Evaluation of mid vs distal left anterior descending artery measures in coronary physiology assessment.

Background: Angina with no obstructive coronary artery disease (ANOCA) occurs in approximately 40 % of patients who undergo diagnostic coronary angiography for symptoms of angina. Coronary physiology assessment (CPA) is a guideline proven method to assess and diagnose these patients for an effective treatment strategy. There is currently no data regarding optimal wire or sensor position for CPA using bolus coronary thermodilution.

Evaluation of Intravenous Versus Intracoronary Adenosine in Coronary Reactivity Testing.

Coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) obtained through coronary bolus thermodilution are used to assess and treat patients with angina and no obstructive coronary artery disease. Previous studies demonstrate comparable results assessing epicardial ischemia by fractional flow reserve using intravenous (IV) or intracoronary (IC) adenosine. It is unknown if there is a similarity between IC and IV hyperemia with adenosine when performing coronary reactivity testing (CRT).

Challenges with the current United Network for Organ Sharing heart allocation system.

Purpose Of Review: The revised United States heart organ allocation system was launched in October 2018. In this review, we summarize this United Network for Organ Sharing (UNOS) policy and describe intended and unintended consequences.

Recent Findings: Although early studies published after the change suggested postheart transplant survival declined at 6 months and 1 year, recent publications with longer follow-up time have confirmed comparable posttransplant survival in adjusted models and several patient cohorts.

Profiling Cardiometabolic Health in Jordan: A Call to Action to Improve Cardiovascular Health.

Over the past decades, Jordan has witnessed unprecedented growth in the prevalence of cardiometabolic diseases, with a crude prevalence of 48.2% in 2020, up from 38% in 2009. This is slightly higher than the reported prevalence of 40% in the US population.

Angiographic Features and Clinical Outcomes of Balloon Uncrossable Lesions during Chronic Total Occlusion Percutaneous Coronary Intervention.

Balloon uncrossable lesions are defined as lesions that cannot be crossed with a balloon after successful guidewire crossing. We analyzed the association between balloon uncrossable lesions and procedural outcomes of 8671 chronic total occlusions (CTOs) percutaneous coronary interventions (PCIs) performed between 2012 and 2022 at 41 centers. The prevalence of balloon uncrossable lesions was 9.

3-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis.

Background: Randomized data comparing outcomes of transcatheter aortic valve replacement (TAVR) with surgery in low-surgical risk patients at time points beyond 2 years is limited. This presents an unknown for physicians striving to educate patients as part of a shared decision-making process.

Objectives: The authors evaluated 3-year clinical and echocardiographic outcomes from the Evolut Low Risk trial.

Sex Differences in Stress-Induced (Takotsubo) Cardiomyopathy.

Background: Takotsubo cardiomyopathy (TC) affects predominantly women. Prior studies have suggested that men might have worse short-term outcomes, but limited data are available regarding long-term outcomes. We hypothesized that men, compared to women, with TC have worse short- and long-term outcomes.

A novel artificial intelligence based algorithm to reduce wearable cardioverter-defibrillator alarms.

Background: The wearable cardioverter defibrillator (WCD) is an important tool in mitigating sudden cardiac death (SCD). The WCD provides patient alarms for detected arrhythmias or electrical noise/artifact. Some patients experience frequent alarms for artifact.

Single vs. multiple operators for chronic total occlusion percutaneous coronary interventions: From the PROGRESS-CTO Registry.

Background: There is limited data on the impact of a second attending operator on chronic total occlusion (CTO) percutaneous coronary intervention (PCI) outcomes.

Methods: We analyzed the association between multiple operators (MOs) (>1 attending operator) and procedural outcomes of 9296 CTO PCIs performed between 2012 and 2021 at 37 centers.

Results: CTO PCI was performed by a single operator (SO) in 85% of the cases and by MOs in 15%.

Use of the Limited Antegrade Subintimal Tracking Technique in Chronic Total Occlusion Percutaneous Coronary Intervention.

Background: There are limited data on the limited antegrade subintimal tracking (LAST) technique for chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Objectives: The aim of this study was to analyze the frequency of use and outcomes of the LAST technique for CTO PCI.

Methods: We analyzed 2,177 CTO PCIs performed using antegrade dissection and re-entry (ADR) in the PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) registry between 2012 and January 2022 at 39 centers.

Safety and efficacy of apixaban, dabigatran and rivaroxaban in obese and morbidly obese patients with heart failure and atrial fibrillation: A real-world analysis.

Background: Atrial fibrillation and heart failure are combined risk factors for thromboembolic events. Obese and morbidly obese individuals have been underrepresented in clinical trials studying safety and efficacy of direct oral anticoagulants (DOACs).

Objectives: Study the comparative safety and efficacy of DOACs in obese and morbidly obese patients with atrial fibrillation or flutter, and concomitant congestive heart failure.

Spontaneous coronary artery dissection and acute myocardial infarction in women.

Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of acute coronary syndrome, acute myocardial infarction, and sudden death in young patients, particularly women, presenting to the emergency department with chest pain. It is the most common cause of nonatherosclerotic coronary artery disease in women <50 years of age. Current guidelines for SCAD management come from case series that have demonstrated low success rates and high rates of complications with percutaneous coronary intervention.

Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement.

Background: Transcatheter aortic-valve replacement (TAVR) for the treatment of aortic stenosis can lead to embolization of debris. Capture of debris by devices that provide cerebral embolic protection (CEP) may reduce the risk of stroke.

Methods: We randomly assigned patients with aortic stenosis in a 1:1 ratio to undergo transfemoral TAVR with CEP (CEP group) or without CEP (control group).

Effect of empagliflozin on circulating proteomics in heart failure: mechanistic insights into the EMPEROR programme.

Aims: Sodium-glucose co-transporter 2 (SGLT2) inhibitors improve cardiovascular outcomes in diverse patient populations, but their mechanism of action requires further study. The aim is to explore the effect of empagliflozin on the circulating levels of intracellular proteins in patients with heart failure, using large-scale proteomics.

Methods And Results: Over 1250 circulating proteins were measured at baseline, Week 12, and Week 52 in 1134 patients from EMPEROR-Reduced and EMPEROR-Preserved, using the Olink® Explore 1536 platform.

Multi-center matched cohort study of convalescent plasma for hospitalized patients with COVID-19.

Background: Although frequently used in the early pandemic, data on the effectiveness of COVID-19 convalescent plasma (CCP) remain mixed. We investigated the effectiveness and safety of CCP in hospitalized COVID-19 patients in real-world practices during the first two waves of the pandemic in a multi-hospital healthcare system in Texas.

Methods And Findings: Among 11,322 hospitalized patients with confirmed COVID-19 infection from July 1, 2020 to April 15, 2021, we included patients who received CCP and matched them with those who did not receive CCP within ±2 days of the transfusion date across sites within strata of sex, age groups, days and use of dexamethasone from hospital admission to the match date, and oxygen requirements 4-12 hours prior to the match date.

Biomarker-driven prognostic models in chronic heart failure with preserved ejection fraction: the EMPEROR-Preserved trial.

Aims: Biomarker-driven prognostic models incorporating N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) in heart failure (HF) with preserved ejection fraction (HFpEF) are lacking. We aimed to generate a biomarker-driven prognostic tool for patients with chronic HFpEF enrolled in EMPEROR-Preserved.

Methods And Results: Multivariable Cox regression models were created for (i) the primary composite outcome of HF hospitalization or cardiovascular death, (ii) all-cause death, (iii) cardiovascular death, and (iv) HF hospitalization.