Journal of Cardiac Failure最新文献

{"title":"Should We Systematically Screen for the Amyloidogenic V142I Variant?","authors":"JESSICA A. REGAN MD , MICHEL G. KHOURI MD , OPEYEMI A. OLABISI MD, PhD , KEVIN M. ALEXANDER MD , SADIYA S. KHAN MD, MSc , SVATI H. SHAH MD, MHS , SENTHIL SELVARAJ MD, MS, MA","doi":"10.1016/j.cardfail.2024.08.055","DOIUrl":"10.1016/j.cardfail.2024.08.055","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 136-139"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288087","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":"Highlights for the Heart Failure Cardiologist from the Seventh World Symposium on Pulmonary Hypertension: Are We Out of the Woods Yet?","authors":"THOMAS M. CASCINO MD, MSc , BRADLEY A. MARON MD , JEAN-LUC VACHIÉRY MD , VALLERIE V. McLAUGHLIN MD , RYAN J. TEDFORD MD","doi":"10.1016/j.cardfail.2024.09.009","DOIUrl":"10.1016/j.cardfail.2024.09.009","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 127-131"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347284","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":"Readability and Accessibility of Patient-Education Materials for Heart Failure in the United States","authors":"SONALI SHARMA BSc ,&nbsp;ZARA LATIF MD ,&nbsp;TRACY T. MAKUVIRE MD, MPH ,&nbsp;CHRISTY N. TAYLOR ,&nbsp;FABIAN VARGAS MD ,&nbsp;NORA S. ABO-SIDO MD, MPH ,&nbsp;NASRIEN E. IBRAHIM MD, MPH ,&nbsp;ERSILIA M. DEFILIPPIS MD","doi":"10.1016/j.cardfail.2024.06.015","DOIUrl":"10.1016/j.cardfail.2024.06.015","url":null,"abstract":"<div><div>Online education materials are widely used by patients and caregivers to understand the management of complex chronic diseases such as heart failure (HF). Organizations such as the American Medical Association and National Institutes of Health recommend that materials be written at a 6th-grade reading level. The current study examined the readability and accessibility of online education materials for patients with HF. Whole page texts from each included website were entered into an online readability calculator. Five validated readability indices (Flesch-Kincaid Grade Level, Flesch Reading Ease Scale, Gunning Fog Index, Coleman-Liau Index, and Simple Measure of Gobbledygook (SMOG Index)) were used to evaluate each source. Websites were categorized by source (government, public and private). The availability of audiovisual accessibility features and content in non-English languages were assessed for each website. Of the 36 online resources analyzed, the median readability level was 9th–10th grade according to the Flesch-Kincaid Grade Level and college level, according to the Flesch Reading Ease Scale. The Gunning Fog Index and Coleman-Liau Index both showed median readability scores corresponding to a 12th grade reading level, whereas the SMOG Index showed a median score corresponding to that of the 9th grade. Only 10 websites (28%) offered information in languages other than English, and none provided comprehensive accessibility features for users with disabilities. Common online educational materials for patients with HF are characterized by higher readability levels than those recommended by the National Institutes of Health and the American Medical Association, and there were limited multilingual and accessibility options, potentially limiting the accessibility of resources to patients and caregivers.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 154-157"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878752","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 Power in Our Patients’ Hands: Exploring LVAD and Suicide","authors":"QUENTIN R. YOUMANS MD, MSc ,&nbsp;CHRISTINE YU MOUTIER MD ,&nbsp;KATHY NEELY MD ,&nbsp;ALYSSA M. VELA PhD ,&nbsp;EREN YOUMANS WATKINS PhD ,&nbsp;ANJAN TIBREWALA MD, MS","doi":"10.1016/j.cardfail.2024.06.013","DOIUrl":"10.1016/j.cardfail.2024.06.013","url":null,"abstract":"","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 132-135"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988071","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":"Are Two Gliflozins Different: A Prospective Multicenter Randomized Study to Assess Effect of Remogliflozin Compared With Empagliflozin on Biomarkers of Heart Failure in Indian Patients With Type 2 Diabetes Mellitus with Chronic Heart Failure (REMIT-HF Study)","authors":"SHANTANU SENGUPTA MD, DNB, PHD, FACC, FASE ,&nbsp;JAYAGOPAL PATHIYILBALAGOPALAN MD, DM ,&nbsp;ASHWANI MEHTA MD, DM ,&nbsp;J.P.S. SAWHNEY MD, DM ,&nbsp;SATISH SURYAVANSHI MD, DM ,&nbsp;NAVEEN JAMWAL MD, DM, FESC ,&nbsp;DILIP KADAM MD, DM ,&nbsp;AMBANNA GOWDA MD, DM ,&nbsp;RAMESH DARGAD MD, DM ,&nbsp;AMIT BHATE MD, DM ,&nbsp;VINOD KAPOOR MD, DM ,&nbsp;SUMIT BHUSHAN MD ,&nbsp;ABHISHEK MANE MD ,&nbsp;RUJUTA GADKARI BSc, MBA ,&nbsp;SAIPRASAD PATIL MD ,&nbsp;HANMANT BARKATE MD","doi":"10.1016/j.cardfail.2024.07.020","DOIUrl":"10.1016/j.cardfail.2024.07.020","url":null,"abstract":"<div><div>There is limited data comparing two gliflozins on their effect on biomarkers in diabetic patients with chronic heart failure. A prospective, multicenter, active controlled, double-arm, investigator-initiated, interventional study enrolled 250 adults with type 2 diabetes mellitus (T2DM) and comorbid congestive heart failure (CHF; left ventricular ejection fraction [LVEF] &lt;40%; N-terminal pro-B-type natriuretic peptide [NT-proBNP] &gt;600 pg/mL). A total of 125 patients were allocated each to a remogliflozin (R) and empagliflozin (E) group and followed up for 24 weeks. The primary endpoint was the mean percentage change from baseline in NT-proBNP level after 24 weeks. There was significant improvement from baseline in mean NT-proBNP level in both groups after 24 weeks. However, there was no significant difference between the two groups (<em>P</em> = .214). The mean NT-proBNP level improved from 2078.15 ± 1764.70 pg/mL at baseline to 1185.06 ± 1164.21 pg/mL at 6 months in the R-group (<em>P</em> ≤ .001) and from 2283.98 ± 1759.15 pg/mL at baseline to 1395.33 ± 1304.18 pg/mL at 6 months in the E-group (<em>P</em> &lt; .001). LVEF and LV volumes improved in both groups. The glycemic parameters (HbA1c, FPG, and PPG) demonstrated a significant reduction from baseline to week 24 in both groups. Similar improvement was seen in heart rate, blood pressure, and weight reduction over 6 months in both groups. There was no drug-related serious adverse events in any group. Remogliflozin and empagliflozin significantly improve glycemic parameters and NT-proBNP levels as the index of the therapeutic effects in T2DM patients with CHF. The positive effects are comparable in both groups.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 158-162"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995831","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 Diabetic Emergencies On Cardiovascular Outcomes Among Heart Failure Hospitalization: A Nationwide Retrospective Analysis","authors":"Chikodili Nebuwa ,&nbsp;Olayiwola Bolaji ,&nbsp;Dipesh Mandal ,&nbsp;Anderson Ariaga ,&nbsp;Hazique Mohammad ,&nbsp;Benoit Bewley","doi":"10.1016/j.cardfail.2024.10.070","DOIUrl":"10.1016/j.cardfail.2024.10.070","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 40% of patients with heart failure (HF) have coexisting diabetes mellitus. We examined the cardiovascular outcomes among hospitalization for heart failure with and without diabetic emergencies.</div></div><div><h3>Methods</h3><div>We stratified patients admitted for HF into diabetic emergencies versus without diabetic emergencies and examined the cardiovascular outcomes between the two cohorts using NIS database (2016-2020) and ICD-10-CM codes. The impact of diabetic emergencies such as diabetic ketoacidosis, hyperosmolar hyperglycemic states and diabetic hyperglycemia were assessed. The outcomes were examined using multivariable logistic regression. Propensity scores were employed to balance the differences between the groups using inverse probability treatment weighting. Illness severity, risk of mortality, and comorbidity were adjusted using All-Patient-Refined Diagnosis-related-groups metrics and the Charlson comorbidity index</div></div><div><h3>Results</h3><div>A total of 2 782 004 patients were admitted for HF, 14 129 of them experienced diabetic emergencies. The cohort was mostly female (51%, p,0.001), for both cohorts. Patients admitted for HF with diabetic emergencies, had higher associated comorbidities like pulmonary disease, hypothyroidism, anemia, hypertension, except for obesity, renal failure (p &lt;0.01). Compared to patients admitted for HF with diabetic emergencies, patients without diabetic emergencies had higher in hospital mortality (5.4% versus 0.7%, p &lt;0.001), cardiogenic shock (1.2% versus 0%, p &lt;0.001), acute stroke (1.4% versus 0.4%, p &lt;0.001), acute MI (5.1 versus 2.1, p &lt;0.001), sudden cardiac arrest (2.3% versus 0.8%, p &lt;0.001), although patients with diabetic emergencies had more AKI and venous thromboembolism [41.2% versus 25.6%, p &lt;0.001 and 0.2% versus 0.1%, p=0.06) respectively.</div></div><div><h3>Conclusion</h3><div>Patients admitted for HF without diabetic emergencies had high mortality rates and in hospital cardiovascular events despite having less associated comorbidities. This could in part be due to frequent hospitalization or frequent clinic visits by patients who have more comorbidities as well as diabetic emergencies during hospitalization. Close monitoring should also be given to patients with less comorbidities or less severity of illness during and post hospitalization to ensure their improvement of the aforementioned outcomes.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Page 207"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141542","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":"Integrated Multiomics Myocardial Analysis Suggests Impaired Alternative Fuel Utilization In Heart Failure With Preserved Ejection Fraction","authors":"Mohammad Keykhaei,&nbsp;Navid Koleini,&nbsp;Mariam Meddeb,&nbsp;Abigail Mulligan,&nbsp;Masih Tajdini,&nbsp;Kavita Sharma,&nbsp;David Kass,&nbsp;Virginia S Hahn","doi":"10.1016/j.cardfail.2024.10.024","DOIUrl":"10.1016/j.cardfail.2024.10.024","url":null,"abstract":"<div><h3>Introduction</h3><div>Prior metabolomic data have suggested impaired metabolism of fatty acids and other fuels in heart failure with preserved ejection fraction (HFpEF). However, tissue metabolites can be lower due to lower uptake, lower flux, or higher flux/consumption. Integration of protein abundance of key metabolic enzymes can improve estimation of the overall increase or decrease in fuel utilization.</div></div><div><h3>Hypothesis</h3><div>Based on the prior metabolomic data, we hypothesize HFpEF will display lower protein expression of enzymes related to metabolism of fatty acids (FA) and alternative fuels.</div></div><div><h3>Methods</h3><div>Endomyocardial biopsies from the RV septum of HFpEF patients and RV septal tissue from non-failing controls were subjected to metabolomics (n=38 HFpEF, n=20 control), RNAseq (n=41 HFpEF, n=24 control), and protein quantification by Western blotting of key proteins related to metabolism of FA, ketones, and branched-chain amino acids (BCAA). Protein abundance was compared between HFpEF and controls using a Welch's t-test.</div></div><div><h3>Results</h3><div>Although expression of genes related to FA transport (ACSL1 and CPT1A) were significantly lower in HFpEF, protein abundance of CPT enzymes, known for catalyzing the formation of acylcarnitines and considered rate-limiting, were unchanged in HFpEF vs controls (Figure). In contrast, ACSL1, a pivotal mediator of FA uptake into cardiomyocytes, (P=0.002), the FATP family (P&lt;0.05 FATP1,3,4), and enzymes of FA oxidation (ACAD [ACADM, P=0.02; ACADVL, P=0.009), HADH [HADHA, P&lt;0.0001; HADHB, P=0.0006), and gene expression of master regulators PPARa, P&lt;0.0001, PGC1a, P=0.01) were lower in HFpEF vs controls. Regarding ketone metabolism, protein expression of SLC16A1 (the cardiac transporter of ketones, P=0.0002), BDH1 (first enzymatic step, P=0.003), and ACAT (P=0.002) were lower in HFpEF, suggesting an overall reduction in ketone metabolism in HFpEF consistent with the metabolomic data. Regarding BCAA metabolism, BCAT2 (P=0.002) and BCKDH (P=0.0006) protein expression were lower in HFpEF vs controls, in contrast to higher BCAT gene expression in HFpEF, together suggesting impaired oxidation of both BCAA (by BCAT) and branched-chain ketoacids (by BCKDH). Phosphorylation status of BCKDH (assessed by P-BCKDH/BCKDH and BCKD kinase expression) was unchanged.</div></div><div><h3>Conclusions</h3><div>Integration of our findings with the prior metabolomic study suggests impaired metabolism of FA and alternative fuels (ketones and BCAA) in the myocardium in patients with HFpEF, with targeted defects associated with uptake and oxidation of both ketones and FA, and oxidation of both BCAA and branched-chain keto-acids. These findings highlight potential therapeutic targets for metabolic modulation in HFpEF.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Pages 186-187"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143142598","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":"Axillary Mechanical Circulatory Support As A Bridge To Transplantation: Impella 5.5 Versus Intra-Aortic Ballon Pump Waitlist And Transplant Outcomes","authors":"Ameesh Isath ,&nbsp;Vasiliki Gregory ,&nbsp;Shazli Khan ,&nbsp;Gregg Lanier ,&nbsp;Chhaya Aggarwal ,&nbsp;Junichi Shimamura ,&nbsp;Stephen Pan ,&nbsp;Avi Levine ,&nbsp;Alan Gass ,&nbsp;Suguru Ohira","doi":"10.1016/j.cardfail.2024.10.009","DOIUrl":"10.1016/j.cardfail.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>The use of axillary (Ax) access mechanical circulatory support (MCS), including the intra-aortic balloon pump (IABP) and the Impella 5.5 as bridge to heart transplant (HT) is vital in Status 2 HT candidates with increasing waitlist times. Yet, comparative data between IABP and Impella 5.5 regarding waitlist outcomes, device-related complications, and post-transplant outcomes are scarce.</div></div><div><h3>Methods</h3><div>Among 149 patients listed for HT at our institution from Nov 2019 to Jan 2024, 85 Status 2 patients with surgical Ax MCS were categorized by the modality of MCS: IABP (n=68) vs Impella 5.5 (n=17, including 3 patients weaned from ECPELLA). There were 3 crossovers from IABP to Impella and 1 crossover from Impella to IABP. Waitlist outcomes were analyzed as intention to treat with MCS at the time of listing and post-HT outcomes were analyzed with MCS at the time of HT (Figure).</div></div><div><h3>Results</h3><div>Impella 5.5 group was younger (51.3±12.3 vs. 57.5±11.1 years, P=0.03). All MCS insertions were technically successful, with right Ax access used in 82.3% for Impella, contrasting with IABP's exclusive left Ax access (P&lt;0.001).</div><div>Waiting list outcomes are shown in Table. There was a significantly lower device malfunction with Impella 5.5 (5.8 % vs 30.9%, P=0.04), with a numerically lower rate of device exchange in the Impella group (5.8% vs 20.6%, P=0.28). The median waitlist time was similar in both groups (19 [7,30] vs 15.5 [9,31] days, P=0.96). The rate of successful bridge to HT was similar in both groups. (Impella, 82.3% vs 95.5%, P=0.09).</div><div>Post-HT outcomes, including mortality, primary graft dysfunction, stroke, renal replacement therapy, rates were comparable between both groups. Post-HT infection related to axillary MCS was higher in the Impella 5.5 group (18.7% vs 0%, P=0.021. All patients with local infection (N=3) were heart-kidney transplant on Impella support for 51±13 days (bacteremia [N=1]; extra-anatomical bypass [N=2]).</div></div><div><h3>Conclusion</h3><div>Impella 5.5 and IABP both provide effective MCS via axillary access for HT candidates but differences in complications, device malfunctions, and infection warrant careful consideration in device and patient selection. Infection of axillary graft could be an issue for patients on waitlist &gt; 1 month and undergoing heart kidney transplant with a high-risk profile for infection, due to more superficial remanent graft with Impella 5.5.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Page 180"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141382","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":"Barriers Of Successful Implementation Of Discharge Criteria At A Tertiary Heart Function Clinic","authors":"Ansh Patel,&nbsp;Dhruv Srikanth,&nbsp;Rebecca Wood,&nbsp;Drew McLean,&nbsp;Kelly McNabb,&nbsp;Sam Gouett,&nbsp;Wendy Earle,&nbsp;Dianne Kirkpatrick,&nbsp;Hoshiar Abdollah,&nbsp;Josh Durbin,&nbsp;Aws Almufleh","doi":"10.1016/j.cardfail.2024.10.072","DOIUrl":"10.1016/j.cardfail.2024.10.072","url":null,"abstract":"<div><h3>Introduction</h3><div>Most multidisciplinary heart function clinics cannot absorb the high volume of referrals they receive. The effectiveness of discharge protocols to offload stable patients from HF clinics has been poorly studied. We aimed to examine the predictors and barriers of implementing discharge criteria at a tertiary HF clinic.</div></div><div><h3>Methods</h3><div>We reviewed patients with ≥3 visits to our heart function Clinic between Aug 1st and Feb 29th, 2024. We extracted patient-related and provider-related characteristics at initial and most recent clinic visits. The clinic's established discharge algorithm (Figure 1), was used to categorize patients as eligible or ineligible for discharge. The primary outcome was rate of successful discharge (defined as actual discharge of patients deemed suitable for discharge according to the protocol).</div></div><div><h3>Results</h3><div>Of 144 patients reviewed (mean age 71± 13 yrs, 65% men, and 8% HFpEF), 60 patients (41.7%) were deemed suitable for discharge, however, only 25/60 (41.7%) were actually discharged.Failure to discharge was associated with atrial fibrillation (AF) (20.8% of patients with AF were discharged vs 55.6%; p-value 0.009), having a HF hospitalization within 12 months (28.6% vs 53.1%; p-value 0.054), and those with improved EF to less than 50% (33.3% vs 64.7%; p-value 0.027). For provider-specific characteristics, there was a trend towards an association between having a cardiologist (discharge rate 100% among patients with a cardiologist vs 38.6%; p-value 0.067); whereas having a primary care provider did not correlate with discharge success (p-value &gt;0.05). As for heart function providers’ characteristics, low clinical experience (defined as &lt;5 years in practice) was associated with a low rate of successful discharge (10.5% vs 52.6%; p-value 0.002).Thematic analysis revealed the desire to re-repeat the echocardiogram to confirm consistent improvement in ejection fraction (14/34, 41.7%), and to follow-up on non-heart failure consultants’ opinions (arrhythmia, surgery, structural heart team; 9/34. 26.5%), to be the most common reasons for failure to discharge.</div></div><div><h3>Conclusion</h3><div>The rate of successful discharge from our clinic is suboptimal (41.6%) which impedes timely care for new referrals. We identified several patient-related characteristics and provider-specific barriers for successful discharge. More studies are needed to explore this important area.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Page 208"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141544","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 Sodium-Glucose Co-transporter 2 Inhibitors Use On Clinical Outcomes In Patients With Wild-type Transthyretin Amyloid Cardiomyopathy: A Retrospective Cohort Study","authors":"Vibhu Parcha ,&nbsp;Ahmed Saleh ,&nbsp;Gina Josey ,&nbsp;Stephen Clarkson","doi":"10.1016/j.cardfail.2024.10.038","DOIUrl":"10.1016/j.cardfail.2024.10.038","url":null,"abstract":"<div><h3>Background</h3><div>Wild-type transthyretin amyloid cardiomyopathy (wtATTR-CM) is a progressive restrictive cardiomyopathy characterized by the deposition of misfolded transthyretin in myocardium resulting in high mortality. The burden of this disease and its clinical trajectory are further exacerbated by the presence of concomitant type II diabetes mellitus (T2DM). Sodium-glucose co-transporter 2 inhibitors (SGLT2i), initially demonstrating improved heart failure (HF) hospitalizations in those with T2DM, are now recommended for use across the spectrum of left ventricular ejection fraction, regardless of T2DM status. However, there are limited data regarding the use of SGLT2i in wATTR-CM patients.</div></div><div><h3>Methods</h3><div>This study utilized real-world EHR-based dataset (TriNetX, Inc.) that collects health records from academic medical center network across the United States. This platform was used to identify individuals diagnosed with wATTR-CM and having T2DM, using standardized ICD-10 and RxNorm codes to define population characteristics and identifying study outcomes. The study population was stratified based on SGLT2i use at the time of diagnosis of wATTR-CM. The primary study outcome was all-cause mortality at 3 years. The secondary study outcomes included incident atrial fibrillation, end-stage renal disease (ESRD), ventricular tachycardia/ventricular fibrillation (VT/VF), and stroke. Propensity-score matching (1:1) was used to balance the study population groups based on demographics, Elixhauser comorbidities, and Tafamidis use.</div></div><div><h3>Results</h3><div>A total population of 1,276 wTTR-CM patients with T2DM were identified, with 421 (33%) patients receiving SGLT2i. After matching, 381 patients were identified in each study group (those using SGLT2i and not using SGLT2i). In the setting of similar background use of Tafamidis (37.6% vs. 40.3%), the risk of all-cause mortality at 3-years was significantly lower among wATTR-CM patients with T2DM on SGLT2i compared with those not on SGLT2i (14.4% vs. 26.0%, HR: 0.53 [95% CI: 0.38-0.74]) (<strong>Figure</strong>). Treatment with SGLT2i among wATTR-CM patients with T2DM was associated with a similar risk for developing atrial fibrillation (28.8% vs. 24.6%, HR: 1.05, 95% CI: 0.66-1.66), ESRD (2.8% vs. 4.3%; HR: 0.50, 95% CI: 0.21-1.19), VT/VF (15.3% vs. 13.2%; HR: 1.14, 95% CI: 0.74-1.76), and stroke (7.3% vs. 4.3%; HR: 1.63, 95% CI: 0.82-3.25).</div></div><div><h3>Conclusions</h3><div>This observational study indicates that SGLT2i use among wATTR-CM patients having T2DM is associated with a lower risk of all-cause mortality. These findings support prospective randomized clinical trials evaluating the cardioprotective efficacy of SGLT2i in wATTR-CM.</div></div>","PeriodicalId":15204,"journal":{"name":"Journal of Cardiac Failure","volume":"31 1","pages":"Page 193"},"PeriodicalIF":6.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141727","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}