American heart journal plus : cardiology research and practice最新文献

{"title":"Corrigendum to “The controversies in the clinical management of β-blockers in acute heart failure induced by rapid atrial fibrillation: A narrative review” [AHJO_100655]","authors":"Wenfang Zhu, Jinpeng Xu, Liang Zhang","doi":"10.1016/j.ahjo.2025.100711","DOIUrl":"10.1016/j.ahjo.2025.100711","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100711"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experience of people with hypertension in Ethiopia: A phenomenological study, 2025","authors":"Ousman Adal ,&nbsp;Mekides Misganaw ,&nbsp;Asnake Gashaw Belayneh ,&nbsp;Destaw Endeshaw ,&nbsp;Abebu Tegenaw Delie ,&nbsp;Yeshimebet Tamir Tsehay ,&nbsp;Tadele Fentabel Anagaw ,&nbsp;Eyob Ketema Bogale","doi":"10.1016/j.ahjo.2026.100729","DOIUrl":"10.1016/j.ahjo.2026.100729","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension poses a substantial and growing public health challenge in Ethiopia. Despite its increasing prevalence, significant knowledge gaps remain regarding how patients experience and manage the condition within their social, cultural, and economic contexts. This study aimed to explore the lived experiences of patients with hypertension in Ethiopia using a qualitative approach, contributing to improved understanding and supporting sustainable, equitable, and patient-centered care.</div></div><div><h3>Methods</h3><div>Data were collected from adults living with hypertension who were receiving treatment in tertiary hospitals in northwest Amhara, Ethiopia, in July 2025. Participants were selected using purposive and heterogeneous sampling to include both males and females across all age groups above 18 years. Data were collected in the local language (Amharic), translated into English, and imported into ATLAS.ti v7 for coding and analysis. A thematic analysis was conducted, and rigor was ensured by considering credibility, dependability, confirmability, and transferability.</div></div><div><h3>Results</h3><div>Eight themes emerged from the analysis: (1) emotional and cognitive responses to diagnosis; (2) health provider interaction and communication; (3) adaptation and self-management; (4) treatment challenges and complications; (5) social and family support; (6) impact on daily life; (7) perception and control of hypertension; and (8) healthcare system and access barriers. Participants highlighted the importance of tailored patient education, effective provider communication, and community engagement for improving adherence and health outcomes. While most participants accepted their condition calmly, prior knowledge and interactions with healthcare providers shaped understanding and coping strategies. Adaptation included lifestyle modification, dietary adherence, and treatment compliance, with some challenges such as transportation issues, medication shortages, and long waiting times noted.</div></div><div><h3>Conclusion</h3><div>Understanding patients lived experiences provides insights for designing culturally appropriate interventions, improving adherence, and enhancing overall management of hypertension in Ethiopia.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"63 ","pages":"Article 100729"},"PeriodicalIF":1.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease is associated with worse survival after revascularization in subjects with genetically diagnosed familial hypercholesterolemia and significant coronary artery disease","authors":"Kae-Woei Liang ,&nbsp;Han-Ni Chuang ,&nbsp;Li-Chin Liao ,&nbsp;Tzu-Hung Hsiao ,&nbsp;Wayne H.-H. Sheu ,&nbsp;Hsin Tung","doi":"10.1016/j.ahjo.2026.100730","DOIUrl":"10.1016/j.ahjo.2026.100730","url":null,"abstract":"<div><h3>Background</h3><div>Familial hypercholesterolemia (FH) is a genetic disorder associated with elevated low-density lipoprotein cholesterol (LDL-C) and coronary artery disease (CAD). Few studies have reported survival data and the associated factors in FH patients with significant CAD after revascularization.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 79 genetically confirmed FH who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in a single medical center. Genetic variants for FH were identified by next-generation sequencing. A logistic regression was performed to find the associated factors for choosing CABG revascularization. The Kaplan-Meier equation and the stratified survival curve with log-rank testing were depicted for significant associated factors for survival.</div></div><div><h3>Results</h3><div>There were 62 men (78.5%) and 17 women (21.5%) in this study. Twenty-three (29.1%) underwent CABG and 56 (70.9%) received only PCI. Logistic regression revealed that a higher LDL-C record and a higher coronary Jeopardy score were associated with CABG revascularization. The median duration of follow-up was 61 months after revascularization and 11 patients (13.9%) died. The cumulative survival at 5 years was 88.5%. The deceased patients had significantly lower estimated glomerular filtration rate (eGFR) (62.3 ± 18.6 vs. 81.2 ± 21.2 ml/min/1.73 m², <em>p</em> = 0.007) and a higher proportion with CKD (54.5% vs. 14.7%, p = 0.007). The Kaplan-Meier equation with log-rank testing (<em>p</em> = 0.018) showed that subjects with chronic kidney disease (CKD) had worse survival.</div></div><div><h3>Conclusions</h3><div>A higher LDL-C and coronary severity score were associated with CABG revascularization. Chronic kidney disease and lower eGFR were associated with worse survival in subjects with FH and CAD after revascularization.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"63 ","pages":"Article 100730"},"PeriodicalIF":1.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of health and hospitalization risk in heart failure: A Retrospective analysis","authors":"Alisha A. Crump ,&nbsp;Milan Bimali ,&nbsp;Sanchia McCall ,&nbsp;Pearman Parker ,&nbsp;Taren Massey-Swindle ,&nbsp;Kevin Wayne Sexton ,&nbsp;Emel Seker ,&nbsp;Maryam Y. Garza ,&nbsp;Tremaine B. Williams","doi":"10.1016/j.ahjo.2026.100731","DOIUrl":"10.1016/j.ahjo.2026.100731","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure affects over 6.5 million Americans and accounts for substantial healthcare utilization, with social determinants of health (SDOH) increasingly recognized as critical factors influencing patient outcomes. The present study aims to examine the relationships among specific SDOH (food insecurity risk, financial resource strain, and medical transportation needs) with subsequent hospitalization risk among patients with heart failure.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study analyzed electronic health record data from the Arkansas Clinical Data Repository for 2494 patients with heart failure hospitalized between January 2014 and December 2023 at the University of Arkansas for Medical Sciences. Quantile regression on the median was used to analyze the data.</div></div><div><h3>Results</h3><div>Study population descriptive results demonstrated moderate hospitalization risk (average score 40.3). The population was predominantly older adults (mean age ∼ 65), female (55.8%), non-Hispanic (98.3%) and White (54.3%). In fully adjusted models, all three social determinants remained significant predictors of increased subsequent hospitalization risk: food insecurity was associated with a 9.37-point increase (95% CI: 4.83–13.90, <em>p</em> &lt; 0.01), high financial resource strain with a 13.13-point increase (95% CI: 8.50–17.76, p &lt; 0.01), and medical transportation needs with a 13.23-point increase (95% CI: 7.55–18.89, p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Food insecurity risk, financial resource strain, and medical transportation needs are associated with increased future hospitalization risk among patients with heart failure. These findings support the integration of social determinant screening into clinical risk stratification and the development of targeted interventions addressing these modifiable social factors to potentially reduce healthcare utilization and improve outcomes for vulnerable populations with heart failure.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"63 ","pages":"Article 100731"},"PeriodicalIF":1.8,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of nutritional status on outcome of patients of acute coronary syndrome","authors":"Bashir Ahmed Joy ,&nbsp;Md. Fakhrul Islam Khaled ,&nbsp;Deepta Majumder ,&nbsp;Sujoy Kumar Saha ,&nbsp;Saleha Salahuddin Asha ,&nbsp;Ariful Islam Joarder ,&nbsp;Dipal Krishna Adhikary ,&nbsp;Sheikh Ahmedul Haque ,&nbsp;Md. Monir Hossain Shimul","doi":"10.1016/j.ahjo.2026.100725","DOIUrl":"10.1016/j.ahjo.2026.100725","url":null,"abstract":"<div><h3>Background</h3><div>Acute Coronary Syndrome (ACS) remains a leading cause of mortality in Bangladesh, where malnutrition is prevalent but often overlooked in clinical care. Malnourished ACS patients may experience worse outcomes, yet nutritional assessment is rarely routine. This study evaluates the impact of nutritional status on short-term outcomes using CONUT scoring.</div></div><div><h3>Methods</h3><div>This prospective cohort study was conducted at the Department of Cardiology, Bangladesh Medical University, Dhaka, Bangladesh, over 18 months. A total of 100 adult ACS patients were included in the final analysis and stratified into nutritional status categories using the Controlling Nutritional Status (CONUT) scoring system. Key outcomes included in-hospital mortality and length of stay. Statistical analyses were performed using SPSS version 29.0.2.0, employing ANOVA, Fisher's exact test, and regression models to examine associations between nutritional status and clinical outcomes.</div></div><div><h3>Results</h3><div>Among the patients, 43% had mild malnutrition, 24% had moderate malnutrition, and 33% had no malnutrition. Nutritional status was significantly associated with both duration of hospital stay (<em>p</em> &lt; .001) and mortality (<em>p</em> = .003). Patients with moderate malnutrition had significantly longer hospital stays (β = 4.388, <em>p</em> &lt; .001) and higher mortality odds (β = 0.167, p &lt; .001) compared to those without malnutrition.</div></div><div><h3>Conclusion</h3><div>Nutritional status, particularly moderate malnutrition as assessed by CONUT scoring, is a significant predictor of adverse clinical outcomes in ACS patients. Integrating nutritional assessment in ACS management protocols may improve prognosis and reduce healthcare burdens.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100725"},"PeriodicalIF":1.8,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulants for the prevention and treatment of venous thromboembolism in humans exposed to microgravity: A hybrid systematic and narrative review","authors":"Adele Watfa ,&nbsp;Arwa Younis ,&nbsp;Andrew Winnard-Brewer ,&nbsp;Katie M. Greenlee ,&nbsp;Julia Ferrin ,&nbsp;Niraj Varma ,&nbsp;Jerry G. Myers Jr. ,&nbsp;Virginia Wotring ,&nbsp;Kenneth A. Mayuga","doi":"10.1016/j.ahjo.2026.100724","DOIUrl":"10.1016/j.ahjo.2026.100724","url":null,"abstract":"<div><h3>Importance</h3><div>Microgravity induces physiological changes that may predispose astronauts to venous thromboembolism (VTE), yet no studies have directly evaluated the safety or efficacy of anticoagulation in this environment.</div></div><div><h3>Objective</h3><div>To perform a systematic review of anticoagulant use for VTE prevention and treatment in microgravity-exposed individuals and, in the absence of eligible studies, to synthesize existing physiologic and terrestrial evidence relevant to VTE risk and thromboprophylaxis.</div></div><div><h3>Methods</h3><div>A comprehensive search of 13 biomedical and aerospace databases (MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, CINAHL, NASA Technical Reports Server, ESA archives, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, NASA Life Sciences Data Archive, ISS Publications Archive, DLR database, NASA SS Research Database) was performed following PRISMA guidelines. Eligible studies included astronauts or individuals in microgravity analogs receiving pharmacologic anticoagulation for VTE prevention or treatment.</div></div><div><h3>Results</h3><div>The search yielded zero studies meeting predefined PICOS criteria. To contextualize this absence of evidence, we synthesized key physiologic findings from microgravity and ground-based analog studies demonstrating venous stasis, endothelial dysfunction, increased fibrinogen synthesis, altered platelet function, and hypercoagulability.</div></div><div><h3>Conclusions and relevance</h3><div>VTE appears rare in spaceflight, but the absence of direct evidence on anticoagulation underscores a critical research gap. Further studies are needed to evaluate anticoagulant safety and efficacy in microgravity, adapt risk assessment tools, and develop evidence-based protocols to safeguard astronaut health.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100724"},"PeriodicalIF":1.8,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer therapy-associated Takotsubo cardiomyopathy: A narrative review of mechanisms, drug associations, and clinical implications","authors":"Michael Simeon ,&nbsp;Elizabeth Evans ,&nbsp;Sally Arif ,&nbsp;Thomas Granado ,&nbsp;Tochukwu M. Okwuosa ,&nbsp;Annabelle Santos Volgman ,&nbsp;Salaheldin Abusin","doi":"10.1016/j.ahjo.2026.100723","DOIUrl":"10.1016/j.ahjo.2026.100723","url":null,"abstract":"<div><div>Anticancer therapies have been increasingly associated with Takotsubo cardiomyopathy (TTC). As prior reports remain fragmented across case studies and drug-specific reviews, this paper offers one of the most comprehensive reviews to date of cancer therapy-associated TTC. While classically triggered by emotional or physical stress, TTC has been increasingly associated with chemotherapy and other cancer-directed therapies. This literature review explores the pathophysiology, clinical features, and evolving evidence linking anticancer agents to TTC, with a focus on cytotoxic cancer therapy, hormonal therapy, targeted treatments, and immune checkpoint inhibitors.</div><div>We describe the proposed mechanisms of cancer therapy-associated TTC, the diagnostic challenges, particularly in patients with cancer, and the complex management strategies, especially regarding the decision to resume oncologic treatment after TTC recovery.</div><div>Given the increasing use of cardiotoxic agents, a multidisciplinary approach to cardio-oncology care among patients with suspected TTC is crucial. More research is needed to understand the role of TTC in cardiac dysfunction among patients with cancer, clarify risk stratification methods, and improve outcomes for patients at risk of TTC during cancer treatment.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"63 ","pages":"Article 100723"},"PeriodicalIF":1.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 inhibitor therapy and clinical outcomes in HIV-related cardiomyopathy","authors":"Hesham Sheashaa ,&nbsp;Ramzi Ibrahim ,&nbsp;Hoang Nhat Pham ,&nbsp;Kamal Awad ,&nbsp;Isabel G. Scalia ,&nbsp;Juan M. Farina ,&nbsp;Balaji Tamarappoo ,&nbsp;Cameron Holloway ,&nbsp;Reza Arsanjani ,&nbsp;Chadi Ayoub","doi":"10.1016/j.ahjo.2026.100722","DOIUrl":"10.1016/j.ahjo.2026.100722","url":null,"abstract":"<div><h3>Background</h3><div>HIV cardiomyopathy (HIV-CM) is associated with significant morbidity and mortality. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have benefits in heart failure (HF), but their role in the specialized population of HIV-CM is poorly understood.</div></div><div><h3>Methods</h3><div>Patients in the TriNetX Network with HIV-CM and SGLT2i therapy were compared to a propensity matched control group of patients with HIV-CM without SGLT2i use. The primary endpoint was all-cause mortality, secondary endpoints included all-cause hospitalizations, acute HF, stroke, acute myocardial infarction (MI), cardiac arrest, atrial fibrillation and ventricular tachycardia.</div></div><div><h3>Results</h3><div>In the total of 2606 included patients, SGLT2i therapy was associated with significant reduction in all-cause mortality (HR 0.475, 95%CI 0.337–0.671), all-cause hospitalization (HR 0.725, 95%CI 0.646–0.814). No significant differences were observed in the individual outcomes of acute HF, MI, stroke, or cardiac arrest.</div></div><div><h3>Conclusion</h3><div>SGLT2i use was associated with significant reductions in all-cause mortality and hospitalizations in patients with HIV-CM.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100722"},"PeriodicalIF":1.8,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in transcatheter aortic valve replacement: A contemporary nationwide analysis","authors":"Charley Sun ,&nbsp;Michael Zhu ,&nbsp;Daniel McGrath ,&nbsp;Patrick Warner ,&nbsp;Michael Dacey ,&nbsp;Benjamin Wessler ,&nbsp;Yong Zhan","doi":"10.1016/j.ahjo.2026.100720","DOIUrl":"10.1016/j.ahjo.2026.100720","url":null,"abstract":"<div><h3>Background</h3><div>Racial disparities have been reported in the management of cardiovascular diseases. Transcatheter aortic valve replacement (TAVR) volume continues to increase with evolving indications and practice changes.</div></div><div><h3>Objectives</h3><div>This study aims to provide insight regarding procedure access and outcomes to evaluate for potential racial disparities in the contemporary era of TAVR.</div></div><div><h3>Methods</h3><div>TAVR patients (aged ≥18) were identified in the National Inpatient Sample from 2016 to 2019 and grouped by race. Baseline characteristics and in-hospital outcomes were compared between White and non-White patients before and after propensity-score matching. Primary outcomes were in-hospital mortality and a composite outcome. The individual components of the composite outcome served as secondary outcomes.</div></div><div><h3>Results</h3><div>Of 42,877 total TAVR patients, 37,319 were White and 5558 were non-White. Annual procedure volume in both groups increased significantly (<em>Ptrend</em> &lt; 0.001 for both). The proportions of White and non-White patients remained steady over time (12.5%–13.5% non-White, <em>Ptrend</em> = 0.117). The characteristics of White and non-White patients differed significantly. There was no difference in in-hospital mortality (1.5% vs 1.6%, <em>P</em> <em>=</em> 0.585) or composite outcome (23.8% vs 24.6%, <em>P</em> <em>=</em> 0.316). Non-White race was associated with higher rates of acute renal failure (odds ratio [OR]:1.21, 95% confidence interval [CI]:1.10–1.33, <em>P</em> <em>&lt;</em> 0.001), transfusion (OR:1.18, 95%CI:1.05–1.32, <em>P</em> <em>=</em> 0.006), and vascular complications (OR:1.62, 95%CI:1.29–2.04, <em>P</em> <em>&lt;</em> 0.001), but lower rates of permanent pacemaker implantation (OR:0.83, 95%CI:0.75–0.93, <em>P</em> <em>=</em> 0.001).</div></div><div><h3>Conclusion</h3><div>TAVR remains safe in both White and non-White patients with comparable in-hospital mortality and overall outcomes. Differences in baseline characteristics and individual complications indicate the presence of racial disparities in procedure accessibility and outcomes.</div><div>Meeting presentation: Presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2024, October 27–30, 2024, Washington D.C.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100720"},"PeriodicalIF":1.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initiation, titration, and safety of vericiguat for treatment of heart failure in United States clinical practice","authors":"Stephen J. Greene ,&nbsp;Alexander Michel ,&nbsp;Coralie Lecomte ,&nbsp;Paolo Manca ,&nbsp;Katsiaryna Holl ,&nbsp;Michele Senni","doi":"10.1016/j.ahjo.2026.100721","DOIUrl":"10.1016/j.ahjo.2026.100721","url":null,"abstract":"<div><h3>Study objective</h3><div>To evaluate the following among new users of vericiguat: up-titration patterns, factors associated with up-titration, occurrence of hypotension/syncope, predictors of hypotension/syncope.</div></div><div><h3>Design</h3><div>Retrospective cohort study (linked claims and electronic health record data).</div></div><div><h3>Setting</h3><div>US clinical practice.</div></div><div><h3>Participants</h3><div>1361 new users of vericiguat.</div></div><div><h3>Interventions</h3><div>N/A.</div></div><div><h3>Main outcome measures</h3><div>Vericiguat starting dose, up-titration patterns and predictors, occurrence and predictors of hypotension/syncope, over a 3-month follow-up period.</div></div><div><h3>Results</h3><div>Among 1361 new users of vericiguat, 770 (57%) initiated a starting dose of 2.5 mg/day, 330 (24%) initiated a dose of 5 mg/day, and 261 (19%) initiated a dose of 10 mg/day. Over 3-month follow-up, the 10 mg target dose was reached by 349 (26%) patients. Among these patients, the median time to reach the 10 mg dose was 60 days among 2.5 mg/day starters, and 41 days among 5 mg/day starters. Among the 2.5 mg starters, 68% had no up-titration. Among patients initiating either the 2.5 mg/day or 5 mg/day dose, a starting dose of 5 mg (vs. 2.5 mg) was the only significant predictor for reaching the 10 mg dose; adjusted hazard ratio 2.89 (95% CI: 1.86, 4.49, <em>p</em> &lt; 0.0001). Overall, 130 patients (9.6%) had a hypotension event and 67 patients (4.9%) had a syncope event. History of hypotension was the strongest independent predictor of hypotension/syncope events (adj. HR 2.85, 95% CI: 1.96, 4.13, <em>p</em> &lt; 0.0001). A &gt; 2.5 mg/day vericiguat starting dose was not associated with the occurrence of hypotension/syncope (vs. 2.5 mg/day); adj. HR 0.82, 95% C.I. (0.58, 1.16).</div></div><div><h3>Conclusion</h3><div>Vericiguat users initiated on the 5 mg/day dose were considerably more likely to reach the target dose of 10 mg/day vs. those started on the recommended 2.5 mg/day dose, without excess risk of hypotension or syncope.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"62 ","pages":"Article 100721"},"PeriodicalIF":1.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}