking water, major adverse cardiovascular events (MACE), and diet is not well studied.</div></div><div><h3>Objectives</h3><div>The aim of this study was to determine whether long-term exposure to metals (copper, manganese, aluminum, zinc, and cadmium) and nonmetals (selenium, sulfate, and nitrate-nitrogen) in drinking water was associated with MACE outcomes, and whether the dietary patterns could modify the association between long-term exposure to low-quality drinking water and MACE.</div></div><div><h3>Methods</h3><div>Data from a prospective population-based cohort from Yinzhou District, Ningbo (follow-up between 2016 and 2022) were linked to Yinzhou Health Information System. MACE endpoints included acute myocardial infarction (AMI), heart failure, stroke, angina, and cardiovascular death. Effect modification of the associations between exposure and MACE by dietary factors was determined.</div></div><div><h3>Results</h3><div>In the final cohort of 24,212 participants, 57 had an AMI; 886 developed heart failure; 733 had a stroke; 23 had angina; and 134 had a cardiovascular death. An increased risk of: 1) AMI was seen with exposure to copper, aluminum, cadmium, and selenium; 2) stroke with exposure to zinc, copper, and selenium; 3) angina with exposure to zinc and copper; and 4) cardiovascular death with exposure to zinc and aluminum in drinking water. Consuming fish, white meat, and grain products attenuated MACE outcomes induced by metals and nonmetals in drinking water.</div></div><div><h3>Conclusions</h3><div>In this study, long-term exposure to higher metallic and nonmetallic elements in drinking water was associated with an increased risk of MACE. Specific dietary patterns modified the associations. Further studies are needed in this area.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101669"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Congenital Cardiac Catheterization Registry Analysis From the United States and Low- and Middle-Income Countries","authors":"Fatima Ali MBBS ,&nbsp;Mary J. Yeh BA ,&nbsp;Fiona E. Walshe BSc ,&nbsp;Lisa Bergersen MD, MPH ,&nbsp;Kimberlee Gauvreau ScD ,&nbsp;Oliver M. Barry MD ,&nbsp;Brian A. Boe MD ,&nbsp;Ralf J. Holzer MD ,&nbsp;Rik De Decker MD ,&nbsp;Kathy Jenkins MD ,&nbsp;Jacqueline Kreutzer MD ,&nbsp;Raman Krishna Kumar DM ,&nbsp;John Lozier MD ,&nbsp;Michael L. O’Byrne MD ,&nbsp;Igor Polivenok MD ,&nbsp;Miguel Ronderos MD ,&nbsp;Babar Hasan MBBS ,&nbsp;Brian P. Quinn MD","doi":"10.1016/j.jacadv.2025.101649","DOIUrl":"10.1016/j.jacadv.2025.101649","url":null,"abstract":"<div><h3>Background</h3><div>Disparities in congenital heart disease care exist between high-income and low- and middle-income countries (LMICs), likely extending to congenital cardiac catheterization (CCC).</div></div><div><h3>Objectives</h3><div>This study compares patient characteristics and outcomes of CCC in the U.S.-based Congenital Cardiac Catheterization Project on Outcomes (C3PO) and the International Quality Improvement Collaborative—Congenital Heart Disease Catheterization Registry (IQIC-CHDCR) from LMICs.</div></div><div><h3>Methods</h3><div>The analysis included all CCC procedures recorded in C3PO (19 sites) and IQIC-CHDCR (19 sites) from 2019 to 2022. Patient and procedural characteristics, resource utilization, and outcomes were compared.</div></div><div><h3>Results</h3><div>A total of 28,957 C3PO and 6,485 IQIC-CHDCR cases were analyzed. Single ventricle patients accounted for 30% of C3PO and 13% of International Quality Improvement Collaborative (IQIC), with high-risk procedures (procedural risk in congenital cardiac catheterization 3-5) performed more frequently in C3PO (42% vs 23%). Median procedure duration was longer in C3PO (1.5 vs 0.8 hours). Clinically meaningful adverse event (CMAE) rates were higher in C3PO (3.9% vs 1.5%), though mortality was comparable (0.5% vs 0.7%). Risk-adjusted analysis showed a lower ratio in IQIC for both CMAE (0.50; 95% CI: 0.39-0.62) and severity level 4/5 events (0.71; 95% CI: 0.52-0.96). However, failure-to-rescue rates were higher in IQIC (7.1% vs 2.1%).</div></div><div><h3>Conclusions</h3><div>The harmonized databases facilitated direct comparison of CCC practices, revealing more complex patients and resource-intensive procedures in C3PO, while the IQIC cohort demonstrated lower CMAE rates but a slightly higher mortality rate. These findings emphasize the need for further risk adjustment modeling for LMICs and identify areas to enhance global resource access and patient outcomes.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101649"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Achieved Diastolic Blood Pressure and Cardiovascular Outcomes in Elderly Patients With Hypertension","authors":"Qianhui Ling MD ,&nbsp;Xilan Dong MD ,&nbsp;Xueyan Zhao MD, PhD ,&nbsp;Jun Cai MD, PhD","doi":"10.1016/j.jacadv.2025.101675","DOIUrl":"10.1016/j.jacadv.2025.101675","url":null,"abstract":"<div><h3>Background</h3><div>Blood pressure profiles differ in males and females. Low diastolic blood pressure (DBP) is associated with increased risk of cardiovascular disease (CVD). However, sex differences in achieved DBP and associated CVD risk remain unclear.</div></div><div><h3>Objectives</h3><div>The aim of this study was to examine sex differences in achieved DBP and CVD outcomes in elderly hypertensive patients.</div></div><div><h3>Methods</h3><div>This study is a secondary analysis of the STEP (Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients) trial. The mean achieved DBP was compared between male and female participants. The association between mean achieved DBP and cardiovascular risk was evaluated as a continuous and categorical variable with a cubic spline model or Cox proportional hazards regression model.</div></div><div><h3>Results</h3><div>A total of 8,355 patients were included in this analysis. Median follow-up time was 3.08 years (Q1-Q3: 2.97-3.25 years). Female patients achieved lower DBP levels than male patients throughout the trial duration (<em>P</em> &lt; 0.001), and in each treatment group (<em>P</em> &lt; 0.05 for all). Mean achieved DBP exhibited a J-curve association with cardiovascular risk in females, but not in males. Both female and male patients showed increased cardiovascular risk at DBP &gt;81 mm Hg (females: HR: 1.10; 95% CI: 1.03-1.16; males: HR: 1.06; 95% CI: 1.01-1.11). Mean achieved DBP of &lt;65 mm Hg was associated with increased CVD risk only in female patients (females: HR: 2.33; 95% CI: 1.01-5.34; males: HR: 0.87; 95% CI: 0.12-6.25).</div></div><div><h3>Conclusions</h3><div>This study shows in elderly hypertensive patients, females have lower achieved DBP. A J-shaped relation between achieved DBP and CVD risk was observed in female, but not male patients. Low achieved DBP is associated with higher CVD risk among females but not males.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101675"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Endothelin-1 Is Associated With Morbidity in Single Ventricle Heart Disease in Children Undergoing Fontan Palliation","authors":"Benjamin S. Frank MD ,&nbsp;Sierra Niemiec MS ,&nbsp;Ludmila Khailova MS ,&nbsp;Christopher A. Mancuso PhD ,&nbsp;Max B. Mitchell MD ,&nbsp;Gareth J. Morgan MD ,&nbsp;Mark Twite MD ,&nbsp;Michael V. DiMaria MD ,&nbsp;Carmen C. Sucharov PhD ,&nbsp;Jesse A. Davidson MD, MPH","doi":"10.1016/j.jacadv.2025.101672","DOIUrl":"10.1016/j.jacadv.2025.101672","url":null,"abstract":"<div><h3>Background</h3><div>Endothelin-1 (ET1) is a potent vasoconstrictor and stimulator of pulmonary artery smooth muscle cell proliferation. We previously demonstrated that failure to suppress ET1 is associated with morbidity in infants with single ventricle heart disease (SVHD) undergoing stage 2 palliation.</div></div><div><h3>Objectives</h3><div>The aim of this study is to evaluate whether persistent failure to suppress ET1 is associated with impaired recovery among children with SVHD undergoing the stage 3 (Fontan) operation.</div></div><div><h3>Methods</h3><div>A prospective cohort study that includes 84 children with SVHD undergoing stage 3 palliation and 50 controls. Samples for ET1 analysis were collected at preoperation (systemic and pulmonary vein), 2, 24, and 48 hours postoperation for SVHD cases and a single timepoint for controls. Primary outcomes were Fontan pressure and systemic oxygen saturation at 24 hours postoperation.</div></div><div><h3>Results</h3><div>SVHD cases showed higher ET1 in the systemic vein than pulmonary vein (1.0 vs 0.7 pg/mL, <em>P</em> &lt; 0.001) and lower systemic vein levels than controls (1.0 vs 1.4 pg/mL, <em>P</em> = 0.001). Among cases, ET1 concentration peaked at 2 hours postoperation, decreased by 24 hours, and was stable but not back to baseline by 48 hours. Adjusting for clinical covariates, higher preoperative ET1 was associated with higher 24-hour Fontan pressure. Higher 24-hour postoperative ET1 was associated with lower systemic oxygen saturation at 24 hours postoperation, higher 24-hour Fontan pressure, more pleural drainage, and longer length of stay.</div></div><div><h3>Conclusions</h3><div>SVHD children with higher peri-operative ET1 experience more post-stage 3 morbidity. Failure to suppress ET1 may be a modifiable risk factor for intolerance of SVHD palliation.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101672"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Timing to Noncardiac Surgery following Cardiac Operations: A National Analysis","authors":"Saad Mallick MD ,&nbsp;Shayan Ebrahimian MS ,&nbsp;Sara Sakowitz MS, MPH ,&nbsp;Nguyen Le MS ,&nbsp;Syed Shahyan Bakhtiyar MD, MBE ,&nbsp;Peyman Benharash MD","doi":"10.1016/j.jacadv.2025.101668","DOIUrl":"10.1016/j.jacadv.2025.101668","url":null,"abstract":"<div><h3>Background</h3><div>Despite advancements in peri-operative care and conflicting evidence regarding the need for preoperative coronary revascularization, the optimal timing of noncardiac surgery (NCS) following cardiac operations remains unclear.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate the effect of time interval between cardiac surgery and NCS on peri-operative risk of major adverse events (MAEs).</div></div><div><h3>Methods</h3><div>Adults undergoing elective CABG, valve repair or replacement, or combined procedures were identified in the 2016 to 2020 Nationwide Readmissions Database, with subsequent admission for NCS analyzed. The time interval in between NCS and index cardiac operations was modeled using restricted cubic splines, and clinical outcome differences were evaluated across various NCS risk and urgency categories.</div></div><div><h3>Results</h3><div>Of 1,335,175 patients undergoing cardiac surgery, 20,253 (1.5%) required a subsequent NCS. On risk-adjusted examination of MAE rates as a function of time delay after cardiac surgery, an inflection point was noted at 100 days postoperatively. Based on this threshold, 47.9% of patients who had NCS within 100 days were considered <em>early</em> while others were grouped as <em>late</em>. Late NCS was associated with significantly lower odds of MAE (adjusted OR: 0.69; 95% CI: 0.62-0.76), and in-hospital mortality (adjusted OR: 0.66; 95% CI: 0.46-0.96), as compared to early NCS. This relationship persisted across all cardiac surgical subgroups and whether subsequent NCS was elective. Additionally, nonelective procedures classically categorized as low risk in the general population, exhibited comparable rates of MAE to high-risk procedures following early NCS.</div></div><div><h3>Conclusions</h3><div>When feasible, delaying NCS, particularly beyond 100 days, appears to be associated with a reduction in adverse events, suggesting a potential opportunity for optimization of patient outcomes.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101668"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hardly a Windfall","authors":"Avital B. Ludomirsky MD, MPP, MHS ,&nbsp;Jonathan B. Edelson MD, MSCE ,&nbsp;Kimberly Y. Lin MD ,&nbsp;Justin H. Berger MD, PhD ,&nbsp;Matthew J. O'Connor MD ,&nbsp;Carol A. Wittlieb-Weber MD ,&nbsp;Heather Griffis PhD ,&nbsp;Bingqing Zhang MPH ,&nbsp;Joseph W. Rossano MD, MS","doi":"10.1016/j.jacadv.2025.101661","DOIUrl":"10.1016/j.jacadv.2025.101661","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 4","pages":"Article 101661"},"PeriodicalIF":0.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}