Avsnitt
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In the latest JACC offering from EuroPCR, JACC Associate Editor Celina M. Yong, MD, FACC, interviews Dr. Ashkan Eftekhari, PhD, to discuss insights into his study, Biolimus-Eluting Biomatrix Stent Versus a Dual-Therapy Sirolimus-Eluting Stent in PCI: SORT OUT XI Randomized Trial. The biolimus A9-eluting BioMatrix Alpha stent (BES), has not been compared with another contemporary drug eluting stent. This study compared one-year target lesion failure (TLF) in BES versus the dual-therapy sirolimus-eluting Combo stent (DTS) in an all-comer population undergoing PCI. A total of 3,136 patients were randomized 1:1 to either BES or DTS. The primary result showed that BES was non-inferior to DTS. Additionally, there was a significantly higher rate of definite stent thrombosis in the BES arm. In conclusion, BES was non-inferior to DTS at one-year follow-up with respect to the primary endpoint, TLF.
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Hosts Mitsuaki Sawano, MD, and Nobuhiro Ikemura, MD, welcome Yoshitaka Kimura, MD, PhD, of Leiden University Medical Center, to discuss proactive ablation strategies in patients with repaired Tetralogy of Fallot (rTOF). Dr. Kimura presents data from a long-term, single-center study evaluating electroanatomical mapping and preventive ablation of slow-conducting anatomical isthmuses (SCAI) in rTOF patients without prior ventricular tachycardia (VT). The findings show that identifying and successfully ablating SCAI significantly reduced VT incidence, with all VT events occurring in patients where ablation failed. Moreover, this approach reduced the proportion of patients qualifying for ICD implantation from 25–51% under current guidelines to just 11%. Dr. Kimura underscores a paradigm shift in congenital heart disease management—from treating VT reactively to preventing it proactively—highlighting the value of data-driven, tailored care strategies that avoid unnecessary device implantation and better target high-risk individuals.
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Go behind the scenes with JACC as editor-in-chief Harlan M. Krumholz, MD, SM, FACC, talks about what 's caught his attention in the latest JACC issue on amyloid. In this paper by Sheikh et al, the authors did a pre-specified exploratory analysis from the HELIOS-B trial, evaluating vutrisiran in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). The study showed that vutrisiran helped preserve or improve functional capacity and quality of life over 30 months, with consistent benefits across both monotherapy and tefamidis-treated patients. Waterfall plots illustrated the full spectrum of individual patient responses, revealing meaningful improvements in many while underscoring variability in outcomes. The analysis emphasized this heterogeneity, supporting a move toward precision care in amyloidosis.
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In this special issue of JACC, Dr. Valentin Fuster presents groundbreaking advances in the understanding and treatment of transthyretin amyloid cardiomyopathy, a once-fatal disease now facing a wave of therapeutic innovation. Highlighting seven key presentations, the episode explores novel biomarkers, gene editing, stabilizers, silencers, and real-world clinical outcomes that signal a new era of hope for patients.
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JACC Executive Associate Editor Karthik Murugiah, MD, FACC, speaks with author Jasmine M. Marquard, MD, PhD, on her study published in JACC and presented at EuroPCR. The discussion focuses on 10-year outcomes, including repeated events, of fractional flow reserve (FFR)-guided complete revascularization versus treatment of the infarct-related artery only in ST-segment elevation myocardial infarction. As the original trial, the primary outcome was a composite of all-cause mortality, recurrent myocardial infarction, or any revascularization. Complete revascularization reduced the risk of the primary outcome by 24%. Complete re-vascularization showed an absolute reduction of 13 events (-1 to 28 events) per 100 persons after 10 years. FFR-guided complete revascularization reduced future and repeated events after 10 years, primarily by reducing revascularization rates, without reducing myocardial infarctions or death.
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JACC: Associate Editor Michelle M. Kittleson, MD, PhD, FACC, and JACC: CardioOncology Deputy Editor Ronald Witteles, MD, FACC, discuss the current findings on the impact of vutrisiran in patients with transthyretin amyloidosis with cardiomyopathy (ATTR-CM). This study on HELIOS-B comprises details on cardiovascular (CV) events and provides updated mortality analyses from a later data cut than the primary analysis. Risk of ACM and CV events, including CV hospitalizations and heart failure events, was reduced with vutrisiran versus placebo in the overall population, with consistent trends regardless of baseline tafamidis use. These findings reinforce the balanced benefit on mortality and CV events demonstrated in the primary analysis of HELIOS-B.
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Hosts Mitsuaki Sawano, MD, co-host Nobuhiro Ikemura, MD, welcome Kentaro Kamiya, PhD, from Kitasato University, to discuss the ACTIVE-ADHF trial, a landmark multicenter RCT on early cardiac rehabilitation in acute decompensated heart failure. The study found that initiating exercise-based rehab during hospitalization significantly improved physical function, quality of life, and activity levels at discharge—even in non-frail patients—without increasing adverse events. Dr. Kamiya emphasizes that early rehab can prevent functional decline and support recovery, challenging assumptions about who benefits from acute-phase intervention and offering globally relevant evidence grounded in Japan’s unique clinical setting.
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Join JACC Editor in Chief Harlan Krumholz, MD, SM, as he speaks about this ACC.25 presentation published in JACC. This fascinating study by Rohan Khera et al independently analyzed patient-level data from the SURMOUNT trials of tirzepatide for obesity. The study revealed striking individual variability in weight loss and metabolic response, even to a highly effective therapy—an insight powerfully illustrated through waterfall plots. Reviewers praised the transparent, sponsor-independent approach and the study’s contribution to precision medicine, though they noted it was descriptive rather than predictive, underscoring the need for future research to identify what drives differential treatment response.
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This special lipid-themed issue of JACC emphasizes the importance of innovative research in lipid disorders to reduce cardiovascular risk, highlighting studies that extend our understanding of lipid biology and evaluate new treatments. Key reviews and original investigations explore novel lipid-modifying therapies, such as RNA interference and antibody therapies, demonstrating their potential in managing complex lipid disorders. The issue also includes editorials and case studies that provide critical context and underscore the need for personalized and mechanism-driven approaches in lipid management.
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In this special issue of the JACC, Dr. Valentin Fuster explores the latest findings in lipid research, covering groundbreaking therapies aimed at tackling cardiovascular risks tied to lipid disorders. Key highlights include innovative approaches to lowering triglyceride-rich lipoproteins using angiopoietin-like protein 3 inhibitors and other novel treatments, with promising data on reducing cardiovascular risk through targeted therapies.
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Hosts Mitsuaki Sawano, MD, and co-host Satoshi Shoji, MD, welcome regional associate editor Kentaro Ejiri, MD, for his debut appearance on the JACC: Baran Journal Club. Dr. Ejiri presents insights on the Altshock-2 trial, a pivotal randomized controlled trial evaluating early intra-aortic balloon pump (IABP) support in heart failure-related cardiogenic shock (HF-CS). The discussion covers the trial’s clinical relevance, key challenges, and the implications of its findings within the Japanese healthcare context. The episode also delves into evolving definitions of cardiogenic shock, trial methodology, and the potential for Altshock-2 to inform more individualized treatment approaches in Japan.
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In a Deep Dive in our May 13 issue, Editor-in-Chief Harlan Krumholz, MD, SM, FACC, discusses a study led by Barry Borlaug that investigates whether excess weight or metabolic dysfunction has a greater impact on heart failure with preserved ejection fraction (HFpEF). The findings showed that obesity—more than insulin resistance—was strongly associated with worse hemodynamic and functional outcomes. Reviewers praised the study's nuanced approach and use of invasive measures, while editorialists emphasized the ongoing importance of addressing both adiposity and metabolic health in HFpEF management.
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This JACC Deep Dive in our May 13 issue highlights new findings from the SUMMIT CKD study, showing that terzepatide improves symptoms, function, and weight in patients with HFpEF and obesity—regardless of kidney function. The analysis also underscores the importance of using both creatinine and cystatin C to better assess kidney health. Reviewers praised the study’s methodological rigor and dual focus, while noting the need for larger, long-term trials to confirm renal outcomes.
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In a time of rising global tensions, JACC reaffirms its commitment to science as a unifying, borderless force—advocating for truth, equity, and collaboration to improve health worldwide. By fostering inclusive research, promoting open dialogue, and resisting politicization, JACC aims to build a global medical community working together to overcome disease and conflict.
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In this podcast, Dr. Valentin Fuster discusses a groundbreaking study from the Orbiter 2 trial, which explores how dobutamine stress echocardiography (DSE) can predict the efficacy of percutaneous coronary intervention (PCI) in relieving angina in patients with stable coronary artery disease. The study reveals that the degree of ischemia, as measured by DSE, is strongly correlated with improvement in symptoms, offering new insights into patient selection for PCI treatment.
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In this episode, Dr. Valentin Fuster, provides a concise summary of the May 13, 2025 issue. He discusses four original studies on key cardiovascular topics, including the impact of chronic kidney disease and obesity on heart failure, the role of dobutamine stress echocardiography in predicting PCI outcomes, the effects of empagliflozin on erythropoiesis in heart failure, and the influence of adiposity, insulin resistance, and diabetes in heart failure with preserved ejection fraction. He highlights emerging insights into treatment strategies and ongoing challenges in understanding these complex cardiovascular conditions. Concluding with a separate review on anthracycline cardiotoxicity in cancer patients.
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In this podcast, Dr. Valentin Fuster reviews findings from the SUMMIT trial, which examined how tirzepatide impacts patients with obesity-related heart failure with preserved ejection fraction (HFpEF) and chronic kidney disease (CKD). The study revealed that while tirzepatide improved cardiovascular outcomes and slightly boosted kidney function, the benefits in CKD patients may stem from mechanisms beyond glomerular filtration alone.
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In this podcast, Dr. Valentin Fuster explores a study on the effects of SGLT2 inhibitors, like empagliflozin, on erythropoiesis and iron mobilization in heart failure patients. The research reveals how these drugs activate key metabolic pathways, potentially enhancing iron utilization and improving clinical outcomes, with significant implications for treatment in heart failure and chronic kidney disease.
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In this podcast, Dr. Valentin Fuster discusses a study published in the JACC examining the impact of obesity, insulin resistance, and diabetes on patients with heart failure and preserved ejection fraction. The findings suggest that while obesity is closely linked to heart abnormalities, insulin resistance and diabetes have a less direct impact, urging further research into cardiometabolic therapies and the role of body fat in managing heart failure.
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In this podcast, Dr. Valentin Fuster dives into the crucial review of anthracycline-induced cardiotoxicity in adult cancer patients, exploring the molecular mechanisms, treatment regimens, and long-term cardiovascular risks associated with this widely used chemotherapy. The podcast highlights the importance of early detection, collaborative care between oncologists and cardiologists, and the development of proactive strategies to manage and mitigate the heart-related side effects of anthracyclines for cancer survivors.
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