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

{"title":"Trends in Alzheimer's disease and heart failure-related mortality among older American adults: Insights from the CDC WONDER database","authors":"Yasmeen Shaikh ,&nbsp;Syeda Shahnoor ,&nbsp;Muhammad Ahmed Ali Fahim ,&nbsp;Abdul Moiz Khan ,&nbsp;Tasleem Shaikh ,&nbsp;Abdul Moeed ,&nbsp;Muhammad Sohaib Asghar","doi":"10.1016/j.ahjo.2025.100677","DOIUrl":"10.1016/j.ahjo.2025.100677","url":null,"abstract":"<div><h3>Introduction</h3><div>Alzheimer's disease is one of the leading causes of death among the elderly in the United States with heart failure sharing similar risk factors. This study investigated trends and disparities in Alzheimer's disease mortality among older adults with heart failure from 1999 to 2020 in the United States.</div></div><div><h3>Methods</h3><div>Making use of ICD-10 codes death certificate data from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research database was retrieved for patients aged ≥65 years between 1999 and 2020. Age-adjusted mortality rates (AAMRs), per 100,000 people, and Annual Percentage Change (APCs) with their respective 95 % Confidence Intervals (CI) were also calculated. Data was stratified by year, gender, race and geographical distribution.</div></div><div><h3>Results</h3><div>Alzheimer's disease with coexisting heart failure was responsible for 192,459 deaths between 1999 and 2020. Overall the AAMR increased from 21.32 in 1999 to 24.56 in 2005 (APC: 1.9760*; 95 % CI: 0.6001 to 3.9507) after which a significant decrease to 16.52 by 2013 was observed (APC: −4.9301*; 95 % CI: −6.5209 to −4.0119). AAMRs decreased from this point forward reaching 22.21 in 2020 (APC: 4.1573*; 95 % CI: 3.0373 to 5.7232). Women had higher AAMRs than men (21.57 vs 18.41). Among racial groups, the Non-Hispanic (NH) White (21.62) population had the highest AAMRs followed by NH Black/African American (17.87), Hispanic/Latino (14.3) and NH Asian/Pacific Islander (8.96). Furthermore, AAMRs also varied by census region (West: 24.05; Midwest: 22.83; South: 21.1; Northeast: 13.38). Moreover, nonmetropolitan areas had higher AAMRs compared to metropolitan areas (27.23 vs 19.09). States in the top 90th percentile such as Kentucky, Oklahoma, Washington, North Dakota and Mississippi had AAMRs that were three times higher relative to states in the lower 10th percentile including Nevada, Florida, New York, District of Columbia and Hawaii.</div></div><div><h3>Conclusion</h3><div>Alzheimer's disease mortality with associated heart failure has shown considerable variation in adults ≥65 years. AAMRs were highest in women, NH Whites, residents of the West and nonmetropolitan patient populations. Targeted interventions and a more holistic approach to patient management are essential in achieving favorable outcomes for vulnerable groups moving forward.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100677"},"PeriodicalIF":1.8,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571561","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":"All-cause mortality and cardiovascular outcomes with glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes and heart failure with reduced ejection fraction","authors":"Aravinthan Vignarajah ,&nbsp;Peter Oro ,&nbsp;Joseph El Dahdah ,&nbsp;Nishanthi Vigneswaramoorthy ,&nbsp;Amanda R. Vest ,&nbsp;Gautam Shah","doi":"10.1016/j.ahjo.2025.100676","DOIUrl":"10.1016/j.ahjo.2025.100676","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a popular first-line treatment option in managing Type 2 Diabetes Mellitus (T2DM) with cardiovascular co morbidities. Studies have established the benefit of GLP-1 RAs in improving cardiovascular (CV) outcomes in patients with T2DM. However, the impact of GLP-1 RAs on mortality and cardiovascular outcomes in patients with T2DM and Heart failure with reduced ejection fraction (HFrEF) remains uncertain.</div></div><div><h3>Methods</h3><div>This retrospective cohort study employed an active-comparator new-user design using the TriNetX Research Network database. Patients aged 18 years or older with T2DM and left ventricular ejection fraction of ≤40 % were identified for inclusion. Patients were classified into two groups: GLP-1 RAs users versus dipeptidyl peptidase 4 inhibitor (DPP4i) users. Propensity score matching (1:1) was conducted based on demographics, body mass index, comorbidities, glycated hemoglobin levels, medications and socioeconomic factors resulting in a matched cohort of 26,196 patients. Outcomes analyzed included all-cause mortality, acute myocardial infarction, cerebrovascular accident, and all-cause hospitalization.</div></div><div><h3>Results</h3><div>The GLP-1 RA user group demonstrated a reduced hazard ratio (HR, 95 % confidence interval) over 5 years compared with the DPP4i user group for all-cause mortality (0.62, 0.59–0.66, <em>P</em> &lt; 0.001), all-cause hospitalization (0.71, 0.69–0.73, <em>P</em> &lt; 0.001), acute myocardial infarction (0.87, 0.82–0.92, <em>P</em> &lt; 0.001), heart failure exacerbation (0.83, 0.81–0.86, <em>P</em> &lt; 0.001) and cerebrovascular accidents (0.85, 0.80–0.92, P &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In patients with T2DM and HFrEF, GLP-1 RA therapy shows potential beneficial effects in reducing CV events over 5 years compared to control (DPP4i) group.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100676"},"PeriodicalIF":1.8,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520838","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":"Artificial intelligence enhanced contemporary pulmonary hypertension care","authors":"Pyi Naing ,&nbsp;Gregory M. Scalia ,&nbsp;Dale Murdoch ,&nbsp;Isuru Ranasinghe ,&nbsp;Doug L. Forrester ,&nbsp;Geoff Strange ,&nbsp;David Playford","doi":"10.1016/j.ahjo.2025.100673","DOIUrl":"10.1016/j.ahjo.2025.100673","url":null,"abstract":"<div><div>All-cause pulmonary hypertension (PH) is associated with increased mortality and an enormous public health concern. However, given its complexity, multiple potential etiologies and inherent diagnostic challenges, PH diagnosis may be delayed or missed entirely. Artificial Intelligence (AI) shows potential to provide a simple but multifaceted, personalized approach for early identification of PH. AI-assisted patient triage may help highlight individuals requiring further investigation. Echocardiography may improve the identification of PH due to left heart disease and PH from other causes using a combination of AI systems such as image guidance, auto-measurement, deep phenotyping and smart reporting. Multi-level AI integrating clinical and echocardiographic data has the potential to democratize access to medical care and assist in selecting those most at risk for thorough evaluation at expert centers. In this state-of-the-art review, we discuss how new technology including AI can assist in improving the diagnosis and management of PH.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100673"},"PeriodicalIF":1.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520828","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":"The association of epicardial adipose tissue thickness and human neutrophil lipocalin with mitral annular calcification","authors":"Yeheng Xue ,&nbsp;Xinyi Wang ,&nbsp;Xiaohong Liu ,&nbsp;Qingxue Zhang ,&nbsp;Zhijian Liu ,&nbsp;Bin Leng ,&nbsp;Xiuchang Li","doi":"10.1016/j.ahjo.2025.100672","DOIUrl":"10.1016/j.ahjo.2025.100672","url":null,"abstract":"<div><h3>Study objective</h3><div>Mitral annular calcification (MAC) is significantly associated with coronary artery stenosis and valvular dysfunction. And epicardial adipose tissue (EAT) can secrete inflammatory factors and human neutrophil lipocalin (HNL) are widely used as indicators of inflammation. There is now increasing evidence of a strong link between MAC and the inflammatory response. This study aims to investigate the effects of EAT thickness and HNL in MAC.</div></div><div><h3>Design</h3><div>A cross-sectional approach was used in this study.</div></div><div><h3>Setting</h3><div>The Second Affiliated Hospital of Shandong First Medical University.</div></div><div><h3>Participants</h3><div>The included patients was classified into a calcification group (MAC group) and a control group based on the presence or absence of MAC on echocardiography.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main outcome measures</h3><div>The clinical data, HNL, EAT thickness of the two groups were measured, collected and analyzed. Logistic regression analysis was used to assess the independent risk factors for MAC and the receiver operating characteristic (ROC) curve was plotted to evaluate the effectiveness of EAT thickness and HNL in diagnosing MAC.</div></div><div><h3>Results</h3><div>Patients in the MAC group had significantly higher basal and apical EAT thickness and HNL level than those in the control group. Basal EAT thickness was independently associated with MAC (OR = 2.003, 95 % CI = 1.474–2.721, <em>P</em> &lt; 0.001). The AUC for basal EAT thickness to predict MAC was 0.880.</div></div><div><h3>Conclusion</h3><div>Our data suggest EAT thickness and HNL were significantly associated with MAC, and basal EAT thickness near the right coronary artery was independently associated with MAC and had a high predictive value for MAC.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100672"},"PeriodicalIF":1.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571964","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 sustained adherence to guideline-directed medical therapy on clinical outcomes in older adults with new-onset heart failure with reduced ejection fraction","authors":"Xichong Liu ,&nbsp;Chan Hee J. Choi ,&nbsp;C. William Pike ,&nbsp;Gavin Hui ,&nbsp;Jananee Muralidharan ,&nbsp;Shriram Nallamshetty","doi":"10.1016/j.ahjo.2025.100670","DOIUrl":"10.1016/j.ahjo.2025.100670","url":null,"abstract":"","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100670"},"PeriodicalIF":1.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520391","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":"NF-κB and pulmonary hypertension: Advances in mechanistic research and therapeutic applications","authors":"Menghan Si ,&nbsp;Ye Hu ,&nbsp;Zichong Jin ,&nbsp;Yaqi Mao ,&nbsp;Longli Kang","doi":"10.1016/j.ahjo.2025.100669","DOIUrl":"10.1016/j.ahjo.2025.100669","url":null,"abstract":"<div><div>Pulmonary hypertension (PH) is a severe cardiovascular disorder characterized by pulmonary arterial smooth muscle cells (PASMCs) proliferation and vascular remodeling. The nuclear factor-kappa B (NF-κB) family of transcription factors serves as a central mediator of inflammatory responses and plays a critical role in both innate and adaptive immunity. In recent years, the involvement of NF-κB signaling in PH pathogenesis has attracted growing interest. Accumulating evidence indicates that NF-κB contributes to pulmonary vascular remodeling and right ventricular (RV) dysfunction by modulating inflammatory processes, cell proliferation, and apoptosis. This review systematically summarizes the molecular mechanisms by which NF-κB contributes to PH, emphasizing its cell-specific roles in PASMCs and pulmonary arterial endothelial cells (PAECs), and evaluates the therapeutic potential of NF-κB as a target in PH.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100669"},"PeriodicalIF":1.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520840","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":"Integration of BNP and blood glucose for identifying coronary flow reserve impairment: A cardiovascular–kidney–metabolic perspective","authors":"Kotaro Matsumoto ,&nbsp;Kenichiro Otsuka ,&nbsp;Shunsuke Kagawa ,&nbsp;Hiroki Yamaura ,&nbsp;Tsubasa Miura ,&nbsp;Kazuya Sugioka ,&nbsp;Wataru Saitoh ,&nbsp;Akihiro Okamoto ,&nbsp;Go Kajio ,&nbsp;Naoki Fujisawa ,&nbsp;Tomohiro Yamaguchi ,&nbsp;Takenobu Shimada ,&nbsp;Yusuke Hayashi ,&nbsp;Atsushi Shibata ,&nbsp;Asahiro Ito ,&nbsp;Takanori Yamazaki ,&nbsp;Daiju Fukuda","doi":"10.1016/j.ahjo.2025.100671","DOIUrl":"10.1016/j.ahjo.2025.100671","url":null,"abstract":"<div><div>Cardiovascular-kidney-metabolic (CKM) syndrome may predispose patients to coronary microvascular dysfunction (CMD) through systemic microvascular injury. We investigated the association between CKM risk factors and CMD, focusing on the diagnostic performance of accessible biomarkers. In this exploratory analysis, we retrospectively analyzed 65 patients who underwent invasive coronary physiological assessment with thermodilution-derived coronary flow reserve (CFR) and index of microcirculatory resistance (IMR). Clinical variables included casual blood glucose, B-type natriuretic peptide (BNP), and the urine albumin-to-creatinine ratio (ACR), along with echocardiographic indices of diastolic function. Among the 65 patients, 20 (31 %) had impaired CFR. BNP (AUC = 0.74; 95 % confidence interval, CI, 0.60–0.88) and casual blood glucose (area under the curve, AUC = 0.64; 95 % CI, 0.49–0.80) showed diagnostic accuracy for impaired CFR of &lt;2.0, while ACR improved model performance when combined with BNP or E/e′. The combination of BNP and casual glucose significantly improved diagnostic performance compared with either marker alone (AUC = 0.83 vs. 0.75; 95 % CI, 0.73–0.93; <em>p</em> = 0.03). The elevated BNP (AUC = 0.77, 95 % CI: 0.59–0.95) and higher ACR (AUC = 0.71, 95 % CI: 0.52–0.90) were significantly associated with structural CMD defined as CFR &lt; 2.0 and IMR ≥ 25, whereas casual blood glucose was not. From a CKM perspective, BNP and casual blood glucose were associated with impairment of CFR and may serve as simple, accessible biomarkers for its early detection and risk stratification.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100671"},"PeriodicalIF":1.8,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571965","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":"Left atrial global strain supports left atrial end-diastolic volume as a measure of left atrial function","authors":"Sachiyo Igata ,&nbsp;Dwight Bibby ,&nbsp;Qizhi Fang ,&nbsp;Walter Rasmussen ,&nbsp;Theodore Abraham ,&nbsp;Jeffrey Olgin ,&nbsp;Nelson B. Schiller","doi":"10.1016/j.ahjo.2025.100668","DOIUrl":"10.1016/j.ahjo.2025.100668","url":null,"abstract":"<div><h3>Background</h3><div>Left atrial end-diastolic volume index (LAEDVI), the smallest achieved diastolic volume, strongly predicts cardiovascular events. We hypothesize that echocardiographic left atrial reservoir strain (LASr) parallels LAEDVI, providing an additional measurement of LA function.</div></div><div><h3>Methods</h3><div>We analyzed 133 subjects from the BEAT-AFib study. All subjects were in sinus rhythm when studied and were either deemed at risk for atrial fibrillation (Afib) (At-risk, <em>n</em> = 73) or had a history of Afib (Afib, <em>n</em> = 60). The at-risk group had two or more of the following: age &gt; 65 years, hypertension, diabetes, sleep apnea, BMI ≥ 30 kg/m², stable heart failure, and chronic kidney disease without dialysis. We included 83 normal subjects from our laboratory database. LA volumes were measured from 3-dimensional images. LASr was obtained by 2-dimensional speckle tracking R-R gating method from apical 4- and 2- chamber views.</div></div><div><h3>Results</h3><div>LASr was 38 % in normal, 31 % in at-risk, and 23 % in Afib, (<em>p</em> &lt; 0.01). LAEDVI was 11 mL/m² in normal, 15 mL/m² in at-risk, and 21 mL/m² in Afib (<em>p</em> &lt; 0.01). LASr was associated with LAEDVI (<em>r</em> = −0.684), LAESVI (<em>r</em> = −0.528), LA ejection fraction (<em>r</em> = 0.661), E/e’ ratio medial (<em>r</em> = −0.571) (all <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>LAEDVI are significantly different among normal subjects, those at-risk for Afib development and sinus rhythm with Afib history. LASr paralleled with LAEDVI in its ability to distinguish among these groups indicating that LASr is an additional useful component in evaluating LA function.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100668"},"PeriodicalIF":1.8,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520271","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 diabetes mellitus on one-year outcomes of bioresorbable versus durable polymer drug-eluting stents in patients undergoing percutaneous coronary intervention following rotational atherectomy: Results from a large prospective registry","authors":"Matthew Siano ,&nbsp;Rakhee Makhija ,&nbsp;Neel Patel ,&nbsp;Samantha Sartori ,&nbsp;Serdar Farhan ,&nbsp;David Power ,&nbsp;Yihan Feng ,&nbsp;Wen Chang ,&nbsp;Anton Camaj ,&nbsp;Frank Kalaba ,&nbsp;Vishal Dhulipala ,&nbsp;Keisuke Yasumura ,&nbsp;Roja Thapi ,&nbsp;Pooja Vijay ,&nbsp;Nikito Gurung ,&nbsp;Manish Vinayak ,&nbsp;Amit Hooda ,&nbsp;Parasuram Krishnamoorthy ,&nbsp;Joseph Sweeny ,&nbsp;George Dangas ,&nbsp;Samin Sharma","doi":"10.1016/j.ahjo.2025.100664","DOIUrl":"10.1016/j.ahjo.2025.100664","url":null,"abstract":"<div><h3>Background</h3><div>Patients with diabetes mellitus (DM) have worse outcomes after percutaneous coronary intervention (PCI), even with everolimus-eluting stents (EES). Limited data are available comparing outcomes in DM versus non-DM receiving various bioresorbable polymer (BP) or durable polymer (DP) EES after rotational atherectomy (RA). We aimed to study the impact of DM on outcomes in patients undergoing PCI with BP-EES and DP-EES after RA.</div></div><div><h3>Methods</h3><div>Consecutive patients undergoing PCI with RA between 2014 and 2021 were included. The primary outcome was major adverse cardiac events (MACE), a composite of death, myocardial infarction (MI), or stroke at 1 year, which was stratified according to DM status. Regression analysis was performed to adjust for confounders.</div></div><div><h3>Results</h3><div>Among 2376 patients (mean age 70.3 ± 10.7, 49.5 % DM) that underwent RA, 552 received BP-EES and 1824 received DP-EES. Both groups had similar number of stents implanted and stent diameters; however, the BP-EES group had a higher SYNTAX score and was more likely to have multi-vessel disease and undergo PCI to the left anterior descending, circumflex, and right coronary artery. In both BP-EES and DP-EES groups, there was no significant difference in adjusted risk of MACE (BP-EES: 7.3 % vs. 7.1 %, HR 0.78, 95 % CI 0.35–1.78, <em>P</em> = 0.562 &amp; DP-EES: 7.5 % vs. 3.7 %, HR 1.49, 95 % CI 0.89–2.50, <em>P</em> = 0.130) between diabetics and non-diabetics.</div></div><div><h3>Conclusions</h3><div>Despite differences in baseline characteristics, DM was not associated with worse MACE at one year in patients with complex coronary artery disease undergoing RA and PCI with contemporary BP-EES or DP-EES.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"60 ","pages":"Article 100664"},"PeriodicalIF":1.8,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520272","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":"Patterns and predictors of palliative care use in acute heart failure hospitalizations","authors":"Aimen Shafiq ,&nbsp;Ali Salman ,&nbsp;Sadia Akram ,&nbsp;Muhammad Rizwan Farooq ,&nbsp;Qais Bin Abdul Ghaffar ,&nbsp;Anam Ijaz ,&nbsp;Abdullah Imtiaz ,&nbsp;Humna Irshad ,&nbsp;Aroon Kumar ,&nbsp;Muhammad Faisal Riaz ,&nbsp;Saman Rauf ,&nbsp;Usman Sarwar ,&nbsp;Kaneez Fatima ,&nbsp;Ali Hasan ,&nbsp;Raheel Ahmed","doi":"10.1016/j.ahjo.2025.100667","DOIUrl":"10.1016/j.ahjo.2025.100667","url":null,"abstract":"<div><h3>Background</h3><div>Palliative care consultation (PCC) in acute decompensated heart failure (ADHF) may enhance care quality and align treatment with patient goals. However, national trends and predictors of PCC in ADHF remain poorly defined.</div></div><div><h3>Methods</h3><div>We used the National Inpatient Sample (2018–2020) to identify hospitalizations for adults (≥18 years) with a primary diagnosis of ADHF using ICD-10-CM codes. PCC was defined by ICD-10-CM code Z51.5. Multivariable survey-weighted logistic regression identified predictors of PCC use, adjusting for demographics, socioeconomic status, comorbidities, and hospital factors.</div></div><div><h3>Results</h3><div>Among 3,655,265 hospitalizations, older age was associated with higher odds of PCC (aOR 1.05 per year; 95 % CI, 1.05–1.05). Compared to White individuals, odds of PCC were lower for Asian or Pacific Islander (aOR 0.74), Black (aOR 0.83), and Hispanic individuals (aOR 0.76). Medicare patients had lower odds than those with Medicaid (aOR 0.72). The highest income quartile was associated with greater PCC use (aOR 1.18). PCC was less common in the Northeast (aOR 0.88), South (aOR 0.93), and West (aOR 0.91) compared to the Midwest. Urban teaching hospitals had higher PCC rates than rural hospitals (aOR 1.48). Patients with greater comorbidity and higher mortality risk were more likely to receive PCC.</div></div><div><h3>Conclusion</h3><div>PCC use in ADHF is influenced by demographic, socioeconomic, clinical, and institutional factors. Racial, regional, and hospital-level disparities suggest a need for interventions to promote equitable access to palliative care for patients with ADHF.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"61 ","pages":"Article 100667"},"PeriodicalIF":1.8,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684870","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}