Polycystic ovarian syndrome and long-term risk of acute myocardial infarction and ischaemic stroke.

Aims: Polycystic ovary syndrome (PCOS) affects 5-20% of reproductive-aged women and is linked to cardiovascular risk factors and atherosclerosis. Yet, its long-term association with atherosclerotic cardiovascular disease remains uncertain and will be the focus of this study.

Methods And Results: Women diagnosed with PCOS (1995-2024) were identified through Danish nationwide registries and matched 1:4 with female controls from the background population by age and year of index.

Adiposity-Related Anthropometrics and Clinical Outcomes in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Participant-Level Pooled Analysis of Randomized Clinical Trials.

Background: Obesity is highly prevalent among individuals with heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserved ejection fraction (HFpEF) and is associated with increased risk of disability and death.

Objectives: The purpose of this study is to explore the association between different adiposity-related anthropometrics and clinical outcomes in this population.

Methods: In this participant-level pooled analysis of 5 international randomized trials that enrolled adults with HFmrEF/HFpEF, the association between adiposity-related anthropometrics (body mass index [BMI], waist circumference [WC], and waist-to-height ratio [WHtR]) and heart failure (HF) and mortality outcomes was evaluated, overall and by age and sex.

Mitral valve replacement or repair and long-term risk of infective endocarditis: a Danish nationwide study.

Background And Aims: Infective endocarditis (IE) after mitral valve (MV) interventions is a serious complication. However, information on the long-term risk of first-time IE after MV replacement or repair is lacking. The 10-year incidence of first-time IE was examined in patients undergoing MV replacement or repair, compared with those at moderate risk of IE.

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.

Obesity and Risk of Kidney Outcomes in Heart Failure With Preserved Ejection Fraction: A Participant-Level Pooled Analysis of 4 Contemporary Trials.

Background: Obesity is prevalent among patients with heart failure with preserved ejection fraction (HFpEF).

Objectives: This study aims to evaluate whether anthropometrics including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) are associated with kidney outcomes in patients with HFpEF.

Methods: In this participant-level pooled analysis of DELIVER, PARAGON-HF, TOPCAT Americas, and I-PRESERVE, we evaluated the impact of adiposity-related anthropometrics on risk of kidney outcomes (sustained eGFR reduction of ≥50%, end-stage kidney disease, or kidney-related death).

Comprehensive Analysis of the Effects of Sacubitril/Valsartan According to Sex Among Patients With Heart Failure and Reduced Ejection Fraction in PARADIGM-HF.

Background: Women with heart failure (HF) ejection fraction appeared to respond more favorably to sacubitril/valsartan, compared with valsartan, than men in PARAGON-HF (Prospective Comparison of ARNI With ARB Global Outcomes in Heart Failure With Preserved Ejection Fraction), driven by a greater reduction in total (first and recurrent) HF hospitalizations. Sex-specific efficacy and safety of sacubitril/valsartan in PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) remain unreported.

Methods And Results: This post hoc analysis of PARADIGM-HF examined sex-based outcomes in patients with HF and reduced ejection fraction randomized to sacubitril/valsartan or enalapril.

Mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction according to body weight.

Aims: Obesity is associated with excessive adipocyte-derived aldosterone secretion, independent of the classical renin-angiotensin-aldosterone cascade, and mineralocorticoid receptor antagonists (MRAs) may be more effective in obese patients with heart failure (HF) with reduced ejection fraction (HFrEF).

Methods And Results: Using individual patient-level data from two randomized placebo-controlled trials, RALES and EMPHASIS-HF, the effect of MRA treatment, compared with placebo, and outcomes were assessed according to body weight at baseline, examined both as a categorized (above/below median) and continuous variable. The primary outcome was the composite of HF hospitalization or cardiovascular death.

Finerenone, chronic obstructive pulmonary disease, and heart failure with mildly reduced or preserved ejection fraction: A prespecified analysis of the FINEARTS-HF trial.

Aims: Chronic obstructive pulmonary disease (COPD) is associated with worse outcomes in heart failure (HF) with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF). A post hoc analysis of TOPCAT suggested that the effectiveness of the steroidal mineralocorticoid receptor antagonist (MRA), spironolactone, may be modified by pulmonary disease, with a greater benefit in patients with COPD/asthma. We examined the effects of the non-steroidal MRA, finerenone, compared to placebo, according to COPD status in a prespecified analysis of FINEARTS-HF.

Finerenone, glycaemic status, and heart failure with mildly reduced or preserved ejection fraction: A prespecified analysis of the FINEARTS-HF trial.

Aims: The efficacy and safety of the non-steroidal mineralocorticoid receptor antagonist, finerenone, have not been examined in patients without diabetes. We examined the efficacy and safety of finerenone, compared with placebo, according to glycaemic status in FINEARTS-HF.

Methods And Results: A total of 6001 patients with heart failure (HF) with New York Heart Association functional class II-IV, left ventricular ejection fraction ≥40%, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomized to finerenone or placebo.

Disparities Among Immigrants and Native Patients in Denmark With New-Onset Heart Failure With Reduced Ejection Fraction.

Background: Worldwide, major health care variations exist in patients with heart failure (HF).

Objectives: In this study, the authors sought to examine and compare immigrants grouped by region of origin and native Danish patients presenting with new-onset heart failure with reduced ejection fraction (HFrEF).

Methods: The authors used data from the Danish Heart Failure Registry and administrative registries comprising information on medication, comorbidity, vital status, income level, and education.

Patient-reported symptoms and admission pathways in stroke mimics versus confirmed stroke or transient ischaemic attack: a cross-sectional observational study.

Objectives: To determine patient-reported symptoms and clinical factors associated with mimics and differences in health-seeking behaviour versus stroke.

Design: This is a post-hoc analysis of a cross-sectional survey of interviews on patient-reported factors in patients admitted with suspected stroke. Patients were categorised as genuine stroke or mimic.

Temporal Trends in Mortality and Hospitalization Risk in Patients With Heart Failure According to the Hospital Frailty Risk Score.

Background: Heart failure (HF) and frailty often coexist. However, it is unknown how the interplay between HF and frailty at HF onset impacts prognosis of frail patients with HF and how this has evolved over time.

Methods And Results: We identified 131 235 patients with new-onset HF (median age 74 years, 39.

Antithrombotic therapy following transcatheter aortic valve implantation: a Danish nationwide study.

Background: Antithrombotic therapy post-transcatheter aortic valve implantation (TAVI) has been widely debated in the past two decades. Data describing practice patterns of antithrombotic therapy are warranted. This study examined the trends in use of antithrombotic therapy post-TAVI in Denmark.

Near-universal prevalence of central adiposity in heart failure with preserved ejection fraction: the PARAGON-HF trial.

Background And Aims: An expansion of fat mass is an integral feature of patients with heart failure and preserved ejection fraction (HFpEF). While body mass index (BMI) is the most common anthropometric measure, a measure of central adiposity-the waist-to-height ratio (WHtR)-focuses on body fat content and distribution; is not distorted by bone or muscle mass, sex, or ethnicity; and may be particularly relevant in HFpEF.

Methods: The PARAGON-HF trial randomized 4796 patients with heart failure (HF) and ejection fraction ≥45% to valsartan or sacubitril/valsartan.

Finerenone and new-onset diabetes in heart failure: a prespecified analysis of the FINEARTS-HF trial.

Background: Data on the effect of mineralocorticoid receptor antagonist therapy on HbA levels and new-onset diabetes are conflicting. We aimed to examine the effect of oral finerenone, compared with placebo, on incident diabetes in the Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure (FINEARTS-HF) trial.

Methods: In this randomised, double-blind, placebo-controlled trial, 6001 participants with heart failure with New York Heart Association functional class II-IV, left ventricular ejection fraction 40% or higher, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomly assigned to finerenone or placebo, administered orally.

Bacteraemia after transcatheter aortic valve implantation: a nationwide cohort study.

Background: Bacteraemia and infective endocarditis (IE) are rare but severe complications of transcatheter aortic valve implantation (TAVI). Limited data exist on the incidence and microbiological profile of early bacteraemia in this population. This study aimed to evaluate the 6-month incidence of bacteraemia, IE and associated mortality following TAVI.

Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction: Prespecified Analysis of FINEARTS-HF.

Background: Obesity is associated with excessive adipocyte-derived aldosterone secretion, independent of the classical renin-angiotensin-aldosterone cascade, and mineralocorticoid receptor antagonists may be more effective in patients with heart failure (HF) and obesity.

Objectives: This study sought to examine the effects of the nonsteroidal mineralocorticoid receptor antagonist finerenone compared with placebo, according to body mass index (BMI) in FINEARTS-HF (FINerenone trial to investigate Efficacy and sAfety superioR to placebo in paTientS with Heart Failure).

Methods: A total of 6,001 patients with HF with NYHA functional class II, III, and IV, a left ventricular ejection fraction of ≥40%, evidence of structural heart disease, and elevated natriuretic peptide levels were randomized to finerenone or placebo.

Long-term rate of heart failure in patients with autoimmune disease: A nationwide cohort study.

Aims: Although certain autoimmune diseases (AIDs) have been associated with an increased rate of heart failure (HF), data on the long-term rate of HF across the spectrum of AIDs are lacking. We investigated the long-term rate of HF in individuals with a history of 28 different AIDs.

Methods And Results: Individuals diagnosed with an AID (2000-2021) were identified through Danish nationwide registries.