September 2023 News Roundup
This month: the CV legacy of incarceration, machine learning for PCI, cardiomyopathy in pregnancy, and more.
Every month, Section Editor L.A. McKeown curates a roundup of recent news tidbits from journals and medical meetings around the globe.
An article in Atherosclerosis reviews existing treatment guidelines and data on outcomes for atherosclerotic cardiovascular disease (ASCVD) in men and women, and highlights next directions in research, including pathophysiologic differences in clinical trial design as well as individual-level and systems-based interventions that are needed to continue equalizing CV outcomes.
Compared with white patients with critical limb ischemia (CLI), those who are Black, Hispanic, Asian, or Pacific Islander are more likely to receive invasive treatments, including major amputations and revascularization, an analysis from the National Inpatient Sample suggests. Writing in the Journal of the American Heart Association, the authors say, “The disparities gap is slowly closing for some, but much work is still necessary to ensure equitable care and better outcomes for patients with CLI.”
Having a parent who is in prison may increase an individual’s risk of early-onset hypertension and elevated high-sensitivity C-reactive protein (hs-CRP) in adulthood by 33% and 60%, respectively, according to findings from the Add Health study published in JAMA Cardiology. Although other CV risk factors were not increased, the authors say the findings “suggest possible transgenerational health consequences of mass incarceration.”
Physician assessment of aortic stenosis severity strongly correlates with clinical outcomes, including all-cause death and CV hospitalization, according to data from a real-world cohort of nearly 50,000 patients. Reporting in the American Heart Journal, researchers say patients with moderate-to-severe aortic stenosis had outcomes that were similar to patients with severe disease, while those with moderate aortic stenosis had outcomes comparable to what’s seen with mild aortic stenosis.
An analysis of patients who had concurrent acute MI and COVID-19 in 2020 reveals a number of racial disparities. These include greater in-hospital mortality in Black and Asian/Pacific Islander patients compared with white patients, and less likelihood of receiving PCI for acute MI in Black, Hispanic, and Asian/Pacific Islander patients compared with white patients, investigators write in Current Problems in Cardiology.
A scientific statement from the American Heart Association examines barriers to achieving ideal CV health and discusses leveraging existing resources to reduce healthcare inequities and optimize prevention. Published in Circulation, the document asserts that effective and equitable care “requires a coordinated multidisciplinary and multilayer approach.”
The success of a machine-learning model to predict death, ischemic stroke, and major bleeding after PCI suggests that this may be a way forward in benchmarking and risk prediction utilizing routinely collected administrative data like the National Inpatient Sample. The researchers report the findings in the International Journal of Cardiology.
With the use of patient-reported outcomes (PROs) on the rise in cardiology, a statement from multiple European medical and patient advocacy groups highlights their use in clinical practice, for monitoring the quality of care, and as input for regulatory and reimbursement decisions. The statement appears in the European Heart Journal.
A state-of-the-art review published in JACC: Heart Failure highlights important considerations in the management of women with confirmed or suspected cardiomyopathy during pregnancy. The review covers preconception counseling, risk stratification and management extending to the postpartum period, the safety of heart failure medications during pregnancy and lactation, and pregnancy considerations in women on a left ventricular assist device (LVAD) and those who have had a heart transplantation.
Remote digital monitoring programs may help patients with uncontrolled hypertension achieve better BP measurements. In a 13-state study, a digital phone app available in both English and Spanish that prompted patients to provide their BP readings increased the percentage with controlled BP from 31% to 61% over a median length of use of 227 days. The study was presented at the American Heart Association’s Hypertension Scientific Sessions.