Publications by authors named "Claggett B"
Background: Females with hypertrophic cardiomyopathy present at a more advanced stage of the disease and have a higher risk of heart failure and death. The factors behind these differences are unclear. We aimed to investigate sex-related differences in clinical and genetic factors affecting adverse outcomes in the Sarcomeric Human Cardiomyopathy Registry.
View Article and Find Full Text PDFAims: Hepcidin regulates plasma and tissue iron levels. We studied the association of hepcidin levels with the risk of incident heart failure (HF) and cardiac dysfunction in older adults.
Methods: We included adults from the ongoing, longitudinal Atherosclerosis Risk in Communities (ARIC) study who were free from prevalent anemia and HF at Visit 5 (2011-2013) and had available hepcidin and covariate data.
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.
Background: An initial decline in estimated glomerular filtration rate (eGFR) often leads to reluctance to continue life-saving therapies in patients with heart failure (HF).
Objectives: The goal of this study was to describe the association between initial decline in eGFR and subsequent clinical outcomes in patients randomized to placebo or finerenone.
Methods: In this prespecified analysis of FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure), we examined the association between initial decline in eGFR (≥15%) from randomization to 1 month and subsequent outcomes in patients assigned to finerenone or placebo.
Background: Hypertension is common in patients with heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF), and current guidelines recommend treating systolic blood pressure (SBP) to a target <130 mm Hg. However, data supporting treatment to this target are limited. Additionally, pulse pressure (PP), a marker of aortic stiffness, has been associated with increased risk of cardiovascular events, but its prognostic impact in HFpEF has not been extensively studied.
View Article and Find Full Text PDFBackground: This study aims to characterize right ventricular dysfunction (RVD) in heart failure (HF) with preserved ejection fraction and understand the cumulative prognostic value of abnormal RV echocardiographic parameters in HF with preserved ejection fraction.
Methods And Results: Data from 809 patients in the PARAGON-HF (Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor With Angiotensin-Receptor Blocker Global Outcomes in HF With Preserved Ejection Fraction) echocardiographic substudy (55% women, mean age 74±8 years) were analyzed. Correlates of RVD (defined as tricuspid annular plane systolic excursion <1.
Background: IMPLEMENT-HF demonstrated a virtual team-based care strategy was safe and improved prescription of guideline directed medical therapy (GDMT) in hospitalized patients with heart failure and reduced ejection fraction (HFrEF). We evaluated differences in efficacy and safety outcomes by ethnicity in IMPLEMENT-HF.
Methods: IMPLEMENT-HF evaluated a provider-facing virtual team-based care strategy vs.
Aims: The temporal changes in clinical profiles and outcomes of high-risk myocardial infarction survivors enrolled in clinical trials are poorly described. This study compares mortality rates, baseline characteristics, and the prognostic impact of therapies among participants of the VALIANT and PARADISE-MI trials.
Methods And Results: Exclusively VALIANT participants who matched the inclusion criteria of the PARADISE-MI trial were included in the analysis.
Aims: The relationship between body mass index (BMI) and clinical outcomes in patients with cardiovascular disease, including acute heart failure (AHF) and acute myocardial infarction (AMI), remains debated. This study investigates the association between BMI and clinical outcomes within the PARADISE-MI cohort, while also evaluating the impact of angiotensin receptor-neprilysin inhibitor (ARNI) versus angiotensin-converting enzyme inhibitor (ACE-I) treatment on this relationship.
Methods And Results: The analysis included 5589 patients from the PARADISE-MI study with available baseline BMI data.
Aims: To evaluate clinical outcomes, echocardiographic features, and the efficacy and safety of sacubitril/valsartan compared to valsartan across age groups in the PARAGON-HF trial.
Methods And Results: A total of 4796 participants ≥50 years of age with chronic heart failure (HF) and left ventricular ejection fraction (LVEF) ≥45% were divided into three age groups: <65 years (n = 825), 65-74 years (n = 1772), and ≥75 years (n = 2199). Echocardiograms of 1097 patients were analysed in a standardized fashion at a core imaging laboratory.
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.
Article Synopsis
- - Hypertrophic cardiomyopathy (HCM) was traditionally seen as caused by rare, high-risk single-gene changes, but new research indicates common low-risk variants (LowSVs) also play a significant role in the disease.
- - In a study of over 6000 patients, 12 LowSVs were discovered, which are relatively common in the general population and more prevalent in HCM patients, suggesting they may influence disease severity and risk.
- - While LowSVs alone are linked to a later onset of HCM and fewer complications, their presence alongside more severe genetic variants increases health risks significantly.
Background: Despite evidence demonstrating that influenza vaccination is associated with reduced risk of cardiovascular events and all-cause mortality in individuals with diabetes mellitus (DM), vaccine uptake remains suboptimal.
Objectives: The purpose of this study was to assess the effectiveness of electronically delivered nudges on influenza vaccine uptake according to the presence of DM status versus other chronic diseases.
Methods: NUDGE-FLU-CHRONIC was a nationwide, randomized, pragmatic implementation trial among younger and middle-aged (18-64 years) Danish citizens with chronic disease during the 2023/2024 influenza season.
Article Synopsis
- Lower eGFR might lead to reluctance in starting heart failure therapies, and the study examines how kidney function influences the effectiveness of sacubitril/valsartan compared to valsartan.
- The PARAGON-HF trial included 4,796 chronic heart failure patients and found that those with lower baseline eGFR (<45 mL/min/1.73 m²) experienced a greater reduction in cardiovascular events when treated with sacubitril/valsartan.
- The results suggest that sacubitril/valsartan is particularly beneficial for heart failure patients with preserved ejection fraction and lower eGFR, indicating the need for careful consideration when prescribing treatments in this population.
Background And Aims: Individuals with heart failure (HF), other forms of cardiovascular disease, or kidney disease are at increased risk for the development and adverse health effects of diabetes. As such, prevention or delay of diabetes is an important treatment priority in these groups. The aim of this meta-analysis was to determine the effect of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on incident diabetes in HF across the spectrum of left ventricular ejection fraction (LVEF) and across the broader spectrum of cardiovascular or kidney disease.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the safety and efficacy of finerenone in treating heart failure, focusing on differences between men and women.
- Conducted as part of the FINEARTS-HF trial, it included over 6000 participants aged 40 and older across multiple countries.
- Results show that finerenone significantly reduces the risk of combined cardiovascular death and heart failure events in both sexes, with women experiencing slightly better outcomes on average.
Article Synopsis
- The study focuses on the significance of influenza vaccination in patients with acute myocardial infarction (AMI) and evaluates methods to enhance vaccine uptake among this high-risk group.
- The research consists of three nationwide randomized clinical trials conducted in Denmark that tested the effectiveness of electronically delivered behavioral nudges against usual care in increasing vaccination rates among AMI patients.
- The primary outcome measured was the rate of influenza vaccinations received, with findings suggesting that these behavioral nudges could potentially improve vaccination uptake in the targeted population.
Article Synopsis
- Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, improved outcomes for heart failure patients in the FINEARTS-HF trial but led to elevated serum potassium levels.
- The study aimed to analyze the frequency of abnormal serum potassium levels (<3.5 mmol/L and >5.5 mmol/L) and the impact of finerenone treatment compared to placebo on patient outcomes.
- Results showed that participants taking finerenone experienced significantly higher potassium levels over time, with increased risk of levels >5.5 mmol/L and reduced risk of levels <3.5 mmol/L, indicating a notable effect of the drug on potassium regulation.
Article Synopsis
- Medical record review by physician committees is the current standard for identifying cardiovascular outcomes in clinical trials, but it's time-consuming and inconsistent.
- A new AI model called "HF-NLP" was developed to automatically assess heart failure outcomes, tested on data from international trials, including the DELIVER trial.
- The AI achieved 83% agreement with expert committee decisions, and when supplemented with human reviews for uncertain cases, it could reach 91% agreement while significantly reducing workload.
Article Synopsis
- * The FINEARTS-HF trial compared the effectiveness of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, against a placebo, measuring primary outcomes like cardiovascular death and HF worsening events.
- * Results showed that lower KCCQ Total Symptom Scores (TSS) indicated a higher risk of adverse events, but finerenone significantly reduced event risks across all KCCQ TSS tertiles, suggesting it may improve outcomes for patients with varying levels of symptom severity.
Background: An improved understanding of the natural history in NYHA functional class I patients with obstructive hypertrophic cardiomyopathy (oHCM) is needed.
Objectives: Using a multicenter registry (SHaRe [Sarcomeric Human Cardiomyopathy Registry]), this study described the natural history in patients with oHCM who were classified as NYHA functional class I at the initial visit compared with patients classified as NYHA functional class II and reported baseline characteristics associated with incident clinical events.
Methods: Incident events assessed included a composite of NYHA functional class III to IV symptoms, left ventricular ejection fraction <50%, atrial fibrillation, stroke, ventricular arrhythmias, septal reduction therapy, ventricular assist device or transplantation, or death.
Background: Finerenone has kidney-protective effects in patients with chronic kidney disease with type 2 diabetes, but effects on kidney outcomes in patients with heart failure with and without diabetes and/or chronic kidney disease are not known.
Objectives: The purpose of this study was to examine the effects of finerenone on kidney outcomes in FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure), a randomized trial of finerenone vs placebo among patients with heart failure with mildly reduced or preserved ejection fraction.
Methods: We explored the effects of finerenone on the secondary outcome of a sustained ≥50% estimated glomerular filtration rate (eGFR) decline or kidney failure (sustained eGFR decline <15 mL/min/1.
Background: Type 2 diabetes mellitus (T2DM) may be a long-term sequela of infection with () by mechanisms that remain to be fully explained. We evaluated the association between sensitization and T2DM and, via mediation analysis, the extent to which it is mediated by insulin resistance and/or β-cell failure.
Methods: Adults were assessed for T2DM by fasting plasma glucose, 2-hour oral glucose tolerance testing, and hemoglobin A; β-cell dysfunction and insulin resistance by homoeostasis model assessment 2; and sensitization by tuberculin skin testing.