American heart journal最新文献

{"title":"Low-dose colchicine for the prevention of cardiovascular events after percutaneous coronary intervention: Rationale and design of the COL BE PCI trial","authors":"Emmanuel De Cock MD ,&nbsp;Shakeel Kautbally MD, PhD ,&nbsp;Frank Timmermans MD, PhD ,&nbsp;Kris Bogaerts MSc, PhD ,&nbsp;Claude Hanet MD, PhD ,&nbsp;Walter Desmet MD, PhD ,&nbsp;Olivier Gurné MD, PhD ,&nbsp;Pascal Vranckx MD, PhD ,&nbsp;Nick Hiltrop MD ,&nbsp;Karl Dujardin MD ,&nbsp;Philippe Vanduynhoven MD ,&nbsp;Paul Vermeersch MD, PhD ,&nbsp;Charles Pirlet MD, PhD ,&nbsp;Kurt Hermans MD ,&nbsp;Bert Van Reet MD ,&nbsp;Bert Ferdinande MD ,&nbsp;Adel Aminian MD ,&nbsp;Willem Dewilde MD, PhD ,&nbsp;Antoine Guédès MD, PhD ,&nbsp;François Simon MD ,&nbsp;Ian Buysschaert MD, PhD","doi":"10.1016/j.ahj.2024.08.022","DOIUrl":"10.1016/j.ahj.2024.08.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with coronary artery disease (CAD) remain vulnerable to future major atherosclerotic events after revascularization, despite effective secondary prevention strategies. Inflammation plays a central role in the pathogenesis of CAD and recurrent events. To date, there is no specific anti-inflammatory medicine available with proven effective, cost-efficient, and favorable benefit-risk profile, except for colchicine. Initial studies with colchicine have sparked major interest in targeting atherosclerotic events with anti-inflammatory agents, but further studies are warranted to enforce the role of colchicine role as a major treatment pillar in CAD. Given colchicine's low cost and established acceptable long-term safety profile, confirming its efficacy through a pragmatic trial holds the potential to significantly impact the global burden of cardiovascular disease.</div></div><div><h3>Methods</h3><div>The COL BE PCI trial is an investigator-initiated, multicenter, double-blind, event-driven trial. It will enroll 2,770 patients with chronic or acute CAD treated with percutaneous coronary intervention (PCI) at 19 sites in Belgium, applying lenient in- and exclusion criteria and including at least 30% female participants. Patients will be randomized between 2 hours and 5 days post-PCI to receive either colchicine 0.5 mg daily or placebo on top of contemporary optimal medical therapy and without run-in period. All patients will have baseline hsCRP measurements and a Second Manifestations of Arterial Disease (SMART) risk score calculation. The primary endpoint is the time from randomization to the first occurrence of a composite endpoint consisting of all-cause death, spontaneous non-fatal myocardial infarction, non-fatal stroke, or coronary revascularization. The trial is event-driven and will continue until 566 events have been reached, providing 80% power to detect a 21 % reduction in the primary endpoint taking a premature discontinuation of 15% into account. We expect a trial duration of approximately 44 months.</div></div><div><h3>Conclusion</h3><div>The COL BE PCI Trial aims to assess the effectiveness and safety of administering low-dose colchicine for the secondary prevention in patients with both chronic and acute coronary artery disease undergoing PCI. Trial registration: ClinicalTrials.gov: <span><span>NCT06095765</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 61-71"},"PeriodicalIF":3.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131663","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":"Temporal trends in infection-related hospitalizations among patients with heart failure: A Danish nationwide study from 1997 to 2017","authors":"Sørine Lundberg MD ,&nbsp;Pauline Knigge MD ,&nbsp;Jarl E. Strange MD, PhD ,&nbsp;Nina Nouhravesh MD ,&nbsp;Andrea K. Wagner MD, PhD ,&nbsp;Mariam E. Malik MD ,&nbsp;Jawad H. Butt MD, PhD ,&nbsp;Charlotte Andersson MD, PhD ,&nbsp;Tor Biering-Sorensen MD, PhD ,&nbsp;Gunnar Gislason MD, PhD, Prof ,&nbsp;Mark C. Petrie MD, PhD, Prof ,&nbsp;John McMurray MD, PhD, Prof ,&nbsp;Lars Køber MD, DMSc ,&nbsp;Emil L. Fosbol MD, PhD ,&nbsp;Morten Schou MD, PhD, Prof","doi":"10.1016/j.ahj.2024.08.016","DOIUrl":"10.1016/j.ahj.2024.08.016","url":null,"abstract":"<div><h3>Background</h3><div>Despite improved survival, hospitalization is still common among patients with heart failure (HF).</div></div><div><h3>Objective</h3><div>This study aimed to examine temporal trends in infection-related hospitalization among HF patients and compare it to temporal trends in the risk of HF hospitalization and death.</div></div><div><h3>Methods</h3><div>Using Danish nationwide registers, we included all patients aged 18 to 100 years, with HF diagnosed between January 1, 1997 and December 31, 2017, resulting in a total population of 147.737 patients. The outcomes of interest were primarily infection-related hospitalization and HF hospitalization and secondarily all-cause mortality. The Aalen Johansen's estimator was used to estimate 5-year absolute risks for the primary outcomes. Additionally, cox analysis was used for adjusted analyses.</div></div><div><h3>Results</h3><div>The population had a median age of 74 [64, 82] years and 57.6 % were males. Patients with HF had a higher risk of infection over time 16.4 % (95% CI 16.0-16.8) in 1997 to 2001 vs 24.5% (95% CI 24.0-24.9) in 2012 to 2017. In contrast, they had a lower risk of HF hospitalization 26.5% (95% CI 26.1-27.0) in 1997 to 2001 vs 23.2% (95% CI 22.8-23.7) in 2012 to 2017. The risk of infection stratified by infection type showed similar trends for all infection types and marked the risk of pneumonia infection as the most significant in all subintervals.</div></div><div><h3>Conclusion</h3><div>In the period from 1997 to 2017, we observed patients with HF had an increased risk of infection-related hospitalization, driven by pneumonia infections. In contrast, the risk of HF hospitalization decreased over time.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 83-92"},"PeriodicalIF":3.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103702","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":"Accelerometer-measured physical activity in patients with heart failure and reduced ejection fraction: Determinants and relationship with patient-reported health status","authors":"Camilla Fuchs Andersen MD ,&nbsp;Massar Omar MD, PhD ,&nbsp;Julie Hempel Larsen MD ,&nbsp;Caroline Kistorp MD, PhD ,&nbsp;Christian Tuxen MD, PhD ,&nbsp;Finn Gustafsson MD, PhD, DMSc ,&nbsp;Lars Køber MD, PhD ,&nbsp;Mikael Kjær Poulsen MD, PhD ,&nbsp;Jan Christian Brønd PhD ,&nbsp;Jacob Eifer Møller MD, PhD, DMSc ,&nbsp;Morten Schou MD, PhD ,&nbsp;Jesper Jensen MD, PhD","doi":"10.1016/j.ahj.2024.08.017","DOIUrl":"10.1016/j.ahj.2024.08.017","url":null,"abstract":"<div><h3>Background</h3><p>Accelerometer-measured physical activity is an increasingly used endpoint in heart failure (HF) trials. We investigated the determinants of accelerometer-measured physical activity and the relationship with patient-reported health status.</p></div><div><h3>Methods</h3><p>Post-hoc analysis of the Empire HF trial, including outpatients with HF with reduced ejection fraction (HFrEF). Physical activity was quantified as average accelerometer counts per minute (CPM) with higher values representing higher activity. We investigated associations between activity level and clinical variables, including age, sex, and body mass index, as well as patient-reported health status assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ).</p></div><div><h3>Results</h3><p>Complete data were available in 180 (95%) patients (86% male, mean age 65 year). Baseline median physical activity level was 1,318 CPM (Q1-Q3 1,111-1,585). Age and anemia were independently associated with activity level (β-coefficients: −10 CPM per year age increase [95% CI −16 to −5.1], <em>P</em> = .00015, and −126 CPM for anemia [95% CI −9.1 to −244], <em>P</em> = .035). Significant independent associations were observed between activity level and all KCCQ summary scores (β-coefficient point estimates of 3.7, 4.6, and 4.9 CPM, all <em>P</em> &lt; .02). For 12-week changes in KCCQ-summary scores, only the KCCQ-CSS was associated with activity level; mean increase of 17.5 CPM [95% CI 1.5 to 34.0], <em>P</em> = 0.032, per 5-point increase in KCCQ-CSS. Associations were not modified by treatment allocation (interaction <em>P</em>-values &gt; .05).</p></div><div><h3>Conclusions</h3><p>In patients with HFrEF, older age and anemia were independently associated with lower activity. Moreover, physical activity only weakly increased with better health status, suggesting that changes in physical activity reflect improvements in patients’ health status to a limited degree. This highlights the need to better understand the endpoint with regards to all other health parameters to ease interpretation in future HF trials.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 14-23"},"PeriodicalIF":3.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324002205/pdfft?md5=90ab1af541729a5f7e4c80e436878665&pid=1-s2.0-S0002870324002205-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103690","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":"Milvexian vs apixaban for stroke prevention in atrial fibrillation: The LIBREXIA atrial fibrillation trial rationale and design","authors":"Sneha S. Jain MD, MBA ,&nbsp;Kenneth W. Mahaffey MD ,&nbsp;Karen S. Pieper MS ,&nbsp;Wataru Shimizu MD, PhD ,&nbsp;Tatjana Potpara MD, PhD ,&nbsp;Christian T. Ruff MD, MPH ,&nbsp;Hooman Kamel MD, MS ,&nbsp;Basil S. Lewis MD ,&nbsp;Jan H. Cornel MD ,&nbsp;Peter R. Kowey MD ,&nbsp;Jay Horrow MD ,&nbsp;John Strony MD ,&nbsp;Alexei N. Plotnikov MD ,&nbsp;Danshi Li MD, PhD ,&nbsp;Stephen Weng PhD ,&nbsp;Julia Donahue BA ,&nbsp;C. Michael Gibson MS, MD ,&nbsp;P. Gabriel Steg MD ,&nbsp;Roxana Mehran MD ,&nbsp;Jeffrey I. Weitz MD ,&nbsp;Carolyn S.P. Lam MBBS, PhD","doi":"10.1016/j.ahj.2024.08.011","DOIUrl":"10.1016/j.ahj.2024.08.011","url":null,"abstract":"<div><h3>Background</h3><p>Direct oral anticoagulants are the standard of care for stroke prevention in eligible patients with atrial fibrillation and atrial flutter; however, bleeding remains a significant concern, limiting their use. Milvexian is an oral Factor XIa inhibitor that may offer similar anticoagulant efficacy with less bleeding risk.</p></div><div><h3>Methods</h3><p>LIBREXIA AF (NCT05757869) is a global phase III, randomized, double-blind, parallel-group, event-driven trial to compare milvexian with apixaban in participants with atrial fibrillation or atrial flutter. Participants are randomly assigned to milvexian 100 mg or apixaban (5 mg or 2.5 mg per label indication) twice daily. The primary efficacy objective is to evaluate if milvexian is noninferior to apixaban for the prevention of stroke and systemic embolism. The principal safety objective is to evaluate if milvexian is superior to apixaban in reducing the endpoint of International Society of Thrombosis and Hemostasis (ISTH) major bleeding events and the composite endpoint of ISTH major and clinically relevant nonmajor (CRNM) bleeding events. In total, 15,500 participants from approximately 1,000 sites in over 30 countries are planned to be enrolled. They will be followed until both 430 primary efficacy outcome events and 530 principal safety events are observed, which is estimated to take approximately 4 years.</p></div><div><h3>Conclusion</h3><p>The LIBREXIA AF study will determine the efficacy and safety of the oral Factor XIa inhibitor milvexian compared with apixaban in participants with either atrial fibrillation or atrial flutter.</p></div><div><h3>Trial registration</h3><p>ClinicalTrials.gov NCT05757869</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"277 ","pages":"Pages 145-158"},"PeriodicalIF":3.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0002870324002060/pdfft?md5=9d5dedf46b35a702a85245f6480f289f&pid=1-s2.0-S0002870324002060-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103692","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":"Variations in antihypertensive medication treatment and blood pressure control among Veterans with HIV and existing hypertension","authors":"Chan Woo Kim MD ,&nbsp;Mohammed Haji MD ,&nbsp;Vrishali V. Lopes MS ,&nbsp;Christopher Halladay MS ,&nbsp;Jennifer L. Sullivan PhD ,&nbsp;David Ross MD ,&nbsp;Karen Slazinski PharmD ,&nbsp;Tracey H. Taveira PharmD ,&nbsp;Anupama Menon MD ,&nbsp;Melissa Gaitanis MD ,&nbsp;Christopher T. Longenecker MD ,&nbsp;Gerald S. Bloomfield MD ,&nbsp;James L Rudolph MD, SM ,&nbsp;Wen-Chih Wu MD, MPH ,&nbsp;Sebhat Erqou MD, PhD","doi":"10.1016/j.ahj.2024.08.009","DOIUrl":"10.1016/j.ahj.2024.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension is a leading risk factor for cardiovascular disease among patients living with HIV (PLWH). Understanding the predictors and patterns of antihypertensive medication prescription and blood pressure (BP) control among PLWH with hypertension (HTN) is important to improve the primary prevention efforts for this high-risk population. We sought to assess important patient-level correlates (eg, race) and inter-facility variations in antihypertension medication prescriptions and BP control among Veterans living with HIV (VLWH) and HTN.</div></div><div><h3>Methods</h3><div>We studied VLWH with a diagnosis of HTN who received care in the Veterans Health Administration (VHA) from January 2018 to December 2019. We evaluated HTN treatment and blood pressure control across demographic variables, including race, and by medical comorbidities. Data were also compared among VHA facilities. Predictors of HTN treatment and control were assessed in 2-level hierarchical multivariate logistic regression models to estimate odds ratios (ORs). The VHA facility random-effects parameters from the hierarchical models were used to calculate the median odds ratios to characterize the variation across the different VHA facilities.</div></div><div><h3>Results</h3><div>A total of 17,468 VLWH with HTN (mean age 61 years, 97% male, 54% Black, 40% White) who received care within the VHA facilities in 2018-2019 were included. 73% were prescribed antihypertension medications with higher prescription rates among Black vs White patients (75% vs 71%) and higher prescription rates among patients with a history of cardiovascular disease, diabetes, and kidney disease (&gt;80%), and those receiving antiretroviral therapy and with controlled HIV viral load (∼75%). Only 27% of VLWH with HTN had optimal BP control of systolic BP &lt;130 mmHg and diastolic BP &lt;80 mmHg, with a lower rate of control among Black vs White patients (24% v. 31%). In multivariate regression, Black patients had a higher likelihood of HTN medication prescription (OR 1.32, 95% CI: 1.22-1.42) but were less likely to have optimal BP control (OR 0.82; 0.76-0.88). Important positive correlates of antihypertensive prescription and optimal BP control included: number of outpatient visits in prior year, and histories of diabetes, coronary artery disease, and heart failure. There was about 10% variability in both antihypertensive prescription and BP control patterns between VHA facilities for patients with similar characteristics. There was increased inter-facility variation in antihypertensive prescription among those with a history of heart failure and those not receiving antiretroviral therapy.</div></div><div><h3>Conclusion</h3><div>In a retrospective analysis of large VHA data, we found that VLWH with HTN have suboptimal antihypertensive medication prescription and BP control. Black VLWH had higher HTN medication prescription rates but lower optimal BP control.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 48-60"},"PeriodicalIF":3.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103703","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 of sex with in-hospital management and outcomes of patients with heart failure: Data from the REAL-HF registry","authors":"Giuseppe D. Sanna MD, PhD ,&nbsp;Gian Luca Erre MD, PhD ,&nbsp;Matteo Cameli MD, PhD ,&nbsp;Federico Guerra MD, PhD ,&nbsp;Maria Concetta Pastore MD ,&nbsp;Alessandro Marini MD ,&nbsp;Alessandro Campora MD ,&nbsp;Pierpaolo Gironella MD ,&nbsp;Mario Costamagna MD ,&nbsp;Giulia Elena Mandoli MD, PhD ,&nbsp;Mirko Casiraghi MD ,&nbsp;Angelo Scuteri MD, PhD ,&nbsp;Matteo Lisi MD ,&nbsp;Gavino Casu MD ,&nbsp;Martino Deidda MD, PhD ,&nbsp;Christian Cadeddu Dessalvi MD, PhD ,&nbsp;REAL-HF investigators","doi":"10.1016/j.ahj.2024.08.018","DOIUrl":"10.1016/j.ahj.2024.08.018","url":null,"abstract":"<div><h3>Background</h3><div>There are sex differences in HF patients. It is not clear whether such differences mainly reflect cultural behaviours and clinical inertia, and the role of sex on clinical outcomes is still controversial. We aimed to investigate the association of sex with in-hospital management and outcomes in patients with HF.</div></div><div><h3>Methods</h3><div>We analyzed data of 4016 adult patients hospitalized for HF in 2020 to 2021 and enrolled in a multicentre national registry.</div></div><div><h3>Results</h3><div>Women (n = 1,818 [45%]) were older than men (83 <em>vs</em> 77 years, <em>P</em> &lt; .0001), with a higher prevalence of arterial hypertension (73% <em>vs</em> 69%, <em>P</em> = .011) and atrial fibrillation. Women presented more frequently with HF and preserved ejection fraction -HFpEF (55% <em>vs</em> 32%, <em>P</em> &lt; .001). They were more often hospitalized in internal medicine departments (71% <em>vs</em> 51%), and men in highly specialized cardiology units (49% <em>vs</em> 29%). When considering HF pharmacological treatments at discharge in the subgroup with reduced ejection fraction -HFrEF (n=1525), there were no significant differences (49% of women treated with GDMT [guideline-directed medical therapy] <em>vs</em> 52% of men, <em>P</em> = .197). Sex was not associated either with hospital readmissions (30-days OR [95% CI] = 0.89 [0.71-1.11], <em>P</em> = .304; 1-year OR [95% CI] = 1.02[0.88-1.19], <em>P</em> = .777) or with mortality (in-hospital OR [95% CI] = 1.14 [0.73-1.78], <em>P</em> = .558; 1-year OR [95% CI] = 1.08 [0.87-1.33], <em>P</em> = .478). Similar results were obtained when considering different HF categories based on left ventricular ejection fraction.</div></div><div><h3>Conclusions</h3><div>Women and men exhibited distinct clinical profiles. Although this may have had an impact on hospital pathways (noncardiology/cardiology units) and pharmacological prescriptions, sex <em>per se</em> did not appear as an independent determinant of clinical choices. Moreover, when considering homogeneous groups, women were not undertreated. Finally, female sex was not associated with worse clinical outcomes.</div></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 72-82"},"PeriodicalIF":3.7,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103691","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":"Effect of tirzepatide on the progression of coronary atherosclerosis using MDCT: Rationale and design of the tirzepatide treatment on coronary atherosclerosis progression: The (T-Plaque) randomized-controlled trial design","authors":"Hossein Hamidi MD,&nbsp;Marziyeh Bagheri MD,&nbsp;Travis Benzing MD,&nbsp;Srikanth Krishnan MD,&nbsp;Sina Kianoush MD,&nbsp;Keishi Ichikawa MDPhD,&nbsp;Ahmed K. Ghanem MD,&nbsp;Denise Javier MD,&nbsp;Beshoy Iskander MD,&nbsp;Jairo Aldana-Bitar MD,&nbsp;Matthew J. Budoff MD","doi":"10.1016/j.ahj.2024.08.015","DOIUrl":"10.1016/j.ahj.2024.08.015","url":null,"abstract":"<div><h3>Introduction</h3><p>Tirzepatide is a novel once-week dual GIP/GLP-1 RA agonist approved for T2DM and its role to reduce cardiovascular events remains to be elucidated. The goal of this trial is to assess how tirzepatide affects the progression of atherosclerotic plaque as determined by multidetector computed tomography angiography (MDCTA).</p></div><div><h3>Methods</h3><p>This trial is a double blind, randomized, prospective, placebo-controlled multicenter phase IV trial.</p><p>Participant eligible for the study will be adults with T2DM between 40 and 80 years of age who have HbA1c ≥ 7.0% to ≤ 10.5% and at least 20% stenosis in major epicardial vessel on CCTA. Baseline examination will include the results of their demographics, lab tests, coronary calcium, as well as coronary plaque volume/composition. Following randomization, tirzepatide or placebo will be given at a weekly dose of 2.5 mg, and a fixed dose-escalation strategy will be followed. Patients will undergo quarterly visits for safety assessments and labs, and follow up with repeat CCTA at 1 year.</p></div><div><h3>Discussion</h3><p>This study evaluates the antiatherogenic potential of tirzepatide, providing a mechanism of potential CV benefit. This is crucial to our understanding of T2DM treatment and CVD since plaque progression portends worse outcomes in these populations. MDCTA is a noninvasive method that assesses the volume, composition, and degree of coronary vessel stenosis.</p></div><div><h3>Conclusion</h3><p>This study will be the first study to assess the effects of tirzepatide on atherosclerotic plaque progression measured by MDCTA in participants with T2DM.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 24-32"},"PeriodicalIF":3.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071786","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":"Information for Readers","authors":"","doi":"10.1016/S0002-8703(24)00213-8","DOIUrl":"10.1016/S0002-8703(24)00213-8","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"276 ","pages":"Page v"},"PeriodicalIF":3.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049332","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":"BASELINE trial: update in study design","authors":"Rutger-Jan Nuis MD, PhD,&nbsp;Nicolas M. Van Mieghem MD, PhD,&nbsp;BASELINE Investigators","doi":"10.1016/j.ahj.2024.08.013","DOIUrl":"10.1016/j.ahj.2024.08.013","url":null,"abstract":"","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 1-4"},"PeriodicalIF":3.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046151","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":"Antihypertensive medication prescription dispensation among pregnant women in the United States: A cohort study","authors":"Melanie T. Chen MD, MPH ,&nbsp;Brandi L. Vollmer MPH, PhD ,&nbsp;C. Adair Blyler PharmD ,&nbsp;Natalie A. Cameron MD, MPH ,&nbsp;Eliza C. Miller MD, MS ,&nbsp;Yongmei Huang MD, DrPH ,&nbsp;Alexander M. Friedman MD ,&nbsp;Jason D. Wright MD ,&nbsp;Amelia K. Boehme MSPH, PhD ,&nbsp;Natalie A. Bello MD, MPH","doi":"10.1016/j.ahj.2024.08.010","DOIUrl":"10.1016/j.ahj.2024.08.010","url":null,"abstract":"<div><h3>Importance</h3><p>Hypertension is increasingly common in pregnancy capable individuals, yet there is limited data on antihypertensive medication dispensation in peripartum individuals.</p></div><div><h3>Objective</h3><p>To describe antihypertensive medication dispensation from preconception through the first year postpartum.</p></div><div><h3>Design, Setting, and Participants</h3><p>This retrospective cohort study used the Truven Health Market Scan administrative data from 2008 to 2014 to identify women in the United States with commercial or government health insurance, aged 15-54, free from heart disease, who experienced a pregnancy and filled at least 1 prescription for an antihypertensive medication between 3 months prior to conception and 12 months after the end of the pregnancy.</p></div><div><h3>Main Outcomes and Measures</h3><p>We describe antihypertensive dispensation patterns (continuation, initiation, and discontinuation) by medication class during 5 time periods: preconception, first, second, and third trimesters, and the first year postpartum.</p></div><div><h3>Results</h3><p>Of 1,058,521 pregnancies, 108,614 (10.3%) were exposed to at least 1 antihypertensive medication dispensation. The most commonly dispensed medications across all periods combined were adrenergic blockers, calcium channel blockers (CCBs), and diuretics. Renin-angiotensin-aldosterone system (RAAS) inhibitors were the third most dispensed medication class in the preconception period (26.4%), and fills decreased to 5.7% and 1.7% in the second and third trimesters, respectively. Of the women with chronic hypertension who filled at least 1 prescription prior to conception, 8.4% were not dispensed an antihypertensive medication during the first year after delivery.</p></div><div><h3>Conclusions and Relevance</h3><p>Antihypertensive prescription dispensation of both preferred and potentially harmful agents is common in pregnancy capable individuals. Patterns of dispensation suggest room for improvement in the treatment of chronic hypertension after a pregnancy.</p></div>","PeriodicalId":7868,"journal":{"name":"American heart journal","volume":"278 ","pages":"Pages 5-13"},"PeriodicalIF":3.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046150","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}