Ghaffari G, Mehrpooya M, Faghihinia M
… +3 more, Shahmohamadi E, Larti F, Geraiely B
Cardiol Res Pract
· 2026 · PMID 41694622
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OBJECTIVE: This study investigates the effect of peak glycemia on the no-reflow phenomenon in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) to exami...OBJECTIVE: This study investigates the effect of peak glycemia on the no-reflow phenomenon in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) to examine the relationship between elevated blood glucose (BG) levels and no-reflow. METHOD: A total of 252 STEMI patients (81.7% male) who underwent PPCI were enrolled. BG was measured by a glucometer every 6 h for 24 h, starting at the time of patient admission. The maximum measured BG was considered the peak glycemic level. A corrected TIMI frame count (CTFC) of less than 27 was used to define the no-reflow phenomenon in this study. RESULTS: 42.4% of participants experienced no flow, with a significant association between this condition and diabetes mellitus, peak glycemia, smoking history, and elevated LDL cholesterol levels. Specifically, peak glycemia levels above 180 mg/dL independently increased the odds of no-reflow occurrence (OR = 8.16, 95% CI = 4.1-16.2, < 0.001). CONCLUSION: The importance of monitoring BG levels in STEMI patients, as well as the critical role of a multidisciplinary approach, regardless of diabetic status, in mitigating the risk of no-reflow and improving clinical outcomes, should be highlighted.
van Bergeijk K, Venema CS, Ophuis B
… +14 more, Plekkenpol L, Tomei M, Al-Barwary H, Tromp J, Hummel Y, Ouwerkerk W, van den Heuvel A, van der Werf H, Douglas Y, Tomii D, Pilgrim T, Windecker S, Voors A, Wykrzykowska J
Am Heart J Plus
· 2026 Mar · PMID 41694544
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BACKGROUND: Transcatheter aortic valve implantation (TAVI) aims to improve symptoms and prognosis, while minimising adverse outcomes. Available prediction models focus on individual outcomes, but those combining adverse...BACKGROUND: Transcatheter aortic valve implantation (TAVI) aims to improve symptoms and prognosis, while minimising adverse outcomes. Available prediction models focus on individual outcomes, but those combining adverse events and symptom improvement in a single prediction model are scarce, and include only few variables and lack external validation. Using machine learning, we developed a clinically relevant model to identify patients at high risk of both adverse events and poor symptom improvement after TAVI. METHODS: In total, 72 candidate variables including clinical, medication use, biomarkers and (AI-derived) echocardiographic parameters were collected in patients with severe symptomatic AS undergoing TAVI. The primary outcome was a combination of poor symptom improvement (NYHA compared with baseline) and a composite of cardiovascular mortality, stroke or heart failure hospitalisation) at one year follow-up. LASSO Logistic regression was used for variable selection. External validation was performed in the Bern TAVI-registry. RESULTS: From a total of 827 patients (age 79.2 (± 7.29), 53% female), 101 patients (12%) had both adverse events and poor symptom improvement during one-year follow-up after TAVI, while 529 (64%) improved without any adverse events. Predictors for the combined primary outcome were history of COPD, use of vitamin-K antagonist, concomitant heart failure, reflected by mineralocorticoid receptor antagonists use, lower sodium and higher urea and (log-)NT-proBNP levels, lower AV mean gradient and larger LVOT diameter (area under the curve (AUC): 0.74 (internal validation: 0.72 and external validation: 0.66)). CONCLUSION: Our externally validated model can reasonably identify patients with both poor symptom improvement and adverse events after TAVI.
Gašpárková V, Tran BT, Ošťádal P
… +3 more, Lambert L, Hájek P, Kala P
Am Heart J Plus
· 2026 Mar · PMID 41694543
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Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot located between the myocardium and visceral pericardium, characterized by direct microvascular, paracrine, and vasocrine continuity with the he...Epicardial adipose tissue (EAT) is a metabolically active visceral fat depot located between the myocardium and visceral pericardium, characterized by direct microvascular, paracrine, and vasocrine continuity with the heart. Under physiological conditions, EAT exhibits beige- and brown-fat-like features that support myocardial energy homeostasis, thermoregulation, and local cardioprotection. In obesity, diabetes, and aging, EAT undergoes pathological remodeling toward a pro-inflammatory and profibrotic phenotype. Accumulating evidence implicates excess and dysfunctional EAT in the pathophysiology of multiple cardiovascular diseases, including coronary artery disease, coronary microvascular dysfunction (CMD), vasospastic angina, atrial fibrillation, and heart failure. Through inflammatory signaling, immune activation, extracellular matrix remodeling, autonomic dysregulation, and mechanical pericardial restraint, EAT contributes to myocardial fibrosis, impaired diastolic function, CMD, and reduced exercise capacity. This review focuses on the biological characteristics of EAT, current imaging approaches for its detection and quantification using echocardiography, cardiac computed tomography, and cardiac magnetic resonance imaging, and the relationship between EAT, CMD, and other cardiovascular pathologies. We also summarize therapeutic strategies targeting EAT, including pharmacological interventions with established cardiometabolic benefit, such as glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, intensive lipid-lowering therapies, and lifestyle interventions. Finally, we highlight ongoing clinical studies investigating EAT as an imaging biomarker and a potential therapeutic target in cardiometabolic cardiovascular disease.
Mylavarapu M, Tiwari A, Kaur H
… +10 more, Vempati R, Kumar H, Kodali LSM, Khan KG, Dadana S, Garcia I, Cabrera FEP, Singh A, Kyasa SL, Purewal VS
Cardiol Res Pract
· 2026 · PMID 41675345
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This review examines the bidirectional relationship between the gut microbiota and cardiovascular diseases (CVDs), aiming to understand how microbial dysbiosis contributes to CVDs, including atherosclerosis, hypertension...This review examines the bidirectional relationship between the gut microbiota and cardiovascular diseases (CVDs), aiming to understand how microbial dysbiosis contributes to CVDs, including atherosclerosis, hypertension, and heart failure. Recent research emphasizes the gut microbiota's role in modulating immunity via SCFAs and tryptophan metabolites, maintaining intestinal barrier integrity, and producing metabolites such as SCFAs (acetate, propionate, butyrate) and pro-atherogenic TMAO. Dietary patterns, particularly the Mediterranean versus Western diet, significantly influence gut microbiota composition and CVD risk. Polyphenols and exercise have shown positive effects on gut microbiota and cardiovascular outcomes. A significant interplay exists between gut microbiota and cardiovascular health. Dysbiosis and metabolites like TMAO and LPS are implicated in CVD, while SCFAs and a balanced microbiota offer protection. Future research should focus on precision medicine, next-gen probiotics, optimized FMT, and multiomics approaches to identify personalized CVD therapies.
Escobar J, Riaz I, Khawaja M
… +7 more, Virk HUH, Hahn J, Al-Azzam F, Wang Z, Alam M, Strauss M, Krittanawong C
Am Heart J Plus
· 2026 Jan · PMID 41669742
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Obesity has long been identified as a noteworthy risk factor for cardiovascular diseases, including aortic stenosis. Nevertheless, an unexplained phenomenon known as the obesity paradox has arisen in the context of trans...Obesity has long been identified as a noteworthy risk factor for cardiovascular diseases, including aortic stenosis. Nevertheless, an unexplained phenomenon known as the obesity paradox has arisen in the context of transcatheter aortic valve implantation (TAVI), inquiring conventional beliefs. The obesity paradox refers to better clinical outcomes observed in obese individuals undergoing TAVI. These include reduced all-cause mortality, lower rates of procedural complications, and improved long-term survival rates compared to their lean counterparts. Several theories have been proposed to explain the obesity paradox in TAVI. One of the most popular is the adipose tissue-mediated cardioprotective effect hypothesis. It is known that adipose tissue could offer both protective and harmful effects on the cardiovascular system. These effects can be linked to the adipose tissue's distribution, extension, and intrinsic biological characteristics. Obesity has been associated with adipose tissue malfunction, leading to proinflammatory and deleterious effects on the cardiovascular system. As opposed to what is believed, it is suggested that a healthy obese phenotype might be facilitated by exercise, leading to outstanding cardiovascular benefits. A healthy obese phenotype is also associated with a secretome profile that has unique adipose tissue features like adequate fat storage and formation of lipid droplets, a significant capacity for adipogenesis, minimal extracellular matrix fibrosis, potential for angiogenesis, adipocyte browning, and limited infiltration or activation of macrophages. This article is presented as a specialized narrative review, synthesizing current evidence on the relationship between obesity and outcomes in patients undergoing TAVI.
Crump AA, Bimali M, McCall S
… +6 more, Parker P, Massey-Swindle T, Sexton KW, Seker E, Garza MY, Williams TB
Am Heart J Plus
· 2026 Mar · PMID 41658273
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BACKGROUND: 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...BACKGROUND: 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. METHODS: 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. RESULTS: 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, < 0.01), high financial resource strain with a 13.13-point increase (95% CI: 8.50-17.76, p < 0.01), and medical transportation needs with a 13.23-point increase (95% CI: 7.55-18.89, p < 0.01). CONCLUSIONS: 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.
Am Heart J Plus
· 2026 Mar · PMID 41658272
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BACKGROUND: 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...BACKGROUND: 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. METHODS: 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. RESULTS: 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 m, = 0.007) and a higher proportion with CKD (54.5% vs. 14.7%, p = 0.007). The Kaplan-Meier equation with log-rank testing ( = 0.018) showed that subjects with chronic kidney disease (CKD) had worse survival. CONCLUSIONS: 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.
McIlraith B, Mariani JA, Downey R
… +4 more, Clare G, Daly M, El Banna H, Crozier I
Am Heart J Plus
· 2026 Mar · PMID 41658271
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INTRODUCTION: In patients with permanent pacemakers, magnetic resonance imaging (MRI) traditionally requires resource-intensive manual device reprogramming before and after the scan putting demands on clinical resources....INTRODUCTION: In patients with permanent pacemakers, magnetic resonance imaging (MRI) traditionally requires resource-intensive manual device reprogramming before and after the scan putting demands on clinical resources. METHODS: In this single-center case series, we report five MRI procedures in three patients with a pacemaker using an always-on MRI workflow facilitating feature (MRI Guard 24/7) that automatically detects MRI conditions and adjusts the pacing mode without the need for pre- or post-scan checks. RESULTS: All scans were completed successfully, with automatic switching into MRI mode and reverting to the permanent setting. No device reconfigurations were required pre- or post-scan. DISCUSSION: We discuss the potential of this feature to streamline MRI workflows, reduce staffing demands and improve access to timely imaging for patients with cardiac implantable electronic devices.
Adal O, Misganaw M, Belayneh AG
… +5 more, Endeshaw D, Delie AT, Tsehay YT, Anagaw TF, Bogale EK
Am Heart J Plus
· 2026 Mar · PMID 41658270
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BACKGROUND: 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 conditio...BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: Understanding patients lived experiences provides insights for designing culturally appropriate interventions, improving adherence, and enhancing overall management of hypertension in Ethiopia.
Cardiol Res Pract
· 2026 · PMID 41648791
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BACKGROUND: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been established to decrease hospitalizations and cardiac death within all heart failure groups. The exact mechanisms by which the oral antidiabetic med...BACKGROUND: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been established to decrease hospitalizations and cardiac death within all heart failure groups. The exact mechanisms by which the oral antidiabetic medication dapagliflozin achieves this advantage are still unknown. The potential beneficial effects of dapagliflozin on inflammation and the immune system may contribute to these mechanisms. METHOD: The laboratory and echocardiographic data of 191 consecutive patients who were started on dapagliflozin due to heart failure were compared before and 6 months after the treatment began. The systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) were calculated using the following formulae: (platelet × neutrophil)/lymphocyte and (neutrophil × monocyte)/lymphocyte, respectively. RESULTS: The mean age of the patients included in the study was 66.17 ± 10.7 years. A total of 156 patients (81.7%) had diabetes mellitus. Seventy patients (36.6%) had heart failure with reduced ejection fraction (HFrEF), 31 (16.2%) had heart failure with mildly reduced ejection fraction (HFmrEF), and 90 (47.1%) had heart failure with preserved ejection fraction (HFpEF). While no significant change was observed in echocardiographic parameters with dapagliflozin treatment ( > 0.05), a significant decrease was detected in the SII and SIRI (1357.4 ± 1404.3 vs. 805.8 ± 586.7, < 0.001 and 3.68 ± 3.6 vs. 2.19 ± 1.7, < 0.001). In these indices, a consistently significant decrease was observed in all groups, irrespective of the type of heart failure and the presence of diabetes mellitus ( < 0.005). CONCLUSION: With dapagliflozin treatment, the most recent inflammation parameters, SII and SIRI, have significantly decreased. This effect may be one reason for the cardiovascular benefits of dapagliflozin treatment.
Cardiol Res Pract
· 2026 · PMID 41640464
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BACKGROUND: Although previous studies have revealed the correlation between inflammatory markers and coronary heart disease (CHD), this study aims to explore the relationship between inflammatory markers and CHD in the m...BACKGROUND: Although previous studies have revealed the correlation between inflammatory markers and coronary heart disease (CHD), this study aims to explore the relationship between inflammatory markers and CHD in the male and female population, respectively. METHODS: This study includes participants from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. Inflammatory markers included the following: systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). Multivariate logistic regression was performed to investigate the correlation between these inflammatory markers and CHD. The trend test was employed to examine potential linear trend associations, and the restricted cubic splines (RCSs) were utilized to depict nonlinear relationships. RESULTS: The NHANES database including 40,177 participants was stratified into two cohorts: the CHD group ( = 1667) and the non-CHD group ( = 38,510). With further gender stratification, we found that LMR, PLR, and SII all exhibited negatively significant correlation with CHD in the male group, while LMR and NLR were meaningful factors in the female group. We also detected that LMR, PLR, and SII all have nonlinear relationship with CHD in the male group ( for nonlinear < 0.05), while PLR had nonlinear relationship with CHD in the female group ( for nonlinear < 0.05). CONCLUSIONS: Our study revealed that LMR, PLR, and SII are significantly negative correlative markers of CHD in males, while LMR and NLR are more accurate predictors of CHD in females.
Southwick L, Sehgal NKR, Torrente D
… +10 more, Murgulescu V, Schroeder D, Asch DA, Ungar L, Mitra N, Groenveld P, Kimmel SE, Weissman GE, Guntuku SC, Merchant RM
Am Heart J Plus
· 2026 Feb · PMID 41631189
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A retrospective, exploratory cross-sectional analysis exploring whether social media data is associated with cardiovascular disease (CVD) risk beyond traditional clinical models. While social media data may capture behav...A retrospective, exploratory cross-sectional analysis exploring whether social media data is associated with cardiovascular disease (CVD) risk beyond traditional clinical models. While social media data may capture behavioral and social markers relevant to CVD, their associations with CVD risk remains uncertain.
Simeon M, Evans E, Arif S
… +4 more, Granado T, Okwuosa TM, Volgman AS, Abusin S
Am Heart J Plus
· 2026 Mar · PMID 41631001
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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 comprehensiv...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. 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. 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.
Imani M, Maroosi A, Shojaei S
… +6 more, Heidari K, Hoseinzadeh SM, Daneshi N, Saber Z, Sajadi N, Mohammadzadeh M
Am Heart J Plus
· 2026 Mar · PMID 41631000
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BACKGROUND: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, arising from complex interactions among demographic, clinical, behavioral, and social determinants. Leveraging large, nationally...BACKGROUND: Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, arising from complex interactions among demographic, clinical, behavioral, and social determinants. Leveraging large, nationally representative datasets such as the 2022 Behavioral Risk Factor Surveillance System (BRFSS) offers a unique opportunity to identify emerging risk patterns, monitor population-level disparities, and inform more targeted prevention strategies. METHODS: A total of 221,643 participants from the BRFSS 2022 survey were included after excluding records with missing data. Thirteen key predictors spanning demographics, chronic conditions, and social factors were selected. Data were split into training (80%) and testing (20%) sets. Four machine learning models, XGBoost, Random Forest, Logistic Regression, and Naive Bayes, were developed and evaluated using stratified 10-fold cross-validation. Model performance was assessed via accuracy, F1 score, precision, sensitivity, and ROC AUC. Synthetic Minority Over-sampling Technique (SMOTE) addressed class imbalance. SHAP values provided insights into feature importance and model interpretability. RESULTS: XGBoost demonstrated the best predictive performance (accuracy 94.2%, F1 score 85.3%, ROC AUC 0.94). SHAP analysis highlighted age ≥ 65, male gender, and diabetes as the strongest predictors, with additional contributions from kidney disease, employment status, and social isolation. Protective effects were observed for never smoking and higher education. Stratified analyses revealed that while overweight/obesity (BMI ≥25) was generally associated with higher CVD prevalence, the association was attenuated in older adults, smokers, and those with diabetes or kidney disease, suggesting illness-related weight loss, frailty, and behavioral confounding. These subgroup insights contextualize the apparent "BMI paradox" observed in the aggregate data. CONCLUSIONS: Findings from the BRFSS 2022 highlight both established and emerging determinants of CVD risk, including the modifying effects of comorbidities, social isolation, and BMI-related heterogeneity. Beyond algorithmic performance, these results underscore the value of national surveillance data for informing applied, actionable strategies in CVD prevention and risk stratification.
Cardiol Res Pract
· 2026 · PMID 41625557
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Arrhythmia is an important cause of cardiovascular disease deaths and a serious threat to human health, but the current means of identification are limited. Biomarkers, with the advantages of easy access and rapid detect...Arrhythmia is an important cause of cardiovascular disease deaths and a serious threat to human health, but the current means of identification are limited. Biomarkers, with the advantages of easy access and rapid detection, have shown significant value in arrhythmia risk prediction, precision diagnosis, and prognosis assessment. In recent years, with the development of molecular biology and multiomics technology, some novel biomarkers have made great breakthroughs in revealing the pathological mechanisms of arrhythmia. However, clinical translation still faces challenges such as a lack of standardization of assays and insufficient clinical prospective validation. This review comprehensively searched studies published between 2010 and 2025 in PubMed, Web of Science, Embase, and CENTRAL databases, focusing on the mechanisms underlying the role of arrhythmia biomarkers in inflammation, fibrosis, autoimmunity, and electrical remodeling and clinical translation potential. Future research should focus on the combined application of multiple biomarkers and the discovery of subtype-specific markers. Conducting large-scale, multicenter studies to validate these biomarkers and ultimately integrate them into clinical practice is crucial for advancing biomarker-guided individualized antiarrhythmic therapy.
Sun C, Zhu M, McGrath D
… +4 more, Warner P, Dacey M, Wessler B, Zhan Y
Am Heart J Plus
· 2026 Feb · PMID 41624400
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BACKGROUND: 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. O...BACKGROUND: 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. OBJECTIVES: This study aims to provide insight regarding procedure access and outcomes to evaluate for potential racial disparities in the contemporary era of TAVR. METHODS: 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. RESULTS: Of 42,877 total TAVR patients, 37,319 were White and 5558 were non-White. Annual procedure volume in both groups increased significantly ( < 0.001 for both). The proportions of White and non-White patients remained steady over time (12.5%-13.5% non-White, = 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%, 0.585) or composite outcome (23.8% vs 24.6%, 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, 0.001), transfusion (OR:1.18, 95%CI:1.05-1.32, 0.006), and vascular complications (OR:1.62, 95%CI:1.29-2.04, 0.001), but lower rates of permanent pacemaker implantation (OR:0.83, 95%CI:0.75-0.93, 0.001). CONCLUSION: 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.Meeting presentation: Presented at the Transcatheter Cardiovascular Therapeutics (TCT) 2024, October 27-30, 2024, Washington D.C.
Watfa A, Younis A, Winnard-Brewer A
… +6 more, Greenlee KM, Ferrin J, Varma N, Myers JG, Wotring V, Mayuga KA
Am Heart J Plus
· 2026 Feb · PMID 41624399
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IMPORTANCE: 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....IMPORTANCE: 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. OBJECTIVE: 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. METHODS: A comprehensive search of 13 biomedical and aerospace databases (MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, CINAHL, NASA Technical Reports Server, ESA archives, ClinicalTrials.gov, 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. RESULTS: 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. CONCLUSIONS AND RELEVANCE: 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.