American heart journal最新文献

{"title":"A series of randomized trials of behavioral economic interventions to increase racial and ethnic diversity of research participants:Rationale and design of ITERATE.","authors":"Nirali Patel, Casey Whitman, Adina Lieberman, Shira Blady, Colleen Morse, Nawar Naseer, Joellen Weaver, Modele O Ogunniyi, Rachel Kohn, Kevin G Volpp, Scott D Halpern, Alanna A Morris, Alisa Stephens-Shields, Alexander C Fanaroff","doi":"10.1016/j.ahj.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.016","url":null,"abstract":"<p><strong>Rationale: </strong>Prospective clinical research studies are essential for determining the effectiveness and safety of drugs, medical devices, and healthcare delivery interventions. However, low enrollment, particularly among Black and Hispanic patients, challenges the generalizability of results and fairness of research. Leveraging insights from behavioral economics to modify the content of messages recruiting patients to join research studies may increase enrollment and representativeness of trial populations.</p><p><strong>Primary hypothesis: </strong>Method of outreach, source of outreach, message framing, and financial incentives will have important effects on enrollment fraction of Black and Hispanic patients electronically approached for participation in a prospective clinical research study.</p><p><strong>Design: </strong>ITERATE (NCT05827718) is a series of four randomized clinical trials (RCTs) designed to rigorously, systematically, and iteratively test the effects of different messaging strategies informed by behavioral economic theory on the enrollment of Black and Hispanic individuals into the Penn Medicine BioBank (PMBB), a prospective registry. For all four RCTs, we will identify patients eligible for enrollment in the PMBB (those with ≥ 1 encounter with the University of Pennsylvania Health System in the past 3 months, a phone number able to receive text messages or a valid email address on file, no history of consenting to or declining enrollment in the PMBB, and able to provide their own consent) and randomly assign them to receive different outreach messages. RCT 1 will test the method of outreach (email vs. text message vs. email + text message); RCT 2, source of outreach (research team vs. clinical team); RCT 3, message framing (appeal to altruism vs. appeal to social proof vs. control); and RCT 4, financial incentive (none vs. medium guarantee vs. small guarantee + small lottery vs. medium lottery vs. large lottery). In each RCT, at least 50% of the participants will be Black or Hispanic. The primary outcome of each RCT is enrollment fraction, defined as the number of participants who enroll in the PMBB divided by the total number of participants who received an outreach message, compared between arms among both Black and Hispanic patients. Secondary outcomes will include overall enrollment fraction and enrollment fraction among White patients. The \"winning\" strategies in earlier RCTs will be incorporated as the \"standard of care\" in the subsequent RCTs.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750736","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":"Sex as a biological variable: a contemporary perspective.","authors":"Fatima Farrukh, Richard C Becker","doi":"10.1016/j.ahj.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.012","url":null,"abstract":"<p><p>This review discusses the significance of incorporating sex as a biological variable (SABV) in biomedical research to enhance the translational value of findings and improve healthcare outcomes for both sexes. We review foundational policies, such as the NIH SABV mandate, and assess progress in integrating SABV in preclinical and clinical research. By highlighting disparities in cardiovascular disease presentation and treatment responses, as well as the pivotal roles of funding agencies, publishers, and the pharmaceutical industry, we underscore the necessity of SABV for equitable and effective healthcare. Strategies for advancing SABV integration, including mandatory training, policy enforcement, and clinical trial participation, are proposed to foster a research environment that prioritizes inclusivity and scientific rigor.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750737","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":"HELicobacter Pylori screening to prevent gastrointestinal bleeding in patients with acute Myocardial Infarction(HELP-MI SWEDEHEART)Design and rationale of a cluster randomized, crossover, registry-based clinical trial.","authors":"Robin Hofmann, Stefan James, Martin O Sundqvist, Jonatan Wärme, Ole Fröbert, Oskar Angerås, Per M Hellström, Kristina Hambraeus, Joakim Alfredsson, David Erlinge, Jörg Lauermann, Lars Lindhagen, Ollie Östlund, Tomas Jernberg, Magnus Bäck","doi":"10.1016/j.ahj.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.014","url":null,"abstract":"<p><strong>Background: </strong>The role of Helicobacter pylori (H. pylori) screening and eradication on reducing upper gastrointestinal bleeding (UGIB) complications after acute myocardial infarction (MI) is uncertain. The HELicobacter Pylori screening to prevent gastrointestinal bleeding in patients with acute MI (HELP-MI SWEDEHEART) trial aims to determine whether systematic H. pylori screening compared to usual care reduces UGIB, mortality, and cardiovascular outcomes after MI.</p><p><strong>Methods: </strong>A cluster randomized, crossover, registry-based clinical trial using SWEDEHEART as trial platform for study population definition and source for data collection in combination with nationwide Swedish health data registries. Thirty-five Swedish hospitals, organized into 18 clusters based on percutaneous coronary intervention networks, were randomized to either routine H. pylori screening for adults with acute type-1 MI or usual care. After one year, a 2-month blanking period was followed by a crossover to the alternate allocation for one year. The trial enrolment was concluded after one additional year of registry-based follow-up. The primary endpoint is UGIB. Secondary endpoints include all-cause death, cardiovascular death, readmission for MI, stroke, or heart failure. Endpoints will be reported combined (Net Adverse Clinical Events; Major Adverse Cardiac or Cerebrovascular Events) and separately. The primary analysis will include all available follow-up time corresponding to a maximum follow-up time of 3 years and 2 months.</p><p><strong>Conclusion: </strong>HELP-MI SWEDEHEART aims to determine the utility of routine H. pylori screening to reduce UGIB and improve cardiovascular outcomes after MI. By integrating national registry follow-up data with a pragmatic trial design, it has the potential to provide evidence for the effect of the implementation of routine H. pylori screening as part of acute MI care.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT05024864.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742012","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":"Corrigendum to “Days alive out of hospital in heart failure: Insights from the PARADIGM-HF and CHARM trials” [Am Heart J 241 (2021) 108-119]","authors":"Yiming Chen MS ,&nbsp;John Lawrence PhD ,&nbsp;Norman Stockbridge MD, PhD","doi":"10.1016/j.ahj.2025.03.007","DOIUrl":"10.1016/j.ahj.2025.03.007","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"285 ","pages":"Page 105"},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704537","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}

{"title":"Absence of Coronary Artery Disease in Patients Undergoing Coronary Imaging and Association with Amyloidosis - A Danish Nationwide Study.","authors":"Navid Noory, Oscar Westin, Eva Havers Borgersen, Charlotte Kragelund, Jens Dahlgaard Hove, Matthew S Maurer, Lars Køber, Finn Gustafsson, Emil Fosbøl","doi":"10.1016/j.ahj.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.011","url":null,"abstract":"<p><p>This nationwide registry-based study in Denmark revealed a higher 10-year cumulative incidence of amyloidosis among 79,443 coronary artery disease-negative patients compared to matched controls, with an adjusted hazard ratio of 7.43 [95% CI 4.01-13.7]. These findings warrant prospective studies to investigate the prevalence of amyloidosis in patients negative for coronary artery disease after coronary examination.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742006","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":"Hyperoxemic Oxygen Therapy in Patients with Acute Anterior Myocardial Infarction: HOT-AAMI - Design and Rationale of a Randomized Trial.","authors":"Uwe Zeymer, Fathema Hassinger, Peter Bramlage, Andreas Schäfer, Dirk Westermann, Holger Thiele","doi":"10.1016/j.ahj.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute anterior ST-elevation myocardial infarction (STEMI) are at high risk for death and heart failure (HF) despite treatment with primary percutaneous coronary intervention (PCI). Adjunctive therapy with hyperoxemic supersaturated oxygen (SSO2) following PCI reduced infarct size in previous randomized trials, but none of these trials were powered for clinical endpoints.</p><p><strong>Aims: </strong>The HOT-AAMI trial evaluates whether hyperoxemic supersaturated oxygen (SSO2) therapy following PCI reduces the risk of death and heart failure.</p><p><strong>Methods: </strong>HOT-AAMI is a multicenter, 1:1 randomized, open-label study across 50 sites in Germany. Patients presenting with anterior STEMI and undergoing successful PCI of the left anterior descending artery are randomized to receive SSO2 therapy on top of standard care or standard of care alone. The primary endpoint is a composite of all-cause mortality or unplanned heart failure hospital admission or outpatient visit due to heart failure requiring intravenous diuretic therapy during 12-48 months follow-up. Secondary endpoints include cardiovascular mortality, recurrent myocardial infarction, stroke, and quality of life. The sample size calculation for the HOT-AAMI trial is based on detecting a relative reduction of 25% in the primary composite endpoint. In the control group, a yearly event rate of 16% is expected, comprised of mortality (7%), hospitalization for heart failure (5%), and acute heart failure requiring outpatient treatment (4%). The study is designed to detect this 25 % relative difference with a two-sided significance level of 0.05 and 80% power, requiring a total of 393 events; therefore 1266 patients will be enrolled.</p><p><strong>Conclusions: </strong>The HOT-AAMI trial is the first trial powered to determine whether SSO2 therapy, administered immediately post-PCI, improves death and heart failure outcomes in patients with anterior STEMI.</p><p><strong>Trial registration: </strong>HOT-AAMI Clinicaltrials.gov NCT06742684.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690877","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":"Association between vasopressin administration and mortality in patients with cardiogenic shock.","authors":"Dhruv Sarma, Ryan Smith, Mitchell Padkins, Aniket S Rali, Saraschandra Vallabhajosyula, Ashish K Khanna, Kianoush Kashani, Benjamin Hibbert, Jacob C Jentzer","doi":"10.1016/j.ahj.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.009","url":null,"abstract":"<p><strong>Background: </strong>The utility of vasopressin as an adjunctive, catecholamine-sparing vasopressor in cardiogenic shock (CS) has not been widely examined.</p><p><strong>Methods: </strong>We included consecutive adult patients admitted with a diagnosis of CS requiring vasopressors. High-dose vasopressors (HDV) were defined as ≥0.3 mcg/kg/min of norepinephrine equivalent. Multivariable logistic regression and propensity analysis was used to calculate odds ratio (OR) and 95% confidence interval (CI) values for in-hospital mortality, before and after adjustment for relevant covariates.</p><p><strong>Results: </strong>We included 721 CS patients, including HDV in 32.5%. Vasopressin was administered in 207 (29%) patients within the first 24 hours. In-hospital mortality occurred in 38.1% and was higher in the HDV group (56.8% vs. 29.2%). Vasopressin was associated with lower propensity adjusted in-hospital mortality (adjusted OR 0.59, 95% CI 0.35-0.99, p = 0.05). Vasopressin use was also associated with lower mortality in the HDV group (unadjusted OR 0.54, 95% CI 0.32-0.92, p = 0.02).</p><p><strong>Conclusions: </strong>Vasopressin use in the first 24 hours was associated with lower adjusted mortality in patients with CS, particularly amongst those requiring HDV. The use of vasopressin in CS merits dedicated prospective evaluation.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690872","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":"The 2024 Think Tank on Prevention of Sudden Cardiac Death in the Young: Pathway to Survival: A Report from the Cardiac Safety Research Consortium.","authors":"Jordan E Ezekian, Charles C Anderson, Peter F Aziz, Samia Baluch, Stuart Berger, Martha Lopez-Anderson, Vincent Miller, Yoshihide Mitani, Silvana Molossi, Valarie Morrow, Victoria L Vetter, Elizabeth Vickers Saarel, Bhavya Trivedi, Salim F Idriss","doi":"10.1016/j.ahj.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.010","url":null,"abstract":"<p><p>Sudden cardiac arrest and death in the young is a critical public health issue. It occurs in children of any age, sex, racial or ethnic demographic, or socioeconomic status. Importantly, it can affect any individual - athlete and non-athlete alike. Prevention of sudden death in the young is of high importance not only because of the loss of a young life but also because of the substantial impact to families and to society at large. This White Paper summarizes the proceedings of a third national Think Tank on prevention of sudden cardiac death in the young. The Think Tank, which convened on January 11-12, 2024 at Duke University in Durham, NC, was organized and conducted by the Cardiac Safety Research Consortium in collaboration with a broad panel of US and international stakeholders including representatives from the United States Food and Drug Administration, medicine, academia, industry, the military, parents and sudden cardiac arrest/death prevention advocates, and the public. Primary and secondary prevention of sudden cardiac death in youth were discussed in depth with a goal of developing consensus on uniform approaches which could be applied nationally.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668708","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":"Advancement of the Implementation of Evidence-based Therapies for Cardiovascular-Kidney-Metabolic Conditions: A Multi-Stakeholder Perspective.","authors":"Nkiru Osude, Harriette Van Spall, Hayden Bosworth, Konstantin Krychtiuk, John Spertus, Sam Fatoba, Lee Fleisher, Edward Fry, Jennifer Green, Stephen Greene, Michael Ho, Jennifer Jackman, Jane Leopold, Melissa Magwire, Darren McGuire, George Mensah, Katherine R Tuttle, Vincent Willey, Neha Pagidipati, Christopher Granger","doi":"10.1016/j.ahj.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.005","url":null,"abstract":"<p><p>Cardiovascular disease remains the leading cause of mortality and healthcare expenditures in the United States. It is also a major contributor to premature mortality, years lived with disability, and rising healthcare costs around the world. Despite the availability of proven therapies and interventions that could vastly decrease the burden of cardiovascular disease and cardiometabolic conditions, their implementation is poor, with generally less than half of patients being treated with the most effective therapies. Implementation science offers promise in bridging this gap and mitigating disparities. However, even though small studies have shown that there are effective methods to improve the implementation of evidence-based therapies, these methods have not been scaled to make an impact at the level of health systems or nationally. A coordinated, multi-stakeholder approach is essential to identify barriers to implementation on a broad scale and, more critically, to develop and deploy practical solutions. The Duke Clinical Research Institute conducted an Implementation Summit entitled \"Scalability, Spread, and Sustainability\" to explore strategies for advancing the uptake of evidence-based interventions for cardiometabolic diseases in healthcare in the United States. This manuscript presents the participants' multi-stakeholder perspective on the steps necessary to improve the implementation of evidence-based therapies in cardiometabolic disease. Key recommendations include focused efforts on evidence generation around broad implementation strategies, dissemination of the evidence generated, uptake of evidence into usual care settings, and investment in training the current and next generations of leaders in implementation.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662063","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":"Cardiac auscultation skills among medical trainees.","authors":"Neil S Zhang, Joy Y Yang, Joshua I Goldhaber, Binh An P Phan, Melvin D Cheitlin","doi":"10.1016/j.ahj.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.03.006","url":null,"abstract":"<p><p>Many experts suspect there has been a gradual decline in cardiac auscultation skills among physicians, though no studies have examined this hypothesis. To better evaluate the long-term change in cardiac auscultation skills, we performed a repeated, cross-sectional study to analyze medical trainee performance on a cardiac auscultation simulation test over an 11-year period. Our data demonstrated a decline in simulation test scores over time among medical students. This study underscores the importance of broad investment in strategies for teaching cardiac auscultation in order to preserve and improve this valuable skill.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647000","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}