Sex differences in venous thromboembolism outcomes: findings from the GARFIELD-VTE registry.

Background: The association of sex with clinical outcome risk in venous thromboembolism (VTE) is unclear.

Objective: To investigate sex differences in clinical outcomes and anticoagulation effectiveness in VTE in the GARFIELD-VTE registry.

Methods: Outcomes included all-cause mortality, VTE recurrence, major and any bleeding, myocardial infarction (MI)/acute coronary syndrome (ACS), and stroke/transient ischaemic attack (TIA) over 3 years of follow-up.

Agreement Between Different Types of Blood Pressure Monitoring : A Systematic Review and Network Meta-analysis.

Background: Accurate blood pressure measurement (BPM) is essential for managing hypertension, but previous studies have not systematically compared different monitoring methods across varying BP levels. To address this gap, a comprehensive analysis using network meta-analysis (NMA) and meta-regression was done to evaluate their agreement and clinical implications.

Purpose: To compare BP values obtained using different BPM methods using office BPM (OBPM) as the reference.

Elevated Exercise Capacity Mitigates Atrial Fibrillation Incidence and Major Cardiovascular Outcomes: A Decade-Long Cohort Study.

Background: Atrial fibrillation (AF) increases cardiovascular risks and reduces quality of life. Although impaired physical activity has correlated with incident AF, the impacts of exercise capacity and blood pressure changes during exercise on AF development remain unclear.

Objectives: The purpose of this study was to evaluate the association between exercise capacity and AF incidence and its effects on major adverse cardiovascular events (MACE).

Impact of PIK3CA Mutations on the Clinical Benefits of CDK 4/6 Inhibitors in HR+/HER2- Advanced Breast Cancer: An Updated Pairwise and Network Meta-Analysis.

Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) have revolutionized the treatment of hormone receptor-positive (HR+) and human epidermal growth factor receptor-2 negative (HER2-) advanced breast cancer. However, identifying reliable biomarkers and determining overall survival (OS) outcomes for CDK4/6i remains challenging. We conducted a systematic review and updated pairwise meta-analysis of randomized controlled trials to evaluate the clinical benefits and biomarker interactions of CDK4/6i in HR+ and HER2- advanced breast cancer.

LV Diastolic Dysfunction and Inappropriate LV Filling Pressure Escalation: The Core of Exercise Intolerance in Heart Failure.

Background And Objectives: Exercise intolerance is the most common symptom of patients with heart failure (HF), regardless of the phenotypes. We aim to investigate the determinants of exercise capacity in chronic stable HF with reduced, mildly reduced, preserved, and recovered ejection fraction (EF).

Methods: Ambulatory HF subjects were recruited for a combined cardiopulmonary exercise test and exercise stress echocardiography.

Prognostic impacts of left ventricular strain in hemodialytic patients with preserved left ventricular systolic function.

Left ventricular dysfunction is a known risk factor for morbidity and mortality in hemodialysis patients. The prognostic value of left ventricular global longitudinal strain (LV GLS) among those with preserved left ventricular ejection fraction (LVEF) remains uncertain. Subjects with end-stage renal disease initiated hemodialysis at Taipei Veteran General Hospital between 2015 and 2018 were registered.

Incretin-based therapy: An update focusing on the major revolution in cardiovascular-kidney-metabolic health.

Type 2 diabetes mellitus and obesity have become the rising burden across various geographic and economic regions, and they are also the common causes of chronic kidney disease, which further contributes to the development and progression of cardiovascular disease. The recently proposed cardiovascular-kidney-metabolic syndrome-the new paradigm of recognizing excess or dysfunctional adipose tissue as the shared pathophysiology-has signaled the interconnection of type 2 diabetes mellitus, obesity, chronic kidney disease, and cardiovascular disease beyond the disturbance of glucose homeostasis, for which recently developed incretin-based therapy has offered an avenue of holistic management. Glucagon-like peptide-1 (GLP1) is one of the incretins and potentiates insulin secretion after food intake, additionally offering extra-pancreatic metabolic effects-reduced hepatic gluconeogenesis and steatosis, increased muscular glucose uptake, and increased lipolysis and glucose uptake in the adipose tissue.

Finerenone According to Frailty in Heart Failure: A Prespecified Analysis of the FINEARTS-HF Randomized Clinical Trial.

Importance: Patients with frailty are often perceived to have a less favorable benefit-risk profile for novel therapies and therefore may be less likely to receive these.

Objective: To examine the efficacy and safety of finerenone, compared with placebo, according to frailty status in patients with heart failure (HF) and mildly reduced ejection fraction (HFmrEF) or with HF and preserved ejection fraction (HFpEF).

Design, Setting, And Participants: This was a prespecified secondary analysis of a phase 3 randomized clinical trial, the Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure (FINEARTS-HF), conducted across 653 sites in 37 countries.

Race and Ethnicity in Heart Failure Trials: Time to Update Recommended Categories for Global Relevance.

Background: The collection of race and ethnicity data in clinical trials using standardized categories is recommended by the US Food and Drug Administration, although this is primarily for domestic reasons. The applicability and understanding of the categories in multinational trials are uncertain.

Methods: We analyzed patient-level data from 13 major heart failure trials, examining race and ethnicity data recorded by country, as recommended by the Food and Drug Administration: "American Indian or Alaska Native," "Asian," "Black or African American," "Native Hawaiian or Other Pacific Islander," and "White" for race and "Hispanic or Latino" as a minimum for ethnicity (with an expanded list of ethnicities available).

The Impact of Aortic Pulsatile Hemodynamics on Renal Function Trajectories in Acute Heart Failure.

Background: Perturbation of aortic pulsatile hemodynamics and the presence of impaired renal function (IRF) may increase post-discharge events in patients hospitalized for acute heart failure (AHF). The present study investigated whether on-admission aortic pulsatile hemodynamics is associated with IRF and in-hospital changes in renal function, and modulates its impact on post-discharge adverse events in patients with AHF.

Methods: A total of 240 AHF patients (69.

The efficacy of finerenone on hierarchical composite endpoint analysed using win statistics in patients with heart failure and mildly reduced or preserved ejection fraction: A prespecified analysis of FINEARTS-HF.

Aims: FINEARTS-HF demonstrated the efficacy of finerenone in reducing total worsening heart failure (HF) events (first and recurrent) and cardiovascular death, compared to placebo, in patients with HF and mildly reduced or preserved ejection fraction. We examined the effect of finerenone on these events according to their clinical importance using win statistics.

Methods And Results: We developed a prespecified hierarchical composite endpoint including the components of the original primary outcome: cardiovascular death (tier 1), total HF hospitalizations (tier 2), and total urgent HF visits (tier 3).

Comparison of machine learning and conventional criteria in detecting left ventricular hypertrophy and prognosis with electrocardiography.

Aims: Left ventricular hypertrophy (LVH) is clinically important; current electrocardiography (ECG) diagnostic criteria are inadequate for early detection. This study aimed to develop an artificial intelligence (AI)-based algorithm to improve the accuracy and prognostic value of ECG criteria for LVH detection.

Methods And Results: A total of 42 016 patients (64.

Supranormal Left Ventricular Ejection Fraction, Concentric Remodeling, and Long-Term Survival.

Background: Supranormal left ventricular ejection fraction (LVEF) confers a paradoxically higher mortality risk; however, whether intrinsic structural changes of left ventricle (LV) play an important role remain unclear.

Objectives: The authors sought to investigate the prognostic implication of supranormal LVEF and its interaction with LV concentric remodeling.

Methods: Consecutive participants undergoing echocardiography in a tertiary medical center with LVEF >60% were included.

2024 Guidelines of the Taiwan Society of Cardiology on the Primary Prevention of Atherosclerotic Cardiovascular Disease --- Part II.

For the primary prevention of atherosclerotic cardiovascular disease (ASCVD), the recommended treatment target for each modifiable risk factor is as follows: reducing body weight by 5-10%; blood pressure < 130/80 mmHg (systolic pressure < 120 mmHg in high-risk individuals); low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL in high-risk individuals, LDL-C < 115 mg/dL in moderate-risk individuals, LDL-C < 130 mg/dL in low-risk individuals, and LDL-C < 160 mg/dL in those with a minimal; complete and persistent abstinence from cigarette smoking; hemoglobin A1C < 7.0%; fulfilling recommended amounts of the six food groups according to the Taiwan food guide; and moderate-intensity physical activity 150 min/wk or vigorous physical activity 75 min/wk. For the primary prevention of ASCVD by pharmacological treatment in individuals with modifiable risk factors/clinical conditions, statins are the first-line therapy for reducing LDL-C levels; some specific anti-diabetic drugs proven to be effective in randomized controlled trials for the primary prevention of ASCVD are recommended in patients with type 2 diabetes mellitus; pharmacological treatment is recommended to assist in weight management for obese patients with a body mass index ≥ 30 kg/m (or 27 kg/m who also have at least one ASCVD risk factor or obesity-related comorbidity); an angiotensin-converting enzyme inhibitor, a glucagon-like peptide-1 receptor agonist, a sodium-dependent glucose cotransporter-2 inhibitor, and finerenone can be used in diabetic patients with chronic kidney disease for the primary prevention of ASCVD.

Tissue inhibitor of metalloproteinase (TIMP)-1 predicts failure of recovery of ejection fraction in acute heart failure with reduced ejection fraction.

Background: Heart failure (HF) with improved ejection fraction (HFimpEF) is a recently identified phenotype of HF, which had better cardiovascular outcomes compared with persistent HF with reduced ejection fraction (HFrEF). The present study aimed to investigate the predictive value of tissue inhibitor of metalloproteinase (TIMP)-1 and matrix metalloproteinases-9 (MMP-9) in the recovery of left ventricular ejection fraction (LVEF).

Methods: Subjects who presented with acute decompensated HF and reduced LVEF of ≤40% were eligible for this study.

Evaluation of glucose-lowering medications in older people: a comprehensive systematic review and network meta-analysis of randomized controlled trials.

Background: Type 2 diabetes mellitus (T2DM) is increasingly being diagnosed in older adults. Our objective is to assess the advantages and potential drawbacks of different glucose-lowering medications in this specific population.

Methods: A network meta-analysis was conducted to identify randomized controlled trials that examined patient-centered outcomes in adults aged ≥65 years with T2DM.

Geographical variation in patient characteristics and outcomes in heart failure with mildly reduced and preserved ejection fraction.

Aims: Compared to heart failure (HF) with reduced ejection fraction, HF with preserved ejection fraction (HFpEF), and HF with mildly reduced ejection fraction (HFmrEF) are increasing in prevalence, yet little is known about the geographic variation in patient characteristics, treatments and outcomes among these two HF phenotypes. The aim of this study was to investigate geographic differences in HFpEF and HFmrEF.

Methods And Results: We conducted an individual patient analysis of five clinical trials enrolling patients with HFpEF or HFmrEF from North America (NA), Latin America (LA), Western Europe (WE), Central/Eastern Europe and Russia (CEER), and Asia-Pacific (AP).

Baseline characteristics of patients with heart failure with mildly reduced or preserved ejection fraction: The FINEARTS-HF trial.

Aims: To describe the baseline characteristics of participants in the FINEARTS-HF trial, contextualized with prior trials including patients with heart failure (HF) with mildly reduced and preserved ejection fraction (HFmrEF/HFpEF). The FINEARTS-HF trial is comparing the effects of the non-steroidal mineralocorticoid receptor antagonist finerenone with placebo in reducing cardiovascular death and total worsening HF events in patients with HFmrEF/HFpEF.

Methods And Results: Patients with symptomatic HF, left ventricular ejection fraction (LVEF) ≥40%, estimated glomerular filtration rate ≥ 25 ml/min/1.

Oral anticoagulants and cognitive impairment in patients with atrial fibrillation: A systematic review with meta-analysis and trial sequential analysis.

Background: This systematic review assesses the likelihood of developing dementia and cognitive impairment in patients with atrial fibrillation (AF) receiving non-vitamin K antagonist oral anticoagulants (NOACs) as opposed to vitamin K antagonists (VKAs).

Methods: We performed a systematic review with meta-analysis and trial sequential analysis (TSA), which encompassed both randomized controlled trials (RCTs) and observational studies. The objective was to assess the impact of NOACs and VKAs on the incidence of dementia in individuals diagnosed with AF.

ELUCIDATE Trial: A Single-Center Randomized Controlled Study.

Background: Dapagliflozin, a sodium-glucose cotransporter 2 inhibitor, is an epochal oral antidiabetic drug that improves cardiorenal outcomes. However, the effect of early dapagliflozin intervention on left ventricular (LV) remodeling in patients with type 2 diabetes free from cardiovascular disease remains unclear.

Methods And Results: The ELUCIDATE trial was a prospective, open-label, randomized, active-controlled study that enrolled 76 patients with asymptomatic type 2 diabetes with LV ejection fraction ≥50%, randomized to the dapagliflozin 10 mg/day add-on or standard-of-care group.