Age and Health Status Benefits Following Initiation of Atrial Fibrillation-Specific Treatments.

Background: Atrial fibrillation (AF) is managed with various strategies, including rate and rhythm control, to improve patients' health status. Although its incidence increases with age, how age affects health status improvements following AF treatment remains unknown.

Methods: Using data from a multicenter registry for outpatients with newly recognized AF, baseline and 1-year health status was assessed with the Atrial Fibrillation Effect on Quality-of-life quesTionnaire (AFEQT).

Health Status Outcomes With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in ISCHEMIA.

Background: In ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches), an invasive strategy demonstrated better health status outcomes than a conservative strategy in patients with chronic coronary disease (CCD). Some previous studies have shown greater health status benefits with coronary artery bypass grafting (CABG) than percutaneous coronary intervention (PCI). Whether the health status benefits of invasive management in ISCHEMIA were driven primarily by participants treated with CABG is unknown.

Minimally Important Kansas City Cardiomyopathy Questionnaire Changes Across the Spectrum of Heart Failure Severity.

Background: Although the Kansas City Cardiomyopathy Questionnaire (KCCQ) assesses important outcomes for patients with heart failure, whether a 5-point change in KCCQ represents a minimal clinically important difference (MCID) in an individual patient with very poor, as compared with very good, heart failure severity is unknown.

Objectives: This study aims to define MCIDs for the KCCQ-Overall Summary Score (OSS) and KCCQ-Clinical Summary Score (CSS) across the range of baseline health status.

Methods: Outpatients with heart failure with ejection fractions ≤40% recruited from 14 clinics completed KCCQs at baseline and 6 ± 2 weeks later, along with a 15-point Likert scale assessing their perceived changes in health status.

Quality of Life after Mitral Valve Surgery. Results from the Cardiothoracic Surgical Trials Network.

Objective: To understand patterns and patient factors associated with health status recovery after mitral valve surgery.

Methods: Patient-level data from 3 multicenter randomized trials of mitral valve surgery were harmonized, with heart failure-specific health status assessed with the Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS) score. Linear mixed-effects models were used to describe health status over time and to explore patient factors associated with health status recovery.

β-Blocker Use and Health Status Among Patients With Heart Failure With Preserved Ejection Fraction.

Importance: β-Blockers are widely used for patients with heart failure with preserved ejection fraction (HFpEF). However, their association with health status among this population remains unknown.

Objective: To evaluate the association of β-blocker use with health status among patients with HFpEF.

The Heartline Experience: Achieving Long-Term Participant Engagement in Digital Health Technology Trials.

Background: Digital health technologies can potentially improve clinical research efficiency and increase participant diversity but have challenges with long-term participant engagement.

Objectives: The Heartline Study evaluated the impact of a mobile app-based heart health engagement program with the Irregular Rhythm Notification (IRN) and electrocardiogram features of the Apple Watch on diagnosis, treatment, and outcomes of atrial fibrillation in U.S.

Temporal trends and hospital variation in post-resuscitation fever for in-hospital cardiac arrest.

Background: A goal of post-resuscitation care among patients successfully resuscitated from in-hospital cardiac arrest (IHCA) is fever avoidance. However, the incidence of post-resuscitation fever after the initial therapeutic hypothermia trials in 2002 and after the Targeted Temperature Management (TTM) trial in 2013 is unknown.

Methods: Within the U.

Reliability of a German version of the Kansas City Cardiomyopathy Questionnaire (KCCQ) administered via telephone.

To date, there is no validated telephone version of the Kansas City Cardiomyopathy Questionnaire (KCCQ) available to collect data about health-related quality of life among patients with heart failure (HF). We assessed the reliability of the German KCCQ administered via telephone in comparison to the self-administered version. Patients with HF admitted to the outpatient clinic of the University Hospital Würzburg were consecutively identified and recruited.

Risk-Stratified Prognostic Implications of Contrast-Associated Acute Kidney Injury After Percutaneous Coronary Intervention.

Background: The clinical importance of contrast-associated acute kidney injury (CA-AKI), the most common complication after percutaneous coronary intervention (PCI), is debated.

Objectives: We aimed to assess the association between CA-AKI and long-term outcomes, overall and across the National Cardiovascular Data Registry (NCDR) AKI risk categories.

Methods: We analyzed patients undergoing PCI between September 2008 and October 2021 from a Japanese registry aligned with the NCDR and categorized them by the NCDR AKI risk score tertiles (low-risk [<4.

Noninvasive Screening for Elevated LVEDP and Health Status in Outpatients at Risk for Heart Failure.

Background: Heart failure (HF) is frequently underrecognized in primary care due to nonspecific symptoms, resulting in many patients presenting with severely compromised health status (symptoms, function, and quality of life) at the time of diagnosis.

Objectives: The purpose of this study was to evaluate the diagnostic yield of screening outpatients at risk for HF using a noninvasive assessment of left ventricular end-diastolic pressure (LVEDP) and describe the health status of patients identified with elevated LVEDP.

Methods: A convenience sample of adults with diabetes mellitus, chronic kidney disease (CKD), or suspected HF were screened at 3 primary care clinics using the Vivio System to identify patients with LVEDP >18 mm Hg (positive screening).

Left-Digit Bias in Serum Creatinine Levels and Contrast Administration: A Nationwide Cohort Study Using a Japanese Percutaneous Coronary Intervention Registry.

Background: Contemporary quality initiatives emphasize minimizing contrast volume as a key modifiable factor to prevent acute kidney injury (AKI) following percutaneous coronary intervention (PCI). Left-digit bias is a cognitive bias where the leftmost digit of a number disproportionately influences decisions. This bias may unintentionally affect contrast administration when interpreting laboratory values like serum creatinine.

Adding the patient perspective: the necessity of patient reported outcomes in cardiac surgery clinical trials.

Purpose Of Review: This review highlights the growing importance of patient reported outcomes (PROs) in cardiac surgery trials. Cardiac surgery trials have traditionally focused on cardiovascular events such as survival, stroke or myocardial infarction. However, as surgical outcomes have continued to improve, incorporating the patient's perspective through PROs has become increasingly critical.

Predicting Heart Failure Outcomes Using Patient-Reported Health Status: Real-World Validation of the KCCQ-12.

Background: The Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12), a patient-reported outcome measure for adults with heart failure, is associated with hospitalizations and mortality in clinical trials. Curated data sets from controlled trials differ substantially from pragmatic data collected from real-world settings, however, and few data exist on the KCCQ-12's predictive utility in clinical practice.

Objectives: This study sought to evaluate the predictive utility of the KCCQ-12 for hospitalizations and mortality when administered during outpatient heart failure care.

Association between body mass index and survival outcomes for in-hospital cardiac arrest.

Background: Body mass index (BMI), a key clinical marker, may influence outcomes after in-hospital cardiac arrest (IHCA), but its association with neurologically favorable survival remains unclear.

Methods: Within Get With The Guidelines®-Resuscitation, we analyzed 56,411 IHCA patients with BMI data during 2006-2012. BMI was classified as underweight (<18.

Stakeholder Perspectives on the Meaningful Integration of Clinical Informatics Interventions Using Patient-Reported Outcomes in Healthcare.

Background: Patient-reported outcomes (PROs) capture where patients are on their disease trajectory and can identify changes in health status from their perspective.

Objectives: This study applied the equity and sustainability-informed RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) to gain insights into clinical informatics interventions for collection and use of PROs across health systems.

Methods: A total of 14 health informatics and clinical professionals were interviewed about the development and use of PROs within their health systems and individual practices.

Impact of severe COVID-19 infection on coronary microvascular dysfunction in ANOCA patients: A cross-sectional study.

Background And Aims: Millions of survivors from severe COVID-19 infection suffer from residual symptoms including anginal chest pain. The pathophysiological mechanisms, particularly the role of coronary microvascular dysfunction (CMD), however, remain elusive. We compared the incidence and endotypes of CMD in patients with angina without obstructive coronary artery disease (ANOCA) between those who had a history of severe COVID-19 infection (COVID group, defined as COVID patients needing supplemental oxygen therapy with SpO2 < 90 % on room air), versus those who didn't (Control group).

Use of coronary artery bypass graft surgery and percutaneous coronary intervention and associated outcomes in the ISCHEMIA trial.

Background: In the ISCHEMIA Trial, 5,179 patients with stable coronary disease were randomized to initial invasive or conservative management.

Methods: PCI was recommended with a SYNTAX score 0 to 22 (low) and CABG with a SYNTAX score ≥33 (high). Either could be recommended for intermediate scores.

Efficacy of Aficamten in Patients with Obstructive Hypertrophic Cardiomyopathy and Mild Symptoms: Results from the SEQUIOA-HCM Trial.

Background And Aims: Patients with obstructive hypertrophic cardiomyopathy (oHCM) treated with aficamten in SEQUOIA-HCM (NCT05186818) demonstrated marked improvement in symptoms and functional capacity. This analysis explores whether oHCM and mild symptoms experience similar clinical benefit with aficamten as patients with more advanced limitation.

Methods: Patients in SEQUOIA-HCM (N=282) were grouped at baseline according to symptom severity.

Cardiovascular Event Prevalence in Type 1 Versus Type 2 Diabetes: Veradigm Metabolic Registry Insights.

Background: Diabetes mellitus type 1 (DM1) and type 2 (DM2) are well-established risk factors for cardiovascular disease but differ pathophysiologically in that DM1 results from insulin deficiency, whereas DM2 results from insulin insensitivity. The association between DM1 and DM2 and cardiovascular events remains undetermined.

Methods: For DM1 or DM2 patients aged 46 to 75 years receiving care at outpatient facilities with primary care and/or endocrinology enrolled in the National Cardiovascular Data Registry Veradigm Metabolic Registry 2017-2022, we compared the prevalence of incident cardiovascular events including myocardial infarction, percutaneous coronary intervention, coronary artery bypass grafting, stroke, carotid revascularization, limb ischemia, and peripheral revascularization.

Nirmatrelvir-ritonavir versus placebo-ritonavir in individuals with long COVID in the USA (PAX LC): a double-blind, randomised, placebo-controlled, phase 2, decentralised trial.

Background: The substantial burden of post-COVID-19 condition (also known as long COVID) underscores the need for effective pharmacological interventions. Given that viral persistence has been hypothesised as a potential cause of long COVID, antiviral therapy might offer a promising approach to alleviating long COVID symptoms. We therefore investigated the efficacy, safety, and tolerability of nirmatrelvir-ritonavir for treating long COVID.

Invasive vs Conservative Management of Patients With Chronic Total Occlusion: Results From the ISCHEMIA Trial.

Background: Randomized trials of chronic total occlusion (CTO) revascularization vs medical therapy have yielded inconsistent results.

Objectives: The aim of this study was to evaluate outcomes with an initial invasive strategy (INV) vs an initial conservative strategy (CON) in patients with coronary computed tomographic angiography (CCTA)-determined CTO in the ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) trial.

Methods: Participants in ISCHEMIA who underwent CCTA evaluated for CTO by the core laboratory (3,113 of 5,179 randomized patients [60%]) were categorized into subgroups with (100% stenosis) and without (<100% stenosis) CTO.