American Heart Association, Nov. 11-13

The annual meeting of the American Heart Association was held this year from Nov. 11 to 13 in Philadelphia and attracted participants from around the world, including cardiovascular specialists, surgeons, and nurses as well as other health care professionals. The conference featured presentations focusing on the latest advances in cardiovascular medicine and surgery.

In one study, Cody Gathers, M.D., of the Children’s Hospital of Philadelphia and the University of Pennsylvania, and colleagues found racial and neighborhood disparities in the incidence rates of cardiac arrest to be striking.

The authors evaluated data from the Cardiac Arrest Registry to Enhance Survival in an effort to gain insight into racial, ethnic, and socioeconomic disparities in out-of-hospital cardiac arrests and survival outcomes. The researchers found that Black children had four times higher incidence rates for out-of-hospital cardiac arrest as White and Hispanic children, while children from high-risk neighborhoods had three times higher incidence rates for cardiac arrest as children from low-risk neighborhoods. Black children were 36 percent less likely to have good neurologic survival compared with White children, and children from high-risk neighborhoods were 46 percent less likely to have good neurologic survival.

“Efforts should focus on preventing cardiac arrest in these communities. Additionally, the racial and socioeconomic disparities in survival are likely driven by disparities in bystander cardiopulmonary resuscitation,” Gathers said. “We should prioritize robust and targeted interventions for cardiopulmonary resuscitation training and education in high-risk communities.”

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In another study, Deepak K. Gupta, M.D., of the Vanderbilt Translational and Clinical Cardiovascular Research Center in Nashville, Tennessee, and colleagues observed a clinically meaningful lowering of blood pressure through reduction in dietary sodium, achieved safely and rapidly in one week in middle-aged and elderly individuals. The effect was comparable to that seen with a commonly utilized first-line antihypertensive medication.

The authors conducted a randomized diet-order cross-over study involving individuals with and without treated hypertension as well as diabetes to understand how addition of sodium or reduction of sodium to an individuals’ own usual diet affected blood pressure. Specifically, 213 patients were randomly assigned to a high-sodium diet (2,200 mg of sodium added to their usual daily diet) or a low-sodium diet (total of 500 mg of sodium daily). Participants then crossed over to the other study arm. The researchers discovered that the usual diet for most individuals was already very high in sodium (about 4,500 mg/day). The addition of sodium resulted in an average sodium diet of 5,000 mg/day, but this did not significantly raise systolic blood pressure compared with usual diet; however, reduction in dietary sodium to an average of 1,300 mg/day significantly lowered systolic blood pressure.

“The low-sodium diet reduced systolic blood pressure by an average of 8 mm Hg compared with the high-sodium diet. This effect was consistent across subgroups, including individuals already taking medications to lower blood pressure and individuals with and without diabetes,” Gupta said. “The decline in blood pressure resulting from dietary sodium reduction was independent of hypertension status and antihypertensive medication use, was generally consistent across subgroups, and did not result in excess adverse events.”

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In the phase 2 AZALEA-TIMI 71 trial, Christian T. Ruff, M.D., of Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues found that potent inhibition of factor XI with abelacimab, an experimental anticlotting medication, among patients with atrial fibrillation is safe and associated with very low rates of bleeding.

The authors compared bleeding occurrence in 1,287 patients taking either 90 or 150 mg of abelacimab or 20 mg daily of rivaroxaban. In patients with atrial fibrillation at moderate-to-high risk for stroke, the researchers found that abelacimab potently inhibited factor XI (>95 percent inhibition). Abelacimab resulted in substantial and highly significant reductions in bleeding compared with standard-of-care rivaroxaban (67 and 77 percent reduction in major or clinically relevant nonmajor bleeding for the 150- and 90-mg doses, respectively). Furthermore, gastrointestinal bleeding was almost eliminated with abelacimab compared with rivaroxaban (93 percent reductions in both dosage arms). The trial was halted early based on the recommendation of an independent data monitoring committee in September 2023 due to the positive reduction in bleeding.

“Although current anticoagulation with direct-acting oral anticoagulants is effective in reducing stroke in patients with atrial fibrillation, clinically important bleeding is frequent and leads to substantial undertreatment,” Ruff said. “Abelacimab confirms the promise that inhibition of factor XI uncouples hemostasis from thrombosis, allowing us to potentially provide patients with effective and incredibly safe anticoagulation. We eagerly await ongoing results of phase 3 trials that will confirm the efficacy of abelacimab.”

The study was funded by Anthos Therapeutics, which is developing abelacimab.

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AHA: Lung Inflation Occurs Infrequently With Ventilation During 30:2 CPR

FRIDAY, Nov. 17, 2023 (HealthDay News) — Lung inflation occurs infrequently with bag-valve-mask ventilation during 30:2 cardiopulmonary resuscitation, according to a study published online Nov. 12 in Circulation to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Percutaneous Coronary Intervention Significantly Cuts Angina Symptoms

FRIDAY, Nov. 17, 2023 (HealthDay News) — Percutaneous coronary intervention improves symptoms versus placebo among patients with stable angina and taking no chest pain medication, according to a study published online Nov. 11 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Self-Monitoring, Remote Physician-Guided Titration Aids Postpartum BP Control

FRIDAY, Nov. 17, 2023 (HealthDay News) — The combination of self-monitoring and physician-guided titration of antihypertensive medications is associated with lower postpartum blood pressure following a hypertensive pregnancy compared with usual postnatal outpatient care, according to a study published online Nov. 11 in the Journal of the American Medical Association to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Avoidance of Aspirin Noninferior With LVAD in Advanced Heart Failure

THURSDAY, Nov. 16, 2023 (HealthDay News) — Avoidance of aspirin as part of an antithrombotic regimen that includes a vitamin K agonist is noninferior to an aspirin-containing regimen for patients with advanced heart failure receiving support from a fully magnetically levitated left ventricular assist device, according to a study published online Nov. 11 in the Journal of the American Medical Association. The research was published to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Sodium Reduction in Diet Lowers Blood Pressure in Seniors

THURSDAY, Nov. 16, 2023 (HealthDay News) — Sodium reduction in the diet lowers blood pressure, with the effect generally consistent across subgroups, according to a study published online Nov. 11 in the Journal of the American Medical Association to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Apixaban Beneficial for Patients With Subclinical A-Fib

TUESDAY, Nov. 14, 2023 (HealthDay News) — Apixaban results in a lower risk for stroke or systemic embolism than aspirin for patients with subclinical atrial fibrillation, according to a study published online Nov. 12 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: No Real Benefit Seen for Liberal Transfusion Strategy in AMI, Anemia

TUESDAY, Nov. 14, 2023 (HealthDay News) — For patients with acute myocardial infarction and anemia, a liberal transfusion strategy does not significantly reduce the risk for recurrent myocardial infarction or death compared with a restrictive strategy, according to a study published online Nov. 11 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Semaglutide Cuts Risk for CVD Events in Patients Without Diabetes

MONDAY, Nov. 13, 2023 (HealthDay News) — Weekly subcutaneous semaglutide significantly cuts the incidence of cardiovascular death and nonfatal heart attacks and strokes in adults with preexisting cardiovascular disease and overweight or obesity but no diabetes, according to a study published online Nov. 11 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Fresh Produce Prescription Improves Glycemic Control

MONDAY, Nov. 13, 2023 (HealthDay News) — A fresh produce prescription program can significantly improve hemoglobin A1c among low-income patients with diabetes and poor glycemic control, according to a study presented at the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Daily Marijuana Use Linked to Incident Heart Failure

MONDAY, Nov. 13, 2023 (HealthDay News) — Daily marijuana use is associated with incident heart failure, and cannabis use disorder is associated with increased odds of major adverse cardiac and cerebrovascular events, according to two studies presented at the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: PREVENT Risk Calculator Estimates Risk for Cardiovascular Disease

MONDAY, Nov. 13, 2023 (HealthDay News) — The Predicting Risk of Cardiovascular Disease Events risk calculator estimates the risk for cardiovascular disease, including heart failure, according to a methods paper and accompanying scientific statement published online Nov. 10 in Circulation to coincide with the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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AHA: Depression, Anxiety Linked to CVD Risk Factors, MACE

WEDNESDAY, Nov. 8, 2023 (HealthDay News) — Depression and anxiety are associated with an increased risk for cardiovascular disease risk factors and major adverse cardiovascular events, and a higher composite measure of perceived stress is associated with atherosclerotic and global cardiovascular disease, according to two studies to be presented at the American Heart Association Scientific Sessions 2023, being held from Nov. 11 to 13 in Philadelphia.

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AHA: High Cardiovascular Health Linked to Lower Phenotypic Age

WEDNESDAY, Nov. 8, 2023 (HealthDay News) — There is an inverse association for cardiovascular health with phenotypic age and phenotypic age acceleration, according to a study to be presented at the American Heart Association Scientific Sessions 2023, held from Nov. 11 to 13 in Philadelphia.

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