JAMA cardiology最新文献

{"title":"The First Decade of JAMA Cardiology.","authors":"Robert O Bonow","doi":"10.1001/jamacardio.2026.0119","DOIUrl":"https://doi.org/10.1001/jamacardio.2026.0119","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"82 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Outcomes in Patients Hospitalized for Heart Failure With Reduced Ejection Fraction Prescribed Quadruple Medical Therapy at Discharge.","authors":"Stephen J Greene,Haolin Xu,Karen Chiswell,G Michael Felker,Sabra C Lewsey,Punag H Divanji,Hans-Peter Goertz,Stephen B Heitner,Sanatan Shreay,Ambarish Pandey,Clyde W Yancy,Javed Butler,Gregg C Fonarow","doi":"10.1001/jamacardio.2025.5339","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.5339","url":null,"abstract":"ImportanceAmong patients with heart failure with reduced ejection fraction (HFrEF) in US clinical practice, the residual risk of poor clinical outcomes despite quadruple medical therapy is not well characterized.ObjectiveTo evaluate clinical outcomes and health care costs among patients hospitalized for HFrEF prescribed quadruple medical therapy at discharge.Design, Setting, and ParticipantsThis retrospective cohort study examined Medicare beneficiaries hospitalized for HFrEF in the Get With The Guidelines-Heart Failure registry and discharged from US hospitals receiving any dose of quadruple medical therapy (angiotensin receptor-neprilysin inhibitor, β-blocker, mineralocorticoid receptor antagonist, and sodium-glucose cotransporter 2 inhibitor) between July 1, 2021, and December 31, 2023. Data analysis was conducted from October 2024 through March 2025.ExposurePrescription of quadruple medical therapy (angiotensin receptor-neprilysin inhibitor, β-blocker, mineralocorticoid receptor antagonist, and sodium-glucose cotransporter 2 inhibitor) at time of hospital discharge.Main Outcomes and MeasuresThe primary outcomes were mortality, HF hospitalization, mortality or HF hospitalization, and per-patient health care expenditure (Medicare Part A and B inpatient and outpatient costs, in 2023 US dollars).ResultsAmong 20 651 patients with HFrEF eligible for quadruple medical therapy across 532 US hospitals, 1490 (7.2%) were prescribed quadruple therapy at discharge, with high between-hospital variance (median odds ratio, 2.04; 95% CI, 1.89-2.24). Median (IQR) age of patients prescribed quadruple therapy was 74 (69-81) years, and 543 patients (36.4%) were women. Over 12-month follow-up, cumulative incidences of all-cause mortality, HF hospitalization, and all-cause mortality or HF hospitalization were 19.3% (95% CI, 17.3%-21.4%), 26.0% (95% CI, 23.6%-28.5%), and 37.1% (95% CI, 34.4%-39.8%), respectively. Median (IQR) 12-month per-patient health care expenditure was $27 956 ($7478-$61 126). Twelve-month mortality and HF hospitalization outcomes were similar for patients prescribed quadruple medical therapy at discharge in the first half vs the second half of the study period.Conclusions and RelevanceIn this nationwide cohort study, even when prescribed quadruple medical therapy, older patients hospitalized for HFrEF in US clinical practice face substantial residual risk of death and HF readmission and often accrue high health care costs.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"74 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular-Kidney-Metabolic Medication Eligibility Across National Survey, Community-Based, and Ambulatory Healthcare Samples.","authors":"Louisa A Mounsey,Mandana Chitsazan,Ivy Shi,Pedro H Ribeiro,Juhi K Parekh,Athar Roshandelpoor,Chiadi Ndumele,Norrina B Allen,Sadiya S Khan,Bruce M Psaty,James S Floyd,Daniel Levy,Rudolf A de Boer,Navin Suthahar,Kevin Damman,Michelle C Odden,Ron T Gansevoort,Kunihiro Matsushita,Carine Hamo,Issa J Dahabreh,Robert W Yeh,Mahnaz Maddah,Shaan Khurshid,Patrick T Ellinor,Emily S Lau,Dhruv S Kazi,Jennifer E Ho","doi":"10.1001/jamacardio.2025.5305","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.5305","url":null,"abstract":"ImportanceThe prevalence of obesity and cardiovascular-kidney-metabolic (CKM) syndrome continues to rise. Indications for novel CKM therapies, including glucagonlike peptide 1 receptor agonists (GLP-1RAs), sodium-glucose cotransporter-2 inhibitors (SGLT2is), and nonsteroidal mineralocorticoid antagonists (nsMRAs) continue to expand, yet the proportion of adults meeting expanded indications, including for multiple medications remains unclear.ObjectiveTo examine proportion of adults meeting US Food and Drug Administration (FDA)-approved indications for GLP1-RAs, SGLT2is, and nsMRAs across national survey, community-based, and ambulatory health care samples.Design, Setting, and ParticipantsThis study used a representative cross-sectional survey of US adults (National Health and Nutrition Examination Survey [NHANES], weighted 245 million; mean [SD] age, 47 [18] years; 126.8 million [52%] female), 5 pooled community-based cohort studies (the Framingham Heart Study, the Multi-Ethnic Study of Atherosclerosis, the Prevention of Renal and Vascular Endstage Disease Study, the Atherosclerosis Risk in Communities Study, and the Cardiovascular Health Study; n = 30 929; mean [SD] age, 63 [14] years; 16 749 [54%] female), and 2 ambulatory health care samples (the Beth Israel Deaconess Medical Center cohort [BIDMC], n = 84 714; mean [SD] age, 46 [17] years; 51 113 [60%] female] and the Mass General Brigham cohort [MGB], n = 362 485; mean [SD] age, 48 [17] years; 227 206 [61%] female). Data were analyzed from November 2024 to November 2025.ExposuresFDA-approved indications for GLP-1RAs, SGLT2is, and nsMRAs.Main Outcomes and MeasuresMedication class eligibility within each study sample.ResultsThe proportion of individuals who met current FDA-approved indications for 1 or more CKM medication was 60% in NHANES (representing 148 million US adults), 61% in the pooled cohorts, 42% in the BIDMC ambulatory cohort, and 46% in the MGB ambulatory cohort. Eligibility for GLP-1RA therapy was most common, with 56% (representing 137.1 million US adults) in NHANES, 49% in the pooled cohorts, 41% in the BIDMC cohort, and 46% in the MGB cohort. This was followed by SGLT2i therapy (24% [57.9 million] in NHANES, 33% in the pooled cohorts, 14% for both BIDMC and MGB) and nsMRA (5% [11.7 million] in NHANES, 5% in the pooled cohorts, and 1% to 2% in ambulatory samples). Overlapping eligibility for multiple classes was common, with 12% to 17% for GLP1-RA and SGLT2i therapies and 1% to 5% for all 3 classes (an estimated 11.7 million US adults in NHANES).Conclusions and RelevanceThis study found that up to 61% of adults met FDA-approved indications for at least 1 of 3 novel CKM therapy classes. This represents an estimated 148 million US adults, including 11.7 million US adults with potential FDA indications for triple therapy, highlighting the urgent need to optimize implementation and utilization of CKM syndrome therapies.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"102 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Abstract and Text.","authors":"","doi":"10.1001/jamacardio.2025.5536","DOIUrl":"10.1001/jamacardio.2025.5536","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":" ","pages":""},"PeriodicalIF":14.1,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12853280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Left Ventricular Remodeling and Outcomes in Aortic Regurgitation.","authors":"Robert O Bonow,Patrick T O'Gara","doi":"10.1001/jamacardio.2025.5241","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.5241","url":null,"abstract":"","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"31 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Left Ventricular Remodeling for Risk Stratification of Patients With Aortic Regurgitation.","authors":"Pilar Lopez Santi,Federico Fortuni,Jérémy Bernard,Camille Sarrazyn,Aileen P Chua,Steele C Butcher,Maria C Meucci,Jingnan Zhang,Roxana Enache,Edgar Tay,Alice Bergeron,Kai-Hang Yiu,Marie-Annick Clavel,Philippe Pibarot,Jeroen J Bax,Nina Ajmone Marsan","doi":"10.1001/jamacardio.2025.5249","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.5249","url":null,"abstract":"ImportanceLeft ventricular (LV) dilatation is an established prognosticator in aortic regurgitation (AR). Current guidelines recommend aortic valve surgery (AVS) using LV end-systolic diameter index (LVESDi) with a uniform threshold, irrespective of sex. While LV end-systolic volume index (LVESVi) may better characterize LV remodeling, it was only recently included in European guideline recommendations, with a threshold of 45 mL/m2 for both men and women.ObjectiveTo assess sex differences in LV remodeling using linear and volumetric dimensions and their association with outcomes in AR.Design, Setting, and ParticipantsThis was a multicenter cohort study of patients with moderate-severe AR and preserved LV ejection fraction (LVEF) between December 2003 and December 2022, with a median (IQR) follow-up of 7 (4-11) years. The study took place at 5 centers in the Netherlands, Singapore, Hong Kong, Canada, and Romania. Patients with at least moderate-severe AR and preserved LVEF (≥50%) were included. Those with symptoms, acute AR, significant other valvular disease, or prior valve surgery were excluded. Data were analyzed from January to November 2024.ExposureLV dilatation assessed by LVESDi and LVESVi.Main Outcomes and MeasuresAll-cause mortality during medical management and following AVS.ResultsA total of 808 patients (mean [SD] age, 56 [19] years; 488 men and 320 women) were included, 323 of whom underwent AVS. Mean (SD) baseline LVESDi did not differ between sexes (women: 20 [5] mm/m2 vs men: 20 [4] mm/m2; P = .77), whereas men had larger mean (SD) LVESVi (39 [16] mL/m2 vs 31 [15] mL/m2; P < .001). During follow-up under medical management, 74 patients died. Adjusted 6-year survival was lower in women (80% vs 89%; P = .001). Receiver operating characteristic curve analysis identified LVESDi 20 mm/m2 or greater for both sexes, LVESVi 40 mL/m2 or greater for women, and LVESVi 45 mL/m2 or greater for men as thresholds associated with mortality. These cutoffs were validated using age-adjusted cubic splines and remained associated with outcomes after multivariable adjustment, with a differential effect by sex for LVESVi but not for LVESDi. After AVS, survival did not differ by sex (85% women vs 89% men; P = .31). Only preoperative LVESVi was associated with mortality, with a significant sex interaction (HR, 1.03; 95% CI, 1.00-1.06; P = .04).Conclusions and RelevanceIn this study among individuals with moderate-severe AR, similar LVESDi thresholds (20 mm/m2) for both sexes, but lower than currently recommended by guidelines, were independently associated with mortality. In turn, LVESVi thresholds were 40 mL/m2 for women and 45 mL/m2 for men, suggesting the need for sex-specific cutoffs to improve risk stratification.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"39 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Engagement With Home Blood Pressure Monitoring.","authors":"Ozan Unlu,David Zelle,Christopher P Cannon,Simin Lee,Marian McPartlin,Samantha Subramaniam,Michela Tucci,Michael Oates,Christian Figueroa,Hunter Nichols,Tabitha V Rutkowski,Alexander J Blood,Benjamin M Scirica,Naomi D L Fisher","doi":"10.1001/jamacardio.2025.5196","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.5196","url":null,"abstract":"ImportanceHome blood pressure monitoring (HBPM) is essential and universally recommended for hypertension management, but patterns of real-world patient engagement with HBPM have not been studied and remain largely unknown.ObjectiveTo evaluate patient engagement with HBPM in a remote hypertension management program.Design, Setting, and ParticipantsThis retrospective cohort study analyzing prospectively collected program data was conducted within a remote hypertension management program at a large academic health care system, Mass General Brigham, in Boston, Massachusetts. Data were collected from from September 2018 to June 2022. Adults with uncontrolled hypertension enrolled in the program were eligible for inclusion. Data analyses were conducted from February to April 2025.InterventionsPatients received free automated HBPM devices, education, and ongoing personalized support from health care navigators via telephone and messaging, with algorithm-guided medication titration.Main Outcomes and MeasuresThe primary outcome was engagement at baseline. Weekly HBPM frequency was categorized as no engagement (0 measurements), low engagement (1-11 measurements/week), intermediate engagement (12-23 measurements/week), and high engagement (24-28 measurements/week).ResultsA total of 3390 patients were enrolled in the remote hypertension program; median (IQR) patient age was 61 (52-69) years, with 1958 (57.8%) female patients. Mean (SD) systolic BP at baseline was 143 (13) mm Hg, and most patients had comorbidities, including 1369 patients (40.4%) with atherosclerotic cardiovascular disease and 996 (29.4%) with diabetes. At baseline, 1107 patients (32.7%) had no engagement, 484 (14.3%) had low engagement, 618 (18.2%) had intermediate engagement, and 1181 (34.8%) had high engagement.Conclusions and RelevanceIn this cohort study of a remote hypertension management program, patient engagement with HBPM was suboptimal despite free devices, education, and personalized support with a navigator. To support optimal HBPM, innovative methods of BP monitoring that are more convenient and less burdensome for patients may enhance engagement and improve hypertension management outcomes.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"3 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediabetes, Subclinical Myocardial Injury or Stress, and Heart Failure Risk for Adults With Hypertension.","authors":"Arnaud D Kaze,Stephen P Juraschek,Jordana B Cohen,Siddharth Singh,Chiadi E Ndumele,Christie M Ballantyne,Jarrett D Berry,Justin B Echouffo-Tcheugui","doi":"10.1001/jamacardio.2025.4927","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.4927","url":null,"abstract":"ImportanceIt is unclear whether and the extent to which subclinical myocardial injury or stress coexisting with prediabetes is associated with the risk of heart failure (HF).ObjectiveTo evaluate the joint associations of prediabetes and subclinical myocardial injury or stress with incident HF risk.Design, Setting, and ParticipantsThis post hoc prospective cohort study analyzed data from the Systolic Blood Pressure Intervention Trial (SPRINT). Two analytic samples were used: (1) adults with hypertension without diabetes or prior HF for the baseline biomarkers analysis and (2) participants with biomarker measurements at both baseline and 12 months for the longitudinal biomarkers' change. Prediabetes was defined as a fasting plasma glucose level of 100 to 125 mg/dL. Subclinical myocardial injury was defined as a high-sensitivity cardiac troponin I (hs-cTnI) level of 6 ng/L or higher in men and 4 ng/L or higher in women and subclinical myocardial stress defined as an N-terminal pro-B-type natriuretic peptide (NT-proBNP) level of 125 pg/mL or higher. A 25% or greater increase in any biomarker concentration from baseline to 12 months defined longitudinal change. Data were analyzed between January 1 and May 31, 2025.Main Outcomes and MeasuresThe primary outcome was adjudicated incident HF. Cox proportional hazards models were used to estimate hazard ratios (HRs) for HF across joint categories of prediabetes and biomarker elevation.ResultsOf 8234 participants (mean [SD] age, 68 [9] years; 37.1% women), 3271 (39.7%) had prediabetes, 2942 (35.7%) had subclinical myocardial injury, and 3593 (43.6%) had subclinical myocardial stress. Over a median follow-up of 3.2 years (IQR, 2.8-3.8 years), 122 participants developed HF. Compared with normoglycemia and no myocardial injury, those with both prediabetes and injury had the highest HF risk (HR, 4.20; 95% CI, 2.31-7.63); similar findings were observed for myocardial stress (HR, 5.20; 95% CI, 2.52-10.70). In the longitudinal analysis (median follow-up, 2.3 years [IQR, 1.9-2-8 years]), 7449 participants with both prediabetes and a 25% or greater increase in hs-cTnI or NT-proBNP level had the highest risk of HF (for hs-cTnI: HR, 3.05; 95% CI, 1.58-5.88; for NT-proBNP: HR, 2.39; 95% CI, 1.28-4.46).Conclusions and RelevanceThese findings suggest that among adults with hypertension, prediabetes in combination with subclinical myocardial injury or stress is associated with a significantly elevated risk for HF. These findings support the integration of glycemic status and cardiac biomarkers profiling to improve HF risk stratification and guide prevention.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"54 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Operator Procedural Volumes and Outcomes for TAVR and MTEER in the US","authors":"Dharam J. Kumbhani, Saket Girotra, Huaying Dong, Yang Song, Pratik Manandhar, Ayman Elbadawi, James A. de Lemos, Adnan K. Chhatriwalla, John Carroll, Ralph Brindis, Tsuyoshi Kaneko, Vinod Thourani, Wayne Batchelor, Robert W. Yeh, Sreekanth Vemulapalli","doi":"10.1001/jamacardio.2025.5645","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.5645","url":null,"abstract":"Importance Recent evidence suggests that hospital-level associations between procedural volume and outcomes for transcatheter aortic valve replacement (TAVR) and mitral transcatheter edge-to-edge repair (MTEER) may be plateauing. Less is known about the operator volumes–outcomes association in the contemporary era. Objective To determine whether an operator-level volume-outcomes association exists for TAVR and MTEER in the contemporary era. Design, Setting, and Participants This cohort study examined data from patients undergoing TAVR or MTEER between January 2020 and December 2023 included in the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapies (TVT) Registry, a national all-comers real-world registry. Consecutive patients undergoing TAVR for aortic stenosis or MTEER for mitral regurgitation were included. Data analysis was performed from October 2024 to December 2025. Exposure TAVR or MTEER. Main Outcomes and Measures The primary outcome measures were (1) 30-day all-cause mortality, (2) a 30-day composite outcome, and (3) in-hospital procedural complications following TAVR or MTEER. Data from the STS/ACC TVT Registry were analyzed for patients undergoing TAVR or MTEER between 2020 and 2023. The primary analysis assessed the association between operator volume and 30-day outcomes using a 2-level random-effects logistic regression model. The interaction between operator and hospital volumes and the association between TAVR and MTEER outcomes were also evaluated. Results A total of 358 943 patients underwent TAVR at 827 hospitals (7524 operators; median [IQR] annual volume, 24 [11-47]), and 51 407 patients underwent MTEER at 493 hospitals (2483 operators; median [IQR] annual volume, 12 [7-19]). For TAVR, median (IQR) patient age was 79.0 (73.0-85.0) years, and 152 186 patients (42.4%) were female; for MTEER, median (IQR) patient age was 79.0 (71.0-84.0) years, and 23 402 patients (45.5%) were female. Low-volume operators demonstrated inferior process of care measures compared with high-volume operators. In adjusted analyses, a higher risk of 30-day mortality (odds ratio [OR], 1.13; 95% CI, 1.02-1.26; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .02) and in-hospital complications (OR, 1.09; 95% CI, 1.03-1.16; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .005) was observed for low-volume TAVR operators (&amp;amp;lt;15/y) compared with high-volume operators (&amp;amp;gt;37/y). For MTEER, in-hospital complications (OR, 1.31; 95% CI, 1.11-1.56; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .002) were higher for low-volume operators (&amp;amp;lt;8/y) compared with high-volume operators (&amp;amp;gt;16/y), while 30-day mortality was not different (OR, 1.16; 95% CI, 0.96-1.41; &lt;jats:italic toggle=\"yes\"&gt;P&lt;/jats:italic&gt; = .12). Associations were consistent across hospital volume strata. Operator-level outcomes for TAVR and MTEER were not correlated. Conclusions and Relevance In this cohort study, results from","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"1 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Determinants of Health and Clinical Outcomes in Hypertrophic Cardiomyopathy.","authors":"Neha Hafeez,Brian L Claggett,Anjali T Owens,Adam S Helms,Sara Saberi,Rachel Lampert,John C Stendahl,Euan A Ashley,Victoria N Parikh,Neal K Lakdawala,Jodie Ingles,Iacopo Olivotto,Carolyn Y Ho,Matthew R Taylor,Sadiya S Khan,Sharlene M Day","doi":"10.1001/jamacardio.2025.4869","DOIUrl":"https://doi.org/10.1001/jamacardio.2025.4869","url":null,"abstract":"ImportanceArea-based indicators of social determinants of health (SDOH) are associated with higher risk for acquired heart disease, but their impact on conditions with a strong genetic etiology, such as hypertrophic cardiomyopathy (HCM), is not well understood.ObjectiveTo determine the association of area-based SDOH with clinical outcomes in patients with HCM.Design, Setting, and ParticipantsThis multicenter, prospective cohort study was conducted among US adult patients with HCM from 5 sites in the Sarcomeric Human Cardiomyopathy Registry (a multicenter prospective registry of patients with HCM) who were followed up for a median (IQR) period of 2.15 (0.15-5.82) years. Data were entered from 2015 to March 2024, and data analysis was completed from March 2024 to June 2025.ExposuresPatients' residential addresses were geocoded at the zip code level and linked to the American Communities Survey to estimate area-based (1) median household income and (2) social deprivation index (SDI), which ranges from 0 to 100, with higher scores indicating a more deprived area.Main Outcomes and MeasuresMultivariate models, adjusting for age at diagnosis, body mass index, hypertension, and sex, were used to estimate the independent association of area-based median household income and SDI with heart failure (HF), ventricular arrhythmias (VA), and an overall composite outcome (VA, HF, atrial fibrillation, stroke, and death).ResultsAmong 4431 US adult patients with HCM, median (IQR) age at HCM diagnosis was 51.3 (38.9-61.6) years, and 1862 patients (42.0%) were female. Median (IQR) area-based household income was $80 000 ($60 000-$110 000), and median (IQR) SDI was 25 (10-55). Adjusted hazard ratios comparing the lowest income group to the highest income group were 2.07 (95% CI, 1.77-2.42; P < .001) for HF, 1.31 (95% CI, 0.97-1.78; P = .08) for VA, and 1.52 (95% CI, 1.36-1.69; P < .001) for the overall composite outcome. Adjusted hazard ratios comparing the highest SDI (ie, more deprived) group to the lowest SDI group were 1.48 (95% CI, 1.29-1.70; P < .001) for HF, 1.55 (95% CI, 1.15-2.09; P = .004) for VA, and 1.36 (95% CI, 1.22-1.50; P < .001) for the overall composite outcome.Conclusions and RelevanceIn this multicenter cohort study, residing in an area with lower median household income or worse SDI were each independently associated with adverse clinical outcomes in patients with HCM. These findings suggest that despite the genetically determined nature of HCM, place of residence is associated with patient outcomes.","PeriodicalId":14657,"journal":{"name":"JAMA cardiology","volume":"3 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}