April 2025 Dispatch for the CV Team

Every month, Section Editor L.A. McKeown curates a roundup of recent news beyond our regular TCTMD coverage, with tidbits from journals and medical meetings around the globe that are of special interest to heart teams and allied cardiovascular professionals.

Data from over 1 million patients in the United Kingdom’s Myocardial Ischemia National Audit Project (MINAP) suggest that one in 10 acute MI patients experience heart failure (HF) hospitalization within the first year after discharge. This represents a significant increase since 2005. A HF hospital stay was associated with a threefold increase in 1-year mortality, the authors write in European Heart Journal Open.

An immobilization period of just 2 hours is safe for most patients following elective transfemoral TAVI and may help streamline early discharge protocols, minimize in-hospital morbidity, and improve patient experience. In a paper published in JSCAI, the investigators of the single-center RCT report no difference in postprocedural bleeding in patients randomized to short-duration immobilization versus those randomized to 4 hours.

Patients undergoing mitral valve-in-valve (MViV) replacement who are deemed clinically frail are at higher risk than nonfrail patients for returning to the hospital within 30 days and dying within 1 year, a study in Structural Heart suggests. Although frailty did not impact NYHA classification or increase cardiac-related hospitalization, the researchers advise that this characteristic be assessed as part of patient selection and procedural planning.

For pregnant women, better cardiovascular health in the first trimester and lower genetic risk are independently and additively associated with a lower risk of developing hypertensive disorders of pregnancy (HDP), data from the nuMoM2b study demonstrate. Writing in the Journal of the American College of Cardiology, the researchers say this suggests that having favorable CV health in early pregnancy could help mitigate an increased genetic risk for HDP.

In adults with Down syndrome, systolic blood pressure and pulse pressure rise only modestly with increasing age and body-mass index, a study published in the New England Journal of Medicine suggests. The authors say their findings provide further support for the idea that a unique cardiovascular phenotype in these individuals may confer lower risks of developing these conditions over the years.

More than 15 alcoholic drinks per week for men and more than eight per week for women is associated with a greater risk of CHD among people of all ages, according to data reported in the American Journal of Preventive Cardiology. The study supports earlier findings from the UK Biobank and others showing that any cardioprotective effects of alcohol are likely restricted to light drinkers with healthy lifestyles.

After endovascular aortic aneurysm repair (EVAR), Black patients are 56% more likely to experience late aortic-related events compared with white patients, according to a retrospective cohort study published in Circulation. The researchers say additional study of “preoperative medical management and barriers to postoperative healthcare access is necessary to further elucidate underlying mechanisms for the observed disparities.”

Routinely walking at an average or brisk pace (≥ 3-4 miles per hour) may help reduce future risk of rhythm disturbances, according to a study published in Heart. Compared with people who walked at a slow pace, those with a faster pace had less atrial fibrillation and other cardiac arrhythmias over a median follow-up of 13.7 years.

Respiratory syncytial virus (RSV) infection may confer an increased risk of cardiovascular events, a Danish study hints. In a nationwide case series analysis, the risk of ischemic stroke and HF hospitalization was four to eight times higher in the 14 days after a positive RSV test. The brief report, published in the Journal of the American College of Cardiology, raises important clinical considerations regarding how to manage older adults during RSV outbreaks, the authors say.

In symptomatic or asymptomatic patients with carotid artery stenosis ≥ 50% and low-to-intermediate 5-year risk of ipsilateral stroke, revascularization does not reduce risks of periprocedural death, fatal stroke, fatal MI, nonfatal stroke, nonfatal MI, or new silent cerebral infarction on imaging compared with optimal medical therapy (OMT) alone. The 2-year interim data from the Second European Carotid Surgery Trial (ECST-2), published in Lancet Neurology, suggest that an OMT strategy in these patients is recommended at least until the 5-year ECST-2 results become available.

News Highlights From TCTMD:

Oral GLP-1 Drug Shines in Phase III ACHIEVE-1 Trial, Lilly Says

Cardiotoxicity Rare With Common GI Chemotherapy

Nurses Can Be Pivotal in Post-ACS Secondary Prevention: ALLEPRE

EARLY TAVR: Delaying Valve Replacement Increases Risk of Poor Outcomes

Tight Fluid Restriction Not Needed in Chronic HF Patients: FRESH-UP