JACC advances最新文献

{"title":"Lipoprotein(a), High-Sensitivity C-Reactive Protein, and All-Cause Mortality in a Primary Prevention Cohort","authors":"Vincent Chen MD , Danielle Brennan MS , Madlaina Costa-Scharplatz PhD , Leslie Cho MD","doi":"10.1016/j.jacadv.2025.101783","DOIUrl":"10.1016/j.jacadv.2025.101783","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101783"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481142","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":"Full Issue PDF","authors":"","doi":"10.1016/S2772-963X(25)00375-8","DOIUrl":"10.1016/S2772-963X(25)00375-8","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101954"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481494","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":"Future of Stroke Prevention","authors":"Alexander C. Razavi MD, PhD, MPH ,&nbsp;Aaron L. Troy MD, MPH ,&nbsp;Jaideep Patel MD ,&nbsp;Laxmi S. Mehta MD ,&nbsp;Jared A. Spitz MD ,&nbsp;Donald Lloyd-Jones MD, ScM ,&nbsp;Seamus P. Whelton MD, MPH ,&nbsp;Michelle C. Johansen MD, PhD ,&nbsp;Roger S. Blumenthal MD","doi":"10.1016/j.jacadv.2025.101724","DOIUrl":"10.1016/j.jacadv.2025.101724","url":null,"abstract":"<div><div>Approximately 9 to 10 million adults (4%) have experienced a stroke in the United States. While stroke incidence has generally declined, progress has been less pronounced among young individuals, and such trends have underlined the importance of focusing on the primary prevention of stroke. In 2024, the American Heart Association and American Stroke Association released new guidelines for the primary prevention of stroke. Here, we review major updates in 7 domains: dietary modification, glucagon-like peptide-1 receptor agonists, blood pressure targets, lipid-lowering medications, antithrombotic agents, colchicine therapy, and sex-specific preventive risk assessment. Through this process, we review important randomized controlled trial evidence contributing to guideline updates and provide key perspectives on the incorporation of lifestyle and pharmacotherapy for personalized stroke prevention.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101724"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054360","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":"Interprofessional Clinician Perspectives on LVAD Deactivation Compared to Dialysis Discontinuation","authors":"Arielle Fried MD ,&nbsp;Max Hockstein MD, MS ,&nbsp;Anirudh Rao MD ,&nbsp;Michael Pottash MD, MPH","doi":"10.1016/j.jacadv.2025.101835","DOIUrl":"10.1016/j.jacadv.2025.101835","url":null,"abstract":"<div><h3>Background</h3><div>Requests for left ventricular assist device (LVAD) deactivation may pose unique emotional and moral burdens on clinicians.</div></div><div><h3>Objectives</h3><div>The authors aimed to explore the perspectives of interprofessional clinicians regarding LVAD deactivation across clinical settings compared to cessation of hemodialysis.</div></div><div><h3>Methods</h3><div>Vignette-based interviews were conducted with a sample of interprofessional clinicians at a heart and vascular center from April 14, 2023, to June 5, 2023. Likert-scale responses to paired vignettes were analyzed descriptively and with inferential statistics.</div></div><div><h3>Results</h3><div>Eighty clinicians agreed to be interviewed for this study (27.5% physicians, 23.8% nurses, 17.5% physician trainees, 16.3% advanced practice providers, and 15% social workers, bioethicists, and chaplains). Clinicians uniformly felt that vignettes depicting LVAD deactivation were more ethically complex and less likely to be honored than dialysis discontinuation across clinical scenarios (<em>P</em> &lt; 0.001). Clinicians were more likely to rate scenarios that described the patient without other medical comorbidities (“tired of life”) for either the patient with a LVAD or a patient on dialysis as ethically complex and were less likely to suggest honoring the patient's request (<em>P</em> &lt; 0.001). These trends remained consistent across all demographic and clinician disciplines.</div></div><div><h3>Conclusions</h3><div>When compared to requests to discontinue hemodialysis, clinicians perceive LVAD deactivation as more ethically complex and were less likely to honor the patient's request. These differences persisted across clinical scenarios, from acutely ill to chronically ill to independent.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101835"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188641","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":"Dapagliflozin's Association With Cardiorenal Outcomes and Apolipoprotein M Levels in HFrEF Patients","authors":"Andrew J. Sauer MD ,&nbsp;Joycie Chang BS ,&nbsp;Zhuxuan Fu PhD ,&nbsp;Carla Valenzuela Ripoll MD ,&nbsp;Yoonje Cho BS ,&nbsp;Zhen Guo PhD ,&nbsp;Philip Jones MS ,&nbsp;Senthil Selvaraj MD, MS, MA ,&nbsp;Sheryl L. Windsor BS ,&nbsp;Mansoor Husain MD ,&nbsp;Silvio E. Inzucchi MD ,&nbsp;Darren K. McGuire MD, MHSc ,&nbsp;Bertram Pitt MD ,&nbsp;Benjamin M. Scirica MD, MPH ,&nbsp;Bethany A. Austin MD ,&nbsp;Guillermo Umpierrez MD ,&nbsp;Sinh Tran MLS ,&nbsp;Björn Dahlbäck MD, PhD ,&nbsp;Ali Javaheri MD, PhD ,&nbsp;Mikhail N. Kosiborod MD","doi":"10.1016/j.jacadv.2025.101800","DOIUrl":"10.1016/j.jacadv.2025.101800","url":null,"abstract":"<div><h3>Background</h3><div>Apolipoprotein M (ApoM) is associated with lower mortality in heart failure (HF) patients and protects against cardiac and kidney injury in mice.</div></div><div><h3>Objectives</h3><div>The authors investigated dapagliflozin's cardiorenal effects by studying its association with ApoM in patients with HF with reduced ejection fraction.</div></div><div><h3>Methods</h3><div>We performed a secondary analysis of DEFINE-HF (Dapagliflozin Effects on Biomarkers, Symptoms, and Functional Status in Patients with HF with Reduced Ejection Fraction) to assess dapagliflozin's effects on ApoM, N-terminal pro B-type natriuretic peptide (NT-proBNP), and urine albumin-creatinine ratio (UACR) changes from baseline to 12 weeks.</div></div><div><h3>Results</h3><div>Of 263 randomized patients, 236 had ApoM values at baseline (mean 0.641 ± 0.181 μM) and 12 weeks. Dapagliflozin did not significantly affect ApoM vs placebo. However, each 0.1 μM increase in ApoM was associated with a significant decrease in log-transformed NT-proBNP overall (β = −0.11, <em>P</em> = 0.006), particularly in dapagliflozin-treated patients (β = −0.19, <em>P</em> &lt; 0.001; <em>P</em> interaction = 0.025). The inverse relationship between ApoM and NT-proBNP varied by changes in UACR. Dapagliflozin-treated patients with reduced UACR at 12 weeks (n = 53, 22%) experienced a mean NT-proBNP reduction of −0.28 per 0.1 μM increase in ApoM (<em>P</em> &lt; 0.001), compared to a smaller reduction in those without UACR change (−0.07, <em>P</em> = 0.47). Placebo-treated patients with reduced UACR over 12 weeks did not show significant NT-proBNP changes (β = −0.17, <em>P</em> = 0.11).</div></div><div><h3>Conclusions</h3><div>Dapagliflozin did not significantly alter ApoM overall; however, an inverse association between ApoM and NT-proBNP was observed in dapagliflozin-treated patients with albuminuria. While some NT-proBNP reductions were seen in the placebo group, the significant interaction with treatment allocation suggests a potential dapagliflozin-mediated effect.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101800"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480815","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":"Lifestyle Interventions in Cardiovascular-Kidney-Metabolic Syndrome JACC: Advances Expert Panel","authors":"Izza Shahid MBBS ,&nbsp;Jerrin Philip MD ,&nbsp;Eleonora Avenatti MD ,&nbsp;Deepika Laddu PhD ,&nbsp;Michael D. Shapiro DO, MCR ,&nbsp;Amit Khera MD, MSc ,&nbsp;Ambarish Pandey MD, MSCS ,&nbsp;Chiadi E. Ndumele MD, PhD ,&nbsp;Martha Gulati MD, MS ,&nbsp;Khurram Nasir MD, MPH, MSc ,&nbsp;Kershaw V. Patel MD, MSCS","doi":"10.1016/j.jacadv.2025.101788","DOIUrl":"10.1016/j.jacadv.2025.101788","url":null,"abstract":"<div><div>Cardiovascular-kidney-metabolic (CKM) syndrome impacts nearly all organ systems, with progressive dysfunction leading to morbidity and mortality. The high burden of CKM syndrome requires accessible, scalable, and low-cost interventions to prevent downstream complications. Nonpharmacologic interventions targeting lifestyle factors, such as diet, physical activity, and behavioral modification, represent the cornerstone of CKM syndrome management to prevent a progressive disease and associated adverse outcomes. Lifestyle interventions play a key role not only in primordial and primary prevention in the earlier stages of CKM syndrome (stages 0-2) but also in subclinical cardiovascular disease (stage 3) as well as prevalent cardiovascular disease (stage 4). The purpose of the present review is to describe the evidence from randomized clinical trials for specific lifestyle interventions across CKM syndrome stages. This review will explore the impact of lifestyle interventions in each CKM syndrome stage and how they impact interrelated systems.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101788"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480757","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":"Differential Selection of Obesity Treatments by Race/Ethnicity","authors":"Rebecca L. Tisdale MD, MPA ,&nbsp;Tariku J. Beyene PhD ,&nbsp;Wilson Tang MD ,&nbsp;Alexander T. Sandhu MD, MS ,&nbsp;Paul Heidenreich MD, MS ,&nbsp;Steven Asch MD, MPH ,&nbsp;Celina M. Yong MD, MBA, MSc","doi":"10.1016/j.jacadv.2025.101819","DOIUrl":"10.1016/j.jacadv.2025.101819","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101819"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481149","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":"Neighborhood Deprivation and Racial Disparities in Heart Failure Outcomes","authors":"Wenxi Huang MS ,&nbsp;Yuru Zhu PhD ,&nbsp;Stephen E. Kimmel MD, MSCE ,&nbsp;Mustafa M. Ahmed MD ,&nbsp;Steven M. Smith PharmD ,&nbsp;Yao An Lee MS ,&nbsp;Carl Yang PhD ,&nbsp;Jiang Bian PhD ,&nbsp;Yong Chen PhD ,&nbsp;Jingchuan Guo MD, PhD","doi":"10.1016/j.jacadv.2025.101808","DOIUrl":"10.1016/j.jacadv.2025.101808","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) is a major contributor to hospitalizations and mortality in the United States, with significant racial disparities in care access and clinical outcomes. Social determinants of health (SDoH) play a critical role in shaping these disparities.</div></div><div><h3>Objectives</h3><div>This study aimed to assess the impact of neighborhood deprivation on racial disparities in HF outcomes and quantify the changes in adverse outcomes if non-Hispanic Black (NHB) patients resided in neighborhoods with SDoH level equal to those of non-Hispanic White (NHW) patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using electronic health records from the University of Florida, including adults hospitalized for HF between 2016 and 2021. SDoH level was measured using the Area Deprivation Index (ADI). The primary outcome was a composite measure of 1-year readmission and all-cause mortality. A counterfactual framework was applied to estimate how NHB patient outcomes might change if they lived in neighborhoods with ADI distributions equivalent to NHW patients.</div></div><div><h3>Results</h3><div>Among 42,279 patients (mean age 65 ± 14.3 years; 48% women), NHB patients had more 1-year composite outcomes (32.92%) compared to NHW patients (27.69%). Adjusted analyses showed NHB patients had a higher risk of readmission or mortality (aOR: 1.101; 95% CI: 1.063-1.139). Counterfactual modeling showed that if NHB patients resided in neighborhoods with ADI distributions same as NHW patients, their outcome rate would decrease by 1.31% (95% CI: 1.309%-1.311%).</div></div><div><h3>Conclusions</h3><div>This study highlights racial disparities in HF outcomes attributed to neighborhood deprivation. Improving socioeconomic conditions in deprived neighborhoods could mitigate disparities in HF.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101808"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481148","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":"Advancing Preventive Cardiology","authors":"Garima Sharma MD ,&nbsp;Jared A. Spitz MD ,&nbsp;Anurag Mehta MD ,&nbsp;Michael D. Shapiro DO, MCR ,&nbsp;Sadeer Al-Kindi MD","doi":"10.1016/j.jacadv.2025.101868","DOIUrl":"10.1016/j.jacadv.2025.101868","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101868"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481144","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":"High-Density Lipoprotein Cholesterol and Statin Use Among U.S. Adults With Intermediate 10-Year Predicted ASCVD Risk","authors":"Alexander R. Zheutlin MD, MS ,&nbsp;Joshua A. Jacobs PharmD ,&nbsp;Adam P. Bress PharmD, MS","doi":"10.1016/j.jacadv.2025.101725","DOIUrl":"10.1016/j.jacadv.2025.101725","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 6","pages":"Article 101725"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054709","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}