December 2024 News Roundup

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.

The treating hospital plays a key role in whether patients get access to cardiac rehab after acute MI, CABG, PCI, or heart valve repair/replacement, according to a study of Medicare beneficiaries. Published in JACC: Advances, the study found up to tenfold differences in cardiac rehab enrollment rates between hospitals, with fewer than 1% of centers achieving an enrollment rate greater than 70%.

Poor adherence to cardiovascular medications isn’t a simple issue to understand or solve. In a study of patients who were sent text message reminders when they delayed refilling their prescriptions, no improvement was seen in adherence based on pharmacy data or reductions in clinical events at 12 months. The study in JAMA suggests that “additional interventions need to be rigorously tested to try to improve adherence to chronic cardiovascular medications, given the growing incidence of chronic cardiovascular conditions.”

Compared with other racial and ethnic groups, Black patients stand to gain the most from the opening of a PCI-capable center in their neighborhood, with significant benefits in those with NSTEMI and those with STEMI, according to a rapid communication published in the Journal of the American Heart Association. Since some differences were seen according to how much communities were integrated, the authors suggest that more research into “potential factors contributing to the smaller benefits observed in segregated communities is warranted, particularly as prior literature has shown that socioeconomic and environmental resources and opportunities differ in segregated versus integrated communities.”

Young asylum seekers to the United States have a high risk for CV disease, with stress and trauma found to be strongly predictive of comorbid CVD symptoms. Writing in Nature Mental Health, the investigators say they were surprised to find that 47% of the 450 individuals they studied, who had a median age of 30, reported palpitations, presyncope/syncope, stroke symptoms, or chest pain. They note that this is a largely untapped area of CV research that could have far-ranging consequences for population health and healthcare resource allocation.

In patients with cardiac implantable electronic devices (CIEDs), those who have changes in atrial fibrillation (AF) burden over time are at greater risk of stroke and mortality than those with stable AF. Writing in JACC: Clinical Electrophysiology, the authors say the study demonstrates that AF risk is not static over time and that there may be a benefit to early rhythm control interventions for patients with device-detected AF duration changes.

A study of parents and clinicians suggests that skepticism about blood pressure readings and concerns about starting medication may impede the early management of hypertension in children. “Although parents prioritized annual blood pressure checks, clinicians often downplayed high blood pressure in clinic, with both groups favoring lifestyle changes over medication, highlighting the need for improved communication around nonpharmacologic treatments,” the researchers conclude in the paper published in JAMA Network Open. 

In real-world patients who have heart failure with reduced ejection fraction (HFrEF), the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors was associated with a 25% decrease in all-cause mortality and a 23% lower risk of CV mortality, according to data from the Danish Heart Failure Registry. The association was consistent across subgroups, including patients with and without type 2 diabetes, the authors report in the British Medical Journal.

Compared with white patients, those who are Black and Hispanic present with more-advanced disease at when they get a diagnosis of severe tricuspid regurgitation, according to a study from the Bronx-Valve registry published in the International Journal of Cardiology. While mortality rates at 5 years were not significantly different between racial/ethnic groups, Black patients had a higher overall risk of HF hospitalization.

An expert consensus decision pathway from the American College of Cardiology addresses practical approaches for AF monitoring in the poststroke patient. The document covers various populations and technologies, including a discussion about how clinicians can assist patients with the use of certain consumer monitoring devices, where appropriate. The paper was published in the Journal of the American College of Cardiology.

Just in time for the holidays, a large Swedish study suggests that while sugar-sweetened beverages and sugary treats like baked goods and chocolate increase cardiovascular risk when consumed frequently, the occasional treat may be less harmful than no treats at all. “While our observational study cannot establish causation, these findings suggest that extremely low sugar intake may not be necessary or beneficial for cardiovascular health,” the researchers write in Frontiers in Public Health. Frequent consumption of sugar-sweetened drinks was found to be associated with a greater risk of ischemic stroke, HF, AF, and abdominal aortic aneurysm than any other form of sugar consumption.

News Highlights From TCTMD:

Smokeless Oral Nicotine: Many Unknowns, Potential Risks to CV Health

Obesity Trends May Be Going in the Right Direction for the First Time in a Decade

Palliative Care in HF: Practical Advice From the HFSA

Questions Raised Anew About Aspirin for Secondary Prevention of ASCVD

EXCEL Data Highlight Bleeding Patterns After CABG, PCI for LM Disease