Cardiology and Therapy最新文献

{"title":"A Summary of Cardiometabolic Disorders in the Maghreb: Insights from the 2025 Saclay Cardiometabolic Summit.","authors":"Faouzi Addad, Walid Amara, Ahmed Bennis, Franck Boccara, M Abed Bouraghda, Mohammed Chettibi, Hinde Iraqi, Selma Siham El Khayat, Inès Khochtali, Nadia Laredj, Rachid Malek, Habib Skhiri, Aida Soufiani, Marilucy Lopez-Sublet","doi":"10.1007/s40119-026-00451-x","DOIUrl":"10.1007/s40119-026-00451-x","url":null,"abstract":"<p><p>The inaugural 2025 Cardiometabolic Summit in Saclay, France, aimed to (i) disseminate the latest research on cardiometabolic diseases (CMDs) from the Maghreb and/or Middle East and North Africa region; (ii) discuss CMD management and provide clinical practice suggestions for improving adherence and reducing clinical inertia; and (iii) suggest policy and clinical practice initiatives to improve outcomes in patients with CMDs. Cardiovascular disease (CVD) is the leading cause of death worldwide, with 80% of CVD fatalities occurring in low- and middle-income countries. This trend is mirrored in Algeria, Morocco and Tunisia, three countries in the Maghreb region. In these countries, CMDs, such as type 2 diabetes mellitus (T2DM) and hypertension, have high prevalence and are undertreated. At the Cardiometabolic Summit, attended by 110 clinicians from Algeria, Morocco and Tunisia, regional CMD epidemiology and management data were presented, along with evidence on regional research initiatives to reduce the burden of CMDs and CVD and how Ramadan fasting affects adults with T2DM. Context-specific holistic strategies to improve the management of patients with multimorbidities were reviewed, including targeting modifiable risk factors to prevent T2DM and hypertension. Two barriers to optimal CMD management were addressed: (i) poor patient treatment adherence and (ii) clinician-related therapeutic inertia, noting the latter may be a greater contributor to poor outcomes. Prescription of single-pill combinations was recommended for initial blood pressure control, and a cost-effective sulfonylurea plus a sodium-glucose cotransporter 2 inhibitor or glucagon-like peptide 1 receptor agonist (whenever feasible) was recommended for glycaemic control plus cardiorenal protection. Polypills may be appropriate where intervention for additional CMDs is required. Strategies for enhancing patient adherence and opportunities for reducing therapeutic inertia were presented. Finally, policy actions and clinical practice priorities were suggested. These steps provide a realistic path towards reducing CMD and CVD burden in the Maghreb.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"135-153"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Description of Clinical Characteristics and Outcomes in Patients with Hereditary ATTR Amyloidosis: Results from the Multicountry OverTTuRe Study.","authors":"Kevin M Alexander, Shun Kohsaka, Steen Hvitfeldt Poulsen, Astrid J Terkelsen, J Gustav Smith, Johan Sundström, Jason Wright, Krister Järbrink, Arti Gauvri Bhimjiyani, Laura Davis, Yuya Matsue, Lisa J Anderson, Björn Pilebro","doi":"10.1007/s40119-026-00450-y","DOIUrl":"10.1007/s40119-026-00450-y","url":null,"abstract":"<p><strong>Introduction: </strong>Timely diagnosis and treatment are essential for improving outcomes and quality of life in patients with transthyretin (ATTR) amyloidosis. Early multisystem manifestations are often unrecognized, leading to diagnostic delays and misdiagnosis. Large-scale, multicountry, observational studies are needed to better characterize the real-world trajectory of these patients.</p><p><strong>Methods: </strong>OverTTuRe, an ANTHOLOGY study, is a retrospective, observational, descriptive, longitudinal, multicountry study using secondary data from claims databases, electronic health records, and healthcare registries. The primary aim of this analysis was to characterize baseline characteristics, early clinical manifestations, and outcomes in patients with hereditary transthyretin (ATTRv) amyloidosis from the United States (US), United Kingdom (UK), Japan, Denmark, and Sweden.</p><p><strong>Results: </strong>Of 1502 patients identified, the predominant phenotype across countries was ATTRv amyloidosis with polyneuropathy (ATTRv-PN 51.3-63.7%); however, many patients had ATTRv with mixed phenotype (ATTRv mixed 36.3-48.8%). Compared to patients with ATTRv mixed, patients with ATTRv-PN were younger, and a higher proportion were female (36.6-64.1% vs. 19.3-56.4%). Median (interquartile range) time from any initial cardiac or noncardiac manifestation to diagnosis varied across countries; time from any noncardiac manifestation to diagnosis was longest for both phenotypes in the US (ATTRv-PN 2.9 [1.0-4.0] years; ATTRv mixed 2.4 [0.8-3.7] years). Following diagnosis, treatment was not available for most patients. Mortality (ATTRv-PN 14.6-36.2%; ATTRv mixed 21.0-73.0%) and hospitalization (ATTRv-PN 23.5-66.2%; ATTRv mixed 20.8-70.5%) risk varied across countries in the 5 years following diagnosis. Pre- and post-diagnosis healthcare resource utilization was high for both phenotypes.</p><p><strong>Conclusions: </strong>These findings highlight the heterogeneity of clinical manifestations and outcomes of ATTRv amyloidosis across phenotypes and countries. Patients frequently experience diagnostic delays and numerous healthcare interactions. Elevated clinical suspicion to facilitate earlier diagnosis, together with a multidisciplinary care approach and timely access to targeted therapies, is needed to improve outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT06355934.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"201-229"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on Transthyretin Amyloid Cardiomyopathy (ATTR-CM) Treatment Attributes.","authors":"Nisith Kumar, Joshua Coulter, Alexandra Haddad-Angulo, Louis Baig, Haechung Chung, Sanjana Mahalakshmi Chandrasekar, Caroline Vass, Jayne Galinsky, Anne Marie Carr, Katharine McIntosh, Brett Hauber","doi":"10.1007/s40119-026-00452-w","DOIUrl":"10.1007/s40119-026-00452-w","url":null,"abstract":"<p><strong>Introduction: </strong>Transthyretin amyloid cardiomyopathy (ATTR-CM), a progressive disease characterized by the accumulation of misfolded transthyretin amyloid proteins in the myocardium, often leads to heart failure. The experiences and treatment priorities of individuals living with ATTR-CM have not been evaluated in depth.</p><p><strong>Methods: </strong>This multinational patient advisory board qualitatively explored patients' experiences with ATTR-CM and their preferences for the attributes of current and emerging treatments for heart failure caused by ATTR-CM. In a pre-advisory board survey, participants answered benefit-risk scaling questions to gauge the importance of treatment side effects, treatment benefits, and modes of administration. The results of the survey were then discussed during the advisory board.</p><p><strong>Results: </strong>Of the 13 participants who completed the survey (two in Australia, two in Canada, one in Switzerland, four in the United Kingdom, and four in the United States), 11 participated in the advisory board discussion and two in follow-up discussions. The survey results and advisory board discussion revealed tiredness and fatigue to be the most bothersome and injection site pain to be the least bothersome of the side effects evaluated. Lowering the risk of death was the most important and being able to easily take a bath or a shower was the least important of the treatment benefits evaluated. On average, once-daily oral administration was the most preferred mode of administration tested, over twice-daily oral administration, subcutaneous injection, and infusion, although participants' preferences were heterogeneous. Although the length of life was important, quality of life was also important to participants: they especially valued spending time doing the activities they enjoyed and prioritized these activities over basic functioning and self-care routines.</p><p><strong>Conclusions: </strong>Individuals living with ATTR-CM have heterogeneous preferences. As the ATTR-CM treatment landscape expands to include treatments with distinct attributes, patients and care teams should participate in shared decision-making to prioritize patients' preferences and goals.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"231-253"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mavacamten in Chinese Patients with Obstructive Hypertrophic Cardiomyopathy: Patient-Reported Health Status Analysis up to 78 Weeks in the EXPLORER-CN Study.","authors":"Zhuang Tian, Xiaoyan Li, Liwen Li, Qing Zhang, Jian'an Wang, Yunqi Shi, Daoquan Peng, Wei Ma, Ping Yang, Xiang Cheng, Wei Jin, Fang Wang, Arteid Memaj, Yimeng Xie, Beth Pan, Victoria Florea, Jing Zheng, Yue Zhong, Shuyang Zhang","doi":"10.1007/s40119-026-00449-5","DOIUrl":"10.1007/s40119-026-00449-5","url":null,"abstract":"<p><strong>Introduction: </strong>Improvement of symptoms, physical function, and quality of life is one treatment goal for patients with obstructive hypertrophic cardiomyopathy (HCM). Mavacamten improved left-ventricular outflow tract gradients in Chinese patients with obstructive HCM in the EXPLORER-CN trial. We report here a detailed analysis of patient-reported health status per the 23-item Kansas City Cardiomyopathy Questionnaire (KCCQ-23) in Chinese patients after 78 weeks of mavacamten.</p><p><strong>Methods: </strong>Patients who completed the double-blind, placebo-controlled (DBPC) period of EXPLORER-CN with no active safety concerns could enter a long-term extension (LTE) period to receive mavacamten for 48 weeks at either the 30-week dose (mavacamten-mavacamten group) or a once-daily starting dose of 2.5 mg (subsequently adjusted via pharmacodynamics-based dose titration: placebo-mavacamten group). Health status endpoints included KCCQ-23 clinical summary score (CSS), overall symptom score (OSS), total symptom score (TSS), physical limitations score, and quality-of-life scores through week 78. Week 78 endpoint analyses were descriptive.</p><p><strong>Results: </strong>In the DBPC period, 54 patients received mavacamten and 27 received placebo; of these, 54 and 25, respectively, entered the LTE period. KCCQ-23 CSS, OSS, and TSS improved with mavacamten and worsened with placebo during the DBPC period (mean change baseline to week 30: 5.7, 6.4, and 8.1, respectively [mavacamten-mavacamten group] and - 5.4, - 4.3, and - 4.8, respectively [placebo-mavacamten group]). CSS, OSS, and TSS continued to improve in the mavacamten-mavacamten group during the LTE period (mean change baseline to week 78: 7.1, 8.2, and 10.0, respectively). Scores improved in the placebo-mavacamten group after switching to mavacamten (mean change week 30 to week 78: 7.3, 9.5, and 5.7, respectively). Similar improvements in KCCQ-23 physical limitations and quality-of-life scores with mavacamten were observed throughout both study periods.</p><p><strong>Conclusions: </strong>Long-term mavacamten treatment for up to 78 weeks led to sustained improvements in patient-reported health status, supporting long-term treatment with mavacamten for Chinese patients with symptomatic obstructive HCM.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT05174416.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"185-200"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pre-Kidney Transplant Cardiovascular Evaluation: A Narrative Review of Current Scientific Statements and Consensus Documents.","authors":"Jacob B Michaud, Gaeth Al-Zaneen, Kim Anderson, Anukul Ghimire, Karthik K Tennankore, Amanda J Vinson, George L Worthen","doi":"10.1007/s40119-026-00448-6","DOIUrl":"10.1007/s40119-026-00448-6","url":null,"abstract":"<p><p>Cardiovascular disease is the leading cause of mortality among individuals with kidney failure, yet evidence-based strategies to reduce cardiovascular risk in this population are limited. Kidney transplantation has been consistently shown to improve survival, including cardiovascular-specific outcomes among those with kidney failure. Substantial heterogeneity exists across transplant centers regarding the pre-transplant cardiovascular evaluation, and the evidence supporting specific testing strategies remains sparse. Current scientific guidelines and consensus statements on pre-kidney transplant cardiovascular assessment, which guide clinical practice, recommend asymptomatic testing in most individuals. However, emerging retrospective evidence suggests limited short-term benefit from routine asymptomatic screening. Ongoing randomized studies may clarify optimal strategies for repeat cardiovascular screening in waitlisted individuals who have undergone initial cardiovascular evaluation. In this review of kidney transplant candidates, we (i) examine contemporary data on cardiovascular screening (ii) highlight the diagnostic limitations of noninvasive testing in kidney failure and the lack of clear benefit from revascularization in the pre-kidney transplant setting, and (iii) outline the consequences of untimely and potentially unnecessary cardiovascular testing.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"155-170"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trimetazidine's Anti-ischemic Effectiveness in Patients with Stable Angina with Prior Myocardial Infarction Evaluated via Stress Echocardiography with Speckle Tracking: METHOD study.","authors":"Boris B Kvasnikov, Olga L Barbarash, Olga M Polikutina, Yuriy P Burtsev","doi":"10.1007/s40119-026-00447-7","DOIUrl":"10.1007/s40119-026-00447-7","url":null,"abstract":"<p><strong>Introduction: </strong>Stress-test echocardiography with speckle tracking modality (STM) is sensitive to detect myocardial ischemia. Data on trimetazidine (TMZ) therapy's effectiveness on myocardial ischemia and contractile function using STM is limited. This study aimed to assess the anti-ischemic effectiveness of trimetazidine 80 mg once daily (TMZ OD) in patients with symptomatic stable coronary artery disease (CAD) with a history of myocardial infarction (MI), in real-world practice.</p><p><strong>Methods: </strong>The METHOD study (NCT05210465) was a 6-month observational study evaluating TMZ OD's anti-ischemic and antianginal effectiveness in CAD patients with MI history using stress echocardiography with dobutamine and STM. Adult outpatients starting TMZ OD alongside standard antianginal therapy were included. The primary outcome was the mean change in left ventricular global longitudinal strain (LV GLS) after 6 months. Secondary outcomes were changes in regional peak systolic deformation (RPSD) and global post-systolic index, along with traditional antianginal effectiveness indicators and quality of life (QoL) using the EQ-5D-5L questionnaire.</p><p><strong>Results: </strong>Thirty-six patients were included. TMZ OD significantly improved LV GLS by 2% (95% CI - 2.6 to - 1.5, p < 0.001). RPSD significant improvements were observed in 12/17 LV segments, ranging from - 2.6% to - 0.5%. Angina frequency and short-acting nitrate use decreased from 1.0 (1.4) to 0.1 (0.4) attacks per week and from 0.5 (1.0) to 0.1 (0.3) times per week, respectively (both p < 0.05). QoL improved significantly in mobility (1.8 [0.9] vs. 1.4 [0.7]), pain (2.0 [0.4] vs. 1.3 [0.5]) and anxiety domains (1.5 [0.7] vs. 1.2 [0.5]), (all p < 0.05). TMZ OD was well tolerated with no reported adverse events.</p><p><strong>Conclusions: </strong>This real-world study supports TMZ OD role as a valuable adjunct to standard antianginal therapy in outpatients with stable CAD and a history of MI.</p><p><strong>Trial registration: </strong>ClinicalTrialsGov: The METHOD (NCT05210465).</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"171-184"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Hospital and 1-Year Outcomes of Octogenarian and Nonagenarian Patients with Severely Calcified Coronary Lesions Treated with Rotational Atherectomy.","authors":"Mohamed Samy, Ahmad Alali, Oleg Schiopu, Karim Elbasha, Felix Hofmann, Abdelhakim Allali, Mohammed Saad, Danial Amoey, Derk Frank, Martin Landt, Arief Kurniadi, Ralph Toelg, Stephan Fichtlscherer, Gert Richardt, Holger Nef, Nader Mankerious","doi":"10.1007/s40119-026-00445-9","DOIUrl":"10.1007/s40119-026-00445-9","url":null,"abstract":"<p><strong>Introduction: </strong>Severely calcified coronary lesions are a common challenge in older percutaneous coronary intervention (PCI) populations. We aimed to investigate in-hospital and 1-year outcomes of octogenarian and nonagenarian patients with heavily calcified coronary lesions treated with rotational atherectomy (RA).</p><p><strong>Methods: </strong>Patients who underwent RA at our center were divided into two groups: octogenarians/nonagenarians (age ≥ 80 years) (n = 194) and younger counterparts (age < 80 years) (n = 591). Patients presented with acute coronary syndrome, and those treated with bare-metal stents were excluded. At 1 year, major adverse cardiac events (MACE) were investigated as a composite of cardiac death, spontaneous myocardial infarction (MI), or target lesion revascularization (TLR).</p><p><strong>Results: </strong>In-hospital adverse outcome rates were 10.3% in the octogenarian/nonagenarian group versus 13.5% in the younger group (p = 0.266). Notably, the octogenarian/nonagenarian group had numerically higher in-hospital mortality (2.1% vs. 0.5%, p = 0.067). However, after adjusting for potential confounders, in-hospital mortality did not differ significantly between study arms (adj. HR 3.68; 95% CI 0.69-19.5, p = 0.126). At 1 year, the octogenarian/nonagenarian group was associated with a higher MACE rate (20% vs. 13%, adj. HR 1.78; 95% CI 1.27-2.50, p = 0.001), which was driven mainly by more cardiac deaths (13% vs. 4%, log-rank p < 0.001). Rates of MI (log-rank p = 0.708) and TLR (log-rank p = 0.333) were comparable between both study arms.</p><p><strong>Conclusions: </strong>RA is feasible in octogenarian and nonagenarian patients, with in-hospital adverse outcomes comparable to those of younger patients. Advanced age remains a strong predictor of 1-year MACE, given its inherently higher mortality. Graphical abstract available for this article.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"101-114"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure in Kidney Transplant Recipients: Narrative Review of Risk Factors, Therapy, and Current Gaps in Management.","authors":"Anukul Ghimire, Gaeth Al-Zaneen, Jacob B Michaud, George Worthen, Christie Rampersad, Sunita K S Singh, Ngan N Lam, S Joseph Kim, Karthik K Tennankore, Amanda Vinson","doi":"10.1007/s40119-026-00446-8","DOIUrl":"10.1007/s40119-026-00446-8","url":null,"abstract":"<p><p>Among kidney transplant recipients (KTR), cardiovascular disease remains the leading cause of mortality, with heart failure (HF) being especially common in this population. Risk factors for HF in KTR can be categorized as traditional (risks relevant to the general population) versus nontraditional (unique to kidney disease and transplantation). Despite the substantial burden of cardiovascular disease, KTR have been excluded from large clinical trials in cardiovascular medicine and from landmark studies looking at the kidney-protective effects of novel cardiorenal metabolic agents, including sodium-glucose cotransporter 2 inhibitors (SGLT2i). Thus, there is uncertainty about the safety and efficacy of the use of guideline directed medical therapy (GDMT) for HF in this population. Long-term optimal use of GDMT in KTR is limited by various barriers, including the risk of hyperkalemia from concomitant use of renin-angiotensin inhibitors and mineralocorticoid receptor antagonists, fears about genitourinary infections from SGLT2i, and lack of evidence for kidney-protective effects from GDMT agents among KTR. Overcoming these barriers will require a multifaceted approach that involves evidence generation to understand the efficacy and safety of GDMT among KTR, implementation-based strategies to increase uptake of GDMT, and development of multispecialty combined clinical care approaches to care for KTR with HF.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"1-23"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study Design and Baseline Characteristics of the VERINA Study: Phase IV Evidence of Vericiguat for Worsening Heart Failure Management.","authors":"Jabir Abdulakutty, Atul Abhyankar, Sandeep Seth, Kamal Sharma, Rakesh Kumar Aggarwal, Nirav Bhalani, Vinod Vijan, Sandeep Bansal, Rajendra Kumar Premchand Jain, Suvro Banerjee, V K Chopra, Abraham Oomman, Pravin Kahale, Priyanka Sodhi, Ashish Gawde","doi":"10.1007/s40119-025-00442-4","DOIUrl":"10.1007/s40119-025-00442-4","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with heart failure with reduced ejection fraction (HFrEF) experience higher rates of in-hospital and all-cause mortality. On the basis of the VERINA trial, vericiguat is indicated for patients who have had a worsening heart failure (WHF) event despite optimal heart failure (HF) therapy, or for those with tolerability concerns.</p><p><strong>Methods: </strong>This multicenter, prospective, single-arm, non-randomized, real-world, descriptive study assessed the efficacy and safety of vericiguat in Indian patients aged ≥18 years with chronic HFrEF who were vericiguat-naïve and started treatment as per the local label. This analysis is based on interim data and the final results may differ. The main endpoint was a composite of cardiovascular (CV) death or first HF hospitalization. Secondary endpoints included each component of the primary outcome, all-cause death, and safety. Dose-titration parameters, including time to reach and duration at various dose levels, were also assessed.</p><p><strong>Results: </strong>A total of 205 patients were enrolled (58.0 ± 13.27 years; 73.7% male; 34.1% aged ≥ 65 years, baseline N-terminal pro-B-type natriuretic peptide (NT-proBNP) 2490.1 pg/mL). Left ventricular ejection fraction (LVEF) < 30% was observed in 48.8% patients, 24.9% were in New York Heart Association (NYHA) class III. WHF events included recent HF hospitalization within < 7 days (10.7%) or 7 days-3 months (30.2%). Common background therapies included β-blockers (84.9%), mineralocorticoids receptor antagonist (MRAs) (80.5%), sodium-glucose cotransporter 2 (SGLT2) inhibitors (75.6%), and angiotensin receptor-neprilysin inhibitor (ARNI) (52.7%), with 66.3% receiving triple HF therapy. Vericiguat target dose (10 mg) was achieved by 91.1% of patients.</p><p><strong>Conclusion: </strong>This study enrolled high-risk patients with recent decompensation event consistent with the VICTORIA trial. The usage of standard of care (SoC) was as per current clinical practice in HF; VERINA enrolled 52.7% on ARNI compared to 14.5% in VICTORIA and 75.6% on SGLT2i compared to 2% in VICTORIA. Safety data did not reveal any new safety signals or adverse trends in the interim analysis.</p><p><strong>Trial registration: </strong>Clinical Trials Registry of India (CTRI/2022/11/047636).</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"83-99"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145854500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Outcomes Among Patients in the United States Receiving Tafamidis for Transthyretin Amyloid Cardiomyopathy.","authors":"Daniel P Judge, Margarita Udall, Andrew M Rosen, Neil Lamarre, Elizabeth Nagelhout, Hanh Dung Dao, Mathew S Maurer","doi":"10.1007/s40119-025-00443-3","DOIUrl":"10.1007/s40119-025-00443-3","url":null,"abstract":"<p><strong>Introduction: </strong>Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, often fatal disease. Tafamidis demonstrated efficacy in ATTR-CM clinical trials; however, real-world disease outcomes are not thoroughly characterized. We examined real-world outcomes among patients with wild-type (ATTRwt-CM) and variant (ATTRv-CM) ATTR-CM treated with tafamidis, the only approved treatment at the time of the study.</p><p><strong>Methods: </strong>This retrospective observational study analyzed Komodo Healthcare Map® data (1/1/2016‒6/30/2024) for tafamidis-treated patients with ATTR-CM. Outcomes included all-cause hospitalization, cardiovascular-related hospitalization (CVH), heart failure (HF)-related hospitalization, outpatient worsening HF (OWHF) with oral diuretic intensification, and mortality. Subgroup analyses examined outcomes by ATTR-CM type and N-terminal pro-B-type natriuretic peptide (NT-proBNP)/B-type natriuretic peptide (BNP) baseline levels.</p><p><strong>Results: </strong>Among 3239 tafamidis-treated patients (mean age 77.2 years; 75.9% male; 83.0% ATTRwt-CM; 11.7% ATTRv-CM), the cumulative incidence of first all-cause hospitalization was 22% at 6 months and 36% at 12 months, and that of first CVH was 22% and 35%, respectively. Median time to first CVH was 699 days. The cumulative incidence of OWHF with oral diuretic intensification was 22% at 6 months and 33% at 12 months. Mortality was 12.0% over the 5-year follow-up, and 6.2% at 12 months. The cumulative incidence of the composite endpoint (CVH, OWHF, or death) was 37% within 6 months and 53% within 12 months. In the subgroup with NT-proBNP/BNP baseline measurements (n = 412), patients with high NT-proBNP (> 3000 pg/mL, or BNP > 600 pg/mL) had worse outcomes, including a higher cumulative incidence of first CVH (51% vs. 27%) and higher mortality (9.7% vs. 4.1%) at 12 months.</p><p><strong>Conclusions: </strong>In this large real-world cohort of tafamidis-treated patients, the cumulative incidences of hospitalization and worsening HF were substantial regardless of ATTR-CM subtype. Elevated NT-proBNP/BNP at baseline was associated with worse outcomes. These findings characterize the burden of disease outcomes in tafamidis-treated patients and underscore ongoing unmet needs in ATTR-CM management.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"59-82"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}