American heart journal最新文献

{"title":"Self-Expanding Versus Balloon-Expandable Transcatheter Heart Valves in Patients with Excessive Aortic Valve Cusp Calcification.","authors":"Daijiro Tomii, Bashir Alaour, Dik Heg, Taishi Okuno, Masaaki Nakase, Daryoush Samim, Fabien Praz, Jonas Lanz, Stefan Stortecky, David Reineke, Stephan Windecker, Thomas Pilgrim","doi":"10.1016/j.ahj.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.09.011","url":null,"abstract":"<p><strong>Background: </strong>Excessive aortic cusp calcification increases the risk of periprocedural complications after transcatheter aortic valve replacement (TAVR). Differences in device performance in patients with excessive calcification may affect long-term clinical outcomes.</p><p><strong>Objectives: </strong>To compare periprocedural and long-term outcomes between self-expanding (SEV) and balloon-expandable (BEV) prostheses in patients with excess cusp calcification undergoing TAVR.</p><p><strong>Methods: </strong>Consecutive patients with severe aortic stenosis and aortic valve complex calcium volume ≥235 mm³ (on contrast images with Hounsfield unit threshold of 850) who underwent TAVR with either CoreValve/Evolut SEV or SAPIEN BEV from August 2007 to June 2023 were included from a prospective-single center registry. A 1:1 propensity-matched analysis was performed to account for baseline differences between groups.</p><p><strong>Results: </strong>Among 1,345 patients, 271 matched pairs were identified. Procedural success was achieved in >85% of patients with no difference between groups. Annular rupture occurred more frequently with BEV compared to SEV (2.2% vs 0%, p=0.030). SEV had a lower transprosthetic gradient (8.0 mmHg vs. 11.2 mmHg, p <0.001) but higher rates of mild or greater paravalvular regurgitation (69.7% vs. 58.1%, p=0.008) and new permanent pacemaker implantation (22.6% vs. 15.5%, p=0.001). At 5 years, there was no statistically significant difference in mortality between groups (45.1% vs. 50.2%, p=0.173).</p><p><strong>Conclusions: </strong>In patients with excessive leaflet calcification undergoing TAVR, BEV had a higher risk of annular rupture, but a lower risk of paravalvular regurgitation, and a lower risk of permanent pacemaker implantation compared to SEV. Mortality was comparable between SEV and BEV throughout 5 years of follow-up.</p><p><strong>Clinical trial registration: </strong>https://www.</p><p><strong>Clinicaltrials: </strong>gov. NCT01368250.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102609","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":"Cumulative Effect of Hyperglycemia and Insulin Resistance on Cardiac Dysfunction - TheCoronary Artery Risk Development in Young Adults (CARDIA) Study.","authors":"Yilin Yoshida, Yuanhao Zu, David Aguilar, Keith C Ferdinand, Vivian A Fonseca","doi":"10.1016/j.ahj.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.09.008","url":null,"abstract":"<p><p>We investigated whether cumulative fasting glucose (FG) and insulin resistance (IR) over 20 years are associated with midlife cardiac dysfunction in young adults with or without type 2 diabetes (T2D)/pre-diabetes. We included young adults with T2D/prediabetes (N=279) and matched euglycemic individuals (N=514) who had repeated measures of FG and IR and echocardiography assessment from the Coronary Artery Risk Development in Young Adults study (CARDIA). We found that cumulative hyperglycemia is associated with midlife diastolic dysfunction in patients with early-onset T2D, and sustained IR negatively affects systolic and diastolic function regardless of T2D status.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091098","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":"Risk-Guided Disease Management To Prevent Heart Failure In Adult Cancer Survivors of Previous Cardiotoxic Cancer Treatments: Baseline Results of the REDEEM Trial.","authors":"Joshua Wong, Joel Smith, Cheng Hwee Soh, Erin Howden, Jack S Talbot, Mark Nolan, Kristyn Whitmore, Leah Wright, Ashleigh-Georgia Sherriff, Eswar Sivaraj, Greg Wheeler, Kirsty Wiltshire, Phillip Campbell, Satish Ramkumar, Constantine Tam, Thomas H Marwick","doi":"10.1016/j.ahj.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.ahj.2025.09.009","url":null,"abstract":"<p><strong>Background: </strong>Adult cancer survivors are at increased risk of heart failure (HF) due to standard risk factors and cancer treatment-related cardiac dysfunction. However, the prevalence and treatment of subclinical/stage B heart failure (SBHF) in this population are not well defined.</p><p><strong>Objectives: </strong>The REDEEM (Risk-guided Disease managEment plan to prevEnt heart failure in patients treated with previous cardiotoxic cancer treatMents) trial will evaluate HF screening and targeted intervention in long-term cancer survivors.</p><p><strong>Methods: </strong>Survivors ≥40 years old, ≥5 years post potentially-cardiotoxic therapy, and with ≥1 HF risk factor were screened by echocardiography for SBHF (abnormal global longitudinal shortening [GLS], left ventricular hypertrophy [LVH], diastolic dysfunction or abnormal 3-dimensional left ventricular ejection fraction [3D-LVEF]). Those with SBHF were randomized to multi-disciplinary cardio-oncology disease management plan (CO-DMP), including neurohormonal blockade, exercise training and risk factor optimization, or usual care. The primary endpoint is change in cardiorespiratory fitness (VO₂peak) over 6 months.</p><p><strong>Results: </strong>Of 1,124 survivors screened, 604 underwent echocardiography, and 145 (24%) had SBHF (age 68±18 years; 81% women). Of those eligible for randomization, 64% had breast cancer and 35% had hematological malignancy. Although baseline 3D-LVEF was preserved (52.8±6.8%), subclinical LV dysfunction was common (GLS 15.6±2.1%) and 39% had evidence of functional impairment (VO₂peak≤18ml/kg/min^-1). Abnormal GLS was associated with age, BMI, diabetes and anthracycline exposure, whereas functional impairment was only associated with age. Abnormal GLS and functional impairment were not significantly associated (OR 0.90 [95% CI 0.72-1.11], p=0.360).</p><p><strong>Conclusions: </strong>Risk-based screening can identify a high-risk subpopulation of cancer survivors with SBHF.</p><p><strong>Registration: </strong>ClinicalTrials.gov NCT04962711, https://www.</p><p><strong>Clinicaltrials: </strong>gov/study/NCT04962711.</p>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084960","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 Glycemic Control and Adverse Outcomes in Atrial Fibrillation: Evidence from a Large Real-World Cohort","authors":"Ekow Essien,&nbsp;Justice Owusu-Achiaw,&nbsp;Abraham Carboo,&nbsp;Karldon Nwaezeapu,&nbsp;Abena Agyekum,&nbsp;Patrick Berchie,&nbsp;Kwame Mensa-Yawson,&nbsp;Edmund Mireku Bediako,&nbsp;Ashley E Kodjo","doi":"10.1016/j.ahj.2025.07.064","DOIUrl":"10.1016/j.ahj.2025.07.064","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus and atrial fibrillation frequently coexist, but the impact of glycemic control on outcomes in patients with both conditions remains incompletely characterized. This study aimed to compare adverse cardiovascular and renal outcomes between atrial fibrillation patients with poorly controlled versus well-controlled diabetes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX Research Network, a global federated health research platform. Patients with atrial fibrillation and type 2 diabetes were stratified by hemoglobin A1c (HbA1c) levels: poorly controlled (HbA1c ≥7.0%) versus well-controlled (HbA1c ≤6.9%). After propensity score matching for demographic and clinical characteristics, cohorts of 332,060 patients each were analyzed. Primary outcomes included all-cause mortality, heart failure, cardiogenic shock, and renal complications. Outcomes were analyzed using risk analysis and Kaplan-Meier survival analysis with hazard ratios (HR) and 95% confidence intervals (CI) over a five-year follow-up period.</div></div><div><h3>Results</h3><div>In this propensity-matched cohort, patients with poorly controlled diabetes demonstrated significantly higher all-cause mortality compared to those with well-controlled diabetes (26.3% vs 25.6%; HR 1.070, 95% CI 1.060-1.080; p&lt;0.001). Poorly controlled diabetes was also associated with increased risk of heart failure (23.1% vs 22.8%; HR 1.071, 95% CI 1.056-1.086; p&lt;0.001), acute kidney injury (19.8% vs 18.3%; HR 1.132, 95% CI 1.117-1.148; p&lt;0.001), and chronic kidney disease (19.4% vs 17.8%; HR 1.161, 95% CI 1.145-1.178; p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>In patients with atrial fibrillation and type 2 diabetes, poor glycemic control is associated with increased mortality, heart failure, and renal complications. These findings highlight the importance of optimal diabetes management in this high-risk population.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"290 ","pages":"Page 28"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061447","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":"Impact of Relacorilant on Blood Pressure and Antihypertensive Medication Burden in Patients With Hypercortisolism and Hypertension: Results From the GRACE Study","authors":"Serge Jabbour ,&nbsp;Giorgio Arnaldi ,&nbsp;Richard J. Auchus ,&nbsp;Corin Badiu ,&nbsp;Salvatore Cannavo ,&nbsp;Ulrich Dischinger ,&nbsp;Rogelio García-Centeno ,&nbsp;Georgiana A. Dobri ,&nbsp;Diane M. Donegan ,&nbsp;Zeina C. Hannoush ,&nbsp;Rosario Pivonello ,&nbsp;Aurelian-Emil Ranetti ,&nbsp;Antonio Stigliano ,&nbsp;Christina Wang ,&nbsp;Austin L. Hand ,&nbsp;Katherine A. Araque ,&nbsp;Andreas G. Moraitis","doi":"10.1016/j.ahj.2025.07.045","DOIUrl":"10.1016/j.ahj.2025.07.045","url":null,"abstract":"<div><div>In the phase 3 GRACE study (NCT03697109) in adults with endogenous hypercortisolism and hypertension, hyperglycemia, or both, relacorilant significantly improved blood pressure (BP), meeting the primary endpoint. We report on the impact of relacorilant on BP and antihypertensive medication use among study participants with hypertension. GRACE comprised a 22-week, open-label (OL) phase of relacorilant 100–400 mg once daily followed by a 12-week, double-blind, placebo-controlled randomized withdrawal phase. Hypertension was defined as mean systolic blood pressure (SBP) 135–170 mm Hg and/or diastolic blood pressure (DBP) 85–110 mm Hg. Among participants with hypertension at OL baseline (n=102), mean SBP and DBP were 141 and 89 mm Hg, respectively, and 76% (78/102) were taking ≥1 antihypertensive medication. The most common (≥15%) antihypertensive classes were calcium channel blockers (31%), angiotensin-converting enzyme (ACE) inhibitors (26%), angiotensin II receptor blockers (ARBs) (25%), beta blockers (22%), and aldosterone antagonists (20%). Relacorilant significantly improved BP from baseline to week 22 (P&lt;0.0001), and 19% (15/78) of those taking antihypertensive medications discontinued and/or decreased use by week 22 or their early termination visit. Medication reductions were most common with aldosterone antagonists (10%) and ARBs (8%). Complete discontinuation was highest for loop diuretics (31%) and calcium channel blockers (19%), followed by aldosterone antagonists (10%), ACE inhibitors (7%), beta blockers (5%), and ARBs (4%). In summary, in GRACE, relacorilant improved BP and resulted in antihypertensive medication decreases/discontinuations for participants with hypertension.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"290 ","pages":"Pages 17-18"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061515","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":"Impact of Depression on Clinical Outcomes Among Spontaneous Coronary Artery Dissection Patients: A Propensity-Matched Analysis Using the TriNetX Research Network","authors":"Abena Korwaa Agyekum MD ,&nbsp;Ekow Essien MD ,&nbsp;Karldon Nwaezeapu MD ,&nbsp;Godbless Ajenaghughrure MD ,&nbsp;Nana Osei MD ,&nbsp;Maureen Masara MD ,&nbsp;Gloria Amoako MD ,&nbsp;Esther Obeng-Danso MD ,&nbsp;Inna Bukharovich ,&nbsp;Suzette Graham-Hill MD","doi":"10.1016/j.ahj.2025.07.037","DOIUrl":"10.1016/j.ahj.2025.07.037","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous coronary artery dissection (SCAD) is a major cause of acute coronary syndrome in young women without traditional cardiovascular risk factors. Depression is common among SCAD survivors, but its impact on clinical outcomes is poorly understood. We compared mortality, cardiovascular events, and other clinical outcomes in SCAD patients with and without depression.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX Research Network (130 healthcare organizations). SCAD patients (ICD-10 I25.42) with depression (F32, F32A, F33, and F33.1) were compared to those without. After propensity score matching for baseline demographics and comorbidities, 3,247 patients per group were analyzed. The primary outcome was all-cause mortality. Secondary outcomes included heart failure (HF), atrial fibrillation (AF), cardiogenic shock, cerebrovascular disease (CVD), acute kidney injury (AKI), and pacemaker implantation.</div></div><div><h3>Results</h3><div>In propensity-matched cohorts (3,247 patients per group), depression was associated with increased risk of HF (16.8% vs 12.2%; risk ratio [RR] 1.376, 95% CI 1.191-1.591; p&lt;0.001), CVD (12.8% vs 9.9%; RR 1.287, 95% CI 1.104-1.501; p=0.001), AKI (9.8% vs 5.5%; RR 1.768, 95% CI 1.453-2.152; p&lt;0.001), and AF (7.0% vs 5.4%; RR 1.288, 95% CI 1.045-1.588; p=0.017). There was no significant difference in all-cause mortality, cardiogenic shock, and pacemaker implantation.</div></div><div><h3>Conclusion</h3><div>Among SCAD patients, comorbid depression is associated with significantly higher risk of adverse outcomes including HF, CVD, AKI and AF. These findings underscore the importance of mental health screening and integrated cardiovascular care in this population.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"290 ","pages":"Page 13"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061568","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":"Comparative Cardiovascular Outcomes Between Carvedilol and Metoprolol in Patients with Takotsubo Syndrome: A Propensity-Matched Cohort Study","authors":"Karldon Iwuchukwu Nwaezeapu ,&nbsp;Godbless Ajenaghughrure ,&nbsp;Ekow Essien ,&nbsp;Abena Agyekum","doi":"10.1016/j.ahj.2025.07.054","DOIUrl":"10.1016/j.ahj.2025.07.054","url":null,"abstract":"<div><h3>Background</h3><div>Takotsubo syndrome presents significant cardiovascular complications requiring beta-blocker therapy. This study investigated outcome differences between carvedilol and metoprolol in patients with Takotsubo syndrome.</div></div><div><h3>Methods</h3><div>Using the TriNetX Global Collaborative Network, we conducted a retrospective cohort study of patients aged 18-79 years with Takotsubo syndrome. Carvedilol-treated patients (n=4,141) were compared to metoprolol-treated patients (n=18,071) after propensity score matching (4,139 per cohort). Outcomes were analyzed over a 5-year follow-up period (1-1,825 days post-treatment initiation). Statistical analyses included risk ratios, hazard ratios, and survival analyses.</div></div><div><h3>Results</h3><div>After matching, carvedilol-treated patients demonstrated significantly lower all-cause mortality (11.3% vs 16.0%; RR=0.71, p&lt;0.001), heart failure (16.7% vs 19.6%; RR=0.85, p=0.009), ventricular tachycardia (1.7% vs 2.4%; RR=0.71, p=0.033), atrial fibrillation/flutter (3.8% vs 6.0%; RR=0.63, p&lt;0.001), acute myocardial infarction (6.2% vs 8.4%; RR=0.73, p=0.004), and pulmonary hypertension (2.7% vs 3.5%; RR=0.76, p=0.033). No significant differences were observed in stroke, cardiogenic shock, or acute kidney injury outcomes.</div></div><div><h3>Conclusion</h3><div>Carvedilol treatment in Takotsubo syndrome patients is associated with significantly improved cardiovascular outcomes compared to metoprolol, particularly in mortality, heart failure, and arrhythmias. These findings suggest carvedilol may be the preferred beta-blocker for Takotsubo syndrome management, potentially due to its additional alpha-blocking and antioxidant properties. Prospective studies are warranted to confirm these observations.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"290 ","pages":"Page 23"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060950","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":"Influence of Obstructive Sleep Apnea on Long-Term Cardiovascular Outcomes in Heart Transplant Recipients: A Retrospective Database Study","authors":"Abena Agyekum,&nbsp;Nana Osei,&nbsp;Ekow Essien,&nbsp;Abraham Carboo,&nbsp;Karldon Nwaezeapu","doi":"10.1016/j.ahj.2025.07.062","DOIUrl":"10.1016/j.ahj.2025.07.062","url":null,"abstract":"<div><h3>Background</h3><div>Obstructive sleep apnea (OSA) is commonly observed in cardiovascular patients, but its impact on heart transplant recipients remains incompletely characterized. This study aimed to compare cardiovascular outcomes between heart transplant recipients with and without OSA.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study using the TriNetX Global Collaborative Network. Adult patients (18-90 years) with heart transplant status were stratified by OSA diagnosis. After propensity score matching for demographics and comorbidities, cohorts of 7,486 patients each were analyzed. Primary outcome was all-cause mortality. Secondary outcomes included cardiovascular complications over a five-year follow-up period.</div></div><div><h3>Results</h3><div>Heart transplant recipients with OSA demonstrated no significant difference in all-cause mortality compared to those without OSA (20.0% vs 19.0%; HR 1.004, 95% CI 0.934-1.080; p=0.908). However, OSA was associated with significantly higher risk of cardiogenic shock (8.5% vs 6.2%; HR 1.303, 95% CI 1.130-1.502; p&lt;0.001), heart failure (32.2% vs 21.8%; HR 1.438, 95% CI 1.281-1.614; p&lt;0.001), ventricular tachycardia (9.3% vs 6.7%; HR 1.335, 95% CI 1.159-1.537; p&lt;0.001), atrial fibrillation (14.3% vs 11.7%; HR 1.161, 95% CI 1.032-1.306; p=0.013), and pulmonary hypertension (17.4% vs 12.0%; HR 1.399, 95% CI 1.255-1.560; p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>In heart transplant recipients, OSA is associated with significantly higher risk of cardiovascular complications despite similar mortality rates. These findings suggest that screening for and treating OSA should be considered in the comprehensive care of heart transplant recipients.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"290 ","pages":"Page 27"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061445","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":"Tirzepatide vs Semaglutide in Coronary Artery Disease and Obesity: Real-World Cardiovascular Outcomes Analysis from the TriNetX Research Network","authors":"Ekow Essien ,&nbsp;Gloria Amoako ,&nbsp;Abena Agyekum ,&nbsp;Godslove Bonnah ,&nbsp;Abraham Carboo ,&nbsp;Karldon Nwaezeapu ,&nbsp;Aba Kwakomah Dapaah","doi":"10.1016/j.ahj.2025.07.060","DOIUrl":"10.1016/j.ahj.2025.07.060","url":null,"abstract":"<div><h3>Background</h3><div>Novel incretin-based therapies have demonstrated cardiovascular benefits beyond glycemic control. This study compared cardiovascular outcomes between patients with coronary artery disease (CAD) and obesity treated with tirzepatide versus semaglutide.</div></div><div><h3>Methods</h3><div>Using the TriNetX Research Network, we identified adults with CAD and obesity (BMI ≥30 kg/m²) prescribed either tirzepatide (n=43,023) or semaglutide (n=110,544). After propensity score matching, 43,019 patients remained in each cohort. The primary outcome was all-cause mortality. Secondary outcomes included heart failure, arrhythmias, renal complications, and pulmonary outcomes.</div></div><div><h3>Results</h3><div>Tirzepatide treatment was associated with lower all-cause mortality compared to semaglutide (1.1% vs 1.7%, HR 0.65, 95% CI 0.58-0.73; p&lt;0.001). Tirzepatide use also demonstrated reduced incidence of heart failure (4.1% vs 5.4%, HR 0.76, 95% CI 0.70-0.81; p&lt;0.001), atrial fibrillation (2.3% vs 2.9%, HR 0.79, 95% CI 0.72-0.87; p&lt;0.001), cardiogenic shock (0.3% vs 0.4%, HR 0.74, 95% CI 0.58-0.94; p=0.012), and acute kidney injury (3.5% vs 4.0%, HR 0.86, 95% CI 0.80-0.93; p&lt;0.001). Similar benefits were observed for pulmonary embolism, pulmonary edema, and cerebrovascular disease.</div></div><div><h3>Conclusion</h3><div>In patients with CAD and obesity, tirzepatide was associated with lower mortality and reduced risk of cardiovascular and renal complications compared to semaglutide, suggesting differences in cardiorenal protection between these incretin-based therapies.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"290 ","pages":"Page 26"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061475","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 Design of MOMENTUM: A Prospective Study of the Prevalence of Endogenous Hypercortisolism in Individuals With Resistant Hypertension","authors":"Jorge Plutzky ,&nbsp;Richard J. Auchus ,&nbsp;Jan N. Basile ,&nbsp;Deepak L. Bhatt ,&nbsp;Michael J. Bloch ,&nbsp;Matthew A. Cavender ,&nbsp;James W. Findling ,&nbsp;Yehuda Handelsman ,&nbsp;Silvio E. Inzucchi ,&nbsp;Norman E. Lepor ,&nbsp;Neha J. Pagidipati ,&nbsp;Raymond R. Townsend ,&nbsp;Matthew R. Weir ,&nbsp;Iulia Cristina Tudor ,&nbsp;Daniel Einhorn","doi":"10.1016/j.ahj.2025.07.044","DOIUrl":"10.1016/j.ahj.2025.07.044","url":null,"abstract":"<div><div>Hypertension affects up to 50% of US adults and resistant hypertension (rHTN) occurs in 10-20% of cases. Endogenous hypercortisolism (eHC) may contribute to rHTN in some individuals, but the prevalence of eHC in individuals with rHTN is currently unknown. The CATALYST study assessing eHC prevalence in individuals with difficult-to-control type 2 diabetes, reported a 40% prevalence of eHC in participants with systolic blood pressure (BP) ≥135 mm Hg despite taking ≥3 BP medications (Handelsman Y, et al. WCIRDC 2024. Poster 0050). MOMENTUM is the first large, prospective study to examine the prevalence of eHC in people with rHTN in the US.</div><div>MOMENTUM is an observational study of ∼1,000 adults with rHTN using American Heart Association criteria. Key exclusion criteria are investigator-determined white coat hypertension, nonadherence to BP medications, and individuals in whom the dexamethasone suppression test is difficult to interpret. The primary endpoint is to assess the eHC prevalence in this population. Key secondary endpoints are to assess clinical and laboratory features associated with increased eHC risk. Hyperaldosteronism will also be screened for. Descriptive statistics will be used to characterize participants with and without eHC.</div><div>In conclusion, the MOMENTUM study, as designed and currently enrolling, will provide an estimate of eHC prevalence and its associated clinical characteristics in people with rHTN. (ClinicalTrials.gov Identifier: NCT06829537)</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"290 ","pages":"Pages 16-17"},"PeriodicalIF":3.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061514","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}