Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.054
E. Berthelot , E. Audureau , D. Logeart , F. Roubille , J.-M. Tartière , T. Damy , F. Bauer
Introduction
Heart failure (HF) requires continuous monitoring and patient engagement. Mobile applications (app) may enhance self-care by providing symptom tracking, medication reminders, dietary guidance, appointment scheduling, and physical activity recommendations.
Objective
To evaluate whether a dedicated HF app improves self-care, quality of life, physical activity, and medication adherence.
Method
This prospective, randomized controlled trial was conducted across 11 centers. Patients were assigned to either standard care or standard care plus the HF app. The primary outcome was self-care improvement, measured by the European Heart Failure Self-care Behaviour (EHFScB) scale at 6-month follow-up. Secondary outcomes included quality of life (Minnesota Living with Heart Failure MLWHF questionnaire), physical activity, and medication adherence at follow-up.
Results
A total of 123 patients were included (mean age: 54.9 ± 13.0 years, 83.7% male). Self-care scores improved slightly in the HF app group, but without reaching significance (P = 0.53) (Table 1). Quality of life improved over time without significant differences (P = 0.84). However, the app group showed greater increases in intense physical activity (P = 0.027) and moderate physical activity (P = 0.026). Medication adherence improved at 6 months (P = 0.05) but not over the full follow-up (P = 0.75). App engagement was variable, with only 52.1% of users actively engaging, highlighting the challenge of sustained digital adherence.
Conclusion
While the HF app did not significantly impact self-care or quality of life, it improved physical activity and short-term medication adherence. Future research should focus on enhancing long-term engagement and optimizing digital interventions for HF management.
{"title":"Interest in the use of the “MonCœur” Smartphone application for monitoring out patients with heart failure","authors":"E. Berthelot , E. Audureau , D. Logeart , F. Roubille , J.-M. Tartière , T. Damy , F. Bauer","doi":"10.1016/j.acvd.2025.10.054","DOIUrl":"10.1016/j.acvd.2025.10.054","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) requires continuous monitoring and patient engagement. Mobile applications (app) may enhance self-care by providing symptom tracking, medication reminders, dietary guidance, appointment scheduling, and physical activity recommendations.</div></div><div><h3>Objective</h3><div>To evaluate whether a dedicated HF app improves self-care, quality of life, physical activity, and medication adherence.</div></div><div><h3>Method</h3><div>This prospective, randomized controlled trial was conducted across 11 centers. Patients were assigned to either standard care or standard care plus the HF app. The primary outcome was self-care improvement, measured by the European Heart Failure Self-care Behaviour (EHFScB) scale at 6-month follow-up. Secondary outcomes included quality of life (Minnesota Living with Heart Failure MLWHF questionnaire), physical activity, and medication adherence at follow-up.</div></div><div><h3>Results</h3><div>A total of 123 patients were included (mean age: 54.9<!--> <!-->±<!--> <!-->13.0 years, 83.7% male). Self-care scores improved slightly in the HF app group, but without reaching significance (<em>P</em> <!-->=<!--> <!-->0.53) (<span><span>Table 1</span></span>). Quality of life improved over time without significant differences (<em>P</em> <!-->=<!--> <!-->0.84). However, the app group showed greater increases in intense physical activity (<em>P</em> <!-->=<!--> <!-->0.027) and moderate physical activity (<em>P</em> <!-->=<!--> <!-->0.026). Medication adherence improved at 6 months (<em>P</em> <!-->=<!--> <!-->0.05) but not over the full follow-up (<em>P</em> <!-->=<!--> <!-->0.75). App engagement was variable, with only 52.1% of users actively engaging, highlighting the challenge of sustained digital adherence.</div></div><div><h3>Conclusion</h3><div>While the HF app did not significantly impact self-care or quality of life, it improved physical activity and short-term medication adherence. Future research should focus on enhancing long-term engagement and optimizing digital interventions for HF management.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S30"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.031
S. Jaber, J. Mercier, K. Haddad, J. Haddad, A. Ionescu, B. Potter, A. Matteau, S. Mansour
Introduction
The most recent myocardial infarction (MI) definition has classified type 2 myocardial infarction (T2MI) as a different entity from myocardial injury and other myocardial infarction subtypes. Despite the high burden of patients with T2MI, current guidelines lack specific diagnostic and therapeutic recommendations.
Objective
We demonstrate the prevalence of T2MI misclassification, and the heterogeneity of its presentation, diagnosis and management.
Method
We conducted a retrospective cohort study at a tertiary Canadian high volume center, including all adult patients admitted with a diagnosis of NSTEMI. Demographic data, clinical characteristics, laboratory and imaging results, medical management, and discharge plan were extracted. Data were presented as number (percent) for categorical variables. P-values were calculated using Chi-squared test with P-value < 0.05 for statistical significance.
Results
Between January 2020 and October 2023, a total of 233 patients were included, with 59 (25.3%) classified as T1MI and 174 (74.7%) as T2MI. More than one third (n = 73, 31.3%) of T2MI patients should have received the diagnosis of myocardial injury. Patients with myocardial injury had lower prevalence of known CAD (34.2% vs. 52.5% vs. 54.2%; P = 0.027) and congestive heart failure (15.0% vs. 47.5% vs. 32%; P < 0.01) compared to T2MI and T1MI, respectively. The most common ischemic precipitating factor, in T2MI, was acute infection (47.5%), followed by acute anemia (35.6%), arrythmia (29.7%), hypotension (27.7%), and surgery (25.7%). T2MI patients were less likely to undergo coronary angiography (22.8%) compared to T1MI patients (62.7%; P < 0.01). Among T2MI patients undergoing angiography, 82.6% had significant CAD. T2MI patients received less intensive antithrombotic therapy: aspirin (64.4% vs. 81.4%; P = 0.036), P2Y12 inhibitor (32.7% vs 67,8%; P < 0.01), and DAPT (25.7% vs. 57.6%, P < 0.01) as compared to T1MI patients. Median hospitalisation duration was longer in T2MI patients 12 vs 6 days (P < 0.01) as compared to T1MI. Only 45.5% of T2MI patients had documented cardiology follow-up post-discharge as compared to 66.1% of T1MI patients (P = 0.019).
Conclusion
T2MI patients had a significant cardiovascular risk burden and received less aggressive diagnostic and therapeutic interventions compared to T1MI patients. Misclassification of myocardial injury as T2MI remains common despite the new definition of MI.
最新的心肌梗死（MI）定义将2型心肌梗死（T2MI）分类为不同于心肌损伤和其他心肌梗死亚型的实体。尽管T2MI患者负担沉重，但目前的指南缺乏具体的诊断和治疗建议。目的探讨T2MI误分的普遍性及其表现、诊断和治疗的异质性。方法：我们在加拿大一家三级高容量中心进行了一项回顾性队列研究，包括所有诊断为NSTEMI的成年患者。提取人口统计资料、临床特征、实验室和影像学结果、医疗管理和出院计划。数据以数字（百分比）表示分类变量。p值计算采用卡方检验，p值<； 0.05为有统计学意义。结果2020年1月至2023年10月共纳入233例患者，其中59例（25.3%）为T1MI， 174例（74.7%）为T2MI。超过三分之一（n = 73,31.3%）的T2MI患者应接受心肌损伤的诊断。与T2MI和T1MI相比，心肌损伤患者的已知CAD患病率（34.2% vs. 52.5% vs. 54.2%, P = 0.027）和充血性心力衰竭患病率（15.0% vs. 47.5% vs. 32%, P < 0.01）分别较低。T2MI中最常见的缺血诱发因素是急性感染（47.5%），其次是急性贫血（35.6%）、心律失常（29.7%）、低血压（27.7%）和手术（25.7%）。T2MI患者接受冠状动脉造影的可能性（22.8%）低于T1MI患者（62.7%;P < 0.01）。在接受血管造影的T2MI患者中，82.6%有明显的CAD。T2MI患者接受强度较低的抗血栓治疗：与T1MI患者相比，阿司匹林（64.4%对81.4%,P = 0.036）、P2Y12抑制剂（32.7%对67.8%,P < 0.01）和DAPT（25.7%对57.6%,P < 0.01）。与T1MI患者相比，T2MI患者的中位住院时间更长，分别为12天和6天（P < 0.01）。只有45.5%的T2MI患者在出院后进行了心脏学随访，而T1MI患者的这一比例为66.1% （P = 0.019）。结论t2mi患者与T1MI患者相比具有显著的心血管风险负担，且接受的诊断和治疗干预较少。尽管对心肌梗死有了新的定义，但将心肌损伤误分类为T2MI仍然很常见。
{"title":"NSTEMI Type 2 and myocardial injury: Hidden burden, diagnostic challenges, and therapeutic inertia","authors":"S. Jaber, J. Mercier, K. Haddad, J. Haddad, A. Ionescu, B. Potter, A. Matteau, S. Mansour","doi":"10.1016/j.acvd.2025.10.031","DOIUrl":"10.1016/j.acvd.2025.10.031","url":null,"abstract":"<div><h3>Introduction</h3><div>The most recent myocardial infarction (MI) definition has classified type 2 myocardial infarction (T2MI) as a different entity from myocardial injury and other myocardial infarction subtypes. Despite the high burden of patients with T2MI, current guidelines lack specific diagnostic and therapeutic recommendations.</div></div><div><h3>Objective</h3><div>We demonstrate the prevalence of T2MI misclassification, and the heterogeneity of its presentation, diagnosis and management.</div></div><div><h3>Method</h3><div>We conducted a retrospective cohort study at a tertiary Canadian high volume center, including all adult patients admitted with a diagnosis of NSTEMI. Demographic data, clinical characteristics, laboratory and imaging results, medical management, and discharge plan were extracted. Data were presented as number (percent) for categorical variables. <em>P</em>-values were calculated using Chi-squared test with <em>P</em>-value<!--> <!--><<!--> <!-->0.05 for statistical significance.</div></div><div><h3>Results</h3><div>Between January 2020 and October 2023, a total of 233 patients were included, with 59 (25.3%) classified as T1MI and 174 (74.7%) as T2MI. More than one third (<em>n</em> <!-->=<!--> <!-->73, 31.3%) of T2MI patients should have received the diagnosis of myocardial injury. Patients with myocardial injury had lower prevalence of known CAD (34.2% vs. 52.5% vs. 54.2%; <em>P</em> <!-->=<!--> <!-->0.027) and congestive heart failure (15.0% vs. 47.5% vs. 32%; <em>P</em> <!--><<!--> <!-->0.01) compared to T2MI and T1MI, respectively. The most common ischemic precipitating factor, in T2MI, was acute infection (47.5%), followed by acute anemia (35.6%), arrythmia (29.7%), hypotension (27.7%), and surgery (25.7%). T2MI patients were less likely to undergo coronary angiography (22.8%) compared to T1MI patients (62.7%; <em>P</em> <!--><<!--> <!-->0.01). Among T2MI patients undergoing angiography, 82.6% had significant CAD. T2MI patients received less intensive antithrombotic therapy: aspirin (64.4% vs. 81.4%; <em>P</em> <!-->=<!--> <!-->0.036), P2Y12 inhibitor (32.7% vs 67,8%; <em>P</em> <!--><<!--> <!-->0.01), and DAPT (25.7% vs. 57.6%, <em>P</em> <!--><<!--> <!-->0.01) as compared to T1MI patients. Median hospitalisation duration was longer in T2MI patients 12 vs 6 days (<em>P</em> <!--><<!--> <!-->0.01) as compared to T1MI. Only 45.5% of T2MI patients had documented cardiology follow-up post-discharge as compared to 66.1% of T1MI patients (<em>P</em> <!-->=<!--> <!-->0.019).</div></div><div><h3>Conclusion</h3><div>T2MI patients had a significant cardiovascular risk burden and received less aggressive diagnostic and therapeutic interventions compared to T1MI patients. Misclassification of myocardial injury as T2MI remains common despite the new definition of MI.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S20"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.016
H. Touati, Z.E. Ben Ali, F. Nouri, I. Ben Krayen, R. Fekih, C. Brahem, I.T. Mtiri, Lassoued, S. Milouchi
Introduction
Frank's sign is a skin sign (Fig. 1) easily collected by clinical examination, defined by a pronounced diagonal fold in the ear lobule. Several series have demonstrated its relationship with coronary atherosclerosis.
Objective
To assess the correlation between the severity of coronary artery disease using the syntax score I and the presence of Frank's sign in patients admitted for acute coronary syndrome (ACS).
Method
This is a monocentric observational cross-sectional study, carried out in the Cardiology Department at Medenine University Hospital and conducted between April 2023 and July 2023 including 100 patients admitted for ACS.
Results
The mean age of our population was 60 ± 12 years with a M/F sex-ratio of 3.54. Diabetes and smoking were the risk factors most frequently found in 63% and 48% of the study population respectively. The percentage of patients admitted for STEMI was 48%, compared with 52% for NSTEMI. Frank's sign was positive in 50% of the population. Patients with a positive Frank's sign had a significantly higher Syntax I score, reflecting more severe coronary damage (13.81 ± 11.14 vs 23.13 ± 8.32; P < 0.001). Frank's sign was correlated with a syntax score higher than 22 (74% vs 24%; P < 0.001). The presence of Frank's sign increased the probability of having a syntax score > 22 (OR = 9; 95% CI: 3.643/22.298; P < 0.001) with a sensitivity of 75% and a specificity of 77%.
Conclusion
Frank's sign, a cutaneous sign easily collected by clinical examination, correlates with severe coronary involvement in patients admitted for ACS.
弗兰克征是一种临床检查容易发现的皮肤征（图1），由耳叶明显的对角线褶皱定义。几个系列已经证实了它与冠状动脉粥样硬化的关系。目的应用句法评分I评价急性冠脉综合征（ACS）患者冠状动脉疾病严重程度与Frank’s体征的相关性。方法：这是一项单中心观察性横断面研究，于2023年4月至2023年7月在Medenine大学医院心内科进行，包括100例ACS患者。结果本组人口平均年龄为60±12岁，男女性别比为3.54。糖尿病和吸烟是最常见的危险因素，分别占研究人群的63%和48%。STEMI住院的患者比例为48%，而NSTEMI住院的患者比例为52%。50%的人都是阳性的。Frank’s体征阳性的患者Syntax I评分明显较高，反映冠脉损害更严重（13.81±11.14 vs 23.13±8.32;P < 0.001）。弗兰克的符号与语法得分高于22的人相关（74%对24%；P < 0.001）。Frank’s sign的存在增加了句法评分为22分的概率（OR = 9; 95% CI: 3.643/22.298; P < 0.001），敏感性为75%，特异性为77%。结论弗兰克征是一种临床检查容易发现的皮肤征象，与ACS患者严重冠脉受累有关。
{"title":"Frank's Sign: When the ear hears the heart suffering!","authors":"H. Touati, Z.E. Ben Ali, F. Nouri, I. Ben Krayen, R. Fekih, C. Brahem, I.T. Mtiri, Lassoued, S. Milouchi","doi":"10.1016/j.acvd.2025.10.016","DOIUrl":"10.1016/j.acvd.2025.10.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Frank's sign is a skin sign (<span><span>Fig. 1</span></span>) easily collected by clinical examination, defined by a pronounced diagonal fold in the ear lobule. Several series have demonstrated its relationship with coronary atherosclerosis.</div></div><div><h3>Objective</h3><div>To assess the correlation between the severity of coronary artery disease using the syntax score I and the presence of Frank's sign in patients admitted for acute coronary syndrome (ACS).</div></div><div><h3>Method</h3><div>This is a monocentric observational cross-sectional study, carried out in the Cardiology Department at Medenine University Hospital and conducted between April 2023 and July 2023 including 100 patients admitted for ACS.</div></div><div><h3>Results</h3><div>The mean age of our population was 60<!--> <!-->±<!--> <!-->12 years with a M/F sex-ratio of 3.54. Diabetes and smoking were the risk factors most frequently found in 63% and 48% of the study population respectively. The percentage of patients admitted for STEMI was 48%, compared with 52% for NSTEMI. Frank's sign was positive in 50% of the population. Patients with a positive Frank's sign had a significantly higher Syntax I score, reflecting more severe coronary damage (13.81<!--> <!-->±<!--> <!-->11.14 vs 23.13<!--> <!-->±<!--> <!-->8.32; <em>P</em> <!--><<!--> <!-->0.001). Frank's sign was correlated with a syntax score higher than 22 (74% vs 24%; <em>P</em> <!--><<!--> <!-->0.001). The presence of Frank's sign increased the probability of having a syntax score<!--> <!-->><!--> <!-->22 (OR<!--> <!-->=<!--> <!-->9; 95% CI: 3.643/22.298; <em>P</em> <!--><<!--> <!-->0.001) with a sensitivity of 75% and a specificity of 77%.</div></div><div><h3>Conclusion</h3><div>Frank's sign, a cutaneous sign easily collected by clinical examination, correlates with severe coronary involvement in patients admitted for ACS.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S13"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.087
N. Ali Tatar, M.T. Chenti
Introduction
Muscular dystrophy is a recessive muscular disease characterized by progressive weakness caused by dystrophin abnormalities in all striated muscles. In addition to conduction disorders, cardiac muscle involvement leading to progressive dilated cardiomyopathy (DCM) is common in this context.
Objective
To describe features of cardiovascular diseases in patients with neuromuscular disorders referred by the neurology department.
Method
From October 2005 to December 2024, 43 patients (pts), among them 33 men and 10 women, mean age 38 ± 15 years, from 5 to 67 years, with muscular dystrophy underwent clinical, electrocardiogram (ECG), echocardiography based on Recommendations for Cardiac Chamber Quantification from the European Association of Cardiovascular imaging.
Results
Among 13 pts with Becker muscular dystrophy, 11 men and two women aged from 12 to 53 years, 2patients underwent Cardiac Resynchronization therapy (CRT) among them, one patient died after cardiogenic shock. 2 patients with DCM and global reduction ejection fraction were on maximally tolerated doses of beta blocker and Angiotensin-converting enzyme (ACE). Left ventricular hypertrophy (LVH) was present in 3 pts. Among 2 pts with polymyositis, coroscanner shows in a woman 35 years old with coronary spasm, myocardial bridging. Atrial fibrillation occurs in one of them. Among 3 patients, all men, with Steinert myopathy, one had atrial flutter, one had left Bundle–branch blocks with DCM, one had J wave syndrome. Among the two women with Friedreich's ataxia, one had negative T wave on ECG and normal. Among 9 pts with Duchenne muscular dystrophy (all men), 3 had severe DCM and death occurs in one. Sarcoglycanopathy occurs in four patients: among them, left ventricular hypertrophy on ECG was observed (Fig. 1).
Conclusion
The challenge in pts with neuromuscular disorders is to detect subtil abnormalities in the forms in which ejection fraction is preserved. Follow-up with evaluation of longitudinal and circumferential myocardial strain on echocardiography completed by cardiovascular magnetic resonance imaging (CMR) will be on interest to detect occult regional cardiac dysfunction in pediatric patients.
{"title":"Cardiac Involvement in patients referred from neurology with muscular dystrophy","authors":"N. Ali Tatar, M.T. Chenti","doi":"10.1016/j.acvd.2025.10.087","DOIUrl":"10.1016/j.acvd.2025.10.087","url":null,"abstract":"<div><h3>Introduction</h3><div>Muscular dystrophy is a recessive muscular disease characterized by progressive weakness caused by dystrophin abnormalities in all striated muscles. In addition to conduction disorders, cardiac muscle involvement leading to progressive dilated cardiomyopathy (DCM) is common in this context.</div></div><div><h3>Objective</h3><div>To describe features of cardiovascular diseases in patients with neuromuscular disorders referred by the neurology department.</div></div><div><h3>Method</h3><div>From October 2005 to December 2024, 43 patients (pts), among them 33 men and 10 women, mean age 38<!--> <!-->±<!--> <!-->15 years, from 5 to 67 years, with muscular dystrophy underwent clinical, electrocardiogram (ECG), echocardiography based on Recommendations for Cardiac Chamber Quantification from the European Association of Cardiovascular imaging.</div></div><div><h3>Results</h3><div>Among 13 pts with Becker muscular dystrophy, 11 men and two women aged from 12 to 53 years, 2patients underwent Cardiac Resynchronization therapy (CRT) among them, one patient died after cardiogenic shock. 2 patients with DCM and global reduction ejection fraction were on maximally tolerated doses of beta blocker and Angiotensin-converting enzyme (ACE). Left ventricular hypertrophy (LVH) was present in 3 pts. Among 2 pts with polymyositis, coroscanner shows in a woman 35 years old with coronary spasm, myocardial bridging. Atrial fibrillation occurs in one of them. Among 3 patients, all men, with Steinert myopathy, one had atrial flutter, one had left Bundle–branch blocks with DCM, one had J wave syndrome. Among the two women with Friedreich's ataxia, one had negative T wave on ECG and normal. Among 9 pts with Duchenne muscular dystrophy (all men), 3 had severe DCM and death occurs in one. Sarcoglycanopathy occurs in four patients: among them, left ventricular hypertrophy on ECG was observed (<span><span>Fig. 1</span></span>).</div></div><div><h3>Conclusion</h3><div>The challenge in pts with neuromuscular disorders is to detect subtil abnormalities in the forms in which ejection fraction is preserved. Follow-up with evaluation of longitudinal and circumferential myocardial strain on echocardiography completed by cardiovascular magnetic resonance imaging (CMR) will be on interest to detect occult regional cardiac dysfunction in pediatric patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S49-S50"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.074
N. Girerd , C. Fauvel , E. Berthelot , M.-F. Seronde , P. Assyag , N. Pages , S. Nisse Durgeat , O. Hanon
Introduction
Heart failure (HF) is a growing public health concern, particularly among aging populations. The European Society of Cardiology Guidelines recommend an evidence-based approach that combines pharmacological therapies, device interventions, and lifestyle measures.
Objective
The REMOTE-HF study, conducted using the Satelia® Cardio remote monitoring platform, assessed adherence to these guidelines, described patient clinical characteristics, and evaluated the role of telemonitoring in optimizing treatment.
Method
The study included 20,310 HF patients monitored via Satelia® Cardio, with data extracted as of December 15, 2024. Key parameters analyzed included age, sex, NYHA classification, left ventricular ejection fraction (LVEF), and HF etiology. Prescribed therapies (ACE inhibitors/ARBs/ARNi, beta-blockers, mineralocorticoid receptor antagonists [MRAs], and SGLT2 inhibitors) were compared with ESC guideline recommendations, considering patient profiles and cardiologist practice settings (hospital-based vs. private practice).
Results
Most patients were classified as NYHA class II (63%), and 45% had reduced LVEF (<40%). The most common etiology was ischemic heart disease (43%). Among patients with reduced LVEF, adherence to ESC guidelines was high: beta-blockers were prescribed to 67%, ARNi to 59%, MRAs to 60%, and SGLT2 inhibitors to 57%. Overall, SGLT2 inhibitors were more frequently used than MRAs (43% vs. 39%) and were widely adopted in patients with LVEF 40–50% (48%), but remained underused in those with preserved LVEF (≥50%) at 38%. SGLT2 inhibitor use was higher in men (45%) and in patients under 80 years of age (47%). There was also relatively consistent prescription of beta-blockers (54–55%) and ARNi (31–32%) between hospital-based and private-practice cardiologists. However, variations remained in other drug classes and among patients with preserved LVEF or complex comorbidities (Table 1).
Conclusion
The REMOTE-HF study illustrates the value of remote monitoring in enhancing adherence to ESC heart failure treatment guidelines, particularly in patients with reduced EF. The increased use of SGLT2 inhibitors marks a significant shift in clinical practice. Nevertheless, the study reveals persistent gaps in care, especially among older patients and those with preserved ejection fraction. These findings underscore the importance of telemonitoring as a lever to standardize therapeutic management and improve outcomes across all care settings.
{"title":"Adherence to European Guidelines in heart failure management: Insights from the REMOTE-HF study using remote monitoring","authors":"N. Girerd , C. Fauvel , E. Berthelot , M.-F. Seronde , P. Assyag , N. Pages , S. Nisse Durgeat , O. Hanon","doi":"10.1016/j.acvd.2025.10.074","DOIUrl":"10.1016/j.acvd.2025.10.074","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a growing public health concern, particularly among aging populations. The European Society of Cardiology Guidelines recommend an evidence-based approach that combines pharmacological therapies, device interventions, and lifestyle measures.</div></div><div><h3>Objective</h3><div>The REMOTE-HF study, conducted using the Satelia® Cardio remote monitoring platform, assessed adherence to these guidelines, described patient clinical characteristics, and evaluated the role of telemonitoring in optimizing treatment.</div></div><div><h3>Method</h3><div>The study included 20,310 HF patients monitored via Satelia® Cardio, with data extracted as of December 15, 2024. Key parameters analyzed included age, sex, NYHA classification, left ventricular ejection fraction (LVEF), and HF etiology. Prescribed therapies (ACE inhibitors/ARBs/ARNi, beta-blockers, mineralocorticoid receptor antagonists [MRAs], and SGLT2 inhibitors) were compared with ESC guideline recommendations, considering patient profiles and cardiologist practice settings (hospital-based vs. private practice).</div></div><div><h3>Results</h3><div>Most patients were classified as NYHA class II (63%), and 45% had reduced LVEF (<40%). The most common etiology was ischemic heart disease (43%). Among patients with reduced LVEF, adherence to ESC guidelines was high: beta-blockers were prescribed to 67%, ARNi to 59%, MRAs to 60%, and SGLT2 inhibitors to 57%. Overall, SGLT2 inhibitors were more frequently used than MRAs (43% vs. 39%) and were widely adopted in patients with LVEF 40–50% (48%), but remained underused in those with preserved LVEF (≥50%) at 38%. SGLT2 inhibitor use was higher in men (45%) and in patients under 80 years of age (47%). There was also relatively consistent prescription of beta-blockers (54–55%) and ARNi (31–32%) between hospital-based and private-practice cardiologists. However, variations remained in other drug classes and among patients with preserved LVEF or complex comorbidities (<span><span>Table 1</span></span>).</div></div><div><h3>Conclusion</h3><div>The REMOTE-HF study illustrates the value of remote monitoring in enhancing adherence to ESC heart failure treatment guidelines, particularly in patients with reduced EF. The increased use of SGLT2 inhibitors marks a significant shift in clinical practice. Nevertheless, the study reveals persistent gaps in care, especially among older patients and those with preserved ejection fraction. These findings underscore the importance of telemonitoring as a lever to standardize therapeutic management and improve outcomes across all care settings.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S42-S43"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.078
F. Ecarnot, C. Bettinger, N. Vionnet, R. Chopard, M.-F. Seronde
Introduction
Heart failure (HF) is a disease whose clinical course is punctuated by highs and lows in an unpredictable pattern, despite recent improvements in therapy, and prognostication is difficult for clinicians.
Objective
We investigated whether the simultaneous presence of both elevated BNP and anemia would improve prediction of one-year mortality compared to the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score, in patients with stable chronic heart failure (CHF).
Method
Single-centre, retrospective study. We calculated the MAGGIC score for all patients with stable chronic heart failure, and retrieved additional socio-demographic and medical data from electronic medical records (age, sex, left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP) levels, anemia, comorbidities) for all patients being followed for CHF.
Results
From 17 July 2005 to 19 October 2020, 981 patients were included, mean age 62.9 ± 13.0 years, 734 (74.8%) men. Mean LVEF was 34.3 ± 12.3%. Median MAGGIC score was 21 (Q1-Q3, 16-26). Overall, 295 patients (29.6%) had elevated BNP, 295 patients (29.7%) had anemia, and 117 patients (11.9%) had both. Over 1-year follow-up, 74 patients (7.5%, 95%CI, 5.9–9.3%) died, median time to death was 169.5 days [Q1–Q3, 72–256]. By multivariable analysis, we identified a 2.33-fold increased risk (95% CI, 1.82-3.00) of 1-year mortality in patients with both elevated BNP level and anemia. Cumulative adjusted 1-year mortality was 2.3% (95% CI, 2.16–2.76) for non-BNP/no-anemia patients and 14.5% (95% CI, 13.7–11.0) (P < 0.001) for patients with both elevated BNP and anemia (Fig. 1). The addition of BNP and anemia on top of MAGGIC score improved global model fit, with significant improvement in risk classification.
Conclusion
These results suggest that the association of both elevated BNP and anemia on top of the MAGGIC score identifies CHF patients with a higher risk of mortality. This could assist providers in potentially adjusting HF management, in a framework of shared decision-making with individual patients.
{"title":"Presence of both elevated brain natriuretic peptide level and anemia is highly predictive of one-year mortality in stable chronic heart failure: Results from a single center cohort analysis","authors":"F. Ecarnot, C. Bettinger, N. Vionnet, R. Chopard, M.-F. Seronde","doi":"10.1016/j.acvd.2025.10.078","DOIUrl":"10.1016/j.acvd.2025.10.078","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a disease whose clinical course is punctuated by highs and lows in an unpredictable pattern, despite recent improvements in therapy, and prognostication is difficult for clinicians.</div></div><div><h3>Objective</h3><div>We investigated whether the simultaneous presence of both elevated BNP and anemia would improve prediction of one-year mortality compared to the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score, in patients with stable chronic heart failure (CHF).</div></div><div><h3>Method</h3><div>Single-centre, retrospective study. We calculated the MAGGIC score for all patients with stable chronic heart failure, and retrieved additional socio-demographic and medical data from electronic medical records (age, sex, left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP) levels, anemia, comorbidities) for all patients being followed for CHF.</div></div><div><h3>Results</h3><div>From 17 July 2005 to 19 October 2020, 981 patients were included, mean age 62.9<!--> <!-->±<!--> <!-->13.0 years, 734 (74.8%) men. Mean LVEF was 34.3<!--> <!-->±<!--> <!-->12.3%. Median MAGGIC score was 21 (Q1-Q3, 16-26). Overall, 295 patients (29.6%) had elevated BNP, 295 patients (29.7%) had anemia, and 117 patients (11.9%) had both. Over 1-year follow-up, 74 patients (7.5%, 95%CI, 5.9–9.3%) died, median time to death was 169.5 days [Q1–Q3, 72–256]. By multivariable analysis, we identified a 2.33-fold increased risk (95% CI, 1.82-3.00) of 1-year mortality in patients with both elevated BNP level and anemia. Cumulative adjusted 1-year mortality was 2.3% (95% CI, 2.16–2.76) for non-BNP/no-anemia patients and 14.5% (95% CI, 13.7–11.0) (<em>P</em> <!--><<!--> <!-->0.001) for patients with both elevated BNP and anemia (<span><span>Fig. 1</span></span>). The addition of BNP and anemia on top of MAGGIC score improved global model fit, with significant improvement in risk classification.</div></div><div><h3>Conclusion</h3><div>These results suggest that the association of both elevated BNP and anemia on top of the MAGGIC score identifies CHF patients with a higher risk of mortality. This could assist providers in potentially adjusting HF management, in a framework of shared decision-making with individual patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Page S45"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.032
E. Ben Brahim , S. Chenik , A. Haggui , N. Hajlaoui , W. Fehri
Introduction
Ramadan fasting introduces changes in dietary and medication routines that may impact the stability of the international normalized ratio (INR) in patients treated with vitamin K antagonists (VKA).
Objective
This study aims to evaluate the impact of Ramadan fasting on INR levels in patients on VKA therapy, comparing outcomes between fasting and non-fasting individuals to assess whether fasting necessitates enhanced monitoring or dosage adjustments.
Method
A retrospective analytical study was conducted at the Military Hospital of Tunis during Ramadan 2025. Medical records of 43 patients under VKA therapy were reviewed (17 fasting, 26 non-fasting). INR values, thromboembolic and hemorrhagic events, treatment adherence, and timing of anticoagulant intake were analyzed before and during Ramadan.
Results
The study included a total of 43 patients receiving oral anticoagulant therapy with vitamin K antagonists (VKA), divided into fasting (39%) and non-fasting (61%) groups.
A significant difference was observed (P = 0.0038) between the two groups. Fasting patients had significantly lower INR levels compared to non-fasting patients (Table 1).
Conclusion
Ramadan fasting is associated with a significant increase in subtherapeutic INR levels in fasting patients on VKA therapy, suggesting a heightened risk of thromboembolic events. Non-fasting patients exhibited relatively stable INR control. These findings underscore the importance of individualized monitoring and dosage management during Ramadan to ensure therapeutic safety in anticoagulated patients.
{"title":"Ramadan fasting and INR fluctuations","authors":"E. Ben Brahim , S. Chenik , A. Haggui , N. Hajlaoui , W. Fehri","doi":"10.1016/j.acvd.2025.10.032","DOIUrl":"10.1016/j.acvd.2025.10.032","url":null,"abstract":"<div><h3>Introduction</h3><div>Ramadan fasting introduces changes in dietary and medication routines that may impact the stability of the international normalized ratio (INR) in patients treated with vitamin K antagonists (VKA).</div></div><div><h3>Objective</h3><div>This study aims to evaluate the impact of Ramadan fasting on INR levels in patients on VKA therapy, comparing outcomes between fasting and non-fasting individuals to assess whether fasting necessitates enhanced monitoring or dosage adjustments.</div></div><div><h3>Method</h3><div>A retrospective analytical study was conducted at the Military Hospital of Tunis during Ramadan 2025. Medical records of 43 patients under VKA therapy were reviewed (17 fasting, 26 non-fasting). INR values, thromboembolic and hemorrhagic events, treatment adherence, and timing of anticoagulant intake were analyzed before and during Ramadan.</div></div><div><h3>Results</h3><div>The study included a total of 43 patients receiving oral anticoagulant therapy with vitamin K antagonists (VKA), divided into fasting (39%) and non-fasting (61%) groups.</div><div>A significant difference was observed (<em>P</em> <!-->=<!--> <!-->0.0038) between the two groups. Fasting patients had significantly lower INR levels compared to non-fasting patients (<span><span>Table 1</span></span>).</div></div><div><h3>Conclusion</h3><div>Ramadan fasting is associated with a significant increase in subtherapeutic INR levels in fasting patients on VKA therapy, suggesting a heightened risk of thromboembolic events. Non-fasting patients exhibited relatively stable INR control. These findings underscore the importance of individualized monitoring and dosage management during Ramadan to ensure therapeutic safety in anticoagulated patients.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S20-S21"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.acvd.2025.10.024
A. Oancea, M. Floria
Introduction
Chronic ischemic heart disease and atrial fibrillation (AF) are prevalent cardiovascular conditions, between whom there is a dual relationship, with significant morbidity and mortality. Recent studies have highlighted the roles of galectin-3 (Gal3) and pentraxin-3 (PTX3), as potential biomarkers in atherosclerosis, yet their specific interactions and implications in patients with chronic coronary syndrome (CCS) and AF remain underexplored.
Objective
This study aimed to evaluate the levels of Gal3 and PTX3 in a cohort of patients with CCS and AF, assessing their association with disease severity and clinical outcomes.
Method
A total of 131 patients diagnosed with CCS or/and AF were stratified based on coronary stenosis severity (significant, S-CCS: defined as stenosis ≥ 70% for one of the coronary arteries, except for left main where stenosis ≥ 50%) and non-significant, N-CCS coronary lesions: defined as stenosis < 70% for one of the coronary arteries, except for left main where stenosis < 50%) and arrhythmia burden. Blood samples were collected to measure serum levels of galectin-3 and pentraxin-3 using enzyme-linked immunosorbent assay (ELISA) techniques. Clinical data, including demographic information, comorbidities, medication use and biological markers of systemic inflammation, were recorded.
Results
The galectin-3 value was more than double in patients with S-CCS compared to those with N-CCS (17.39 ± 4.459 ng/mL versus 7.49 ± 2.732 ng/mL, P < 0.001). Atrial fibrillation was not associated with statistically significant variations in galectin-3 values, neither overall nor separately in the group of S-CCS or N-CCS. However, pentraxin-3 values, were similar in S-CCS compared to those with N-CCS (2839.18 ± 1521.639 pg/mL versus 2564.07 ± 1299.055 pg/mL, P = 0.417). These values were lower in patients with sinus rhythm, with a mean of 2469.91 ± 1253.782 pg/mL and steadily increase in those with paroxysmal, persistent and permanent AF, for whom they reach a mean of 3162.87 ± 1893.068 pg/mL. The results are detailed in Table 1.
Conclusion
Elevated levels of galectin-3 appear to correlate with coronary stenosis severity and may inform future strategies for risk stratification, patients’ selection for invasive coronarography or therapeutic targeting in CCS.
慢性缺血性心脏病和心房颤动（AF）是常见的心血管疾病，两者之间存在双重关系，具有显著的发病率和死亡率。最近的研究强调了半乳糖凝集素-3 （Gal3）和pentaxin -3 （PTX3）作为动脉粥样硬化的潜在生物标志物的作用，但它们在慢性冠状动脉综合征（CCS）和房颤患者中的具体相互作用和意义仍未得到充分探讨。目的：本研究旨在评估CCS和房颤患者队列中Gal3和PTX3的水平，评估其与疾病严重程度和临床结局的关系。方法根据冠状动脉狭窄严重程度（显著，S-CCS：定义为其中一条冠状动脉狭窄≥70%，除左主干狭窄≥50%）和非显著，N-CCS冠状动脉病变：定义为其中一条冠状动脉狭窄≥70%，除左主干狭窄≥50%)和心律失常负担对131例确诊为CCS或/和房颤的患者进行分层。采集血样，采用酶联免疫吸附测定（ELISA）技术测定血清半乳糖凝集素-3和戊曲辛-3水平。记录临床数据，包括人口统计信息、合并症、药物使用和全身性炎症的生物标志物。结果S-CCS患者的半凝集素-3值是N-CCS患者的两倍多（17.39±4.459 ng/mL vs 7.49±2.732 ng/mL, P < 0.001）。在S-CCS或N-CCS组中，心房颤动与半凝集素-3值的总体或单独变化均无统计学意义。然而，与N-CCS相比，S-CCS组的pentaxin -3值相似（2839.18±1521.639 pg/mL vs . 2564.07±1299.055 pg/mL, P = 0.417）。这些数值在窦性心律患者中较低，平均为2469.91±1253.782 pg/mL，在阵发性、持续性和永久性房颤患者中稳步上升，平均达到3162.87±1893.068 pg/mL。结果详见表1。结论：半乳糖凝集素-3水平升高似乎与冠状动脉狭窄严重程度相关，并可能为未来的风险分层策略、有创冠状动脉造影患者的选择或CCS的治疗靶向提供信息。
{"title":"Biomarker insights: Galectin-3 and pentraxin-3 in chronic ischemic heart disease and atrial fibrillation","authors":"A. Oancea, M. Floria","doi":"10.1016/j.acvd.2025.10.024","DOIUrl":"10.1016/j.acvd.2025.10.024","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic ischemic heart disease and atrial fibrillation (AF) are prevalent cardiovascular conditions, between whom there is a dual relationship, with significant morbidity and mortality. Recent studies have highlighted the roles of galectin-3 (Gal3) and pentraxin-3 (PTX3), as potential biomarkers in atherosclerosis, yet their specific interactions and implications in patients with chronic coronary syndrome (CCS) and AF remain underexplored.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the levels of Gal3 and PTX3 in a cohort of patients with CCS and AF, assessing their association with disease severity and clinical outcomes.</div></div><div><h3>Method</h3><div>A total of 131 patients diagnosed with CCS or/and AF were stratified based on coronary stenosis severity (significant, S-CCS: defined as stenosis<!--> <!-->≥<!--> <!-->70% for one of the coronary arteries, except for left main where stenosis<!--> <!-->≥<!--> <!-->50%) and non-significant, N-CCS coronary lesions: defined as stenosis<!--> <!--><<!--> <!-->70% for one of the coronary arteries, except for left main where stenosis<!--> <!--><<!--> <!-->50%) and arrhythmia burden. Blood samples were collected to measure serum levels of galectin-3 and pentraxin-3 using enzyme-linked immunosorbent assay (ELISA) techniques. Clinical data, including demographic information, comorbidities, medication use and biological markers of systemic inflammation, were recorded.</div></div><div><h3>Results</h3><div>The galectin-3 value was more than double in patients with S-CCS compared to those with N-CCS (17.39 <!--> <!-->±<!--> <!-->4.459<!--> <!-->ng/mL versus 7.49<!--> <!-->±<!--> <!-->2.732<!--> <!-->ng/mL, <em>P</em> <!--><<!--> <!-->0.001). Atrial fibrillation was not associated with statistically significant variations in galectin-3 values, neither overall nor separately in the group of S-CCS or N-CCS. However, pentraxin-3 values, were similar in S-CCS compared to those with N-CCS (2839.18<!--> <!-->±<!--> <!-->1521.639<!--> <!-->pg/mL versus 2564.07<!--> <!-->±<!--> <!-->1299.055<!--> <!-->pg/mL, <em>P</em> <!-->=<!--> <!-->0.417). These values were lower in patients with sinus rhythm, with a mean of 2469.91<!--> <!-->±<!--> <!-->1253.782<!--> <!-->pg/mL and steadily increase in those with paroxysmal, persistent and permanent AF, for whom they reach a mean of 3162.87<!--> <!-->±<!--> <!-->1893.068<!--> <!-->pg/mL. The results are detailed in <span><span>Table 1</span></span>.</div></div><div><h3>Conclusion</h3><div>Elevated levels of galectin-3 appear to correlate with coronary stenosis severity and may inform future strategies for risk stratification, patients’ selection for invasive coronarography or therapeutic targeting in CCS.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"119 1","pages":"Pages S16-S17"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Information on treatment persistence and tolerability of sacubitril/valsartan (S/V) in elderly patients with heart failure (HF) is limited.
Aims: To evaluate treatment persistence, adherence and safety-related events in patients with HF treated with S/V, and to compare outcomes in subgroups of patients younger and older than 75 years.
Methods: This observational study was performed using the French national healthcare claims database. All patients who started S/V between April 2015 and December 2020 were eligible and were followed until 31 December 2020 or death. All deliveries of medication were documented. Persistence was defined as the interval between the first delivery and permanent discontinuation. Adherence was defined as the proportion of days covered (PDC). Adverse events of special interest (AESIs) were hospitalizations for hypotension, acute renal failure, hyperkalaemia or angioedema. All-cause mortality was documented.
Results: A total of 104,910 patients were enrolled, including 44,743 (42.6%) aged ≥75 years. Median (interquartile range [IQR]) follow-up duration was 18.1 (8.5-30.1) months. Twelve-month persistence rates (95% confidence intervals) were 83.0% (82.7-83.2) overall, 86.0% (85.7-86.3) in patients aged <75 years and 78.7% (78.3-79.1) in patients aged ≥75 years. The median (IQR) PDC was 0.90 (0.82-0.96), with no significant difference between the two age groups. Hospitalizations with AESIs were documented in 20,624 patients (19.7%), were more frequent in patients aged ≥75 years (22.8%) than in younger patients (17.3%) and were associated with concomitant discontinuation of S/V in 3408 patients (3.2%; <75 years: 2.3%; ≥75 years: 4.0%).
Conclusions: S/V can be considered a suitable treatment option for patients aged ≥ 75 years with HF.
{"title":"Real-world persistence with sacubitril/valsartan in patients with heart failure in France: A claims database study.","authors":"Olivier Hanon, Ariel Cohen, Patrick Jourdain, Emmanuelle Leray, Gérard de Pouvourville, Mélanie Goguillot, Géraldine Hugon, Ribal Al-Mawla, Stéphanie Duret, Damien Logeart","doi":"10.1016/j.acvd.2025.11.010","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.11.010","url":null,"abstract":"<p><strong>Background: </strong>Information on treatment persistence and tolerability of sacubitril/valsartan (S/V) in elderly patients with heart failure (HF) is limited.</p><p><strong>Aims: </strong>To evaluate treatment persistence, adherence and safety-related events in patients with HF treated with S/V, and to compare outcomes in subgroups of patients younger and older than 75 years.</p><p><strong>Methods: </strong>This observational study was performed using the French national healthcare claims database. All patients who started S/V between April 2015 and December 2020 were eligible and were followed until 31 December 2020 or death. All deliveries of medication were documented. Persistence was defined as the interval between the first delivery and permanent discontinuation. Adherence was defined as the proportion of days covered (PDC). Adverse events of special interest (AESIs) were hospitalizations for hypotension, acute renal failure, hyperkalaemia or angioedema. All-cause mortality was documented.</p><p><strong>Results: </strong>A total of 104,910 patients were enrolled, including 44,743 (42.6%) aged ≥75 years. Median (interquartile range [IQR]) follow-up duration was 18.1 (8.5-30.1) months. Twelve-month persistence rates (95% confidence intervals) were 83.0% (82.7-83.2) overall, 86.0% (85.7-86.3) in patients aged <75 years and 78.7% (78.3-79.1) in patients aged ≥75 years. The median (IQR) PDC was 0.90 (0.82-0.96), with no significant difference between the two age groups. Hospitalizations with AESIs were documented in 20,624 patients (19.7%), were more frequent in patients aged ≥75 years (22.8%) than in younger patients (17.3%) and were associated with concomitant discontinuation of S/V in 3408 patients (3.2%; <75 years: 2.3%; ≥75 years: 4.0%).</p><p><strong>Conclusions: </strong>S/V can be considered a suitable treatment option for patients aged ≥ 75 years with HF.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.acvd.2025.11.009
Erwan Donal, Christophe Tribouilloy, Anne Bernard, Augustin Coisne, Bernard Iung
{"title":"French perspectives on the 2025 ESC/EACTS guidelines for valvular heart disease.","authors":"Erwan Donal, Christophe Tribouilloy, Anne Bernard, Augustin Coisne, Bernard Iung","doi":"10.1016/j.acvd.2025.11.009","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.11.009","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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