# HartVaat.nl, every article in English (4456) Generated 2026-08-28T16:42:09Z; content changed 2026-08-28T15:15:36Z. Quote freely with attribution and a link to hartvaat.nl (the record's url). Summaries are editorial work by HartVaat; the original publications remain their publishers' (doi). Not medical advice. ## Prediction of Atrial Fibrillation Occurrence With Handheld Mobile Electrocardiogram: Deep Learning Model Development Using Real-World Data. *2026-08-28 · JMIR medical informatics · https://doi.org/10.2196/87142 · https://hartvaat.nl/2026/08/20/deep-learning-op-mobiele-ecg-voorspelt-atriumfibrilleren-binnen-30-dagen/* Researchers developed a deep learning model that predicts the short-term occurrence of atrial fibrillation (AF) within 7, 14, and 31 days using a single resting ECG recording from a handheld mobile device. In a real-world cohort of over 386,000 recordings from 8,200 users, the model achieved an AUROC of 0.79 for 31-day prediction, significantly outperforming single-lead approaches. These findings suggest that AI-driven risk stratification from consumer-grade ECGs could serve as a practical tool for opportunistic AF screening, enabling targeted follow-up in primary care and cardiology. ## Timing-Specific Factors Associated With Early, Intermediate, and Late Readmission After Heart Failure Hospitalisation. *2026-08-28 · ESC heart failure · https://doi.org/10.1093/eschf/xvag219 · https://hartvaat.nl/2026/08/20/risicofactoren-voor-vroege-tussen-en-late-hartfalenheropnames-na-ontslag/* This secondary analysis of 1,992 patients discharged from a single-centre heart failure cohort identified distinct risk factors for readmissions within 180 days. Early readmissions (≤28 days) were linked to advanced heart failure severity, reduced eGFR, and hyponatraemia, whereas late readmissions (91-180 days) showed stronger associations with dementia, chronic kidney disease, and diabetes. Predictive models showed modest discrimination (AUC 0.63–0.68). The findings suggest that post-discharge follow-up strategies should be tailored to the specific time window and the patient’s comorbidity profile. ## Cardiovascular, Renal, and Pulmonary Risks of Long COVID: A Retrospective Cohort Study Stratified by Age and Sex. *2026-08-28 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.126.049226 · https://hartvaat.nl/2026/08/20/long-covid-verhoogt-risico-op-hart-nier-en-longcomplicaties-trinetx-cohort/* In a retrospective cohort of over 300,000 propensity-matched COVID-19 patients, Long COVID was associated with an elevated risk of cardiovascular, renal, and pulmonary complications. The relative risk was disproportionately higher in younger adults, particularly young women for cardiovascular and renal outcomes, and young men for pulmonary outcomes. These findings highlight the need for structured follow-up and risk-reduction strategies for Long COVID patients in routine clinical practice. ## Parental Obesity and Offspring Risk for Cardiorenal Diseases. *2026-08-28 · Current hypertension reports · https://doi.org/10.1007/s11906-026-01379-2 · https://hartvaat.nl/2026/08/20/ouderlijke-obesitas-verhoogt-cardiorenale-risico-s-bij-nakomelingen-review/* This narrative review examines evidence linking parental obesity, particularly maternal obesity, to an increased risk of cardiorenal and metabolic dysfunction in offspring. Emerging data suggest that intrauterine exposures, chronic inflammation, mitochondrial dysfunction, and altered intercellular signaling contribute to transgenerational disease programming. For clinical practice, these findings reinforce the importance of preconception counseling, weight management during pregnancy, and early-life interventions to mitigate long-term cardiovascular risk in the next generation. ## Kidney Tubular Secretion Capacity and Risk of Cardiovascular Mortality in the General Population: The HUNT Study. *2026-08-28 · Clinical journal of the American Society of Nephrology : CJASN · https://doi.org/10.2215/CJN.0000001183 · https://hartvaat.nl/2026/08/20/aangetaste-tubulaire-secretiecapaciteit-verhoogt-cardiovasculaire-sterfte-hunt-s/* Researchers from the HUNT study investigated the association between kidney tubular secretion capacity and cardiovascular mortality in a general community-dwelling population. After adjusting for eGFR, albuminuria, and traditional risk factors, each standard deviation decrease in a composite tubular secretion score was linked to a 27% higher risk of cardiovascular death (HR 1.27; 95% CI 1.03–1.56). The findings indicate that impaired tubular function independently predicts cardiovascular mortality, even in individuals with preserved kidney filtration and no significant albuminuria. ## First ESC guideline on cardiac rehabilitation: multidisciplinary, also home-based and digital, and for far more patients than the post-infarction group *2026-08-28 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag099 · https://hartvaat.nl/2026/08/28/eerste-esc-richtlijn-hartrevalidatie-multidisciplinair-ook-thuis-en-digitaal-en-/* Published today in the European Heart Journal ahead of its Monday presentation: the first dedicated ESC guideline on cardiac rehabilitation, chaired by Maria Bäck (Gothenburg), Matthias Wilhelm (Bern) and Dominique Hansen (Hasselt). Core components are exercise training, psychological support and personalised education on lifestyle and adherence, delivered by a multidisciplinary team, in hospital or through digitally supported home-based programmes with remote monitoring. Indications extend beyond myocardial infarction to heart failure, congenital heart disease, atrial fibrillation, valve replacement and patients receiving cardiotoxic cancer therapy. The guideline calls out the under-use of one of the most effective and cost-effective treatments in cardiology. ## Fifth Universal Definition of Myocardial Infarction: the type numbers go, replaced by primary, secondary and procedure-related infarction *2026-08-28 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag101 · https://hartvaat.nl/2026/08/28/vijfde-universele-definitie-van-het-myocardinfarct-de-typenummers-verdwijnen-voo/* ESC, ACC, AHA and WHF published the Fifth Universal Definition of MI today in the European Heart Journal, simultaneously in Circulation and Global Heart. The numbered types (1 to 5, 4a to 4c) are replaced by three clinical categories: primary MI (plaque rupture, spontaneous coronary artery dissection, spasm, thrombosis), secondary MI (supply-demand mismatch) and procedure-related MI (within 30 days of a cardiac procedure or surgery). The aim is a language patients understand and a research frame for underdiagnosed causes such as SCAD, which predominantly affects women. Chairs: Nicholas Mills (ESC), Kristin Newby (ACC/AHA), Sarah Zaman (WHF). ## CMR GUIDE: an ICD for scar on CMR with LVEF 36 to 50 percent misses its primary endpoint but reduces sudden cardiac death, with benefit confined to patients under 70 *2026-08-28 · JAMA · https://doi.org/10.1001/jama.2026.17078 · https://hartvaat.nl/2026/08/28/cmr-guide-icd-bij-littekenweefsel-en-lvef-36-tot-50-procent-mist-het-primaire-ei/* 353 patients with LVEF 36 to 50 percent on optimal therapy and myocardial scar on cardiovascular magnetic resonance (ischaemic or non-ischaemic, 18 centres in Australia, Germany and the UK) were randomised to an ICD or an implantable loop recorder. The primary composite of sudden cardiac death or haemodynamically significant ventricular arrhythmia was 7.8 versus 9.2 percent (HR 0.76, 95% CI 0.37 to 1.58). Sudden cardiac death alone: 1.7 versus 5.8 percent (HR 0.26, 95% CI 0.07 to 0.95). Under 70 the primary endpoint fell by 72 percent; at 70 and over there was no benefit. Hot Line 1, JAMA. ## POET-II: response-tailored antibiotic duration in left-sided endocarditis saves two weeks and is non-inferior, at the cost of more relapses *2026-08-28 · New England Journal of Medicine · https://doi.org/10.1056/NEJMoa2607887 · https://hartvaat.nl/2026/08/28/poet-ii-responsgestuurde-antibioticaduur-bij-linkszijdige-endocarditis-scheelt-t/* Investigator-initiated open-label trial in 508 clinically stable patients with left-sided endocarditis due to S. aureus, E. faecalis or streptococci (13 centres, Denmark, Sweden, US). Stopping antibiotics once stabilisation criteria were met after a minimum of 2 to 4 weeks yielded 183 versus 169 days alive without antibiotics within 6 months (p under 0.001), median 26 versus 41 days of treatment; the safety composite of death, unplanned valve surgery or symptomatic embolism was 8.2 versus 10.7 percent, meeting non-inferiority. Relapse was more frequent: 5.1 versus 1.6 percent (p=0.04). Hot Line 1, NEJM. ## New 2026 ESC guideline on cardiovascular disease and chronic kidney disease: eGFR and albuminuria for every cardiac patient, an SGLT2 inhibitor regardless of ejection fraction, and a chair from Groningen *2026-08-28 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag098 · https://hartvaat.nl/2026/08/28/nieuwe-esc-richtlijn-hart-en-nier-2026-egfr-en-albuminurie-bij-elke-hartpatient-/* Published today in the European Heart Journal ahead of its Saturday presentation: the first ESC guideline that treats cardiovascular disease and chronic kidney disease as one condition, endorsed by the European Renal Association and chaired by Kevin Damman (UMC Groningen) with William Herrington (Oxford); Jozine ter Maaten (UMCG) co-ordinated. Class I: every patient with CVD is tested for CKD with creatinine-based eGFR and a spot morning urine albumin-to-creatinine ratio, classified by GFR and albuminuria, confirmed over three months. SGLT2 inhibitors across CKD stages and in heart failure regardless of LVEF, early RAS inhibition, finerenone, GLP-1 receptor agonists in diabetes, statins, DOACs over VKA down to an eGFR of 15. The STAMP framework: Screen, Triage, Address CKD risk, Modify CVD management, Plan services. ## SINGLE-AF: a DOAC protects patients with atrial fibrillation and a single stroke risk factor, without excess major bleeding *2026-08-28 · New England Journal of Medicine · https://doi.org/10.1056/NEJMoa2607978 · https://hartvaat.nl/2026/08/28/single-af-doac-beschermt-patienten-met-atriumfibrilleren-en-een-risicofactor-zon/* The first randomised trial in the guideline grey zone: 1,803 Korean patients with AF and a CHA2DS2-VASc score of 1 (men) or 2 (women) were randomised to apixaban or rivaroxaban versus no anticoagulation. At 24 months the composite of stroke, systemic embolism, major bleeding or cardiovascular death occurred in 0.5 percent versus 1.5 percent (HR 0.31, 95% CI 0.10 to 0.94, p=0.028); ischaemic stroke 0.1 versus 1.1 percent; major bleeding 0.3 versus 0.5 percent. Hot Line 1, NEJM. ## CARDIO-TTRansform: eplontersen misses its primary endpoint in ATTR cardiomyopathy, with only a nominal signal in patients not on a stabiliser *2026-08-28 · New England Journal of Medicine · https://doi.org/10.1056/NEJMoa2608510 · https://hartvaat.nl/2026/08/28/cardio-ttransform-eplontersen-mist-het-primaire-eindpunt-bij-attr-cardiomyopathi/* The largest ATTR-CM trial to date (1,432 patients, 130 centres) randomised eplontersen 45 mg every four weeks against placebo. The primary composite of cardiovascular death and recurrent cardiovascular events through week 140 was not reduced (rate ratio 0.89, 95% CI 0.73 to 1.09, p=0.277). In the prespecified 43 percent without a baseline stabiliser the signal was nominally positive; on top of tafamidis or acoramidis there was no added benefit. Serum TTR was suppressed throughout. Presented in Hot Line 1 by Mathew Maurer and published in the NEJM. ## New 2026 ESC heart failure guideline: two phenotypes instead of three, an MRA for everyone, stages A to D and semaglutide for HFpEF with obesity *2026-08-28 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag100 · https://hartvaat.nl/2026/08/28/nieuwe-esc-hartfalenrichtlijn-2026-twee-fenotypes-in-plaats-van-drie-mra-voor-ie/* Presented in Munich on 28 August 2026 and published in the European Heart Journal: the first full revision of the ESC heart failure guideline since 2021. HFmrEF disappears (HFrEF now means LVEF below 50 percent, HFpEF 50 percent and above), a stage A to D framework puts prevention on the map, 'acute' becomes 'decompensated', and GDMT is replaced by foundational, additional and interventional therapy. New class I recommendations: an MRA for symptomatic HF regardless of LVEF (finerenone for HFpEF), in-hospital SGLT2 inhibitor start after stabilisation, uptitration every 1 to 2 weeks, IV iron, early advanced-HF referral and palliative care access. Class IIa: semaglutide or tirzepatide for HF with LVEF 45 percent or higher and BMI 30 or higher, digoxin or digitoxin for symptomatic HFrEF. Four Dutch task force members. ## ACACIA-HCM: aficamten improves symptoms and exercise capacity in non-obstructive HCM, the first positive trial ever in this population *2026-08-28 · New England Journal of Medicine · https://doi.org/10.1056/NEJMoa2603021 · https://hartvaat.nl/2026/08/28/acacia-hcm-aficamten-verbetert-symptomen-en-inspanningscapaciteit-bij-niet-obstr/* Presented in Hot Line 1 at ESC Congress 2026 in Munich and published simultaneously in the NEJM: in 517 patients with symptomatic non-obstructive hypertrophic cardiomyopathy, aficamten improved both KCCQ-CSS (difference 3.0 points, p=0.021) and peak VO2 (difference 0.67 mL/kg/min, p=0.003) at 36 weeks versus placebo. NYHA class improved in 42 percent versus 28 percent, NT-proBNP fell by more than half, and 53 percent versus 13 percent responded in three or more domains. The price: LVEF below 50 percent in 10.5 percent versus 0.8 percent, and more serious adverse events. A first drug for a third of the HCM population, with a modest effect size and a safety signal that demands echo-guided titration. ## Reappraising long-term antiplatelet therapy after percutaneous coronary intervention *2026-08-27 · The Lancet · https://doi.org/10.1016/S0140-6736(26)01206-7 · https://hartvaat.nl/2026/08/22/clopidogrel-superieur-aan-aspirine-na-pci-10-jaar-host-exam/* The 10-year follow-up of the HOST-EXAM trial compares clopidogrel versus aspirin monotherapy in patients after percutaneous coronary intervention (PCI). Results demonstrate sustained reductions in composite ischaemic and bleeding outcomes with clopidogrel, with no mortality difference between the two agents. These long-term data challenge the historical primacy of aspirin in chronic secondary prevention post-PCI. Clinicians should consider clopidogrel as a preferred monotherapy option for long-term management following PCI. ## Association of 10-year Cardiovascular Risk with Left Ventricular Hypertrophy in a Population of Nigerian Hypertensives. *2026-08-27 · The Nigerian postgraduate medical journal · https://doi.org/10.4103/npmj.npmj_580_25 · https://hartvaat.nl/2026/09/01/verhoogd-10-jaar-ascvd-risico-gekoppeld-aan-linkerventrikelhypertrofie-bij-hyper/* In a cohort of 934 hypertensive patients, an elevated 10-year ASCVD risk score (≥7.5%) was associated with a two-fold higher odds of left ventricular hypertrophy (LVH) on both echocardiography and ECG. Patients with high ASCVD risk had a significantly higher prevalence of LVH compared to those with low risk (42.1% vs 32.3% for echo; 26.3% vs 19.6% for ECG; p < 0.05). These findings suggest that routine ASCVD risk stratification could help identify patients needing timely LVH evaluation, particularly in resource-limited settings. ## Effect of a ≥50% Reduction in Low-Density Lipoprotein Cholesterol From Baseline in Patients With Ischemic Stroke. *2026-08-27 · Neurology · https://doi.org/10.1212/WNL.0000000000218491 · https://hartvaat.nl/2026/09/22/ldl-c-reductie-50-verlaagt-risico-op-secundaire-cardiovasculaire-gebeurtenissen-/* A retrospective cohort study of 89,414 patients following an acute ischemic stroke found that achieving a ≥50% reduction in LDL-C from baseline independently lowers the risk of recurrent stroke, myocardial infarction, and all-cause mortality, regardless of whether an absolute LDL-C target of <70 mg/dL is met. Patients failing to reach the relative reduction threshold had a significantly higher risk of the primary outcome (adjusted HR 1.12 if LDL-C was <70 mg/dL, and HR 1.28 if ≥70 mg/dL). These findings reinforce current guidelines advocating for intensive lipid-lowering strategies that target both absolute and relative LDL-C reductions to optimize secondary prevention in stroke survivors. ## Dual pathology in aortic stenosis: Identifying transthyretin amyloidosis likelihood in patients referred for transcatheter aortic valve implantation. *2026-08-27 · International journal of cardiology. Heart & vasculature · https://doi.org/10.1016/j.ijcha.2026.101991 · https://hartvaat.nl/2026/10/01/cardiale-amyloidose-komt-bij-9-van-tavi-patienten-voor-ongeacht-stromingspatroon/* A retrospective analysis of 2,764 patients undergoing TAVI for severe aortic stenosis found a high likelihood of coexisting transthyretin cardiac amyloidosis in 9% of cases, regardless of the aortic stenosis flow pattern. While procedural success was similar, patients with dual pathology had a higher 3-year all-cause mortality (44% vs 29%), an association that was largely attenuated after adjustment for baseline surgical risk (STS score). These findings suggest that cardiac amyloidosis is relatively common in the TAVI population and contributes to long-term mortality primarily through underlying patient risk rather than procedural complications. Routine consideration of amyloidosis screening may improve prognostic stratification, though it does not currently alter TAVI technique. ## The association of MASLD, lipoprotein(a) and long-term outcomes: Results from the multi-ethnic study of atherosclerosis. *2026-08-27 · Metabolism: clinical and experimental · https://doi.org/10.1016/j.metabol.2026.156723 · https://hartvaat.nl/2026/10/01/masld-verhoogt-sterfte-en-cv-risico-onafhankelijk-van-lipoproteine-a/* A secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) demonstrates that metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to lower lipoprotein(a) [Lp(a)] levels but independently increases long-term mortality and cardiovascular risk. Patients with MASLD and elevated Lp(a) faced a twofold higher risk of hard cardiovascular events (HR 2.07), while those with MASLD and low Lp(a) still had a 28% higher all-cause mortality risk (HR 1.28). These findings highlight MASLD as an independent predictor of poor long-term outcomes, suggesting that Lp(a) measurement may refine risk stratification in patients with fatty liver disease. ## Finerenone benefits in patients with cardio-kidney-metabolic syndrome with or without history of cancer: the FINE-HEART pooled analysis. *2026-08-26 · European heart journal · https://doi.org/10.1093/eurheartj/ehag522 · https://hartvaat.nl/2026/08/18/finerenone-blijft-effectief-bij-ckm-patienten-met-kankeranamnese-fine-heart/* A pooled analysis of three major RCTs (FIDELIO-DKD, FIGARO-DKD, FINEARTS-HF) including 18,991 patients with cardio-renal-metabolic (CKM) syndrome found that 7.3% had a history of cancer. Finerenone consistently reduced all-cause mortality, heart failure, hospitalizations, and composite kidney and cardiovascular outcomes regardless of cancer status, with a consistent safety profile despite slightly higher adverse event rates in the cancer subgroup. The findings reassure clinicians that a prior cancer diagnosis does not diminish the cardiorenal and cardiovascular benefits of finerenone, supporting its use in this complex patient population. ## Deterministic Economic Modelling Study of Tafamidis in Transthyretin Amyloid Cardiomyopathy Across Four European Healthcare Systems. *2026-08-26 · European heart journal. Quality of care & clinical outcomes · https://doi.org/10.1093/ehjqcco/qcag129 · https://hartvaat.nl/2026/08/18/tafamidis-bij-attr-cardiomyopathie-kosteffectiviteit-onder-de-maat-in-vier-europ/* A deterministic modelling study indicates that tafamidis for transthyretin amyloid cardiomyopathy (ATTR-CM) is unlikely to be cost-effective in France, Spain, Germany, and the UK against a €100,000/QALY threshold. Incremental cost-effectiveness ratios ranged from €398,136 to €1,398,706 per QALY, with sensitivity analyses showing less than 13% probability of meeting the acceptability threshold. While tafamidis improves survival and quality of life in ATTR-CM, these findings raise significant concerns regarding the funding and accessibility of this high-cost therapy across European healthcare systems. ## Invasive and echocardiographic gradients of self- and balloon-expandable valves in failing aortic bioprostheses. *2026-08-26 · Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · https://doi.org/10.1007/s12471-026-02061-7 · https://hartvaat.nl/2026/08/18/echocardiografie-overschatte-drukgradienten-na-tav-in-tav-met-ballon-expandable-/* A study of 56 patients undergoing TAV-in-TAV or TAV-in-SAV compared hemodynamics of self-expanding versus balloon-expandable valves. While invasive mean gradients were similar between valve types (6.0 vs 7.0 mmHg), transthoracic echocardiography consistently showed higher gradients for balloon-expandable devices, leading to a significantly larger echo-invasive discrepancy. This highlights the need for cardiologists and imaging specialists to account for valve type when interpreting post-procedural echocardiographic data to avoid misdiagnosing prosthetic dysfunction. ## Sheath-to-Artery Diameter Ratio: A Robust Predictor of Early Access-Site Adverse Events in Percutaneous Procedures. *2026-08-26 · Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · https://doi.org/10.1002/ccd.70808 · https://hartvaat.nl/2026/08/18/sheath-to-artery-ratio-voorspelt-access-site-complicaties-bij-femoraal-ingrijpen/* A retrospective nested case-control study of 2,660 patients undergoing femoral percutaneous procedures with sheaths >6 Fr. identified the sheath-to-artery diameter (SHAD) ratio as a strong independent predictor of early vascular access site complications. A SHAD ratio ≥ 1.07 optimally predicted adverse events (OR 6.71; AUC 0.83), while ultrasound- or fluoroscopy-guided puncture significantly reduced complication risk. For interventionalists, these findings support routine pre-procedural vessel assessment and image-guided access to minimize access-site morbidity. ## Effect of Semaglutide on the Inflammatory Biomarker High-Sensitivity CRP in Patients With Established Cardiovascular Disease and Overweight or Obesity in SELECT: A Prespecified Secondary Analysis. *2026-08-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.074482 · https://hartvaat.nl/2026/08/18/semaglutide-verlaagt-hscrp-en-ontstekingsactiviteit-bij-ascvd-patienten-met-over/* In a prespecified secondary analysis of the SELECT trial, researchers evaluated the effect of semaglutide on high-sensitivity C-reactive protein (hsCRP) in 17,604 patients with established atherosclerotic cardiovascular disease and overweight/obesity without diabetes. Semaglutide reduced hsCRP by 37.8% at 104 weeks, with reductions evident as early as 4 weeks and independent of weight loss or statin use. The magnitude of hsCRP reduction correlated with lower major adverse cardiovascular event (MACE) risk, suggesting that anti-inflammatory effects partially mediate the cardiovascular benefits of semaglutide in this high-risk population. ## Glucagon-Like Peptide-1-Based Therapies in Cardiovascular Disease: Evidence, Mechanisms, and Emerging Clinical Applications. *2026-08-25 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag430 · https://hartvaat.nl/2026/08/18/glp-1-agonisten-verlagen-cardiovasculaire-risicos-bij-diabetes-en-obesitas-overz/* GLP-1 receptor agonists and emerging dual GIP/GLP-1 agonists have evolved into key cardiometabolic therapies with proven cardiovascular benefits. Large outcome trials demonstrate that these agents significantly reduce major adverse cardiovascular events in patients with type 2 diabetes and elevated risk, with effects extending well beyond glycaemic control. Recent evidence also indicates a reduction in cardiovascular events in obesity without diabetes, alongside promising signals in heart failure with preserved ejection fraction. Clinicians across primary care, internal medicine, and cardiology should integrate these agents into risk management strategies, weighing their metabolic, anti-inflammatory, and haemodynamic benefits against safety considerations. ## Differential Rates of Guideline-Directed Medical Therapy Modification in C-MIC and Control Patients: Results from the C-MIC II Trial. *2026-08-25 · ESC heart failure · https://doi.org/10.1093/eschf/xvag220 · https://hartvaat.nl/2026/08/18/c-mic-apparaat-vermindert-hartfalen-ernst-onafhankelijk-van-gdmt-aanpassingen-c-/* A secondary analysis of the C-MIC II trial evaluated whether the benefits of C-MIC device therapy in HFrEF patients were independent of background guideline-directed medical therapy (GDMT) adjustments. While GDMT intensity slightly increased in the control group—likely reflecting clinical deterioration—it decreased in the C-MIC group. Despite this, C-MIC therapy consistently improved left ventricular ejection fraction, patient-reported outcomes, and exercise capacity regardless of baseline SGLT2 inhibitor use. These findings indicate that the device provides clinical benefits independent of pharmacological intensification, supporting its role as an effective add-on strategy in HFrEF management. ## Clinical association between fibroblast growth factor 23 (FGF23) levels and the severity of vascular calcification and cardiovascular event risk in peritoneal dialysis patients. *2026-08-25 · Clinical nephrology · https://doi.org/10.5414/CN111818 · https://hartvaat.nl/2026/08/18/fgf23-niveaus-correleren-met-vaatcalcificatie-en-cv-risico-bij-peritonealdialyse/* In a retrospective cohort of 150 peritoneal dialysis patients, higher circulating intact FGF23 levels were independently associated with greater vascular calcification burden and an increased risk of cardiovascular events. After full adjustment, each unit increase in log-transformed FGF23 corresponded to a 74% higher hazard for cardiovascular events (HR 1.74; 95% CI 1.18–2.56; p=0.005). Adding FGF23 to a baseline model modestly improved risk reclassification, suggesting its potential utility for refined cardiovascular risk stratification in dialysis patients, though prospective validation is still required. ## Beyond erythropoiesis-stimulating agents: The evolving role of hypoxia-inducible factor stabilizers in anemia of chronic kidney disease. *2026-08-25 · Clinical nephrology · https://doi.org/10.5414/CN112100 · https://hartvaat.nl/2026/08/18/hif-stabilisatoren-als-orale-alternatief-voor-esas-bij-anemie-bij-chronische-nie/* This narrative review evaluates hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) as an oral treatment for anemia in chronic kidney disease (CKD). Phase 3 trials demonstrate that HIF-PHIs are non-inferior to erythropoiesis-stimulating agents (ESAs) and effectively maintain hemoglobin levels, while also improving iron mobilization by lowering hepcidin. However, emerging safety signals regarding major adverse cardiovascular events and thromboembolism, particularly in non-dialysis patients, have prompted divergent regulatory approvals across regions. Clinicians should consider HIF-PHIs a promising alternative to ESAs, but therapy initiation requires individualized cardiovascular risk assessment and ongoing post-marketing surveillance. ## Combination Pharmacotherapy in Type 2 Diabetes and Chronic Kidney Disease: Translating Evidence into Clinical Practice. *2026-08-25 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag136 · https://hartvaat.nl/2026/08/18/combinatietherapie-bij-t2dm-en-chronische-nierziekte-evidence-naar-praktijk/* Chronic kidney disease in type 2 diabetes affects 30–40% of patients and substantially increases cardiovascular risk and mortality. Recent evidence supports the simultaneous use of SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, GLP-1 receptor agonists, and RAAS blockade to target distinct pathophysiological pathways. This combination strategy reduces cardiovascular events, delays progression to end-stage renal disease, and improves survival. Clinically, it underscores the importance of early, mechanism-driven combination pharmacotherapy in patients with T2DM and CKD. ## Longitudinal automated lipid target monitoring integrated into a laboratory-based clinical decision support system: a real-world cardiovascular risk management approach. *2026-08-24 · Clinica chimica acta; international journal of clinical chemistry · https://doi.org/10.1016/j.cca.2026.121283 · https://hartvaat.nl/2026/08/15/geautomatiseerde-lipidenmonitoring-en-risicoclassificatie-in-de-huisartspraktijk/* A laboratory-integrated clinical decision support system (CDSS) was evaluated for automated cardiovascular risk stratification and longitudinal lipid monitoring across 9,507 primary care patients. Despite high exposure to lipid-lowering therapy, target attainment remained low, particularly in very high and high-risk groups (14.9% and 7.8%, respectively). These real-world findings highlight the need for automated, longitudinal monitoring tools in primary care to bridge the gap between guideline-directed therapy and actual lipid control. ## Association of non-invasive liver-related scores with cardiovascular disease and a four-domain cardiovascular-renal-hepatic-metabolic phenotype in patients with type 2 diabetes mellitus and MASLD. *2026-08-24 · Endocrine · https://doi.org/10.1007/s12020-026-04751-z · https://hartvaat.nl/2026/08/15/fib-4-en-fni-duiden-op-cardiorenale-en-metabole-belasting-bij-t2dm-en-masld/* In a retrospective analysis of 216 patients with type 2 diabetes and MASLD, non-invasive liver scores were evaluated for their association with cardiovascular disease and a four-domain cardiorenal-hepatic-metabolic (CRHM) phenotype. Patients with CVD had significantly higher FNI and Hellenic Score II values, while the CRHM phenotype was independently associated with elevated FIB-4 (OR 5.4; 95% CI 1.6-18.6), with combined scores reaching an AUROC of 0.81. These exploratory findings suggest that routine liver scores may help identify systemic cardiorenal and metabolic burden in this population, though external validation is needed before clinical implementation. ## Injectable Lipid-Lowering Therapies in Advanced Chronic Kidney Disease: Efficacy, Safety and the Dialysis Paradox. *2026-08-24 · Cardiovascular drugs and therapy · https://doi.org/10.1007/s10557-026-07934-y · https://hartvaat.nl/2026/08/15/injecteerbare-lipidendalers-bij-gevorderde-chronische-nierziekte-en-dialyse-narr/* This narrative review evaluates injectable lipid-lowering therapies (PCSK9 inhibitors, inclisiran, and emerging agents) in patients with advanced chronic kidney disease (CKD) and dialysis dependence. While these agents achieve substantial LDL reductions without renal toxicity, dialysis patients remain critically underrepresented in trials, contributing to divergent guidelines and the dialysis paradox. Integrating these therapies warrants serious consideration for their ability to target multiple cardiorenal risk pathways beyond LDL alone, though dedicated studies are needed to clarify their role in this high-risk population. ## Effect of tirzepatide and semaglutide on blood pressure: A systematic review and meta-analysis. *2026-08-24 · Endocrine · https://doi.org/10.1007/s12020-026-04757-7 · https://hartvaat.nl/2026/08/15/tirzepatide-verlaagt-hypertensierisico-maar-verhoogt-hypotensie-meta-analyse/* A meta-analysis of 32 RCTs (47,332 participants) compared the blood pressure-related safety profiles of tirzepatide and semaglutide in patients with type 2 diabetes or obesity. Tirzepatide significantly reduced the risk of hypertension-related adverse events (RR 0.40) but increased the risk of dose-dependent hypotension (RR 2.45), whereas semaglutide demonstrated a neutral profile. These distinct hemodynamic effects highlight the need for individualized dosing and careful blood pressure monitoring, particularly in patients with low baseline readings. ## Long Term Exposure to Ambient Particulate Matter *2026-08-24 · Kidney international reports · https://doi.org/10.1016/j.ekir.2026.106693 · https://hartvaat.nl/2026/09/01/pm2-5-blootstelling-versnelt-daling-van-egfr-bij-volwassenen/* In a longitudinal cohort of 12,271 adults from Chennai and Delhi (2010–2016), researchers examined the association between long-term ambient PM2.5 exposure and estimated glomerular filtration rate (eGFR). Each 5 μg/m³ increase in annual PM2.5 was significantly associated with a decline in eGFR (-0.32 ml/min/1.73m² in Chennai and -0.42 ml/min/1.73m² in Delhi). These findings highlight sustained air pollution as a key modifiable risk factor for progressive kidney dysfunction, underscoring the importance of environmental prevention strategies in chronic kidney disease management. ## Sex Differences in Peripheral Arterial Disease: Presentation, Treatment, and Outcomes. *2026-08-23 · The International journal of angiology : official publication of the International College of Angiology, Inc · https://doi.org/10.1055/a-2886-6566 · https://hartvaat.nl/2026/09/01/vrouwen-met-perifeer-arterieel-vaatlijden-presenteren-later-met-meer-distale-zie/* This narrative review synthesizes current evidence on sex-related differences in peripheral arterial disease (PAD), drawing from observational studies, registries, and randomized trials. Women typically present at an older age with more comorbidities, atypical symptoms, and more diffuse distal disease, leading to delayed diagnosis and higher procedural complexity. While contemporary limb salvage rates are comparable to men, women experience more repeat revascularizations and periprocedural complications, likely driven by smaller vessel diameter and higher comorbidity burden. These findings highlight the need for earlier detection, equitable guideline-directed medical therapy, and sex-specific management strategies in PAD. ## Your map to the heart - Cardiac CT applications in modern electrophysiology. *2026-08-23 · Clinical imaging · https://doi.org/10.1016/j.clinimag.2026.110898 · https://hartvaat.nl/2026/10/01/cardiale-ct-als-standaard-in-de-electrophysiologie-planning-en-veiligheid-bij-af/* This narrative review outlines the expanding role of cardiac CT in modern electrophysiology, particularly for atrial fibrillation ablation, cardiac implantable electronic device (CIED) management, and left atrial appendage closure. Optimized CT protocols provide high-resolution, low-radiation imaging that is essential for anatomical mapping, thrombus exclusion, device sizing, and early detection of procedural complications. For electrophysiologists and cardiologists, integrating cardiac CT into routine planning enhances procedural efficiency, improves patient safety, and supports personalized care pathways. ## Hepcidin and Cardiovascular Events in CKD With and Without Dialysis. *2026-08-23 · Kidney international reports · https://doi.org/10.1016/j.ekir.2026.106703 · https://hartvaat.nl/2026/10/01/hepcidine-heeft-beperkte-waarde-voor-het-sturen-van-anemietherapie-bij-ckd/* A post hoc analysis of two phase 3 trials evaluated the prognostic value of baseline hepcidin levels for major adverse cardiovascular events (MACE) in CKD patients, both on and off dialysis. Non-dialysis patients showed a nonlinear association with MACE (lowest risk in the second quartile), whereas no link was observed in dialysis patients. These findings indicate limited utility of hepcidin measurement for guiding anemia treatment selection between daprodustat and conventional ESAs in routine care. ## Development of a Three-Source Convergent Risk Assessment Tool for Amyloidosis Screening in Carpal Tunnel Syndrome Patients. *2026-08-23 · Journal of hand surgery global online · https://doi.org/10.1016/j.jhsg.2026.101102 · https://hartvaat.nl/2026/11/01/risicotool-identificeert-attr-cardiomyopathie-bij-patienten-met-carpaaltunnelsyn/* Researchers developed a weighted risk assessment tool to screen for transthyretin amyloid cardiomyopathy (ATTR-CM) in patients with carpal tunnel syndrome (CTS). By integrating data from three independent sources—including a TriNetX cohort of 800,662 patients, clinical cohorts, and tenosynovial biopsy findings—the team established a four-tier risk stratification system. Key predictors included arrhythmias, chronic fatigue, and dyspnea. This tool may help clinicians identify CTS patients warranting targeted ATTR-CM screening or biopsy during surgical release. ## Association of sleep duration and hypertension in older adults: a cross-sectional study. *2026-08-23 · Blood pressure · https://doi.org/10.1080/08037051.2026.2717792 · https://hartvaat.nl/2026/12/01/kort-slapen-6-uur-verhoogt-kans-op-hypertensie-bij-ouderen-clhls/* This cross-sectional study examined the association between sleep duration and hypertension in 15,650 Chinese older adults (mean age 87.1 years). Participants reporting less than 6 hours of sleep had a 30% higher odds of hypertension compared to those sleeping 6–8 hours (OR 1.30; 95% CI 1.17–1.44), while sleep duration of 9 hours or more showed no significant association. The findings highlight sleep assessment as a practical, low-cost tool for identifying older adults at elevated cardiovascular risk, though longitudinal studies are needed to establish causality. ## CT-based multi-threshold calcium scoring for aortic valve assessment: comparable predictive performance across HU thresholds in a pre-TAVI cohort. *2026-08-22 · The international journal of cardiovascular imaging · https://doi.org/10.1007/s10554-026-03800-y · https://hartvaat.nl/2026/08/14/hogere-hu-drempels-voegen-geen-waarde-toe-aan-ct-calciumscoring-voor-aortaklepst/* In a single-center retrospective cohort of 63 patients with severe aortic stenosis, researchers evaluated whether higher Hounsfield unit (HU) thresholds for CT calcium scoring offer additional value beyond the conventional 130-HU Agatston method. While calcium scores at all thresholds correlated with transvalvular gradients, higher thresholds (up to 1000 HU) did not outperform the standard 130-HU scoring and showed only modest discrimination for very severe hemodynamic burden. These findings reinforce that the conventional 130-HU threshold remains sufficient for clinical aortic valve assessment, with higher thresholds serving only as complementary densitometric tools rather than alternative diagnostic cut-offs. ## Precision Lipid Management in the Era of Biotechnology and Artificial Intelligence: From Gene Editing to Smart Drug Delivery. *2026-08-22 · Therapeutic innovation & regulatory science · https://doi.org/10.1007/s43441-026-01033-8 · https://hartvaat.nl/2026/08/14/biotechnologie-en-ai-veranderen-precisielipidenmanagement-van-pcsk9-tot-crispr/* This narrative review examines how biotechnology and artificial intelligence are reshaping precision lipid management for hyperlipidemia and ASCVD. While PCSK9 monoclonal antibodies demonstrate established cardiovascular outcome benefits and inclisiran offers durable LDL-C lowering with infrequent dosing, emerging approaches like CRISPR gene editing, nanoparticle delivery, and AI-driven optimization remain largely preclinical or early-stage, constrained by delivery efficiency, algorithmic bias, and validation challenges. For clinical practice, the review underscores that current biologic therapies are ready for use, whereas next-generation platforms require long-term safety data, standardized delivery, and adaptive regulatory frameworks before routine implementation. ## Effects of Dapagliflozin on the Bone of Patients with CKD on Dialysis. *2026-08-22 · Calcified tissue international · https://doi.org/10.1007/s00223-026-01587-7 · https://hartvaat.nl/2026/08/14/dapagliflozin-verlaagt-serum-klotho-bij-dialysepatienten-zonder-effect-op-botbio/* A post-hoc analysis of an RCT evaluated the effects of dapagliflozin 10 mg daily on bone biomarkers in 79 dialysis-dependent CKD patients over 24 weeks. While dapagliflozin significantly lowered serum Klotho levels compared to standard care (p=0.03), it had no impact on FGF23, other bone markers, osteopenia/osteoporosis prevalence, or fracture rates. These findings indicate that short-term dapagliflozin use does not confer clinically relevant benefits for bone health in this population, despite modulating the Klotho pathway. ## Optimizing hyperkalemia management in CKD: real-world nephrologist strategies and impact on patient outcomes. *2026-08-22 · Journal of nephrology · https://doi.org/10.1093/joneph/aajag149 · https://hartvaat.nl/2026/08/14/kaliumbinders-ondersteunen-raasi-gebruik-bij-ckd-maar-terugkeer-van-hyperkaliemi/* A prospective multicenter observational study (n=429) evaluated real-world management of hyperkalemia in patients with chronic kidney disease (CKD). Hyperkalemia recurred in 43.8% of patients over two years, a pattern associated with a significantly faster eGFR decline of 2.4 ml/min/year. While potassium binders (patiromer and sodium zirconium cyclosilicate) facilitate the continuation of RAAS inhibitors and MRAs, recurrent episodes remain common and may accelerate renal deterioration. Clinicians should consider early integration of potassium binders to sustain guideline-directed cardiorenal therapies and mitigate kidney function loss. ## Risk factors for recurrent cardiovascular events in CKD: results from the KNOW-CKD study. *2026-08-22 · Journal of nephrology · https://doi.org/10.1093/joneph/aajag150 · https://hartvaat.nl/2026/08/14/crp-en-albuminurie-duiden-op-hoog-risico-op-herhalende-hart-en-vaatziekten-bij-c/* The prospective KNOW-CKD cohort followed 2,099 non-dialysis patients with chronic kidney disease for a median of 8.3 years to assess predictors of first and recurrent non-fatal cardiovascular events. Nine point seven percent of participants experienced at least one event; older age, diabetes, prior cardiovascular disease, elevated CRP, albuminuria, and lower BMI were consistently linked to recurrence, with CRP and albuminuria showing a particularly strong association with repeated events compared to initial ones. These findings highlight that cardiovascular risk stratification in CKD should extend beyond traditional metabolic factors to include markers of vascular injury and systemic inflammation, informing more comprehensive preventive strategies. ## Analysis of adjudicated causes of death in a large cohort of Brazilian patients undergoing dialysis. *2026-08-21 · Journal of nephrology · https://doi.org/10.1093/joneph/aajag152 · https://hartvaat.nl/2026/08/14/infectie-is-belangrijkste-doodsoorzaak-bij-dialysepatienten-retrospectieve-analy/* A retrospective analysis of 1,742 adjudicated deaths among dialysis patients in Brazil identified infection as the leading cause of mortality (41%), followed by cardiovascular disease (30%). Most deaths occurred in hospital settings (84%), with over half classified as unexpected, highlighting gaps in end-of-life care and prevention strategies. These findings underscore the need for structured mortality reviews and targeted interventions to reduce both infectious and cardiovascular risks in dialysis populations. ## Rethinking atrial pacing support in cardiac resynchronization therapy: insights from the CRT-NEXT trial. *2026-08-21 · Heart failure reviews · https://doi.org/10.1007/s10741-026-10664-w · https://hartvaat.nl/2026/08/14/vereenvoudigd-crt-systeem-zonder-atriale-pacing-niet-slechter-dan-conventioneel-/* The CRT-NEXT trial demonstrated that a simplified two-lead CRT-DX system, which enables atrial sensing without active pacing, is non-inferior to conventional three-lead CRT-D. At 12 months, the composite endpoint of all-cause mortality, cardiovascular hospitalization, and lead-related complications was comparable between groups, with the DX system showing shorter procedure times and fewer atrial lead complications. These findings suggest that reliable atrial sensing may suffice for most patients without sinus node dysfunction, potentially eliminating the need for routine atrial lead implantation and reducing device-related risks. ## Efficacy and tolerability of sodium-glucose cotransporter-2 inhibitors in transthyretin amyloid cardiomyopathy: A systematic review and stratified meta-analysis. *2026-08-21 · Current problems in cardiology · https://doi.org/10.1016/j.cpcardiol.2026.103409 · https://hartvaat.nl/2026/10/01/sglt2-remmers-geassocieerd-met-lagere-sterfte-bij-attr-cardiomyopathie-meta-anal/* A systematic review and stratified meta-analysis of 18 observational studies (n≈24,000) indicates that SGLT2 inhibitors are associated with reduced all-cause mortality in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) (HR 0.65; 95% CI 0.56–0.76). Benefits were also observed for composite mortality and heart failure events, with a favorable safety profile and low discontinuation rates. However, the evidence remains limited by the observational design, endpoint heterogeneity, and potential database overlap. While promising for cardiologists and internists managing this rare cardiomyopathy, dedicated randomized trials are required before SGLT2 inhibitors can be routinely recommended in this population. ## Associated prognostic impact of opioid use before Transcatheter aortic valve implantation - A Danish nationwide cohort study. *2026-08-21 · International journal of cardiology. Heart & vasculature · https://doi.org/10.1016/j.ijcha.2026.101981 · https://hartvaat.nl/2026/10/01/voorgebruik-van-opioiden-verhoogt-sterfte-en-ziekenhuisopnames-na-tavi-deens-coh/* In a Danish nationwide cohort of 6,505 patients undergoing TAVI between 2015 and 2022, pre-procedural opioid use was associated with worse one-year outcomes compared to non-users. Opioid users had a significantly higher risk of all-cause mortality (10.4% vs 6.9%; adjusted HR 1.35) and increased hospitalization burden, with mortality rising in a dose-dependent manner. These findings highlight pre-procedural opioid use as an important prognostic marker in TAVI candidates, likely reflecting underlying comorbidities. Clinicians should consider this factor when assessing perioperative risk and planning post-procedural care. ## Burden of high blood pressure and associated risk for all-cause and cardiovascular mortality among US young adults. *2026-08-21 · Blood pressure · https://doi.org/10.1080/08037051.2026.2715846 · https://hartvaat.nl/2026/12/01/verhoogde-bloeddruk-bij-jonge-volwassenen-verdubbelt-sterftekans-nhanes-cohort/* A cohort analysis of NHANES data (1999–2016) reveals that 23.9% of US young adults (mean age 28.6) have prehypertension and 14.3% have hypertension. Compared with normotensive peers, adjusted hazard ratios for all-cause mortality were 1.82 for prehypertension and 2.39 for hypertension, rising to 4.17 for cardiovascular mortality in those with hypertension. These findings underscore the importance of early blood pressure screening and management in young adults to mitigate long-term mortality risk. ## Clonal hematopoietic mutations as a predictor of adverse outcomes in cytopenic patients with chronic kidney disease. *2026-08-20 · Blood research · https://doi.org/10.1007/s44313-026-00161-2 · https://hartvaat.nl/2026/08/12/clonale-hematopoiese-voorspelt-nierfunctievermindering-en-sterfte-bij-cytopenie-/* In a retrospective cohort study of 67 patients with cytopenia and chronic kidney disease (CKD), clonal hematopoiesis (CH) was present in 53.7% and independently predicted CKD progression (adjusted HR 2.83) and higher mortality (adjusted HR 3.90) over a median follow-up of 43.5 months. The association was most pronounced in patients with myelodysplastic syndromes. Identifying CH in this population may improve risk stratification and guide closer monitoring of renal decline and survival outcomes. ## Comparative Effectiveness and Cardiovascular Safety of Romosozumab versus Teriparatide in Osteoporosis Patients with CKD: Target Trial Emulation Study. *2026-08-20 · Clinical journal of the American Society of Nephrology : CJASN · https://doi.org/10.2215/CJN.0000001168 · https://hartvaat.nl/2026/08/12/romosozumab-vermindert-wervelfracturen-en-mace-bij-osteoporose-met-chronische-ni/* A retrospective target trial emulation using TriNetX real-world data compared romosozumab and teriparatide in patients aged ≥40 with osteoporosis and CKD (eGFR <60). Romosozumab was associated with a significantly lower risk of vertebral fractures (HR 0.64) and improved cardiovascular safety, showing reduced MACE (HR 0.82) and myocardial infarction (HR 0.77) compared to teriparatide. These findings suggest a potential dual benefit of romosozumab in high-risk CKD patients, though prospective trials are needed to confirm efficacy and safety in advanced kidney disease. ## Long-term risk of cardiovascular disease after assisted reproductive technology and infertility: A cohort study. *2026-08-20 · PLoS medicine · https://doi.org/10.1371/journal.pmed.1005120 · https://hartvaat.nl/2026/08/12/ivf-gebruik-niet-geassocieerd-met-hart-en-vaatziekten-behalve-herseninfarct/* A Swedish nationwide cohort study of nearly 380,000 women found that long-term use of assisted reproductive technology (ART) is not associated with an increased risk of cardiovascular or metabolic diseases, except for a 44% higher risk of cerebral ischemia over 30 years (RR 1.44). Women with a history of infertility, however, consistently showed elevated risks for heart failure, type 2 diabetes, and chronic kidney disease, reinforcing infertility as a marker for underlying cardiometabolic risk. These findings reassure regarding the long-term cardiovascular safety of ART while highlighting the need for proactive cardiovascular risk assessment in women with infertility. ## HDL-associated proteins affecting CVD and systemic inflammation. *2026-08-20 · Current opinion in lipidology · https://doi.org/10.1097/MOL.0000000000001052 · https://hartvaat.nl/2026/08/13/hdl-eiwitten-bepalen-cvd-en-ontstekingsrisico-onafhankelijk-van-hdl-c/* This narrative review explains why elevated HDL-C is a poor predictor of cardiovascular protection, emphasizing that HDL function depends on its associated proteins. Key molecules like ApoM, ApoA-I, and SR-B1 modulate inflammation, LDL deposition, and endotoxin clearance, with ApoM showing a protective association in chronic kidney disease. While CETP inhibition improved survival in a murine sepsis model, clinical translation remains pending as key trials continue. The authors advocate shifting focus from HDL-cholesterol levels to HDL functionality in both research and clinical practice. ## Evidence of a Protective Effect of Metformin on Abdominal Aortic Aneurysm Risk: Insights From an Observational Study and Mendelian Randomisation Analysis Using Putative Metformin Targets. *2026-08-20 · Annals of human genetics · https://doi.org/10.1111/ahg.70049 · https://hartvaat.nl/2026/09/01/metformin-verlaagt-risico-op-buikaorta-aneurysma-mr-en-cohortanalyse/* Combining a large UK Biobank cohort study with a two-sample Mendelian randomisation analysis, researchers investigated whether metformin use causally reduces the risk of abdominal aortic aneurysm (AAA). Observational data showed a strong protective association (OR 0.49), which was corroborated by genetic analysis indicating a 43% risk reduction per standard deviation decrease in HbA1c via metformin targets (OR 0.57; p = 0.010). While the findings suggest a potential causal link, they remain observational and genetically inferred. Dedicated clinical trials are required to evaluate whether metformin can effectively slow AAA progression or prevent rupture in patients. ## Patients With Patent Foramen Ovale or Atrial Septal Defect Have Worse Outcomes After Pulmonary Vein Isolation. *2026-08-19 · The American journal of cardiology · https://doi.org/10.1016/j.amjcard.2026.06.030 · https://hartvaat.nl/2026/09/01/pre-existent-pfo-of-asd-verhoogt-risico-op-recidief-en-stroke-na-ablatie-bij-atr/* A propensity-matched cohort study using TriNetX claims data compared outcomes in 2,804 patients with a pre-existing PFO or ASD versus 2,804 without these defects following pulmonary vein isolation for atrial fibrillation. Over two years, patients with a septal defect had significantly higher rates of hospitalization (HR 1.14), direct-current cardioversion (HR 1.18), antiarrhythmic drug use (HR 1.12), and stroke (HR 1.36), with no difference in mortality or redo ablation. These real-world findings suggest that EP specialists should counsel patients with PFO or ASD about their elevated risk of arrhythmia recurrence and stroke following catheter ablation. ## Cardiac Opioid System and Its Role in Heart Failure and Ischemia-Reperfusion Injury. *2026-08-19 · Anesthesiology · https://doi.org/10.1097/ALN.0000000000006139 · https://hartvaat.nl/2026/09/01/perioperatieve-opioiden-bij-hartfalen-lokale-cardiale-routes-en-klinische-risico/* This review outlines the local cardiac opioid system and its contrasting roles in heart failure versus ischemia-reperfusion injury. While preclinical models indicate cardioprotective effects during ischemia-reperfusion, clinical opioid administration in heart failure is associated with higher in-hospital mortality and increased ventilatory support. Clinicians should account for these hemodynamic and prognostic risks when selecting perioperative analgesia. ## Individualized vs Standard Blood Pressure Control During Thrombectomy for Ischemic Stroke: The DETERMINE Randomized Clinical Trial. *2026-08-19 · Neurology · https://doi.org/10.1212/WNL.0000000000218420 · https://hartvaat.nl/2026/09/08/gepersonaliseerde-bloeddrukregeling-tijdens-thrombectomie-verbetert-functionele-/* A multicenter randomized trial evaluated whether individualized mean arterial pressure (MAP) management during mechanical thrombectomy for acute anterior large vessel occlusion improves 90-day functional outcomes compared with standard systolic BP control (140–180 mmHg). Among 433 patients, individualized MAP targeting (within 10% of baseline) did not increase the rate of favorable functional outcomes at 90 days (44.2% vs 48.8%; aOR 0.82; p=0.34), with no differences in symptomatic intracranial hemorrhage or mortality. These results support maintaining current standard BP protocols during thrombectomy, as individualized targeting offers no additional clinical benefit in this acute setting. ## Association of the HIGS score with permanent pacemaker implantation and mortality after transcatheter aortic valve implantation. *2026-08-19 · Annals of medicine · https://doi.org/10.1080/07853890.2026.2715272 · https://hartvaat.nl/2026/12/01/higs-score-voorspelt-pacemaker-implantatie-en-sterfte-na-tavi/* In a retrospective single-center study of 196 TAVI patients, the Hematological Inflammatory Global Score (HIGS) derived from routine blood parameters was independently associated with permanent pacemaker implantation (PPI) and in-hospital mortality. Higher HIGS values correlated with a significantly increased risk of PPI (OR 3.96) and death (OR 4.92), while also improving the predictive performance of conventional clinical models. Although HIGS shows promise as a readily available risk-stratification tool, prospective multicenter validation is needed before routine clinical adoption. ## Impact of antithrombotic therapy on outcomes of incidental unruptured intracranial aneurysms in patients with ischemic stroke. *2026-08-19 · Annals of medicine · https://doi.org/10.1080/07853890.2026.2705593 · https://hartvaat.nl/2026/12/01/antitrombotica-veilig-bij-incidentele-ongescheurde-intracraniele-aneurysmas-na-i/* A single-center retrospective cohort study evaluated whether standard antithrombotic regimens increase the risk of rupture in patients with ischemic stroke and concomitant incidental unruptured intracranial aneurysms. Among 197 patients followed for a mean of 28.6 months, only two experienced aneurysm rupture (1.0%), with no statistically significant difference between single antiplatelet therapy, anticoagulation, or no regular therapy. These findings suggest that standard secondary stroke prevention can be safely continued in this population, though the low event rate warrants cautious interpretation and individualized risk assessment. ## Urinary Biomarkers for the Risk Assessment and Management of Heart Failure: Pearls and Pitfalls. *2026-08-18 · Current heart failure reports · https://doi.org/10.1007/s11897-026-00774-9 · https://hartvaat.nl/2026/08/10/urine-albumine-en-natrium-hebben-prognostische-waarde-bij-hartfalen-experimentel/* This narrative review evaluates the clinical utility of urinary biomarkers in heart failure management. While urine albumin and sodium offer established prognostic and diagnostic value for guiding medication prioritization and diuretic therapy, experimental markers such as NGAL, KIM-1, and IGFBP7/TIMP-2 currently lack evidence of superior kidney injury prediction compared to serum creatinine. For clinical practice, this reinforces the role of routine urine parameters in cardiorenal risk stratification, while highlighting that novel biomarkers remain primarily of research and mechanistic interest at this time. ## Dietary Interventions for Hypertriglyceridemia. *2026-08-18 · Current atherosclerosis reports · https://doi.org/10.1007/s11883-026-01444-w · https://hartvaat.nl/2026/08/10/voedingspatronen-en-macronutrientenvervanging-verlagen-triglyceriden-bij-hypertr/* This narrative review outlines the pathophysiology of hypertriglyceridemia (HTG) and evaluates dietary strategies for its management. Guideline recommendations stress individualized dietary patterns based on triglyceride severity and underlying etiology, emphasizing partial carbohydrate replacement with unsaturated fats or protein, alongside limiting added sugars and alcohol. Combined with physical activity and weight management, these interventions form a cornerstone of cardioprotective lifestyle therapy. Clinicians can use these tailored dietary approaches to optimize lipid profiles and reduce cardiometabolic risk. ## The Impact of Anemia on Clinical Outcomes of Patients Above 80 Years Old Following Transcatheter Aortic Valve Replacement. *2026-08-18 · Structural heart : the journal of the Heart Team · https://doi.org/10.1016/j.shj.2026.101057 · https://hartvaat.nl/2026/09/01/anemie-verergert-mortaliteit-en-hartfalenheropnames-na-tavr-bij-patienten-boven-/* An observational study shows that anemia is highly prevalent in patients over 80 years undergoing transcatheter aortic valve replacement (TAVR) and is linked to a higher burden of cardiovascular and non-cardiovascular comorbidities. Baseline anemia predicts worse long-term outcomes, including increased all-cause mortality and heart failure rehospitalization. These findings reinforce anemia as a key prognostic marker and potential therapeutic target in this high-risk elderly population. ## Posterior versus anterior circulation infarct location and outcomes after breakthrough ischemic stroke in orally anticoagulated patients for atrial fibrillation: An ASPERA-R inverse probability-weighted analysis. *2026-08-18 · Journal of the neurological sciences · https://doi.org/10.1016/j.jns.2026.126100 · https://hartvaat.nl/2026/10/15/posteriorcirculatie-infarcten-na-doorbraakstroke-op-anticoagulantia-duiden-op-sl/* A retrospective multicentre analysis of 1,649 atrial fibrillation patients experiencing an ischemic stroke despite continuous oral anticoagulation demonstrates that infarct location significantly influences prognosis. Patients with posterior circulation infarcts faced a higher risk of a 90-day composite endpoint (recurrent stroke, MI, or vascular death; aHR 1.50), greater all-cause mortality (aHR 1.85), and worse functional outcomes (mRS shift) compared to those with anterior circulation infarcts. These findings highlight infarct location as a valuable prognostic marker, aiding risk stratification and follow-up intensity for AF patients experiencing breakthrough strokes on anticoagulation. ## Early antihypertensive therapy in acute ischemic stroke: A Meta-analysis of randomized controlled trials. *2026-08-18 · Journal of the neurological sciences · https://doi.org/10.1016/j.jns.2026.126125 · https://hartvaat.nl/2026/10/15/vroege-bloeddrukverlaging-bij-acute-ischemische-stroke-verbetert-functioneel-her/* A meta-analysis of seven RCTs involving 15,521 patients found that initiating antihypertensive therapy within 48 hours of an acute ischemic stroke effectively lowers blood pressure but does not improve mortality or functional outcomes. Pooled risk ratios for all-cause mortality (RR 0.97) and death or functional dependency (RR 1.01) showed no significant benefit compared with placebo or usual care. These results reinforce current guidelines against routine early blood pressure lowering in the general acute stroke population and highlight the need for individualized hemodynamic management. ## Prevention of new-onset chronic kidney disease with renin-angiotensin system blockers in type 2 diabetes with preserved kidney function. *2026-08-17 · Renal failure · https://doi.org/10.1080/0886022X.2026.2711459 · https://hartvaat.nl/2026/12/01/ras-remmers-verlagen-risico-op-nieuwe-ckd-bij-diabetes-type-2-met-behoudende-nie/* In a multicenter retrospective cohort study of 3,316 patients with type 2 diabetes, newly diagnosed hypertension, and preserved kidney function, researchers evaluated the impact of ACE inhibitors or ARBs on the development of new-onset chronic kidney disease. RAS blocker therapy was associated with a significantly reduced risk of new-onset CKD (HR 0.72; 95% CI 0.60-0.86), with consistent results in competing-risk and time-dependent analyses. These findings support the early use of RAS blockade for renal protection in this population, even when baseline kidney function remains normal. ## Positive life orientation and blood pressure in older adults: evidence from two Finnish generational cohorts born 20 years apart. *2026-08-17 · Blood pressure · https://doi.org/10.1080/08037051.2026.2692239 · https://hartvaat.nl/2026/12/01/positieve-levensorientatie-en-bloeddruk-bij-ouderen-nauwelijks-klinisch-relevant/* An observational study in two Finnish cohorts of 70-year-olds (n=1,554) examined the association between positive life orientation and blood pressure. After adjustment for age, sex, smoking, and BMI, no significant association was found between life orientation and systolic or diastolic blood pressure. The findings suggest that psychosocial well-being alone does not substantially influence blood pressure levels, particularly in populations with widespread antihypertensive treatment. ## Health system competence and care continuity in patients with hypertension: electronic cohort in Uruguay. *2026-08-17 · Blood pressure · https://doi.org/10.1080/08037051.2026.2702689 · https://hartvaat.nl/2026/12/01/lage-richtlijnconformiteit-en-zorgcontinuiteit-bij-hypertensie-in-uruguay/* A longitudinal cohort study of 200 adults in Uruguay reveals that only 42% had controlled blood pressure at baseline and merely 11.5% received all guideline-recommended interventions. Overall blood pressure control reached 34.4%, with notably lower continuity of care and guideline adherence among newly diagnosed patients. These findings highlight systemic gaps in hypertension management and underscore the need for structured follow-up and quality improvement initiatives in primary care settings. ## Gestational cardiovascular health and adverse pregnancy outcomes: a prospective cohort study in China. *2026-08-17 · Annals of medicine · https://doi.org/10.1080/07853890.2026.2703887 · https://hartvaat.nl/2026/12/01/optimale-cardiometabole-gezondheid-tijdens-zwangerschap-verlaagt-risico-op-compl/* A prospective cohort study of 2,775 pregnant women in China evaluated the association between gestational cardiovascular health metrics and adverse maternal and neonatal outcomes. Each one-point increase in the composite health score was linked to a 7% lower risk of maternal complications and a 4% lower risk of neonatal complications, with women achieving an ideal score showing 21% and 12% reduced risks, respectively. The findings highlight the potential value of integrating cardiometabolic risk assessment into routine prenatal care to improve short-term pregnancy outcomes and long-term cardiovascular health. ## Inter-ankle systolic blood pressure difference is associated with microalbuminuria in non-diabetic hypertension patients: A cross-sectional study from two cohorts. *2026-08-17 · Clinical and experimental hypertension (New York, N.Y. : 1993) · https://doi.org/10.1080/10641963.2026.2712543 · https://hartvaat.nl/2026/12/31/inter-enkel-bloeddrukverschil-correleert-met-microalbuminurie-bij-hypertensiepat/* A cross-sectional analysis of 2,500 nondiabetic hypertensive patients found that an inter-ankle systolic blood pressure difference is independently associated with microalbuminuria (UACR > 30 mg/g). Receiver operating characteristic curves demonstrated that this simple physical examination finding effectively identifies subclinical renal damage. The results suggest that measuring ankle blood pressure differences could serve as a practical, low-cost tool for risk stratification and early renal assessment in primary care and cardiology practice. ## Ventricular Assist Device Use in Single Ventricle Heart Disease: Current Outcomes and Considerations. *2026-08-16 · Current cardiology reports · https://doi.org/10.1007/s11886-026-02396-y · https://hartvaat.nl/2026/07/30/vad-implantatie-bij-enkelventrikelhart-overleving-verbetert-maar-complicaties-bl/* This narrative review outlines current outcomes and clinical considerations for ventricular assist device (VAD) therapy in patients with single-ventricle congenital heart disease. Although survival historically lagged behind biventricular physiology, recent evidence suggests this gap is narrowing, despite a persistently high rate of adverse events across all palliation stages. Many available devices lack pediatric regulatory approval, underscoring the need for careful patient selection and monitoring. Cardiologists managing complex congenital heart failure must integrate a thorough understanding of both disease physiology and device mechanics to optimize clinical outcomes. ## Heart Failure with Preserved Ejection Fraction in Women: Sex-Specific Insights Across the Continuum from Diagnosis to Outcomes. *2026-08-16 · Current cardiology reports · https://doi.org/10.1007/s11886-026-02392-2 · https://hartvaat.nl/2026/07/30/hfpef-bij-vrouwen-vereist-geslachtsspecifieke-diagnostiek-en-behandelstrategieen/* This narrative review examines sex-specific differences in the pathophysiology, diagnostic challenges, and therapeutic responses of heart failure with preserved ejection fraction (HFpEF) in women. Women face a twofold higher lifetime risk of HFpEF compared to HFrEF, with obesity and microvascular dysfunction playing key roles. Current echocardiographic parameters for assessing diastolic dysfunction and filling pressures may require sex-specific refinements to improve diagnostic accuracy. Enhancing outcomes will depend on greater female representation in cardiovascular trials and further investigation into sex-targeted diagnostic and treatment approaches. ## Association between fish-related metabolites and metabolic syndrome risk factors in Japan: INTERLIPID metabolome -wide association study. *2026-08-16 · European journal of nutrition · https://doi.org/10.1007/s00394-026-04068-7 · https://hartvaat.nl/2026/07/30/visinname-en-visgerelateerde-metabolieten-geassocieerd-met-lagere-triglyceriden-/* A cross-sectional study of 1,047 Japanese adults examined the relationship between fish intake, fish-related metabolites, and metabolic syndrome risk factors. Higher consumption of fish and shellfish was significantly associated with lower triglycerides, lower systolic blood pressure, and a more favorable HDL cholesterol profile. The results suggest that cooking methods may modulate the metabolic impact of seafood, offering nuanced insights for dietary counseling in cardiovascular and metabolic risk prevention. ## Incidence, Analysis and Risk of Out-of-Hospital Cardiac Arrest in Individuals with Non-Ischaemic Dilated Cardiomyopathy. *2026-08-16 · ESC heart failure · https://doi.org/10.1093/eschf/xvag207 · https://hartvaat.nl/2026/07/31/uit-het-hospitaal-hartstilstand-komt-12-keer-vaker-voor-bij-niet-ischemische-car/* A nationwide Danish register study spanning two decades reveals that patients with non-ischaemic dilated cardiomyopathy (NIDCM) face a substantially higher risk of out-of-hospital cardiac arrest (OHCA) compared to the general population. The incidence rate is approximately 12 times higher (532 vs 45 per 100,000 person-years), with a 10-year cumulative risk of 3.4% in men and 2.1% in women. Although NIDCM-related arrests more frequently present with a shockable rhythm, 30-day and 1-year mortality remain comparable to non-NIDCM cases. These epidemiological insights assist cardiologists and primary care physicians in refining sudden cardiac death risk stratification and guiding preventive strategies, such as implantable cardioverter-defibrillator placement, in this distinct heart failure cohort. ## Efficacy and safety of finerenone in non-diabetic patients with IgA nephropathy. *2026-08-16 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag023 · https://hartvaat.nl/2026/07/31/finerenone-verhoogt-complete-nierremissie-bij-niet-diabetische-iga-nefropatie/* A retrospective cohort study of 382 patients with non-diabetic IgA nephropathy demonstrates that finerenone significantly improves complete renal remission rates (HR 2.58; p < 0.001) and reduces the risk of a ≥30% eGFR decline (HR 0.30; p = 0.036) compared to standard care alone. Potassium levels remained stable, and adding finerenone to an SGLT2 inhibitor yielded the highest remission rates. These findings support the nephroprotective role of finerenone in non-diabetic IgA nephropathy, particularly when combined with SGLT2 inhibitors. ## Efficacy of 15 mg Edoxaban on Long-Term Outcome after Percutaneous Coronary Intervention in Patients with Atrial Fibrillation and High Bleeding Risk. *2026-08-15 · International heart journal · https://doi.org/10.1536/ihj.25-558 · https://hartvaat.nl/2026/07/31/15-mg-edoxaban-na-pci-bij-atriumfibrilleren-met-hoog-bloedingrisico-geen-superie/* A retrospective analysis of 148 patients with atrial fibrillation undergoing PCI compared 15 mg versus 30 mg edoxaban in those at high bleeding risk. Although the 15 mg dose showed numerically lower rates of major bleeding (6.8% vs 19.7%) and thrombotic events (3.0% vs 7.4%), these differences did not reach statistical significance. Clinicians should note that current evidence does not support switching to the lower edoxaban dose over the standard 30 mg regimen in this high-risk population. ## A meta-analysis of randomized controlled trials on atenolol's impact on postoperative atrial fibrillation in adults undergoing cardiac surgery. *2026-08-15 · Medicine · https://doi.org/10.1097/MD.0000000000050029 · https://hartvaat.nl/2026/07/31/atenolol-vermindert-postoperatief-atriumfibrilleren-na-hartchirurgie/* A meta-analysis of six randomized controlled trials (870 patients) demonstrates that atenolol significantly reduces the incidence of postoperative atrial fibrillation following cardiac surgery (RR 0.55; 95% CI 0.32-0.93). However, atenolol showed no superiority over sotalol and performed similarly to other control agents such as metoprolol and propafenone. These findings reinforce the established role of beta-blockers in POAF prophylaxis, without providing evidence to favor atenolol over alternative antiarrhythmic or beta-blocking strategies. ## SGLT2 inhibitor prescription at discharge in very old adults with heart failure irrespective of diabetes status. *2026-08-15 · International journal of cardiology. Heart & vasculature · https://doi.org/10.1016/j.ijcha.2026.101980 · https://hartvaat.nl/2026/10/01/sglt2-remmers-bij-zeer-oude-hartfalenpatienten-nierfunctie-en-palliatieve-zorg-b/* A single-centre retrospective study of 1,235 hospitalisations in a cardiogeriatric unit found that SGLT2 inhibitors were prescribed at discharge in 82.3% of very old heart failure patients (median age 88.6 years), regardless of diabetes status. Non-prescription was strongly associated with advanced chronic kidney disease (CKD stages 4–5) and palliative care orientation, but not with age or comorbidity burden. These patterns highlight that renal function and care goals, rather than diabetes or frailty alone, currently drive SGLT2 inhibitor use in this vulnerable population, informing discharge prescribing decisions. ## Biomarker-guided pharmacotherapy in cardiovascular-kidney-metabolic syndrome: A three-dimensional framework for precision drug selection and monitoring. *2026-08-15 · Pharmacology & therapeutics · https://doi.org/10.1016/j.pharmthera.2026.109089 · https://hartvaat.nl/2026/10/01/biomarker-gestuurde-farmacotherapie-biedt-raamwerk-voor-precisiebehandeling-bij-/* This review proposes a three-dimensional framework for biomarker-guided pharmacotherapy in cardiovascular-kidney-metabolic (CKM) syndrome. It maps organ-specific biomarkers to drug targets, identifies cross-system markers like hs-CRP and IL-6 for targeting inflammatory and metabolic pathways, and emphasizes serial biomarker trajectories to distinguish drug effects from disease progression. Central to the approach is 'pharmacological phenotyping,' using multi-biomarker panels to define drug-responsive states and guide therapeutic selection. The framework offers a practical roadmap for clinicians to navigate the expanding arsenal of cardiorenal and metabolic agents with greater precision and monitoring. ## The impact of drinking patterns on the relationship between alcohol use and levels of serum high-density lipoprotein cholesterol (HDL-C). *2026-08-15 · Alcohol (Fayetteville, N.Y.) · https://doi.org/10.1016/j.alcohol.2026.07.003 · https://hartvaat.nl/2026/09/01/drinkfrequentie-bepaalt-hdl-c-niveau-meer-dan-hoeveelheid-per-keer-troms-studie/* In a cross-sectional study of 18,614 adults (aged 40–79), the frequency of alcohol consumption showed a stronger positive association with HDL-C levels than the amount consumed per occasion. Each additional gram of alcohol per day was associated with a 0.005 mmol/L increase in HDL-C, whereas large amounts per drinking occasion were linked to lower HDL-C, particularly among infrequent drinkers. These findings highlight that drinking patterns influence HDL-C interpretation and cardiovascular risk assessment, though they do not support recommending alcohol for prevention. ## Estimated glomerular filtration rate slope and clinical outcomes: a narrative review. *2026-08-14 · Diabetes research and clinical practice · https://doi.org/10.1016/j.diabres.2026.113477 · https://hartvaat.nl/2026/07/31/steilere-egfr-daling-voorspelt-nierfalen-en-cardiovasculaire-mortaliteit-narrati/* This narrative review synthesizes current evidence on the prognostic value of the estimated glomerular filtration rate (eGFR) slope for kidney failure, cardiovascular events, and all-cause mortality. A steeper decline over three years is consistently associated with higher risks of end-stage kidney disease, hospitalization, and death, with a notable U-shaped relationship observed for mortality. Incorporating eGFR slope into routine clinical assessment can improve risk stratification, support personalized management, and serve as a reliable surrogate endpoint for evaluating renoprotective therapies like SGLT2 inhibitors. ## Serum ketone body levels and risk of incident kidney and cardiovascular events among patients with type 2 diabetes: a prospective cohort study. *2026-08-14 · Diabetes research and clinical practice · https://doi.org/10.1016/j.diabres.2026.113476 · https://hartvaat.nl/2026/07/31/verhoogde-serumketonen-verlagen-niercomplicaties-bij-type-2-diabetes-prospectief/* A prospective cohort study of 1,392 stable patients with type 2 diabetes found that mildly elevated serum ketone levels were independently associated with a reduced risk of kidney complications. Over a median follow-up of 23.2 months, participants in the highest ketone tertile had a 54% lower risk of a ≥40% decline in eGFR (adjusted HR 0.46) and a 37% lower risk of a composite kidney outcome (aHR 0.63) compared to the lowest tertile, with similar non-significant trends for cardiovascular events. While these findings highlight ketones as a potential biomarker for renal risk, they do not yet translate into specific clinical interventions. ## Admission serum bicarbonate is associated with early diuretic resistance in acute decompensated heart failure. *2026-08-14 · Cardiovascular journal of Africa · https://doi.org/10.5830/CVJA-2026-021 · https://hartvaat.nl/2026/07/31/hoge-serumbicarbonaat-bij-opname-voorspelt-diuretische-resistentie-bij-acute-har/* A retrospective single-centre cohort of 1,000 patients with acute decompensated heart failure found that elevated admission serum bicarbonate (>28 mmol/L) is independently associated with early diuretic resistance and less effective decongestion. Patients with this alkalosis phenotype required earlier diuretic escalation, had smaller 24- to 48-hour fluid losses, and exhibited lower early urine sodium levels. Incorporating bicarbonate into urine-sodium-guided decongestion protocols may enable faster, more objective diuretic titration, though prospective trials are needed to confirm impact on clinical outcomes. ## Associations of dietary inflammatory and antioxidant indices with mortality in adults with cardiovascular-kidney-metabolic syndrome: A mediation analysis. *2026-08-14 · Medicine · https://doi.org/10.1097/MD.0000000000050040 · https://hartvaat.nl/2026/07/31/ontstekingsrijke-voeding-verhoogt-sterfterisico-bij-ckm-syndroom-nhanes-cohort/* In a cohort of 21,420 NHANES participants with cardiovascular-kidney-metabolic (CKM) syndrome, higher dietary inflammatory index (DII) and lower composite dietary antioxidant index (CDAI) scores were independently associated with increased all-cause and cardiovascular mortality. The highest versus lowest DII tertile corresponded to a hazard ratio of 1.27, while a high CDAI reduced mortality risk to HRs of 0.84 and 0.78, respectively. Mediation analysis indicated that obesity and systemic inflammation indices accounted for only 4–9% of this association. These findings reinforce the potential role of anti-inflammatory, antioxidant-rich dietary patterns in reducing mortality risk among patients with CKM syndrome. ## Wearable Devices for Monitoring and Management of Comorbid Obstructive Sleep Apnea and Hypertension: Scoping Review. *2026-08-14 · JMIR mHealth and uHealth · https://doi.org/10.2196/84506 · https://hartvaat.nl/2026/07/31/draagbare-sensoren-voor-comorbiditeit-osa-en-hypertensie-huidige-stand-van-zaken/* This scoping review synthesizes 13 studies on wearable sensors for patients with comorbid obstructive sleep apnea (OSA) and hypertension. Current devices, primarily wrist- and patch-based, focus on screening, risk stratification, and nocturnal blood pressure monitoring, but exhibit substantial variability in validation and diagnostic thresholds. Clinically, wearables currently serve only as adjunctive tools for risk warning and cannot replace standard sleep studies or conventional blood pressure monitoring. Large-scale prospective multicenter trials are required to establish definitive clinical utility. ## Comparative Cardiovascular Outcomes and Safety Profiles of Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Trials. *2026-08-13 · Cureus · https://doi.org/10.7759/cureus.111723 · https://hartvaat.nl/2026/06/01/glp-1-agonisten-verlagen-mace-met-14-bij-diabetes-type-2-meta-analyse/* A systematic review and meta-analysis of nine placebo-controlled cardiovascular outcome trials (n = 69,730) demonstrates that GLP-1 receptor agonists significantly reduce major adverse cardiovascular events in patients with type 2 diabetes. The pooled hazard ratio was 0.86 (95% CI: 0.82–0.92; p < 0.001), representing a 14% relative risk reduction driven primarily by fewer myocardial infarctions and strokes. While gastrointestinal events and a mild increase in gallbladder disease were noted, the overall safety profile remains acceptable. These findings reinforce current guidelines recommending GLP-1 receptor agonists as a cornerstone of cardiovascular risk reduction in diabetes, though heterogeneity across trials prevents definitive ranking of individual agents. ## Efficacy and Safety of Dual and Triple Glucagon-Like Peptide-1-Based Polyagonists in Metabolic Dysfunction-Associated Steatotic Liver Disease and Steatohepatitis: A Systematic Review and Meta-Analysis. *2026-08-13 · Cureus · https://doi.org/10.7759/cureus.111728 · https://hartvaat.nl/2026/06/01/glp-1-polyagonisten-verbeteren-leverhistologie-en-vetgehalte-bij-masld-mash-meta/* A meta-analysis of six randomized controlled trials (n=961) demonstrates that dual and triple GLP-1-based polyagonists significantly improve histological resolution of MASLD and MASH (RR 3.32) and reduce liver fat content by over 44 percentage points compared with placebo. While gastrointestinal adverse events are more common, serious adverse events and treatment discontinuation rates remain comparable to placebo. These findings reinforce the cardiometabolic and hepatic benefits of next-generation GLP-1 agonists, though high heterogeneity in weight loss outcomes and limited follow-up duration warrant cautious interpretation until larger phase 3 trials clarify long-term efficacy and cardiovascular impact. ## Androgen Deprivation Therapy and Cardiovascular Health: Challenges and Opportunities in Prostate Cancer Care. *2026-08-13 · Archivos espanoles de urologia · https://doi.org/10.56434/j.arch.esp.urol.20267905.87 · https://hartvaat.nl/2026/06/01/cardiovasculair-risico-van-adt-en-arpi-s-bij-prostaatkanker-narrative-review/* A narrative review examines the cardiovascular toxicity of androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) in patients with prostate cancer. ADT induces metabolic and vascular alterations that promote a proatherogenic state; GnRH antagonists appear to carry a lower early risk of major adverse cardiovascular events compared to agonists, while darolutamide demonstrates a more favorable cardiovascular safety profile than abiraterone or apalutamide. Routine cardiovascular risk assessment, aggressive management of modifiable risk factors, and a multidisciplinary cardio-oncology approach are essential to optimize long-term outcomes in this population. ## Transcatheter versus surgical aortic valve replacement for severe aortic stenosis in low-risk adults: a network meta-analysis. *2026-08-13 · Indian journal of thoracic and cardiovascular surgery · https://doi.org/10.1007/s12055-026-02245-1 · https://hartvaat.nl/2026/09/01/tavr-met-ballon-expanderbare-klep-heeft-vergelijkbare-overleving-en-minder-compl/* A network meta-analysis of 31 studies (37,741 patients) compared transcatheter (TAVR) and surgical aortic valve replacement (SAVR) in low-risk patients with severe aortic stenosis. TAVR, particularly with balloon-expandable valves, demonstrated comparable short- and intermediate-term survival while significantly reducing 30-day stroke, major bleeding, acute kidney injury, and readmission rates, and shortening hospital stays by approximately four days. SAVR remained associated with lower rates of paravalvular regurgitation and permanent pacemaker implantation across all time horizons. These findings support platform-specific, individualized decision-making, positioning balloon-expandable TAVR as a safe and efficient alternative to surgery in low-risk patients. ## Evaluation of the effect of empagliflozin on prevention of atrial fibrillation after heart valve surgery: a double-blind, randomized, placebo-controlled trial. *2026-08-13 · Indian journal of thoracic and cardiovascular surgery · https://doi.org/10.1007/s12055-026-02240-6 · https://hartvaat.nl/2026/09/01/perioperatieve-empagliflozin-verlaagt-trend-postoperatieve-boezemfibrilleren-na-/* A double-blind RCT (n=110) evaluated whether perioperative empagliflozin (10 mg daily) prevents postoperative atrial fibrillation (POAF) following elective heart valve surgery. Among 81 patients in the modified intention-to-treat analysis, POAF occurred in 20% of the empagliflozin group versus 39% in the placebo group (49% relative risk reduction, p=0.088). Although the primary endpoint did not reach statistical significance, the trend toward reduced arrhythmia incidence, combined with improved postoperative glycemic control and a favorable safety profile, warrants further investigation. Larger trials are needed before perioperative SGLT2 inhibitor use can be recommended for POAF prevention. ## [Predictive value of the Vasoactive Inotropic Score for 28-day mortality in patients with atrial fibrillation-related hemodynamic deterioration in the intensive care unit]. *2026-08-12 · Zhonghua wei zhong bing ji jiu yi xue · https://doi.org/10.3760/cma.j.cn121430-20260108-00018 · https://hartvaat.nl/2026/06/01/vis-score-voorspelt-28-daagse-mortaliteit-bij-atriumfibrilleren-met-hemodynamisc/* In a single-center retrospective cohort of 123 ICU patients with atrial fibrillation and hemodynamic deterioration, the vasoactive inotropic score (VIS) showed good predictive value for 28-day mortality (AUC 0.801). A VIS ≥ 129.7 was an independent risk factor for death (OR 70.5), while anticoagulation therapy was protective (OR 0.073). These findings support VIS as a practical risk-stratification tool in critically ill patients with AF, though results are limited to a single center and require external validation. ## Comparison of In-Hospital Outcomes of Acute ST Segment Elevation Myocardial Infarction in Young Versus Older Patients. *2026-08-12 · Cureus · https://doi.org/10.7759/cureus.111767 · https://hartvaat.nl/2026/06/01/oudere-stemi-patienten-hebben-meer-complicaties-en-hogere-sterfte-dan-jongeren-e/* Among 300 STEMI patients, those over 40 had significantly higher rates of heart failure, cardiogenic shock, acute kidney injury, and in-hospital death (11.3% vs 4.0%; p=0.017). Multivariable analysis revealed that mortality was independently predicted by mechanical complications, ventricular arrhythmias, shock, and AKI, rather than age itself. These findings reinforce that the higher burden of comorbidities and acute complications in older patients drives worse outcomes, underscoring the need for vigilant monitoring and early intervention in this population. ## Symptom severity assessment in patients with atrial fibrillation after catheter ablation using a smartphone application. *2026-08-12 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag139 · https://hartvaat.nl/2026/06/02/smartphone-app-voor-symptoomregistratie-na-ablatie-bij-atriumfibrilleren-isolati/* An analysis of the ISOLATION study evaluated a smartphone-based photoplethysmography app for daily symptom severity tracking in 140 patients following catheter ablation for atrial fibrillation. Among 8,575 recordings, 11% showed active AF, with nearly half of these episodes being asymptomatic. Symptom severity was higher during AF, in women, and at higher heart rates. This digital approach offers clinicians a more precise assessment of patient burden beyond rhythm status alone, potentially refining post-ablation follow-up. ## Autonomic effects and ablation success after pulsed field and cryoballoon ablation: a SINGLE SHOT CHAMPION substudy. *2026-08-12 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag152 · https://hartvaat.nl/2026/06/02/pulsfield-ablatie-levert-betere-vrijwaring-van-recidief-dan-cryoballoon-bij-paro/* In this substudy of a multicentre RCT, 210 patients with symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation using either pulsed field ablation (PFA) or cryoballoon ablation (CBA). At 12 months, freedom from arrhythmia recurrence was significantly higher with PFA than CBA (63% vs 49%, p=0.046), accompanied by higher heart rate variability and lower resting heart rates in the PFA group. Although PFA exerts less autonomic nervous system modulation, these results suggest that autonomic effects are not critical for successful paroxysmal AF ablation. The findings reinforce PFA as a highly effective first-line ablation strategy. ## Early catheter ablation vs. antiarrhythmic drugs in treatment-naïve ischaemic ventricular tachyarrhythmias: a meta-analysis of randomized controlled trials. *2026-08-12 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag073 · https://hartvaat.nl/2026/06/02/vroege-katheterablatie-even-effectief-als-antiaritmica-bij-ischemische-ventricul/* A meta-analysis of three randomized controlled trials (n=618) evaluated early catheter ablation versus antiarrhythmic drugs as initial therapy for ventricular tachycardia in patients with prior myocardial infarction. Both strategies demonstrated comparable efficacy for all-cause mortality, appropriate ICD therapies, and VT storm, while ablation showed a trend toward fewer hospitalizations and adverse events, though largely driven by a single study. These results support considering early ablation as a first-line option in selected patients, pending further confirmation in larger trials. ## Catheter ablation of atrial fibrillation in transthyretin and light-chain cardiac amyloidosis: results from the multicentre AMYL-AF study. *2026-08-11 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag143 · https://hartvaat.nl/2026/06/02/catheterablatie-bij-atriumfibrilleren-in-cardiale-amyloidose-levert-42-ritmievri/* The multicentre AMYL-AF registry evaluated catheter ablation outcomes in 109 patients with transthyretin (ATTR) or light-chain (AL) cardiac amyloidosis and atrial fibrillation. After a median follow-up of 22.7 months, 42% remained arrhythmia-free, while 25% experienced the composite endpoint of all-cause mortality or heart failure hospitalisation. Recurrent persistent AF was associated with a three-fold higher risk of these adverse outcomes. These real-world data assist cardiologists and internists in counselling patients and selecting appropriate rhythm-control strategies in this high-risk population. ## Atrial cardiomyopathy as a multidomain disease: longitudinal evidence for autonomic remodelling. *2026-08-11 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag132 · https://hartvaat.nl/2026/06/02/autonoom-remodelling-vormt-onafhankelijk-domein-binnen-atriale-cardiomyopathie/* A prospective cohort study of 670 adults aged 65 years without prior atrial fibrillation demonstrates that autonomic remodelling, assessed via longitudinal heart rate variability, constitutes an independent domain of atrial cardiomyopathy. Involvement of two or more remodelling axes (autonomic, electrical, and structural) was associated with a more than twofold higher risk of incident AF (HR 2.43) and increased rates of major cardiovascular events and mortality. These findings support a multidimensional framework for atrial substrate assessment, suggesting that longitudinal autonomic monitoring may help identify high-risk individuals before clinical arrhythmia onset. ## Compliance to direct oral anticoagulation therapy and clinical outcomes after catheter ablation for atrial fibrillation: a nationwide cohort study. *2026-08-11 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag151 · https://hartvaat.nl/2026/06/02/doac-gebruik-na-ablatie-voor-atriumfibrilleren-aanhouderij-daalt-na-drie-jaar/* A nationwide Danish cohort of 13,438 patients undergoing first-time catheter ablation for atrial fibrillation was analysed for DOAC adherence and persistence, focusing on those with a CHA₂DS₂-VASc score ≥2. After three years, 87.6% met the adherence threshold (PDC ≥80%), but persistence dropped to 73.0%, indicating that over 20% had discontinued therapy. Thromboembolic and major bleeding rates remained low. The findings highlight a need for structured follow-up and adherence support to maintain long-term stroke prevention after AF ablation. ## Catheter ablation versus no ablation for atrial fibrillation in cardiac amyloidosis: a propensity-matched cohort study. *2026-08-11 · Global cardiology science & practice · https://doi.org/10.21542/gcsp.2026.26 · https://hartvaat.nl/2026/06/30/catheterablatie-verlaagt-sterfte-en-complicaties-bij-af-in-cardiale-amyloidose-t/* In a propensity-matched cohort of nearly 1,800 patients with cardiac amyloidosis and atrial fibrillation, catheter ablation combined with antiarrhythmic drugs significantly reduced a composite endpoint of all-cause mortality, stroke, bleeding, and myocardial infarction at 12 months compared to medical therapy alone (8.3% vs 13.2%; HR 0.59). Although the ablation group experienced more repeat procedures and device implantations, it also showed a lower mortality rate without differences in new-onset heart failure or hospitalizations. These findings suggest that ablation may be a viable option for carefully selected patients, particularly those with earlier-stage disease or significant symptom burden. ## Clinical outcomes with vutrisiran in transthyretin amyloidosis: a systematic review and meta-analysis of randomized trials. *2026-08-11 · Global cardiology science & practice · https://doi.org/10.21542/gcsp.2026.25 · https://hartvaat.nl/2026/06/30/vutrisiran-remt-ttr-en-vermindert-valrisico-bij-attr-cardiomyopathie-meta-analys/* A systematic review and meta-analysis of three RCTs (HELIOS-A, HELIOS-B, and a phase-1 trial, n=976) demonstrates that vutrisiran, an RNA interference therapy, reduces transthyretin (TTR) levels by up to 97% with durable suppression. While the analysis suggests trends toward improved quality of life, functional capacity, and mortality (RR 0.51; p=0.29), these did not reach statistical significance. Vutrisiran significantly reduced fall risk (RR 0.62; p=0.001) without increasing overall adverse events, indicating a favourable safety profile. These findings confirm robust biomarker suppression and safety, but larger long-term trials are required to definitively establish clinical and survival benefits in transthyretin amyloidosis. ## Pulmonary congestion assessed by lung ultrasound in stable ambulatory patients with heart failure and preserved ejection fraction in primary care. *2026-08-10 · Family practice · https://doi.org/10.1093/fampra/cmag050 · https://hartvaat.nl/2026/06/11/longultrasongrafie-onthult-subklinische-longcongestie-bij-stabiele-hfpef-in-de-h/* In a prospective observational study of 188 stable HFpEF patients managed in primary care, lung ultrasound detected subclinical pulmonary congestion (B-lines) in 86.5% of participants, with one-third having ≥5 B-lines despite clinical stability. B-line counts correlated with higher systolic blood pressure, pulmonary crackles, and elevated NT-proBNP and CA-125 levels, but not with functional capacity or quality of life. These findings suggest that lung ultrasound may help identify occult congestion in clinically stable HFpEF patients, potentially refining monitoring and diuretic titration in primary care settings. ## Machine Learning Based Prediction of Hospital Mortality in Post-Cardiotomy Cardiogenic Shock with Mechanical Support. *2026-08-10 · ESC heart failure · https://doi.org/10.1093/eschf/xvag145 · https://hartvaat.nl/2026/06/13/ml-modellen-voorspellen-sterfte-bij-post-cardiotomisch-shock-op-ecmo-elso-regist/* A retrospective cohort analysis of 5,982 adults with post-cardiotomy cardiogenic shock on ECMO from the ELSO registry demonstrates that machine learning models can predict in-hospital mortality. The boosting algorithm achieved the highest discrimination (AUC 0.759), with lactate, arterial pH, age, and BMI as key predictors. While the model shows promise as a tool for dynamic risk assessment in the cardiac ICU, external validation and calibration are required before clinical implementation. ## Multifactorial Risk Assessment and Anticoagulation Strategy Optimization for Deep Vein Thrombosis After Major Joint Surgery: A Retrospective Study. *2026-08-10 · Journal of visualized experiments : JoVE · https://doi.org/10.3791/70890 · https://hartvaat.nl/2026/06/16/rivaroxaban-verlaagt-dvt-risico-na-gewrichtsvervanging-maar-verhoogt-bloedingen/* A multicenter retrospective cohort study of 32,512 patients undergoing total hip or knee arthroplasty found that rivaroxaban reduced 30-day deep vein thrombosis incidence compared with low-molecular-weight heparin (2.3% vs 3.6%; aOR 0.62). This efficacy benefit was accompanied by a modestly higher rate of major bleeding (1.48% vs 1.08%). The results highlight the importance of individualized anticoagulation strategies that balance thrombotic and hemorrhagic risks, particularly in patients with obesity, advanced age, or prior venous thromboembolism. ## Sex disparities in receiving evidence-based medications in patients with CKD. *2026-08-10 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag135 · https://hartvaat.nl/2026/06/19/vrouwen-met-ckd-krijgen-minder-vaak-ras-remmers-en-sglt2-remmers-dan-mannen/* An international observational cohort of 4,192 patients with chronic kidney disease (CKD) revealed that women were significantly less likely to receive evidence-based medications, including renin-angiotensin system inhibitors (OR 0.75) and SGLT2 inhibitors (OR 0.79), compared to men after multivariable adjustment. This prescribing gap persisted across all high-risk subgroups and age categories. The findings highlight a persistent global inequity in cardiorenal care, underscoring the need for clinicians to actively ensure equitable initiation of guideline-directed therapies in female CKD patients. ## Prevalence of cardiac amyloidosis in screening studies: a systematic review and meta-analysis. *2026-08-10 · ESC heart failure · https://doi.org/10.1093/eschf/xvag172 · https://hartvaat.nl/2026/06/22/cardiale-amyloidose-komt-frequent-voor-bij-hfpef-aortastenose-en-lvh-meta-analys/* A meta-analysis of 83 studies reveals that cardiac amyloidosis (CA) is relatively prevalent in patients with HFpEF/HFmrEF (12.6%), severe aortic stenosis (9.6%), and left ventricular hypertrophy (15.1%). Prevalence estimates rise substantially when only patients meeting confirmatory testing criteria are evaluated, reaching up to 35.4% in LVH/HCM cohorts. Clinically, the findings underscore the need for structured screening pathways and clear referral criteria rather than selective testing based on clinical suspicion alone. ## AI as co-pilot: what the ESC 2026 spotlight theme actually means *2026-08-10 · HartVaat congresredactie · · https://hartvaat.nl/2026/08/10/ai-als-co-piloot-wat-het-spotlightthema-van-esc-2026-concreet-betekent/* ESC Congress 2026 puts artificial intelligence in the spotlight, framed as a co-pilot from diagnostics to care delivery, with two dedicated programme tracks and hands-on demonstrations. The theme reflects a field moving past research: AI already reads echos, filters rhythm-monitoring alerts and sharpens risk prediction, while the congress rightly programmes the reliability, accountability and equity questions alongside. ## Non-obstructive HCM: why ACACIA-HCM is the first real shot at a drug *2026-08-10 · HartVaat congresredactie · · https://hartvaat.nl/2026/08/10/niet-obstructieve-hcm-waarom-acacia-hcm-de-eerste-echte-kans-op-een-medicijn-is/* Myosin inhibitors transformed obstructive hypertrophic cardiomyopathy, but the non-obstructive third of patients still has no approved disease-targeted therapy, and mavacamten failed to deliver there. ACACIA-HCM, opening the Hot Line programme at ESC Congress 2026 on Friday 28 August, met both primary endpoints (KCCQ-CSS and pVO2 at week 36) in its 5 May topline; Munich brings the effect sizes, the LVEF safety signals and the MAPLE-HCM comparison. ## ATTR cardiomyopathy on the eve of CARDIO-TTRansform *2026-08-10 · HartVaat congresredactie · · https://hartvaat.nl/2026/08/10/attr-cardiomyopathie-aan-de-vooravond-van-cardio-ttransform/* Transthyretin amyloid cardiomyopathy has moved from rare diagnosis to recognised cause of heart failure in older adults. CARDIO-TTRansform, presented in Hot Line 1 on Friday 28 August, tested the antisense agent eplontersen in 1,432 patients and, as announced by AstraZeneca and Ionis, missed its primary endpoint of CV death plus recurrent CV events to week 140. A prespecified monotherapy subgroup showed a nominally significant HR of 0.71, with no added effect on top of stabilisers: Munich has to explain why. ## Factor XI inhibition: the hypothesis, the promise and the LIBREXIA ACS lesson *2026-08-10 · HartVaat congresredactie · · https://hartvaat.nl/2026/08/10/factor-xi-remming-de-hypothese-de-belofte-en-de-les-van-librexia-acs/* Factor XI inhibition promises antithrombotic effect without the bleeding cost, but the field keeps hitting reality: after asundexian, the 14,000-patient LIBREXIA ACS trial of milvexian was halted for futility in November 2025. The full results, presented at ESC Congress 2026, will determine what remains of the factor XI hypothesis in ACS, while the AF and stroke programmes continue. ## Heart and kidney in one guideline: why the ESC now treats them together *2026-08-10 · HartVaat congresredactie · · https://hartvaat.nl/2026/08/10/hart-en-nier-in-een-richtlijn-waarom-de-esc-ze-samen-behandelt/* ESC Congress 2026 delivers the first dedicated ESC guideline on cardiovascular disease in chronic kidney disease, presented Saturday 29 August. It formalises care for a huge overlap population long excluded from trials, arriving exactly as SGLT2 inhibitors, finerenone and GLP-1 agonists have turned cardio-renal protection into a treatable continuum. ## The new ESC heart failure guideline: what lands on 28 August *2026-08-10 · HartVaat congresredactie · · https://hartvaat.nl/2026/08/10/de-nieuwe-esc-hartfalenrichtlijn-wat-er-op-28-augustus-op-tafel-ligt/* The new ESC heart failure guideline, the first full revision since 2021, is presented on Friday 28 August at ESC Congress 2026, followed by an Ask the Task Force session. Expect consolidation of four-pillar HFrEF therapy and its rapid initiation, a firmer evidence base for HFpEF treatment, and close alignment with the simultaneously released guideline on cardiovascular disease and chronic kidney disease. ## Statins beyond seventy: what STAREE will and will not answer *2026-08-10 · HartVaat congresredactie · · https://hartvaat.nl/2026/08/10/statines-na-je-zeventigste-wat-staree-wel-en-niet-gaat-beantwoorden/* STAREE randomised almost 10,000 healthy Australians aged 70 and over to atorvastatin or placebo, with disability-free survival as its primary endpoint. Presented in Hot Line 2 at ESC Congress 2026, it addresses the largest remaining evidence gap in primary prevention: whether statins help healthy older adults live longer without disability or dementia. Either outcome will directly change everyday consultations about starting, or stopping, statins in older age. ## Pathophysiology of pregnancy-associated acute kidney injury. *2026-08-09 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag142 · https://hartvaat.nl/2026/06/23/zwangerschapsgeassocieerd-acuut-nierfalen-pathofysiologie-en-verhoogd-langetermi/* This narrative review outlines the pathophysiology of pregnancy-associated acute kidney injury (PrAKI), which affects an estimated 40–100 per 10,000 pregnancies. The authors highlight how pregnancy-specific hemodynamic shifts, placental ischemia, and immune dysregulation impair renal reserve and endothelial function, leading to long-term risks of chronic kidney disease and cardiovascular disease. Recognizing these mechanisms underscores the need for structured long-term follow-up and cardiovascular risk management in women who have experienced PrAKI. ## Cardiometabolic Heart Failure with Preserved Ejection Fraction (HFpEF): Epidemiology, Mechanisms, and the Role of Lifestyle Modification. *2026-08-09 · Journal of cardiovascular development and disease · https://doi.org/10.3390/jcdd13070291 · https://hartvaat.nl/2026/06/23/lifestyle-modificatie-en-metabole-therapieen-bij-cardiometabole-hfpef-overzicht/* Cardiometabolic HFpEF is increasingly recognized as a systemic syndrome driven by visceral adiposity and chronic inflammation. This narrative review highlights that combined aerobic and resistance exercise training, with or without caloric restriction, significantly improves exercise capacity, physical function, and quality of life in clinically stable patients. The authors also emphasize that SGLT2 inhibitors and GLP-1 receptor agonists exert beneficial effects largely through metabolic pathways. For clinicians, the findings reinforce lifestyle modification and early metabolic pharmacotherapy as cornerstone strategies in the management of cardiometabolic HFpEF. ## Retrospective Evaluation of Recombinant Human Brain Natriuretic Peptide Therapy for Decompensated Right Heart Failure Across Pulmonary Hypertension Groups. *2026-08-09 · Medicina (Kaunas, Lithuania) · https://doi.org/10.3390/medicina62071213 · https://hartvaat.nl/2026/06/23/rhbnp-therapie-vermindert-congestie-en-dyspnoe-bij-rechterhartfalen-door-longhyp/* A retrospective evaluation of 763 patients with pulmonary hypertension (groups 1, 2, and 4) demonstrates that adding recombinant human brain natriuretic peptide (rhBNP) to conventional therapy significantly reduces markers of cardiac congestion, including NT-proBNP, bilirubin, and body weight. Clinical improvement in dyspnea and lower limb edema was observed in 49.9% and 66.6% of cases, respectively, with a low overall adverse event rate (0.66%). While these findings support rhBNP as a useful adjunct for decompensated right heart failure, the authors emphasize the need for close blood pressure monitoring, particularly in high-risk group 1 pulmonary arterial hypertension patients. ## Composition and Characterization of the Different Lipoproteins in Overweight/Obese Children vs. Normal-Weight Children. *2026-08-09 · Biomolecules · https://doi.org/10.3390/biom16070927 · https://hartvaat.nl/2026/06/23/vldl-en-hdl-tg-verhoogd-bij-overgewicht-bij-kinderen-geavanceerd-lipoproteinepro/* An observational study compared advanced lipoprotein profiling via 1H-NMR in overweight/obese children versus normal-weight peers. The overweight/obese group showed significantly higher levels of VLDL-C, VLDL-TG, IDL-TG, HDL-TG, total VLDL particle count, and REM-C, alongside smaller mean LDL particle size. These findings highlight early metabolic alterations associated with childhood excess weight. Advanced lipoprotein profiling may provide incremental risk information beyond standard lipid panels. ## Efficacy and safety of inclisiran monotherapy in Chinese adults with elevated low-density lipoprotein cholesterol: Results from the VICTORION-Mono China trial. *2026-08-09 · Journal of clinical lipidology · https://doi.org/10.1016/j.jacl.2026.06.016 · https://hartvaat.nl/2026/06/26/inclisiran-als-monotherapie-verlaagt-ldl-c-met-47-5-in-chinese-volwassenen-victo/* The phase-3 VICTORION-Mono trial evaluated inclisiran monotherapy in 207 Chinese adults with elevated LDL-C and low-to-moderate ASCVD risk. At day 150, inclisiran reduced LDL-C by 47.5% compared with placebo, with sustained lipid-lowering effects and significant reductions in Lp(a) and ApoB through day 360. The treatment was well-tolerated, supporting inclisiran as a viable monotherapy option for dyslipidemia management in this population. ## Observational Assessments of Chicken, Beef, and Seafood Proportions with a Mediterranean-Style Healthy Dietary Pattern and Cardiovascular Risk Factor Changes: Post Hoc Analysis of a Controlled Feeding Trial. *2026-08-08 · Nutrients · https://doi.org/10.3390/nu18132062 · https://hartvaat.nl/2026/06/24/meer-kip-dan-rundvlees-of-vis-bij-avondmaaltijd-gekoppeld-aan-grotere-bloeddrukd/* A post hoc analysis of a 12-week controlled feeding trial (n=52) in adults with metabolic syndrome found that a Mediterranean-style dietary pattern improved blood pressure and lipid profiles. Within the diet, higher consumption of chicken at dinner was modestly associated with greater reductions in systolic and diastolic blood pressure compared to beef or seafood, with no significant differences observed for lipid parameters. These results reinforce the cardiovascular benefits of a Mediterranean diet, though the specific association with chicken requires independent validation before influencing clinical dietary advice. ## Rethinking Congestion in Heart Failure from Volume Overload to Venous Pressure and Organ Disfunction with VExUS. *2026-08-08 · Medicina (Kaunas, Lithuania) · https://doi.org/10.3390/medicina62071224 · https://hartvaat.nl/2026/06/24/vexus-scoring-biedt-completer-beeld-van-congestie-bij-hartfalen/* Congestion drives symptoms and hospitalizations in heart failure, yet bedside assessment remains challenging. This narrative review discusses the Venous Excess Ultrasound (VExUS) score, which integrates inferior vena cava, hepatic, portal, and intrarenal Doppler assessments to better capture venous pressure transmission and end-organ impact. Observational data link VExUS abnormalities to invasive hemodynamics, acute kidney injury, and mortality, but randomized trials are still lacking. The authors recommend VExUS as a complementary tool within a multimodal congestion assessment strategy. ## Hypertensive Heart Failure with Preserved Ejection Fraction: Guidelines vs. Randomized Controlled Trials Evidence Gaps. *2026-08-08 · Medicina (Kaunas, Lithuania) · https://doi.org/10.3390/medicina62071222 · https://hartvaat.nl/2026/06/24/sglt2-remmers-en-bloeddrukdoelen-bij-hypertensief-hfpef-een-overzicht-van-richtl/* This narrative review evaluates current evidence for blood pressure targets (<130/80 mmHg) and SGLT2 inhibitor therapy in patients with hypertensive heart failure with preserved ejection fraction (HFpEF). Post-hoc analyses from EMPEROR-Preserved and DELIVER demonstrate consistent reductions in heart failure events with SGLT2 inhibitors (pooled HR 0.79), alongside modest systolic blood pressure lowering. While biomarkers such as sST2 and NT-proBNP aid risk stratification, significant evidence gaps remain regarding guideline harmonisation, device therapies like renal denervation, and real-world adherence. The review underscores the need for phenotype-driven management and dedicated randomised trials to translate current recommendations into routine clinical practice for this growing patient population. ## Association between periodontitis and heart failure: Mechanisms and clinical implications (Review). *2026-08-08 · Molecular medicine reports · https://doi.org/10.3892/mmr.2026.13974 · https://hartvaat.nl/2026/10/01/parodontitis-kan-via-systemische-ontsteking-bijdragen-aan-hartfalen-narratieve-r/* This narrative review explores the potential mechanisms linking periodontitis to heart failure, including systemic inflammation, microbial dysbiosis, and immune dysregulation. While observational data suggest an association, current evidence is insufficient to establish causality or demonstrate that dental interventions improve heart failure outcomes. Clinically, routine periodontal screening is not yet recommended, but oral health assessment may be considered as part of a comprehensive, multidisciplinary heart failure management strategy. ## Predicted adherence and ischaemic stroke risk in atrial fibrillation patients initiating oral anticoagulation: A cohort study of the medication adherence score. *2026-08-08 · International journal of cardiology · https://doi.org/10.1016/j.ijcard.2026.134660 · https://hartvaat.nl/2026/10/15/lage-voorspelde-adherentie-verhoogt-stroke-risico-bij-af-patienten-die-starten-m/* In a retrospective cohort study of 11,233 AF patients with a CHA₂DS₂-VASc score ≥ 2 initiating oral anticoagulation, a validated Medication Adherence Score (MAS) was used to predict adherence levels. Patients with low predicted adherence faced a significantly higher 12-month risk of ischemic stroke compared to those with high adherence (subdistribution HR 0.67; 95% CI 0.56-0.80; cumulative incidence 5.08% vs. 7.97%). These findings suggest that applying the MAS at OAC initiation could help clinicians identify high-risk patients for targeted adherence support, potentially improving stroke prevention in routine practice. ## Long-term outcomes of ICE-guided left atrial appendage occlusion from a large single-center experience. *2026-08-07 · International journal of cardiology · https://doi.org/10.1016/j.ijcard.2026.134664 · https://hartvaat.nl/2026/10/15/ice-gestuurde-laac-toont-lage-stroke-en-bloedingsrisicos-op-lange-termijn/* A single-center retrospective cohort of 411 patients undergoing intracardiac echocardiography (ICE)-guided left atrial appendage closure (LAAC) between 2009 and 2024 demonstrated a 99.8% technical success rate and a 5.1% major adverse event rate. Over a mean follow-up of 44 months, the annualized stroke/TIA rate was 1.7% (73% lower than CHA₂DS₂-VASc predicted) and major bleeding occurred at 1.1% per year. These findings support ICE guidance as a safe and effective alternative to TEE for LAAC, offering favorable long-term ischemic and bleeding outcomes in a high-risk atrial fibrillation population. ## Emerging Evidence for Cardiorenal Protection with Sodium-Glucose Cotransporter Inhibitors, Glucagon-like peptide-1 Receptor Agonists, and Mineralocorticoid Receptor Blockers in People with Type 1 Diabetes. *2026-08-07 · Endocrinology and metabolism clinics of North America · https://doi.org/10.1016/j.ecl.2026.04.007 · https://hartvaat.nl/2026/09/01/cardiorenale-bescherming-door-sglt2-remmers-glp-1-agonisten-en-mra-s-bij-type-1-/* This narrative review synthesizes current evidence on the cardiorenal benefits of SGLT2 inhibitors, GLP-1 receptor agonists, and mineralocorticoid receptor antagonists in patients with type 1 diabetes. While these drug classes have fundamentally transformed cardiovascular and renal care in type 2 diabetes, robust long-term outcome data in type 1 diabetes remain limited. Clinicians should consider these agents on a case-by-case basis for cardiorenal risk reduction, pending further dedicated trials to establish definitive safety and efficacy profiles in this population. ## Beyond Insulin: Why Type 1 Diabetes Mellitus Needs More? *2026-08-07 · Endocrinology and metabolism clinics of North America · https://doi.org/10.1016/j.ecl.2026.04.001 · https://hartvaat.nl/2026/09/01/naast-insuline-zijn-nieuwe-medicijnen-nodig-om-het-hart-en-vaatrisico-bij-type-1/* Patients with type 1 diabetes continue to face elevated cardiovascular risk and mortality that cannot be fully explained by traditional risk factors or dysglycemia alone. This narrative review highlights the contribution of glycemic variability, insulin-related weight gain, and insulin resistance, emphasizing the need for additional pharmacological agents targeting these pathways. However, data on long-term outcomes and hard cardiovascular endpoints remain sparse. Clinicians should be aware of these mechanisms and the current evidence gap when managing cardiometabolic risk in type 1 diabetes. ## Current State of Cardiorenal Disease in People with Type 1 Diabetes. *2026-08-07 · Endocrinology and metabolism clinics of North America · https://doi.org/10.1016/j.ecl.2026.04.004 · https://hartvaat.nl/2026/09/01/cardiorenale-risicos-bij-type-1-diabetes-een-overzicht-van-de-huidige-stand-van-/* Individuals with type 1 diabetes (T1D) face a substantially elevated risk of cardiovascular disease, heart failure, and chronic kidney disease. While novel glucose-lowering agents have demonstrated significant cardiorenal protection in type 2 diabetes, patients with T1D have historically been excluded from most outcome trials. This review synthesizes current evidence on the high cardiorenal burden in T1D and highlights the clinical need for targeted risk management and dedicated research in this population. ## Sodium-Glucose Cotransporter-Inhibitors, Incretin Receptor Agonists (Glucagon-Like Peptide-1 Receptor Agonists and Dual Glucose-Dependent Insulinotropic Polypeptide/Glucagon-Like Peptide-1 Receptor Agonists), and Finerenone for Kidney Protection in Type 1 Diabetes. *2026-08-07 · Endocrinology and metabolism clinics of North America · https://doi.org/10.1016/j.ecl.2026.04.015 · https://hartvaat.nl/2026/09/01/sglt2-remmers-glp-1-agonisten-en-finerenone-voor-nierbescherming-bij-type-1-diab/* This narrative review outlines the pathophysiology of diabetic kidney disease in type 1 diabetes and evaluates the emerging evidence for adjunctive kidney-protective agents, including SGLT2 inhibitors, GLP-1 receptor agonists, and finerenone. While large-scale outcome trials specific to type 1 diabetes are still maturing, current mechanistic data and early clinical findings support their potential role in mitigating hyperfiltration and inflammatory injury. Clinicians should anticipate a shift toward integrating these cardiorenal therapies into standard management protocols for type 1 diabetes as evidence continues to accumulate. ## A Machine-Learning Model for Accurate Diuresis Prediction in Acute Heart Failure (DRC-AHF). *2026-08-06 · ESC heart failure · https://doi.org/10.1093/eschf/xvag185 · https://hartvaat.nl/2026/06/26/machine-learning-voorspelt-diureticumrespons-bij-acuut-hartfalen-drc-ahf/* A prospective single-centre study developed a machine learning model to predict 6-hour urine output after intravenous furosemide in acute heart failure, using eGFR and spot urine sodium/creatinine measured two hours post-dose. In an external validation cohort (n=50), the model showed strong correlation with observed output (r=0.90) and correctly classified diuresis response in 88% of patients, outperforming the standard NRPE equation (58%). While the tool offers a promising approach to personalizing diuretic therapy in diuretic-resistant AHF, its single-centre derivation and small validation sample warrant multicentre external validation before routine clinical adoption. ## Systolic blood pressure and albuminuria reduction mediate cardiovascular benefits of finerenone in T2 diabetes and CKD. *2026-08-06 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag150 · https://hartvaat.nl/2026/06/26/finerenone-verlaagt-hart-en-vaatrisico-via-vroege-daling-van-uacr-en-systolische/* A causal mediation analysis of the pooled FIDELITY trial data (n = 12,143) demonstrates that the cardiovascular benefit of finerenone in patients with type 2 diabetes and chronic kidney disease is largely driven by early reductions in urine albumin-to-creatinine ratio (UACR) and systolic blood pressure. Within four months, UACR and systolic blood pressure changes accounted for 39% and 21% of the long-term cardiovascular risk reduction, respectively, while shifts in body weight and serum potassium did not mediate outcomes. These findings highlight UACR and blood pressure as complementary early markers to monitor cardiovascular efficacy when initiating finerenone therapy. ## Peptide hormone-based combinational pharmacotherapies for chronic metabolic diseases. *2026-08-06 · Pharmacological reviews · https://doi.org/10.1016/j.pharmr.2026.100150 · https://hartvaat.nl/2026/06/26/peptidehormooncombinaties-bieden-superieure-effectiviteit-bij-metabole-multimorb/* This narrative review evaluates the pharmacological and clinical advances of combination therapies using peptide hormone co-agonists, such as GLP-1 combined with FGF21 or GDF15 analogs, for chronic metabolic diseases including obesity, type 2 diabetes, MASLD, and cardiovascular disease. The authors highlight that synergistic targeting of multiple metabolic pathways yields superior efficacy over monotherapy, addressing the growing burden of metabolic multimorbidity. For clinicians, these findings outline the evolving therapeutic landscape and underscore the potential of next-generation co-agonists to transform cardiometabolic care, while noting ongoing challenges in clinical development and safety profiling. ## Sodium-Glucose Co-Transporter 2 Inhibitors and Hyperkalemia-Related Discontinuation of Renin-Angiotensin-Aldosterone System Inhibitors During Mineralocorticoid Receptor Antagonist Therapy: A Real-World Cohort Study. *2026-08-06 · Pharmacy (Basel, Switzerland) · https://doi.org/10.3390/pharmacy14040091 · https://hartvaat.nl/2026/06/26/sglt2-remmers-kunnen-hyperkaliemie-gerelateerd-stoppen-van-raas-remmers-voorkome/* In a retrospective cohort of 905 patients, adding a mineralocorticoid receptor antagonist (MRA) to RAAS inhibition doubled the risk of hyperkalemia. However, co-prescription of an SGLT2 inhibitor neutralized the association between MRA use and hyperkalemia-driven RAAS inhibitor discontinuation: discontinuation rates increased more than fivefold without an SGLT2 inhibitor, but remained low in those receiving one. This real-world data suggests that SGLT2 inhibitors may help preserve RAASi and MRA therapy in patients prone to hyperkalemia, supporting their early integration in cardiorenal management. ## Improved diagnosis of familial hypercholesterolemia by correcting LDL-C for lipoprotein(a) in a German cohort. *2026-08-06 · Journal of clinical lipidology · https://doi.org/10.1016/j.jacl.2026.06.017 · https://hartvaat.nl/2026/06/26/correctie-van-ldl-c-voor-lipoproteine-a-verbetert-diagnose-familiaire-hyperchole/* A German cohort study of 384 patients suspected of familial hypercholesterolemia (FH) demonstrates that adjusting LDL-C for lipoprotein(a) improves diagnostic accuracy. Correcting LDL-C by 17.3% of the measured Lp(a) level significantly increased specificity for both the DLCN score and a fixed LDL-C cutoff, primarily by reclassifying false positives among genetically unconfirmed patients without compromising sensitivity. Implementing this simple correction could streamline FH screening, reduce unnecessary genetic testing, and minimize overdiagnosis in routine lipid management. ## The Prognostic Impact of the Cachexia Index in Patients Hospitalized with Heart Failure. *2026-08-05 · Medicina (Kaunas, Lithuania) · https://doi.org/10.3390/medicina62071246 · https://hartvaat.nl/2026/06/27/laag-cachexie-index-voorspelt-overleving-en-heropname-bij-hartfalenpatienten/* In a retrospective single-center cohort of 127 patients hospitalized for decompensated heart failure, a low cachexia index (CXI)—calculated from skeletal muscle mass, serum albumin, and the neutrophil-to-lymphocyte ratio—was strongly associated with all-cause mortality and recurrent hospitalizations. Patients with a CXI below 20.87 had a mortality rate of 80.5% and a median of 4 heart failure-related readmissions, compared to 4.7% mortality and 0.5 readmissions in those with a high CXI. While the CXI shows promise as an integrative prognostic tool for risk stratification, its clinical utility requires validation in larger, multicenter prospective studies. ## Renal Functional Reserve-Informed Personalized Renoprotection in Chronic Kidney Disease: A Proposed Extension of the KDIGO CGA Framework. *2026-08-05 · Biomedicines · https://doi.org/10.3390/biomedicines14071478 · https://hartvaat.nl/2026/06/29/functioneel-nierreservoir-als-aanvulling-op-kdigo-cga-bij-chronische-nierziekte/* This narrative review proposes a functional-hemodynamic extension to the standard KDIGO CGA framework for chronic kidney disease by integrating renal functional reserve (RFR), blood pressure, volume status, and tubular markers. The authors distinguish established renoprotective therapies (RAASi, SGLT2i, non-steroidal MRAs) from conceptual treatment sequencing hypotheses, while clarifying that the model remains a hypothesis-generating tool rather than a validated clinical algorithm. This framework aids clinicians in physiological phenotyping and interpreting early eGFR changes, ultimately guiding the design of prospective studies to test RFR's independent prognostic value. ## Economic evaluation of dapagliflozin added to standard therapy in chronic heart failure in Argentina: a cost-utility analysis. *2026-08-05 · Lancet regional health. Americas · https://doi.org/10.1016/j.lana.2026.101571 · https://hartvaat.nl/2026/10/01/dapagliflozin-kosteneffectief-bij-chronisch-hartfalen-economische-evaluatie-in-a/* A cost-utility analysis in Argentina demonstrates that adding dapagliflozin to standard therapy for chronic heart failure is cost-effective. Based on DAPA-HF and DELIVER trial data, dapagliflozin yielded an incremental gain of 0.76 and 0.44 QALYs, with ICERs of US$6,672 and US$10,371 per QALY, respectively. At a willingness-to-pay threshold of 1 GDP per capita, the probability of cost-effectiveness was 97% for HFrEF and 73% for HFpEF/mHFrEF. While region-specific, these findings reinforce the established value of SGLT2 inhibitors in heart failure and highlight the importance of pricing strategies and reimbursement policies for equitable patient access. ## Hospital volume and efficiency in transcarotid transcatheter aortic valve replacement: Insights from a national database of 10,000+ cases. *2026-08-05 · JTCVS structural and endovascular · https://doi.org/10.1016/j.xjse.2026.100123 · https://hartvaat.nl/2026/09/01/hogere-ziekenhuisvolumes-verbeteren-efficientie-bij-transcarotide-tavr-maar-mort/* A retrospective analysis of over 10,000 transcarotid TAVR procedures across 118 US academic centers reveals that higher hospital volumes are associated with greater resource efficiency, including shorter length of stay (4.9 vs 7.5 days) and reduced ICU admissions (42.5% vs 70.7%). Mortality and complication rates, however, remain comparable across volume quartiles, likely reflecting lower baseline patient complexity at high-volume sites. These findings suggest that procedural volume primarily impacts logistical efficiency rather than short-term safety outcomes for transcarotid TAVR. ## The Menopausal Transition and Cardiovascular Aging: Implications for Prevention in Midlife. *2026-08-05 · Obstetrics and gynecology clinics of North America · https://doi.org/10.1016/j.ogc.2026.04.003 · https://hartvaat.nl/2026/09/01/menopauze-en-cardiovasculaire-veroudering-preventiekansen-in-de-middenleeftijd/* The menopausal transition marks a critical window for cardiovascular health, as normal age-related vascular and myocardial changes can accelerate in the presence of cardiometabolic risk factors and unhealthy lifestyles. This narrative review highlights how modifiable targets, particularly lifestyle modification and standardized cardiovascular health scores, offer a practical framework for early risk stratification in midlife women. Implementing proactive preventive strategies during this period can significantly reduce the long-term burden of cardiovascular disease in women. ## Frailty and Heart Failure: An Integrated Review of a Bidirectional Relationship. *2026-08-04 · ESC heart failure · https://doi.org/10.1093/eschf/xvag178 · https://hartvaat.nl/2026/06/27/frailte-versnelt-hartfalenprogressie-en-vermindert-therapietolerantie/* This integrated review examines the bidirectional relationship between frailty and heart failure in older adults, highlighting how frailty independently predicts incident HF while HF accelerates frailty progression through inflammation, sarcopenia, and deconditioning. Frailty is strongly associated with higher mortality, reduced quality of life, and poorer tolerance of guideline-directed medical therapy, with the newly proposed Heart Failure Frailty Score (HFFS) offering a dedicated assessment tool. Clinically, routine frailty screening and targeted interventions—including exercise rehabilitation, nutritional support, and structured medication review—are essential to optimise outcomes in this vulnerable population. ## Transcatheter Aortic Valve Replacement in Patients Aged 65 Years and Younger: Unresolved Issues and Future Directions. *2026-08-04 · Life (Basel, Switzerland) · https://doi.org/10.3390/life16071075 · https://hartvaat.nl/2026/06/27/tavr-bij-patienten-65-jaar-hogere-sterfte-en-heropnames-dan-chirurgie-maar-onvol/* This narrative review examines transcatheter aortic valve replacement (TAVR) in patients aged 65 and younger, a population where guidelines still prefer surgical aortic valve replacement (SAVR). Observational data indicate higher mid-term mortality and heart failure readmissions following TAVR compared with SAVR, though these outcomes are likely confounded by the higher comorbidity burden and surgical risk in patients selected for the procedure. With no dedicated randomized trials and unresolved questions regarding valve durability and future redo interventions, the choice between TAVR and SAVR in younger patients remains highly centre-dependent and requires careful individualized assessment. ## From Phenotype to Genotype and Beyond: Insights into Familial Hypercholesterolemia and Familial Hypertriglyceridemia. *2026-08-04 · Medicina (Kaunas, Lithuania) · https://doi.org/10.3390/medicina62071257 · https://hartvaat.nl/2026/06/29/familiaire-hypercholesterolemie-en-hypertriglyceridemie-nieuw-diagnostisch-algor/* This narrative review highlights the limitations of current phenotypic diagnostic criteria for familial hypercholesterolemia (FH) and familial hypertriglyceridemia (FHTG), such as the DLCN score, and proposes a new four-step algorithm integrating genetic testing, ApoB quantification, and lifetime Lp(a) screening. Evidence from Mendelian randomization studies confirms that cardiovascular risk in these conditions is driven by ApoB-containing particles and remnant cholesterol rather than LDL-C or triglycerides alone. For clinical practice, this underscores the need to shift from LDL-C-centric to particle- and genotype-driven diagnostic pathways, improving early detection and cascade screening in primary care and lipid clinics. ## Changing Patterns in Infective Endocarditis: A Contemporary Epidemiological Perspective. *2026-08-04 · Pathogens (Basel, Switzerland) · https://doi.org/10.3390/pathogens15070697 · https://hartvaat.nl/2026/06/30/infectieuze-endocarditis-verschuiving-naar-oudere-patienten-met-comorbiditeiten-/* This narrative review outlines the shifting epidemiology of infective endocarditis (IE), highlighting a transition from younger patients with structural heart disease to older individuals with multiple comorbidities and frequent healthcare exposure. The increasing prevalence of end-stage renal disease, immunosuppression, intravenous drug use, and implanted cardiac devices has broadened the susceptible population and altered microbiological patterns, with staphylococci and enterococci now dominating. Clinicians should recognize this evolving risk profile, as it necessitates targeted prevention strategies around prosthetic valves and cardiac devices, alongside a heightened index of suspicion in complex, multimorbid patients. ## Carpal Tunnel Syndrome and Other Predictors of Amyloidosis. *2026-08-04 · Journal of hand surgery global online · https://doi.org/10.1016/j.jhsg.2026.100952 · https://hartvaat.nl/2026/05/01/hartfalen-als-belangrijkste-risicofactor-voor-amyloidose-bij-carpaaltunnelsyndro/* A retrospective cohort study of carpal tunnel syndrome (CTS) patients identifies heart failure as the strongest associated risk factor for developing amyloidosis within six years. The absolute risk difference was 702 per 100,000 in men and 261 per 100,000 in women. These findings may help clinicians identify CTS patients with heart failure who should be considered for tenosynovial biopsy to screen for ATTR amyloidosis. ## Lipoprotein apheresis: From familial hypercholesterolemia and elevated lipoprotein(a) to emerging roles in peripheral arterial and renal disease. *2026-08-03 · Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · https://doi.org/10.1016/j.transci.2026.104483 · https://hartvaat.nl/2026/08/01/lipoproteine-afseparatie-bij-refractaire-fh-en-lp-a-verschuivende-rol-naar-vaat-/* Lipoprotein apheresis (LA) acutely lowers LDL-C and Lp(a) by 60–80% through extracorporeal removal of apoB-containing particles, remaining the cornerstone therapy for homozygous and severe refractory heterozygous familial hypercholesterolemia. While long-term registry data demonstrate consistent reductions in major adverse cardiovascular events, LA utilization is declining due to PCSK9 inhibitors and inclisiran, with novel RNA-based Lp(a) agents poised to further reshape its role. Emerging observational evidence also supports LA in peripheral arterial disease and steroid-resistant focal segmental glomerulosclerosis via pleiotropic rheologic and anti-inflammatory mechanisms. Clinicians should anticipate a gradual contraction of LA in LDL-centric management, a sustained niche in Lp(a)-driven disease until RNA therapies demonstrate outcome benefits, and a mechanistically plausible but evidence-limited application in select vascular and renal phenotypes. ## Antithrombotic Management in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation. *2026-08-03 · Current cardiology reports · https://doi.org/10.1007/s11886-026-02384-2 · https://hartvaat.nl/2026/06/27/oac-monotherapie-is-superieur-aan-combinatie-met-antiplatelets-bij-stabiele-ccs-/* A recent narrative review synthesizes evidence on antithrombotic management in patients with stable chronic coronary syndrome (CCS) and atrial fibrillation (AF). Trials including AFIRE, EPIC-CAD, AQUATIC, and ADAPT-AF-DES demonstrate that oral anticoagulant (OAC) monotherapy is superior to combination therapy with antiplatelets, resulting in significantly fewer major bleeding events without an increase in ischemic complications, and even showing excess mortality with prolonged combination regimens. For clinical practice, this supports OAC monotherapy as the preferred long-term strategy, effectively balancing ischemic protection with bleeding risk reduction. ## Left Atrial Structural and Functional Changes After Pulmonary Vein Isolation Using Different Energy Sources. *2026-08-03 · Sensors (Basel, Switzerland) · https://doi.org/10.3390/s26134103 · https://hartvaat.nl/2026/06/28/cryoballoonablatie-resulteert-in-meer-linkeratrium-uitzetting-dan-radiofrequente/* A prospective study of 42 patients evaluated whether pulmonary vein isolation (PVI) for atrial fibrillation induces different short-term structural and functional changes in the left atrium when using cryoballoon ablation (CBA) versus radiofrequency catheter ablation (RFCA). At 12-month follow-up, the CBA group showed a significantly greater increase in left atrial diameter (p = 0.0017) compared with RFCA, with no significant differences in volumetric indices or mechanical function. Given the small sample size and exploratory nature of the findings, the results do not currently support a change in ablation strategy in routine clinical practice. ## AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026). *2026-08-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehag500 · https://hartvaat.nl/2026/06/29/nieuwe-universele-definitie-van-hartfalen-vervangt-vaste-ef-cutoffs-door-verbete/* A joint expert consensus from the AHA, ACC, ESC, and WHF introduces the second universal definition of heart failure to resolve longstanding diagnostic ambiguities and standardize global surveillance. The updated framework replaces rigid left ventricular ejection fraction cutoffs with dynamic categories of reduced, preserved, and improved ejection fraction, while formally integrating pre-heart failure (stage B), recovery trajectories, and social determinants into clinical classification. This standardized nomenclature will streamline early detection, guide prevention strategies, and align research and practice across primary care, cardiology, and health systems worldwide. ## The kidney failure risk equation in people with CKD and multimorbidity: the effect of competing mortality risks. *2026-08-03 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfaf252 · https://hartvaat.nl/2026/06/30/kfre-aangepast-voor-multimorbiditeit-verbetert-schatting-nierfalenrisico/* A large cohort study using UK Biobank and SCREAM data demonstrates that the standard Kidney Failure Risk Equation (KFRE) underestimates kidney failure risk in chronic kidney disease patients with multimorbidity. An updated model that accounts for competing mortality risks significantly improved calibration (O/E ratio 0.98 versus 1.75 for the original KFRE), while cystatin C-based eGFR did not enhance performance. This refined risk stratification tool offers clinicians a more accurate basis for timing nephrology referral and managing complex multimorbid patients. ## The effect of icodextrin on peritoneal dialysis patients with congestive heart failure: a time-varying exposure design and target trial emulation approach. *2026-08-02 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfaf265 · https://hartvaat.nl/2026/06/30/icodextrin-verlaagt-sterfte-en-mace-bij-dialysepatienten-met-hartfalen/* A retrospective cohort study of 1,800 peritoneal dialysis patients with congestive heart failure found that icodextrin use was associated with significantly lower risks of all-cause mortality (HR 0.16), cardiovascular mortality (HR 0.20), and MACE (HR 0.68). Using time-varying exposure modeling and target trial emulation, the authors suggest icodextrin improves fluid management and survival in this high-risk group, though transplantation rates were lower. These findings support prioritizing icodextrin in dialysis patients with heart failure, but prospective validation is warranted. ## Trends in nephrology: from "supportive care" to CKD combination therapy. *2026-08-02 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag003 · https://hartvaat.nl/2026/06/30/combinatietherapie-met-vier-pilaren-verlaagt-nierfalenrisico-bij-ckd/* This narrative review outlines the shift in chronic kidney disease (CKD) management from renin-angiotensin system inhibitor monotherapy to a four-pillar combination approach incorporating SGLT2 inhibitors, GLP-1 receptor agonists, and nonsteroidal mineralocorticoid receptor antagonists. Evidence and the 2024 KDIGO guidelines indicate that these complementary therapies significantly reduce kidney failure risk in diabetic patients while improving safety and tolerability, notably by mitigating hyperkalemia. Clinicians should consider early integration of this multimodal strategy, with ongoing research focusing on non-diabetic CKD populations and novel agents like aldosterone synthase inhibitors. ## Distribution of Lipoprotein(a) concentrations in children and young people with Familial Hypercholesterolemia (FH) compared to those without FH: A systematic review and narrative synthesis. *2026-08-02 · Atherosclerosis · https://doi.org/10.1016/j.atherosclerosis.2026.120823 · https://hartvaat.nl/2026/08/01/verhoogde-lp-a-komt-vaker-voor-bij-kinderen-met-familiaire-hypercholesterolemie-/* This systematic review evaluated Lipoprotein(a) [Lp(a)] concentrations in children and young people with familial hypercholesterolaemia (FH) compared with non-FH peers. While most non-FH children remained below adult risk thresholds, 20–40% of those with FH exhibited elevated Lp(a), indicating a substantially higher lifetime atherosclerotic burden from an early age. These findings support the integration of targeted Lp(a) screening in paediatric FH to refine early cardiovascular risk stratification and guide preventive strategies. ## Combination GLP-1 receptor agonist and SGLT2 inhibitor therapy versus GLP-1 receptor agonist monotherapy on arrhythmia outcomes in non-diabetic obese patients: A real-world time-dependent analysis. *2026-08-02 · International journal of cardiology. Cardiovascular risk and prevention · https://doi.org/10.1016/j.ijcrp.2026.200681 · https://hartvaat.nl/2026/09/01/combinatie-glp-1ra-en-sglt2-remmer-verlaagt-hartritmestoornissen-bij-niet-diabet/* A retrospective real-world cohort study evaluated arrhythmia outcomes in non-diabetic obese adults treated with combined GLP-1 receptor agonist and SGLT2 inhibitor therapy versus GLP-1 receptor agonist monotherapy. At 60 months, combination therapy was associated with a 17.5% lower odds of composite arrhythmia (OR 0.825), primarily driven by a reduced incidence of atrial fibrillation/flutter. Although ventricular tachycardia was initially more frequent in the combination group, this difference normalized over time. The findings suggest a favorable long-term electrophysiological profile for dual cardiometabolic therapy in obesity, informing arrhythmia monitoring in clinical practice. ## Hydrocortisone Use for Septic Shock in Patients With CKD. *2026-08-02 · Kidney international reports · https://doi.org/10.1016/j.ekir.2026.106686 · https://hartvaat.nl/2026/09/01/hydrocortison-verhoogt-sterfte-en-cardiorenale-uitkomsten-bij-ckd-met-septische-/* In a large propensity-matched cohort of 26,282 patients with nondialysis CKD and septic shock, hydrocortisone use was associated with higher 90-day mortality (HR 1.31), major adverse kidney events (HR 1.08), and major adverse cardiovascular events (HR 1.19). While reinfection rates were slightly lower, there were no significant differences in hyperglycemia or delirium. These observational findings highlight potential cardiorenal and survival risks with hydrocortisone in CKD patients with sepsis, underscoring the need for rigorous randomized trials to guide therapy in this high-risk population. ## [Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i): A Therapeutic Revolution Beyond Diabetes. New Indications in Non-Diabetic Chronic Kidney Disease and Heart Failure]. *2026-08-01 · Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia · https://doi.org/10.69097/43-03-2026-09 · https://hartvaat.nl/2026/06/30/sglt2-remmers-breiden-indicatie-uit-naar-niet-diabetische-nier-en-hartfalenziekt/* This narrative review synthesizes evidence on sodium-glucose cotransporter 2 inhibitors (SGLT2i) for non-diabetic chronic kidney disease and heart failure with reduced or preserved ejection fraction. Large trials demonstrate that SGLT2i improve renal and cardiac outcomes independent of diabetes status, primarily through restoration of tubuloglomerular feedback and favorable shifts in myocardial metabolism. The review provides practical guidance for clinicians on dose adjustment, monitoring the expected initial eGFR decline, and preventing euglycemic ketoacidosis. ## Prevalence of erectile dysfunction and its associated factors among hypertensive men in Africa: a systematic review and meta-analysis. *2026-08-01 · Sexual medicine reviews · https://doi.org/10.1093/sxmrev/qeag046 · https://hartvaat.nl/2026/06/30/erectiestoornis-komt-bij-twee-op-drie-hypertensieve-mannen-voor-in-afrika-meta-a/* A systematic review and meta-analysis of 18 studies (3,648 men) reveals a pooled prevalence of erectile dysfunction of 65% among hypertensive men in Africa. Risk factors significantly associated with ED include older age, hypertension duration over 10 years, stage II hypertension, depression, comorbidities, and antihypertensive polytherapy. These findings highlight the need for routine ED screening in hypertensive patients and underscore the importance of medication review and integrated cardiometabolic care. ## Segmental and global amyloid burden and myocardial mechanics: a multimodality imaging comparison. *2026-08-01 · Journal of medicine and life · https://doi.org/10.25122/jml-2026-0071 · https://hartvaat.nl/2026/05/01/spect-en-cmri-bij-attr-cardiomyopathie-beeldvorming-toont-beperkte-segmentale-na/* This retrospective study of 16 patients with ATTR-CM compared bisphosphonate SPECT, cMRI-derived extracellular volume (ECV), and echocardiography. Segmental amyloid burden on SPECT significantly correlated with ECV, but global amyloid burden showed only a weak, nonsignificant association with global longitudinal strain. ECV remained independently linked to impaired myocardial mechanics, whereas radiotracer uptake lost significance in combined models. These findings indicate that conventional SPECT can estimate global amyloid burden but lacks the segmental precision of cMRI, limiting its utility for detailed regional disease monitoring. ## Self-testing and clinical outcomes in Black and White patients on warfarin for atrial fibrillation or venous thromboembolism. *2026-08-01 · Research and practice in thrombosis and haemostasis · https://doi.org/10.1016/j.rpth.2026.106801 · https://hartvaat.nl/2026/05/01/inr-zelftest-verbetert-ttr-en-vermindert-bloedingen-bij-patienten-met-atriumfibr/* This retrospective registry study of 5,903 patients with atrial fibrillation or venous thromboembolism compared clinical outcomes between patients using INR self-testing and those receiving traditional clinic-based monitoring. Self-testers achieved a significantly higher time in therapeutic range (65.3% vs 59.8%) and experienced fewer non-major bleeding events (20.9 vs 29.9 per 100 patient-years), with benefits observed across both Black and White racial groups. Despite low utilization rates, particularly among Black patients, the findings reinforce the clinical value of INR self-testing for optimizing anticoagulation control and reducing bleeding risk. ## Therapeutic use of cardioselective beta-blockers for patients with chronic obstructive pulmonary disease: a review of current clinical evidence. *2026-08-01 · Current medical research and opinion · https://doi.org/10.1080/03007995.2026.2692171 · https://hartvaat.nl/2026/05/01/cardioselectieve-betablokkers-veilig-en-nuttig-bij-copd-systematische-review/* This systematic review evaluates the safety and efficacy of cardioselective beta-blockers (bisoprolol, metoprolol, nebivolol) in patients with COPD and concomitant cardiovascular disease. Contrary to historical concerns about bronchoconstriction, recent trials and meta-analyses demonstrate that cardioselective agents are safe and provide significant cardiovascular benefits without clinically relevant deterioration in lung function. These findings reinforce current guidelines, confirming that cardioselective beta-blockers should be used as first-line therapy in patients with heart failure, coronary artery disease, or hypertension who also have COPD. ## Reported decision-making regarding diuretic use and urinary sodium monitoring in acute heart failure: a vignette-based survey in three European countries. *2026-07-31 · ESC heart failure · https://doi.org/10.1093/eschf/xvag161 · https://hartvaat.nl/2026/05/05/grote-variatie-in-diureticabeleid-en-zeldzame-natriummeting-bij-acuut-hartfalen/* A multinational vignette survey of 787 clinicians in Switzerland, Germany, and Austria reveals substantial variability in diuretic management and monitoring for acute heart failure. Only 16.9% reported routinely using urinary sodium measurement, while 64.6% preferred sequential nephron blockade for inadequate diuretic response. These findings highlight a significant gap between guideline recommendations and real-world practice. Targeted educational initiatives may be needed to standardize monitoring and optimize acute heart failure care. ## Oxygen utilization during moderate-intensity resistance and aerobic exercise in arrhythmogenic cardiomyopathy: the central role of the periphery. *2026-07-31 · ESC heart failure · https://doi.org/10.1093/eschf/xvag163 · https://hartvaat.nl/2026/05/05/perifere-zuurstofextractie-bepaalt-belasting-bij-arrhythmogene-cardiomyopathie-f/* In a small mechanistic study (n=19), researchers quantified central oxygen delivery and peripheral extraction during resistance and aerobic exercise in patients with arrhythmogenic cardiomyopathy (ACM). While central oxygen delivery increased only modestly, peripheral oxygen extraction and diffusive conductance rose significantly and accounted for 77% of the variance in whole-body oxygen uptake. These findings suggest that moderate exercise imposes predominantly peripheral, rather than central, physiological stress in ACM, providing a physiological rationale for prescribing safe exercise training in this population. ## Permanent Left Ventricular Assist Devices: Long-Term Management and Outcomes. *2026-07-31 · Clinics in chest medicine · https://doi.org/10.1016/j.ccm.2026.04.014 · https://hartvaat.nl/2026/09/01/langdurige-lvad-behandeling-klinisch-beheer-en-uitkomsten-in-de-heartmate-3-erat/* This review outlines the physiological principles and long-term clinical management of durable left ventricular assist devices (LVAD), with a focus on the HeartMate 3 era. While major complications such as pump thrombosis and stroke have declined, gastrointestinal bleeding, right ventricular failure, infection, and arrhythmias remain significant clinical challenges. The article emphasizes that LVAD therapy continues to be a vital strategy for bridge-to-transplant, destination therapy, and potential myocardial recovery amid ongoing organ shortages. ## The Left Ventricular Assist Device Patient in the Intensive Care Unit: A Clinically Focused Guide for Intensivists. *2026-07-31 · Clinics in chest medicine · https://doi.org/10.1016/j.ccm.2026.04.015 · https://hartvaat.nl/2026/09/01/lvad-patienten-op-de-intensive-care-richtlijnen-voor-monitoring-en-acute-zorg/* This narrative review outlines the critical care management of patients with left ventricular assist devices (LVADs), focusing on the unique physiological interactions and common ICU complications. It provides practical guidance on device monitoring, hemodynamic management, and the treatment of acute pathophysiological states in this growing patient population. The review offers cardiologists and intensivists a structured approach to optimizing care for LVAD recipients presenting with acute decompensation or critical illness. ## Device Management of Patients on Left Ventricular Assist Device Support: A Practical Review for the ICU Clinician. *2026-07-31 · Clinics in chest medicine · https://doi.org/10.1016/j.ccm.2026.04.016 · https://hartvaat.nl/2026/09/01/lvad-beheer-in-de-icu-praktische-richtlijnen-voor-intensivisten/* This practical review outlines the physiological challenges and clinical management of patients supported by continuous-flow left ventricular assist devices (LVADs). It highlights increased preload and afterload sensitivity, reduced systemic pulsatility, and right ventricular implications, providing actionable guidance for troubleshooting alarms and managing common complications. The article serves as a concise reference for intensivists and cardiologists caring for complex heart failure patients. ## Global trend and predictors of non-labelled sacubitril-valsartan dosing: results from IKNOW-HF survey. *2026-07-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag162 · https://hartvaat.nl/2026/05/05/off-label-dosering-van-sacubitril-valsartan-wijdverspreid-in-de-praktijk/* A global survey of 1,285 clinicians reveals that 86.1% prescribe sacubitril-valsartan at unlabelled doses in heart failure patients, often as a pragmatic strategy for advanced disease. Prescribing patterns vary significantly by region and experience, with HF specialists more likely to deviate from standard dosing while pharmacist involvement shows a trend toward reduced non-labelled use. These findings highlight a substantial gap between guideline recommendations and real-world practice, underscoring the need for targeted education and greater integration of clinical pharmacists to optimize GDMT. ## Predicted versus observed outcomes in the ALT-FLOW early feasibility study. *2026-07-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag101 · https://hartvaat.nl/2026/05/05/apture-shunt-verlaagt-hartfalen-heropnames-bij-patienten-met-hfpef-hfmref-alt-fl/* In a post-hoc analysis of the ALT-FLOW early feasibility study, patients with heart failure with preserved or mildly reduced ejection fraction (LVEF >40%) who received an APTURE left atrial-to-coronary sinus shunt showed higher 1-year survival than predicted by the MAGGIC score (94.7% vs 87.0%; P=0.04). Heart failure hospitalizations dropped significantly from 37.9% before to 9.6% after implantation (P<0,0001), with consistent benefits across SGLT2 inhibitor subgroups and NT-proBNP strata. While these hypothesis-generating results are promising, confirmation in the ongoing sham-controlled ALT-FLOW II randomized trial is required before clinical adoption. ## Cardiac magnetic resonance imaging parameters predict new-onset symptoms of heart failure in hypertrophic cardiomyopathy. *2026-07-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag160 · https://hartvaat.nl/2026/05/05/cmr-parameters-voorspellen-nieuwe-hartklachten-bij-hypertrofische-cardiomyopathi/* In a single-centre retrospective cohort study of 276 asymptomatic hypertrophic cardiomyopathy (HCM) patients, 93 developed heart failure symptoms (NYHA class II–IV) over a median 6.3-year follow-up. Multivariable analysis identified left atrial enlargement (HR 1.63), higher LV mass index (HR 1.014), and male sex (HR 1.7) as independent predictors of new-onset HF symptoms. These findings highlight the role of cardiac MRI in refining risk stratification and guiding follow-up intensity for HCM patients in clinical practice. ## High-urgency heart transplantation and outcome trade-offs: early post-transplant infection and mortality. *2026-07-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag167 · https://hartvaat.nl/2026/05/05/harttransplantatie-bij-hoogste-urgentie-meer-vroege-infecties-en-sterfte-mede-do/* A retrospective cohort study of 801 adult heart transplant recipients in South Korea found that patients listed at the highest urgency status (Status 0) had a significantly higher five-year mortality rate compared to lower-urgency patients (28.0% vs. 13.5%). Early post-transplant infections were more frequent in the highest-urgency group and mediated nearly half of the excess mortality risk. After adjustment for clinical severity, prolonged mechanical ventilation (>24 hours) emerged as the strongest independent predictor of infection. These findings highlight the need for targeted infection prevention and optimized perioperative ventilation strategies in critically ill transplant candidates. ## Event rates in major Phase 3 heart failure trials over the last 20 years. *2026-07-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag169 · https://hartvaat.nl/2026/05/05/sterftecijfers-in-controle-armen-van-hartfalen-rcts-dalen-niet-ondanks-betere-ac/* An analysis of 38 phase 3 heart failure RCTs published in the NEJM between 2004 and 2024 reveals that control-arm mortality rates have not declined, despite increased use of evidence-based background therapies such as beta-blockers and MRAs. After adjusting for follow-up duration, cardiovascular mortality and the composite of death or HF hospitalization remained stable over time, while the adoption of natriuretic peptide cut-offs for patient selection increased significantly. These findings suggest that risk-enriched enrolment and shorter follow-up periods may offset therapeutic gains in modern trials, highlighting key considerations for interpreting control arms and designing future cardiovascular research. ## Early anthracycline cardiotoxicity in adolescents and young adults with sarcoma: a prospective echocardiographic study. *2026-07-29 · ESC heart failure · https://doi.org/10.1093/eschf/xvag143 · https://hartvaat.nl/2026/05/05/vroege-harttoxiciteit-na-doxorubicine-bij-jongvolwassenen-met-sarcoom/* A prospective cohort study of 70 adolescents and young adults (15–39 years) with sarcoma receiving high-dose doxorubicin evaluated early echocardiographic changes. At one year, 44.4% met the primary endpoint, primarily driven by a decline in the LVWT/D ratio, with significant subclinical reductions in LVEF and global longitudinal strain also observed. Approximately half of these abnormalities persisted at two years, and one patient developed symptomatic heart failure. These findings highlight the need for routine echocardiographic and strain monitoring to detect subclinical cardiotoxicity early in this vulnerable population. ## Transseptal puncture in cardiovascular interventions: a clinical consensus statement of the European Heart Rhythm Association, the Heart Failure Association, the European Association of Percutaneous Cardiovascular Interventions, the European Association of Cardiovascular Imaging of the ESC, and the Association for European Paediatric and Congenital Cardiology. *2026-07-29 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag021 · https://hartvaat.nl/2026/05/06/transseptale-punctie-bij-linkshartinterventies-nieuwe-esc-consensus-over-technie/* A multi-society ESC working group has released a clinical consensus on transseptal puncture (TSP), a foundational technique for over 250,000 annual atrial fibrillation ablations and various structural heart interventions. The statement emphasizes the critical role of echocardiographic guidance for precise fossa ovalis targeting, outlines standardized techniques, and provides clear algorithms for preventing and managing life-threatening complications such as cardiac tamponade and aortic puncture. This consensus offers interventional cardiologists and electrophysiologists a practical, evidence-based framework to enhance procedural safety and outcomes across routine and complex cases. ## Outcomes of simplified left atrial appendage occlusion using the WATCHMAN FLX device: the ROSE-FLX study. *2026-07-29 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag045 · https://hartvaat.nl/2026/05/06/vereenvoudigde-linkervoorhoofdaanhangsel-occlusie-onder-fluoroscopie-met-watchma/* The prospective multicentre ROSE-FLX registry evaluated simplified left atrial appendage occlusion (LAAO) using the WATCHMAN FLX device under exclusive fluoroscopic guidance and local anaesthesia in 400 patients with non-valvular atrial fibrillation at high thromboembolic and bleeding risk. Procedural success was 100%, with low rates of pericardial effusion (0.5%), access-site complications (1.3%), and major bleeding (0.8%). Over a median follow-up of 194.5 days, all-cause mortality was 0.8%, TIA 3.3%, and device-related thrombosis 0.3%, with COPD and higher CHA2DS2-VASc scores independently predicting adverse events. These findings suggest that fluoroscopy-only LAAO is a safe, feasible, and resource-efficient alternative for centres lacking advanced echocardiographic or anaesthetic support, pending confirmation from head-to-head trials. ## Coffee consumption and chronic kidney disease. *2026-07-29 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag107 · https://hartvaat.nl/2026/05/12/matige-koffiedrinken-waarschijnlijk-veilig-en-mogelijk-gunstig-bij-chronische-ni/* This narrative review synthesises current evidence on the relationship between caffeine intake, chronic kidney disease (CKD), and cardiovascular outcomes. The authors conclude that moderate coffee consumption is likely safe for patients with CKD and may offer potential renal and cardioprotective benefits. While these findings are reassuring, the evidence base remains largely observational, highlighting the need for more robust studies before formal clinical recommendations can be established. In practice, moderate coffee intake does not need to be restricted in most patients with chronic kidney disease. ## Albuminuria drives hyperlipidemia in patients with Alport syndrome. *2026-07-29 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag100 · https://hartvaat.nl/2026/05/15/verhoogde-albuminurie-drijft-hypercholesterolemie-bij-patienten-met-het-syndroom/* In a multicenter retrospective cohort of 459 patients with Alport syndrome, 59.3% had hypercholesterolemia and 58.5% elevated LDL-C. Multivariable analysis identified albuminuria as the primary independent driver of total cholesterol and LDL-C levels, whereas eGFR and BMI were not significant predictors. These findings highlight a critical gap in current management and support routine lipid screening and risk-adapted therapy to mitigate long-term cardiovascular risk in this population. ## Atrial Fibrillation in Infiltrative Cardiomyopathies: From Atrial Cardiomyopathy Imaging to Targeted Management-A Narrative Review. *2026-07-28 · Medicina (Kaunas, Lithuania) · https://doi.org/10.3390/medicina62061023 · https://hartvaat.nl/2026/05/25/multimodale-beeldvorming-verheldert-atriumfibrilleren-bij-infiltratieve-cardiomy/* This narrative review explores the pathophysiological link between infiltrative cardiomyopathies and atrial fibrillation, highlighting atrial cardiomyopathy as a common underlying substrate. Multimodality cardiac imaging is discussed as a key tool for characterizing this atrial substrate, potentially guiding patient stratification and targeted management. The review provides cardiologists and internists with a practical overview on integrating imaging insights into the clinical care of these complex patients. ## Role of Inflammatory Biomarkers in Peripheral Arterial Disease: A Comprehensive Review of Prognostic and Therapeutic Implications. *2026-07-28 · Biomolecules · https://doi.org/10.3390/biom16060789 · https://hartvaat.nl/2026/05/27/inflammatoire-biomarkers-verbeteren-risicostratificatie-bij-perifeer-arterieel-v/* This narrative review evaluates the prognostic value of classical and emerging inflammatory biomarkers in peripheral arterial disease (PAD). Elevated levels of markers such as CRP, GDF-15, galectin-3, and composite indices like the neutrophil-to-lymphocyte ratio are consistently associated with disease severity and adverse cardiovascular and limb outcomes. Incorporating these biomarkers into routine risk assessment may help identify high-risk patients who could benefit from targeted anti-inflammatory strategies, including colchicine and PCSK9 inhibitors, to mitigate residual cardiovascular risk. ## Cardiovascular Toxicity of Novel HER2-Targeted Agents and Multikinase Inhibitors in Oncology: From Mechanisms to Real-World Clinical Evidence. *2026-07-28 · Pharmaceuticals (Basel, Switzerland) · https://doi.org/10.3390/ph19060833 · https://hartvaat.nl/2026/05/27/cardiotoxiciteit-van-her2-remmers-en-multikinaseremmers-mechanismen-en-klinisch-/* This narrative review examines the cardiovascular toxicity associated with novel HER2-targeted therapies and multikinase inhibitors in oncology. It outlines key mechanisms such as mitochondrial dysfunction and endothelial damage, while summarizing real-world incidence rates and current management strategies. The authors advocate for standardized cardiotoxicity definitions, biomarker-guided monitoring, and multidisciplinary cardio-oncology care to mitigate cardiovascular risk in cancer patients. ## Development of Atrial Fibrillation in patients with Heart Failure and vice versa: Incidence, risk factors, and their impact on survival. *2026-07-28 · ESC heart failure · https://doi.org/10.1093/eschf/xvag152 · https://hartvaat.nl/2026/05/28/atriumfibrilleren-en-hartfalen-versterken-elkaar-en-verhogen-sterfte-aanzienlijk/* A UK Biobank cohort study of 31,374 participants demonstrates a strong bidirectional relationship between atrial fibrillation (AF) and heart failure (HF): AF increases the risk of subsequent HF by threefold, while HF raises the risk of AF by 2.75 times. Patients with both conditions face a substantially higher mortality risk compared to those with either condition alone, regardless of which disease developed first. These findings highlight the need for proactive prevention strategies and close monitoring in both AF and HF populations to interrupt this harmful cycle. ## New kidneys, old risks: cardiovascular challenges after transplantation. *2026-07-28 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfaf239 · https://hartvaat.nl/2026/05/29/cardiovasculaire-ziekte-blijft-leidend-na-niertransplantatie-overzicht-van-uitda/* Kidney transplantation significantly improves survival, yet cardiovascular disease remains the leading cause of morbidity and mortality in transplant recipients. This review highlights how traditional risk factors, immunosuppressive therapies, and post-transplant metabolic complications sustain a high cardiovascular burden, while evidence for targeted interventions remains largely extrapolated from non-transplant populations. For clinical practice, this underscores the need for rigorous risk stratification and cautious adoption of emerging cardiorenal therapies like SGLT2 inhibitors and GLP-1 receptor agonists, alongside a strong push for transplant-specific randomized trials. ## Body roundness index and mortality risk in patients with chronic kidney disease: moving beyond the obesity paradox. *2026-07-27 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfaf237 · https://hartvaat.nl/2026/05/29/lichaamsrondheidsindex-bri-voorspelt-sterfte-bij-nierpatienten-beter-dan-bmi/* An observational cohort study using NHANES data evaluated the prognostic value of the body roundness index (BRI) compared with BMI and waist circumference in 6,240 patients with chronic kidney disease (CKD). A BRI >10 was independently associated with a significantly higher risk of all-cause mortality (aHR 1.82) and cardiovascular mortality (aHR 2.15), whereas a BMI >30 paradoxically correlated with lower mortality rates. These findings suggest that BRI may offer superior risk stratification over traditional BMI thresholds in CKD populations, particularly among patients under 65 years or with elevated albuminuria. ## Molecular Mechanisms and Therapeutic Targets of RNA-Based and Traditional Lipid-Lowering Agents in Residual Cardiovascular Risk: A Scoping Review of Key Directions Towards Future Perspectives. *2026-07-27 · Biomolecules · https://doi.org/10.3390/biom16060807 · https://hartvaat.nl/2026/05/29/rna-remmers-verlagen-lp-a-en-triglyceriden-bij-residual-risico-scoping-review/* This scoping review maps the molecular mechanisms and pharmacodynamic profiles of RNA-based lipid-lowering therapies targeting residual cardiovascular risk in patients inadequately controlled on standard care. GalNAc-conjugated siRNAs and ASOs demonstrate substantial efficacy, achieving 80–98% reductions in Lp(a), 50–80% in triglycerides, and 36–44% in LDL-C, with sustained effects every 3–6 months and a favorable safety profile. The analysis highlights how these novel agents address pathways beyond traditional statins and ezetimibe, offering clinicians a structured overview of emerging options for high-risk cardiometabolic patients. ## Phenotyping patients with a low-flow, low-gradient aortic stenosis and a preserved ejection fraction undergoing TAVI. *2026-07-27 · ESC heart failure · https://doi.org/10.1093/eschf/xvag146 · https://hartvaat.nl/2026/05/31/hfpef-fenotype-duidt-op-hogere-sterfte-na-tavi-bij-laagstroom-laaggradient-aorta/* In a cohort of 827 patients undergoing TAVI, unsupervised clustering of AI-assessed echocardiographic parameters identified two distinct phenotypes among the 35% with paradoxical low-flow, low-gradient aortic stenosis and preserved ejection fraction. Patients exhibiting a HFpEF and atrial fibrillation phenotype faced a significantly higher risk of cardiovascular mortality and heart failure hospitalisation at 1 and 5 years. These findings suggest that targeted guideline-directed medical therapy for HFpEF, including SGLT2 inhibitors and MRAs, may improve outcomes in this high-risk subgroup. ## Does treatment of nonsleepy OSA with CPAP therapy change CVD risk? A systematic review. *2026-07-27 · Sleep medicine · https://doi.org/10.1016/j.sleep.2026.109093 · https://hartvaat.nl/2026/10/01/cpap-therapie-verlaagt-diastolische-bloeddruk-bij-niet-slaapige-osa-systematisch/* A PRISMA-guided systematic review of 11 randomized trials evaluated the cardiovascular impact of CPAP therapy in adults with non-sleepy obstructive sleep apnea (OSA). Pooled analysis demonstrated a significant reduction in diastolic blood pressure by 2.33 mmHg, whereas systolic blood pressure and hard cardiovascular endpoints showed no significant benefit. For clinical practice, this suggests CPAP offers only a modest effect on diastolic pressure in this population, highlighting the need for longer follow-up and standardized endpoints to confirm hard cardiovascular outcomes. ## Restless legs syndrome determines whether periodic limb movements are associated with altered lipid profiles in sleep-disordered breathing. *2026-07-27 · Sleep medicine · https://doi.org/10.1016/j.sleep.2026.109109 · https://hartvaat.nl/2026/10/01/rusteloze-benen-en-slaapbewegingen-bepalen-lipidenprofiel-bij-slaapapneu/* A cross-sectional analysis of 643 adults with sleep-disordered breathing evaluated whether periodic limb movements (PLM) independently associate with lipid profiles, and whether restless legs syndrome (RLS) modifies this relationship. While PLM alone showed no significant association with cardiometabolic markers, RLS status fundamentally altered the pattern: in RLS-positive patients, higher PLM frequency correlated with elevated HDL, LDL, and total cholesterol, whereas an inverse trend appeared in RLS-negative individuals. These findings suggest that the co-occurrence of RLS and PLM identifies a distinct cardiometabolic phenotype that may benefit from targeted lipid screening in clinical practice. ## Tenosynovial and Transverse Carpal Ligament Biopsy for Early Transthyretin Amyloidosis Cardiomyopathy Detection: A Systematic Review and African American Retrospective Cohort Study *2026-07-26 · Journal of hand surgery global online · https://doi.org/10.1016/j.jhsg.2026.101020 · https://hartvaat.nl/2026/09/01/tcl-biopsie-tijdens-carpaaltunneloperatie-heeft-lage-diagnostische-yield-voor-at/* A systematic review and retrospective cohort study evaluated the diagnostic yield of transverse carpal ligament (TCL) biopsy during carpal tunnel release for early detection of transthyretin amyloid cardiomyopathy (ATTR-CM). While pooled literature reports an amyloid detection rate of 10% to 30%, the institutional cohort of 89 patients (61.8% African American) showed a 0% yield. These negative findings highlight the need to refine patient selection criteria and standardize sampling techniques before TCL biopsy can be reliably integrated into ATTR-CM screening pathways. ## GLP-1-agonisten verlagen MACE en hartfalen-heropnames bij diabetes en ASCVD — meta-analyse *2026-07-26 · Cardiovascular endocrinology & metabolism · https://doi.org/10.1097/XCE.0000000000000360 · https://hartvaat.nl/2026/09/01/glp-1-agonisten-verlagen-mace-en-hartfalen-heropnames-bij-diabetes-en-ascvd-meta/* A systematic review and meta-analysis of seven randomised trials (n=56,191) demonstrates that GLP-1 receptor agonists significantly reduce major adverse cardiovascular events by 11% (HR 0.89; 95% CI 0.83–0.96) in adults with type 2 diabetes and established atherosclerotic cardiovascular disease. The intervention also lowered all-cause mortality by 11% (HR 0.89; 95% CI 0.82–0.97) and heart failure hospitalisations by 7% (HR 0.93; 95% CI 0.89–0.98), with high-certainty evidence across outcomes. Incorporating recent data from the SOUL trial and oral formulations, these findings reinforce the established cardiovascular benefits of GLP-1RAs and support their continued integration into cardiometabolic care pathways. ## Lipoprotein(a) and premature myocardial infarction: Mechanistic insights and implications for PCI-era residual risk *2026-07-26 · International journal of cardiology. Cardiovascular risk and prevention · https://doi.org/10.1016/j.ijcrp.2026.200657 · https://hartvaat.nl/2026/09/01/verhoogd-lp-a-gekoppeld-aan-ernstiger-coronaire-ziekte-en-pci-uitkomsten-scoping/* A structured scoping review with exploratory meta-analysis evaluated the association between elevated lipoprotein(a) [Lp(a)] and premature acute myocardial infarction, focusing on PCI outcomes and South Asian populations. Although the quantitative synthesis was limited to three studies (pooled RR 1.16 for MACE; 95% CI 0.93–1.43), qualitative data consistently linked higher Lp(a) levels to multivessel disease, higher SYNTAX scores, increased thrombus burden, and recurrent post-PCI events. These findings reinforce the value of routine Lp(a) screening in high-risk patients, particularly among South Asian cohorts who experience earlier and more severe coronary disease. ## LDL-cholesterol distance to target: A practical tool for guiding lipid-lowering treatment decisions *2026-07-26 · Atherosclerosis plus · https://doi.org/10.1016/j.athplu.2026.100574 · https://hartvaat.nl/2026/09/01/afstand-tot-ldl-doelwaarde-stuurt-keuze-lipiddalende-therapie/* This practical review proposes calculating the 'distance to target'—the percentage reduction in LDL-C required from baseline—as a streamlined tool for selecting lipid-lowering therapy in patients with atherosclerotic cardiovascular disease. Despite stringent 2025 ESC/EAS guidelines and strong evidence linking cumulative LDL exposure to cardiovascular risk, less than one-third of secondary prevention patients achieve target levels due to therapeutic inertia. By aligning the expected efficacy of available agents (statins, ezetimibe, bempedoic acid, PCSK9 inhibitors, inclisiran) with individual patient needs, this framework helps clinicians overcome treatment gaps and optimize early, intensive lipid lowering. ## Awareness and perceptions of systemic inflammation in atherosclerotic cardiovascular disease and chronic kidney disease: The SPARK-CVD China survey *2026-07-26 · Atherosclerosis plus · https://doi.org/10.1016/j.athplu.2026.100570 · https://hartvaat.nl/2026/09/01/inflammatie-als-risicofactor-krijgt-onvoldoende-ruimte-in-de-ascvd-en-ckd-prakti/* A nationwide survey of 1,500 Chinese cardiologists and nephrologists reveals a significant knowledge-practice gap regarding systemic inflammation and hsCRP in patients with ASCVD and CKD. While 73.3% recognize inflammation as a key cardiovascular risk factor, only 35.2% discuss it with patients, and barriers such as limited experience and safety concerns hinder the use of anti-inflammatory therapies like colchicine. Conversely, the cardiorenal and anti-inflammatory benefits of GLP-1 receptor agonists are widely acknowledged (97.9%). These findings highlight an urgent need for targeted physician education and clearer guideline recommendations to integrate inflammation-guided care into routine cardiorenal practice. ## How Accurate Is Inpatient Blood Pressure Measurement? *2026-07-25 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26355 · https://hartvaat.nl/2026/04/03/hoe-nauwkeurig-is-bloeddrukmeting-bij-opgenomen-patienten-vaak-slordig-blijkt-ui/* Accurate blood-pressure measurement depends on good technique, but no guidelines exist for inpatient BP measurement. In a major teaching hospital, 278 measurements in 153 patients across three non-critical wards were observed and assessed against ten consensus criteria for an ideal measurement. Concordance was high for device calibration (92%), uncrossed legs (82%), correct cuff size (77%) and back support (75%), but poor for the highest-ranked criteria: seated position (26%), no talking (23%), cuff at heart height (15%) and at least two measurements (7%). No measurement met all ten criteria. Routine inpatient BP measurement thus deviates substantially from optimal technique, which may cause inaccurate and biased readings — standardised, hospital-specific guidelines and training are needed. ## Machine-learningmodel voorspelt periprocedurele complicaties bij TAVI voor bicuspide aortaklepstenose *2026-07-25 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003749?rss=1 · https://hartvaat.nl/2026/04/03/machine-learningmodel-voorspelt-periprocedurele-complicaties-bij-tavi-voor-bicus/* Transcatheter aortic valve replacement (TAVR) is increasingly used for severe bicuspid aortic valve (BAV) stenosis, but these patients face multiple procedural challenges. In this multicentre study (1,266 patients with BAV stenosis), a machine-learning model was developed to predict the risk of periprocedural adverse events (PAEs). Five predictors were identified: Type 0 bicuspid valve, aortic-root calcification volume, horizontal aorta, annular ellipticity and prior atrial fibrillation. The risk model had good discrimination (AUC 0.80), with a clearly graded PAE risk by quartile (0.6%, 1.7%, 3.2% and 9.6%). A nomogram enables individual risk calculation. The model can thus individualise procedural planning and in-hospital care for bicuspid TAVR. ## Obstetric History Versus Biomarkers: Hypertension Risk Up to 15 Years Postpartum *2026-07-25 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25552 · https://hartvaat.nl/2026/04/07/voor-het-voorspellen-van-hypertensie-na-de-zwangerschap-telt-de-obstetrische-voo/* The sFlt-1/PlGF ratio predicts severe preeclampsia, but its link to long-term hypertension was unclear. In this retrospective cohort (LIFECODES biobank, 993 participants; sFlt-1 and PlGF measured in the second half of pregnancy), 29% developed stage 1 and 17% stage 2 hypertension over 15 years. A history of preeclampsia or gestational hypertension was strongly associated with later hypertension (adjusted HR 2.17 and 3.50, respectively), whereas the sFlt-1/PlGF ratio showed no association. PlGF levels were, however, lower in women who later developed hypertension. For long-term prediction of hypertension, obstetric history is thus more informative than pregnancy biomarkers — a simple basis for follow-up after a hypertensive pregnancy. ## WARRIOR-trial: intensieve medicamenteuze behandeling verbetert de uitkomsten niet bij vrouwen met ANOCA/INOCA *2026-07-24 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004115?rss=1 · https://hartvaat.nl/2026/04/03/warrior-trial-intensieve-medicamenteuze-behandeling-verbetert-de-uitkomsten-niet/* Women with angina referred for coronary angiography often have no obstructive coronary artery disease (ANOCA/INOCA). The randomised WARRIOR trial (2,476 women, 71 US sites) tested whether intensive medical treatment (IMT: high-intensity statin, ACE inhibitor or ARB, and aspirin) reduces cardiovascular events (MACE) versus usual care. Recruitment was lower than planned, yielding an older population with well-controlled BP and LDL at baseline. At 2.5 years, 421 events occurred, with no difference in the primary endpoint (HR 1.13; p=0.20) or secondary outcomes; angina hospitalisations were the dominant contributor to MACE. IMT thus did not improve outcomes, though the trial was underpowered to exclude a possible benefit. The findings underscore the high disease burden and the need for better research in this population. ## Adolescent Blood Pressure and Cardiovascular Disease Before Age 50 Years *2026-07-24 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26414 · https://hartvaat.nl/2026/04/07/hoge-bloeddruk-op-de-tienerleeftijd-voorspelt-hart-en-vaatziekten-voor-het-50e-j/* Adolescent blood-pressure guidelines rely largely on expert consensus, as evidence on hard cardiovascular outcomes is lacking. In this cohort of 902,741 adolescents (aged 16-19, evaluated for mandatory service, 1979-2019, without pre-existing cardiometabolic conditions), participants were followed to age 50. Over more than 18 million person-years, 6,305 cardiovascular events occurred (ischaemic heart or cerebrovascular disease). Higher systolic, diastolic and mean arterial blood pressure were associated with higher risk: compared with normal BP, the adjusted hazard ratio was 1.14 for stage 1, 1.31 for stage 2 and 2.42 for hypertension, with stage 1 particularly sensitive to diastolic pressure. Elevated blood pressure in adolescence is thus strongly associated with early cardiovascular disease — arguing for refining current guidelines. ## Blood Pressure Control and Mortality Among US Veterans *2026-07-24 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25787 · https://hartvaat.nl/2026/04/07/bij-2-3-miljoen-amerikaanse-veteranen-was-de-sterfte-het-laagst-bij-een-systolis/* Intensive blood-pressure lowering reduces mortality and cardiovascular disease in clinical trials, but real-world BP measurements often differ from standardised protocols. In this retrospective cohort of over 2.3 million US Veterans with hypertension (mean age 66; 36% diabetes, 22% cardiovascular disease, 19% kidney disease), systolic BP was treated as a time-dependent variable across seven categories. Lowest mortality was seen at a systolic BP of 130-139 mmHg. Compared with a year at BP ≥160 mmHg, adjusted hazard ratios included 1.29 at <110, 0.83 at 130-139 and 0.86 at 140-149 mmHg — a J-shaped relationship consistent across patients with and without cardiovascular or kidney disease. In routine practice, a somewhat higher BP target thus appears appropriate, especially for older patients with comorbidity. ## 'Sterftereductie' of uitstel van overlijden? Waarom de taal in cardiovasculaire trials ertoe doet *2026-07-24 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004039?rss=1 · https://hartvaat.nl/2026/04/09/sterftereductie-of-uitstel-van-overlijden-waarom-de-taal-in-cardiovasculaire-tri/* In cardiology, 'mortality reduction' is often used to summarise the benefit of modern therapies — a powerful phrasing suggesting deaths have been prevented and lives saved. This Open Heart viewpoint shows that many cardiovascular trials, however, rely on time-to-event analyses that, within a limited follow-up, mainly demonstrate a difference in the timing of death. Such findings are frequently translated as 'reduced mortality', whereas the effect is in reality more a modest extension of survival than the prevention of death. Although statistically correct within the predefined time horizon, this framing may overstate clinical benefit and obscure its time-dependent nature. The authors argue for interpretive precision: distinguishing survival extension from mortality reduction makes communication more transparent and supports shared decision-making aligned with what patients actually experience. ## Risicostratificatie bij longembolie: hoe bruikbaar zijn de huidige instrumenten? *2026-07-24 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/9/480?rss=1 · https://hartvaat.nl/2026/04/10/risicostratificatie-bij-longembolie-hoe-bruikbaar-zijn-de-huidige-instrumenten/* International guidelines recommend risk stratification of acute pulmonary embolism (PE) to guide treatment. Key prognostic factors include clinical presentation, comorbidities, (imaging) biomarkers and haemodynamic status. The most widely used algorithm, from the 2019 ESC/ERS guideline, classifies patients as high-risk (massive), intermediate-risk (submassive, high or low) and low-risk (non-massive), with the risk of adverse outcomes rising at each level. Yet leading guidelines differ substantially in their risk classification and corresponding treatment recommendations, owing to a lack of top-level (1A) evidence. This review evaluates current stratification tools and identifies the main knowledge gaps — relevant to the everyday choice between outpatient treatment, admission or reperfusion in PE. ## Sekseverschillen in secundaire preventie na ACS: vrouwen halen minder vaak hun LDL-doel (TEXTMEDS) *2026-07-23 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003856?rss=1 · https://hartvaat.nl/2026/04/09/sekseverschillen-in-secundaire-preventie-na-acs-vrouwen-halen-minder-vaak-hun-ld/* Good risk-factor control and medication adherence after an acute coronary syndrome (ACS) help determine long-term prognosis, and sex plays a role. In this secondary analysis of the randomised TEXTMEDS trial (1,379 patients post-ACS, 79% male), sex differences in secondary-prevention targets were examined. Women were less likely to reach the LDL-cholesterol target (<1.8 mmol/L; aOR 0.61) and to exercise regularly (aOR 0.61), but more likely to achieve a healthy BMI (aOR 1.47). Women were also less adherent to medication (aOR 0.68), though this association weakened and lost significance after adjustment for socioeconomic factors. The findings argue for sex-sensitive strategies for risk-factor control and adherence to improve cardiovascular outcomes. ## Aorticorenal Ganglion Ablation Enhances Blood Pressure Reduction After Renal Denervation *2026-07-23 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26719 · https://hartvaat.nl/2026/04/09/aanvullende-ablatie-van-het-aorticorenale-ganglion-versterkt-het-bloeddrukeffect/* The aorticorenal ganglion (ARG) is an upstream component of renal sympathetic fibres and a possible new target in hypertension. In this exploratory study, patients with uncontrolled hypertension underwent renal denervation (RDN); if blood pressure rose during high-frequency stimulation at the ARG, that ganglion was additionally ablated (RDN+ARG). In 41 patients (20 RDN, 21 RDN+ARG), mean 24-hour systolic blood pressure at three months fell by 9.7 mmHg after RDN alone and by 18.2 mmHg after RDN+ARG — a difference of 7.5 mmHg, with no major complications. In a canine model, ARG ablation reduced renal and systemic sympathetic activity more than RDN alone. The ARG thus appears a key regulator of sympathetic tone and a promising target; adjunctive ARG ablation with RDN warrants validation in larger trials. ## Zuinig machine-learningmodel voorspelt 1-jaarssterfte en zinloosheid na TAVI *2026-07-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/9/488?rss=1 · https://hartvaat.nl/2026/04/10/zuinig-machine-learningmodel-voorspelt-1-jaarssterfte-en-zinloosheid-na-tavi/* Existing risk scores inadequately predict long-term mortality after transcatheter aortic valve replacement (TAVR), hampering decisions about procedural futility. The investigators developed a machine-learning model using only preprocedural variables to predict 1-year all-cause mortality. The model was trained on 1,025 TAVR patients with 52 clinical and echocardiographic variables; via an evolutionary algorithm it was reduced to 13 variables while preserving performance and simplicity. The final model was externally validated in an independent cohort of 270 patients and compared with EuroSCORE II, FRANCE-2 and TAVI2-SCORE. A simple, preprocedural-data-based model can thus identify patients with high 1-year mortality — useful to support decision-making around TAVR. ## Integrative Proteomic Profiling of Blood Pressure and Hypertension *2026-07-23 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26407 · https://hartvaat.nl/2026/04/09/grootschalige-proteomics-van-bloeddruk-en-hypertensie-wijst-nherf2-aan-als-mogel/* Hypertension affects one-third of adults worldwide and is largely idiopathic; protein biomarkers may reveal underlying mechanisms and treatment targets. This study linked 2,922 plasma proteins to blood pressure (systolic and diastolic) and hypertension in 45,991 UK Biobank participants, validated in 5,759 Framingham Heart Study participants. In the UK Biobank, 342 proteins were associated with systolic and 276 with diastolic blood pressure; new-onset hypertension was associated with 60 proteins. Mendelian randomisation identified hundreds of proteins with a causal signal, involved in blood-vessel and cardiac-muscle morphogenesis, vasoconstriction and inflammation; BP-related proteins were enriched for atherosclerotic, liver and kidney diseases. NHERF2 emerged as a putatively causal protein and promising therapeutic target. The study thus provides a comprehensive protein signature of blood pressure and hypertension risk. ## Mitralisklepreparatie bij endocarditis geeft betere langetermijnoverleving dan klepvervanging *2026-07-23 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004008?rss=1 · https://hartvaat.nl/2026/04/15/mitralisklepreparatie-bij-endocarditis-geeft-betere-langetermijnoverleving-dan-k/* The optimal surgical strategy for mitral valve (MV) endocarditis is uncertain: although repair is increasingly advocated, replacement is often performed, and good comparative long-term data are lacking. In this retrospective single-centre study (88 consecutive patients undergoing MV surgery for endocarditis-related mitral regurgitation, 2011-2025), replacement was performed in 51%; these patients were older (median 62 vs 51 years). In-hospital mortality was 4.5% (no deaths in the repair group) and long-term mortality 14.8%. In the replacement group, older age and diabetes (OR 7.8) independently predicted mortality. Mean survival was significantly longer after repair than replacement (161 vs 130 months). MV repair for endocarditis is thus safe and associated with better long-term survival; diabetes is a strong risk factor in replacement. ## Direct naar CT-coronairangiografie bij verdenking angina: snellere diagnose en minder polibezoeken *2026-07-22 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003948?rss=1 · https://hartvaat.nl/2026/04/17/direct-naar-ct-coronairangiografie-bij-verdenking-angina-snellere-diagnose-en-mi/* Rapid-access chest pain (RACP) clinics suffer delays from sequential consultations and tests. In this prospective single-centre pilot (149 primary-care referrals, June 2024-January 2025), a 'test-first' pathway was tested in which eligible patients with suspected angina and no known coronary disease went directly to CT coronary angiography (CTCA). Median referral-to-diagnosis time fell from 88 to 29 days. CTCA showed no or mild coronary disease in 70%; only 32% needed a face-to-face consultation. Follow-up testing comprised exercise ECG (17%), echocardiography (8%) and invasive angiography (7%); incidental findings occurred in 30%. An estimated 102 outpatient visits per year were avoided (saving about £32,620). A direct-to-CTCA pathway is thus feasible, speeds diagnosis and aligns with NICE guidelines, without loss of diagnostic quality. ## Langetermijnuitkomsten na de Ross-operatie: één op de vier krijgt een heroperatie *2026-07-22 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003782?rss=1 · https://hartvaat.nl/2026/04/17/langetermijnuitkomsten-na-de-ross-operatie-een-op-de-vier-krijgt-een-heroperatie/* In aortic valve disease, the Ross procedure — transposing the patient's own pulmonary valve to the aortic position with a homograft in the pulmonary position — remains an alternative for young patients or those avoiding long-term anticoagulation. Long-term prognosis, however, was largely unknown. In the Swedish congenital heart disease registry, 82 adults after a Ross procedure were identified (mean age at the procedure 23.6 years). After a mean of 16.8 years, 24.4% had undergone a first reoperation — cumulative incidence about 15% at 10 years and 30% at 20 years — mostly on the pulmonary valve (85%). Mortality was low (2.3%). In selected patients the Ross procedure thus remains a viable option, provided late morbidity is considered; secondary Ross surgery was associated with better left ventricular function. ## Subklinische atherosclerose bij vrouwen na pre-eclampsie: systematische review en meta-analyse *2026-07-22 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/9/473?rss=1 · https://hartvaat.nl/2026/04/10/subklinische-atherosclerose-bij-vrouwen-na-pre-eclampsie-systematische-review-en/* Women who experienced pre-eclampsia have an increased later-life risk of cardiovascular disease (CVD), but uniform screening recommendations are lacking. Subclinical atherosclerosis offers a window to identify and treat at-risk women, measurable by coronary artery calcium scoring (CAC), carotid intima-media thickness (CIMT) and ankle-brachial index (ABI). This systematic review and meta-analysis (MEDLINE, EMBASE, CINAHL) examined the association between a history of pre-eclampsia and the presence of subclinical atherosclerosis, and how this relates to the timing of measurement. The findings support that prior pre-eclampsia is associated with more subclinical atherosclerosis and underscore the importance of cardiovascular risk evaluation in these women. ## Proteomics onthult vier subgroepen van acuut HFpEF met eigen biologische routes (PURSUIT-HFpEF) *2026-07-22 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/9/504?rss=1 · https://hartvaat.nl/2026/04/10/proteomics-onthult-vier-subgroepen-van-acuut-hfpef-met-eigen-biologische-routes-/* The marked heterogeneity of heart failure with preserved ejection fraction (HFpEF) hampers treatment development; distinguishing phenogroups may help tailor therapy. This post-hoc analysis of the prospective, multicentre PURSUIT-HFpEF study (patients hospitalised with acute decompensated HFpEF) examined, in 198 patients with available proteomics data, the protein patterns of phenogroups identified by a machine-learning clustering model. Patients were classified into four phenogroups, each with distinct biological pathways. The study shows that proteomics-driven phenotyping of HFpEF can uncover specific pathophysiological mechanisms per subgroup — a step toward more targeted treatment strategies. ## Tweelingzwangerschap bij vrouwen met een hartaandoening geeft een hoog risico op hartfalen (ROPAC) *2026-07-22 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/9/514?rss=1 · https://hartvaat.nl/2026/04/10/tweelingzwangerschap-bij-vrouwen-met-een-hartaandoening-geeft-een-hoog-risico-op/* Cardiovascular adaptation to pregnancy is more marked in twin than singleton pregnancies and may cause more cardiac events in women with heart disease. In the global, prospective ROPAC registry (Registry Of Pregnancy And Cardiac disease, 2007-2018), outcomes of 96 twin pregnancies were compared with 5,643 singleton pregnancies in women with heart disease. Twin mothers were older (32.1 vs 29.5 years) and had fewer prior cardiac interventions, while cardiac diagnosis, NYHA class, modified WHO class and risk factors were comparable. The risk of heart failure was clearly higher in twin pregnancies. The findings are important for pre-pregnancy counselling and antenatal management of women with heart disease. ## Verhoogd CRP voorspelt hartfalen bij kankeroverlevenden (UK Biobank) *2026-07-21 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003513?rss=1 · https://hartvaat.nl/2026/04/17/verhoogd-crp-voorspelt-hartfalen-bij-kankeroverlevenden-uk-biobank/* Cancer survivors are at risk of heart failure (HF), partly from prior cancer therapy, but early predictors are scarce. Chronic low-grade inflammation has been linked to both cancer and HF. In this UK Biobank analysis (20,244 participants with cancer at baseline, mean age 60), 2.0% developed incident HF over a median 10.5-year follow-up. After adjustment for sociodemographic, lifestyle and clinical factors, CRP above 2 mg/L was associated with a 53% higher HF risk (sHR 1.53). Subgroup analyses confirmed this trend, which was strongest among survivors of cutaneous malignancies. A simple inflammatory marker may thus help identify cancer survivors at elevated HF risk; future research should determine whether reducing inflammation lowers that risk. ## Restrictief vullingspatroon voorspelt heropname bij acuut gedecompenseerd HFpEF (KCHF-register) *2026-07-21 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004093?rss=1 · https://hartvaat.nl/2026/04/17/restrictief-vullingspatroon-voorspelt-heropname-bij-acuut-gedecompenseerd-hfpef-/* A restrictive transmitral inflow pattern (E/A ratio ≥2) predicts poor prognosis in HF with reduced ejection fraction and after infarction, but its significance in HFpEF was unclear. From the Kyoto Congestive Heart Failure registry, 830 patients with acute decompensated HFpEF and available echo data were analysed. A restrictive filling pattern was present in 17.3%; these patients more often had prior atrial fibrillation, a supranormal ejection fraction (>65%) and higher BNP at discharge. The 1-year incidence of HF hospitalisation was clearly higher with a restrictive pattern (31.0% vs 18.1%), while all-cause death did not differ. After adjustment, the restrictive pattern remained independently associated with HF hospitalisation (HR 1.58) but not death. Transmitral inflow pattern is thus a simple echo marker of rehospitalisation risk in HFpEF. ## Niet-invasieve endotypering met stress-MRI verbetert de behandeling van angina zonder vernauwingen (ANOCA) *2026-07-21 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004135?rss=1 · https://hartvaat.nl/2026/04/17/niet-invasieve-endotypering-met-stress-mri-verbetert-de-behandeling-van-angina-z/* Patients with angina and no obstructive coronary artery disease (ANOCA) often receive empirical antianginal therapy that misses the underlying mechanism. In this randomised trial (Coronary Microvascular Angina CMR Imaging Trial; 250 patients with ANOCA after non-obstructive coronary angiography), stress perfusion CMR with myocardial blood-flow quantification (intervention) was compared with angiography-guided care (control). Stress CMR led to a new diagnosis in 53%, with microvascular angina in 51%. At 12 months, treatment satisfaction (TSQM-9) was substantially higher in the intervention group (difference 19.3 points), with more appropriate prescribing: more preventive therapy (86% vs 68%) and more targeted antianginals (more calcium channel blockers and long-acting nitrates). Non-invasive CMR-guided endotyping thus improves satisfaction and leads to more mechanism-targeted medication in ANOCA. ## Delphi-consensus over 'uitgestelde' en 'gemiste' diagnose van coronairlijden *2026-07-21 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003998?rss=1 · https://hartvaat.nl/2026/04/21/delphi-consensus-over-uitgestelde-en-gemiste-diagnose-van-coronairlijden/* A clear definition of delayed or missed coronary artery disease (CAD) diagnosis is lacking, hampering research into its scale and causes. Using a modified Delphi method, a panel of cardiologists (19), general practitioners (35), patients (55) and healthy citizens (34) developed consensus definitions for two domains: acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). After four rounds, two definitions for delayed ACS were highly recommended and thirteen recommended; for missed ACS none reached the highest threshold. For CCS, two definitions for delayed diagnosis and one for missed diagnosis were highly recommended. No one-size-fits-all definition proved possible, reflecting the complexity and context-dependence of diagnostic pathways. The resulting framework and recommended definitions nonetheless provide a basis for comparable future research into delayed and missed CAD diagnoses. ## Eén op de tien volwassenen met een aangeboren hartafwijking heeft een syndroom — en dat verhoogt de sterfte *2026-07-21 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003971?rss=1 · https://hartvaat.nl/2026/04/22/een-op-de-tien-volwassenen-met-een-aangeboren-hartafwijking-heeft-een-syndroom-e/* Syndromic conditions frequently accompany congenital heart disease (CHD), but their distribution and prognostic impact in adults (ACHD) are poorly characterised. In this retrospective study of 9,826 ACHD patients from a tertiary centre, 10.9% had a syndromic diagnosis — most often Marfan syndrome (4.1%) and Down syndrome (3.6%), followed by Noonan and 22q11.2 deletion syndromes. Syndromic patients were younger, more often had pulmonary arterial hypertension (15% vs 6%) and sleep apnoea, but fewer traditional risk factors. Down syndrome clustered with atrioventricular septal defect and 22q11.2 deletion with conotruncal defects. In Tetralogy of Fallot, 22q11.2 deletion was often neither recognised nor tested in adulthood. A syndromic diagnosis was independently associated with higher all-cause mortality (HR 2.06). Better recognition and broader genetic screening may improve risk assessment in this growing patient population. ## Chirurgie voor aortaklependocarditis blijft hoogrisico: spoed en inotropie sterkste voorspellers van sterfte *2026-07-20 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003997?rss=1 · https://hartvaat.nl/2026/04/21/chirurgie-voor-aortaklependocarditis-blijft-hoogrisico-spoed-en-inotropie-sterks/* Native aortic valve endocarditis is often complicated by heart failure, peri-annular extension and conduction disturbances, making surgery challenging. In this retrospective analysis of the UK NICOR registry, 3,694 patients underwent aortic valve replacement (AVR) for endocarditis (1996-2019; mean age 58, 22% female). In-hospital mortality was 7.8%. Non-survivors were older and more often had chronic kidney disease, diabetes, pulmonary disease, cardiogenic shock and poor ventricular function. On multivariable analysis, operative urgency (OR 2.49) and preoperative inotropic support (OR 2.24) were the strongest predictors of mortality, alongside NYHA III-IV, age, kidney disease and atrial fibrillation. More recent years of surgery were associated with better survival. Surgery for aortic valve endocarditis thus remains high risk, though outcomes have improved over time. ## Sekseverschillen bij infectieuze endocarditis: vrouwen vaker conservatief behandeld, slechtere overleving *2026-07-20 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004026?rss=1 · https://hartvaat.nl/2026/04/24/sekseverschillen-bij-infectieuze-endocarditis-vrouwen-vaker-conservatief-behande/* Although interest in male-female differences in cardiovascular disease is growing, evidence in infective endocarditis (IE) is limited and contradictory. This prospective study included 791 patients with definite or possible IE discussed by the endocarditis team (2016-2025; 73% male, 27% female). Women more often had mitral-valve IE, men more often aortic-valve IE, more predisposing conditions and more Cutibacterium. Although the indication for surgery did not differ, men were operated on more often (41% vs 29%), and women with a surgical indication were more often treated conservatively (37% vs 23%). Over a median 2.1-year follow-up, women had higher adjusted mortality (HR 1.39); after excluding non-operated patients with an indication, surgery appeared more protective in women than men. The findings point to sex differences in surgical decision-making and a less favourable prognosis in women. ## Proteomics Signatures of Chronic Kidney Disease in Hypertension *2026-07-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26477 · https://hartvaat.nl/2026/04/22/eiwithandtekening-voorspelt-nierschade-bij-hypertensie-uk-biobank-nieuwe-risicos/* Hypertension is a major modifiable risk factor for chronic kidney disease (CKD), but predicting which patients will progress remains difficult. Using the UK Biobank Pharma Proteomics Project (22,258 hypertensive participants without baseline CKD), a plasma protein-based risk score was developed and validated (internal and external Scotland/Wales). A 13-protein score (C-index ~0.78) predicted incident CKD, with a simplified 3-protein panel (RNASE1, IGFBP4, GDF15) retaining most of the predictive power. Adding the score to the clinical model significantly improved discrimination, whereas a genetic (polygenic) eGFR score added nothing. Mendelian randomisation identified seven proteins with a causal signal, nominating FOLR1 and STC1 as potential treatment targets. The study thus provides a robust protein signature for hypertensive kidney disease and novel therapeutic targets. ## Relatieve apicale sparing op strain-echo voor cardiale amyloïdose: meta-analyse van 41 studies *2026-07-20 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004143?rss=1 · https://hartvaat.nl/2026/04/24/relatieve-apicale-sparing-op-strain-echo-voor-cardiale-amyloidose-meta-analyse-v/* Cardiac amyloidosis (CA) is often missed due to non-specific clinical and echocardiographic features. This systematic review and meta-analysis (41 studies, 3,473 CA patients and 4,525 comparators) evaluated the diagnostic accuracy of the relative apical sparing (RELAPS) pattern on speckle-tracking echocardiography — apical longitudinal strain divided by the sum of basal and mid-ventricular strain. Pooled AUC was 0.82, with sensitivity 66% and specificity 83%. The AL subtype had the highest specificity (93%) and ATTR 84%, with no significant difference between subtypes. Performance varied clearly by analysis software (GE EchoPAC and Philips QLAB better than TomTec). RELAPS thus offers moderate diagnostic accuracy with good specificity but modest sensitivity — useful as a red flag, provided standardised measurement and prespecified cut-offs are used. ## CONFIDENT-HFpEF: A Machine Learning-Based Risk Stratification for Mortality and Hospitalization Using Multimodal Real-World Data. *2026-07-20 · ESC heart failure · https://doi.org/10.1093/eschf/xvag097 · https://hartvaat.nl/2026/04/07/confident-hfpef-machine-learning-voorspelt-sterfte-en-opname-beter-dan-bestaande/* Heart failure with preserved ejection fraction (HFpEF) is heterogeneous, with high morbidity and mortality; accurate risk stratification matters for both care and drug development. The observational CONFIDENT study included 1,208 HFpEF patients (HFA-PEFF criteria) across three centres in Europe and the US (2013-2022), using electronic health records, labs, echocardiography and ECG. Machine-learning models were developed for all-cause mortality and HF hospitalisation. The mortality model achieved fair-to-good discrimination (C-index 0.68-0.72) and performed significantly better than the validated PREDICT-HFpEF and MAGGIC scores across cohorts; the hospitalisation model also outperformed both, including MAGGIC plus natriuretic peptide. Using routinely collected variables, these models can thus reliably predict outcomes and may support personalised care and trial recruitment in HFpEF. ## Chronotype-aligned exercise timing in middle-aged adults at cardiometabolic risk: a randomised controlled trial. *2026-07-19 · Open heart · https://doi.org/10.1136/openhrt-2025-003573 · https://hartvaat.nl/2026/04/14/sporten-op-je-eigen-bioritme-verlaagt-de-bloeddruk-meer-een-gerandomiseerde-stud/* Aligning the timing of exercise with chronotype ('morning' or 'evening' type) may yield greater cardiometabolic benefit. In this 12-week randomised trial (Lahore, Pakistan; 150 sedentary adults aged 40-60 with at least one cardiovascular risk factor), chronotype was determined by questionnaire and confirmed with 48-hour core body-temperature monitoring. Participants trained supervised (5×/week, 40 min moderate intensity) either at their preferred time (chronotype-aligned, CAE) or at their non-preferred time (CME). The CAE group improved significantly more in systolic blood pressure (-10.8 vs -5.5 mmHg), diastolic blood pressure, heart-rate variability (RMSSD), peak VO2, LDL, fasting glucose and sleep quality (PSQI). Matching exercise to individual chronotype could thus be a low-cost, personalised way to improve cardiovascular health. ## Lipid management in type 2 diabetes and non-HDL-cholesterol: target all atherogenic lipoproteins. *2026-07-19 · Cardiovascular diabetology · https://doi.org/10.1186/s12933-026-03166-4 · https://hartvaat.nl/2026/04/12/lipidenmanagement-bij-type-2-diabetes-richt-je-op-alle-atherogene-lipoproteinen-/* Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality in diabetes, partly driven by dyslipidaemia. Although LDL cholesterol (LDL-C) is the primary treatment target, many patients with diabetes have mixed dyslipidaemia with elevated triglycerides and atherogenic remnant lipoproteins, better captured by non-HDL cholesterol (non-HDL-C). Guidelines from the ADA, AACE and ESC recommend both LDL-C and non-HDL-C targets based on individual risk, yet target attainment remains suboptimal in practice. Statins, ezetimibe, bempedoic acid and PCSK9 inhibitors effectively lower LDL-C and non-HDL-C and reduce cardiovascular risk; triglyceride-lowering agents (omega-3, fibrates) lower triglycerides but their effect on hard outcomes remains uncertain. This review argues for using non-HDL-C and apolipoprotein B (apoB) alongside LDL-C as measures of atherogenic burden, and for more targeted treatment of residual atherogenic particles in diabetes. ## Worse Long-Term Outcomes in New-Onset HFpEF vs HFrEF and HFmrEF: Findings from the Stockholm PREFERS Study. *2026-07-19 · ESC heart failure · https://doi.org/10.1093/eschf/xvag105 · https://hartvaat.nl/2026/04/09/prefers-stockholm-nieuw-ontstaan-hfpef-heeft-slechtere-langetermijnuitkomsten-da/* Prospective outcome data for new-onset heart failure (HF) by ejection-fraction category are scarce. The Stockholm PREFERS study followed 547 patients with new-onset HF treated in specialised HF clinics (HFpEF 25%, HFmrEF 11%, HFrEF 64%; median EF 55%, 45% and 30%). The primary endpoint was cardiovascular death or first HF hospitalisation. Over a median 3.8-year follow-up, HFpEF patients had a higher risk of the primary endpoint than HFmrEF and HFrEF combined (adjusted HR 1.7). Moreover, at one year NT-proBNP fell markedly in HFmrEF (-42%) and HFrEF (-55%) with rising EF, whereas in HFpEF the EF actually fell by 5 percentage points and NT-proBNP was unchanged. The study underscores the severity of HFpEF — often underestimated — and the need for more effective treatment strategies. ## Combined effect of educational attainment and diabetes on 1-year all-cause mortality in heart failure patients: findings from the National Heart Failure Registry, India. *2026-07-19 · Open heart · https://doi.org/10.1136/openhrt-2025-003833 · https://hartvaat.nl/2026/04/15/opleidingsniveau-verandert-het-effect-van-diabetes-op-de-sterfte-bij-hartfalen-i/* Patients with both heart failure (HF) and diabetes are often prescribed complex regimens, but their impact may depend on social determinants such as educational attainment. This analysis of India's National Heart Failure Registry (10,850 patients, 53 hospitals, 21 states) followed patients for one year. Cumulative 1-year mortality was 22.1%. Diabetes was associated with 10% higher mortality (HR 1.10), and higher education independently with lower mortality. Compared with patients without diabetes and low education, those with both diabetes and low education had 25% higher risk of death (HR 1.25), whereas those with diabetes and higher education had 22% lower risk (HR 0.78). A significant interaction was found: the adverse effect of diabetes is greater among the less educated. The findings underscore the importance of health literacy and equitable access to care to reduce disparities in heart failure. ## Epidemiology, economic burden and mortality of atrial fibrillation in a region with very high life expectancy: a contemporary, population-based analysis in Catalonia. *2026-07-19 · Open heart · https://doi.org/10.1136/openhrt-2026-004007 · https://hartvaat.nl/2026/04/17/atriumfibrilleren-in-catalonie-prevalentie-gestabiliseerd-incidentie-gedaald-2-v/* The high prevalence of atrial fibrillation (AF) is a public-health challenge, especially in ageing societies. This retrospective population-based study used the Catalan public health system database (8 million people, 2019-2023). Age-standardised AF prevalence remained stable at 2.5%, while incidence fell slightly (from 3.8 to 3.6 per 1,000). The 2023 AF population had a median age of 77.6 years and a high comorbidity burden: heart failure (37.6%), obesity (33.8%) and coronary disease (26.7%). Low socioeconomic status was associated with higher AF prevalence. AF was modestly associated with all-cause mortality (OR 1.25), and its healthcare costs were estimated at 2% of the annual Catalan health budget. In a high-life-expectancy region, AF prevalence thus appears to be plateauing, with a high disease burden and substantial economic impact. ## Balancing Clinical and Ethical Considerations Related to Placebo Use in Trials of Incretin-Based Therapies in Heart Failure. *2026-07-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2026.02.5086 · https://hartvaat.nl/2026/04/21/jacc-beschouwing-placebo-in-trials-met-incretine-therapie-bij-hartfalen-wetensch/* GLP-1 receptor agonists and dual GIP/GLP-1 agonists improve symptoms and function in heart failure with preserved ejection fraction (HFpEF) and obesity, but the trials were small with few hard events. At the same time, these drugs have proven cardiovascular and renal benefits in obesity, diabetes and kidney disease, raising questions about placebo use in future heart-failure trials. In this JACC viewpoint, the authors weigh the scientific, practical and ethical considerations: placebo ensures methodologic rigour but may be ethically problematic given the cardiometabolic benefit, whereas abandoning placebo risks incomplete safety and efficacy data. They introduce a structured framework for when placebo remains appropriate, when active comparison is needed, and how trial design can address the ethical and operational challenges — aiming for definitive evidence to inform guidelines and reimbursement. ## Prevalence of Lipoprotein(a) Testing in Patients With Atherosclerotic Cardiovascular Disease Within a Large Australian Cardiology Network. *2026-07-18 · Heart, lung & circulation · https://doi.org/10.1016/j.hlc.2025.11.017 · https://hartvaat.nl/2026/04/21/lp-a-bepaling-sterk-onderbenut-bij-patienten-met-atherosclerotische-hart-en-vaat/* Elevated lipoprotein(a) (Lp(a)) is a genetically determined causal risk factor for atherosclerotic cardiovascular disease (ASCVD). This retrospective study analysed over 1.1 million de-identified records from a large Australian cardiology network (2011-2022) using natural language processing. Lp(a) testing in ASCVD patients was rare but rising: from 0.9% in the historical cohort to 2.6% in 2022. Of tested patients with a recorded value, 25% had Lp(a) >90 mg/dL (historical) and 30% ≥70 mg/dL (recent), while 87% were already on lipid-lowering therapy. Despite guidelines recommending testing, Lp(a) measurement remains markedly underused — a missed opportunity to identify high-risk patients, especially as targeted Lp(a)-lowering therapies are in development. ## Assessment and management of cardiovascular-kidney-liver metabolic-syndrome in the primary care setting: A multidisciplinary consensus statement. *2026-07-18 · European journal of internal medicine · https://doi.org/10.1016/j.ejim.2026.106902 · https://hartvaat.nl/2026/04/27/consensus-breid-het-cardio-renaal-metabool-syndroom-uit-met-de-lever-cklms-in-de/* The recently introduced cardiovascular-kidney-metabolic (CKM) syndrome captures the close interplay between metabolic risk factors, chronic kidney disease and cardiovascular disease, but underestimates the role of the liver. Metabolic dysfunction-associated steatotic liver disease (MASLD) — the world's most prevalent chronic liver disease — is strongly linked to cardiovascular events, kidney-disease progression and mortality, yet is often missed in practice. This multidisciplinary consensus statement proposes the concept of a cardiovascular-kidney-liver-metabolic syndrome (CKLMS) and offers a practical, primary-care-centred framework. Using accessible, validated tools — blood pressure and lipid profiling, kidney function and albuminuria, non-invasive liver fibrosis testing, and screening for diabetes and obesity — cardiovascular, renal, hepatic and metabolic risk are stratified together. It emphasises early lifestyle intervention, drugs with multi-organ benefit, and clear referral pathways, positioning the primary-care physician as coordinator of longitudinal, patient-centred care. ## Assessing the Cost Effectiveness of an Incremental Lipid-Lowering Therapy Approach After Coronary Artery Bypass Grafting Using Nationwide Data. *2026-07-18 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.124.040272 · https://hartvaat.nl/2026/04/07/kosteneffectiviteit-van-stapsgewijze-lipidenverlaging-na-coronaire-bypasschirurg/* Lipid-lowering therapy (LLT) is important after coronary artery bypass grafting (CABG), but cost limits wider use of PCSK9 inhibitors and newer agents. In a nationwide cohort of US veterans after CABG, the investigators used Monte Carlo simulations to model stepwise initiation of high-intensity statins, ezetimibe and a PCSK9 inhibitor toward LDL targets, followed by a lifetime Markov model with events (stroke, myocardial infarction, revascularisation and death). The aim was to compare the cost-effectiveness of this stepwise LLT approach with observed practice from the health-care perspective. The study provides a framework to inform targeted, stepwise use of costlier lipid-lowering agents. ## Patient Care Pathways and Outcomes Following Newly Diagnosed Atrial Fibrillation. *2026-07-18 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.046111 · https://hartvaat.nl/2026/04/07/zorgpaden-na-nieuw-vastgesteld-atriumfibrilleren-rol-van-de-elektrofysioloog-en-/* Care pathways in atrial fibrillation (AF) are poorly characterised and may influence guideline-concordant treatment. In the Optum database (37,370 patients with incident AF, 2015–2023), 20.6% had a pathway including an electrophysiologist visit. Older patients and those with a higher CHA2DS2-VASc score were less likely to see an electrophysiologist. An electrophysiologist visit was associated with more antiarrhythmic therapy and oral anticoagulation, and in patients aged 80+ with lower stroke risk (HR 0.63). Guideline-concordant care and better outcomes — especially in the highest stroke-risk groups — were thus associated with electrophysiology pathways, even though high-risk groups received that care less often. ## Sex Differences in Outcomes After Breakthrough Ischemic Stroke on Oral Anticoagulants for Atrial Fibrillation: An ASPERA-R Inverse Probability Weighted Analysis. *2026-07-17 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.047064 · https://hartvaat.nl/2026/04/07/vrouwen-hebben-slechtere-uitkomsten-na-een-herseninfarct-ondanks-antistolling-bi/* Sex-specific outcomes after breakthrough ischaemic stroke on oral anticoagulation (OAC) in atrial fibrillation were unknown. In the international retrospective ASPERA-R study (1,649 patients, 52% women, mean age 78), women were older and had more severe baseline impairment. After inverse-probability weighting, women were less likely to return to baseline neurologic function (35.2% vs 42.7%; adjusted RR 0.82), had a worse mRS distribution and more recurrent stroke/TIA (adjusted HR 1.70), with a trend toward more major bleeding. Significant sex interactions were seen for OAC type, endovascular treatment and OAC restart. The findings argue for sex-aware management. ## Sex Differences in Lipids and Lipoproteins and Their Relationship With Cardiovascular Disease: A Prospective Study of UK Biobank Participants. *2026-07-17 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.045533 · https://hartvaat.nl/2026/04/09/sekseverschillen-in-lipiden-en-lipoproteinen-en-het-cardiovasculaire-risico-uk-b/* Sex differences in serum lipids are recognised, but their relationship with cardiovascular disease has not been reliably quantified. In 432,092 UK Biobank participants without cardiovascular disease (median follow-up 13.3 years; 10,699 events in women, 18,950 in men), sex-specific associations of lipids and apolipoproteins with incident CVD were examined. LDL cholesterol, apoB and log-Lp(a) were more strongly associated with risk in men than women (women-to-men HR ratios ~0.94–0.96), whereas triglycerides were more strongly associated with risk in women (ratio 1.06). ApoA1 was less protective in women. Men had higher absolute risk overall. These sex differences argue for sex-specific interpretation of the lipid profile. ## Lipoprotein(a), High-Sensitivity C-Reactive Protein, and Incident ASCVD Risk in Individuals Without Standard Modifiable Risk Factors. *2026-07-17 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag221 · https://hartvaat.nl/2026/04/16/lp-a-en-hscrp-voorspellen-ascvd-bij-mensen-zonder-klassieke-risicofactoren/* The combined value of lipoprotein(a) [Lp(a)] and high-sensitivity CRP (hsCRP) in primary prevention among people without standard modifiable risk factors (SMuRF-less: no smoking, obesity, hypertension, dyslipidaemia or diabetes) was unclear. In 50,450 SMuRF-less UK Biobank participants, 1,104 (2.2%) ASCVD events occurred over 15 years. Both elevated hsCRP (sHR 1.35) and elevated Lp(a) (sHR 1.24) were independently associated with ASCVD; risk was highest with concurrent elevation of both (sHR 1.64, and 1.74 using clinical cutoffs Lp(a) ≥125 nmol/L and hsCRP ≥2.0 mg/L). Combined Lp(a) and hsCRP assessment thus provides complementary risk information, even in apparently low-risk individuals. ## Supra-Annular Versus Intra-Annular Devices for Transcatheter Aortic Valve-in-Valve Replacement: The PANDORA International Registry. *2026-07-17 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.046180 · https://hartvaat.nl/2026/04/16/pandora-register-supra-versus-intra-annulaire-kleppen-bij-tavr-in-tavr/* As transcatheter aortic valve replacement (TAVR) extends to younger, lower-risk patients, the need for repeat procedures (TAVR-in-TAVR) is rising. The international PANDORA registry (172 TAVR-in-TAVR procedures from ~30,000 TAVRs; median interval 1,401 days) compared supra-annular (SAV) and intra-annular (IAV) valve combinations. Structural valve deterioration was the leading failure mechanism (78%). VARC-3 technical success was 91% and 30-day device success 68% — limited by elevated residual gradients (≥20 mmHg in 13%) and 30-day mortality of 7.3%. The IAV-IAV combination had the numerically lowest 1-year freedom from death or heart-failure hospitalisation. Male sex and CKD predicted mortality. TAVR-in-TAVR is feasible, but the valve combination affects outcomes. ## Sex-Specific Cardiovascular Risk of Lower Potassium Intake in Patients with CKD. *2026-07-17 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag226 · https://hartvaat.nl/2026/04/17/lagere-kaliuminname-hangt-samen-met-meer-hart-en-vaatziekte-bij-ckd-vooral-bij-v/* Lower potassium intake is associated with more cardiovascular disease (CVD) in the general population, with sex differences. In this Japanese prospective study (Fukuoka Kidney Disease Registry; 4,314 patients with chronic kidney disease, 5-year follow-up), estimated potassium intake (from spot urine) was related to cardiovascular events. Over five years, 431 patients had an event. There was a significant interaction with sex (p<0.001): in women, lower potassium intake was strongly associated with more events (HR 2.97), but not in men (HR 0.98). In CKD, low potassium intake thus appears to be a risk particularly in women — though potassium management in CKD requires caution because of hyperkalaemia risk. ## Blood Biomarkers and the Risk of Coronary Disease in Atrial Fibrillation. *2026-07-16 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.045735 · https://hartvaat.nl/2026/04/20/biomarkers-voorspellen-coronairlijden-bij-atriumfibrilleren-regards/* Atrial fibrillation (AF) was recently identified as a risk factor for coronary heart disease (CHD), but the pathophysiology is unclear. In the REGARDS cohort, 13 cardiovascular biomarkers were measured in 1,818 participants with AF (no prior stroke or CHD). Over nine years, 201 (11%) developed CHD. Several markers were associated with incident CHD (NT-proBNP, GDF-15, CRP, IL-6, D-dimer, cholesterol, Lp(a), triglycerides, LDL and GGT; HR 1.17–1.69 per SD), strongest for NT-proBNP (HR 1.69) and GDF-15 (HR 1.45). Top-versus-bottom tertile, NT-proBNP, IL-6 and GDF-15 were strongest. Myocardial strain (NT-proBNP) and inflammation appear to drive CHD risk in AF. ## Kidney Dysfunction and Pulmonary Vascular Disease in Heart Failure with preserved Ejection Fraction. *2026-07-16 · European journal of heart failure · https://doi.org/10.1093/ejhf/xuag140 · https://hartvaat.nl/2026/04/27/nierfunctiestoornis-verergert-pulmonale-vaatziekte-bij-hfpef/* Chronic kidney disease (CKD) is common in heart failure with preserved ejection fraction (HFpEF) and is linked to worse outcomes via unclear mechanisms. In this cohort of 925 HFpEF patients undergoing invasive haemodynamic exercise testing (34.5% with eGFR <60), worse kidney function was associated with higher biventricular filling pressures, lower cardiac output and — most strikingly — increasing pulmonary vascular disease: pulmonary vascular resistance rose and pulmonary arterial compliance fell as kidney function declined. During exercise these differences became even more pronounced, with the greatest cardiac-output limitation in the worst kidney function. CKD thus contributes to progressive pulmonary vascular disease in HFpEF. ## Advanced Molecular, Metabolic, and Imaging Approaches to Characterizing Right Ventricular Failure: A Scientific Statement From the American Heart Association *2026-07-16 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001422 · https://hartvaat.nl/2026/04/02/aha-verklaring-geavanceerde-karakterisering-van-rechterventrikelfalen/* Right ventricular (RV) dysfunction is a major predictor of outcomes in pulmonary hypertension and beyond. This American Heart Association scientific statement describes how chronic pressure overload first drives adaptive RV hypertrophy and then maladaptive remodelling with dilation, fibrosis, stiffness and RV–pulmonary arterial uncoupling, ultimately causing right heart failure. It synthesises advanced molecular, metabolic and imaging approaches to characterising RV failure — relevant not only to (pulmonary arterial) hypertension but also to HFpEF, congenital heart disease and other systemic conditions. ## Multiorgan Physiological Deficits During Exercise Identify Clinical and Molecular Predisposition to Heart Failure With Preserved Ejection Fraction *2026-07-16 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077579 · https://hartvaat.nl/2026/04/07/multi-orgaan-inspanningstekorten-kenmerken-de-aanleg-voor-hfpef/* Exercise unmasks the limited multi-organ reserve characteristic of heart failure with preserved ejection fraction (HFpEF). Using invasive cardiopulmonary exercise testing (iCPET), metabolite profiling and genomics, the investigators characterised seven exercise physiologic deficits in HFpEF patients: reduced exercise stroke volume and heart rate, a steep PCWP/cardiac-output slope, elevated pulmonary vascular resistance, pulmonary mechanical limitation, impaired peripheral oxygen extraction, and the obesity-related exaggerated metabolic cost of exercise. They mapped the distribution and the functional and prognostic significance of these deficits and linked them to molecular (metabolite and genetic) signatures — a step toward more targeted HFpEF phenotyping and risk assessment. ## Phone-Based Intervention Under Nurse Guidance for Control of Hypertension After Stroke: A Randomized Multicenter Phase 3 Trial in Ghana *2026-07-16 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077424 · https://hartvaat.nl/2026/04/09/pings-telefonische-verpleegkundig-geleide-bloeddrukcontrole-na-een-beroerte-ghan/* In low-income countries, fewer than 10% of people with hypertension ever achieve blood-pressure control. The PINGS trial (Ghana, 10 hospitals, 500 patients with recent stroke and elevated blood pressure) compared usual care with a 12-month intervention: home blood-pressure self-monitoring with nurse case management, phone-alarm medication reminders, and weekly audio messages on risk reduction in local dialects. At 12 months, systolic blood pressure was a mean of 5.5 mmHg lower, and 67% of the intervention group reached a systolic below 140 mmHg versus 43% with usual care (24% difference). Low-tech mHealth with task-shifting to nurses can safely improve blood-pressure control in stroke survivors in low-resource settings. ## The Natural History of Massive Left Ventricular Hypertrophy in Pediatric Hypertrophic Cardiomyopathy: A Multiregistry Analysis *2026-07-15 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.078843 · https://hartvaat.nl/2026/04/17/massieve-linkerventrikelhypertrofie-bij-kinderen-met-hypertrofische-cardiomyopat/* Massive left ventricular hypertrophy (LVH) is a risk factor for sudden cardiac death in children with hypertrophic cardiomyopathy (HCM), but its natural history is poorly understood. This analysis from two large international registries (SHaRe and IPHCC) compares children with HCM with and without massive LVH — defined as maximal wall thickness ≥30 mm or a z-score ≥+20 before age 18 — using serial wall-thickness measurements and composite outcomes for major ventricular arrhythmia events (sudden cardiac death, aborted sudden cardiac death or appropriate ICD therapy) and heart failure. The study characterises the course and risk profile of this severe phenotype to support risk stratification and treatment decisions such as ICD implantation. ## Performance of PREVENT Cardiovascular Risk in Electronic Health Record-Based Clinical Practice. *2026-07-15 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2026.6838 · https://hartvaat.nl/2026/04/01/prevent-risicoscore-presteert-robuust-in-de-dagelijkse-ehr-praktijk/* The PREVENT equations (AHA, 2023) estimate cardiovascular risk in a race-free, sex-specific manner. In this retrospective cohort from the Duke health system (406,230 patients in the relaxed cohort; 127,151 with complete records), PREVENT showed good discrimination (C-index 0.75–0.77) that remained robust to missing laboratory and vital-sign data when imputation was applied. Calibration was better in the complete-record cohort; local adaptations modestly improved calibration. PREVENT thus appears reliable for risk estimation in routine practice. ## New-onset postoperative atrial fibrillation management and outcomes: the VISION Cardiac Surgery cohort. *2026-07-15 · European heart journal · https://doi.org/10.1093/eurheartj/ehag236 · https://hartvaat.nl/2026/04/08/vision-postoperatief-atriumfibrilleren-na-hartchirurgie-verhoogt-sterfte-na-een-/* In the prospective VISION Cardiac Surgery cohort (12,234 patients, 12 countries), new-onset postoperative atrial fibrillation (POAF) occurred in 31.8% within 30 days of cardiac surgery. Antithrombotic and antiarrhythmic management varied widely: 15.6% received anticoagulation alone, 54.3% antiplatelets alone, 24% both, and 49% amiodarone. At one year, clinical AF was detected in 6.9% of POAF patients versus 0.6% without (aHR 11.3), and all-cause mortality was higher (3.0% vs 1.7%; aHR 1.54). POAF after cardiac surgery is thus common and associated with both more AF and higher mortality in the first year. ## Cardiac evaluation of paediatric athletes. *2026-07-15 · European heart journal · https://doi.org/10.1093/eurheartj/ehag188 · https://hartvaat.nl/2026/04/09/cardiale-screening-van-jonge-sporters-eerste-eapc-aepc-consensus-voor-kinderen/* Children are not simply 'mini-adults': existing athlete-screening recommendations are based on adults. This joint consensus document from the EAPC (ESC) and AEPC provides, for the first time, specific advice for athletes under 16. It recommends cardiac screening with personal and family history, physical examination and a 12-lead resting ECG, starting no later than age 12; an echocardiogram may be appropriate to detect structural disease missed by ECG. The document includes age-specific definitions of normal, borderline and abnormal ECG findings and stresses the need for more research and for training in paediatric sports cardiology. ## Development of an Integrated Monogenic and Polygenic Risk Assessment Tool for Coronary Artery Disease and Its Application in a Community-Based Health Care Biobank. *2026-07-15 · Circulation. Genomic and precision medicine · https://doi.org/10.1161/CIRCGEN.125.005494 · https://hartvaat.nl/2026/04/10/genprobcad-gecombineerde-monogene-en-polygene-risicobepaling-voor-coronairlijden/* Current genetic testing for coronary artery disease (CAD) mainly targets monogenic variants in severe hypercholesterolaemia. GenProbCAD combines monogenic pathogenic variants with polygenic risk scores for CAD and for lipoprotein(a), developed and validated in the UK Biobank (two cohorts of 226,145) and applied in a community biobank (20,477). The integrated score predicted CAD better than monogenic variants or the polygenic score alone and flagged 16% as high-risk — 46-fold more than monogenic carriers — with comparable CAD prevalence and consistent prediction across all LDL strata and ancestries. A universal strategy would hypothetically capture ~21% of all incident CAD, versus 0.3% with current monogenic testing. ## Applying the 2025 ESC/EACTS Recommendations for the Treatment of Severe Tricuspid Regurgitation to Real-World Practice. *2026-07-14 · JACC. Cardiovascular interventions · https://doi.org/10.1016/j.jcin.2026.02.024 · https://hartvaat.nl/2026/04/13/transkatheter-tricuspidalisreparatie-bij-hoogrisicopatienten-real-world-toets-va/* The 2025 ESC/EACTS guideline gives transcatheter tricuspid interventions a Class IIa recommendation but advises optimal medical therapy first in severe left- or right-ventricular dysfunction or precapillary pulmonary hypertension because of futility risk. In the EuroTR registry (1,626 patients with edge-to-edge repair, T-TEER), these 'OMT candidates' (13.1%) had lower 2-year survival free of heart-failure hospitalisation (58.7% vs 74.3%) but comparable symptomatic improvement (≥1 NYHA class in 56% vs 60%). T-TEER may thus offer symptomatic relief in selected high-risk patients; multidisciplinary evaluation at experienced valve centres remains essential. ## Left bundle branch area vs biventricular pacing for cardiac resynchronization therapy: the LEFT-BUNDLE-CRT trial. *2026-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehag225 · https://hartvaat.nl/2026/04/14/left-bundle-crt-linkerbundeltak-pacing-niet-aantoonbaar-non-inferieur-aan-bivent/* This randomized non-inferiority trial compared left-bundle branch area pacing (LBBAP) with biventricular pacing (BiVP) for cardiac resynchronization therapy in 176 patients with a CRT indication and typical left bundle branch block. The primary endpoint (CRT response at six months) was met in 94.6% with BiVP and 89.7% with LBBAP; non-inferiority of LBBAP was not demonstrated (RR 0.95; 95% CI 0.88–1.02). Both strategies yielded high response rates and similar clinical outcomes and complications. LBBAP remains a reasonable alternative, but this evidence does not support non-inferiority to BiVP. ## Ultrasound-guided vs conventional venous puncture for atrial fibrillation ablation: the ULYSSES trial. *2026-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehag291 · https://hartvaat.nl/2026/04/14/ulysses-echogeleide-venapunctie-halveert-toegangscomplicaties-bij-af-ablatie/* The ULYSSES trial randomized 986 patients undergoing catheter ablation for atrial fibrillation or left atrial tachycardia to ultrasound-guided or conventional (palpation-based) femoral venous puncture. The trial stopped early for efficacy: vascular access-site complications occurred in 0.6% with ultrasound guidance versus 3.3% conventionally (risk ratio 0.19). Unintended arterial punctures (2% vs 16%) and failed venous access (0.2% vs 8.2%) also fell sharply. Ultrasound-guided venous puncture is therefore preferable for AF ablation procedures. ## Cardiac resynchronization therapy with or without atrioventricular node ablation in atrial fibrillation: the CAAN-AF trial. *2026-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehag206 · https://hartvaat.nl/2026/04/16/caan-af-av-knoopablatie-verbetert-crt-uitkomsten-bij-permanent-atriumfibrilleren/* The CAAN-AF trial tested whether atrioventricular node ablation (AVNA) added to cardiac resynchronisation therapy (CRT-D) improves outcomes in patients with heart failure with reduced ejection fraction and permanent atrial fibrillation, versus medical rate control. The trial stopped early for futility: among 143 randomized patients there was no difference in the primary endpoint (all-cause mortality plus non-fatal heart-failure events; IRR 1.16) or in secondary outcomes. In this randomized setting AVNA showed no benefit over medical rate control. ## Clinical Impact of Seasonal and Environmental Factors in Patients with Acute Heart Failure. *2026-07-14 · European heart journal. Acute cardiovascular care · https://doi.org/10.1093/ehjacc/zuag059 · https://hartvaat.nl/2026/04/16/winteropname-voor-acuut-hartfalen-gaat-gepaard-met-hogere-sterfte/* In a cohort of 2,857 patients hospitalised for heart failure, seasonal and environmental factors were examined. The winter group was older, had more comorbidity and higher in-hospital and 90-day mortality than the autumn group (odds ratios 1.7–2.1). Lower temperature was associated with 90-day mortality, shorter sunshine duration with all-cause mortality, and higher PM2.5 with in-hospital cardiac mortality; atmospheric pressure, humidity and influenza activity were not. The findings suggest a role for cold and limited sunlight in winter heart-failure mortality. ## PCSK9 inhibitor treatment and outcomes in patients with atherosclerotic cardiovascular disease but without prior ischaemic events: an observational study. *2026-07-13 · European heart journal · https://doi.org/10.1093/eurheartj/ehag176 · https://hartvaat.nl/2026/04/16/pcsk9-remmers-verlagen-events-bij-ascvd-zonder-eerder-infarct-of-beroerte-real-w/* This real-world study (Optum database; 19,670 patients with atherosclerotic cardiovascular disease and no prior ischaemic event) compared PCSK9 monoclonal-antibody initiators with matched non-initiators. Over five years, the composite of non-fatal myocardial infarction, non-fatal ischaemic stroke or death was lower with a PCSK9 inhibitor (17.5% vs 25.4%): a 31% relative and 7.8% absolute risk reduction. LDL cholesterol fell by a mean of 54% (from 118 to 55 mg/dL). The data support early, intensive LDL lowering even before a first event. ## Thyroid dysfunction and cardiovascular disease. *2026-07-13 · European heart journal · https://doi.org/10.1093/eurheartj/ehag248 · https://hartvaat.nl/2026/04/17/schildklierdisfunctie-en-hart-en-vaatziekten-ehj-overzicht/* Thyroid hormones regulate the cardiovascular system; both hypo- and hyperthyroidism are linked to dyslipidaemia, blood-pressure dysregulation, endothelial dysfunction, impaired cardiac function and arrhythmias. This EHJ review summarises the molecular and pathophysiological mechanisms and discusses the effect of levothyroxine in subclinical hypothyroidism on cardiovascular outcomes, which remains uncertain: the largest trial (TRUST) was underpowered but suggested a trend toward benefit. Recent omics and Mendelian-randomisation studies are also covered. ## Pharmacological blood-pressure lowering for the prevention of cardiovascular disease and death across the full spectrum of chronic kidney disease severity: an individual-participant data meta-analysis. *2026-07-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(26)00367-3 · https://hartvaat.nl/2026/04/25/bloeddrukverlaging-beschermt-over-het-hele-spectrum-van-chronische-nierschade-la/* This individual-participant-data meta-analysis from the Blood Pressure Lowering Treatment Trialists' Collaboration (46 trials, 285,124 participants) examined blood-pressure lowering across all stages of chronic kidney disease (CKD). A 5 mmHg systolic reduction lowered major cardiovascular event risk similarly in people with (HR 0.91) and without CKD (HR 0.90), consistent across all CKD stages (including stages 4–5), blood-pressure thresholds (down to <120/70 mmHg) and proteinuria status. However, the relative benefit was attenuated in CKD with concomitant diabetes (HR 0.96), underscoring the need for adapted strategies in that high-risk subgroup. ## Cerebral Amyloid Angiopathy. *2026-07-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMra2411298 · https://hartvaat.nl/2026/05/07/cerebrale-amyloidangiopathie-nejm-state-of-the-art-overzicht/* Cerebral amyloid angiopathy (CAA) — deposition of beta-amyloid in the brain's small vessels — is a major cause of haemorrhagic stroke and contributes to cognitive decline and to complications of anti-amyloid immunotherapy. Diagnosis usually rests on MRI showing multiple (micro)bleeds or cortical/leptomeningeal blood products. For cardiovascular practice the key issue is the high recurrence risk: in patients with an indication for antithrombotic therapy, CAA demands a carefully individualised weighing of bleeding versus thrombotic risk. Research focuses on risk prediction, early markers and disease-modifying therapy. ## Cardiale revalidatie: verbetering depressie hangt samen met betere loopconditie — pleidooi voor geïntegreerde aanpak *2026-07-13 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004051?rss=1 · https://hartvaat.nl/2026/04/29/cardiale-revalidatie-verbetering-depressie-hangt-samen-met-betere-loopconditie-p/* Retrospective observational study on data from the UK National Audit of Cardiac Rehabilitation: 4,585 patients with acute coronary syndrome who underwent both a valid Incremental Shuttle Walk Test and the Hospital Anxiety and Depression Scale before and after cardiac rehabilitation between January 2021 and June 2024. Patients who achieved a minimum clinically important difference (MCID) for depression (>1.7-point HADS improvement) had 23% higher odds of also achieving the MCID for walking fitness (>70 m improvement; OR 1.23; 95% CI 1.01-1.49). Compared with home-based programmes, centre-based group programmes and hybrid programmes had higher odds of clinically meaningful improvement in walking fitness. Older age, female sex, physical inactivity, obesity, and longer waiting time were associated with lower likelihood of MCID improvement. The findings underscore the importance of integrating depression care within cardiac rehabilitation. ## Geleidingssysteem-pacing slaat rechterventrikel-pacing bij AV-blok: -70% hartfalen-opnames in RCT-meta-analyse *2026-07-12 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003954?rss=1 · https://hartvaat.nl/2026/04/29/geleidingssysteem-pacing-slaat-rechterventrikel-pacing-bij-av-blok-70-hartfalen-/* Systematic review and meta-analysis of randomised trials only — 5 RCTs with 985 patients with atrioventricular (AV) block — comparing conduction system pacing (CSP) with conventional right ventricular pacing (RVP). The composite endpoint significantly favoured CSP (HR 0.54; 95% CI 0.31-0.95; p=0.03), with markedly reduced risk of HF hospitalisation (RR 0.30; 95% CI 0.17-0.54; p<0.0001). No significant difference in all-cause mortality (RR 0.69; 95% CI 0.36-1.30; p=0.25). Secondary outcomes: significantly greater LVEF improvement (p=0.008) and shorter QRS duration (p=0.002) with CSP. In AV block, CSP therefore yields cardiac and clinical benefit over RVP — mainly through reduced HF hospitalisation and preservation of physiological activation. Mortality evidence remains uncertain. A practice shift toward CSP in pacemaker selection is supported by these data. ## Experiences of Racism and Risk of Preeclampsia in the Black Women’s Health Study *2026-07-12 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26454 · https://hartvaat.nl/2026/04/29/black-women-s-health-study-dagelijks-en-institutioneel-racisme-verhogen-pre-ecla/* Cohort study within the Black Women's Health Study (n≈59,000 Black women in the US, initiated 1995). Nulliparous women at enrolment with their first birth between 1995 and 2009 were included. Racism was measured as a total daily racism score (interpersonal racism) and an institutional racism summary score (unfair treatment due to race in policing, housing, or employment). Logistic regression adjusted for demographic, reproductive, and health factors. Women in the highest quartile of daily racism had 50% higher odds of preeclampsia versus the lowest quartile (aOR 1.50; 95% CI 1.13-1.99). Women reporting institutional racism in 2 domains had 47% higher odds (aOR 1.47; 95% CI 1.14-1.91). The findings suggest racism contributes to the disproportionate burden of preeclampsia in Black women in the US — relevant to addressing structural cardiovascular disparities. ## Fibromuscular Dysplasia: Emerging Concepts Beyond the International Consensus *2026-07-12 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25633 · https://hartvaat.nl/2026/04/29/fibromusculaire-dysplasie-nieuwe-inzichten-voorbij-de-2019-consensus-bredere-cla/* Hypertension review of recent developments in fibromuscular dysplasia (FMD) since the First International Consensus document of 2019. The authors discuss: (1) a more detailed classification of FMD beyond the multifocal-versus-focal distinction, as a common language for research and clinical practice; (2) new insights into FMD-related phenotypes; (3) emerging imaging and proteomic biomarkers for improved detection, diagnosis, and classification, as well as prognosis and treatment response prediction; and (4) quantitative imaging with computational fluid dynamics (AI-enhanced or not) to assess the haemodynamic significance of FMD lesions. Combined with genetic studies and animal models, these developments pave the way for a more definitive and personalised approach to FMD. ## Geïsoleerde secundaire tricuspidalisinsufficiëntie na linkszijdige klepchirurgie verhoogt sterfte met 29% *2026-07-12 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004063?rss=1 · https://hartvaat.nl/2026/04/29/geisoleerde-secundaire-tricuspidalisinsufficientie-na-linkszijdige-klepchirurgie/* Single-centre observational cohort study in 2,487 patients (mean age 68 years; median follow-up 3 years) who underwent left-sided valve surgery with less than moderate preoperative tricuspid regurgitation (TR) and follow-up echocardiography between 2002 and 2024. All-cause mortality and HF hospitalisations increased with the grade of postoperative TR (p<0.001). Postoperative TR was independently associated with the composite endpoint (death/HFH), adjusted for CV risk factors and comorbidities (aHR 1.29; 95% CI 1.18-1.41; p<0.001), and even after adjustment for RV remodelling and moderate mitral regurgitation (aHR 1.40; 95% CI 1.28-1.53). An increase in TR by ≥2 grades from preoperative occurred in 12.5% and was strongly associated with adverse outcome. Predictors of TR progression: age, sex, myocardial infarction, CABG, atrial fibrillation, and RV remodelling. The findings argue for systematic TR surveillance after left-sided valve surgery. ## Mortality in Relation to Brachial Versus Central Ambulatory Blood Pressure *2026-07-12 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26778 · https://hartvaat.nl/2026/04/29/centrale-versus-brachiale-ambulante-bloeddruk-brachiaal-volstaat-voor-mortalitei/* Analysis of 36,594 patients from the Shanghai Ruijin Ambulatory BP Monitoring Registry (2017-2023) who underwent 24-hour ambulatory blood pressure monitoring with an oscillometric cuff monitor, measuring both brachial (bSBP) and central systolic BP (cSBP, calibrated on brachial or on mean arterial pressure). Median age 53.4 years; 52.8% female. During 4 years of follow-up, 505 participants died, including 174 from cardiovascular causes. Non-linear Cox models fitted better than linear (p<0.001) for both endpoints, regardless of time-of-day or calibration. Adding 24-hour SBP to the base model improved C-statistics for all-cause and cardiovascular mortality (0.003≤p≤0.06). Adding cSBP on top of bSBP did not yield statistically significant improvement (0.054≤p≤0.22). Central BP measurement on top of brachial ambulatory monitoring therefore adds little value for mortality stratification — simple brachial ambulant measurement suffices. ## Erasmus MC: linkeratrium-strain voorspelt aritmieën na chirurgische correctie van rechtszijdige ACHD *2026-07-11 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004033?rss=1 · https://hartvaat.nl/2026/04/29/erasmus-mc-linkeratrium-strain-voorspelt-aritmieen-na-chirurgische-correctie-van/* Dutch longitudinal study within the Erasmus MC Quality of Life cohort in 195 adults with congenital heart disease and right-sided pathology — atrial septal defect (n=78, 40%), pulmonary stenosis (n=45, 23%), or Tetralogy of Fallot (n=72, 37%) — who underwent surgical repair as children between 1968 and 1980. At follow-up in 2012 (mean age 40.7 years), speckle-tracking echocardiography evaluated left atrial reservoir (LASr), conduit, and contractile (LASct) function; clinical outcomes were followed for 10 years. ToF patients had more frequent interventricular conduction abnormalities at baseline and 2.7-fold higher odds of the composite endpoint versus ASD patients. In Cox regression, LASr and LASct were independently associated with symptomatic tachyarrhythmias (LASr HR 0.952; p=0.013; LASct HR 0.936; p=0.046), even after adjustment for LVEF, LA volume index, or NT-proBNP. LA strain therefore provides additional prognostic information in ACHD follow-up — relevant to the growing Dutch ACHD population. ## Blood Pressure Change and Subclinical Target Organ Damage in Mid-Adulthood *2026-07-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26364 · https://hartvaat.nl/2026/04/30/hanzhong-cohort-36-jaar-follow-up-snelle-bloeddrukstijging-in-kindertijd-voorspe/* Cohort study within the Hanzhong Adolescent Hypertension Study in 2,508 participants with ≥4 BP measurements between 1987 and 2023. Growth models constructed age-specific BP levels and rates of change (slopes) and related them to subclinical end-organ damage in mid-adulthood (arterial stiffness, left ventricular hypertrophy, albuminuria). Rates of change at each age point were positively associated with arterial stiffness and albuminuria, independent of BP level itself. The associations rose from childhood, peaked in adolescence, and declined thereafter: per 1 SD increase in systolic BP rate of change, the OR for arterial stiffness was 1.94 at age 6, 2.11 at age 13, and fell to 1.13 by age 52. In childhood and adolescence, the rate of BP increase was more important than the concurrent level; from young adulthood onwards this reversed. Similar patterns for LVH. Early monitoring of the pace of BP rise — not only the level — may therefore be essential for cardiovascular prevention. ## Etnische verschillen in sterfte na acuut coronair syndroom: hogere mortaliteit bij zwarte STEMI-patiënten *2026-07-11 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004072?rss=1 · https://hartvaat.nl/2026/04/30/etnische-verschillen-in-sterfte-na-acuut-coronair-syndroom-hogere-mortaliteit-bi/* Systematic review and meta-analysis of 40 cohort and registry studies (total 14 million patients from the USA, UK, and Canada) on ethnic disparities in mortality after acute coronary syndrome (ACS). Overall mortality was similar between Black and White patients (RR 0.99; 95% CI 0.94-1.03) and between Asian and White patients (RR 1.06; 95% CI 0.95-1.17); however, in US-based studies, Asian patients had higher mortality (RR 1.14; 95% CI 1.03-1.27). Subgroup analysis showed significantly higher mortality in Black patients after STEMI (RR 1.09; 95% CI 1.02-1.17). Meta-regression demonstrated an age-modifying effect for Black-versus-White comparisons: differences attenuated in older populations. Pooled risk of major bleeding was comparable between groups. The findings suggest ethnic disparities in ACS outcomes persist in specific contexts and may be more pronounced in younger patients — though interpretation requires caution due to heterogeneity. ## Peri-Arterial Neural Dissection During Adrenal Surgery Provides a Denervation-Like Benefit in Hypertension Control *2026-07-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26495 · https://hartvaat.nl/2026/04/30/peri-arteriele-zenuwdissectie-tijdens-bijniechirurgie-geeft-renale-denervatie-ef/* Retrospective analysis of 127 hypertensive patients who underwent adrenal surgery between January 2022 and March 2025, classified by surgical peri-arterial neural dissection (PAND) — a surgical manoeuvre that interrupts sympathetic nerve bundles surrounding the renal artery — versus no dissection. After 1:2 matching by age, sex, and hypertension duration, 54 patients remained for analysis. The PAND group had a higher postoperative hypertension remission rate (50.0% vs 16.1%; p=0.008). In multivariable logistic regression, PAND was independently associated with lower odds of non-remission (OR 0.150; 95% CI 0.030-0.744; p=0.020). The dissection group also showed greater reduction in antihypertensive medication use (median defined-daily-dose change -1.0 vs 0.0; p=0.006). Renal function (creatinine, urea) and adrenal hormones (cortisol, ACTH) were comparable between groups. The manoeuvre therefore appears to produce a renal-denervation-like effect without compromising renal or adrenal function. ## From Progress to Plateau: 50-Year Trends in Hypertension Prevalence and Salt Intake in the Finnish Population *2026-07-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25982 · https://hartvaat.nl/2026/05/01/finse-hypertensie-curve-vlakt-af-vooruitgang-gestopt-zoutinname-30-boven-aanbeve/* Analysis of 12 cross-sectional health surveys in Finland between 1972 and 2023 (77,418 randomly selected adults aged 25-64). BP was measured in all; a subsample of 5,035 provided 24-hour urine for salt intake. Hypertension prevalence (SBP ≥140, DBP ≥90, or antihypertensive use) declined in men from 1972 to 2002 and in women until 1997; thereafter declines slowed and in 2023 prevalence remained high (42.6% men, 31.8% women). Median salt intake fell until the early 2000s (men 13.9→9.7 g/day, women 11.1→7.6 g/day) but plateaued thereafter; in 2023 intake remained well above the recommended level (men 10.3 g/day, women 7.6 g/day). The declining trend in hypertension has therefore stalled, paralleling stagnating salt intake — arguing for renewed public-health action on salt reduction. ## Angina toevoegen aan de H2FPEF-score verbetert HFpEF-diagnose bij vrouwen — geen winst bij mannen *2026-07-10 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004054?rss=1 · https://hartvaat.nl/2026/05/04/angina-toevoegen-aan-de-h2fpef-score-verbetert-hfpef-diagnose-bij-vrouwen-geen-w/* Diagnostic study in 515 patients from the UHFO-DM cohort with suspected HFpEF, plus 751 patients from three additional cohorts (UHFO-COPD, STRETCH, TREE). Symptoms, including angina by WHO questionnaire, were collected in standardised fashion; HFpEF was adjudicated by expert panel. HFpEF prevalence 24% in UHFO-DM. The H2FPEF score had an overall AUC of 0.72 (0.69 in women, 0.74 in men). Angina was independently associated with HFpEF in women (OR 3.96; 95% CI 1.72-9.11; p=0.001) but not in men (OR 1.90; p=0.10). Adding one point for angina to H2FPEF in women improved AUC from 0.69 to 0.71 (DeLong p=0.030), sensitivity from 0.53 to 0.60, and NPV from 0.80 to 0.82, with continuous net reclassification improvement 0.449. No gain in men. A simple sex-specific modification of H2FPEF — for women only — therefore improves diagnostic precision for HFpEF. ## STAMI: linkerventrikel-trombus komt na voorwand-STEMI voor (8%), bij Takotsubo nooit — ondanks slechtere LVEF *2026-07-10 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004154?rss=1 · https://hartvaat.nl/2026/05/04/stami-linkerventrikel-trombus-komt-na-voorwand-stemi-voor-8-bij-takotsubo-nooit-/* Prospective cohort study at Sahlgrenska University Hospital in 314 patients with Takotsubo syndrome (TS, n=68), anterior STEMI (n=148), or non-anterior STEMI (n=98), with serial echocardiography on admission and days 1, 2, 3, 7, 14, and 30. Mean LVEF at admission: 39% in TS (lowest), 47% in anterior STEMI, and 53% in non-anterior STEMI. Despite the poorest LV function, no TS patient developed a left ventricular thrombus, while 20 of 246 STEMI patients (8.1%) did — almost exclusively anterior STEMI. All LV thrombi in anterior STEMI were detected within 7 days; the single non-anterior thrombus appeared at day 30. All patients received anticoagulation. Predictors: lower LVEF and higher troponin. The findings underscore pathophysiological differences between TS and STEMI and argue for distinct post-acute surveillance strategies. ## Noorse nationale validatie: myocarditis na mRNA-COVID-vaccinatie 4,5 per 100.000 — meest klinisch mild *2026-07-10 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004112?rss=1 · https://hartvaat.nl/2026/05/04/noorse-nationale-validatie-myocarditis-na-mrna-covid-vaccinatie-4-5-per-100-000-/* Norwegian nationwide population-based validation study of myocarditis after BNT162b2 or mRNA-1273 vaccination (27 December 2020 - 30 April 2022). Among 4.1 million vaccinated individuals (10.9 million doses), 367 potential cases were identified via linked registries; of 349 reviewed, 177 (51%) were validated as vaccine-associated myocarditis by Brighton Collaboration criteria — equating to 4.5 per 100,000 vaccinated individuals. 110 (62%) occurred after the second dose. 79% of validated cases were in men; median age 30 years in men and 54 years in women. Only 3 (2%) were under 18 years. Median hospital stay 4 days; median LVEF 55%. 7 (4%) patients required intensive care; 2 older patients died. None required mechanical circulatory support or heart transplantation. The acute course was generally mild. National surveillance and systematic validation are essential for reliable incidence estimates. ## Blood Pressure Trajectories Among Adults Living in Extreme Poverty: A Population-Based Cohort in Port-au-Prince, Haiti *2026-07-10 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26295 · https://hartvaat.nl/2026/05/06/haiti-cohort-n-2-073-bloeddrukbehandeling-in-extreme-armoede-haalbaar-vier-50-ma/* Population-based cohort study in Port-au-Prince, Haiti, of 2,073 adults with ≥3 BP measurements between March 2019 and April 2025 (median age 43 years; 60% female; 100% Black Haitian; 69% lived on 2 Reliably Associated With ROSC? *2026-07-08 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077980 · https://hartvaat.nl/2026/05/18/trajectory-van-eind-expiratoire-co2-bij-ohca-monitor-7-21-minuten-voor-betrouwba/* Secondary analysis of the cluster-randomised Pragmatic Airway Resuscitation Trial (PART) in 1,168 patients with out-of-hospital cardiac arrest (OHCA). Mean end-tidal CO2 (EtCO2) per 1-minute epoch was classified by trajectory modelling into upward versus downward patterns, stratified by witnessed/unwitnessed status and initial EtCO2 (low ≤30, moderate 31-49, high ≥50 mm Hg). Overall ROSC 18.2% (30.5% witnessed vs 10.5% unwitnessed). In witnessed arrests, the 95% CIs between upward and downward trajectories became non-overlapping at 8 minutes for low initial EtCO2 (RR 3.06), 12 minutes for moderate (RR 1.95), and 21 minutes for high (RR 2.12). In unwitnessed arrests, already at 7 minutes (RR 3.56). Dynamic EtCO2 trajectory monitoring therefore provides early prognostic information during resuscitation, but the minimum required observation time depends on witness status and initial EtCO2 level. ## Evolocumab in Patients With Prior Percutaneous Coronary Intervention and No Prior MI: Results From the VESALIUS-CV Trial *2026-07-08 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.080616 · https://hartvaat.nl/2026/05/19/vesalius-cv-subgroep-prior-pci-zonder-eerder-mi-evolocumab-halveert-hartinfarct-/* Prespecified subgroup analysis of VESALIUS-CV in 3,627 patients (29.6% of the total study population) with prior PCI but no prior myocardial infarction or stroke, randomised to evolocumab or placebo (median follow-up 4.6 years). Median age 66 years, 30.7% women, median time since PCI 4 years. At 48 weeks, median LDL-C was 41.5 versus 107.0 mg/dL with evolocumab versus placebo. Evolocumab reduced 3-point MACE by 30% (5-year KM 7.0% vs 9.5%; HR 0.70; 95% CI 0.56-0.89; p=0.004), 4-point MACE by 18%, MI risk by 50% (3.0% vs 6.1%; HR 0.50; p<0.001), and urgent coronary revascularisation by 39%. The effect was apparent within 6 months. Numerically lower cardiovascular mortality (HR 0.66) and all-cause mortality (HR 0.76). The findings support intensive LDL-C lowering with evolocumab in stable patients with prior PCI even without prior MI — a substantial practical expansion of the indication. ## Multidimensional Social Adversity and Mortality in People With HIV Infection and Heart Failure: Insights From NYC Health + Hospitals HIV–Heart Failure Cohort *2026-07-08 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.078897 · https://hartvaat.nl/2026/05/19/nyc-4h-cohort-sociale-problemen-verviervoudigen-sterfterisico-bij-hiv-patienten-/* Cohort study of the NYC Health + Hospitals HIV-Heart Failure (NYC 4H) registry in 1,044 participants (62.9% male, mean age 61.6 years). At baseline, multidimensional social adversity (SA) was assessed by licensed clinical social workers across 5 domains: economic hardship, healthcare access barriers, unstable neighbourhood/housing, social support challenges, and psychobehavioural instability. 58% had at least one SA domain, most often psychobehavioural instability (n=438). During 3.8 years of follow-up, any SA exposure was associated with higher all-cause mortality (HR 4.32), cardiovascular mortality (HR 4.05), and infection-related mortality (HR 2.37). Domain-specific associations: social support challenges and psychobehavioural instability predicted CV mortality; economic hardship and social support predicted infection mortality. Patients with environmental instability, psychobehavioural instability, or social support challenges had 73%, 75%, and 44% higher 6-month rehospitalisation risk respectively. Multidimensional SA assessment can support domain-specific risk stratification in HIV + heart failure. ## Cardiale MRI bij dystrofinopathie: consensus voor DMD, BMD en vrouwelijke draagsters *2026-07-07 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004037?rss=1 · https://hartvaat.nl/2026/05/20/cardiale-mri-bij-dystrofinopathie-consensus-voor-dmd-bmd-en-vrouwelijke-draagste/* Consensus document from a UK-US expert working group (paediatric cardiologists, neuromuscular specialists, and patient representatives) on the use of cardiac MRI (CMR) in patients with Duchenne (DMD) and Becker (BMD) muscular dystrophy and in female carriers of DMD-gene variants. Heart failure progresses in all DMD patients, but symptoms appear late — making regular imaging essential. Echocardiography remains the first-line modality in the UK, but CMR detects myocardial tissue changes before pump function declines and maintains accuracy as the disease progresses. Recommendation: wider use of CMR in DMD patients >10 years at key decision points, plus in BMD males and female carriers. This would allow earlier detection of cardiac involvement and more timely initiation or adjustment of cardiac medication. ## Cluster Randomized Controlled Trial of Intensive Systolic Blood Pressure Control in Patients With Renal Cell or Thyroid Cancer Receiving VEGFR Tyrosine Kinase Inhibitors: ECOG-ACRIN EAQ191 *2026-07-07 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26016 · https://hartvaat.nl/2026/05/20/ecog-acrin-eaq191-intensieve-bloeddrukcontrole-tijdens-vegfr-tki-therapie-haalba/* Phase 2 cluster-randomised trial in 61 patients with renal cell or thyroid cancer starting VEGFR tyrosine kinase inhibitors (TKIs), randomised at site level (10 sites) to intensive systolic blood pressure control (SBP <120 mm Hg) or usual care (SBP <140 mm Hg), with central BP advisory support. Patients underwent home BP monitoring and study visits at baseline, 1, 2, 3, and 6 months. The intensive arm achieved significantly lower SBP (-12.2 mm Hg at 1 month; -7.6 mm Hg at 3 months; -6.9 mm Hg at 6 months). Grade 3 adverse events were numerically lower with intensive control: kidney injury (1 vs 4), hypotension (2 vs 3), and dyspnoea (0 vs 2). Patient-reported outcomes were largely similar. The first-ever RCT of BP control in active cancer patients on TKI therapy demonstrates the feasibility, safety, and tolerability of the intensive approach. ## SCAPIS-cohort: diastolische dysfunctie even vaak bij prediabetes als diabetes — pleidooi tegen 'diabetische cardiomyopathie' *2026-07-07 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004052?rss=1 · https://hartvaat.nl/2026/05/20/scapis-cohort-diastolische-dysfunctie-even-vaak-bij-prediabetes-als-diabetes-ple/* Cross-sectional study within the Swedish CArdioPulmonary bioImage Study (SCAPIS) in 3,840 men and women aged 50-64 years with transthoracic echocardiography, anthropometry, blood pressure, biochemistry, and coronary CT calcium scoring. Normoglycaemia 82%, pre-diabetes 12%, diabetes 6%. Diastolic dysfunction was significantly more common in pre-diabetes (30%) and diabetes (33%) than in normoglycaemia (21%); prevalence was therefore equivalent between pre-diabetes and diabetes. In dysglycaemic individuals, diastolic dysfunction was associated with hypertension and more severe coronary atherosclerosis. In multivariable analysis, waist circumference (OR 1.034) and high CAC score (OR 2.90) were independent predictors — even after excluding ischaemic heart disease. In individuals without coronary atherosclerosis and hypertension, systolic blood pressure remained the only independent predictor. The findings challenge the concept of an 'isolated diabetic cardiomyopathy' and argue for early, integrated cardiometabolic risk management to prevent HFpEF. ## Dietary Intakes of Plant and Animal Nitrate and 5-Year Blood Pressure Changes *2026-07-07 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26894 · https://hartvaat.nl/2026/05/20/bloeddrukeffecten-van-nitraat-hangen-af-van-de-bron-planten-verlagen-vlees-verho/* Cohort study in 2,942 Chinese adults analysing plant- versus animal-sourced nitrate intake via a validated food frequency questionnaire in relation to 5-year blood pressure changes and arterial stiffness (brachial-ankle pulse wave velocity). Higher plant nitrate intake was associated with greater 5-year SBP decline (β -3.51; 95% CI -5.89 to -1.13) and lower arterial stiffness (OR 0.59; 95% CI 0.35-0.98). Higher animal nitrate intake was conversely associated with DBP increase (β +1.95; 95% CI 0.54-3.37). In 2×2 analyses, plant nitrate + polyphenols or vitamin C gave the strongest BP decline, while animal nitrate + heme iron gave the strongest DBP rise. The BP effect of nitrate therefore depends strongly on the dietary context — an argument for actively promoting plant nitrate sources (green vegetables, beetroot) over animal sources (processed meat). ## Diffuse myocardfibrose bij ernstige aortastenose is ongelijk verdeeld — vooral aan de basis van het hart *2026-07-07 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003583?rss=1 · https://hartvaat.nl/2026/05/20/diffuse-myocardfibrose-bij-ernstige-aortastenose-is-ongelijk-verdeeld-vooral-aan/* Study in 43 patients with severe aortic stenosis who underwent cardiac MRI (cine, T1 relaxometry, and extracellular volume) and transthoracic echocardiography within one week before surgical aortic valve replacement. Endomyocardial biopsies were sampled during surgery. Histological analysis of 192 biopsies showed a median LV collagen volume fraction (CVF) of 19%, peaking in segment 1 (base) per the AHA segment model. Significant moderate correlations between CVF and extracellular volume in AHA segments 1 (r²=0.54) and 16 (r²=0.44) — the segments with the highest fibrosis prevalence. Functional parameters correlated with CVF: global circumferential strain (r²=0.31), radial strain (r²=-0.33), LVEF (r²=-0.34); T1 relaxation correlated with GLS (r²=0.42), MAPSE (r²=-0.39), and S' velocity (r²=-0.45). Fibrosis therefore begins at the base and relates to systolic function — CMR can quantify this regional heterogeneity. ## Hypochloremie bij opname voor acuut hartfalen voorspelt onafhankelijk 30-daagse sterfte (Vietnamees cohort) *2026-07-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003635?rss=1 · https://hartvaat.nl/2026/05/20/hypochloremie-bij-opname-voor-acuut-hartfalen-voorspelt-onafhankelijk-30-daagse-/* Cross-sectional study at Can Tho Central General Hospital (Vietnam, May-December 2024) in 423 patients ≥18 years with acute heart failure and NT-proBNP ≥300 pg/mL (mean age 69.7 years; 48% male). During hospitalisation, 5.0% died; of 252 discharged patients who completed 30-day phone follow-up, 17.1% died. After adjustment for age, sex, coronary disease, chronic HF, LVEF, and serum sodium, hypochloraemia was an independent predictor of both in-hospital mortality (aOR 4.9; 95% CI 1.3-18.5) and 30-day mortality (aRR 1.9; 95% CI 1.1-3.6). Each 1 mmol/L increase in chloride was associated with 5% lower 30-day mortality (RR 0.95; p=0.007). The findings confirm admission serum chloride as a valuable prognostic biomarker in AHF in a population where Western data are scarce. ## Infectieuze endocarditis na TAVI: diabetes belangrijkste risicofactor, E. faecalis dominante verwekker, 2× mortaliteit *2026-07-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004079?rss=1 · https://hartvaat.nl/2026/05/20/infectieuze-endocarditis-na-tavi-diabetes-belangrijkste-risicofactor-e-faecalis-/* Case-control study at Haukeland University Hospital (Norway, 2012-2023) comparing 71 patients with TAVI-related infective endocarditis (TAVI-IE) to 213 age- and sex-matched controls without IE (1:3 ratio). Incidence was 1.2% per patient-year; median time from TAVI to infection was 13 months (IQR 4-29). Diabetes mellitus was the only independent predictor of TAVI-IE in multivariable competing-risk analysis (SHR 2.08; 95% CI 1.19-3.65). Obesity (27% vs 15%) and balloon-expandable valve use (28% vs 13%) were more frequent in IE patients. Enterococcus faecalis was the most common pathogen (30%). TAVI-IE was associated with approximately twofold higher all-cause mortality (aHR 2.13; 95% CI 1.48-3.07), with the highest risk in early infections. The findings can guide targeted monitoring and prevention in high-risk patients. ## Klinisch en genetisch risico op atriumfibrilleren versterken elkaar additief — 13× risico bij beide hoog *2026-07-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004078?rss=1 · https://hartvaat.nl/2026/05/20/klinisch-en-genetisch-risico-op-atriumfibrilleren-versterken-elkaar-additief-13-/* Case-cohort study within the Danish Diet, Cancer and Health cohort (subcohort n=4,040 plus AF cases) combining the FIND-AF clinical risk score (low 0-3, high 4-6, very high 7-14 points) with a genetic risk score (GRS) based on 142 variants, categorised as low (Q1), intermediate (Q2-4), or high (Q5) genetic risk. Over a median follow-up of 12.9 years, 3,094 participants developed AF. Compared with those at low clinical and genetic risk, the adjusted hazard ratio for AF was 3.47 with high clinical + high genetic risk, and 12.76 with very high clinical + high genetic risk. The relative excess risk due to interaction (RERI) was 0.56 — a positive additive interaction between GRS and FIND-AF. Combining clinical and genetic risk stratification can therefore better target future AF prevention and screening. ## Orthostatic Blood Pressure, Cardiovascular Disease, and Hypotensive Events *2026-07-06 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25773 · https://hartvaat.nl/2026/05/20/aric-over-35-jaar-hogere-bloeddruk-niet-alleen-lage-staande-bd-verklaart-syncope/* Analysis of the Atherosclerosis Risk in Communities (ARIC) study: in 11,386 participants (mean age 54 years; 56% female; 25% Black), supine and standing BP were measured once at baseline, with over 35 years of follow-up for coronary heart disease, mortality, falls, and syncope. Drops in systolic BP on standing (absolute or relative) were associated with coronary heart disease, syncope, and mortality. In untreated participants, higher supine systolic BP and mean arterial pressure were associated with syncope. An increase in systolic BP ≥20 mm Hg on standing was associated with more falls (HR 1.52) and syncope (HR 1.40). In treated participants, lower standing BP did predict more syncope (HR 1.55). Regardless of treatment, higher pulse pressure was associated with CHD and mortality, but not with falls or syncope. The findings nuance the view that only low standing BP is the problem: higher BP appears an important risk factor for both cardiovascular and hypotension-related events, particularly in untreated adults. ## Pulmonale hypertensie screenen met echo: cut-off TRV 2,7 m/s beter dan 2,9 onder nieuwe PH-definitie *2026-07-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004185?rss=1 · https://hartvaat.nl/2026/05/20/pulmonale-hypertensie-screenen-met-echo-cut-off-trv-2-7-m-s-beter-dan-2-9-onder-/* Retrospective study in 755 patients at two general hospitals who underwent both transthoracic echocardiography and right heart catheterisation to determine optimal echocardiographic cut-offs for pulmonary hypertension (PH) under the revised definition (mPAP >20 mm Hg). The c-statistic for peak tricuspid regurgitation velocity (TRV) was 0.82 (95% CI 0.79-0.85). An optimal TRV cut-off of 2.7 m/s provided higher sensitivity (72%) than the conventional 2.9 m/s (60%) while maintaining specificity (82%). In 681 patients with available estimated right atrial pressure (eRAP, derived from IVC diameter and respiratory variation), adding eRAP improved discrimination (c-statistic 0.83 vs 0.80; net reclassification improvement 0.14; p=0.002). eRAP ≥5 mm Hg was associated with higher PH risk, and combining it with elevated TRV provided the strongest association. Under the new PH definition, a TRV cut-off of 2.7 m/s is a more useful screening threshold; adding eRAP further refines diagnosis. ## CT-FFR voorspelt MACE 4× hoger bij waarde ≤0,80: bijgewerkte meta-analyse van 20.067 patiënten *2026-07-05 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003979?rss=1 · https://hartvaat.nl/2026/05/20/ct-ffr-voorspelt-mace-4-hoger-bij-waarde-0-80-bijgewerkte-meta-analyse-van-20-06/* Systematic review and meta-analysis of 22 studies (n=20,067) on the prognostic value of CT-derived fractional flow reserve (FFR-CT) in patients with suspected or known coronary artery disease, comparing FFR-CT ≤0.80 versus >0.80 — a fourfold expansion of the 2022 Nørgaard meta-analysis. Patients with FFR-CT ≤0.80 had significantly higher MACE risk (HR 3.94; 95% CI 2.92-5.31; p<0.0001) with substantial heterogeneity (I²=79.9%). Restricting to hard endpoints (death/myocardial infarction, k=6) yielded HR 3.28 (95% CI 2.25-4.79) with zero heterogeneity (I²=0%). No significant differences across FFR-CT technologies (HeartFlow, machine-learning, deep-learning algorithms; p=0.81). Trim-and-fill suggested possible publication bias (adjusted HR 2.35). GRADE certainty moderate. The findings support FFR-CT as a reliable non-invasive prognostic marker — relevant for non-invasive coronary work-up. ## Adolescent Cardiorespiratory Fitness and the Trade-Off Between Atrial Fibrillation Risk and Cardiovascular Benefits: A Nationwide Sibling-Controlled Cohort Study *2026-07-05 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.078250 · https://hartvaat.nl/2026/05/21/hoge-jeugdige-conditie-en-af-risico-trade-off-verdwijnt-na-correctie-voor-famili/* Nationwide Swedish cohort with sibling-controlled analysis of 1,124,049 men (mean age 18.3 years) who underwent mandatory military fitness testing between 1972 and 1995, followed until December 2023. 45,179 (4.0%) developed atrial fibrillation and 96,404 (8.6%) had non-AF cardiovascular disease (median events around age 55 years). In population-wide analysis, the fittest men (highest decile) had a small excess of AF in early adulthood but greater reductions in non-AF CVD from age 45. In full-sibling comparison (controlling for shared familial factors), the trade-off disappeared entirely: from age 35 the reduction in non-AF CVD was already larger (RD -0.11%) than the AF excess (RD +0.06%); at age 65, respectively -3.91% versus +2.30%. High youth fitness therefore confers no net cardiovascular disadvantage — supporting public-health efforts to improve youth fitness and reassuring about the safety of high fitness levels. ## SWEDEHEART: na een eerste hartinfarct is fysieke fitheid bij start cardiale revalidatie ver onder de norm *2026-07-05 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004046?rss=1 · https://hartvaat.nl/2026/05/21/swedeheart-na-een-eerste-hartinfarct-is-fysieke-fitheid-bij-start-cardiale-reval/* Registry study from the Swedish SWEDEHEART post-MI register (2016-2019) in 15,105 patients with first-time myocardial infarction (mean age 62.5 years; 78.4% male) who underwent physiotherapist-led assessments of exercise capacity (symptom-limited cycle ergometry) and muscular endurance (unilateral heel-rise test) at the start of cardiac rehabilitation. Results were compared with Swedish age- and sex-stratified reference values (Kalmar dataset). Mean exercise capacity was only 64.7% of predicted in men and 68.4% in women; muscular endurance 78.4% in men and 61.7% in women. Women showed a steeper age-related decline in heel-rise performance. The results underscore the importance of systematic baseline assessment and tailored rehabilitation targeting both exercise capacity and muscle strength. ## Million Women Study: ernstige obesitas verviervoudigt risico op AF én hartfalen samen bij vrouwen *2026-07-05 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003950?rss=1 · https://hartvaat.nl/2026/05/21/million-women-study-ernstige-obesitas-verviervoudigt-risico-op-af-en-hartfalen-s/* Prospective cohort within the UK Million Women Study: 1.3 million women aged 50-64 recruited in 1996-2001, with baseline data on demographics, BMI, smoking, alcohol, physical activity, and treatment for hypertension, diabetes, and hypercholesterolaemia. Through linked hospital and death records, 19 cardiovascular disease subtypes were tracked. Cardiovascular multimorbidity (CVM, ≥2 diagnoses) and complex CVM (≥4 diagnoses) were analysed. Obesity, smoking, and treated diabetes or hypertension were each independently associated with 2-3× higher CVM risk; severe obesity, heavy smoking, and diabetes with 3-4× higher complex-CVM risk. Strongest associations: severe obesity with fivefold risk of atrial fibrillation + heart failure together, and diabetes with fivefold risk of ischaemic heart disease + heart failure together. Alcohol and physical activity showed weak associations. Targeted risk-factor management is particularly important in women to prevent CV multimorbidity. ## Patiëntspecifieke 3D-hartmodellen bij congenitale hartchirurgie: 18 minuten korter opereren en minder complicaties (meta-analyse) *2026-07-05 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004011?rss=1 · https://hartvaat.nl/2026/05/25/patientspecifieke-3d-hartmodellen-bij-congenitale-hartchirurgie-18-minuten-korte/* Systematic review and meta-analysis of 32 comparative studies (n=1,842) on the impact of patient-specific 3D heart models — printed or virtual — on surgical planning and outcomes in congenital heart surgery, compared with conventional imaging. Use of 3D models was associated with: more frequent modification of the operative plan (RR 1.42; 95% CI 1.21-1.67), shorter operative time (mean -18.4 minutes), fewer postoperative complications (RR 0.74), fewer re-operations (RR 0.52), shorter hospital stay (-1.8 days), and higher self-reported surgeon confidence (SMD 0.88). Certainty of evidence ranged from low to moderate due to non-experimental study designs and heterogeneity. 3D models appear useful in complex congenital anomalies; confirmation in larger, methodologically stronger studies is desirable. ## Laparoscopische pericardio-peritoneale window: kleine prospectieve serie van 24 patiënten zonder recidief in 12 maanden *2026-07-04 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004047?rss=1 · https://hartvaat.nl/2026/05/25/laparoscopische-pericardio-peritoneale-window-kleine-prospectieve-serie-van-24-p/* Single-centre prospective study (2022-2024) in 24 patients with recurrent pericardial effusion requiring surgical intervention. In all, a pericardio-peritoneal window was created via laparoscopy for continuous drainage as a minimally invasive alternative to repeated drainage. The procedure was technically successful in all 24 patients, produced immediate symptomatic improvement, required no postoperative drainage, and allowed next-day discharge; no postoperative complications occurred. At 12 months, there was no clinical or radiological recurrence. The results suggest that a laparoscopic pericardio-peritoneal window is a safe, effective, and durable alternative for patients with recurrent pericardial effusion — though larger randomised trials are needed for definitive confirmation of safety and long-term outcome. ## Acute bloeddrukverhoging tijdens ziekenhuisopname: hoe te handelen bij asymptomatische 'hypertensieve urgentie'? *2026-07-04 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/658?rss=1 · https://hartvaat.nl/2026/05/26/acute-bloeddrukverhoging-tijdens-ziekenhuisopname-hoe-te-handelen-bij-asymptomat/* Heart BMJ review of pragmatic management of acute blood pressure elevations during hospitalisation. True hypertensive emergencies (with end-organ damage) are relatively rare and have clear guidelines; asymptomatic acute BP elevations are far more frequent and lack consensus on appropriate management. Contributing factors: fear of missing true emergencies, limitations in inpatient BP measurement accuracy, and inconsistent data on short- and long-term effects of inpatient BP elevations. Practice varies widely — even within a single hospital — between observation, intravenous or oral antihypertensives, and adjustment of home medication. Some clinicians discharge patients on intensified therapy based on inpatient values. The review synthesises the available evidence and provides a practical, holistic framework for evaluation and treatment. ## 12-leads ECG onderscheidt RASopathie-HCM van sarcomere HCM bij kinderen — superieure asdeviatie en rechterventrikel-hypertrofie *2026-07-04 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/692?rss=1 · https://hartvaat.nl/2026/05/26/12-leads-ecg-onderscheidt-rasopathie-hcm-van-sarcomere-hcm-bij-kinderen-superieu/* Retrospective single-centre cohort study in 84 children with RASopathy-associated hypertrophic cardiomyopathy (RAS-HCM, e.g. Noonan syndrome) versus 113 children with sarcomeric HCM (s-HCM). RAS-HCM ECGs showed significantly more superior axis deviation (29.8% vs 2.5%; p<0.001) and voltage criteria for right ventricular hypertrophy (52.4% vs 28.3%; p<0.001), and significantly fewer pathological Q waves (27.4% vs 47.8%; p<0.001). Over a median follow-up of 6.8 years, 19 (22.6%) RAS-HCM patients experienced major adverse cardiovascular events (cardiovascular death, resuscitation, haemodynamically relevant ventricular arrhythmias, ICD shock, or HF hospitalisation). ST-segment changes >2 mm remained associated with MACE after adjustment (aRR 2.33; 95% CI 1.12-4.86; p=0.024). The 12-lead ECG may therefore serve as a simple discriminating test between RAS-HCM and s-HCM with additional prognostic value. ## Recidief linkerventrikel-trombus: 12% recidief — actieve/eerdere maligniteit verzesvoudigt het risico *2026-07-03 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/684?rss=1 · https://hartvaat.nl/2026/05/26/recidief-linkerventrikel-trombus-12-recidief-actieve-eerdere-maligniteit-verzesv/* Retrospective cohort of 346 patients with resolved left ventricular thrombus (LVT) at a tertiary centre (2011-2021; mean age 59.9 years, 86.4% male, median follow-up 4.4 years). LVT recurrence occurred in 11.8% (41/346) of all cases and 12.0% (23/192) after post-AMI LVT. In multivariable analysis with competing risks, active or previous malignancy was a strong predictor of recurrence — both overall (aSHR 5.59; 95% CI 2.02-15.5) and in post-AMI LVT (aSHR 13.9; 95% CI 4.05-47.7). Initial LVT characteristics also predicted recurrence: thrombus size (per cm; aSHR 1.42) and protrusion into the LV lumen (aSHR 5.46). LVT recurrence was associated with more composite outcomes (MI, ischaemic stroke, acute HF, mortality; aHR 3.04 overall; aHR 2.77 post-AMI). Active malignancy warrants extra screening and prevention strategy in patients with prior LVT. ## Routine huisarts-EMD voorspelt 5-jaars cardiovasculair risico betrouwbaar — Australische validatie bij 850.000 patiënten *2026-07-03 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/674?rss=1 · https://hartvaat.nl/2026/05/26/routine-huisarts-emd-voorspelt-5-jaars-cardiovasculair-risico-betrouwbaar-austra/* Study using routinely collected electronic medical records (EMRs) from 680 Australian general practices (Lumos programme, linked to hospital and death records) in 850,216 patients aged 30-74 years without prior CVD. Over a mean follow-up of 4.9 years, 33,578 cardiovascular events occurred. Sex-specific Cox models with 28 predictors achieved Harrell's C 0.803 (95% CI 0.801-0.804) in females and 0.772 (95% CI 0.770-0.773) in males; simpler LASSO models with 12-15 predictors performed similarly. Models were well calibrated across age, socioeconomic strata, and smoking status, with consistent discrimination across 10 regional Primary Health Networks. Net reclassification improvement up to 0.185 versus existing AusCVDRisk variables. EMR-based models are suitable for automated integration into primary-care software for real-time CVD risk assessment — an important scalability step for primary prevention. ## Asymptomatische matige/ernstige aortaklepinsufficiëntie níet benigne — meta-analyse pleit voor vroege interventie *2026-07-03 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/646?rss=1 · https://hartvaat.nl/2026/05/26/asymptomatische-matige-ernstige-aortaklepinsufficientie-niet-benigne-meta-analys/* Systematic review and meta-analysis of 27 cohort studies (4,720 patients; mean age 49 years; median follow-up 3.9 years) on the natural history of asymptomatic moderate or severe aortic regurgitation (AR). Pooled incidence per 100 person-years: all-cause mortality 1.75 (95% CI 1.27-2.41), cardiac death 1.29, sudden death 0.29, new symptoms 4.30, and aortic valve replacement/repair (AVR) 7.01. Asymptomatic LV dysfunction occurred at only 0.9 per 100 person-years. Mortality rates were more than double those of the general population irrespective of age — 2.45 per 100 person-years in cohorts ≥50 years versus 0.59 in younger cohorts. Early AVR was associated with lower mortality (pooled HR 0.33; 95% CI 0.30-0.37). The findings contradict the historical view of AR as a 'benign' valvular lesion and argue for earlier intervention guided by more sensitive markers of LV damage. ## AccuRhythm AI vermindert valse alarmen bij ILR met 62% — bespaart honderden klinische uren *2026-07-02 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/12/667?rss=1 · https://hartvaat.nl/2026/05/26/accurhythm-ai-vermindert-valse-alarmen-bij-ilr-met-62-bespaart-honderden-klinisc/* Multicenter retrospective study in 800 patients with an implantable loop recorder (Reveal LINQ or LINQ II) evaluating the cloud-based AI filtering algorithm AccuRhythm AI for false-positive alerts and clinical workload. AI filtering reduced false pause alerts by 62% and false AF alerts by 33%, saving 210 clinician hours over 6 months. At the patient level (n=465 Reveal LINQ users), the proportion of patients with ≥1 false-positive transmission fell from 55.5% to 15.1% (p<0.001), saving 1,128 hours. All residual false alerts occurred in patients with R-wave amplitudes <0.4 mV. AccuRhythm AI thus reduces workload without compromising diagnostic accuracy, with R-wave amplitude as the critical factor — underscoring the importance of optimal device implantation and signal quality. ## PFA-SHAM: pulsed field-ablatie verslaat sham-procedure overtuigend bij atriumfibrilleren — placebo-effect uitgesloten *2026-07-02 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.079484 · https://hartvaat.nl/2026/05/26/pfa-sham-pulsed-field-ablatie-verslaat-sham-procedure-overtuigend-bij-atriumfibr/* Prospective, sham-controlled, single-blind randomised trial in 60 patients with highly symptomatic atrial fibrillation (AFEQT score <50), assigned 1:1 to pulsed field ablation (PFA) or a sham procedure. All participants received implantable rhythm monitors for continuous rhythm monitoring. At 6 months: AF recurrence occurred in 6.7% (PFA) versus 83.3% (sham); posterior HR 19.6 (95% Bayesian credible interval 6.7-76.9; posterior superiority probability >0.99). Quality of life (AFEQT) improved +43.9 points with PFA versus +11.3 with sham (difference +32.6 points). AF burden was significantly lower with PFA (median 0% vs 0.43%). Anxiety/depression score (HADS) improved -4 points with PFA versus -0.5 with sham. This first sham-controlled PFA trial excludes a placebo effect and confirms PFA as robustly effective in symptomatic AF — both objectively (rhythm) and subjectively (quality of life, psychological distress). ## KP CHEMO: cumulatieve incidentie cancer-therapy-related cardiac dysfunction 8,4% — hoogste bij HER2-remmers *2026-07-02 · ESC heart failure · https://doi.org/10.1093/eschf/xvag113 · https://hartvaat.nl/2026/04/30/kp-chemo-cumulatieve-incidentie-cancer-therapy-related-cardiac-dysfunction-8-4-h/* Retrospective cohort study within Kaiser Permanente Northern California: 26,646 adults diagnosed with malignant tumours between 2012-2022 who received anthracyclines, HER2 inhibitors, immune checkpoint inhibitors (ICIs), or tyrosine kinase inhibitors (TKIs). Mean age 62 years, 64% women. Cancer therapy-related cardiac dysfunction (CTRCD) — defined as >10% LVEF decline to <53% or incident heart failure — occurred in 8.4% (95% CI 7.7-9.1) cumulative. Highest incidence with HER2 inhibitors (10.7%), lowest with ICIs (5.2%) (p<0.001). Nearly half of all events occurred within the first year. The cohort supports early risk prediction models and targeted cardiology surveillance during oncologic therapy to reduce downstream HF risk — a key message for cardio-oncology practice. ## 3D CT-fluoroscopie-fusie maakt LAAC efficiënter: minder contrast, minder straling, korte procedure *2026-07-01 · International journal of cardiology · https://doi.org/10.1016/j.ijcard.2026.134536 · https://hartvaat.nl/2026/08/15/3d-ct-fluoroscopie-fusie-maakt-laac-efficienter-minder-contrast-minder-straling-/* Retrospective comparative study of 109 consecutive patients undergoing left atrial appendage closure (LAAC) using 3D CT-fluoroscopy fusion (n=51) versus the Real-time Operation Guidance Planning System (ROGPS, n=58). The fusion group required significantly less contrast (60.2 vs 75.3 mL; p<0.001), shorter fluoroscopy time (8.0 vs 10.2 min; p=0.002), and shorter total procedure time (62.2 vs 68.5 min; p=0.005). Radiation dose (DAP) was also lower (29.8 vs 42.2 Gy·cm²; p=0.01). Procedural success was 100% in both groups. Device-related thrombosis and peridevice leak did not differ significantly. 3D CT-fluoroscopy fusion thus improves LAAC efficiency without compromising safety. ## DOAC's + COX-2-selectieve NSAID's geven 37% minder GI-bloedingen dan DOAC's + niet-selectieve NSAID's *2026-07-01 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2026.13941 · https://hartvaat.nl/2026/05/01/doac-s-cox-2-selectieve-nsaid-s-geven-37-minder-gi-bloedingen-dan-doac-s-niet-se/* Multinational cohort study (UK EHR + Quebec claims, 2011-2020) in 30,240 patients with nonvalvular atrial fibrillation initiating concomitant DOAC and NSAID (37,833 episodes; 45.2% COX-2-selective, 54.8% nonselective). Mean age 72.1 years, 56.7% male. Pooled weighted analysis with inverse-probability-of-treatment weighting showed that COX-2-selective NSAIDs combined with DOACs were associated with fewer gastrointestinal bleeds (HR 0.63; 95% CI 0.46-0.87; I²=56%) and fewer non-GI bleeds (HR 0.54; 95% CI 0.40-0.74; I²=0%) versus nonselective NSAIDs. The effect was stronger in women (HR 0.50 for GI bleeding) than in men (HR 0.85). No major effect modification by age, order of initiation, baseline bleeding risk, or specific DOAC. COX-2-selective NSAIDs thus retain their GI-protective benefit during DOAC therapy; future research should clarify the relationship with stroke risk. ## Congestie bij chronisch hartfalen: echografie vult klinisch onderzoek aan en voorspelt slechte prognose *2026-07-01 · ESC heart failure · https://doi.org/10.1093/eschf/xvag126 · https://hartvaat.nl/2026/05/04/congestie-bij-chronisch-hartfalen-echografie-vult-klinisch-onderzoek-aan-en-voor/* Study in 342 patients with chronic heart failure (CHF) during routine clinic visits. Clinical congestion (elevated JVP, pulmonary congestion, or peripheral oedema) was assessed unblinded versus ultrasonographic congestion (inferior vena cava diameter, jugular vein Valsalva/rest ratio, lung B-lines). eGFR was calculated with CKD-EPI 2021. eGFR distribution: <30 in 9%, 30-44 in 18%, 45-59 in 26%, >60 in 47%. Many patients — particularly with low eGFR — had both clinical and ultrasound congestion (51%, 30%, 39%, 25% per eGFR group). Isolated ultrasound congestion was also common (19-34%); isolated clinical congestion was rarer. Congestion, especially when both methods agreed, was associated with higher NT-proBNP and greater risk of HF hospitalisation or death (aHR 2.16; 95% CI 1.25-3.75; p=0.006 vs no congestion). The role of ultrasound congestion assessment in routine HF management warrants further study. ## Microbioom-vriendelijk dieet (DI-GM) geassocieerd met 27% minder hartfalen bij prediabetes (NHANES n=15.219) *2026-06-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag125 · https://hartvaat.nl/2026/05/04/microbioom-vriendelijk-dieet-di-gm-geassocieerd-met-27-minder-hartfalen-bij-pred/* Cross-sectional analysis of NHANES 2007-2018 data in 15,219 US adults with diabetes or prediabetes. The Dietary Index for Gut Microbiota (DI-GM) was calculated from two 24-hour dietary recalls covering 14 food groups linked to gut microbiota. Higher DI-GM scores were independently associated with lower heart failure risk (aOR 0.93 per point; 95% CI 0.89-0.98; p=0.005). Compared with scores 0-3, DI-GM ≥6 was associated with 27% lower HF risk (OR 0.73; 95% CI 0.58-0.92; p=0.007). The inverse association was stronger in prediabetes (OR 0.89 per point; p=0.004) but not significant in diabetes. Microbiota-related dietary patterns may thus play a role in HF prevention in metabolically vulnerable populations. ## Apicale myocardfibrose bij LVAD-implantatie voorspelt cardiale mortaliteit (single-center, n=47) *2026-06-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag135 · https://hartvaat.nl/2026/05/05/apicale-myocardfibrose-bij-lvad-implantatie-voorspelt-cardiale-mortaliteit-singl/* Single-centre retrospective cohort of 47 consecutive patients undergoing durable LVAD implantation (2019-2025; median age 63 years, 14.9% female). At implantation, tissue from the apical LV core was analysed by structured histopathology (THS-10 score) and digital morphometry (QuPath). Median follow-up 1,513 days; 27 deaths (16 cardiovascular, 11 non-cardiac). A threshold of 33.7% collagen-positive area gave the best discrimination for overall mortality (AUC 0.739). On univariable Cox analysis, fibrosis burden (HR 39.4) and THS-10 score (HR 1.51) were strongly associated with mortality. After adjustment for clinical severity (including INTERMACS profile), the all-cause-mortality association attenuated, but fibrosis burden independently predicted cardiac mortality (sHR ≈ 4.1; p=0.02). The cohort-derived threshold for cardiac death was 39.6% (AUC 0.752). The results support myocardial-substrate assessment in LVAD selection; external validation in larger cohorts is needed. ## CMR-LACI ≥21% identificeert hoogrisicopatiënten met HFrEF — onafhankelijk van LVEF en LGE *2026-06-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag130 · https://hartvaat.nl/2026/05/05/cmr-laci-21-identificeert-hoogrisicopatienten-met-hfref-onafhankelijk-van-lvef-e/* Analysis within the multicenter DERIVATE registry: 2,170 patients with LVEF <50% who underwent cardiac MRI (mean age 59.8 years, 24.7% women, median LVEF 31.6%). LACI (left atrioventricular coupling index) was calculated as the ratio of left atrial to left ventricular end-diastolic volume. Median LACI 19.4%. During a median follow-up of 1,016 days, all-cause mortality occurred in 8.8%, mortality/HF in 26.0%, and HF in 20.4%. After adjustment for clinical and CMR parameters (including LVEF and late gadolinium enhancement), each 5% increase in LACI was associated with greater all-cause mortality (HR 1.06), mortality/HF (HR 1.09), and HF (HR 1.09). The optimal cut-off for all-cause mortality was LACI ≥21% (AUC 0.617). LACI provides incremental prognostic information beyond LVEF and LGE in HFrEF. ## UK Biobank: na ischemisch CVA of TIA is het risico op hartfalen groter dan dat op hartinfarct *2026-06-29 · ESC heart failure · https://doi.org/10.1093/eschf/xvag123 · https://hartvaat.nl/2026/05/05/uk-biobank-na-ischemisch-cva-of-tia-is-het-risico-op-hartfalen-groter-dan-dat-op/* Prospective cohort study within UK Biobank (n=405,406, ages 40-69; 45.6% male). Patients with prior heart failure were excluded and stratified by history of ischaemic stroke/TIA. Over 13.7 years of follow-up, 15,565 incident HF events occurred. Stroke survivors had an unadjusted HR of 3.6 (95% CI 3.3-3.8) for HF hospitalisation and adjusted HR of 1.4 (95% CI 1.3-1.5). Notably, the risk of incident HF exceeded the risk of recurrent MI (12.6% vs 5.4%). Stroke survivors who developed HF had lower LVEF and higher LV mass on CMR. Incident HF in this group was associated with aHR 1.8 for mortality. The findings suggest stroke survivors are an underrecognised high-risk population for HF, predominantly with a low-EF phenotype — supporting future preventive HF trials in this group. ## Coronaire embolie bij atriumfibrilleren: hoog rest-trombo-embolisch risico ondanks antistolling *2026-06-29 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.045749 · https://hartvaat.nl/2026/05/05/coronaire-embolie-bij-atriumfibrilleren-hoog-rest-trombo-embolisch-risico-ondank/* Retrospective cohort study (China, 2014-2023, n=4,777 with acute myocardial infarction) in which coronary embolism (CE) was diagnosed via a 3-step validation process (Shibata criteria, angiographic core lab, final adjudication). Patients were grouped: CE with AF (n=78), non-CE AMI with AF (n=205), and non-CE AMI without AF (n=3,937), with propensity-score overlap weighting. CE accounted for 1.6% of all AMIs and 14.7-27.6% of AF-related AMIs. Compared with non-CE AMI without AF, CE+AF patients had significantly higher all-cause mortality (aHR 1.77; 95% CI 1.15-2.71) and ischaemic stroke (aHR 4.45; 95% CI 2.34-8.45), despite 79.2% receiving therapeutic anticoagulation. CE in AF is therefore an underrecognised high-risk phenotype with residual thromboembolic risk. The authors advocate multimodal imaging, embolism-targeted reperfusion, and optimisation of antithrombotic therapy including standard-dose DOACs. ## DAPA-HD: eerste gerandomiseerde studie naar dapagliflozin bij hemodialyse-patiënten — opzet en achtergrond *2026-06-29 · ESC heart failure · https://doi.org/10.1093/eschf/xvag104 · https://hartvaat.nl/2026/05/05/dapa-hd-eerste-gerandomiseerde-studie-naar-dapagliflozin-bij-hemodialyse-patient/* Design of the academic multicenter, double-blind, placebo-controlled DAPA-HD trial (NCT05179668) in 220 patients with kidney failure on maintenance haemodialysis. Background: SGLT2 inhibitors reduce cardiovascular events across a wide range of kidney function, but evidence is lacking for patients on haemodialysis. Stratified block randomisation by patient-reported residual urine volume. Primary outcome is change in left ventricular mass index (echocardiographic) at 6 months. A prespecified subgroup analysis compares patients with residual urine output >200 mL/24 h versus ≤200 mL/24 h. Secondary outcomes: additional echocardiographic parameters, biomarkers, quality of life, and clinical events. The first trial to specifically address the cardiovascular and haemodynamic effects of dapagliflozin in dialysis patients — will close an important evidence gap. ## Reduce-MFA DZHK25: trial naar antifibrotische therapie tegen myocardfibrose na TAVI — opzet en achtergrond *2026-06-28 · ESC heart failure · https://doi.org/10.1093/eschf/xvag083 · https://hartvaat.nl/2026/05/05/reduce-mfa-dzhk25-trial-naar-antifibrotische-therapie-tegen-myocardfibrose-na-ta/* Trial design of the German Reduce-MFA DZHK25 trial: prospective, multicenter, randomised, open-label study with blinded outcome assessment (PROBE design) in patients with severe aortic stenosis and high baseline myocardial fibrosis undergoing TAVI. Only patients with cardiac MRI ECV ≥25.9% (independent mortality predictor) are randomised to 3 arms: (i) standard care, (ii) + spironolactone, (iii) + spironolactone + low-dose dihydralazine (epigenetic reactivation of anti-fibrotic genes), for 12 months. Primary outcome is fibrosis regression by CMR-T1 mapping (ECV-derived LV matrix volume); secondary outcomes include reverse remodelling, KCCQ, 6MWT, NT-proBNP, NYHA class, mortality, and cardiac hospitalisations. Enrolment is complete with 384 screened and 153 randomised. Results may open a new adjuvant treatment route after TAVI for patients with high fibrotic burden. ## Wereldwijde HF-registry (28 landen): FEV1 is een onafhankelijke prognostische factor — pleidooi voor spirometrie *2026-06-28 · ESC heart failure · https://doi.org/10.1093/eschf/xvag128 · https://hartvaat.nl/2026/05/05/wereldwijde-hf-registry-28-landen-fev1-is-een-onafhankelijke-prognostische-facto/* Substudy within the Global Congestive Heart Failure registry, which collected clinical data and spirometry from 3,359 HF patients across 28 high-, middle-, and low-income countries (mean age 61.9 years, 66.4% male; median follow-up 3.8 years). Baseline FEV1 was converted to z-scores standardised for age, sex, and height. Lower FEV1 — even within the 'normal' range — was associated with greater HF burden, more cardiac structural/functional abnormalities, and lower quality of life. FEV1 z-score ≤-2 was independently associated with higher all-cause mortality (HR 2.20; 95% CI 1.61-3.01), CV mortality (HR 2.45), and all-cause hospitalisation (HR 1.40). The effect was comparable to other major HF prognostic factors and consistent across income levels, HF aetiology, HF type, and airflow obstruction. Spirometry therefore deserves a place in routine HF evaluation. ## Thuis-bio-impedantie voor hartfalen: haalbaar en acceptabel, klinische winst (nog) niet aangetoond *2026-06-28 · ESC heart failure · https://doi.org/10.1093/eschf/xvag106 · https://hartvaat.nl/2026/05/05/thuis-bio-impedantie-voor-hartfalen-haalbaar-en-acceptabel-klinische-winst-nog-n/* Multicenter open-label randomised feasibility trial (n=40) in heart failure patients on loop diuretics, randomised to standard care or a home bioelectrical impedance analysis (BIA) device with a paired app providing weekly diuretic guidance. BIA-measurement adherence was 82.5%, completion 100%, and acceptability high (4.21/5 usability, 3.90/5 acceptability). No significant differences in NT-proBNP or oedema index between groups. NYHA worsening occurred less often in the BIA group (10% vs 31.6%; p=0.095). Changes in oedema index correlated more strongly with NT-proBNP (r=0.54) than changes in body weight (r=0.24). No HF hospitalisations or deaths during follow-up. Home BIA monitoring with pre-emptive diuretic management is feasible and safe, but larger trials are needed to demonstrate clinical effect. ## EuroTR-register: co-existente linkszijdige kleplek verhoogt sterfte na transcatheter-tricuspidalis-edge-to-edge repair *2026-06-27 · ESC heart failure · https://doi.org/10.1093/eschf/xvag103 · https://hartvaat.nl/2026/05/05/eurotr-register-co-existente-linkszijdige-kleplek-verhoogt-sterfte-na-transcathe/* Analysis of the European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR) in 1,647 patients undergoing T-TEER. Concomitant left-sided valve disease (VHD) ≥mild was present in 95.8%, ≥moderate in 35.6%, and severe in 3.8%. ≥moderate VHD was associated with significantly lower 2-year survival (p<0.001) and HF-hospitalisation-free survival (p=0.005). Multivariable analysis confirmed ≥moderate VHD as an independent mortality predictor (HR 1.54; 95% CI 1.21-1.96; p<0.001). Despite worse baseline TR and NYHA in patients with ≥moderate VHD, T-TEER delivered significant TR reduction and symptomatic improvement in both groups. Conclusion: left-sided valvular disease should be weighed in the prognosis of T-TEER candidates, while symptomatic benefit is generally preserved. ## Mavacamten in de praktijk: zwarte patiënten krijgen 55% minder vaak toegang — atriumfibrilleren voorspelt slechtere uitkomst *2026-06-27 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.045994 · https://hartvaat.nl/2026/05/05/mavacamten-in-de-praktijk-zwarte-patienten-krijgen-55-minder-vaak-toegang-atrium/* Multicenter observational analysis on TriNetX data (2011-2023) in 15,145 patients with obstructive hypertrophic cardiomyopathy, of whom 509 (3.5%) received mavacamten. After propensity matching (502 mavacamten vs 1,475 weighted controls 1:3), access was sharply stratified: Black patients had 55% lower odds of receiving mavacamten than White patients (OR 0.45; 95% CI 0.33-0.63). Among mavacamten recipients, 4.8% had acute heart failure, 8.3% systolic dysfunction, 10.8% cardiovascular hospitalisation, 6.4% new-onset AF, and 1.4% died. Outcomes were largely similar to controls, except for higher incidence of systolic dysfunction with mavacamten (log-rank p<0.001). Patients with baseline AF (28%) had significantly worse outcomes within the mavacamten group: more acute heart failure (7.8% vs 3.6%), systolic dysfunction (12.8% vs 6.4%), CV hospitalisation (27.7% vs 4.2%), and mortality (5% vs 0%). The equity gap and elevated risk with pre-existing AF are important practice signals. ## Nederlandse huisartsenpost: 1 op 20 contacten voor benauwdheid betreft hartfalen — 6-maands sterfte 32% *2026-06-27 · ESC heart failure · https://doi.org/10.1093/eschf/xvag124 · https://hartvaat.nl/2026/05/05/nederlandse-huisartsenpost-1-op-20-contacten-voor-benauwdheid-betreft-hartfalen-/* Dutch observational study of out-of-hours primary care (OHS-PC) contacts for acute shortness of breath (Sep 2020-Aug 2021). Of 1,833 calls, 102 (5.1%) involved patients in whom heart failure was deemed the cause (mean age 79.6 years, 53% women). 10 (9.8%) were referred directly to the emergency department; of the remaining 92, 60.8% were assessed by home visit, 14.7% at the clinic, and 14.7% by telephone advice. Subsequently 44.6% were referred to the ED and 42.4% received loop diuretics at home (new or up-titrated). Of the 51 ED-referred patients, 82.4% were admitted. The 6-month all-cause mortality was 32.3%. The findings underscore that heart failure patients in out-of-hours primary care are a high-risk subgroup with substantial heterogeneity in care pathway — relevant for triage and long-term outcomes in primary-care acute services. ## EXPANDed: bij 73% verbetert tricuspidalisinsufficiëntie binnen 30 dagen na M-TEER — zonder directe TR-interventie *2026-06-26 · ESC heart failure · https://doi.org/10.1093/eschf/xvag108 · https://hartvaat.nl/2026/05/05/expanded-bij-73-verbetert-tricuspidalisinsufficientie-binnen-30-dagen-na-m-teer-/* Pooled analysis of the EXPAND and EXPAND G4 studies in 160 patients with mitral and tricuspid regurgitation who underwent mitral transcatheter edge-to-edge repair (M-TEER, MitraClip) and received NO direct TR intervention. Echo assessment was by independent core lab. At 30 days, 73% (n=116) improved to ≤moderate TR; 28% (n=44) remained ≥severe. The ≤moderate TR group had less atrial fibrillation (68% vs 89%, p=0.009), slightly lower LVEF (49% vs 56%, p=0.07), and larger LV dimensions (LVEDV 137.5 vs 107.9 mL, p=0.01). TR reduction persisted at 1 year in 86% of the ≤moderate group; 45% of the ≥severe group improved later. Significantly greater NYHA and KCCQ-OS improvements in the ≤moderate group. 1-year mortality was numerically lower with ≤moderate TR (12.4% vs 22.3%; HR 1.92; p=0.16). LV dilation and lower LVEF predicted TR improvement — relevant for selecting patients who may not need an additional TR procedure. ## Vericiguat en sGC-stimulatoren bij hartfalen: werkingsmechanisme en plaats na VICTORIA/VICTOR *2026-06-26 · ESC heart failure · https://doi.org/10.1093/eschf/xvag117 · https://hartvaat.nl/2026/05/05/vericiguat-en-sgc-stimulatoren-bij-hartfalen-werkingsmechanisme-en-plaats-na-vic/* Review in ESC HF on the pharmacological rationale for soluble guanylyl cyclase (sGC) stimulators in chronic heart failure. Intact NO-sGC-cGMP signalling is essential to cardiovascular homeostasis; its impairment is regarded as a key pathomechanism in HF. The review describes the molecular mode of action of NO-independent, haem-dependent sGC stimulators and discusses preclinical and clinical evidence for broad cardiovascular effects, as well as effects on other organs that contribute to clinical outcomes. The sGC stimulator vericiguat has a place — on top of standard therapy — in adults with symptomatic HFrEF after a recent worsening event; this recommendation rests on the phase 3 VICTORIA and VICTOR trials. Outstanding research questions around vericiguat and related drugs are outlined. ## CAR-T-therapie en cardiovasculaire uitkomsten in Duitsland en VS: ernstige events zeldzaam acuut, hoger op lange termijn bij pre-existente hartziekte *2026-06-26 · ESC heart failure · https://doi.org/10.1093/eschf/xvag132 · https://hartvaat.nl/2026/05/08/car-t-therapie-en-cardiovasculaire-uitkomsten-in-duitsland-en-vs-ernstige-events/* Analysis of two independent CAR-T cell therapy registries: 2,545 German patients (DESTATIS) and 1,335 US patients (TriNetX). Acutely severe cardiac events were relatively rare (51 and 20 cases respectively); 5% of German and 1.2% of US patients died shortly after CAR-T. Patients with pre-existing cardiac disease had no increased risk for immune-mediated complications (cytokine release syndrome OR 1.19; neurotoxicity OR 1.59) but higher long-term risk for major cardiovascular events (OR 1.89; 95% CI 1.23-2.91) and kidney failure (OR 2.98; 95% CI 1.85-4.81). The cumulative evidence underscores the need for risk-adapted follow-up and cardiological assessment in CAR-T patients with cardiac comorbidity. Interpretation is subject to potential under- and over-reporting in registries. ## UF-CARE-trial: ultrafiltratie bij type-2 cardiorenaal syndroom geen significante winst (kleine, onderpowered RCT) *2026-06-25 · ESC heart failure · https://doi.org/10.1093/eschf/xvag133 · https://hartvaat.nl/2026/05/09/uf-care-trial-ultrafiltratie-bij-type-2-cardiorenaal-syndroom-geen-significante-/* UF-CARE was a multicenter, open-label randomised trial in 15 French centres in adults with severe heart failure, persistent or recurrent congestion despite high-dose diuretics and guideline-directed therapy, and mild-to-severe CKD (type 2 cardiorenal syndrome). 46 of 108 screened patients were randomised: 24 control (optimal medical therapy alone) and 22 ultrafiltration (peritoneal dialysis, haemodialysis, or isolated ultrafiltration based on clinical judgment, patient preference, and availability). The composite primary outcome (mortality or unplanned HF hospitalisation within 12 months) occurred in 63% of the ultrafiltration group and 87% of controls (p=0.144), after a median follow-up of 262 days. Quality of life improved slightly more with ultrafiltration; one technique-related death occurred. Conclusion: in this underpowered cohort, adding ultrafiltration did not significantly improve outcomes; larger trials are needed. ## DECISION-trial: digoxine staken bij hartfalen leidt tot zevenvoudige stijging in HF-events binnen 6 weken *2026-06-25 · European heart journal · https://doi.org/10.1093/eurheartj/ehag385 · https://hartvaat.nl/2026/05/10/decision-trial-digoxine-staken-bij-hartfalen-leidt-tot-zevenvoudige-stijging-in-/* Prespecified analysis of the DECISION trial: 1,001 heart failure patients on contemporary guideline therapy were randomised to low-dose digoxin or placebo, with a median treatment of 36.5 months. At study end, 587 patients on active treatment (288 digoxin, 299 placebo) underwent blinded withdrawal with 6-week follow-up. During the 100 days before withdrawal, cardiovascular death/HF event rates were similar (5.7 vs 6.5 events per 100 patient-years). After withdrawal, the rate rose sharply in the digoxin arm but not in the placebo arm (42.8 vs 5.9 per 100 patient-years; time-by-treatment interaction p=0.036). 14 events occurred in the digoxin withdrawal arm (12 hospitalisations, 2 urgent HF visits) versus 2 in the placebo withdrawal arm (RR 7.37; 95% CI 1.56-34.88; p=0.012). Withdrawal was accompanied by higher heart rate, lower systolic BP, and rising NT-proBNP. Conclusion: caution is warranted when stopping long-standing digoxin in HF with (mildly) reduced ejection fraction. ## EMERGE LAA: Amulet-occluder in 12.180 patiënten — 96% succes, 1-jaars beroerte 1,6% (real-world register) *2026-06-25 · JACC. Cardiovascular interventions · https://doi.org/10.1016/j.jcin.2026.02.016 · https://hartvaat.nl/2026/05/11/emerge-laa-amulet-occluder-in-12-180-patienten-96-succes-1-jaars-beroerte-1-6-re/* Postapproval registry (EMERGE LAA) of the first 12,180 patients with attempted Amulet occluder implantation for left atrial appendage occlusion (LAAO) in nonvalvular atrial fibrillation, captured in the US NCDR LAAO Registry between August 2021 and December 2023. Implantation success was 96.0% — 88.9% in patients with prior failed LAAO attempt. Clinically relevant closure (peridevice leak ≤3 mm) at day 45 was 97.2%. The composite safety endpoint (death, ischaemic stroke, embolism, device-/procedure-related events) occurred in 0.9%. Major adverse events at day 45 decreased with operator experience (8.4% at <10 cases to 5.8% at ≥30; p<0.001). At 1 year: 1.6% all stroke, 6.3% major bleeding, 2.9% CV/unknown-cause death, 7.9% all-cause death. The real-world data confirm safety and effectiveness of the Amulet occluder and highlight the impact of the learning curve on procedural outcomes. ## Evolocumab effectief en veilig bij CKD stadium 3-4: -56% LDL zonder nierfunctiedaling *2026-06-24 · International journal of clinical pharmacology and therapeutics · https://doi.org/10.5414/CP204964 · https://hartvaat.nl/2026/05/11/evolocumab-effectief-en-veilig-bij-ckd-stadium-3-4-56-ldl-zonder-nierfunctiedali/* Single-centre retrospective study in 200 patients with chronic kidney disease stage 3-4 and hyperlipidaemia treated with evolocumab, with lipids, renal function, and liver enzymes assessed at baseline and 3, 6, and 12 months. After 12 months, LDL cholesterol fell significantly by 56.3 ± 10.5%, with similar reductions in stage 3 and stage 4. Non-HDL and total cholesterol also fell significantly; HDL and triglycerides did not change meaningfully. Renal function (eGFR, serum creatinine, urea) showed no significant deterioration, and no clinically relevant hepatic adverse events occurred. Baseline LDL and age predicted the magnitude of LDL reduction. Public transcriptomic data show that PCSK9 expression is largely liver-specific and minimal in renal tissue — a biological explanation for preserved kidney function. The results support evolocumab as a practical LDL-lowering option in CKD patients. ## Invasieve drukvolumelussen onthullen mechanisme van tricuspidalisinsufficiëntie bij HFrEF: RV-PA-ontkoppeling en sMR *2026-06-24 · ESC heart failure · https://doi.org/10.1093/eschf/xvag134 · https://hartvaat.nl/2026/05/11/invasieve-drukvolumelussen-onthullen-mechanisme-van-tricuspidalisinsufficientie-/* Retrospective study integrating right ventricular pressure-volume loops and Swan-Ganz catheter data with RV/LV imaging in 134 patients with heart failure with reduced ejection fraction (HFrEF). Independent predictors of moderate-to-severe ventricular tricuspid regurgitation (vTR2/3) were: (1) presence of secondary mitral regurgitation (sMR; aOR 1.67), (2) elevated pulsatile RV loads with lower PA compliance (aOR 0.43; AUC 0.82; threshold <2.24 ml/mmHg), largely driven by sMR2/3 (aOR 4.56), and (3) progressive uncoupling of RV elastance/contractility relative to pulmonary elastance (Ees/Ea aOR 0.024; AUC 0.84; threshold <0.6). This RV-PA uncoupling occurred across the entire afterload range and was associated with higher all-cause mortality. The work identifies sMR and RV-PA uncoupling as core drivers of vTR in HFrEF — relevant for determining which patients may benefit from mechanical TR reduction. ## Volwassenen met aangeboren hartafwijking hebben vergelijkbare overleving na hartinfarct als de algemene populatie *2026-06-24 · European heart journal · https://doi.org/10.1093/eurheartj/ehag216 · https://hartvaat.nl/2026/05/11/volwassenen-met-aangeboren-hartafwijking-hebben-vergelijkbare-overleving-na-hart/* Nationwide case-control study (2000-2022) of 214 adults with congenital heart disease (ACHD) and their first acute myocardial infarction, matched to 2,092 controls without ACHD on age, sex, hypertension, diabetes, hyperlipidaemia, and previous PCI/CABG. ACHD patients were younger at first infarction (58 vs 70 years). Over a mean follow-up of 6.5 (ACHD) and 7.3 years (controls), no difference emerged in mortality or recurrent MI at 1 year. At 10 years, mortality appeared higher in ACHD (HR 1.4; 95% CI 1.0-1.9) but lost significance after adjustment. The findings suggest ACHD patients have survival similar to the general population after MI. Since they share the same cardiovascular risk factors, healthy lifestyle and proactive risk management remain essential to prevent acquired heart disease in this growing population. ## Thoracoscopische AF-ablatie met bipolaire clamp: 5-jaars ritmevrijheid 52% met antiaritmica — multicenter register *2026-06-23 · European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · https://doi.org/10.1093/ejcts/ezag161 · https://hartvaat.nl/2026/05/11/thoracoscopische-af-ablatie-met-bipolaire-clamp-5-jaars-ritmevrijheid-52-met-ant/* Retrospective multicenter registry of 678 patients undergoing isolated or hybrid thoracoscopic atrial fibrillation (AF) ablation with a bipolar irrigated radiofrequency clamp (Gemini Clamp) between 2010 and 2023. Most had longstanding persistent AF (66.7%, mean AF duration 61 months), and 33.3% had prior catheter ablation. Freedom from atrial tachyarrhythmias (allowing class I/III antiarrhythmic use) was 82.3% at 1 year, 71.5% at 3 years, and 52.4% at 5 years. Without antiarrhythmics, this declined from 71.7% (year 1) to 44.2% (year 5), underscoring AF's progressive nature. Women presented with greater comorbidity and higher CHA2DS2-VA scores, but long-term rhythm outcomes did not differ by sex or by paroxysmal vs non-paroxysmal AF. Complication rates were low. Variability in arrhythmia-detection methods across centres may have affected outcomes. ## EHJ-overzicht: mechanische complicaties na hartinfarct — zeldzaam (<1%) maar acuut levensbedreigend *2026-06-23 · European heart journal · https://doi.org/10.1093/eurheartj/ehag164 · https://hartvaat.nl/2026/05/11/ehj-overzicht-mechanische-complicaties-na-hartinfarct-zeldzaam-1-maar-acuut-leve/* EHJ review of the three most serious mechanical complications after acute myocardial infarction: free-wall rupture, ventricular pseudoaneurysm, and papillary muscle rupture. With rapid revascularization, incidence has declined to <1% of infarctions, but severe haemodynamic compromise may already be present at admission, requiring immediate diagnosis and intervention. Until recently, surgical repair was the only option, with non-negligible in-hospital mortality, especially with acute circulatory collapse. Transcatheter percutaneous procedures now offer alternatives for high-risk or inoperable patients. Recurrences after repair markedly impact outcome and require careful monitoring. The role of concomitant revascularization remains controversial. Temporary mechanical circulatory support shows promise as 'bridge-to-procedure' or 'bridge-to-recovery'. Optimal management requires a multidisciplinary Heart Team — including a Shock Team — with palliative care integrated where appropriate. ## NHLBI-workshop: bloeddrukmeting verfijnen door de hele levensloop heen — knelpunten en kansen *2026-06-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2026.02.5124 · https://hartvaat.nl/2026/05/12/nhlbi-workshop-bloeddrukmeting-verfijnen-door-de-hele-levensloop-heen-knelpunten/* Report from a 2-day workshop convened by the US National Heart, Lung, and Blood Institute (NHLBI, December 2024) on the state of blood pressure assessment. Hypertension remains the principal modifiable cardiovascular risk factor, yet adequate characterisation of BP is challenging due to lifespan, comorbidity, and environmental influences. Uncertainty in BP measurement contributes to underdiagnosis, undertreatment, and preventable morbidity/mortality. Recent technological developments — home and ambulatory monitoring, wearables — enable richer BP characterisation that could dramatically improve hypertension management and cardiovascular risk reduction. The report summarises the latest evidence, identifies knowledge gaps, and sets research and practice priorities for advancing BP assessment. ## Evoque transcatheter-tricuspidalisklep mogelijk kosteneffectief bij ernstige TR — maar resultaten leunen sterk op extrapolatie *2026-06-22 · ESC heart failure · https://doi.org/10.1093/eschf/xvag137 · https://hartvaat.nl/2026/05/13/evoque-transcatheter-tricuspidalisklep-mogelijk-kosteneffectief-bij-ernstige-tr-/* Markov model from a French payer perspective on the cost-effectiveness of the Evoque transcatheter tricuspid valve replacement (TTVR) versus optimal medical therapy (OMT) in severe tricuspid regurgitation, based on TRISCEND II. Over a lifetime horizon, TTVR yielded 1.76 additional life-years and 1.63 additional QALYs at €39,382 incremental costs, giving an ICER of €22,327/life-year and €24,109/QALY — below the French threshold. However: when no mortality difference is assumed in the extrapolation, the ICER rises to €86,428/QALY (+258%). Results are highly sensitive to time horizon, utility, discount rate, and post-trial mortality extrapolation. Conclusion: Evoque-TTVR appears potentially cost-effective, but the long-term benefit is largely model-driven rather than empirically demonstrated — longer follow-up is needed. ## AI-Echo verslaat AI-ECG en klinische score voor diagnose cardiale amyloïdose (AUROC 0,93) *2026-06-22 · Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · https://doi.org/10.1016/j.echo.2026.05.007 · https://hartvaat.nl/2026/05/13/ai-echo-verslaat-ai-ecg-en-klinische-score-voor-diagnose-cardiale-amyloidose-aur/* Retrospective cohort study in 598 patients referred for cardiac scintigraphy for suspected transthyretin cardiac amyloidosis (ATTR-CA), comparing three risk models: the ATTR-CM clinical score, AI-ECG, and AI-Echo. Median age 76 years; 30% had confirmed ATTR-CA. AI-Echo performed best: AUROC 0.93 (95% CI 0.91-0.95) versus 0.79 for AI-ECG and 0.87 for the ATTR-CM score (p<0.001). Sensitivity/specificity were 86%/85% (AI-Echo), 80%/64% (AI-ECG), and 86%/69% (clinical score). At a threshold of 0.25, AI-Echo avoided the most unnecessary scintigraphies (45 per 100 referrals vs 24 for AI-ECG and 37 for ATTR-CM). AI-Echo appears the most valuable screening tool for ATTR-CA in high-risk populations and may prevent unnecessary nuclear imaging. ## MTMR4-modifier heeft tegenovergestelde invloed op aritmierisico bij LQT1 en LQT2 *2026-06-22 · European heart journal · https://doi.org/10.1093/eurheartj/ehag294 · https://hartvaat.nl/2026/05/13/mtmr4-modifier-heeft-tegenovergestelde-invloed-op-aritmierisico-bij-lqt1-en-lqt2/* Study in 1,192 long-QT syndrome (LQTS) patients (LQT1 n=638, LQT2 n=432, plus 122 Swedish carriers of the p.Y111C-LQT1 mutation), investigating the impact of MTMR4 modifier-gene variants on severe clinical outcomes (cardiac arrest or syncope on beta-blockers). In the LQT1 cohort, the percentage of cardiac events decreased significantly with increasing aa-genotype frequency (AA 15.9% → Aa 11.6% → aa 6.3%); in LQT2 the pattern was reversed (AA 16.5% → Aa 18.2% → aa 27.6%). In combined LQT1, aa was present in 15% of mild/asymptomatic vs 1.7% of severe cases (p=0.002); in LQT2, 24.1% vs 11.9% (p=0.014). QTc did not differ, but repolarization markers (Tpeak-Tend) supported the gene-specific directionality. The MTMR4 minor-allele homozygosity has a gene-specific, opposite impact on arrhythmic risk — relevant for risk stratification. ## VERISEC-register: vericiguat halveert hartfalen-decompensaties bij HFrEF in dagelijkse Spaanse praktijk *2026-06-21 · ESC heart failure · https://doi.org/10.1093/eschf/xvag138 · https://hartvaat.nl/2026/05/13/verisec-register-vericiguat-halveert-hartfalen-decompensaties-bij-hfref-in-dagel/* Prospective multicenter registry (VERISEC) of 835 consecutive patients with HFrEF after recent decompensation initiating vericiguat at 41 Spanish centres (mean age 71.3 years, 78.9% male). Baseline therapy was highly optimised: 91.5% SGLT2i, 90.7% beta-blockers, 85.4% RAAS inhibitors, 79.8% MRAs; quadruple therapy was 61.7-63.0% throughout follow-up. At 1 year, NT-proBNP fell from 3,532 to 2,292 pg/mL (p<0.001), LVEF rose from 30.3% to 35.4% (p<0.001), and NYHA class improved. HF decompensations requiring IV diuretics halved (1.34 → 0.65/year); non-HF cardiovascular hospitalisations fell from 0.98 to 0.39/year. Vericiguat was discontinued in 13.4%, mostly for symptomatic hypotension (49.4%); higher baseline NT-proBNP predicted discontinuation (OR 1.06 per 1,000 pg/mL). The real-world data confirm clinical utility and safety of vericiguat on top of quadruple therapy. ## Hypothese: falen van het RAAS verklaart inappropriate vasodilatatie bij cardiogene shock *2026-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehag292 · https://hartvaat.nl/2026/05/13/hypothese-falen-van-het-raas-verklaart-inappropriate-vasodilatatie-bij-cardiogen/* Conceptual paper in EHJ on an underappreciated aspect of cardiogenic shock (CS): a subgroup of patients — without concurrent sepsis — develop a mixed shock phenotype with unexpected vasodilation on top of the primary myocardial failure, which portends a worse prognosis. The authors propose that failure of the renin-angiotensin-aldosterone system (RAAS), analogous to recent findings in septic shock, plays a key role: through defective angiotensin II generation, enhanced peptide degradation, and/or receptor unavailability, angiotensin II signalling at the AT1 receptor becomes impaired. Recognising RAAS failure in CS could justify new therapeutic strategies to restore vascular tone and improve outcomes in mixed cardiogenic-vasodilatory shock. ## AASI is geen betrouwbare maat voor arteriële stijfheid bij kinderen met risico op secundaire hypertensie *2026-06-21 · European journal of pediatrics · https://doi.org/10.1007/s00431-026-07057-4 · https://hartvaat.nl/2026/05/13/aasi-is-geen-betrouwbare-maat-voor-arteriele-stijfheid-bij-kinderen-met-risico-o/* Cross-sectional study in 75 children and adolescents (8-18 years, mean 12.3; 34 girls) at risk of secondary hypertension: vascular remodeling context (preterm birth n=44, CKD n=7) or hyperkinetic causes (congenital central hypoventilation syndrome n=14, psychostimulant treatment n=10). Alongside 24-hour ambulatory BP monitoring (ABPM), arterial stiffness was measured by several methods: carotid-femoral and heart-finger pulse wave velocity, augmentation index (AIx75), and systemic arterial stiffness via pulse-contour analysis. AASI correlated with none of the direct stiffness measures, only with systolic and diastolic nocturnal BP dipping. In ABPM-hypertensive children (20%), cf-PWV was elevated (5.64 vs 4.92 m/s) but AASI was not. Conclusion: AASI does not reflect true arterial stiffness in children and should not be used as such. ## SPRINT + ACCORD gepoold: bloeddrukvariabiliteit is even prognostisch als gemiddelde bloeddruk — J-vormige curve *2026-06-20 · European heart journal · https://doi.org/10.1093/eurheartj/ehag330 · https://hartvaat.nl/2026/05/14/sprint-accord-gepoold-bloeddrukvariabiliteit-is-even-prognostisch-als-gemiddelde/* Pooled individual-patient analysis of SPRINT and ACCORD in 18,415 participants (median 12 BP measurements, 3.6-year follow-up), in which visit-to-visit blood pressure variability (BPV) from month 3 onward was assessed using multiple metrics (including variation-independent-of-mean, VIM). 1,244 participants (6.8%) experienced a major cardiovascular event. After multivariable adjustment, higher SBP-VIM (highest vs lowest tertile) was associated with greater MCE risk (HR 1.15; 95% CI 1.00-1.32), particularly myocardial infarction and cardiovascular death. Restricted cubic spline analyses revealed a J-shaped relationship: both low and high BPV appear harmful. The prognostic value of SBP-VIM was comparable to mean systolic BP. The findings underscore the importance of defining optimal BPV targets and interventions that modulate BPV. ## Mendeliaanse randomisatie: HMGCR-remming verhoogt diabetesrisico, andere lipidendoelen niet *2026-06-20 · Cardiovascular diabetology · https://doi.org/10.1186/s12933-026-03209-w · https://hartvaat.nl/2026/05/14/mendeliaanse-randomisatie-hmgcr-remming-verhoogt-diabetesrisico-andere-lipidendo/* Cis-Mendelian randomisation study using individual-level data from UK Biobank, Lifelines, and publicly available GWAS sources, examining 13 lipid-related drug targets (including ACLY, ANGPTL3/4, APOB, APOC3, CETP, HMGCR, LDLR, LIPG, LPA, MTTP, NPC1L1, and PCSK9). Lipid modification via HMGCR (statins) was predicted to reduce CAD risk but increase type 2 diabetes risk — a known statin side-effect. Modification via APOC3, LDLR, LPA, MTTP, NPC1L1, and PCSK9 reduced CAD risk without changing T2D risk. ANGPTL4 and CETP reduced risk of both CAD and T2D. For ACLY, ANGPTL3, APOB, and LIPG, no genetic evidence was found for either CAD or T2D effects. The findings suggest substantial variation in diabetes risk between lipid-lowering classes and may guide future drug development and individual therapy decisions. ## Lipidegerelateerd CV-risico voorbij LDL: focus verschuift naar remnant-cholesterol en Lp(a) *2026-06-20 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-326404 · https://hartvaat.nl/2026/05/14/lipidegerelateerd-cv-risico-voorbij-ldl-focus-verschuift-naar-remnant-cholestero/* Heart review of lipid-related cardiovascular risk beyond LDL cholesterol. While LDL lowering has been the dominant target for decades, mechanistic, observational, and genetic studies support a causal role for remnant particles and lipoprotein(a) in ASCVD development. Multiple new drugs targeting these are now in development with RCT results expected. Lipoprotein(a) is largely genetically determined; remnant cholesterol correlates strongly with overeating, obesity, and diabetes. The global obesity epidemic is driving an increase in metabolic dyslipidaemias and related ASCVD risk. The era of LDL-only risk management is over — targeted approaches to metabolically dysregulated and genetically driven lipid fractions are becoming increasingly important. ## Aspirine voor primaire preventie bij verhoogd Lp(a) of LPA-varianten levert geen significante winst op *2026-06-19 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag207 · https://hartvaat.nl/2026/05/15/aspirine-voor-primaire-preventie-bij-verhoogd-lp-a-of-lpa-varianten-levert-geen-/* Systematic review and meta-analysis of 6 studies (total 6,628 participants) on aspirin for primary prevention in adults without ASCVD with elevated lipoprotein(a) (≥50 mg/dL), high-risk LPA genotypes, or elevated genetic risk scores. Pooled analysis showed no significant reduction in major adverse cardiovascular events (HR 0.60; 95% CI 0.31-1.17; p=0.10) and no significant increase in clinical bleeding (HR 1.24; p=0.18). Subgroup analyses showed a non-significant reduction with elevated Lp(a) (HR 0.63) and a statistically significant reduction in LPA rs3798220 carriers (HR 0.37; 95% CI 0.19-0.71), but the latter was inconsistent on sensitivity analysis and likely reflects small-sample bias. The evidence does not support routine aspirin in asymptomatic adults with high Lp(a) or risk-LPA variants. ## EAPCI/EBC-consensus: intracoronaire beeldvorming als standaard bij PCI van hoofdstam *2026-06-19 · European heart journal · https://doi.org/10.1093/eurheartj/ehag353 · https://hartvaat.nl/2026/05/15/eapci-ebc-consensus-intracoronaire-beeldvorming-als-standaard-bij-pci-van-hoofds/* Joint clinical consensus statement from EAPCI and the European Bifurcation Club (EBC) on intracoronary imaging for left main percutaneous coronary intervention. The document underpins recent American and European guideline recommendations to use intravascular ultrasound (IVUS) or optical coherence tomography (OCT) for planning, guidance, and optimisation of left main bifurcation PCI in both chronic and acute coronary syndromes. The authors emphasise that benefit will only be realised when the interventional community routinely deploys intracoronary imaging for these complex high-risk lesions. The document provides practical guidance to maximise the benefit of IVUS and OCT in left main bifurcation disease. ## Laroprovstat: eerste orale PCSK9-remmer haalt -80% LDL-reductie in combinatie met rosuvastatine (fase 1) *2026-06-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.075973 · https://hartvaat.nl/2026/05/15/laroprovstat-eerste-orale-pcsk9-remmer-haalt-80-ldl-reductie-in-combinatie-met-r/* Phase 1 randomised, single-blind, placebo-controlled trial of laroprovstat (AZD0780), the first oral small-molecule PCSK9 inhibitor. Unlike injectable PCSK9 antibodies, laroprovstat does not block the PCSK9-LDLR interaction but stabilises the PCSK9 C-terminal domain, preventing lysosomal degradation of the LDL receptor. In healthy participants with LDL-C ≥70 and ≤190 mg/dL, pharmacokinetics were dose-proportional and suitable for once-daily dosing (half-life ~40 hours), with no food interaction. After a 3-week run-in with rosuvastatin 20 mg, laroprovstat 1 mg reduced LDL by 29% and 30 mg by 51% versus baseline. Combined rosuvastatin + laroprovstat resulted in total LDL reductions of ~70% and ~80%. Safety was favourable with no concerning signals. The results support further development as the first oral PCSK9 inhibitor. ## Non-invasieve veneuze return/cardiac output-mismatch onthult 'gebufferde' staat vóór klinische hartfalen-decompensatie *2026-06-18 · ESC heart failure · https://doi.org/10.1093/eschf/xvag139 · https://hartvaat.nl/2026/05/15/non-invasieve-veneuze-return-cardiac-output-mismatch-onthult-gebufferde-staat-vo/* Study in 193 patients with chronic heart failure, hypertensive heart disease, or acute heart failure (AHF) using noninvasive estimation of mean circulatory filling pressure (via IVC diameter indexed to BSA) and right atrial pressure (via extracellular-to-total-body-water ratio). The calculated venous return / cardiac output (VR-CO) mismatch showed a bimodal pattern with two Gaussian components (means 2.25 and 5.25). All overt AHF cases fell within the higher-mismatch cluster. Intermediate states with increasing mismatch but preserved forward flow were interpreted as buffered states; a subgroup with marked mismatch but no clinical congestion represents a 'highly buffered pre-decompensated state'. AHF can thus be viewed as a failure of circulatory compensation, and this VR-CO framework may aid earlier detection and risk stratification. ## Langetermijnoverleving na ICD-implantatie verschilt sterk per cardiomyopathie: pleit voor etiologie-gestuurde selectie *2026-06-18 · International journal of cardiology · https://doi.org/10.1016/j.ijcard.2026.134561 · https://hartvaat.nl/2026/05/17/langetermijnoverleving-na-icd-implantatie-verschilt-sterk-per-cardiomyopathie-pl/* Retrospective cohort study of 1,091 adults who underwent ICD implantation at the regional referral centre in Asturias, Spain, between 2015 and 2024 (82.1% male, mean age 63 years, mean LVEF 38%). 75.6% received the ICD for primary prevention. Patients were classified by underlying cardiomyopathy: ischaemic (ICM, n=588), non-ischaemic dilated (NI-DCM, n=332), or other arrhythmogenic conditions (ACC, n=171; including HCM). Observed survival was compared with expected survival from age- and sex-matched national life tables. ICM patients had the worst prognosis with excess mortality versus the general population, NI-DCM had intermediate outcomes, and ACC closely matched expected population survival. Findings support an aetiology-informed approach to risk stratification and ICD selection, beyond a purely LVEF-driven strategy. ## Naar precisiecardiologie na het hartinfarct: opkomende biomarkers voor risicostratificatie *2026-06-18 · European heart journal. Quality of care & clinical outcomes · https://doi.org/10.1093/ehjqcco/qcag086 · https://hartvaat.nl/2026/05/18/naar-precisiecardiologie-na-het-hartinfarct-opkomende-biomarkers-voor-risicostra/* EHJ Quality of Care review of biomarkers for prognosis after myocardial infarction (MI). Despite significant advances in acute MI care, long-term prediction and risk stratification remain challenging. Cardiac troponins and natriuretic peptides remain standard for diagnosis and initial risk evaluation. Emerging biomarkers — galectin-3, lipoprotein(a), receptor for advanced glycation end-products (RAGE), and non-coding RNAs — are associated with higher mortality and major adverse cardiovascular events. Further exploration of their biological roles may yield new therapeutic targets. Combined with omics, imaging modalities, and digital monitoring, refined phenotypic characterisation enables personalised post-MI management. ## Global HICC-register: 950+ HoFH-patiënten uit 45 landen — slechts 4% haalt LDL-doelen, mediane sterfteleeftijd 37 jaar *2026-06-17 · European heart journal · https://doi.org/10.1093/eurheartj/ehag357 · https://hartvaat.nl/2026/05/18/global-hicc-register-950-hofh-patienten-uit-45-landen-slechts-4-haalt-ldl-doelen/* Data from the Global HoFH International Clinical Collaborators (HICC) registry, which has now included over 950 patients with homozygous familial hypercholesterolaemia (HoFH) from 45 countries. HoFH is characterised by extremely elevated LDL cholesterol from birth and very high risk of premature atherosclerotic CVD. Median age at diagnosis was 12 years (IQR 5.5-27.0), with untreated LDL cholesterol at median 14.7 mmol/L. At diagnosis 9% already had ASCVD or (supra)aortic valve disease; despite widespread lipid-lowering therapy, only 4% reached guideline LDL goals. Early initiation of lipoprotein apheresis was associated with greater LDL reductions and delayed ASCVD onset. Median age at death is just 37 years [20-50]. No sex differences emerged at diagnosis or in treatment, and the usual sex gap in CVD onset is absent. Global disparities in genetic screening and access to therapy are profound, with earlier events in low-income countries. ## HELIOS-B post-hoc: vutrisiran effectief bij Oost-Aziatische ATTR-CM-patiënten (HR 0,20 voor mortaliteit/CV-events) *2026-06-17 · JACC. Asia · https://doi.org/10.1016/j.jacasi.2026.03.031 · https://hartvaat.nl/2026/05/18/helios-b-post-hoc-vutrisiran-effectief-bij-oost-aziatische-attr-cm-patienten-hr-/* Post-hoc analysis of 32 East Asian participants (Japan and South Korea) from the phase 3 HELIOS-B trial of vutrisiran in transthyretin amyloidosis cardiomyopathy (ATTR-CM), randomised to vutrisiran (n=17) or placebo (n=15). Baseline tafamidis use was lower than in the overall population. Vutrisiran reduced the composite primary endpoint of all-cause mortality and recurrent cardiovascular events (HR 0.20; 95% CI 0.04-0.93). Attenuated declines in 6-minute walk distance and KCCQ-OS scores were observed, and a greater proportion maintained or improved NYHA functional class. NT-proBNP and troponin I increases were smaller with vutrisiran. Similar trends were seen in patients not on baseline tafamidis. Safety matched the overall population. Vutrisiran is thus effective and safe in East Asian ATTR-CM patients. ## FinACAF (n=229.565): hartfalen verhoogt CVA-risico bij AF vooral bij jongere patiënten *2026-06-17 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.047961 · https://hartvaat.nl/2026/05/19/finacaf-n-229-565-hartfalen-verhoogt-cva-risico-bij-af-vooral-bij-jongere-patien/* Nationwide Finnish retrospective cohort study (FinACAF) of 229,565 patients with new-onset atrial fibrillation (AF) between 2007 and 2018. Prevalence of heart failure was much higher in older than younger patients (38.7% vs 4.3%). The relative association between heart failure and ischaemic stroke was age-dependent: in patients <60 years the incidence rate ratio was ≥2.0, falling to ≈1.0 in the oldest group (p<0.001 for interaction). The adjusted absolute event-rate difference remained stable at ≈1 event per 100 patient-years across all age categories. The findings argue for extra weight on heart failure when deciding on oral anticoagulation in younger AF patients — co-existing HF is prognostically more important in this group than in older patients. ## Clopidogrel versus aspirine bij chronisch coronair syndroom: meta-analyse toont winst — maar vooral bij Oost-Aziaten *2026-06-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehag351 · https://hartvaat.nl/2026/05/19/clopidogrel-versus-aspirine-bij-chronisch-coronair-syndroom-meta-analyse-toont-w/* Systematic review and meta-analysis of 7 randomised trials (30,165 patients; 75.1% East Asian, median follow-up 36 months) comparing clopidogrel versus aspirin for secondary prevention in chronic coronary syndrome. Overall, clopidogrel reduced the composite MACE (IRR 0.83; 95% CI 0.69-0.99) and net adverse clinical events (IRR 0.83), with no difference in major bleeding, myocardial infarction, or mortality. However, there was a significant ethnicity interaction: in East Asians, clopidogrel clearly reduced MACE (IRR 0.76; 95% CI 0.59-0.98), while in non-East Asians it did not (IRR 1.00; Pint=0.010), with similar interaction for mortality (Pint=0.014). Evidence favouring clopidogrel over aspirin in chronic coronary syndrome is therefore robust in East Asian populations; further research is needed before generalising to other ethnic groups. ## Gezond eetpatroon verlaagt CV-risico bij kankeroverlevenden — los van genetisch risico (UK Biobank, n=10.414) *2026-06-16 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.048476 · https://hartvaat.nl/2026/05/19/gezond-eetpatroon-verlaagt-cv-risico-bij-kankeroverlevenden-los-van-genetisch-ri/* Prospective cohort study in UK Biobank of 10,414 cancer survivors free of prior CVD who had completed ≥2 dietary recalls (mean age 59.5 years, 37% men). Over a median follow-up of 13.1 years, 1,331 incident CV events occurred. Higher adherence to four healthy dietary patterns reduced CV risk (highest vs lowest tertile): alternate Mediterranean diet HR 0.83, Alternative Healthy Eating Index 2010 HR 0.76, Dietary Approaches to Stop Hypertension HR 0.82, EAT-Lancet HR 0.85. Effects were consistent for ischaemic heart disease (HR 0.77-0.85); AHEI-2010, DASH, and EAT-Lancet also reduced heart failure risk (HR 0.74-0.88); AHEI-2010 and EAT-Lancet also reduced stroke risk. There was no interaction with genetic CVD risk. Healthy eating thus benefits cancer survivors regardless of genetic predisposition — a growing high-risk population. ## ELDERCARE-AF post-hoc: edoxaban-spiegel én PT >13s voorspellen bloedingsrisico bij zeer oude AF-patiënten *2026-06-16 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.042950 · https://hartvaat.nl/2026/05/19/eldercare-af-post-hoc-edoxaban-spiegel-en-pt-13s-voorspellen-bloedingsrisico-bij/* Post-hoc analysis of the randomised double-blind ELDERCARE-AF trial (Japanese patients ≥80 years with atrial fibrillation and high bleeding risk), in which 427 patients received edoxaban 15 mg/day or placebo. After 8 weeks, trough edoxaban concentration (E-trough) and prothrombin time (PT) were measured. Older age, lower body weight, lower creatinine clearance, and congestive heart failure were independent predictors of higher E-trough. Higher E-trough was associated with more major bleeding (0.8%, 1.9%, 3.4%, 4.7% per year across quartiles; p=0.04). E-trough correlated strongly with PT (r=0.43; p<0.0001). At PT >13 seconds, significantly more major bleeding occurred (4.61% vs 0.98%/year; p=0.006). PT may thus serve as a simple bedside marker to identify bleeding risk in very old edoxaban patients. ## SGLT2-remmers bij oudere patiënten opgenomen voor HFrEF: -24% sterfte en -16% heropname bij start vóór ontslag *2026-06-15 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.126.049161 · https://hartvaat.nl/2026/05/19/sglt2-remmers-bij-oudere-patienten-opgenomen-voor-hfref-24-sterfte-en-16-heropna/* Analysis of Medicare data from Get with the Guidelines-Heart Failure: 8,847 patients aged ≥65 years hospitalised for HFrEF between July 2021 and June 2023, eligible for SGLT2 inhibitors but not yet receiving them (median age 77 years, 40% women, median LVEF 28%). 16.5% (n=1,464) initiated an SGLT2 inhibitor at discharge. After overlap weighting via propensity score, SGLT2i initiation was independently associated with lower 12-month all-cause mortality (aHR 0.76; 95% CI 0.67-0.86), all-cause readmission (aHR 0.89), and HF readmission (aHR 0.84). Findings were consistent across age, sex, race/ethnicity, diabetes status, CKD status, and LVEF. Early in-hospital initiation of SGLT2 inhibitors thus improves prognosis in older HFrEF patients in routine practice — a population previously underrepresented in RCTs. ## SGLT2-remmers head-to-head: empagliflozin licht beter dan canagliflozin bij matig CV-risico (target trial van 137.232 patiënten) *2026-06-15 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.046238 · https://hartvaat.nl/2026/05/19/sglt2-remmers-head-to-head-empagliflozin-licht-beter-dan-canagliflozin-bij-matig/* Target trial emulation on US claims data (commercial + Medicare) of adults with type 2 diabetes and moderate cardiovascular risk who started canagliflozin (n=42,877), dapagliflozin (n=17,871), or empagliflozin (n=7,648) between 2015 and 2020. In the weighted cohort (n=137,232; mean age 65.7 years, 81.9% on metformin), MACE risk was slightly lower with empagliflozin versus canagliflozin (HR 0.92; 95% CI 0.87-0.97), driven by reduced all-cause mortality (HR 0.86). Empagliflozin versus dapagliflozin and dapagliflozin versus canagliflozin did not differ. No differences in hyperglycaemic or hypoglycaemic crises between the three drugs. The three most commonly used SGLT2 inhibitors show comparable cardiovascular effectiveness; clinicians and health systems should prioritise enhancing access to this class rather than drug selection. ## Tirzepatide bij HFpEF + obesitas: niet kosteneffectief en niet betaalbaar tegen huidige prijs in Duitsland *2026-06-15 · International journal of cardiology · https://doi.org/10.1016/j.ijcard.2026.134560 · https://hartvaat.nl/2026/05/19/tirzepatide-bij-hfpef-obesitas-niet-kosteneffectief-en-niet-betaalbaar-tegen-hui/* Markov model of tirzepatide versus placebo (both on top of standard care) in the SUMMIT population (HFpEF + obesity) from the German payer perspective, with monthly cycles over 5 years and four KCCQ-defined health states plus death. Discounted per-patient costs: €5,827 (placebo) versus €31,052 (tirzepatide), with QALYs of 3.539 versus 3.638. Tirzepatide yielded 0.100 additional QALYs at incremental costs of €25,225, ICER €252,611/QALY — far above the €100,000/QALY threshold. Five-year budget impact: €1.9-6.2 billion under SUMMIT criteria and €3.8-12.6 billion under broad eligibility, depending on uptake (30/50/100%). Substantial price reduction would be needed for tirzepatide to be both cost-effective and affordable at population scale. ## Vertraagde intracraniële bloeding na trombectomie geassocieerd met slechtere functionele uitkomst en SBP >150 mmHg *2026-06-14 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.048272 · https://hartvaat.nl/2026/05/19/vertraagde-intracraniele-bloeding-na-trombectomie-geassocieerd-met-slechtere-fun/* Retrospective study of 268 patients undergoing endovascular thrombectomy, with dual-energy CT immediately post-procedure and follow-up imaging. Early intracranial haemorrhage (ICH) occurred in 11.9%, delayed ICH in 36.9%, and no ICH in 51.1%. Delayed ICH was associated with lower 90-day functional independence (mRS 0-2; aOR 0.49; 95% CI 0.25-0.94), without elevated mortality. Within delayed ICH, haemorrhagic infarction was mainly associated with functional dependence, while parenchymal haematoma was also linked to death. Higher postprocedural systolic blood pressure predicted delayed ICH, with thresholds at mean >150 mm Hg and peak >166 mm Hg. Optimised BP management may help prevent delayed ICH. ## Team-gebaseerde telehealth-bloeddrukbehandeling acceptabel en haalbaar in achterstandsklinieken — mixed-methods evaluatie *2026-06-14 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.047236 · https://hartvaat.nl/2026/05/19/team-gebaseerde-telehealth-bloeddrukbehandeling-acceptabel-en-haalbaar-in-achter/* Implementation evaluation of a team-based telehealth blood pressure management program using home BP monitoring, self-management, and social support in underserved patient populations. Mixed-methods approach with 20 patients and 16 clinic staff from 2 safety-net clinics in North Carolina, framed by EPIS and Health Equity Implementation Frameworks. Five themes emerged: (1) staffing barriers and coordinated teamwork with user-friendly tools, (2) patient- and provider-centred approach, (3) ease of home BP monitoring, (4) personalised self-management calls, (5) social support. Both patients and clinic staff rated the program highly on acceptability (4.42/5), appropriateness (4.42/5), and feasibility (4.40/5). Successful implementation depends on tailoring, trust-building, and financial sustainability. ## EHJ-review: dyslipidemie bij kankerpatiënten — verhoogd ASCVD-risico, beperkte data, behoefte aan kankerspecifieke risicoscores *2026-06-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehag265 · https://hartvaat.nl/2026/05/19/ehj-review-dyslipidemie-bij-kankerpatienten-verhoogd-ascvd-risico-beperkte-data-/* EHJ review of the challenges of dyslipidaemia in cancer patients and survivors. As cancer survival improves, more patients face cardiovascular complications: both dyslipidaemia and cancer therapy elevate atherosclerotic CVD risk. Most ASCVD risk scores do not incorporate cancer factors and underestimate true risk. Some cancer therapies cause transient elevations in LDL, triglycerides, or HDL reductions, sometimes to extreme levels. Lipid-lowering therapy: reliable data exist for statins and ezetimibe (LDL) and fibrates and omega-3 (hypertriglyceridaemia); newer agents (PCSK9 inhibitors, inclisiran, bempedoic acid) are insufficiently studied in this population. Initiation requires integration of ASCVD risk, drug-drug interactions, side-effects, and prognosis. Statins as cardioprotection in anthracycline therapy opens an additional research avenue. ## Peulvruchten in de voeding verlagen LDL en non-HDL: dose-response meta-analyse van 38 RCT's *2026-06-13 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.046659 · https://hartvaat.nl/2026/05/19/peulvruchten-in-de-voeding-verlagen-ldl-en-non-hdl-dose-response-meta-analyse-va/* Systematic review and dose-response meta-analysis of 38 randomised trials (52 comparisons, n=2,095) on the effect of whole dietary pulses on lipid targets. Median duration 6 weeks, median dose 130 g/day (0.5-0.67 cup). Pulses reduced LDL cholesterol by -0.14 mmol/L (95% CI -0.19 to -0.08), non-HDL cholesterol by -0.22 mmol/L, apoB by -0.08 g/L, and HDL by -0.03 mmol/L (the last clinically trivial). No effect on other lipids. Results were consistent across pulse types. For beans, a linear inverse relationship was demonstrated up to 1 cup/day for LDL (-0.25 mmol/L per 0.5 cup) and non-HDL (-0.45 mmol/L per 0.5 cup). GRADE certainty was moderate-to-high for most outcomes. Effects are small-to-moderate but clinically meaningful, supporting dietary guidelines on pulses as a lipid-lowering strategy. ## CLEAR Taiwan: bempedoïnezuur verlaagt LDL met 19% in real-world Aziatische populatie *2026-06-13 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.126.049917 · https://hartvaat.nl/2026/05/19/clear-taiwan-bempedoinezuur-verlaagt-ldl-met-19-in-real-world-aziatische-populat/* Pragmatic phase 4 study in 180 Taiwanese patients with inadequately controlled hypercholesterolaemia who received bempedoic acid for 12 weeks added to their existing lipid-lowering therapy. Of 180 patients, 88.9% (n=160) completed the study. Median LDL reduction from baseline was -19% (IQR -36.4 to -3.6), with a decrease from 117.5 to 92 mg/dL (p<0.01). Other parameters also fell: non-HDL cholesterol -13.3%, total cholesterol -10.8%, apolipoprotein B -11.5%, and hs-CRP -34.0% (all p<0.01). Effects on triglycerides, HDL and Lp(a) were minimal. At week 12, 31.3% met the LDL target. Safety profile matched the Taiwanese label, with no new signals. Bempedoic acid offers an effective and safe oral add-on for patients who do not reach LDL targets on statins alone. ## ESC Atlas 2025: 3 miljoen CVD-doden per jaar in Europa — middeninkomenlanden hebben dubbele sterfte *2026-06-13 · European heart journal · https://doi.org/10.1093/eurheartj/ehag345 · https://hartvaat.nl/2026/05/19/esc-atlas-2025-3-miljoen-cvd-doden-per-jaar-in-europa-middeninkomenlanden-hebben/* Fifth biennial ESC Atlas report presenting cardiovascular disease statistics from more than 50 ESC member countries for 2024. CVD causes over 3 million deaths and 68 million disability-adjusted life years annually in the region, remaining the leading cause of death. Substantial variation exists by national income: middle-income countries show age-standardised mortality roughly twice that of high-income countries, with major disparities in workforce capacity and access to advanced interventions. The report informs the EU Safe Hearts Plan (adopted December 2025) and highlights new threats — particularly the obesity and diabetes epidemic — that risk reversing progress in CVD reduction. Ageing and socioeconomic inequality call for coordinated European policy to safeguard further progress. ## Lipoproteïne-aferese blijft relevant in het tijdperk van PCSK9-remmers en siRNA *2026-06-12 · European heart journal · https://doi.org/10.1093/eurheartj/ehag328 · https://hartvaat.nl/2026/05/19/lipoproteine-aferese-blijft-relevant-in-het-tijdperk-van-pcsk9-remmers-en-sirna/* Review of lipoprotein apheresis (LA) in the era of modern lipid-lowering therapies. LA selectively removes atherogenic apoB100-containing lipoproteins — LDL, VLDL, and lipoprotein(a) — from blood. Proven effects: protection of endothelium and microcirculation, prevention of new aortic and coronary lesions in homozygous familial hypercholesterolaemia (HoFH), reduction of cardiovascular events, and adjunct in secondary prevention for patients who fail LDL targets or have elevated Lp(a). Despite the rise of PCSK9 inhibitors, antisense oligonucleotides, and siRNA therapies, LA remains a safe option for patients with severe lipid disorders. Barriers to broader use: HoFH and high-Lp(a) underdiagnosis, therapeutic inertia, and limited availability of qualified LA centres. Future research is directed at kidney disease, peripheral arterial disease, pre-eclampsia, macular degeneration, and sudden sensorineural hearing loss. ## Therapietrouw-trajecten na ischemisch CVA: vroeg dubbel staken verhoogt sterfte en recidief met ~50% *2026-06-12 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.048456 · https://hartvaat.nl/2026/05/19/therapietrouw-trajecten-na-ischemisch-cva-vroeg-dubbel-staken-verhoogt-sterfte-e/* Cohort study using Taiwanese registry data (Chang Gung Research Database linked to nationwide claims) of 13,299 patients with first-ever ischaemic stroke or TIA between 2012 and 2018 who survived ≥1 year and initiated secondary prevention. Monthly adherence (proportion of days covered) was modelled into four trajectories: high dual adherence (46.7%), antithrombotic-only (35.1%), early dual discontinuation (12.2%), and gradual dual decline (6.0%). High dual adherence achieved the greatest LDL reduction (-24.3%) and lowest mortality. Early dual discontinuation was associated with higher composite outcome (aHR 1.57), recurrent stroke/embolism (aHR 1.60), myocardial infarction (aHR 1.48), and all-cause death (aHR 1.56). Poor adherence had greater impact in patients with baseline LDL ≥100 mg/dL, younger adults, and men. Sustained dual adherence confers substantial protection; early discontinuation markedly elevates recurrence and mortality risk. ## VICTORION-INCEPTION: vroege inclisiran na acuut coronair syndroom verviervoudigt het halen van LDL-doel *2026-06-12 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.043655 · https://hartvaat.nl/2026/05/19/victorion-inception-vroege-inclisiran-na-acuut-coronair-syndroom-verviervoudigt-/* Open-label phase 3b multicenter randomised trial in 400 patients ≤5 weeks after acute coronary syndrome with LDL-C ≥70 mg/dL (or non-HDL ≥100 mg/dL) on statin therapy or statin-intolerant. 1:1 randomisation to inclisiran 300 mg (days 0, 90, 270) plus usual care versus usual care alone, with 330 days of follow-up. At day 90, 74.6% of inclisiran patients reached LDL <70 mg/dL versus 26.6% with usual care (OR 10.84); for LDL <55 mg/dL it was 63.2% vs 8.5% (OR 26.58). At day 330 the gap persisted: 66.7% vs 28.1% for LDL <70 (OR 5.42; p<0.001) and 54.2% vs 13.6% for LDL <55. Mean LDL reduction from baseline was -46.9% greater with inclisiran. Adverse events were comparable between arms (58.6% vs 53.3%). The first inclisiran trial in recent ACS — early addition rapidly and durably achieves guideline LDL targets. ## Mobiele screeningseenheid in Detroit: 70% van inwoners in achtergestelde wijken heeft minstens één onbeheerste cardiometabole risicofactor *2026-06-11 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.047852 · https://hartvaat.nl/2026/05/19/mobiele-screeningseenheid-in-detroit-70-van-inwoners-in-achtergestelde-wijken-he/* Cross-sectional analysis of the Wayne State University/Wayne Health mobile health unit program, which conducted screening at over 1,000 locations across metropolitan Detroit between July 2021 and September 2025. In voluntary adult participants: median BP 122/75 mm Hg, LDL cholesterol 103 mg/dL, HbA1c 5.7%. About half had elevated BP (48%; n=6,182/12,821) or LDL ≥100 mg/dL (54%; n=3,860/7,115); 16% had HbA1c ≥6.5%. Among 5,393 participants with all four measurements, only 4% had an ideal cardiometabolic risk profile (SBP <120, LDL <70, HbA1c <5.7%), while 70% had at least one uncontrolled risk factor. Older age predicted all four; Black race predicted uncontrolled BP; male sex predicted uncontrolled BP and HbA1c. Mobile units are a valuable tool for detection and targeted intervention in socioeconomically disadvantaged populations. ## Life's Essential 8: lichaamsbeweging is de sterkste schakel tussen laag inkomen en cardiovasculair risico *2026-06-11 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.043789 · https://hartvaat.nl/2026/05/19/life-s-essential-8-lichaamsbeweging-is-de-sterkste-schakel-tussen-laag-inkomen-e/* Mediation analysis of NHANES data (2021-2023) in 3,345 US adults, framed by Life's Essential 8. Low income was associated with lower moderate-to-vigorous physical activity (MVPA), poorer nutrition, and more smoking. Via these behaviours, the path extended to higher fasting glucose, BMI, and systolic blood pressure. Low MVPA was independently associated with higher systolic blood pressure, fasting glucose, and BMI. MVPA showed the strongest mediator effects, suggesting it as a leverage point for reducing income-related cardiovascular risk through population- and community-level interventions. ## Beste bewegingsvorm voor bloeddruk: combinatietraining en HIIT geven -12/-6 mmHg in netwerk-meta-analyse *2026-06-11 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.044003 · https://hartvaat.nl/2026/05/19/beste-bewegingsvorm-voor-bloeddruk-combinatietraining-en-hiit-geven-12-6-mmhg-in/* Bayesian network meta-analysis of 105 randomised trials examining different exercise modalities and doses on blood pressure in prehypertension and established hypertension. Combined training (strength + aerobic) reduced systolic blood pressure by -12.05 mm Hg (95% CrI -15.08 to -9.05) and diastolic by -6.20 mm Hg; high-intensity interval training reduced systolic by -10.97 mm Hg and diastolic by -6.42 mm Hg. Yoga and tai chi had moderate effects; aerobic, isometric, and resistance training were relatively weaker as single modalities. Dose-response was non-linear and U-shaped, with greatest benefit at ~830 metabolic-equivalent minutes per week (optimal dose varying by modality). Conclusion: all modalities lower BP; combined training and HIIT are most effective, with diminishing returns beyond ~830 MET-min/week. ## STOP-CAD: 1 op 6 cervicale arteriedissecties wordt aanvankelijk verkeerd gediagnosticeerd *2026-06-10 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.046408 · https://hartvaat.nl/2026/05/19/stop-cad-1-op-6-cervicale-arteriedissecties-wordt-aanvankelijk-verkeerd-gediagno/* Secondary analysis of the STOP-CAD study in 4,012 patients with cervical artery dissection (CeAD; mean age 47.5 years; 44.6% female). Possible diagnostic error — defined as CeAD symptoms within 30 days before the eventual diagnosis — occurred in 663 (16.5%); 33.8% of these had an ischaemic stroke before diagnosis. Patients with diagnostic delay were younger (OR 0.89), more often had a migraine history (OR 1.35) and presented with headache (OR 1.43) but less often with focal neurological signs (OR 0.68). After adjustment, there were no differences in ischaemic stroke after diagnosis, 90-day mRS <2 or mortality between groups. Heightened differential-diagnostic awareness in younger patients with headache (especially with migraine history) and no focal signs could speed diagnosis. ## SALAMANDER-register: 95,5% technisch succes bij stand-alone linker-hartoor-occlusie in Europese praktijk *2026-06-10 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.046625 · https://hartvaat.nl/2026/05/19/salamander-register-95-5-technisch-succes-bij-stand-alone-linker-hartoor-occlusi/* Prospective multicenter observational cohort of 1,660 patients with non-valvular atrial fibrillation undergoing stand-alone left atrial appendage occlusion (LAAO) at 16 European centres between 2010 and 2024. Median age 76 years (IQR 70-81); 38% women; median CHA2DS2-VASc 4. Indication was significant bleeding in 83.7% — most often on DOAC (68.8%) and less often VKAs (24.9%); main bleeding sites were lower (27.9%) and upper (21.7%) GI tract, with 17.4% history of haemorrhagic stroke. Technical success 95.5% (limited mainly by residual leak 2.2% and tamponade 1.4%); procedural success 90.5% (vascular complications 3.7%, periprocedural death 1.1%). Results were comparable across devices. Virtually all patients received dual antiplatelet therapy post-procedure. ## NutriNet-Santé: voedselconserveermiddelen geassocieerd met meer hypertensie en cardiovasculaire ziekte *2026-06-10 · European heart journal · https://doi.org/10.1093/eurheartj/ehag308 · https://hartvaat.nl/2026/05/20/nutrinet-sante-voedselconserveermiddelen-geassocieerd-met-meer-hypertensie-en-ca/* Prospective French cohort study (NutriNet-Santé, 2009-2024) in 112,395 participants (78.7% women; mean age 42.8 years; median follow-up 7.9 years). Dietary intake was assessed via repeated 24-hour dietary records (up to 96 per participant); exposure to food additives was analysed using multiple composition databases and laboratory assays. Total non-antioxidant preservatives were associated with increased incident hypertension (n=5,544; HR highest vs lowest consumers 1.29; 95% CI 1.20-1.39) and cardiovascular disease (n=2,450; HR 1.16). Antioxidant preservatives were linked only to hypertension (HR 1.22). Of 17 individually examined additives (consumed by ≥10%), eight were associated with hypertension and one with CVD after multiple-testing correction. If confirmed experimentally, the findings call for re-evaluation of regulations on industrial food additives. ## GLP-1-agonisten kosten geen spiermassa tijdens intensieve hartrevalidatie *2026-06-09 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag279 · https://hartvaat.nl/2026/05/21/glp-1-agonisten-kosten-geen-spiermassa-tijdens-intensieve-hartrevalidatie/* Retrospective cohort of 468 patients enrolled in a structured Pritikin intensive cardiac rehabilitation program (UC San Diego, 2017-2024), 67 of whom were taking GLP-1 receptor agonists for a median of 231 days. Body composition was assessed by bioelectrical impedance at baseline and program completion. GLP-1 RA users had higher baseline BMI and body fat but similar skeletal muscle mass (SMM). After adjustment for age, sex, BMI, diabetes, and fitness, there was no significant difference in percent change in SMM (β 0.62%; 95% CI -0.62 to 1.86; p=0.33) or fat mass (p=0.20) between users and non-users. Both groups improved METs significantly. The findings counter — in this setting — the concern that GLP-1 therapy drives clinically relevant sarcopenia and support combining it with structured exercise. ## 1 op 10 patiënten heroptname binnen 30 dagen na TAVI — sterfterisico na 1 jaar verdrievoudigd *2026-06-09 · Open heart · https://doi.org/10.1136/openhrt-2026-004059 · https://hartvaat.nl/2026/05/21/1-op-10-patienten-heroptname-binnen-30-dagen-na-tavi-sterfterisico-na-1-jaar-ver/* Retrospective analysis of 1,347 consecutive TAVI patients (43.8% women, mean age 81 years; 2012-2025). 9.7% (n=131) were readmitted within 30 days, most commonly for infection (22.9%), heart failure (19.8%) and bradycardia (9.9%). Independent predictors of infection readmission: chronic HF (OR 2.60), COPD (OR 3.18) and contrast volume (OR 1.25 per 25 mL). HF readmission was predicted by chronic HF (OR 3.82), paravalvular leak ≥mild (OR 5.05) and reduced post-procedure LVEF (OR 3.85). Discharge conduction abnormalities predicted bradycardia readmission (OR 4.65). Early discharge (≤2 days) did not increase readmission risk. After adjustment, 1-year mortality was three times higher with early readmission (HR 3.03; 95% CI 1.90-4.86). Modifiable risk factors include contrast volume, paravalvular leak, and discharge conduction abnormalities. ## Melatonine en cardiovasculair risico: NHANES nuanceert recent hartfalen-signaal van AHA 2025 *2026-06-09 · Open heart · https://doi.org/10.1136/openhrt-2026-004108 · https://hartvaat.nl/2026/05/21/melatonine-en-cardiovasculair-risico-nhanes-nuanceert-recent-hartfalen-signaal-v/* Short analysis responding to a large electronic-health-record study (presented at AHA Scientific Sessions 2025) that reported a heart failure safety signal with long-term melatonin use in adults with insomnia. The authors emphasise that observational associations between melatonin and cardiovascular outcomes are particularly vulnerable to confounding-by-indication, reverse causality and exposure misclassification — melatonin use often reflects insomnia severity, depression/anxiety, and healthcare utilisation. In a nationally representative NHANES cohort (1999-2018), recent melatonin use was not significantly associated with cardiovascular disease or heart failure after adjustment. The data do not support strong claims of cardiovascular benefit or harm. Clinical guidance: document over-the-counter use, counsel pragmatically, and prioritise evaluation and treatment of underlying sleep disorders. ## Eplerenon halveert recidief ventriculaire tachycardie versus spironolacton bij hartfalen *2026-06-08 · Open heart · https://doi.org/10.1136/openhrt-2025-003858 · https://hartvaat.nl/2026/05/21/eplerenon-halveert-recidief-ventriculaire-tachycardie-versus-spironolacton-bij-h/* Retrospective analysis of heart failure patients with LVEF <50% hospitalised for sustained monomorphic ventricular tachycardia (VT) and receiving a mineralocorticoid receptor antagonist (MRA) at discharge. Of 292 eligible patients, 202 were matched via propensity scoring on 13 variables (median LVEF 30%, 87% male, median follow-up 32 months). All-cause mortality did not differ between eplerenone and spironolactone (HR 0.98). However, eplerenone was associated with significantly fewer VT recurrences (HR 0.42; 95% CI 0.26-0.66; Fine-Gray aHR 0.36; p<0.001). The finding favours eplerenone in HF patients with a history of monomorphic VT, albeit based on observational data. ## Bij coronaire vasospasmen zonder significante stenose voorspelt verhoogd Lp(a) geen MACE *2026-06-08 · Heart and vessels · https://doi.org/10.1007/s00380-026-02669-0 · https://hartvaat.nl/2026/05/21/bij-coronaire-vasospasmen-zonder-significante-stenose-voorspelt-verhoogd-lp-a-ge/* Observational study in 1,373 patients with positive intracoronary acetylcholine provocation and non-significant coronary stenosis, stratified into high Lp(a) (≥50 mg/dL) versus low Lp(a) (<50 mg/dL). 10-year MACE, MACCE and MACCE with recurrent angina were compared using inverse probability of treatment weighting and Cox regression. No significant differences emerged in MACE, MACCE or MACCE with angina between Lp(a) strata. A small increase in revascularisations with high Lp(a) (3.3% vs 0.9%) disappeared after adjustment. While Lp(a) remains an established overall cardiovascular risk factor, it adds little prognostic value in vasospastic angina without obstructive coronary disease. ## FIND-AF-biomarker stratificeert prognose bij HFrEF met atriale cardiomyopathie zonder atriumfibrilleren *2026-06-08 · ESC heart failure · https://doi.org/10.1093/eschf/xvag144 · https://hartvaat.nl/2026/05/21/find-af-biomarker-stratificeert-prognose-bij-hfref-met-atriale-cardiomyopathie-z/* Exploratory retrospective study in 164 patients from the ECG-HF registry (2010-2016) with heart failure with reduced ejection fraction (HFrEF) and atrial cardiomyopathy, but without atrial fibrillation at baseline. Atrial cardiomyopathy was defined per the HFA/ESC 2025 consensus on ECG and echocardiographic parameters. Stratification by the FIND-AF score showed that the composite endpoint (incident AF, ischaemic stroke, all-cause mortality) occurred in 71.9% of high-risk vs 50.8% of low-risk patients (adjusted OR 2.70; p=0.024). FIND-AF outperformed CHA2DS2-VASc for both the composite (AUC 0.74 vs 0.64) and ischaemic stroke (AUC 0.70 vs 0.58). External validation and prospective study are needed. ## Chirurgisch unroofing van myocardiale brug verbetert angina-klachten langdurig (mediaan 5 jaar follow-up) *2026-06-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehag373 · https://hartvaat.nl/2026/05/22/chirurgisch-unroofing-van-myocardiale-brug-verbetert-angina-klachten-langdurig-m/* Prospective study of 218 adults with angina in non-obstructive coronary arteries and a functionally significant LAD myocardial bridge (dobutamine-stress diastolic FFR and/or RFR ≤ 0.76) who underwent surgical unroofing. Median follow-up 5 years. Patients reported significant and clinically meaningful improvement across all Seattle Angina Questionnaire domains: physical limitation, anginal stability and frequency, treatment satisfaction, and quality of life. In a propensity-matched comparison with 65 non-surgical patients, improvement in physical limitation (27.8 vs 11.4; p=0.004) and anginal frequency (30 vs 20; p=0.01) was significantly greater after surgery. For severe angina refractory to maximal medical therapy with a confirmed functionally significant MB, surgical unroofing offers a durable long-term option. ## Autosomaal dominante Alport-syndroom: meest voorkomende monogene nierziekte (1% van de bevolking) *2026-06-07 · Journal of the American Society of Nephrology : JASN · https://doi.org/10.1681/ASN.0000001158 · https://hartvaat.nl/2026/05/22/autosomaal-dominante-alport-syndroom-meest-voorkomende-monogene-nierziekte-1-van/* JASN review of autosomal dominant (AD) Alport syndrome, caused by heterozygous pathogenic variants in COL4A3 or COL4A4. With ~1% population prevalence, it is the most common monogenic kidney disease — characterised by persistent glomerular haematuria, thinned glomerular basement membrane, and family history of kidney disease, without the hearing and ocular abnormalities of X-linked Alport. Penetrance is incomplete (only two-thirds of variant carriers have haematuria). Missense mutations with glycine substitutions confer proteinuria more often. Genetic testing distinguishes AD from X-linked Alport (the latter has higher kidney-failure risk). Recommended: monitoring of albuminuria and treatment with ACE inhibitors and, if needed, SGLT2 inhibitors from onset; genetic testing for all first-degree relatives regardless of haematuria status. ## Efficacy and Safety of Oral PCSK9 Inhibitors: Insights from a Meta-analysis of RCTs. *2026-06-07 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag273 · https://hartvaat.nl/2026/05/22/orale-pcsk9-remmers-meta-analyse-bevestigt-krachtige-ldl-daling/* A meta-analysis of five RCTs of three oral PCSK9 inhibitors (enlicitide, NNC0385-0434 and laroprovstat; 3,295 participants) shows a pooled LDL-C reduction of 59% versus placebo. ApoB (−50%), non-HDL cholesterol (−55%) and Lp(a) (−23%) also fell significantly, with no increase in short-term serious adverse events. The efficacy of oral PCSK9 inhibition is thus comparable to that of the injectable agents — a potential breakthrough for adherence and access. ## Epicardiaal vetweefsel voorspelt aritmieën en hartfalen-events bij genotype-positieve HCM *2026-06-06 · European journal of heart failure · https://doi.org/10.1093/ejhf/xuag179 · https://hartvaat.nl/2026/05/22/epicardiaal-vetweefsel-voorspelt-aritmieen-en-hartfalen-events-bij-genotype-posi/* Retrospective cohort of 282 patients with genotype-positive hypertrophic cardiomyopathy, in whom epicardial adipose tissue (EAT) was quantified by cardiac MRI and patients split into high and low EAT groups by the median. High EAT was associated with greater maximal wall thickness (25.0 vs 20.8 mm), more extensive LGE (6.1% vs 1.0%), and more frequent LVOT obstruction (42.6% vs 15.6%). Over a median of 62 months, EAT was independently associated with malignant ventricular arrhythmias (HR 1.04 per mL) and HF events (HR 1.05; both p<0.001). Discriminative ability (C-statistic 0.79) exceeded even the HCM SCD risk score for arrhythmias (p=0.011). EAT warrants consideration as a novel risk-stratification parameter in HCM. ## M-TEER werkt over het volledige LVEF-spectrum; vergroot linkeratrium-volume voorspelt slechtere uitkomst *2026-06-06 · ESC heart failure · https://doi.org/10.1093/eschf/xvag149 · https://hartvaat.nl/2026/05/22/m-teer-werkt-over-het-volledige-lvef-spectrum-vergroot-linkeratrium-volume-voors/* Retrospective analysis of 93 consecutive patients with symptomatic secondary mitral regurgitation who underwent mitral transcatheter edge-to-edge repair (M-TEER) between 2018 and 2022. Composite clinical improvement (survival without HF hospitalisation, NYHA I-II, KCCQ >60) at 36 months was similar in reduced and preserved LVEF (51.8% vs 62.5%; p=0.32). Mortality was lower with preserved LVEF (9.4% vs 29.6%). Enlarged left atrial volume index (LAVI ≥60 mL/m²) was associated with higher mortality (29.4% vs 11.8%) and remained significant after adjustment. M-TEER thus delivers meaningful benefit across the LVEF spectrum, with left atrial enlargement marking advanced atrial disease and potentially supporting earlier intervention. ## LGE-granulariteit op CMR voorspelt sterfte bij eindstadium hypertrofische cardiomyopathie *2026-06-06 · Circulation. Cardiovascular imaging · https://doi.org/10.1161/CIRCIMAGING.125.019408 · https://hartvaat.nl/2026/05/22/lge-granulariteit-op-cmr-voorspelt-sterfte-bij-eindstadium-hypertrofische-cardio/* Retrospective multicenter cohort of 691 patients with end-stage HCM (LVEF <50%) from three French tertiary centres, followed for a median of 9 years. After 33% mortality (n=226), the LGE granularity model — combining extent (unique vs multiple), location (septal vs other) and pattern (subepicardial vs midwall) — provided independent prognostic value. Late gadolinium enhancement was associated with mortality after adjustment (HR 1.52). Each component independently predicted mortality: LGE extent (HR 2.85), septal location (HR 1.73), and midwall pattern (HR 4.15). The LGE granularity model refines risk stratification in advanced HCM. ## Brede inzet van oraal semaglutide in de VS zou jaarlijks tot 60.000 cardiovasculaire events kunnen voorkomen *2026-06-05 · Cardiovascular diabetology. Endocrinology reports · https://doi.org/10.1186/s40842-026-00299-z · https://hartvaat.nl/2026/05/22/brede-inzet-van-oraal-semaglutide-in-de-vs-zou-jaarlijks-tot-60-000-cardiovascul/* Population-level modeling study applying SOUL trial eligibility criteria to NHANES data of US adults with type 2 diabetes. An estimated 6.1 million Americans met eligibility for oral semaglutide. Without treatment, 847,598 major adverse cardiovascular events (MACE) were projected over 4.5 years; with treatment, 728,934 — a potential prevention of 118,664 events (14% relative reduction; NNT 55). At 50% uptake and 15.5% discontinuation (as in SOUL), this translates to roughly 59,000 MACE prevented, including 14,000 CV deaths, 41,000 non-fatal MIs, and 12,000 non-fatal strokes. The findings support oral semaglutide as a scalable cardiometabolic intervention and argue for system-level strategies to enhance access and uptake. ## PARADISE-cohort: hartfalen en COPD samen verhogen de langetermijnmortaliteit, met name HF *2026-06-05 · ESC heart failure · https://doi.org/10.1093/eschf/xvag136 · https://hartvaat.nl/2026/05/23/paradise-cohort-hartfalen-en-copd-samen-verhogen-de-langetermijnmortaliteit-met-/* Monocentric observational study (PARADISE cohort) of 5,131 patients admitted to the emergency department for acute dyspnea between 2010 and 2019. 3,543 had a primary diagnosis of heart failure, 1,588 of COPD; in both groups ~20% had the other condition. Among primary HF patients, concomitant COPD was paradoxically associated with lower in-hospital mortality (8.5% vs 11.7%; aOR 0.74) but modestly higher long-term mortality (aHR 1.22). Among primary COPD patients, concomitant HF was not significantly associated with in-hospital mortality after adjustment but markedly increased long-term mortality (68.7% vs 48.7%; aHR 1.48). Systematic identification and optimised management of both conditions in the ED are crucial for this high-risk population. ## Lipoprotein(a) and residual cardiovascular risks in Japanese patients with coronary artery disease who achieve guideline-recommended LDL-C goals. *2026-06-05 · European heart journal · https://doi.org/10.1093/eurheartj/ehag446 · https://hartvaat.nl/2026/05/24/lp-a-japan-verhoogd-lp-a-blijft-risicovol-ondanks-ldl-onder-55-mg-dl/* This observational study in 1,581 Japanese patients with coronary artery disease after PCI shows that elevated Lp(a) remains associated with more cardiovascular events even when LDL-C is well controlled (<55 mg/dL). At Lp(a) ≥50 mg/dL the standardised 5-year MACE risk was nearly seven times higher than at Lp(a) <30 mg/dL. The risk threshold sat around 28 mg/dL — lower than values used in Western populations. Intensive LDL lowering thus partly attenuates, but does not eliminate, Lp(a)-related risk. ## RCA- en hoofdstamstenosen geven hoogste kans op plotse hartdood — revascularisatie-strategie moduleert risico *2026-06-04 · JACC. Cardiovascular interventions · https://doi.org/10.1016/j.jcin.2026.03.023 · https://hartvaat.nl/2026/05/25/rca-en-hoofdstamstenosen-geven-hoogste-kans-op-plotse-hartdood-revascularisatie-/* Retrospective analysis of a Finnish registry (Tampere Heart Hospital): 22,495 patients who underwent coronary angiography between 2007 and 2018, followed to end-2022. 1,048 sudden cardiac death events were observed (median follow-up 8.1 years). Independent risk associations: right coronary artery (RCA) stenosis (HR 1.53; 95% CI 1.31-1.80) — the strongest — followed by circumflex stenosis (HR 1.34). LAD stenosis predicted sudden death only in acute coronary syndromes (HR 1.37). Effect varied by revascularization strategy: RCA stenosis weighed heaviest in PCI-treated patients; no lesion site conferred excess risk after CABG; and left main stenosis was riskiest in conservatively managed patients (HR 1.53). Anatomical location is therefore a relevant prognosticator for sudden cardiac death, modulated by the chosen treatment strategy. ## 1 op 5 oudere patiënten heeft hartfalen-opname binnen jaar na TAVR — 1-jaarsmortaliteit 44% versus 4% *2026-06-04 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.048751 · https://hartvaat.nl/2026/05/25/1-op-5-oudere-patienten-heeft-hartfalen-opname-binnen-jaar-na-tavr-1-jaarsmortal/* Retrospective cohort of US Medicare data: 233,309 patients ≥65 years who underwent TAVR between 2017 and 2021. In 45,502 (19.5%) a heart failure hospitalisation occurred between day 31 and day 365 post-procedure. These patients had markedly higher 1-year (43.8% vs 3.6%) and 5-year mortality (80.6% vs 41.0%). After adjustment the association remained strong (aHR 3.17; 95% CI 3.11-3.22). Strongest predictors were advanced cardiac damage stage (aSHR 1.95) and high-risk frailty (aSHR 1.65), with graded risk across stages. Early post-TAVR HF hospitalisation is a sentinel event and supports systematic frailty and cardiac damage staging before and after the procedure. ## Semaglutide verlaagt mortaliteit, CV-events én nierschade in alle stadia van CKM-syndroom: meta-analyse van 39.204 patiënten *2026-06-04 · Cardiovascular diabetology · https://doi.org/10.1186/s12933-026-03215-y · https://hartvaat.nl/2026/05/25/semaglutide-verlaagt-mortaliteit-cv-events-en-nierschade-in-alle-stadia-van-ckm-/* Systematic review and meta-analysis of 8 randomised trials (39,204 patients) on semaglutide versus placebo across the full cardio-kidney-metabolic (CKM) spectrum. Semaglutide significantly reduced all-cause mortality (HR 0.84; 95% CI 0.77-0.92), cardiovascular mortality (HR 0.83), MACE (HR 0.82), non-fatal myocardial infarction (HR 0.75), worsening heart failure (HR 0.84) and adverse kidney outcomes (HR 0.83). No significant effect on non-fatal stroke. The breadth of CKM benefit — kidney, heart and mortality together — distinguishes semaglutide from many other classes and aligns with the recognition of CKM as an integrated disease entity. ## FH cascade screening in the Netherlands holds its steady course in 2026 *2026-06-04 · Stichting LEEFH · https://doi.org/https://www.leefh.nl/ · https://hartvaat.nl/2026/06/04/fh-opsporing-in-nederland-zet-stabiele-lijn-voort-in-2026/* Stichting LEEFH — the Dutch National Expertise Centre for Genetic Research on Familial Cardiovascular Diseases — coordinates the Netherlands' cascade screening programme for familial hypercholesterolaemia (FH). The latest figures show detection holding the stable trajectory of recent years: roughly 806 new detections are projected for 2026, in line with the target of 800. Most arise from family screening around an index patient (projected ~507), supplemented by FH diagnoses from complex DNA testing (~299). The 2025 year-end total is projected at around 873 — above the 857 recorded in 2024 — with final figures due at the end of June as informed-consent forms are still arriving. Cascade screening remains one of the most effective ways to identify first-degree relatives of an FH patient early and prevent premature cardiovascular disease. ## Global survey of genetic testing methods for familial hypercholesterolemia. A study and recommendations from the EAS FHSC registry. *2026-06-04 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag198 · https://hartvaat.nl/2026/05/14/eas-fhsc-wereldwijd-onderzoek-toont-grote-variatie-in-genetische-fh-diagnostiek-/* International survey among national lead-investigators of the European Atherosclerosis Society FH-Studies Collaboration from 55 of 68 countries (81% response; Africa 2, Americas 6, Asia 20, Europe 26, Oceania 1). Referral criteria were most often the Dutch Lipid Clinic Network score (adults 72%, children 57%); Simon Broome and MEDPED were used only in high-income countries. For index patients, next-generation sequencing predominated (62%); for relatives, Sanger sequencing (71%). Copy-number variants were assessed by 65% of centres, mostly via NGS platforms. Nearly all centres screened LDLR (100%), APOB (97%), and PCSK9 (95%); pathogenicity was interpreted largely per ACMG guidelines. The authors call for global standardisation: at minimum the three FH genes, ideally also the five associated/phenocopy genes. ## Lipid clinics worldwide: harmonization and guidance on how to optimally organize and fund. European Atherosclerosis Society consensus statement across 55 countries and more than 500 lipid clinics *2026-06-04 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00123-1/fulltext · https://hartvaat.nl/2026/05/24/eas-consensus-wereldwijde-harmonisatie-van-lipidenklinieken/* Through its Lipid Clinic Network, the European Atherosclerosis Society (EAS) presents the first worldwide consensus on lipid clinics, drawing on data from 55 countries and more than 500 clinics. Lipid clinics deliver specialised diagnostics, lifestyle management and evidence-based lipid-lowering therapy to high-risk patients — including those with familial hypercholesterolaemia, markedly elevated lipoprotein(a), statin intolerance, refractory LDL cholesterol, severe hypertriglyceridaemia and other rare or complex lipid disorders — to prevent atherosclerotic cardiovascular disease and acute pancreatitis. The statement defines lipid clinics across four tiers and offers practical guidance on staffing, referral criteria, Lp(a) and genetic testing, quality monitoring and funding, highlighting the major differences between countries by income level. The authors — including Jeanine Roeters van Lennep (Erasmus MC) — call for national and international harmonisation so that patients everywhere receive equitable, high-quality lipid care. ## EXPLORER-CN week 78: langetermijneffect en veiligheid van mavacamten bij Chinese patiënten met obstructieve HCM *2026-06-03 · Journal of the American Heart Association · https://doi.org/10.1161/JAHA.125.046251 · https://hartvaat.nl/2026/05/25/explorer-cn-week-78-langetermijneffect-en-veiligheid-van-mavacamten-bij-chinese-/* Open-label long-term extension of EXPLORER-CN in 79 Chinese patients with obstructive hypertrophic cardiomyopathy who completed the 30-week placebo-controlled period. Patients on mavacamten continued their dose (n=54); former placebo patients started 2.5 mg daily (n=25). Through week 78, previously achieved reductions in Valsalva and resting LVOT gradients were maintained (mean change -73.0 mm Hg and -56.3 mm Hg). NYHA class, Kansas City Cardiomyopathy Questionnaire score and cardiac biomarkers all showed numerical improvements. Mavacamten was well tolerated; LVEF <50% was rare. The Chinese data confirm long-term durability and safety of mavacamten in obstructive HCM. ## Lipoprotein(a) Levels, Risk of Cardiovascular Events and Benefit of Evolocumab: Findings From the VESALIUS-CV Trial. *2026-06-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.126.080999 · https://hartvaat.nl/2026/05/25/vesalius-cv-lp-a-voorspelt-risico-evolocumab-werkt-ongeacht-uitgangswaarde/* In a prespecified analysis of the VESALIUS-CV trial (7,557 patients with atherosclerosis or high-risk diabetes, without prior MI or stroke), higher Lp(a) was associated with more major coronary events (HR 1.15 per 100 nmol/L), particularly myocardial infarction, but not ischaemic stroke. Evolocumab reduced relative risk to a similar degree regardless of baseline Lp(a), with a numerically greater absolute risk reduction in patients with elevated Lp(a) (NNT 28 vs 40 over five years). The findings support early PCSK9 inhibition, especially in patients with elevated Lp(a). ## Familial hypercholesterolaemia in children and adolescents: a European Atherosclerosis Society consensus statement. *2026-06-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehag382 · https://hartvaat.nl/2026/05/25/eas-consensus-familiaire-hypercholesterolemie-bij-kinderen-en-adolescenten/* A new consensus statement from the European Atherosclerosis Society — led by Dutch authors (Wiegman, Amsterdam UMC; Roeters van Lennep, Erasmus MC) — urges every country to establish paediatric screening programmes, since current diagnostic criteria often miss children carrying an FH-causing variant. It presents revised diagnostic criteria and updated LDL-C goals, and stresses that lipid-lowering therapy in heterozygous FH should start before puberty — from age 6 if needed. With treatment algorithms for HeFH and HoFH and guidance on transition to adult care, the EAS aims to curb underdiagnosis and undertreatment. ## BETAMI-DANBLOCK is representatief: bètablokker-effect ook geldig in echte Noorse infarct-populatie *2026-06-02 · European heart journal · https://doi.org/10.1093/eurheartj/ehag348 · https://hartvaat.nl/2026/05/25/betami-danblock-is-representatief-betablokker-effect-ook-geldig-in-echte-noorse-/* Comparison of participants in the BETAMI (n=2,867) and DANBLOCK (n=2,707) trials with the Norwegian nationwide myocardial infarction registry (NORMI, n=20,804) — all patients with recent MI, LVEF ≥40% and no heart failure. NORMI patients were older on average (66 vs 63 years) and had more diabetes, prior coronary disease and LVEF 40-49%. Absolute 3-year risks were higher in NORMI (mortality/MI 12.0%) than in the trials (7.7-7.8%). A transportability analysis (reweighting the trial population to NORMI characteristics) showed that the beta-blocker treatment effect remained consistent. BETAMI-DANBLOCK findings therefore generalise to the broader Norwegian — and by extension European — post-MI population. ## Longembolie-epidemiologie: stijgende last bij vergrijzing — preventiestrategieën blijven achter *2026-06-02 · European heart journal · https://doi.org/10.1093/eurheartj/ehag388 · https://hartvaat.nl/2026/05/25/longembolie-epidemiologie-stijgende-last-bij-vergrijzing-preventiestrategieen-bl/* EHJ review of acute pulmonary embolism (PE) epidemiology. As ageing populations live longer with chronic diseases associated with venous thromboembolism, PE remains a major public health challenge. Like myocardial infarction and stroke, PE is linked to established cardiovascular risk factors — age, obesity, smoking and chronic inflammatory conditions. Yet population-based primary and secondary prevention strategies remain limited. The authors call for a comprehensive public-health approach that addresses not only acute events and transient risk factors but also community-level risk assessment and long-term prevention, supported by improved clinician education and public awareness. ## Obicetrapib and lipoprotein(a) levels in patients at high cardiovascular risk: a pooled analysis of trials. *2026-06-02 · European heart journal · https://doi.org/10.1093/eurheartj/ehag399 · https://hartvaat.nl/2026/05/25/obicetrapib-verlaagt-naast-ldl-en-apob-ook-lipoproteine-a/* In a pooled analysis of trials in 2,356 high-risk patients (heterozygous FH or established ASCVD), the selective CETP inhibitor obicetrapib 10 mg daily lowered LDL-C by 37%, apoB by 21% and Lp(a) by 37% versus placebo at 12 weeks. Notably, the absolute Lp(a) reduction was similar in patients with mildly and with markedly elevated Lp(a). Obicetrapib thus offers an oral option for patients with mildly elevated Lp(a) who are unlikely to qualify for costlier RNA-targeted Lp(a) therapies. ## PAH met renaal-diabetische overlap komt vaak voor en geeft tweemaal zo hoog mortaliteitsrisico *2026-06-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-327389 · https://hartvaat.nl/2026/05/25/pah-met-renaal-diabetische-overlap-komt-vaak-voor-en-geeft-tweemaal-zo-hoog-mort/* Retrospective international cohort of 555 incident PAH patients (diagnosed 2001-2023). 42% (n=234) had chronic kidney disease and/or diabetes (renal-diabetic, RD): 45 DM only, 135 CKD only, 54 both. RD patients were older, had greater comorbidity burden, worse WHO functional class and higher pulmonary artery wedge pressure. At PAH diagnosis, RD patients were less often treated with endothelin receptor antagonists (61% vs 69%) and more often with single-agent therapy (55% vs 45%). Over 2.5 years of follow-up, the composite of death or PAH hospitalisation was significantly higher in RD (HR 1.45; 95% CI 1.07-1.98), as was all-cause mortality (HR 1.47). PAH with renal-diabetic overlap is common, under-treated and prognostically worse. ## Koreaanse studie van 3,7 miljoen postmenopauzale vrouwen: hormonale levensloop voorspelt hartfalen-risico *2026-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehag380 · https://hartvaat.nl/2026/05/25/koreaanse-studie-van-3-7-miljoen-postmenopauzale-vrouwen-hormonale-levensloop-vo/* Nationwide Korean cohort of 3,692,157 postmenopausal women without prior heart failure or structural heart disease, followed for a median of 120 months. During follow-up, 48,640 women were hospitalised for heart failure. Prior oral contraceptive use (≥1 year; SHR 0.942) and menopausal hormone therapy (≥5 years; SHR 0.782) were associated with lower HF risk. Later menarche (≥17 years), earlier menopause (40-44 years) and shorter total reproductive period (<30 years) were associated with higher risk (all p<0.001). Among women who developed HF, OC and MHT use also reduced mortality. Conclusion: longer lifetime exposure to endogenous and exogenous oestrogens protects against HF incidence and mortality. ## Diabetes en calcifiërende aortaklepziekte: gedeelde immunometabole pathways en therapeutische kandidaten *2026-06-01 · Cardiovascular diabetology · https://doi.org/10.1186/s12933-026-03219-8 · https://hartvaat.nl/2026/05/25/diabetes-en-calcifierende-aortaklepziekte-gedeelde-immunometabole-pathways-en-th/* Review of the immunometabolic mechanisms linking diabetes mellitus to accelerated calcific aortic valve disease (CAVD). Diabetes consistently increases incident aortic stenosis risk (HR 1.3-1.7), calcification burden and disease severity, independent of traditional risk factors. The authors delineate seven overlapping pathways: valvular interstitial cell phenotypic switching driven by hyperglycaemia and insulin resistance, AGE-RAGE signalling, oxidative stress, NLRP3-IL-1β inflammasome activation, endothelial dysfunction, BMP-Runx2-Wnt-Notch osteogenic reprogramming, and CKD-mineralocorticoid receptor cross-talk. Metformin, SGLT2 inhibitors, IL-1β/NLRP3 inhibitors and Lp(a)-lowering strategies are proposed candidates for clinical evaluation. The framework argues for valve-focused randomised trials in diabetic CAVD. ## KDIGO-overzicht: de nier centraal in het cardiovasculair-renaal-metabool (CKM) syndroom *2026-05-31 · Kidney international · https://doi.org/10.1016/j.kint.2026.03.031 · https://hartvaat.nl/2026/05/25/kdigo-overzicht-de-nier-centraal-in-het-cardiovasculair-renaal-metabool-ckm-synd/* Review of KDIGO guidelines addressing the cardiovascular-kidney-metabolic (CKM) syndrome — formally recognised by the American Heart Association in 2023 as the integrated entity linking chronic kidney disease with obesity, diabetes, hypertension, dyslipidaemia, and cardiovascular disease. The review synthesises relevant KDIGO Clinical Practice Guidelines (CKD, blood pressure, diabetes, lipids), the upcoming guideline on heart failure in CKD, and Controversies Conference reports on obesity and CKD prevention. Core themes: early detection and intervention, personalised management of kidney and cardiovascular risk, and multidisciplinary care. KDIGO provides a robust framework for clinical practice and research priorities in patients at risk for or with CKM syndrome. ## Het spectrum van congestie bij hartfalen: pathofysiologie en diagnostische strategieën *2026-05-31 · Heart failure reviews · https://doi.org/10.1007/s10741-026-10639-x · https://hartvaat.nl/2026/05/25/het-spectrum-van-congestie-bij-hartfalen-pathofysiologie-en-diagnostische-strate/* Review of the complex pathophysiology and diagnosis of congestion in heart failure — the principal driver of decompensation recurrence. The authors discuss the recently proposed intra- vs extravascular congestion classification and the lack of a uniform multiparametric assessment. Clinical examination alone often underestimates congestion; a multimodal approach combining ultrasonography (lung, cardiac, IVC, abdominal), invasive haemodynamics and biomarkers is recommended. Key insight: haemodynamic congestion with elevated intracardiac pressures does not always coincide with systemic fluid retention. The review presents profile-driven approaches for early congestion detection. ## Klassieke LV-GLS overtreft nieuwe atriale CMR-parameters bij voorspelling van LV-remodelling na voorwand-STEMI *2026-05-31 · International journal of cardiology · https://doi.org/10.1016/j.ijcard.2026.134587 · https://hartvaat.nl/2026/05/25/klassieke-lv-gls-overtreft-nieuwe-atriale-cmr-parameters-bij-voorspelling-van-lv/* Post-hoc analysis of the EURO-ICE trial in 200 patients with anterior STEMI who underwent CMR at baseline and 3 months. LV global longitudinal strain (GLS) was the strongest functional predictor of adverse LV remodelling (OR 1.16; 95% CI 1.06-1.27; p=0.001), persisting after adjustment for clinical risk factors (OR 1.22). The association disappeared after adjustment for infarct size and microvascular obstruction, suggesting the prognostic value is largely mediated by myocardial injury burden. Left atrial strain and LACI added no predictive value. LV GLS remains the most informative functional CMR parameter and is useful when contrast cannot be given. ## Adipokineprofiel bij acuut hartfalen voorspelt natriuretische respons en mortaliteit *2026-05-30 · ESC heart failure · https://doi.org/10.1093/eschf/xvag150 · https://hartvaat.nl/2026/05/26/adipokineprofiel-bij-acuut-hartfalen-voorspelt-natriuretische-respons-en-mortali/* Prospective observational study in 262 patients with acute heart failure, relating circulating adipokine profiles to the early natriuretic response (spot urine sodium 2 hours after intravenous loop diuretic). Patients with impaired response (uNa+ <90 mmol/L) had higher chemerin and FABP4 levels. An integrated adipokine score was independently associated with sodium excretion (β 3.37; 95% CI 1.51-5.23) and with 1-year mortality. FABP4 was consistently linked to both impaired natriuresis and adverse outcomes. The findings are hypothesis-generating and point to an adipo-inflammatory axis connecting diuretic response and prognosis. ## CAR-T-therapie bij ouderen: 5,8% MACE en sterk verhoogde mortaliteit — cardio-oncologie attent *2026-05-30 · European heart journal · https://doi.org/10.1093/eurheartj/ehag394 · https://hartvaat.nl/2026/05/26/car-t-therapie-bij-ouderen-5-8-mace-en-sterk-verhoogde-mortaliteit-cardio-oncolo/* Retrospective cohort of 3,292 Medicare beneficiaries aged >65 who received CAR-T therapy for relapsed haematologic malignancies between 2018 and 2023. Major adverse cardiovascular events occurred in 5.8%, mainly acute heart failure (3.1%) and ischaemic (1.3%) or haemorrhagic stroke (1%). Pre-treatment atrial fibrillation (aOR 1.52), cardiomyopathy (aOR 2.49), and cerebrovascular disease (aOR 2.40) were independent predictors. MACE was associated with markedly elevated in-hospital mortality (aOR 16.9) and 1-year mortality (HR 1.91). Findings underscore the need for cardiovascular screening and monitoring in oncological immunotherapy. ## Efficacy and safety of Ongericimab in patients with hypercholesterolemia: a systematic review and meta-analysis. *2026-05-30 · European journal of clinical pharmacology · https://doi.org/10.1007/s00228-026-04081-z · https://hartvaat.nl/2026/05/26/ongericimab-nieuwe-pcsk9-antistof-verlaagt-ldl-fors-in-meta-analyse/* Ongericimab, a humanised monoclonal antibody against PCSK9, reduced LDL-C by 62% to 73% depending on the regimen in a meta-analysis of five RCTs (1,421 patients with hypercholesterolaemia). Lp(a) (−45 to −50%), apoB, non-HDL cholesterol and triglycerides also fell, while the adverse-event profile was comparable to placebo. The agent widens the range of PCSK9-targeted therapies; cardiovascular outcome trials are still needed to confirm clinical benefit. ## ODYSSEY-OUTCOMES post-hoc: hsCRP en IL-6 zijn complementaire prognostische markers na ACS *2026-05-29 · European heart journal · https://doi.org/10.1093/eurheartj/ehag317 · https://hartvaat.nl/2026/05/26/odyssey-outcomes-post-hoc-hscrp-en-il-6-zijn-complementaire-prognostische-marker/* Post-hoc analysis of ODYSSEY OUTCOMES (n=11,817 patients with recent acute coronary syndrome, all on optimized statin therapy). In models adjusted for each other, treatment assignment, and clinical characteristics, hsCRP independently predicted MACE (p<0.0001) while IL-6 did not; both independently predicted all-cause death. When dichotomised (hsCRP ≥2 mg/L, IL-6 ≥5 pg/ml), risks of MACE and death were elevated only when both markers were elevated. hsCRP conveys inflammatory residual-risk information beyond IL-6 — together they provide a more complete picture. ## State-of-the-art: MRA's bij hartfalen en nierziekte over alle ejectiefracties *2026-05-29 · Heart failure reviews · https://doi.org/10.1007/s10741-026-10636-0 · https://hartvaat.nl/2026/05/26/state-of-the-art-mra-s-bij-hartfalen-en-nierziekte-over-alle-ejectiefracties/* State-of-the-art review of clinical evidence for steroidal (spironolactone, eplerenone) and non-steroidal (finerenone) mineralocorticoid receptor antagonists in heart failure across the full ejection fraction spectrum. Evidence in HFrEF is robust; in HFmrEF and HFpEF, finerenone has recently improved outcomes. The review covers MRAs in chronic kidney disease (HF prevention and treatment) and proposes practical strategies for minimizing hyperkalaemia. Conclusion: MRAs maintain a favourable benefit-risk profile for HF prevention and treatment, including in CKD. ## ESC-consensusverklaring over microvasculaire obstructie en no-reflow na STEMI *2026-05-29 · European heart journal · https://doi.org/10.1093/eurheartj/ehag334 · https://hartvaat.nl/2026/05/26/esc-consensusverklaring-over-microvasculaire-obstructie-en-no-reflow-na-stemi/* Clinical consensus statement on the pathophysiology, prevention, and management of microvascular obstruction ('no-reflow') after primary PCI in STEMI. Despite timely revascularization, suboptimal myocardial reperfusion persists in up to 60% of cases, with major risk of adverse LV remodeling, heart failure and death. Pharmacological therapies (intracoronary adenosine, nitroprusside) show unclear benefit. Non-pharmacological strategies — ischemic postconditioning, supersaturated oxygen therapy, mechanical LV unloading — show promise but require large-scale RCT validation. The statement underscores the need for better risk stratification and novel microvasculature-targeted therapies. ## ESC-consensus: vrouwenhartcentra (WHC) als nieuw zorgmodel in Europa *2026-05-28 · European heart journal · https://doi.org/10.1093/eurheartj/ehag350 · https://hartvaat.nl/2026/05/26/esc-consensus-vrouwenhartcentra-whc-als-nieuw-zorgmodel-in-europa/* Joint clinical consensus statement from EACVI, EAPCI, HFA and ACVC on establishing Women's Heart Centres (WHC) in Europe. WHCs are conceived as hub-and-spoke networks embedded in existing cardiovascular systems, delivering multidisciplinary, sex-sensitive care across the life course. Key domains: INOCA/MINOCA, cardio-obstetrics, cardio-oncology, autoimmune disease in women, mental health, cardiac rehabilitation. The document defines referral pathways, operational standards and core competencies; available evidence suggests improved diagnostic precision, risk factor control and patient-reported outcomes. ## Multimodaal AI-model verhoogt accuratesse van echo-diagnose cardiale amyloïdose *2026-05-28 · Circulation. Cardiovascular imaging · https://doi.org/10.1161/CIRCIMAGING.126.019610 · https://hartvaat.nl/2026/05/27/multimodaal-ai-model-verhoogt-accuratesse-van-echo-diagnose-cardiale-amyloidose/* The Amyloidosis Imaging International Consortium evaluated an integrated AI model (AI-ECM) combining clinical data, laboratory biomarkers, and echocardiographic parameters with the existing TTE-only AI tool Us2.Ca. In 727 patients with cardiac amyloidosis and 316 controls, the combined model significantly outperformed Us2.Ca alone: AUC 0.94 (vs 0.89), 90% accuracy, 93% sensitivity, 85% specificity. AI-ECM also classified all cases where Us2.Ca was indeterminate in 9%. A step toward scalable AI-guided diagnostics for an underdiagnosed but treatable cause of heart failure. ## SGLT2-remmers verminderen epicardiaal vetweefsel: meta-analyse van 11 studies *2026-05-28 · International journal of obesity (2005) · https://doi.org/10.1038/s41366-026-02110-6 · https://hartvaat.nl/2026/05/27/sglt2-remmers-verminderen-epicardiaal-vetweefsel-meta-analyse-van-11-studies/* Systematic review and meta-analysis of 11 studies (284 patients) on the effect of SGLT2 inhibitors on epicardial adipose tissue (EAT). SGLT2 inhibitor therapy produced a significant reduction in EAT versus conventional antidiabetic therapy (Hedges g -1.64; 95% CI -2.10 to -1.18), consistent across thickness (echocardiography) and volume (CT/CMR) modalities. Modest reductions in BMI and systolic blood pressure were also observed. EAT reduction may contribute to the broad cardiovascular benefits of SGLT2 inhibitors. ## Pulsed Field Ablation for the Interventional Treatment of Atrial Fibrillation. A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS) and the Canadian Heart Rhythm Society (CHRS). *2026-05-27 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag080 · https://hartvaat.nl/2026/04/12/ehra-statement-pulsed-field-ablatie-als-nieuwe-standaard-voor-ablatie-bij-atrium/* International scientific statement from EHRA, HRS, APHRS, LAHRS and CHRS on pulsed field ablation (PFA) for atrial fibrillation. Through irreversible electroporation, PFA achieves myocardial ablation while preserving surrounding structures such as nerves, vasculature and the esophagus. Randomized trials demonstrate efficacy comparable to radiofrequency and cryoballoon ablation, with clear advantages in safety and procedural efficiency. The statement summarizes biophysics, technology and clinical evidence and provides practical guidance for clinical implementation and operator training. ## Glucagon-Like Peptide-1 Receptor Agonists in Patients with Heart Failure with Reduced Ejection Fraction. *2026-05-26 · ESC heart failure · https://doi.org/10.1093/eschf/xvag111 · https://hartvaat.nl/2026/04/17/glp-1-receptoragonisten-geassocieerd-met-lagere-mortaliteit-bij-hfref/* Multicenter retrospective cohort (UT Southwestern) of 2,550 propensity-matched patients with heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%). GLP-1 receptor agonist therapy (semaglutide, tirzepatide, or liraglutide) was associated with 32% lower 1-year all-cause mortality (7.1% vs 10.2%; OR 0.68; HR 0.54) and fewer acute decompensated heart failure hospitalizations (27.7% vs 32.8%; OR 0.79), without an increase in arrhythmic events or new ACS/stroke. Prospective randomized trials are needed before GLP-1 RAs can be recommended in HFrEF. ## Evolocumab in patients with multivessel coronary disease after acute myocardial infarction: A target trial emulation. *2026-05-25 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00098-5/fulltext · https://hartvaat.nl/2026/04/10/vroege-evolocumab-na-hartinfarct-verlaagt-mace-bij-uitgestelde-randstenosen/* Target trial emulation in a multicenter Chinese registry (Shanghai, 2021-2022) of 1,862 patients with acute myocardial infarction and successful culprit-vessel revascularization but ≥1 deferred non-culprit intermediate lesion. Early in-hospital evolocumab initiation (n=174) was compared with standard care (n=1,688). Over 2 years, MACE occurred in 5.9% of evolocumab-treated lesions versus 11.9% in controls. The full 2-year hazard ratio was 0.72 (95% CI 0.48-1.09), but a 30-day landmark analysis showed a significant reduction (HR 0.35; 95% CI 0.16-0.74). Findings support early PCSK9 inhibition in the acute phase after AMI, including in deferred non-culprit lesions. ## In Vivo Base Editing of PCSK9 with VERVE-102 for Hypercholesterolemia *2026-05-25 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2601283 · https://hartvaat.nl/2026/05/25/verve-102-eenmalige-base-editing-schakelt-pcsk9-blijvend-uit-fase-1/* VERVE-102 is a base-editing therapy that permanently inactivates the hepatic PCSK9 gene with a single infusion — an adenine base-editor mRNA plus a guide RNA in a GalNAc lipid nanoparticle. In this phase 1 study of 35 patients with heterozygous familial hypercholesterolaemia or premature coronary artery disease, PCSK9 protein fell dose-dependently by 51% to 88% and LDL cholesterol by up to 62%, with a durable effect after one dose. No dose-limiting toxic effects occurred; there were mild-to-moderate infusion reactions and transient ALT elevations (and one aspiration pneumonitis in a patient with reflux). A one-time, durable LDL reduction thus comes into view as a treatment concept. ## The Quantitative Haemodynamic Effect of Levosimendan, Dobutamine and Milrinone in Heart Failure Patients: a Meta-Analysis. *2026-05-24 · ESC heart failure · https://doi.org/10.1093/eschf/xvag120 · https://hartvaat.nl/2026/05/05/inotropica-bij-low-output-hartfalen-vergelijkbare-hemodynamische-effecten-in-met/* Meta-analysis of 26 studies (1,888 patients) comparing the invasively measured haemodynamic effects of dobutamine, levosimendan and milrinone in low-output heart failure. All three agents improved cardiac index, PCWP, mean pulmonary and arterial pressures, and pulmonary/systemic vascular resistance, without consistent superiority of any one drug. The only significant difference concerned mean arterial pressure (p=0.05): milrinone trended toward a reduction, while dobutamine and levosimendan slightly raised it. In a sensitivity analysis, dobutamine improved cardiac index more than levosimendan in chronic HF. Findings support current practice of selecting inotropes based on individual patient characteristics. ## Intracardiac echocardiography during invasive electrophysiological procedures. A scientific statement of the European Heart Rhythm Association of the ESC, and the European Association of Percutaneous Cardiovascular Interventions of the ESC. *2026-05-23 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag059 · https://hartvaat.nl/2026/04/13/intracardiale-echocardiografie-in-de-elektrofysiologie-gezamenlijk-ehra-eapci-st/* Joint scientific statement from EHRA and EAPCI on the role of intracardiac echocardiography (ICE) during invasive electrophysiological procedures. ICE provides real-time visualization of intracardiac structures and has evolved beyond transseptal puncture into an adjunct for ablation of supraventricular and ventricular arrhythmias, fluoroscopy reduction, early detection and management of periprocedural complications, identification of infective endocarditis, endomyocardial biopsy and left atrial appendage occlusion. The document serves as a practical roadmap with standardized views and considerations for optimal clinical use. ## Safety of internal thoracic artery use in patients with prior mediastinal radiation undergoing coronary artery bypass grafting: a Maryland statewide propensity-matched analysis *2026-05-22 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/10/557?rss=1 · https://hartvaat.nl/2026/04/24/ita-bypass-veilig-bij-patienten-met-eerdere-mediastinale-bestraling-maryland-coh/* Retrospective cohort from the Maryland Cardiac Surgery Quality Initiative database: 29,206 patients who underwent CABG with internal thoracic artery (ITA) grafting between July 2011 and March 2023. 294 patients (1%) had a history of mediastinal radiation. After 1:10 propensity matching, there was no significant difference in the primary composite of operative mortality and deep sternal wound infection (2% vs 3%; p=0.53) or in secondary outcomes (infectious complications, length of stay, 30-day readmission). Findings challenge the prevailing concern about ITA use in irradiated patients and argue against excluding them from arterial revascularization strategies. ## IoT-Based Home Blood Pressure Time in Target Range and Brain Lesions on MRI *2026-05-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26519 · https://hartvaat.nl/2026/04/09/thuis-bloeddruk-time-in-target-range-hoger-percentage-in-doel-geassocieerd-met-m/* Cohort study (n=306, mean age 56 years, 57% women) relating Internet-of-Things-based home blood pressure (measured twice daily for a year) to subclinical cerebrovascular damage on MRI (lacunar infarcts, white matter hyperintensities, microbleeds, intracranial artery stenosis). Median annual Time in Target Range was 100% in untreated participants but only 1.9% in those on antihypertensive medication — a striking signal that office-based BP control overstates real-world regulation. Each 10% higher TTR was associated with a 15% lower prevalence of brain lesions (prevalence ratio 0.85; 95% CI 0.79-0.91), with a stronger effect in untreated individuals. TTR was lower in winter than summer. Home BP TTR may be a valuable complement to office measurement for assessing cerebrovascular health. ## Comparative associations of LDL-C, Lp(a), hsCRP, and IL-6 with cardiovascular risk: Insights from the UK Biobank and MESA. *2026-05-22 · Progress in cardiovascular diseases · https://doi.org/10.1016/j.pcad.2026.05.005 · https://hartvaat.nl/2026/05/22/il-6-sterker-met-hart-en-vaatziekte-geassocieerd-dan-ldl-lp-a-en-crp/* In two large primary-prevention cohorts (UK Biobank and MESA), the inflammatory marker interleukin-6 (IL-6) showed the strongest association with atherosclerotic events, independent of LDL-C, Lp(a) and hsCRP. In fully adjusted models the hazard ratio for the top versus bottom quartile was 1.67 (UK Biobank) and 1.60 (MESA) for IL-6 — higher than for the other biomarkers. The authors propose IL-6 as a key driver of atherosclerosis and an attractive target for future anti-inflammatory prevention. ## The secretory PCSK family in cardiovascular disease and beyond *2026-05-21 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00082-1/fulltext · https://hartvaat.nl/2026/04/29/de-secretoire-pcsk-familie-van-moleculaire-schakelaars-tot-doelwit-voor-cardiova/* Review in Atherosclerosis on the proprotein convertase family (PCSK1-PCSK9), identified between 1990 and 2003. These phylogenetically ancient serine proteases activate or regulate a wide range of secretory proteins — polypeptide hormones, growth factors, receptors, adhesion molecules, metalloproteinases and cytokines — by converting inactive precursors into their active forms. The authors place PCSK9, the best-known member due to its role in LDL-receptor degradation and its therapeutic exploitation via evolocumab, alirocumab and inclisiran, in the broader family context. The article discusses overlap with cardiovascular pathology and identifies emerging therapeutic targets within the PCSK family. ## Bloeddrukvariabiliteit (SPRINT + ACCORD IPD-meta): even prognostisch als gemiddelde bloeddruk in hoog-risico patiënten *2026-05-15 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag330 · https://hartvaat.nl/2026/05/14/bloeddrukvariabiliteit-sprint-accord-ipd-meta-even-prognostisch-als-gemiddelde-b/* IPD meta-analysis of SPRINT and ACCORD (n=18,415, median 12 BP measurements over 3.6 y, 1,244 MACEs). Higher SBP variability (VIM, top vs bottom tertile) was independently associated with MACE (HR 1.15; 95% CI 1.00–1.32), with a J-shaped relationship. Prognostic value comparable to mean SBP. Argues for routine reporting of BP variability in cardiovascular risk models, not just mean BP. ## AHA Scientific Statement 2026: secundaire preventie na coronaire bypassoperatie — eerste update sinds 2015 *2026-05-15 · Circulation · https://doi.org/10.1161/CIR.0000000000001434 · https://hartvaat.nl/2026/05/13/aha-scientific-statement-2026-secundaire-preventie-na-coronaire-bypassoperatie-e/* First AHA scientific statement on post-CABG secondary prevention since 2015, published in Circulation in the week after HF26. Covers lipid lowering (including PCSK9 inhibitors / inclisiran in this population), antiplatelet/anticoagulation, BP targets, diabetes and CKM management, cardiac rehabilitation, and post-discharge follow-up — separating evidence-based from consensus recommendations throughout. Reference document for the multidisciplinary CABG follow-up team. ## Wereldwijde HF-registry: FEV1 is een onafhankelijke prognostische factor — pleidooi voor routine-spirometrie bij hartfalen *2026-05-15 · ESC Heart Failure · https://doi.org/10.1093/eschf/xvag128 · https://hartvaat.nl/2026/05/13/wereldwijde-hf-registry-fev1-is-een-onafhankelijke-prognostische-factor-pleidooi/* Global Congestive Heart Failure registry sub-study (n=3,359, 28 countries, median 3.8-y follow-up) finds FEV1 z-score ≤-2 is independently associated with all-cause mortality (HR 2.20), CV mortality (HR 2.45) and hospitalization (HR 1.40) — effect sizes comparable to other major HF prognostic factors. Even normal-range FEV1 reductions tracked with increased HF burden. Argues for routine spirometry as part of the HF workup across global populations. ## UK Biobank: na ischemisch CVA of TIA is het risico op hartfalen groter dan dat op een infarct *2026-05-15 · ESC Heart Failure · https://doi.org/10.1093/eschf/xvag123 · https://hartvaat.nl/2026/05/13/uk-biobank-na-ischemisch-cva-of-tia-is-het-risico-op-hartfalen-groter-dan-dat-op/* UK Biobank cohort (n=405,406, age 40–69, 13.7-y follow-up) shows ischaemic stroke/TIA survivors face crude HR 3.6 (adjusted 1.4) for HF hospitalization. Notably, HF hospitalization risk (12.6%) exceeds subsequent MI risk (5.4%) in this group. Lower LVEF and higher LV mass on CMR among those who develop HF. Incident HF after stroke carries HR 1.8 for mortality. Argues for systematic cardiac follow-up of stroke survivors with structured HF risk assessment. ## VERISEC: vericiguat in de praktijk halveert hartfalen-decompensaties bij HFrEF — Spaanse 1-jaars registry van 835 patiënten *2026-05-15 · ESC Heart Failure · https://doi.org/10.1093/eschf/xvag138 · https://hartvaat.nl/2026/05/13/verisec-vericiguat-in-de-praktijk-halveert-hartfalen-decompensaties-bij-hfref-sp/* VERISEC (n=835, 41 Spanish centres) confirms vericiguat's real-world benefit in HFrEF after recent decompensation. Over 12 months on top of >90% SGLT2i / >85% RAASi / ~80% MRA / 91% beta-blocker background, NT-proBNP fell from 3,532 to 2,292 pg/mL (p<0.001), LVEF rose from 30.3% to 35.4%, NYHA class improved, and HF decompensations requiring IV diuretics halved (1.34 → 0.65 per year). 13.4% discontinued, mostly for symptomatic hypotension; higher baseline NT-proBNP predicted discontinuation. ## EHJ-editorial Cleland: wereldwijde hartfalenprevalentie overschrijdt 600 miljoen — van gokken naar evidence *2026-05-12 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag331 · https://hartvaat.nl/2026/05/11/ehj-editorial-cleland-wereldwijde-hartfalenprevalentie-overschrijdt-600-miljoen-/* Cleland, Lainscak, Pellicori editorial (EHJ, during HF26) revises global heart failure prevalence: historical ~60M figures reflect symptomatic HF in registries, but contemporary population-based echo screening including stage A/B, HFpEF and structural/functional abnormalities consistently finds 8–12% of older adults — implying a global population >600 million. Calls for international case-definition consensus, routine NT-proBNP + echo screening in primary care, and HF prevalence in national CV registries. Frames HF as a population-health emergency rather than a sub-specialty problem. ## FINEARTS-HF subanalyse: virale luchtweginfecties triggeren hartfalen-verslechtering, finerenon-effect blijft behouden *2026-05-12 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag384 · https://hartvaat.nl/2026/05/11/finearts-hf-subanalyse-virale-luchtweginfecties-triggeren-hartfalen-verslechteri/* FINEARTS-HF (n=6,001) sub-analysis on viral respiratory tract infections (RTIs): RTIs were associated with subsequent worsening HF events and excess mortality, particularly in symptomatic patients. Finerenone did not modify RTI incidence, but its benefit on the primary outcome was preserved across patients with and without intercurrent RTI. Supports vaccination policy emphasis in HFmrEF/HFpEF and reassures that finerenone benefit is robust to common viral illness. ## AHA Scientific Statement: evaluatie en behandeling van het kind met acuut gedecompenseerd hartfalen *2026-05-12 · Circulation · https://doi.org/10.1161/CIR.0000000000001428 · https://hartvaat.nl/2026/05/12/aha-scientific-statement-evaluatie-en-behandeling-van-het-kind-met-acuut-gedecom/* AHA Scientific Statement published in Circulation during HF26 — first integrated framework for acute decompensated heart failure in children and adolescents. Driven by rising pediatric ADHF presentations with higher morbidity/mortality and resource use than adults. Covers triage, risk stratification, diagnostic workup, initial stabilization, inotrope and diuretic choice, mechanical support thresholds, transition to chronic therapy, discharge planning, and post-discharge psychosocial follow-up. Knowledge gaps explicitly named. Useful reference for tertiary paediatric cardiac centres. ## Massieve LVH bij pediatrische HCM: vroeger diagnose, vaker sarcomere variant, drievoudig verhoogde sterfte *2026-05-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.126.078843 · https://hartvaat.nl/2026/05/12/massieve-lvh-bij-pediatrische-hcm-vroeger-diagnose-vaker-sarcomere-variant-driev/* Multi-registry analysis (SHaRe + IPHCC, n=587, of which 186 had massive LVH defined as MLVWT ≥30 mm or z-score ≥+20). Massive LVH in pediatric HCM is associated with younger age at diagnosis (median 9.2 vs 13.6 years; p<0.001), higher sarcomeric variant prevalence (72% vs 61%; p=0.034), and 3.3-fold higher HCM-related mortality (95% CI 1.2–9.7; p=0.026). Supports earlier, more aggressive surveillance and intervention thresholds in this subgroup. ## HCMR (NHLBI): multidimensionele risicovoorspelling beter dan SCD-gefocuste richtlijnen bij hypertrofische cardiomyopathie *2026-05-12 · JAMA · https://doi.org/10.1001/jama.2026.5633 · https://hartvaat.nl/2026/05/11/hcmr-nhlbi-multidimensionele-risicovoorspelling-beter-dan-scd-gefocuste-richtlij/* HCMR (NHLBI HCM Registry) prospectively enrolled 2,750 patients with HCM at 44 expert sites across North America and Europe; all underwent contrast CMR, biomarker/genotyping bloodwork, and structured history. Median follow-up >7 years. An integrated multidimensional model (combining clinical, imaging, genetic and biomarker data via elastic-net selection) outperforms current SCD-only risk prediction, capturing patients at risk of HF events and transplant that are under-recognized today. Likely reduces both unnecessary ICDs (overtreatment) and avoidable deaths (undertreatment). Important context for HCM clinics now selecting candidates for mavacamten/aficamten therapy. ## CADENCE: sotatercept verlaagt pulmonale vaatweerstand bij gecombineerde pre/postcapillaire PH bij HFpEF *2026-05-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.126.079918 · https://hartvaat.nl/2026/05/12/cadence-sotatercept-verlaagt-pulmonale-vaatweerstand-bij-gecombineerde-pre-postc/* CADENCE (n=164, multicentre, randomized, placebo-controlled phase 2) tested sotatercept (activin signalling inhibitor) in patients with combined post- and pre-capillary pulmonary hypertension (CpcPH) in HFpEF. PVR at week 24 dropped by −1.02 Wood units (95% CI −1.81 to −0.23; p=0.004) at the 0.3 mg/kg dose and −0.75 (p=0.024) at 0.7 mg/kg. Mean PAP fell by ~9 mmHg, wedge pressure by 2.5–3 mmHg, 6-min walk improved 20.3 m at the lower dose. Proof of concept for the first therapy in CpcPH-HFpEF, a high-mortality phenotype without approved treatment. Major extension of the sotatercept (WINREVAIR) platform from PAH into HFpEF-PH. (Originally presented at ACC.26 in March; full Circulation publication during HF26.) ## PARADISE: gelijktijdig acuut hartfalen plus luchtweginfectie verhoogt sterfte tijdens opname, niet daarna *2026-05-11 · European Journal of Heart Failure · https://doi.org/10.1093/ejhf/xuag160 · https://hartvaat.nl/2026/05/10/paradise-gelijktijdig-acuut-hartfalen-plus-luchtweginfectie-verhoogt-sterfte-tij/* PARADISE sub-analysis (French dyspnoea cohort 2010–2019, n=11,679): 37% had AHF alone, 44% respiratory infection (RI) alone, 19% both. AHF+RI together had higher in-hospital mortality than AHF alone (aOR 1.62; 95% CI 1.33–1.98; p<0.001) but not higher post-discharge mortality (aHR 0.99; p=0.9). RI alone was not associated with excess mortality. Concomitant RI in AHF is a marker for in-hospital severity, not a long-term prognostic modifier — long-term outcome is dictated by the underlying HF. ## Hartfalen en infarct verdrievoudigen het risico op kanker — vooral hematologisch *2026-05-11 · European Journal of Heart Failure · https://doi.org/10.1093/ejhf/xuag061 · https://hartvaat.nl/2026/05/10/hartfalen-en-infarct-verdrievoudigen-het-risico-op-kanker-vooral-hematologisch/* Federated cohort study (TriNetX) of 120,783 HF patients and 7,896 AMI patients propensity-matched 1:1 to controls without HF/AMI, excluding prior/concurrent cancer. New cancer diagnoses starting 6 months after index hospitalization showed strikingly elevated risk: HF HR 2.80 (95% CI 2.69–2.91); AMI HR 2.02 (95% CI 1.71–2.39); both p<0.001. The excess risk was much greater for haematologic malignancies (HF HR 6.78; AMI HR 4.45) than solid tumours. HFpEF carried slightly higher cancer incidence than HFrEF/HFmrEF (HR 1.10). Hypothesis-generating finding in 'reverse cardio-oncology' — possible mechanisms include shared inflammatory pathways and clonal haematopoiesis. Prospective confirmation needed before screening implications. ## PORTHOS: NT-proBNP-afkapwaarden onbetrouwbaar bij obese patiënten — risico op gemiste hartfalendiagnose *2026-05-11 · European Journal of Heart Failure · https://doi.org/10.1093/ejhf/xuag154 · https://hartvaat.nl/2026/05/10/porthos-nt-probnp-afkapwaarden-onbetrouwbaar-bij-obese-patienten-risico-op-gemis/* PORTHOS (Portugal, population-based, age ≥50, n=2,498) shows NT-proBNP is systematically lower in obesity — ~50 pg/mL lower per 5 kg/m² BMI increase. Obese participants with NT-proBNP <125 pg/mL had higher odds of HF symptoms (OR 1.97) and echo abnormalities (OR 3.63) than lean participants above the cut-off, despite being 9 years younger and having 4x lower NT-proBNP (59 vs 235 pg/mL). Fixed cut-offs miss HF in obesity; primary-care screening pathways need adjustment. ## POSEIDON: 4 op 10 patiënten met hartfalen wereldwijd heeft inflammatoir verhoogd hsCRP — basis voor anti-inflammatoire therapie *2026-05-11 · European Journal of Heart Failure · https://doi.org/10.1093/ejhf/xuag155 · https://hartvaat.nl/2026/05/10/poseidon-4-op-10-patienten-met-hartfalen-wereldwijd-heeft-inflammatoir-verhoogd-/* POSEIDON enrolled 18,904 individuals at 317 sites in 18 countries (2023–2025); 11,809 had HF with hsCRP available. Elevated hsCRP (≥2 mg/L) was present in ~38% of patients across HFpEF, HFmrEF and HFrEF — strikingly consistent across the EF spectrum. Patients with elevated hsCRP were more likely female with a cardio-kidney-metabolic phenotype: CKD, obesity, worse NYHA, higher NT-proBNP. Smoking, autoimmune/inflammatory disease, obesity and reduced eGFR were independent predictors. The findings define the target population for IL-6 trials (ATHENA, HERMES with ziltivekimab) also announced at HF26. ## UF-CARE: ultrafiltratie bij type-2 cardiorenaal syndroom mist primair eindpunt in kleine Franse RCT *2026-05-11 · ESC Heart Failure · https://doi.org/10.1093/eschf/xvag133 · https://hartvaat.nl/2026/05/09/uf-care-ultrafiltratie-bij-type-2-cardiorenaal-syndroom-mist-primair-eindpunt-in/* UF-CARE (15 French centres, n=46 randomized of 108 screened) added ultrafiltration (PD, HD or IUF) to optimized medical therapy in severe HF with refractory congestion and CKD (type-2 cardiorenal syndrome). The primary composite (all-cause death or unplanned HF hospitalization at 12 months) occurred in 63% vs 87% (p=0.144), with one technique-related death. Underpowered; the 24-point absolute difference is hypothesis-generating but not statistically significant. ## SUBCUT HF II: subcutane furosemide thuis verlaagt opnameduur met 5,5 dagen na hartfalenopname *2026-05-11 · Heart Failure 2026 (Late-Breaking Science) · https://doi.org/https://www.prnewswire.com/news-releases/results-of-the-randomized-controlled-trial-of-at-home-subcutaneous-diuretic-therapy-for-heart-failure-associated-edema-to-be-presented-at-heart-failure-2026-302760746.html · https://hartvaat.nl/2026/05/09/subcut-hf-ii-subcutane-furosemide-thuis-verlaagt-opnameduur-met-5-5-dagen-na-har/* SUBCUT HF II (UK, 20 NHS sites, n=170) compared at-home subcutaneous furosemide via the Lasix ONYU patch-pump (80 mg over 5h) versus continued inpatient IV furosemide in patients admitted with HF-associated edema. At-home treatment yielded +4 days alive-and-out-of-hospital at 30 days (p<0.001) and reduced index hospitalization length by 5.5 days (p<0.001), sustained at 60 days, with equivalent safety. Lasix ONYU was FDA-approved October 2025; SUBCUT HF II provides the supporting RCT evidence. Direct implications for cardiology capacity planning. ## Astma geassocieerd met verhoogd risico op degeneratieve hartklepziekte — UK Biobank *2026-05-11 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/10/576?rss=1 · https://hartvaat.nl/2026/04/24/astma-geassocieerd-met-verhoogd-risico-op-degeneratieve-hartklepziekte-uk-bioban/* A prospective cohort analysis of 483,735 UK Biobank participants (median age 56.5 years, 45.2% male) free of valvular heart disease at baseline. Cox regression adjusted for demographic, lifestyle and clinical covariates. The study assessed incidence of aortic stenosis, aortic regurgitation, mitral regurgitation and pulmonary regurgitation. Asthma was associated with higher risk across several degenerative valve disorders, with sensitivity analyses for asthma medications and duration. An under-recognised cardiovascular dimension of asthma that warrants further study. ## Cardiovasculaire ziekte bij sikkelcelziekte: ondergediagnosticeerde drijver van mortaliteit *2026-05-11 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/10/539?rss=1 · https://hartvaat.nl/2026/04/24/cardiovasculaire-ziekte-bij-sikkelcelziekte-ondergediagnosticeerde-drijver-van-m/* A contemporary review of cardiovascular complications in sickle cell disease: myocardial dysfunction, pulmonary hypertension, cardiac iron overload, arrhythmias, myocardial infarction, stroke and sudden death. They remain under-recognised despite their growing role in morbidity and premature mortality. Cardiac MRI with T2* mapping and ECV sequences, speckle-tracking echocardiography and invasive exercise testing reveal a distinct phenotype of restrictive cardiomyopathy with high-output heart failure. The review provides SCD-specific risk stratification and treatment algorithms. ## AHA-statement: kinderen met cardiomyopathie mogen meer bewegen *2026-05-11 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001431 · https://hartvaat.nl/2026/04/23/aha-statement-kinderen-met-cardiomyopathie-mogen-meer-bewegen/* Decades of risk-averse guidance have left children with cardiomyopathy sedentary, with poor cardiorespiratory fitness and added cardiometabolic risk. This AHA Scientific Statement provides an evidence-based framework to actively promote physical activity in paediatric hypertrophic, dilated, restrictive and arrhythmogenic cardiomyopathy. Newer data suggest sudden cardiac death risk in selected patients is not higher with exercise than with inactivity, and physical activity may even support reverse remodelling. The statement offers a practical framework for risk stratification and personalised exercise prescription. ## TELESAT PRIOR-HF: telemonitoring na hartfalenopname verbonden met 46% lagere mortaliteit *2026-05-10 · European Journal of Heart Failure · https://doi.org/10.1093/ejhf/xuag146 · https://hartvaat.nl/2026/05/09/telesat-prior-hf-telemonitoring-na-hartfalenopname-verbonden-met-46-lagere-morta/* Pre-specified TELESAT-HF substudy in patients with prior HF hospitalization (~1,258 RMP, ~2,321 weighted controls from French claims data). Remote monitoring was associated with halved all-cause mortality (23.5% vs 39.6%; HR 0.54), 15% fewer HF rehospitalizations, 32% fewer ED visits, 35% fewer ICU admissions and 1.77 fewer hospital days, without higher total costs. Observational — residual confounding possible despite weighting — but a strong signal supporting structured RMP implementation in post-discharge HF care. ## DELTA-HF: thoracale-duct lymfedecongestie via eLym-systeem haalbaar bij acute hartfalen *2026-05-10 · European Journal of Heart Failure · https://doi.org/10.1093/ejhf/xuag157 · https://hartvaat.nl/2026/05/10/delta-hf-thoracale-duct-lymfedecongestie-via-elym-systeem-haalbaar-bij-acute-har/* DELTA-HF (n=40, single-arm, multicenter) tested the eLym System — an endovenous axial pump creating a reduced-pressure zone at the venous angle to support lymphatic drainage via the thoracic duct — in patients with acute decompensated HF refractory to oral diuretics. Deployment was 100% successful, weight loss 3.6 kg during therapy and 6.8 kg by discharge, congestion score from 5 to 0 (sustained at 6 months), creatinine stable. 95% freedom from device/procedure SAEs; one fatal vascular complication. Encouraging proof of concept in a difficult-to-decongest population; randomized trials warranted. ## Dig-RHD: digoxine verlaagt sterfte en hartfalen bij symptomatische reumatische hartziekte *2026-05-10 · JAMA · https://doi.org/10.1001/jama.2026.7335 · https://hartvaat.nl/2026/05/10/dig-rhd-digoxine-verlaagt-sterfte-en-hartfalen-bij-symptomatische-reumatische-ha/* Dig-RHD is the first RCT of digoxin in rheumatic heart disease. 1,769 patients across 12 Indian tertiary centers (mean age 46, 72% female, 70% AF, 90% NYHA II–IV, mostly with mixed valve lesions) were randomized to digoxin 0.125–0.25 mg/day or placebo and followed a median 2.1 years. The primary composite of all-cause death or new-onset/worsening HF occurred in 31.4% (digoxin) vs 35.5% (placebo) — HR 0.82; 95% CI 0.69–0.96. Practice-changing for the Global South where RHD remains the leading cause of HF; relevant for migrant populations with chronic rheumatic valve disease in Western settings. ## Meta-analyse DECISION + DIGIT-HF + DIG: digitalisglycosiden reduceren verslechterende hartfalenevents over 9.013 patiënten *2026-05-10 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag387 · https://hartvaat.nl/2026/05/09/meta-analyse-decision-digit-hf-dig-digitalisglycosiden-reduceren-verslechterende/* A study-level meta-analysis pooling DECISION, DIGIT-HF and DIG (n=9,013) shows digitalis glycosides reduce CV death or first worsening HF event (HR 0.85; 95% CI 0.80–0.90; p<0.001) and time to first worsening HF event (HR 0.75; p<0.001), with consistent benefit on top of contemporary RALES/EMPHASIS-HF/PARADIGM-HF/DAPA-HF backbones. Population-level evidence reopening the case for digitalis as an add-on in symptomatic HF(m)rEF despite four-pillar therapy. ## DECISION-onttrekkingssubstudie: stoppen van digoxine na lange behandeling leidt tot acute verslechtering *2026-05-10 · European Heart Journal · https://doi.org/10.1093/eurheartj/ehag385 · https://hartvaat.nl/2026/05/10/decision-onttrekkingssubstudie-stoppen-van-digoxine-na-lange-behandeling-leidt-t/* Pre-specified DECISION substudy: 587 patients on active treatment (digoxin or placebo) underwent blinded withdrawal with 6-week in-person follow-up. Pre-withdrawal event rates were similar between groups. Post-withdrawal, digoxin-withdrawn patients had a sharp increase in CV death/worsening HF events (42.8 vs 5.9 per 100 patient-years; RR 7.37; 95% CI 1.56–34.88; p=0.012), accompanied by rising heart rate, falling SBP and rising NT-proBNP. Discontinuing digoxin after long-term exposure is associated with clinical deterioration — a clinically relevant caution for deprescribing reviews. ## DECISION: lage-dosis digoxine mist primair eindpunt bij HF(m)rEF, maar suggereert minder verslechterende hartfalenevents *2026-05-10 · Nature Medicine · https://doi.org/10.1038/s41591-026-04406-6 · https://hartvaat.nl/2026/05/10/decision-lage-dosis-digoxine-mist-primair-eindpunt-bij-hf-m-ref-maar-suggereert-/* DECISION (n=1,001, 43 Dutch sites, median 36.5-month follow-up) is the first major modern RCT of low-dose digoxin in contemporary HF(m)rEF on guideline-directed therapy. The primary composite of worsening HF events plus CV mortality was lower with digoxin (RR 0.81; 95% CI 0.61–1.07) but did not reach statistical significance (p=0.133). Worsening HF events trended lower (RR 0.76); CV mortality was unchanged. Drug was well tolerated. Pooled with DIGIT-HF and DIG (n=9,013), digitalis glycosides did significantly reduce the composite (HR 0.85; p<0.001), reopening the case for digitalis as a cheap, safe add-on in HF(m)rEF. ## HF-REVERT: antisense miRNA-remmer CDR132L mist primair eindpunt na infarct met verminderde EF *2026-05-10 · Nature Medicine · https://doi.org/10.1038/s41591-026-04408-4 · https://hartvaat.nl/2026/05/10/hf-revert-antisense-mirna-remmer-cdr132l-mist-primair-eindpunt-na-infarct-met-ve/* HF-REVERT (n=294) is the first phase 2 randomized trial of an antisense microRNA inhibitor in cardiology. CDR132L (anti-miR-132) given as three IV doses 3–14 days post-MI did not improve the primary endpoint (% change in LVESVi at 6 months) nor any secondary endpoint over placebo. The drug was well tolerated. Pre-specified exploratory analyses suggest potential benefit in patients with marked adverse remodeling at baseline — a hypothesis-generating signal worth pursuing in chronic HF populations. Important null finding for the cardiac RNA-therapeutics pipeline. ## PRAISE-MR: sacubitril-valsartan verbetert inspanningshemodynamiek bij HFpEF met atriale mitralisinsufficiëntie *2026-05-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.126.080833 · https://hartvaat.nl/2026/05/09/praise-mr-sacubitril-valsartan-verbetert-inspanningshemodynamiek-bij-hfpef-met-a/* PRAISE-MR is the first medical-therapy trial demonstrating exercise-hemodynamic benefit in HFpEF with atrial functional mitral regurgitation (AFMR). In 84 patients randomized to sacubitril-valsartan or standard of care, the 6-month change in exercise mPAP/CO slope improved by 0.93 mmHg/L/min with sacubitril-valsartan (95% CI 0.07–1.80; p=0.035). Peak VO2, KCCQ score, NT-proBNP, LA volume and AFMR severity all improved. The findings position ARNI as a credible disease-modifying option for HFpEF + AFMR, alongside transcatheter mitral repair as evidence emerges. ## Bij metabool syndroom zonder diabetes of hypertensie: bloeddruk en triglyceriden zijn de sleutel *2026-05-10 · BMJ open · https://doi.org/10.1136/bmjopen-2025-105379 · https://hartvaat.nl/2026/04/24/bij-metabool-syndroom-zonder-diabetes-of-hypertensie-bloeddruk-en-triglyceriden-/* The Skaraborg cohort (Sweden) followed 2,328 individuals without diabetes or hypertension at baseline (2002-2005, follow-up to 2011). The NCEP-defined metabolic syndrome predicted cardiovascular events (HR 2.4); IDF criteria did not. Blood pressure (HR 1.77) and triglycerides (HR 2.05) were the strongest individual predictors. Combining BP ≥125/80 mmHg with triglycerides ≥1.5 mmol/L matched the full MetS for prediction (HR 2.1; sensitivity 32.5%; NNE 7.1). Lowering the triglyceride cut-off to ≥1.2 mmol/L raised sensitivity to 44.9%. Practical: pay attention to borderline blood pressure and then measure triglycerides. ## Grote ziekenhuisvariatie in MCS-gebruik bij myocardinfarct met cardiogene shock *2026-05-10 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/10/563?rss=1 · https://hartvaat.nl/2026/04/24/grote-ziekenhuisvariatie-in-mcs-gebruik-bij-myocardinfarct-met-cardiogene-shock/* An analysis of the 2019 Nationwide Readmissions Database examined inter-hospital variation in intra-aortic balloon pump (IABP) versus percutaneous ventricular assist device (PVAD) use in adults with AMI complicated by cardiogenic shock. Large inter-hospital differences in device choice were observed, not fully explained by patient factors. Institutional characteristics (volume, academic affiliation) emerged as key determinants — underscoring the need for standardised algorithms for MCS deployment in AMI cardiogenic shock. ## Bayesiaanse netwerkmeta-analyse vergelijkt revascularisatie bij stabiele ischemische hartziekte *2026-05-10 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/10/530?rss=1 · https://hartvaat.nl/2026/04/24/bayesiaanse-netwerkmeta-analyse-vergelijkt-revascularisatie-bij-stabiele-ischemi/* A hierarchical Bayesian network meta-analysis (PROSPERO CRD42024541215) of RCTs published 2005-June 2025 compared three initial strategies for non-acute myocardial ischaemic syndromes: optimal medical therapy alone, PCI added to OMT and CABG added to OMT. The primary outcome was long-term all-cause mortality. The analysis quantifies the strength of evidence on the comparative effectiveness of revascularisation — an area where current ESC and ACC/AHA guidelines diverge — and provides a quantitative framework for decisions in stable coronary disease. ## CRT bij volwassenen met systemische rechterventrikel: gemengde uitkomsten in internationaal cohort *2026-05-09 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/10/549?rss=1 · https://hartvaat.nl/2026/04/24/crt-bij-volwassenen-met-systemische-rechterventrikel-gemengde-uitkomsten-in-inte/* An international retrospective study (33 centres) of 1,721 adults with a systemic right ventricle — after atrial switch for transposition of the great arteries or with congenitally corrected TGA — of whom 105 (3.5%) underwent cardiac resynchronisation therapy. With a median 4.6-year follow-up, the primary endpoint was overall and heart-failure-free survival. CRT in this unique congenital population shows heterogeneous effects depending on baseline QRS width and function; careful selection remains essential for clinical gain. ## Genen voor bloeddruk in de kindertijd voorspellen cardiometabool risico op latere leeftijd *2026-05-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehag313 · https://hartvaat.nl/2026/04/27/genen-voor-bloeddruk-in-de-kindertijd-voorspellen-cardiometabool-risico-op-later/* The largest paediatric GWAS meta-analysis to date (28,425 children for BP, 22,565 for heart rate, ages 4-17) identified eight genome-wide significant loci for childhood blood pressure and three for heart rate — all novel in children but previously reported in adults. Childhood polygenic risk scores explained up to 1.6% of BP and 5.2% of HR variance. In the UK Biobank, higher childhood-BP PRS levels were significantly associated with adult hypertension, angina, myocardial infarction and cardiovascular mortality — supporting cardiovascular prevention strategies that begin early in life. ## PRAETORIAN-DFT: defibrillatietest bij subcutane ICD veilig achterwege te laten *2026-05-09 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.080638 · https://hartvaat.nl/2026/04/25/praetorian-dft-defibrillatietest-bij-subcutane-icd-veilig-achterwege-te-laten/* The multinational PRAETORIAN-DFT RCT randomised 965 subcutaneous ICD recipients across 37 centres to defibrillation testing versus no testing — using the PRAETORIAN score (based on chest X-ray) to assess implant position in the no-DFT arm. First-shock failure for spontaneous ventricular arrhythmias was non-inferior without DFT, with comparable mortality and revisions. Routine defibrillation testing can therefore be omitted in patients with a favourable PRAETORIAN score, reducing implant-related risk. ## SANTORINI UK: LDL-doel onbereikt bij meerderheid van hoogrisicopatiënten na 1 jaar *2026-05-08 · BMJ open · https://doi.org/10.1136/bmjopen-2025-114031 · https://hartvaat.nl/2026/04/24/santorini-uk-ldl-doel-onbereikt-bij-meerderheid-van-hoogrisicopatienten-na-1-jaa/* Secondary analysis of the SANTORINI study (663 UK patients with high/very high CV risk, 8,502 from other European countries) examined 1-year changes in lipid-lowering therapy and LDL-C goal attainment. The proportion on no LLT in the UK dropped from 20.4% to 7.1%. Monotherapy dominates in the UK (74.8% at baseline → 84.9% at 1 year), while combination therapy grew faster elsewhere (27.1% to 40.2%). Mean UK LDL-C fell from 2.5 to 2.1 mmol/L. Yet most patients still miss NICE and ESC/EAS LDL targets — room for intensification, especially via combination therapy. ## Verminderde nierfunctie verhoogt hartfalenrisico bij ouderen — ASPREE-cohort *2026-05-08 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/10/569?rss=1 · https://hartvaat.nl/2026/04/24/verminderde-nierfunctie-verhoogt-hartfalenrisico-bij-ouderen-aspree-cohort/* A prospective cohort analysis nested in the ASPREE trial and its extension study (17,834 older adults) examined whether elevated urine albumin-creatinine ratio (UACR) or reduced eGFR predicted heart failure hospitalisation or death. Over a median 8.6-year follow-up, 354 (1.98%) had a first HF hospitalisation and 147 (0.82%) died from HF. Albuminuria (UACR ≥3.0 mg/mmol; 11.3% of the cohort) was associated with higher risk of HF events. Routine kidney screening in primary care looks valuable for cardiovascular risk stratification in older adults. ## NOAC's onder de 65 jaar: apixaban heeft het gunstigste baten-risicoprofiel *2026-05-08 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2026.9082 · https://hartvaat.nl/2026/04/01/noac-s-onder-de-65-jaar-apixaban-heeft-het-gunstigste-baten-risicoprofiel/* A cohort study in the FDA Sentinel System of >173,000 NVAF patients aged 21-64 found that rivaroxaban was associated with higher major extracranial bleeding (HR 1.91) and gastrointestinal bleeding (HR 1.92) versus apixaban, with no difference in thromboembolic stroke. Dabigatran carried a higher thromboembolic stroke risk than both rivaroxaban and apixaban. Apixaban emerged with the most favourable benefit-harm profile — extending Medicare findings into a younger AF population. ## NKF-consensus: standaardiseer urine-afname om albuminurie betrouwbaar te meten *2026-05-07 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag083 · https://hartvaat.nl/2026/04/24/nkf-consensus-standaardiseer-urine-afname-om-albuminurie-betrouwbaar-te-meten/* The US National Kidney Foundation convened a workshop (April 2025) on pre-analytical factors affecting urinary albumin and protein measurement. Heterogeneity in collection method (24-hour vs single void), timing, repeat sampling, clinical conditions causing false-positives and storage conditions all materially influence results. The consensus report offers practical recommendations to minimise biological and analytical variability — relevant for both clinical decisions and trial data. ## Verminderde RV-vrijewandstrain voorspelt MCS-behoefte bij cardiogene shock *2026-05-07 · ESC heart failure · https://doi.org/10.1093/eschf/xvag116 · https://hartvaat.nl/2026/05/05/verminderde-rv-vrijewandstrain-voorspelt-mcs-behoefte-bij-cardiogene-shock/* A 92-patient single-centre retrospective study found that severely impaired RV free-wall longitudinal strain (<11%) on early echocardiography predicted need for temporary mechanical circulatory support (OR 10.49) in cardiogenic shock. TAPSE and fractional area change were not predictive. Combining RV FWLS with SOFA score and LVEF achieved 78% accuracy and 95% specificity for MCS escalation. RV strain deserves a role in early risk stratification of cardiogenic shock. ## Gecombineerde mitraal- en tricuspidalis-TEER verbetert overleving bij multivalvulair lijden *2026-05-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehag186 · https://hartvaat.nl/2026/04/24/gecombineerde-mitraal-en-tricuspidalis-teer-verbetert-overleving-bij-multivalvul/* In the EuroTR registry of 3,100 patients with severe tricuspid regurgitation, 30% also had moderate mitral regurgitation — associated with higher 2-year mortality (37% vs 23%). After propensity score matching (217 pairs), concomitant mitral TEER added to tricuspid TEER produced greater TR reduction, better NYHA class and 6-minute walk distance, and significantly higher survival (87% vs 76% at 1 year; 81% vs 70% at 2 years). On multivariable analysis, moderate MR predicted death (HR 1.81) and combined M-TEER predicted survival (HR 0.46). Hypothesis-generating — a dedicated RCT is needed. ## Circulerend miR-10b-5p voorspelt AF-recidief na ablatie *2026-05-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag097 · https://hartvaat.nl/2026/05/06/circulerend-mir-10b-5p-voorspelt-af-recidief-na-ablatie/* A two-phase translational study identified circulating microRNAs associated with atrial fibrillation recurrence after catheter ablation. The discovery phase (n=29) flagged 14 miRNAs significantly linked to recurrence; in the prospective validation cohort (n=126), miR-10b-5p showed the highest discrimination (AUC=0.96). Lower miR-10b-5p expression independently predicted recurrence and substantially improved the baseline clinical model (ΔR² 63.3%). Pathway analysis linked miR-10b-5p to FOXO, p53 and circadian signalling — relevant to atrial remodelling. Multicentre validation is needed for clinical use. ## Risicofactoren voor cardiovasculaire events bij heterozygote familiaire hypercholesterolemie *2026-05-06 · Atherosclerosis · https://doi.org/10.1016/j.atherosclerosis.2026.120650 · https://hartvaat.nl/2026/04/01/risicofactoren-voor-cardiovasculaire-events-bij-heterozygote-familiaire-hypercho/* A systematic review and meta-analysis (21 studies, 23,613 genetically confirmed heterozygous FH patients, 3,489 cardiovascular events) showed independent associations between ASCVD and hypertension (effect size 0.41), male sex (0.33), smoking (0.32), Lp(a) (0.22), age (0.21), BMI (0.11), triglycerides (0.08) and LDL-C (0.02). Beyond intensive LDL lowering, aggressive management of classic risk factors — especially blood pressure and smoking — is essential to limit residual risk in this high-risk group. ## Maternale auto-immuunziekte verhoogt cardiovasculair risico bij nakomelingen *2026-05-06 · European heart journal · https://doi.org/10.1093/eurheartj/ehag316 · https://hartvaat.nl/2026/04/22/maternale-auto-immuunziekte-verhoogt-cardiovasculair-risico-bij-nakomelingen/* A Swedish population-based cohort of 1,455,645 singleton births (2001-2014, median 15.2-year follow-up) found that intrauterine exposure to maternal autoimmune disease was associated with a 19% higher risk of cardiovascular disease in offspring up to early adulthood (HR 1.19, 95% CI 1.14-1.24). Maternal effects were stronger than paternal effects, suggesting a pregnancy-specific contribution. Cousin analyses remained significant but somewhat weaker, indicating partial confounding by shared familial factors. The findings support added cardiovascular vigilance in children of mothers with autoimmune disease. ## FH-vrouwen verliezen mediaan 2,9 jaar lipidenverlagende behandeling rond elke kinderwens *2026-05-05 · Atherosclerosis · https://doi.org/10.1016/j.atherosclerosis.2026.120668 · https://hartvaat.nl/2026/04/19/fh-vrouwen-verliezen-mediaan-2-9-jaar-lipidenverlagende-behandeling-rond-elke-ki/* A Norwegian cohort within the FH-FEMINA study followed 27 women with familial hypercholesterolaemia from 36 weeks of gestation until one year postpartum or end of breastfeeding. Median pregnancy-related off-treatment time per woman was 2.9 years (range 0.8–12) across all childbirths. The pregnancy itself accounted for only 42% of off-treatment time; the pre- and post-pregnancy windows together accounted for 58%. Including untreated years in childhood and before diagnosis, lifelong off-treatment time reached a median of 66% of total lifespan. The authors — including Jeanine Roeters van Lennep (Erasmus MC) and Janneke Mulder, both active in the Dutch LEEFH cascade screening programme — call for earlier FH diagnosis in girls, prompt resumption of lipid-lowering therapy immediately after breastfeeding and between pregnancies, and urgently needed evidence on statin safety during pregnancy and lactation. ## Obesitas en primair aldosteronisme: oorzaak, gevolg of beide? *2026-05-05 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26227 · https://hartvaat.nl/2026/04/22/obesitas-en-primair-aldosteronisme-oorzaak-gevolg-of-beide/* A review of the bi-directional relationship between obesity and aldosterone. Obesity correlates with higher circulating aldosterone and urinary excretion in normo- and hypertensive individuals without primary aldosteronism. Mineralocorticoid receptor activation in adipocytes can expand visceral fat, while adipocytes stimulate adrenal aldosterone production via leptin, CTRP-1 and resistin. Patients with idiopathic hyperaldosteronism are more obese than those with aldosterone-producing adenomas; aldosterone falls after weight loss. Mendelian randomisation partly supports causality. Clinical implication: weight loss should be a priority in PA patients. ## ANGPTL3-remmers verlagen breed lipidenspectrum, vooral remnant- en triglyceriden *2026-05-05 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag230 · https://hartvaat.nl/2026/04/22/angptl3-remmers-verlagen-breed-lipidenspectrum-vooral-remnant-en-triglyceriden/* A meta-analysis of 9 RCTs (1,254 participants) showed that angiopoietin-like protein 3 (ANGPTL3) inhibition produces broad lipid lowering: triglycerides −47.1%, LDL-C −21.6%, ApoB −19.9%, non-HDL-C −31.5%, VLDL-C −40.6% and remnant cholesterol −72.7%. Lp(a) fell 11.5%. Evinacumab (monoclonal antibody) gave the largest LDL-C, ApoB and non-HDL-C reductions; siRNAs (zodasiran, solbinsiran) achieved more pronounced VLDL-C lowering. No effect on hs-CRP. ANGPTL3 inhibition is most promising for triglyceride-rich lipoproteins — a significant new pillar against residual cardiovascular risk. ## Geen sekseverschillen in werkzaamheid van hartfalenmedicatie: meta-analyse van 139 RCT's *2026-05-05 · European heart journal · https://doi.org/10.1093/eurheartj/ehag311 · https://hartvaat.nl/2026/04/28/geen-sekseverschillen-in-werkzaamheid-van-hartfalenmedicatie-meta-analyse-van-13/* A meta-analysis of 139 heart failure RCTs (292,027 patients, 28.1% women) tested whether pharmacological efficacy differs by sex. Across 78 trials reporting sex-stratified results the primary-endpoint effect was identical in women and men (delta ln[REM] 0.00; 95% CI −0.04 to 0.03), and meta-regression found no association between the proportion of women enrolled and treatment effect. Decades of female under-representation are therefore unlikely to have masked clinically meaningful sex differences — though better gender balance in HF trials remains ethically and socially essential. ## Preoperatieve PCSK9-remming associeert met minder postoperatieve MACE dan statines *2026-05-04 · Atherosclerosis · https://doi.org/10.1016/j.atherosclerosis.2026.120760 · https://hartvaat.nl/2026/04/25/preoperatieve-pcsk9-remming-associeert-met-minder-postoperatieve-mace-dan-statin/* An active-comparator cohort study (TriNetX, 35,923 propensity-matched pairs) compared perioperative PCSK9 inhibitors with statins in hyperlipidaemia patients undergoing surgery between July 2015 and June 2025. PCSK9 inhibitors were associated with lower 30-day MACE (6.4% vs 9.6%; NNT 31; RR 0.67), all-cause mortality (RR 0.45), acute kidney injury (RR 0.45) and respiratory infections (RR 0.77), as well as less delirium (RR 0.41) and transaminase rise. RCTs are needed to rule out residual confounding. ## Routinematige urine-natriummeting drijft agressievere diurese bij acuut hartfalen *2026-05-04 · ESC heart failure · https://doi.org/10.1093/eschf/xvag119 · https://hartvaat.nl/2026/04/27/routinematige-urine-natriummeting-drijft-agressievere-diurese-bij-acuut-hartfale/* In a single-centre implementation study, routine urine sodium measurement was added for 160 cardiac-ICU admissions with acute heart failure from September 2021, compared with 206 historical controls. Post-implementation, patients received higher 72-hour furosemide doses (340 vs 220 mg; p<0.001) and more aggressive diuresis (aOR 4.8). Cumulative urine output was higher (6,250 vs 4,873 mL) and resolution of jugular venous distension and peripheral oedema was faster. Routine urine sodium guides faster, more aggressive decongestion in the cardiac-ICU setting. ## Doorgaan met dezelfde DOAC na breakthrough-beroerte even goed als wisselen *2026-05-04 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2026.9584 · https://hartvaat.nl/2026/04/01/doorgaan-met-dezelfde-doac-na-breakthrough-beroerte-even-goed-als-wisselen/* A registry-based emulated target trial of 1,006 AF patients with ischaemic stroke during DOAC therapy: 463 continued the same DOAC and 543 switched. After IPTW adjustment, 90-day net clinical benefit was 4.9% with switching versus 5.1% with continuation, a difference of −0.3 percentage points (90% CI −2.7 to 2.1) — within the prespecified non-inferiority margin. Recurrent ischaemic events, intracerebral haemorrhage, all-cause mortality and vascular death did not differ. After a breakthrough stroke on DOAC, switching is not better than continuing — the upfront DOAC choice matters more. ## Cardiovasculair polygeen risico voorspelt witte-stof-hyperintensiteiten in UK Biobank *2026-05-03 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26388 · https://hartvaat.nl/2026/04/22/cardiovasculair-polygeen-risico-voorspelt-witte-stof-hyperintensiteiten-in-uk-bi/* Analysis of 44,996 UK Biobank participants linked polygenic risk scores (PRS) for 35 diseases and traits to white matter hyperintensities (WMH) as a marker of cerebral small vessel disease. Higher PRS for cardiovascular disease, hypertension, ischaemic stroke and blood pressure were associated with greater WMH burden — strongest for total WMH. Higher WMH burden in turn prospectively predicted higher cardiovascular incidence. Multi-omics identified biomarkers jointly associated with WMH and disease-specific PRS. The findings support WMH as an integrated cardiovascular-cerebral risk trajectory. ## Dronedaron na AF-ablatie: gelijke werkzaamheid, minder bijwerkingen dan amiodaron *2026-05-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag095 · https://hartvaat.nl/2026/05/06/dronedaron-na-af-ablatie-gelijke-werkzaamheid-minder-bijwerkingen-dan-amiodaron/* An open-label RCT randomised 280 post-AF-ablation patients to 12 weeks of dronedarone or amiodarone during the blanking period. Atrial tachyarrhythmia recurrence did not differ (23.4% vs 16.9%; p=0.184), but adverse events were far less common with dronedarone (40.9% vs 64.0%; p<0.001), driven mainly by less QTc prolongation (5.8% vs 15.4%) and hypothyroidism (8.8% vs 26.5%). Dronedarone offers comparable rhythm control with a safer profile as bridging therapy after ablation. ## Viborg-screeningsprogramma verlaagt 5-jaarssterfte bij 67-jarigen *2026-05-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehag309 · https://hartvaat.nl/2026/04/28/viborg-screeningsprogramma-verlaagt-5-jaarssterfte-bij-67-jarigen/* The Danish Viborg Screening Program invited all 67-year-olds for population-based screening (carotid plaque, lower-limb arterial disease, abdominal aortic aneurysm, hypertension, arrhythmia/ischaemia and diabetes). Across 5,412 invitees versus 16,236 matched controls, 5-year all-cause mortality was significantly lower (6.9% vs 8.9%; HR 0.76; number-needed-to-invite 49). Benefit was seen in both sexes and was strongest in those without prior CVD (HR 0.70); major adverse limb events also fell (HR 0.70). ## Mexicaanse hypertensieprevalentie daalt over twee decennia, behandelingsgaten blijven *2026-05-02 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25807 · https://hartvaat.nl/2026/04/27/mexicaanse-hypertensieprevalentie-daalt-over-twee-decennia-behandelingsgaten-bli/* Analysis of Mexican Health and Nutrition Surveys 2000-2024 (146,904 adults ≥20 years) showed hypertension prevalence falling from 33.1% in 2000 to 26.0% in 2024, while the diagnosed share rose. Yet a substantial group remains undiagnosed or untreated. The study classifies undiagnosed hypertension into isolated systolic, isolated diastolic and systolic-diastolic phenotypes, and identifies determinants of under-treatment — relevant for public-health strategies across Latin America. ## RAAS-blokkade in de levenscyclus van de nier — actuele behandelstandaard *2026-05-02 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag090 · https://hartvaat.nl/2026/04/20/raas-blokkade-in-de-levenscyclus-van-de-nier-actuele-behandelstandaard/* An ERA-EDTA treatment-standard review on RAAS blockade across the kidney life cycle. ACE inhibitors, ARBs, direct renin inhibitors and mineralocorticoid receptor antagonists remain a cornerstone in proteinuric CKD and even in advanced stages, while benefit in non-proteinuric disease is limited. Non-steroidal MRAs such as finerenone add renal and cardiovascular protection in diabetes and CKD. In dialysis populations RAAS blockade may preserve residual kidney function; in kidney transplantation, early initiation may improve graft and patient survival. SGLT2 inhibitors and GLP-1 receptor agonists complement rather than replace RAAS blockade. ## Lp(a)-verlaging vergelijkbaar tussen alle PCSK9-gerichte middelen *2026-05-02 · Journal of clinical lipidology · https://doi.org/10.1016/j.jacl.2026.03.019 · https://hartvaat.nl/2026/04/01/lp-a-verlaging-vergelijkbaar-tussen-alle-pcsk9-gerichte-middelen/* A systematic review and meta-analysis of 31 RCTs showed that PCSK9 inhibitors and inclisiran reduce lipoprotein(a) by a pooled 25.8% versus control (95% CI −29.5 to −22.0). Meta-regression found no significant differences between alirocumab, evolocumab and inclisiran; lerodalcibep and enlicitide produced similar ~25% reductions. For Lp(a) lowering the agent matters little — choice can be guided by dosing frequency, cost and patient preference. None of these drugs is approved purely for Lp(a) lowering yet. ## Large language models in de hypertensiezorg: kansen en grenzen *2026-05-01 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.27004 · https://hartvaat.nl/2026/04/23/large-language-models-in-de-hypertensiezorg-kansen-en-grenzen/* A PRISMA-ScR scoping review of 33 studies (2023-2025) on large language model (LLM) applications in hypertension care. Use cases include clinical decision support, patient education, medical education, research support and administrative functions. GPT models dominate; evaluation methods are not yet standardised. Validity and clinical applicability remain under-studied. The field needs more robust study designs, clinical-outcome metrics and attention to bias and privacy. ## HFA-consensus: gestructureerde aanpak van recent ontstane cardiomyopathie *2026-05-01 · ESC heart failure · https://doi.org/10.1093/eschf/xvag115 · https://hartvaat.nl/2026/05/05/hfa-consensus-gestructureerde-aanpak-van-recent-ontstane-cardiomyopathie/* The Heart Failure Association of the ESC issues a consensus statement on the evaluation and management of recent-onset non-ischaemic cardiomyopathy. The framework rests on two prognostic axes — potential for left ventricular reverse remodelling and risk of sudden cardiac death — and recognises four LVEF-trajectory categories. Diagnostics combine echocardiography, CMR, genetic testing, biomarkers and early treatment response. The management algorithm emphasises early initiation of guideline-directed medical therapy, re-assessment at 3 and 6 months, and individualised decisions on ICD, CRT, ablation and transcatheter valve repair. ## STOPSTORM: stereotactische bestraling reduceert refractaire VT met 80% *2026-05-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehag338 · https://hartvaat.nl/2026/04/20/stopstorm-stereotactische-bestraling-reduceert-refractaire-vt-met-80/* The European STOPSTORM registry followed 193 patients (88% male, 53% non-ischaemic cardiomyopathy) treated with stereotactic arrhythmia radioablation (STAR) for refractory ventricular tachycardia. Among 107 patients with ≥6-month follow-up, median VT burden fell 80% over the six months after STAR and 72% remained free of ICD shocks. Twelve serious adverse events were adjudicated as possibly or probably treatment-related (including pericardial effusion and coronary events); 12-month overall survival was 77%. ## JAMA Cardiology *2026-05-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2849186 · https://hartvaat.nl/2026/05/01/jama-cardiology-missie-en-visie/* JAMA Cardiology mission statement, positioned at the nexus of clinical investigation, actionable clinical science, and evidence-based cardiovascular medicine. ## Verhoogd Lp(a) hangt samen met mitralisring-calcificatie maar niet met mitralisinsufficiëntie *2026-04-30 · Journal of clinical lipidology · https://doi.org/10.1016/j.jacl.2026.03.022 · https://hartvaat.nl/2026/04/01/verhoogd-lp-a-hangt-samen-met-mitralisring-calcificatie-maar-niet-met-mitralisin/* A retrospective TriNetX cohort study (>130,000 adults with Lp(a) measurements, propensity-matched into 66,292 pairs) found that elevated Lp(a) (>50 mg/dL) was independently associated with mitral annular calcification (HR 1.33) and — as positive control — with aortic stenosis (HR 1.31). No significant association was seen with mitral regurgitation, mitral stenosis or mitral valve prolapse. The findings extend Lp(a)'s role in calcific valvular disease and call for prospective studies. ## Leadless atriaal pacen geeft minder complicaties dan transveneus — 1-jaars Medicare-data *2026-04-30 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag072 · https://hartvaat.nl/2026/03/30/leadless-atriaal-pacen-geeft-minder-complicaties-dan-transveneus-1-jaars-medicar/* Medicare claims compared 428 AVEIR AR leadless pacemaker recipients with 39,881 dual-chamber transvenous (DCTV) and 389 right-atrial transvenous (RATV) systems for sinus node dysfunction without AV block. At 30 days, complications were lower with AVEIR AR vs DCTV (6.7% vs 9.4%; OR 0.7) and similar to RATV; at 1 year, both overall complications (3.6% vs 8.5%; HR 0.4) and reinterventions were lower than in either transvenous cohort, with comparable mortality. Leadless atrial pacing looks attractive for selected SND patients without AV block. ## Triple-pill verlaagt risico op terugkerende beroerte na hersenbloeding *2026-04-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2515043 · https://hartvaat.nl/2026/04/23/triple-pill-verlaagt-risico-op-terugkerende-beroerte-na-hersenbloeding/* In a multinational double-blind RCT of 1670 patients with prior intracerebral haemorrhage, a once-daily low-dose triple pill (telmisartan 20 mg, amlodipine 2.5 mg and indapamide 1.25 mg) added to standard care reduced recurrent stroke by 39% (4.6% vs 7.4%; HR 0.61) over 2.5 years, with mean systolic BP of 127 vs 138 mmHg. Major cardiovascular events were also lower (6.6% vs 9.8%). Early discontinuation for adverse events — mainly serum creatinine rises — was more common with the triple pill (13.6% vs 6.0%). ## ADAPT-CEC: adaptief AI-algoritme voor cardiovasculaire event-adjudicatie in klinische trials *2026-04-28 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.080072 · https://hartvaat.nl/2026/03/30/adapt-cec-adaptief-ai-algoritme-voor-cardiovasculaire-event-adjudicatie-in-klini/* Clinical endpoint classification (CEC) is the gold standard in CV trials but adds time and cost. ADAPT-CEC was developed on ODYSSEY OUTCOMES (MI, stroke, HF) and externally validated on EUCLID (MI, stroke, bleeding, CV death). It matches GPT-4 on F1 and offers a hybrid mode in which only the 30% of events with the lowest AI certainty go to human adjudication. Material implications for trial design: substantial time and cost savings without loss of validity. ## AHA Scientific Statement: acute decompensatie bij hartfalen in het kind — integraal managementkader *2026-04-28 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001428 · https://hartvaat.nl/2026/04/06/aha-scientific-statement-acute-decompensatie-bij-hartfalen-in-het-kind-integraal/* This AHA scientific statement tackles the rising number of children with congenital or acquired heart disease presenting with acute decompensated heart failure. Compared with adults this group has higher morbidity, mortality, and healthcare utilisation, yet existing guidance is thin. The document bridges emergency medicine, paediatric cardiology, critical care, and surgery, and offers an integrated assessment, management, and discharge framework. ## The Lancet-commentaar: vroege atheroma-preventie als kosteneffectieve route naar gezond cardiovasculair ouder worden *2026-04-28 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00419-8/fulltext · https://hartvaat.nl/2026/03/16/the-lancet-commentaar-vroege-atheroma-preventie-als-kosteneffectieve-route-naar-/* With annual ASCVD deaths projected to rise from 20.5 million (2025) to 35.6 million (2050), the authors make the Lancet case for earlier and longer primary prevention — aimed at slowing atheroma formation rather than intervening only once disease becomes symptomatic. The piece frames prevention as a life-course intervention and provides relevant context for conversations about early statin initiation, Lp(a) screening, and lifestyle measures. ## Fontan Outcomes Network: eerste bevindingen uit Noord-Amerikaans register van 1.121 Fontan-patiënten *2026-04-27 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.078152 · https://hartvaat.nl/2026/03/25/fontan-outcomes-network-eerste-bevindingen-uit-noord-amerikaans-register-van-1-1/* The Fontan Outcomes Network is a learning health network of 38 congenital heart centres across the US and Canada. The first 1,121 participants (mean age 16.3 years; 42% female) confirm that hypoplastic left heart syndrome (38.5%) and right ventricular–dominant anatomy (54.9%) remain the dominant subtypes. The registry marks a shift: survival after Fontan palliation has improved sharply; defining the long-term trajectory is the next frontier. ## LVAD-ondersteuning activeert microvasculair herstel in het falende hart: mechanisme ontrafeld *2026-04-27 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.078996 · https://hartvaat.nl/2026/03/25/lvad-ondersteuning-activeert-microvasculair-herstel-in-het-falende-hart-mechanis/* Single-nucleus RNA sequencing on myocardial tissue from HF patients before and after LVAD, complemented by a murine model with lineage tracing, identified the cell populations driving microvascular repair deep enough that some patients avoid transplantation after LVAD removal. A mechanistic study that surfaces concrete targets for HF reversal — and helps explain why some LVAD patients recover without needing a transplant. ## EchoFocus-CHD: AI-model detecteert 20 aangeboren hartafwijkingen op standaard echocardiografie *2026-04-27 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.079781 · https://hartvaat.nl/2026/03/28/echofocus-chd-ai-model-detecteert-20-aangeboren-hartafwijkingen-op-standaard-ech/* EchoFocus-CHD is a multi-task AI model that automatically detects 12 critical and 8 non-critical congenital heart lesions on standard echocardiography. On an external cohort the model matched expert interpretation — with the promise of extending scarce paediatric echo expertise beyond academic centres. A concrete example of where AI-assisted imaging can rapidly deliver clinical value in primary care and smaller hospitals. ## MR-proADM voorspelt mortaliteit en HF-events bij ATTR cardiale amyloïdose *2026-04-26 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077833 · https://hartvaat.nl/2026/03/31/mr-proadm-voorspelt-mortaliteit-en-hf-events-bij-attr-cardiale-amyloidose/* In 337 ATTR-CM patients from Spain, 12 circulating biomarkers were benchmarked for predicting mortality and HF events, with validation in two independent cohorts. Mid-regional pro-adrenomedullin (MR-proADM) emerged as a robust complement to NT-proBNP and high-sensitivity troponin for risk stratification — increasingly relevant as ATTR cardiomyopathy is diagnosed earlier and new therapies improve prognosis. ## Zwangerschap als stresstest: consensus over langetermijn-cardiovasculair risico bij adverse pregnancy outcomes *2026-04-26 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2845161 · https://hartvaat.nl/2026/04/01/zwangerschap-als-stresstest-consensus-over-langetermijn-cardiovasculair-risico-b/* Adverse pregnancy outcomes — hypertensive disorders, gestational diabetes, preterm birth, SGA — complicate nearly one in five pregnancies and are associated with both short- and long-term maternal CV risk. This review consolidates the growing consensus that pregnancy is a natural stress test and the postpartum period an opportunistic window for targeted CV risk screening and lifestyle counselling. It argues for formally embedding pregnancy history into cardiovascular risk assessment. ## AHA Scientific Statement: niet-optimale omgevingstemperatuur als cardiovasculaire risicofactor *2026-04-26 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001419 · https://hartvaat.nl/2026/03/26/aha-scientific-statement-niet-optimale-omgevingstemperatuur-als-cardiovasculaire/* This AHA scientific statement consolidates the evidence that ambient heat and cold drive cardiovascular events: MI, stroke, heart failure decompensation, arrhythmias, and sudden death. Mechanisms include autonomic and neurohormonal activation, endothelial dysfunction, inflammation, haemoconcentration, and impaired thermoregulation. With rising global temperatures and extreme-event frequency, contextual risk assessment — geography, housing, occupation — becomes a serious component of prevention. ## Systematische review: welke factoren voorspellen langetermijnrisico op beroerte na TIA of kleine beroerte? *2026-04-25 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.078763 · https://hartvaat.nl/2026/03/18/systematische-review-welke-factoren-voorspellen-langetermijnrisico-op-beroerte-n/* This systematic review and meta-analysis of 28 cohort studies (n≈86,000) identifies factors predicting long-term stroke risk after TIA or minor stroke. Pooled hazard ratios and population attribution fractions were estimated. The findings reinforce that TIA carries sustained risk over many years and provide practical targets for secondary prevention focused on vascular risk factors. ## CRT zonder atriale lead: tweeledig CRT-DX-systeem non-inferieur aan klassieke drie-leads CRT-D *2026-04-25 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.079859 · https://hartvaat.nl/2026/03/30/crt-zonder-atriale-lead-tweeledig-crt-dx-systeem-non-inferieur-aan-klassieke-dri/* In this Italian multicenter RCT (n=636), a two-lead CRT-DX system with atrial sensing via a floating dipole on the RV lead was non-inferior to standard three-lead CRT-D on the 1-year composite of mortality, cardiovascular hospitalisation, and lead-related complications. For CRT-D candidates without sinus node dysfunction, the simplification is clinically appealing: fewer leads, fewer complications. ## CADENCE: sotatercept verlaagt pulmonale vaatweerstand bij gecombineerde pulmonale hypertensie bij HFpEF *2026-04-25 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.079918 · https://hartvaat.nl/2026/03/29/cadence-sotatercept-verlaagt-pulmonale-vaatweerstand-bij-gecombineerde-pulmonale/* In this phase 2, placebo-controlled trial (n=164), sotatercept lowered pulmonary vascular resistance at week 24 in patients with combined post- and pre-capillary pulmonary hypertension associated with HFpEF. The median placebo-adjusted decline was largest in the 0.3 mg/kg arm. Until now no proven therapy existed for this CpcPH–HFpEF population, which involves remodeling in both the heart and pulmonary vasculature. ## ARIC: CKM-syndroom stadiëring voorspelt hartfalen-risico bij ouderen — ook met subklinisch echoprofiel *2026-04-24 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077894 · https://hartvaat.nl/2026/04/01/aric-ckm-syndroom-stadiering-voorspelt-hartfalen-risico-bij-ouderen-ook-met-subk/* In 5,646 older ARIC participants (66–90), CKM syndrome staging using the AHA framework showed a clear gradient: higher stages tracked with greater echocardiographic remodelling and significantly increased incident heart failure over follow-up. The results validate the CKM framework as a clinically useful risk model in older adults — the very group where HF prevention yields the highest absolute benefit. ## Conduction System Pacing versus biventriculaire pacing: twee trials vergelijken beide CRT-strategieën *2026-04-24 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2845804 · https://hartvaat.nl/2026/04/01/conduction-system-pacing-versus-biventriculaire-pacing-twee-trials-vergelijken-b/* Two new RCTs compare conduction system pacing (chiefly left bundle-branch area pacing) with conventional biventricular pacing in heart failure patients with LBBB. Earlier observational data suggested superior electrical resynchronisation and larger LVEF gains with CSP, fuelling rapid clinical adoption. These trials finally test whether the physiologically attractive approach actually outperforms BiVP on hard endpoints. ## AHA Scientific Statement 2026: nieuwe voedingsleidraad voor cardiovasculaire gezondheid *2026-04-24 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001435 · https://hartvaat.nl/2026/03/31/aha-scientific-statement-2026-nieuwe-voedingsleidraad-voor-cardiovasculaire-gezo/* This AHA scientific statement updates food-based guidance for cardiovascular health with seven practical pillars: energy balance, abundant vegetables and fruit, mostly whole grains, healthy protein sources, unsaturated over saturated fats, less ultra-processed food, and less sodium and added sugar. It deliberately emphasises dietary pattern over isolated nutrients — relevant simultaneously for prevention, CKM syndrome, and oncology. ## MINOCA-oorzaken bij vrouwen én mannen in beeld gebracht met OCT en CMR *2026-04-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.080234 · https://hartvaat.nl/2026/03/28/minoca-oorzaken-bij-vrouwen-en-mannen-in-beeld-gebracht-met-oct-en-cmr/* This international prospective diagnostic study (28 US/Canada/UK sites) used multi-vessel optical coherence tomography during angiography and cardiac MRI within one week to map MINOCA mechanisms. After a women-only opening phase, men were added. The analysis identifies which patients are most likely to show abnormal imaging findings and highlights sex differences in MINOCA mechanisms — relevant for the diagnostic work-up where imaging is now recommended. ## Franse multicentertrial: lage dosis rivaroxaban verlaagt linkerventrikeltrombus na anterior STEMI *2026-04-23 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2845590 · https://hartvaat.nl/2026/04/01/franse-multicentertrial-lage-dosis-rivaroxaban-verlaagt-linkerventrikeltrombus-n/* This French multicenter randomized trial assessed whether adding low-dose rivaroxaban to dual antiplatelet therapy reduces left ventricular thrombus incidence at one month in anterior STEMI patients. The strategy targets a persistent problem: subclinical LV thrombus soon after anterior MI with silent embolic implications. The results support targeted thromboprophylaxis in this high-risk subgroup without disproportionate bleeding. ## Essence-TIMI 73b: APOC3-remmer olezarsen reduceert niet-verkalkte coronairplaque bij hypertriglyceridemie *2026-04-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.080012 · https://hartvaat.nl/2026/03/30/essence-timi-73b-apoc3-remmer-olezarsen-reduceert-niet-verkalkte-coronairplaque-/* This CCTA sub-study of Essence-TIMI 73b showed that olezarsen — an APOC3 antisense oligonucleotide — lowered triglycerides by ~60% and remnant cholesterol by ~70%, with neutral LDL-C and ~15% apoB reduction. Over 12 months in patients with moderate hypertriglyceridemia and non-calcified coronary plaque, olezarsen produced a placebo-adjusted reduction in non-calcified plaque volume. It provides some of the first imaging evidence that triglyceride-directed therapy favorably modifies coronary atherosclerosis. ## Memantine remt premature atriumcontracties in fase 2-trial — nieuw aangrijpingspunt voor atriale aritmie *2026-04-22 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.079023 · https://hartvaat.nl/2026/03/19/memantine-remt-premature-atriumcontracties-in-fase-2-trial-nieuw-aangrijpingspun/* In this phase 2 double-blind randomized trial, memantine — an NMDA-receptor antagonist — suppressed premature atrial contractions in symptomatic adults with ≥1,000 PACs per 24 h. The result opens a genuinely new pharmacological route for atrial arrhythmia, grounded in the recently identified cardiac glutamatergic system. If PAC reduction translates into downstream AF and stroke benefit, it could reshape atrial arrhythmia treatment. ## HEPARIN-STEMI: prehospitale heparine vergroot vroege doorstroming bij STEMI zonder meer bloedingen *2026-04-22 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.126.079839 · https://hartvaat.nl/2026/03/30/heparin-stemi-prehospitale-heparine-vergroot-vroege-doorstroming-bij-stemi-zonde/* This single-center RCT in 593 STEMI patients found that unfractionated heparin (70–100 IU/kg) given at first medical contact — prior to PCI-center arrival — significantly improved TIMI 2–3 flow in the infarct-related artery at initial angiography compared with standard UFH at PCI. BARC 3–5 bleeding was similar. The trial supports prehospital heparin as a simple, low-cost reperfusion strategy ahead of primary PCI. ## 2026 ACC/AHA-richtlijn dyslipidemie: lagere doelen, meer rol voor non-HDL, Lp(a) en apoB *2026-04-22 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001423 · https://hartvaat.nl/2026/03/13/2026-acc-aha-richtlijn-dyslipidemie-lagere-doelen-meer-rol-voor-non-hdl-lp-a-en-/* The 2026 ACC/AHA dyslipidemia guideline retires the 2018 cholesterol document and broadens scope to hypertriglyceridemia and elevated lipoprotein(a). Non-HDL-C and apoB gain ground as secondary targets, LDL goals tighten for high-risk groups, and Lp(a) gets formal standing in risk assessment. Clinicians should anticipate broader lipid panels and more frequent escalation to PCSK9 inhibitors and emerging Lp(a)-lowering therapies. ## EHJ-review: wearables in de cardiovasculaire praktijk — hoe ver zijn we? *2026-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehag189 · https://hartvaat.nl/2026/03/25/ehj-review-wearables-in-de-cardiovasculaire-praktijk-hoe-ver-zijn-we/* This EHJ review maps the current landscape of wearables (smartwatches and activity trackers) in cardiovascular care, from lifestyle coaching to continuous monitoring of heart failure and arrhythmias. It highlights the main barriers — variability in device methodology and validation, EHR incompatibility, and lack of standardised clinical workflows — and discusses AI-assisted interpretation. It offers practical guidance for clinicians integrating wearable data into routine practice. ## CLOROTIC-subanalyse: acute eGFR-daling door thiaziden bij acuut HF is geen prognostisch alarm *2026-04-21 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag070 · https://hartvaat.nl/2026/03/23/clorotic-subanalyse-acute-egfr-daling-door-thiaziden-bij-acuut-hf-is-geen-progno/* In this CLOROTIC sub-analysis (n=225), adding thiazide to loop diuretics in acute decompensated heart failure caused median eGFR declines of 9.7% at day 2 and 14.4% at day 4 (vs ~0% in placebo). However, these acute eGFR declines were not associated with increased mortality or the composite of death or HF hospitalisation at 3-month follow-up. The data support continuing combination diuresis when clinical decongestion is progressing, even with visible eGFR dips. ## Myocardiale brug: praktische gids voor diagnose en behandeling in het CCTA-tijdperk *2026-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1038 · https://hartvaat.nl/2026/03/24/myocardiale-brug-praktische-gids-voor-diagnose-en-behandeling-in-het-ccta-tijdpe/* Myocardial bridging is the most common congenital coronary anomaly, usually benign but increasingly detected by coronary CT angiography and implicated in ischaemia with non-obstructive coronary arteries (INOCA). This EHJ review provides an evidence-based guide to diagnosis (CCTA, invasive angiography with IVUS/OCT) and management, addressing unresolved controversies around symptomatic treatment. A practical reference as imaging-led incidental findings rise. ## Tien jaar real-world sacubitril/valsartan: mortaliteitsreductie bevestigd, maar slechts 15–25% haalt doeldosis *2026-04-20 · ESC heart failure · https://doi.org/10.1093/eschf/xvag095 · https://hartvaat.nl/2026/03/03/tien-jaar-real-world-sacubitril-valsartan-mortaliteitsreductie-bevestigd-maar-sl/* This systematic review of 30 real-world studies confirms sacubitril/valsartan in HFrEF is associated with 10–16% lower cardiovascular mortality, 10–38% fewer HF hospitalisations and 10–25% lower all-cause mortality, along with cardiac reverse remodelling and reduced mitral regurgitation. Hypotension remained the most common adverse event (up to 17.6%). Only 15–25% of patients reach target dose — the true bottleneck is titration discipline rather than drug efficacy. ## Mendeliaanse randomisatie: Lp(a) verhoogt coronarialijden onafhankelijk van LDL-C, maar niet het diabetesrisico *2026-04-20 · JACC. Advances · https://doi.org/10.1016/j.jacadv.2026.102697 · https://hartvaat.nl/2026/03/25/mendeliaanse-randomisatie-lp-a-verhoogt-coronarialijden-onafhankelijk-van-ldl-c-/* A phenome-wide Mendelian randomisation study in the UK Biobank (n=425,677) identified coronary artery disease (OR 1.36) and HbA1c (β 0.099) as the only direct, causal effects of Lp(a) exposure — independent of LDL-C. Very low Lp(a) was not linked to diabetes, addressing earlier safety concerns about Lp(a)-lowering therapies. Ancestry-specific risk thresholds were identified (86 nmol/L European, 93 nmol/L African). The findings support targeted Lp(a) testing and strengthen the mechanistic case for RNA-based Lp(a) lowering. ## ATHENA-register: pulsed field ablatie voor atriumfibrilleren ook effectief bij hartfalen, vooral paroxismaal *2026-04-20 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag049 · https://hartvaat.nl/2026/03/17/athena-register-pulsed-field-ablatie-voor-atriumfibrilleren-ook-effectief-bij-ha/* In the ATHENA registry (n=1224), 79.9% of patients were free from atrial arrhythmias at 1 year after pentaspline pulsed-field ablation. The HF subgroup (n=176) had lower freedom (73.3% vs 81.0%, HR 1.5), driven by paroxysmal-AF patients (68.6% vs 82.2%). No difference was observed in patients with persistent AF. PFA appears safe and effective in heart failure, supporting broader use in this population. ## Gestandaardiseerd stappenplan voor tricuspidalisinsufficiëntie: van verwijzing tot expertcentrum *2026-04-19 · European heart journal · https://doi.org/10.1093/eurheartj/ehag214 · https://hartvaat.nl/2026/03/28/gestandaardiseerd-stappenplan-voor-tricuspidalisinsufficientie-van-verwijzing-to/* This EHJ review proposes a standardised stepwise work-up for patients with tricuspid regurgitation, aligned with the 2025 ESC/EACTS Valvular Heart Disease guidelines. It covers clinical assessment, multimodality imaging (echocardiography, CT, CMR) and invasive haemodynamics, and emphasises multidisciplinary collaboration between imagers, heart failure specialists, interventional cardiologists, electrophysiologists and surgeons. As transcatheter TR therapies expand, the framework aims to improve timely referral and consistent management. ## Hokuriku-Plus: genetische diagnose bij familiaire hypercholesterolemie verlaagt MACE-risico onafhankelijk van LDL-C *2026-04-19 · Circulation journal : official journal of the Japanese Circulation Society · https://doi.org/10.1253/circj.CJ-25-1189 · https://hartvaat.nl/2026/03/20/hokuriku-plus-genetische-diagnose-bij-familiaire-hypercholesterolemie-verlaagt-m/* In the Japanese Hokuriku-Plus registry (n=386 heterozygous FH), 52% of patients underwent genetic testing. These patients achieved lower LDL-C (102 vs 130 mg/dL) and had 34% lower MACE risk (HR 0.66) even after adjusting for LDL-C over 3.9-year median follow-up. The results suggest genetic confirmation itself drives better adherence and treatment intensity, arguing for broader FH genetic testing in clinical practice. ## LINEAR-trial: lattice-tip-katheter verslaat standaard irrigatie bij CTI-ablatie voor typische atriumflutter *2026-04-19 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag046 · https://hartvaat.nl/2026/03/30/linear-trial-lattice-tip-katheter-verslaat-standaard-irrigatie-bij-cti-ablatie-v/* In the randomised LINEAR trial (n=102), the lattice-tip dual-energy catheter achieved bidirectional CTI block in 94.1% of patients versus 68.6% with the standard 3.5-mm irrigated catheter (P=0.002). First-pass block was 90.2% vs 60.8%, with dramatically shorter ablation time (41 vs 245 seconds) and fewer lesions (8.3 vs 13.4). No procedural complications occurred. Lattice-tip technology shows clear technical superiority for CTI ablation; longer-term clinical outcomes are still needed. ## FINE-HEART: vrouwen met cardiovasculair-renaal-metabool syndroom worden systematisch onderbehandeld *2026-04-18 · European heart journal · https://doi.org/10.1093/eurheartj/ehag162 · https://hartvaat.nl/2026/03/26/fine-heart-vrouwen-met-cardiovasculair-renaal-metabool-syndroom-worden-systemati/* This prespecified pooled analysis of FIDELIO-DKD, FIGARO-DKD and FINEARTS-HF (n=18,991) found women with cardiovascular-kidney-metabolic syndrome were older, had more Stage 4 CKM disease, and received fewer guideline-recommended therapies (aspirin, statins, RAS inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists) than men. Rates of HF hospitalisation or CV death were similar across sexes, but women had 17% lower all-cause mortality. Finerenone was equally effective in both sexes. The results highlight a persistent treatment gap that deserves clinical attention. ## Lp(a) verhoogt risico op veneuze trombo-embolie bij premenopauzale vrouwen en hormoon-gebruiksters *2026-04-18 · European heart journal · https://doi.org/10.1093/eurheartj/ehag252 · https://hartvaat.nl/2026/03/28/lp-a-verhoogt-risico-op-veneuze-trombo-embolie-bij-premenopauzale-vrouwen-en-hor/* In the UK Biobank (≈373,000 participants), Lp(a) ≥ 125 nmol/L was associated with incident venous thromboembolism in premenopausal women (aHR 1.32) and in postmenopausal women on menopausal hormone therapy (aHR 1.48), but not in postmenopausal women without hormones or in men. Oral contraceptive use did not modify the relationship in premenopausal women. The findings suggest sex-hormone status modifies Lp(a)-related VTE risk and support considering Lp(a) before starting hormone therapy. ## Meta-analyse: GLP-1-agonisten voorkomen hartfalen in type 2 diabetes, sterkste effect met semaglutide *2026-04-18 · ESC heart failure · https://doi.org/10.1093/eschf/xvag091 · https://hartvaat.nl/2026/03/25/meta-analyse-glp-1-agonisten-voorkomen-hartfalen-in-type-2-diabetes-sterkste-eff/* This meta-analysis of 12 placebo-controlled trials (n=95,023) found GLP-1 receptor agonists reduced heart failure events by 12% (NNT 238), and by 19% (NNT 167) in patients without baseline HF. Semaglutide specifically reduced HF events by 16% overall and by 31% in those without prior HF (NNT 80). Absolute benefits are modest but clinically relevant given the widespread use of GLP-1 therapy in type 2 diabetes and obesity management. ## CONFIDENCE-analyse: acute eGFR-daling bij empagliflozin + finerenone is reversibel en geen reden om te stoppen *2026-04-17 · Journal of the American Society of Nephrology : JASN · https://doi.org/10.1681/ASN.0000001071 · https://hartvaat.nl/2026/03/29/confidence-analyse-acute-egfr-daling-bij-empagliflozin-finerenone-is-reversibel-/* This prespecified CONFIDENCE analysis (n=790 with T2D, CKD and albuminuria) found the greatest acute day-14 eGFR decline with combination therapy (-6.6 mL/min) vs finerenone alone (-2.1) or empagliflozin alone (-4.8), but declines were reversible. Finerenone's additive UACR-lowering effect was non-haemodynamic, while empagliflozin's effect was partly eGFR-mediated. The results reinforce that initial eGFR dips should not trigger discontinuation and support combination therapy in diabetic CKD. ## UK Biobank: hogere intensiteit van beweging belangrijker dan totale tijd voor cardiovasculair risico *2026-04-17 · European heart journal · https://doi.org/10.1093/eurheartj/ehag168 · https://hartvaat.nl/2026/03/29/uk-biobank-hogere-intensiteit-van-beweging-belangrijker-dan-totale-tijd-voor-car/* Using wrist-accelerometer data from 96,408 UK Biobank participants, a higher share of vigorous activity (%VPA) showed a non-linear inverse association with MACE, atrial fibrillation, type 2 diabetes, CKD, dementia and all-cause mortality — independent of total activity volume. Participants exceeding 4% VPA had 29–61% lower risk of these outcomes. The study suggests exercise intensity deserves more weight in prevention counselling, alongside the traditional focus on weekly duration. ## VESALIUS-CV-subgroep JAMA: evolocumab beschermt ook diabeten zonder vastgestelde atherosclerose *2026-04-17 · JAMA · https://doi.org/10.1001/jama.2026.3277 · https://hartvaat.nl/2026/03/28/vesalius-cv-subgroep-jama-evolocumab-beschermt-ook-diabeten-zonder-vastgestelde-/* This prespecified VESALIUS-CV subgroup (n=3655 diabetics with LDL-C ≥ 90 mg/dL and no established atherosclerosis) found that evolocumab on top of optimised statin therapy significantly reduced first MACE over a median 4.8 years of follow-up. The JAMA-published analysis pushes PCSK9 inhibition further upstream in high-risk diabetics without prior arterial disease, calcium score ≥ 100, or stenosis ≥ 50%. It strengthens the case for earlier intensive LDL-C lowering in primary prevention for diabetic patients. ## Nationaal cardiologisch netwerk als nieuwe zorgstandaard in Polen *2026-04-12 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1123 · https://hartvaat.nl/2026/03/05/nationaal-cardiologisch-netwerk-als-nieuwe-zorgstandaard-in-polen/* This article presents Poland's national cardiology network as a new model for cardiovascular care delivery. The authors describe how coordinated network care can improve outcomes for cardiac patients. ## Prasugrel vs. clopidogrel: invloed van patiëntkenmerken op trombocytenremming bij acute beroerte *2026-04-12 · Journal of atherosclerosis and thrombosis · https://doi.org/10.5551/jat.66056 · https://hartvaat.nl/2026/03/03/prasugrel-vs-clopidogrel-invloed-van-patientkenmerken-op-trombocytenremming-bij-/* In a post-hoc analysis of the ACUTE-PRAS trial, this study examined whether the antiplatelet effects of prasugrel and clopidogrel differ by patient characteristics in acute atherothrombotic stroke or TIA. The results identify subgroups at higher risk of high on-treatment platelet reactivity under clopidogrel. ## TREM-1-remming vermindert in-stent neoatherosclerose in diermodel *2026-04-12 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00067-5/fulltext · https://hartvaat.nl/2026/03/05/trem-1-remming-vermindert-in-stent-neoatherosclerose-in-diermodel/* In-stent neoatherosclerosis contributes to late stent thrombosis and restenosis. This study investigated pharmacological TREM-1 inhibition with nangibotide (LR12) in a rabbit model and found favourable effects on neoatherosclerosis development via macrophage polarisation modulation, identifying a potential therapeutic target. ## NLR-trajecten versus absolute waarden als prognostische marker bij acuut hartfalen *2026-04-11 · ESC heart failure · https://doi.org/10.1093/eschf/xvag071 · https://hartvaat.nl/2026/03/05/nlr-trajecten-versus-absolute-waarden-als-prognostische-marker-bij-acuut-hartfal/* The neutrophil-to-lymphocyte ratio (NLR) is a simple inflammatory marker in heart failure. This ESC Heart Failure commentary discusses whether NLR trajectories over time have better prognostic value than a single absolute measurement in acute heart failure. ## Leadless pacemaker-implantatie ter hoogte van de bundel van Bachmann *2026-04-11 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag027 · https://hartvaat.nl/2026/02/13/leadless-pacemaker-implantatie-ter-hoogte-van-de-bundel-van-bachmann/* This Europace study describes initial results of implanting a leadless pacemaker at the Bachmann's bundle region, an alternative stimulation site that may provide more physiological atrial activation. The data are presented as proof of concept. ## Ultrakorte radiofrequentieablatie voor vena cava superior-isolatie *2026-04-11 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag026 · https://hartvaat.nl/2026/02/03/ultrakorte-radiofrequentieablatie-voor-vena-cava-superior-isolatie/* This study investigates the feasibility of very high-power, ultra-short radiofrequency energy for superior vena cava isolation as a source of atrial fibrillation. Translational validation was performed in a porcine model and clinical cohorts, suggesting the technique may improve procedural safety and efficiency. ## Smoothened-signalering bevordert nierfibrose via autofagieremming *2026-04-10 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00140-7/fulltext · https://hartvaat.nl/2026/02/27/smoothened-signalering-bevordert-nierfibrose-via-autofagieremming/* Research in Kidney International shows that enhanced Smoothened receptor signalling promotes renal fibrosis by inhibiting autophagy in fibroblasts. This mechanistic insight into the Hedgehog signalling pathway contributes to understanding progressive kidney disease. ## PDGF-B uit tubulusepitheel drijft nierfibrose aan *2026-04-10 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00141-9/fulltext · https://hartvaat.nl/2026/02/27/pdgf-b-uit-tubulusepitheel-drijft-nierfibrose-aan/* This Kidney International study demonstrates that tubular epithelial cell-derived PDGF-B creates fibrogenic niches and plays a crucial role in renal fibrosis. This epithelial-mesenchymal communication mechanism offers a potential therapeutic target for chronic kidney disease. ## Ongelijke toegang tot cardiovasculaire zorg in Europa *2026-04-10 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1106 · https://hartvaat.nl/2026/03/05/ongelijke-toegang-tot-cardiovasculaire-zorg-in-europa/* This European Heart Journal article highlights inequalities in access to cardiovascular care across Europe. The authors analyse regional differences in treatment outcomes and advocate for policies promoting equitable access to evidence-based cardiovascular care. ## IVUS-segmentatiemethoden vergeleken in de PACMAN-AMI-trial *2026-04-09 · Circulation journal : official journal of the Japanese Circulation Society · https://doi.org/10.1253/circj.CJ-25-0590 · https://hartvaat.nl/2026/03/04/ivus-segmentatiemethoden-vergeleken-in-de-pacman-ami-trial/* This post-hoc analysis of the PACMAN-AMI trial compared two IVUS segmentation methods — conventional 1-mm segmentation versus end-diastolic segmentation — for atherosclerosis measurement accuracy in clinical trials. ## Cardiologen onderschatten omgevingsrisicofactoren *2026-04-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1096 · https://hartvaat.nl/2026/02/26/cardiologen-onderschatten-omgevingsrisicofactoren/* This European Heart Journal article identifies barriers preventing cardiologists from incorporating environmental risk factors such as air pollution and noise exposure into cardiovascular risk assessment. The authors advocate for greater awareness of these growing risk factors. ## Micro- en nanoplastics: nieuw perspectief voor cardiovasculaire preventie *2026-04-09 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077882 · https://hartvaat.nl/2026/03/02/micro-en-nanoplastics-nieuw-perspectief-voor-cardiovasculaire-preventie/* This Circulation perspective discusses the emerging concern about micro- and nanoplastics as potential cardiovascular risk factors. The article outlines possible pathophysiological mechanisms and calls for further research into these ubiquitous environmental contaminants in relation to cardiovascular disease. ## Kwaliteit van hartfalenzorg bij Aziatische patiënten in de VS *2026-04-08 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725101526?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/kwaliteit-van-hartfalenzorg-bij-aziatische-patienten-in-de-vs/* This JACC study examined the quality of heart failure care among Asian patients in the United States and identified disparities in treatment and outcomes. While US-specific, the findings underscore the broader message that ethnic background influences heart failure care quality. ## Voedingskwaliteit en plantaardige voeding centraal voor cardiovasculaire gezondheid *2026-04-08 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726003013?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/voedingskwaliteit-en-plantaardige-voeding-centraal-voor-cardiovasculaire-gezondh/* This JACC editorial emphasises that overall dietary quality and plant-based foods, rather than individual macronutrients, are the key determinants of cardiovascular health. It contextualises recent nutrition research and advocates for a shift from macronutrient-focused thinking to dietary pattern approaches. ## Cardiovasculaire mortaliteit bij chronische nierziekte en dialyse: een tweestappenmodel *2026-04-08 · Journal of atherosclerosis and thrombosis · https://doi.org/10.5551/jat.RV22048 · https://hartvaat.nl/2026/03/03/cardiovasculaire-mortaliteit-bij-chronische-nierziekte-en-dialyse-een-tweestappe/* Dialysis patients face a 10- to 30-fold elevated risk of cardiovascular mortality compared to the general population. This narrative review proposes a two-step model — first the occurrence of a cardiovascular event, then the inability to recover — identifying intervention targets for prevention in CKD. ## Sociaaleconomische status en cardiovasculaire ziekte: wereldwijde meta-analyse *2026-04-08 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00063-8/fulltext · https://hartvaat.nl/2026/03/06/sociaaleconomische-status-en-cardiovasculaire-ziekte-wereldwijde-meta-analyse/* This systematic review and meta-analysis examined the association between socioeconomic status and cardiovascular disease using global data. The strength and direction of the association varied with countries' development level, underscoring the context-dependent role of socioeconomic factors in cardiovascular risk. ## Evolocumab naast empagliflozine verandert LDL-subdeeltjes bij type 2 diabetes *2026-04-08 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00052-3/fulltext · https://hartvaat.nl/2026/03/03/evolocumab-naast-empagliflozine-verandert-ldl-subdeeltjes-bij-type-2-diabetes/* In a pre-specified analysis of a randomised trial, the addition of the PCSK9 inhibitor evolocumab to empagliflozin in type 2 diabetes was found to alter LDL subparticle composition and the lipidome beyond standard LDL-cholesterol reduction, potentially contributing to the cardiovascular benefits of this combination therapy. ## AI-echocardiografie door niet-specialisten: kosteneffectiviteitsanalyse uit Singapore *2026-04-08 · ESC heart failure · https://doi.org/10.1093/eschf/xvag069 · https://hartvaat.nl/2026/03/05/ai-echocardiografie-door-niet-specialisten-kosteneffectiviteitsanalyse-uit-singa/* AI-assisted point-of-care echocardiography can shift left ventricular ejection fraction assessment from specialist sonographers to non-specialist healthcare providers. This cost-minimisation analysis from Singapore shows that AI-POC devices can reduce diagnostic costs in heart failure without compromising accuracy. ## Darmmicrobioom bevordert atriumfibrilleren bij chronische nierziekte via NLRP3-inflammasoom *2026-04-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag037 · https://hartvaat.nl/2026/03/03/darmmicrobioom-bevordert-atriumfibrilleren-bij-chronische-nierziekte-via-nlrp3-i/* Chronic kidney disease increases the risk of atrial fibrillation, but the underlying mechanism is incompletely understood. In a rat model, this study demonstrates that gut microbiome dysbiosis promotes CKD-associated AF via NLRP3 inflammasome activation, opening potential therapeutic avenues at the nephrology-cardiology interface. ## Stand van zaken: palliatieve zorg bij hartfalen *2026-04-07 · ESC heart failure · https://doi.org/10.1093/eschf/xvag067 · https://hartvaat.nl/2026/03/02/stand-van-zaken-palliatieve-zorg-bij-hartfalen/* Heart failure patients often have a high symptom burden and limited life expectancy, yet palliative care remains poorly integrated. This ESC Heart Failure review describes the current state of palliative care research in heart failure and identifies knowledge gaps for future investigation. ## Non-HDL/HDL-ratio als voorspeller van cardiovasculaire ziekte bij CKM-syndroom *2026-04-07 · Journal of clinical hypertension (Greenwich, Conn.) · https://doi.org/10.1111/jch.70221 · https://hartvaat.nl/2026/03/01/non-hdl-hdl-ratio-als-voorspeller-van-cardiovasculaire-ziekte-bij-ckm-syndroom/* The American Heart Association introduced the cardiovascular-renal-metabolic (CKM) syndrome as a new concept. This prospective cohort study evaluated the non-HDL/HDL cholesterol ratio as a predictor of cardiovascular events in CKM stages 0-3, finding it a promising, readily available lipid marker for risk stratification. ## EPIC-HIV trial: PCSK9-remming ter cardiovasculaire preventie bij hiv-patiënten *2026-04-06 · American heart journal · https://doi.org/10.1016/j.ahj.2026.107400 · https://hartvaat.nl/2026/02/28/epic-hiv-trial-pcsk9-remming-ter-cardiovasculaire-preventie-bij-hiv-patienten/* People living with HIV face elevated cardiovascular risk. Following positive results with statins, the EPIC-HIV trial investigates whether PCSK9 inhibition can further reduce cardiovascular risk in HIV patients. This American Heart Journal article describes the trial design and baseline characteristics. ## AI-clustering identificeert functionele risicofenotypen bij hartfalen *2026-04-06 · Open heart · https://doi.org/10.1136/openhrt-2025-003530 · https://hartvaat.nl/2026/02/26/ai-clustering-identificeert-functionele-risicofenotypen-bij-hartfalen/* Using unsupervised AI clustering on 15 multimodal clinical variables in 505 heart failure patients, this study identified distinct functional risk phenotypes. The clusters predicted cardiorespiratory fitness and clinical outcomes, potentially aiding early risk stratification. ## Fluoroscopieminimalisatie bij SVT-ablatie door vrouwelijke elektrofysiologen *2026-04-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag030 · https://hartvaat.nl/2026/02/26/fluoroscopieminimalisatie-bij-svt-ablatie-door-vrouwelijke-elektrofysiologen/* The STOOP registry assessed radiation exposure of female electrophysiologists of reproductive age during catheter ablation of supraventricular tachycardia. Using a fluoroscopy minimisation strategy across 12 European centres, estimated annual occupational exposure remained well within safe limits. ## Klinische impact van veiligheidswaarschuwingen voor implanteerbare pacemakers en defibrillatoren *2026-04-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag031 · https://hartvaat.nl/2026/02/03/klinische-impact-van-veiligheidswaarschuwingen-voor-implanteerbare-pacemakers-en/* Field safety notices for implantable cardiac devices are issued regularly, but their clinical impact is not always clear. This Europace study analyses the real-world effect of these notices on patient safety and clinical decision-making for pacemakers and ICDs. ## Veroudering, immuundysfunctie en nierfibrose: kip of ei? *2026-04-05 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00950-0/fulltext · https://hartvaat.nl/2026/03/04/veroudering-immuundysfunctie-en-nierfibrose-kip-of-ei/* Ageing is a major risk factor for chronic kidney disease, with renal fibrosis as a central feature. This review examines the interplay between immune system ageing, epithelial senescence, and fibrotic changes in the kidney, seeking therapeutic targets for age-related CKD. ## Winterhypertensie: koude als cardiovasculaire risicofactor *2026-04-05 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26518 · https://hartvaat.nl/2026/03/04/winterhypertensie-koude-als-cardiovasculaire-risicofactor/* Cardiovascular events increase globally during winter, partly due to cold-induced hypertension. This Japanese review describes how low ambient temperatures amplify morning blood pressure surges and increase cardiovascular risk, and discusses preventive strategies including home insulation and seasonally adjusted antihypertensive therapy. ## Gerichte immunotherapie bij nierziekten: B-cel-targeting en CAR-T *2026-04-04 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00145-6/fulltext · https://hartvaat.nl/2026/02/27/gerichte-immunotherapie-bij-nierziekten-b-cel-targeting-en-car-t/* This Kidney International review discusses emerging targeted immunotherapies for kidney disease, including CAR-T cell therapy and T-cell engagers directed against B cells. Initial results in treatment-resistant lupus nephritis are promising and may extend to other autoimmune kidney diseases. ## AI-model voorspelt nachtelijke hypertensie bij chronische nierziekte *2026-04-04 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26706 · https://hartvaat.nl/2026/02/26/ai-model-voorspelt-nachtelijke-hypertensie-bij-chronische-nierziekte/* Researchers developed a diffusion model that predicts nocturnal hypertension in chronic kidney disease patients, potentially enabling more selective use of costly 24-hour blood pressure monitoring. The model was validated in an external cohort of over 1,200 patients. ## Editoriaal: langetermijnresultaten van aficamten bij obstructieve HCM *2026-04-04 · European heart journal · https://doi.org/10.1093/eurheartj/ehag059 · https://hartvaat.nl/2026/03/06/editoriaal-langetermijnresultaten-van-aficamten-bij-obstructieve-hcm/* This European Heart Journal editorial places the long-term results of aficamten in the context of the growing arsenal of myosin inhibitors for obstructive hypertrophic cardiomyopathy, discussing the clinical implications. ## MicroRNA's in de celkern sturen hartmetabolisme bij HFpEF *2026-04-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf841 · https://hartvaat.nl/2026/03/05/microrna-s-in-de-celkern-sturen-hartmetabolisme-bij-hfpef/* This European Heart Journal editorial discusses the discovery that nuclear microRNAs, acting via the Argonaute protein, regulate cardiac metabolism in heart failure with preserved ejection fraction. These findings open a new perspective on HFpEF pathophysiology. ## Coronairverkalkingen en myocardiale flowreserve na harttransplantatie *2026-04-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehag163 · https://hartvaat.nl/2026/03/05/coronairverkalkingen-en-myocardiale-flowreserve-na-harttransplantatie/* This longitudinal European Heart Journal study examined the relationship between coronary artery calcification and myocardial flow reserve in heart transplant recipients. The findings are relevant for follow-up and risk stratification in this vulnerable patient population. ## Nucleair AGO2 verergert HFpEF via myocardiale ketogenese *2026-04-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehag067 · https://hartvaat.nl/2026/03/05/nucleair-ago2-verergert-hfpef-via-myocardiale-ketogenese/* Research in the European Heart Journal reveals that nuclear argonaute-2 (AGO2), a core component of the microRNA machinery, exacerbates heart failure with preserved ejection fraction by stimulating myocardial ketogenesis. This mechanistic study identifies a novel therapeutic target for diet-related HFpEF. ## Cardio-oncologie: een snel veranderend vakgebied *2026-04-02 · European heart journal · https://doi.org/10.1093/eurheartj/ehag137 · https://hartvaat.nl/2026/03/05/cardio-oncologie-een-snel-veranderend-vakgebied/* This European Heart Journal editorial by Filippo Crea reviews recent trials and risk scores in cardio-oncology, a rapidly evolving field driven by increasing attention to the cardiovascular side effects of cancer therapies. ## Onbeantwoorde vragen over lipoproteïne(a) en atherosclerose *2026-04-02 · Circulation journal : official journal of the Japanese Circulation Society · https://doi.org/10.1253/circj.CJ-26-0036 · https://hartvaat.nl/2026/02/28/onbeantwoorde-vragen-over-lipoproteine-a-en-atherosclerose/* This review discusses unresolved questions regarding the relationship between lipoprotein(a) and atherosclerotic cardiovascular risk. Despite growing evidence for Lp(a) as an independent risk factor, questions remain about therapeutic thresholds and the efficacy of targeted treatment. ## ADAMTS-7-vaccin beschermt nieren en vaten bij chronische nierziekte *2026-04-02 · Circulation research · https://doi.org/10.1161/CIRCRESAHA.125.327881 · https://hartvaat.nl/2026/02/24/adamts-7-vaccin-beschermt-nieren-en-vaten-bij-chronische-nierziekte/* Researchers report in Circulation Research that a vaccine targeting ADAMTS-7 provides both renal and vascular protection in a chronic kidney disease model. This innovative vaccination approach opens new avenues for treating cardiorenal syndrome. ## Parodontale behandeling remt progressie van atherosclerose *2026-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf525 · https://hartvaat.nl/2026/02/24/parodontale-behandeling-remt-progressie-van-atherosclerose/* This European Heart Journal study investigates the link between oral health and atherosclerosis. Periodontal therapy may slow atherosclerosis progression, suggesting a role for chronic oral inflammation in the pathogenesis of vascular disease. ## Kwaliteitscriteria voor AI-implementatie in de cardiologie bijgewerkt *2026-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehag121 · https://hartvaat.nl/2026/02/24/kwaliteitscriteria-voor-ai-implementatie-in-de-cardiologie-bijgewerkt/* This European Heart Journal article presents updated quality criteria for implementing artificial intelligence in clinical cardiology practice. The authors emphasise the need for standardised evaluation before broad deployment of AI tools in patient care. ## EHJ-editoriaal: hartfalen en cardiomyopathieën *2026-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehag109 · https://hartvaat.nl/2026/02/23/ehj-editoriaal-hartfalen-en-cardiomyopathieen/* In this European Heart Journal editorial, Filippo Crea reviews the current epidemiology and management of heart failure and cardiomyopathies, providing an overview of recent developments in this rapidly evolving field. ## TEMPORARY REMOVAL: Cost-effectiveness of alternative cascade screening strategies for familial hypercholesterolemia with realistic cascade screening acceptance rates and use of novel treatment *2026-04-01 · Atherosclerosis · https://doi.org/10.1016/j.atherosclerosis.2025.120416 · https://hartvaat.nl/2026/04/01/kosteneffectiviteit-van-cascadescreening-voor-familiaire-hypercholesterolemie-ti/* This article on cost-effectiveness of alternative cascade screening strategies for familial hypercholesterolaemia has been temporarily removed by the publisher pending replacement or reinstatement. ## Senescente P16+ cellen verergeren hartremodellering na ischemie via cytotoxische lymfocyten *2026-03-31 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077172 · https://hartvaat.nl/2026/03/02/senescente-p16-cellen-verergeren-hartremodellering-na-ischemie-via-cytotoxische-/* This Circulation study shows that P16-positive senescent cells recruit cytotoxic lymphocytes via CCL8 after myocardial infarction, driving adverse cardiac remodelling. Senolytic therapy showed beneficial effects in a mouse model, identifying a potential therapeutic target. ## Extracellulaire vesikels mediëren adipocyt-cardiomyocytcommunicatie bij diabetisch ischemisch hartfalen *2026-03-31 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076372 · https://hartvaat.nl/2026/03/02/extracellulaire-vesikels-medieren-adipocyt-cardiomyocytcommunicatie-bij-diabetis/* This Circulation study demonstrates that small extracellular vesicles bearing surface adiponectin play a crucial role in adipocyte-cardiomyocyte communication in diabetic ischaemic heart failure. The findings partly explain why diabetes patients have worse prognosis after myocardial infarction. ## Clopidogrel versus aspirine bij coronairlijden: kanttekeningen bij meta-analyse *2026-03-31 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02643-1/fulltext · https://hartvaat.nl/2026/02/28/clopidogrel-versus-aspirine-bij-coronairlijden-kanttekeningen-bij-meta-analyse/* This Lancet correspondence raises methodological concerns about a recent meta-analysis by Valgimigli et al. comparing clopidogrel versus aspirin for secondary prevention in coronary artery disease. The authors point out limitations that nuance the conclusion of clopidogrel superiority. ## Genotype-phenotype correlations in patients with pathogenic/likely pathogenic titin variants from the Swiss Arrhythmogenic Cardiomyopathy Registry *2026-03-31 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003750?rss=1 · https://hartvaat.nl/2026/03/31/titine-cardiomyopathie-meestal-dcm-of-linksdominante-acm-met-blijvend-ritmestoor/* Truncating variants in the titin gene (TTNtv) are associated with cardiomyopathy, mainly dilated cardiomyopathy (DCM); arrhythmogenic phenotypes are scarcely studied. In this Swiss study (46 cardiomyopathy patients with a pathogenic/likely-pathogenic TTNtv; 63% male, median age 47), at baseline 89% met DCM criteria and 17% the revised Padua criteria for arrhythmogenic cardiomyopathy (ACM) — exclusively the left-dominant type, never the ARVC type. Most variants were in the A-band (74%). Under optimal medical therapy, left and right ventricular function improved, yet ventricular arrhythmias in the primary-prevention group still increased over time. Late gadolinium enhancement was usually in the basal septum and was not associated with more arrhythmias; high-grade AV block, unlike in sarcoidosis, did not occur. TTN cardiomyopathy thus presents as DCM or left-dominant ACM, with a persistently high arrhythmia risk despite favourable remodelling. ## Specialised heart valve clinics result in greater adherence to guideline-directed care: a comparative study *2026-03-31 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003608?rss=1 · https://hartvaat.nl/2026/03/31/gespecialiseerde-hartklepklinieken-leiden-tot-betere-richtlijnconforme-zorg/* International guidelines emphasise the role of heart valve centres and specialist heart valve clinics (SHVC) in optimal care for valve disease. In this comparative study, 134 patients with valve disease seen outside an SHVC were compared with 173 SHVC attendees against international guidelines. Outside the SHVC, the relationship between symptoms and valve disease was more often undocumented (31.5% vs 5.7%), exercise testing was used far less (3.4% vs 32%) and surgical referral was lower (3.4% vs 26.8%); no patient with prior valve surgery received endocarditis-prevention advice outside the SHVC (vs 100% within). Overall, management was discordant in 38% of native-valve and 84% of prior-surgery patients outside the SHVC, versus 3-4% within. Almost 5% of valve patients are thus still seen outside a specialist clinic and receive suboptimal care. ## Mortality in patients with ventricular septal defect in Sweden: a national register study *2026-03-31 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004098?rss=1 · https://hartvaat.nl/2026/03/31/volwassenen-met-een-ventrikelseptumdefect-hebben-drie-keer-hogere-sterfte-zweeds/* Ventricular septal defect (VSD) is the most common congenital heart defect, but much about long-term prognosis is unclear. In this Swedish register study, 22,855 VSD patients (born 1970-2017) were compared with ten matched controls without congenital heart disease per patient; patients with complex congenital disease were excluded. Mortality was elevated versus controls: hazard ratio 6.8 at ages 0-17 and 3.1 above age 18. Even in isolated, non-syndromic VSD, mortality remained elevated regardless of whether the defect had been repaired in childhood. Mortality was highest in cohorts with syndromes and associated valvular lesions. Adults with VSD thus have more than threefold higher mortality than controls — arguing for continued cardiology follow-up, even after repair. ## Outcomes according to timely or delayed primary PCI or fibrinolysis in a national registry of STEMI patients *2026-03-31 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003886?rss=1 · https://hartvaat.nl/2026/03/31/stemi-uitgestelde-primaire-pci-gaat-gepaard-met-hogere-sterfte-dan-trombolyse-ie/* Time to reperfusion partly determines long-term outcome in ST-elevation myocardial infarction (STEMI). Timely primary PCI is the preferred strategy; fibrinolysis is recommended when timely PCI is not feasible but may be underused. In this nationwide Irish STEMI registry (4,156 patients, 2013-2018), 4.9% received fibrinolysis, 25.8% delayed primary PCI (>120 min after diagnosis) and 69.3% timely primary PCI (<120 min). Over three years' follow-up, delayed primary PCI was associated with higher mortality than fibrinolysis (adjusted HR 1.36), whereas timely PCI gave comparable mortality to fibrinolysis (HR 1.10; not significant). A sizeable proportion of STEMI patients thus still receive delayed PCI — a strategy that fares worse than fibrinolysis. The findings underscore the importance of timely reperfusion and of fibrinolysis when timely PCI is not possible. ## Tofacitinib in the treatment of cardiac sarcoidosis: towards steroid-sparing disease management *2026-03-31 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003659?rss=1 · https://hartvaat.nl/2026/03/31/tofacitinib-bij-cardiale-sarcoidose-veelbelovend-als-corticosteroidsparende-beha/* Cardiac sarcoidosis (CS) is difficult to treat, especially in patients who fail immunosuppressants and second-line TNF inhibitors; these refractory cases often lead to serious complications. This study treated eight patients with (probable) refractory CS with the JAK inhibitor tofacitinib (University Hospital Zurich, 2020-2024), tracking inflammation with 18F-FDG PET/CT, ejection fraction, corticosteroid use and blood neopterin. Seven of eight patients (87.5%) achieved inactive or remitting disease, with decreased myocardial uptake; ejection fraction stabilised or improved and the mean daily prednisone dose fell from 5.94 to 2.5 mg. Tofacitinib thus shows promising results in treatment-refractory cardiac sarcoidosis, though larger prospective studies are needed to confirm efficacy and safety. ## ERA's ABCDE Framework for Kidney Disease Prevention: Turning the WHO Kidney Health Resolution into action. *2026-03-31 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfaf198 · https://hartvaat.nl/2026/03/31/era-s-abcde-raamwerk-voor-preventie-van-nierziekten/* This ERA ABCDE Framework translated the WHO kidney health resolution into practical action steps for kidney disease prevention, providing a structured approach for implementing global nephrology policy. ## ACC Braunwald Lecture 2025: cardiovasculaire wetenschap en maatschappij *2026-03-30 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000732?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/acc-braunwald-lecture-2025-cardiovasculaire-wetenschap-en-maatschappij/* The 2025 ACC Braunwald Lecture, published in JACC, outlines a future vision at the intersection of cardiovascular science, medicine, and society. It highlights how technological innovation, population health, and health equity will shape cardiology in the coming years. ## Coronaire atherosclerose bij levertransplantatiepatiënten vergeleken met algemene bevolking *2026-03-30 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S073510972600207X?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/coronaire-atherosclerose-bij-levertransplantatiepatienten-vergeleken-met-algemen/* Using protocolised CT angiography in a nationwide Danish cohort, this JACC study compared coronary atherosclerosis between liver transplant recipients and population controls. The findings are relevant for cardiovascular risk stratification in transplant patients. ## Noodprotocollen voor plotse hartstilstand bij jonge sporters moeten worden aangescherpt *2026-03-30 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726003293?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/noodprotocollen-voor-plotse-hartstilstand-bij-jonge-sporters-moeten-worden-aange/* This JACC perspective addresses preparedness for sudden cardiac arrest in young athletes, advocating for improved emergency protocols. The authors stress that current guidelines are insufficient and that AED availability, training, and response plans at sports venues urgently need enhancement. ## LEAF: liraglutide vóór ablatie verbetert AF-vrije overleving *2026-03-30 · JACC. Clinical electrophysiology · https://doi.org/10.1016/j.jacep.2026.03.026 · https://hartvaat.nl/2026/03/30/leaf-liraglutide-voor-ablatie-verbetert-af-vrije-overleving/* In this randomized study, 59 overweight or obese patients with (mostly persistent) atrial fibrillation received three months of risk-factor modification with or without liraglutide before catheter ablation. The primary endpoint — reduction of left-atrial epicardial adipose tissue — did not differ significantly between groups. Nonetheless, one-year freedom from AF/atrial flutter was higher with liraglutide (81% vs 54%; p=0.007). The authors suggest pleiotropic GLP-1 effects may offer a novel target for AF treatment, to be confirmed in larger trials. ## Betere diagnostiek als sleutel tot vooruitgang na acuut myocardinfarct *2026-03-29 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726001488?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/betere-diagnostiek-als-sleutel-tot-vooruitgang-na-acuut-myocardinfarct/* This JACC perspective argues that the next leap in improving outcomes after acute myocardial infarction lies not in treatment but in diagnostics. More accurate and faster diagnosis could fundamentally improve the care trajectory and prevent unnecessary delays. ## Luchtvervuiling en hypertensierisico: ernst van de ziekte doet ertoe *2026-03-29 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726002305?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/luchtvervuiling-en-hypertensierisico-ernst-van-de-ziekte-doet-ertoe/* This JACC study re-examines the association between air pollution and hypertension, highlighting that the effect of air pollution on blood pressure varies with disease severity. The findings carry implications for prevention policy and cardiovascular risk stratification. ## Wereldwijde toename atriumfibrilleren treft steeds vaker jongere volwassenen *2026-03-29 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag036 · https://hartvaat.nl/2026/03/03/wereldwijde-toename-atriumfibrilleren-treft-steeds-vaker-jongere-volwassenen/* Analysis of Global Burden of Disease 2023 data reveals a rising global incidence of atrial fibrillation and atrial flutter, notably among younger and middle-aged adults, particularly in low- and middle-income countries. Six modifiable risk factors were identified as contributing to AF-related mortality. ## CHAMPION-AF: WATCHMAN FLX non-inferieur aan NOAC's en superieur in bloedingsreductie bij atriumfibrilleren *2026-03-29 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2517213&rss=currentIssue · https://hartvaat.nl/2026/03/28/champion-af-watchman-flx-non-inferieur-aan-noac-s-en-superieur-in-bloedingsreduc/* In CHAMPION-AF, 3,000 patients with non-valvular AF were randomized to WATCHMAN FLX LAA closure or NOAC therapy. At 36 months, the device was noninferior for the primary efficacy endpoint (stroke, CV death, systemic embolism: 5.7% vs 4.8%; P<0.001 for noninferiority) and superior for non-procedural bleeding (45% reduction: 10.9% vs 19.0%; P<0.001). This contrasts with the negative CLOSURE-AF trial and establishes WATCHMAN FLX as the first LAA closure device to demonstrate noninferiority vs NOACs as first-line therapy. ## HI-PEITHO: katheter-gestuurde trombolyse halveert ernstige uitkomsten bij intermediair-hoog-risico longembolie *2026-03-29 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2516567&rss=currentIssue · https://hartvaat.nl/2026/03/28/hi-peitho-katheter-gestuurde-trombolyse-halveert-ernstige-uitkomsten-bij-interme/* In the HI-PEITHO trial, 544 patients with acute intermediate-high-risk PE were randomized to ultrasound-facilitated catheter-directed fibrinolysis (EKOS) vs anticoagulation alone. The primary composite endpoint (PE-related death, cardiorespiratory decompensation, or recurrent PE within 7 days) occurred in 3.7% vs 10.3% — a 61% relative risk reduction (RR 0.4; P=0.005). No intracranial bleeding in either group. First positive hard-outcome trial for catheter-directed intervention in intermediate-risk PE. ## Therapietrouw aan lipidenverlagende medicatie na PCI in Nederland *2026-03-28 · Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · https://doi.org/10.1007/s12471-026-02028-8 · https://hartvaat.nl/2026/03/02/therapietrouw-aan-lipidenverlagende-medicatie-na-pci-in-nederland/* This Dutch retrospective cohort study used Vektis claims data to assess adherence to lipid-lowering medication in the first year after percutaneous coronary intervention. Despite proven benefits of post-PCI statin therapy, real-world adherence remained disappointing, highlighting concrete opportunities for quality improvement. ## RYR2-mutaties als oorzaak van onverklaarde plotse hartdood bij jongeren *2026-03-28 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf303 · https://hartvaat.nl/2026/02/03/ryr2-mutaties-als-oorzaak-van-onverklaarde-plotse-hartdood-bij-jongeren/* Calcium release channel deficiency syndrome (CRCDS), caused by loss-of-function RYR2 variants, can lead to ventricular fibrillation without exercise test abnormalities. This study assessed the prevalence of potentially CRCDS-causing variants in idiopathic ventricular fibrillation and unexplained sudden death in young individuals, underscoring the importance of genetic screening. ## Big data-benadering voor aldosteron-renineratio bij primair hyperaldosteronisme *2026-03-28 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26435 · https://hartvaat.nl/2026/03/04/big-data-benadering-voor-aldosteron-renineratio-bij-primair-hyperaldosteronisme/* Using administrative healthcare data from Alberta, Canada, researchers developed a five-component definition of primary hyperaldosteronism independent of the aldosterone-renin ratio (ARR). By circumventing selection bias, the study re-evaluated the sensitivity of ARR thresholds, offering insights for identifying surgically treatable forms of secondary hypertension. ## Coronaire autoregulatie: samenspel van epicardiale en microvasculaire weerstand *2026-03-28 · European heart journal · https://doi.org/10.1093/eurheartj/ehag145 · https://hartvaat.nl/2026/03/28/coronaire-autoregulatie-samenspel-van-epicardiale-en-microvasculaire-weerstand/* This EHJ review examines coronary autoregulation: the coronary circulation's ability to keep flow stable despite fluctuating perfusion pressure, with microvascular resistance as the main control. New techniques such as continuous intracoronary thermodilution allow simultaneous measurement of absolute coronary flow and epicardial and microvascular resistance. The authors present an integrative model from rest to maximal hyperaemia and stress that understanding this interplay is essential for correctly interpreting coronary physiological assessments in epicardial coronary disease. ## KARDINAL: tonlamarsen verlaagt angiotensinogeen maar laat geen significant bloeddrukeffect zien *2026-03-28 · Journal of the American College of Cardiology · https://doi.org/https://www.jacc.org/doi/10.1016/j.jacc.2026.03.001 · https://hartvaat.nl/2026/03/28/kardinal-tonlamarsen-verlaagt-angiotensinogeen-maar-laat-geen-significant-bloedd/* In the KARDINAL phase 2 trial, 206 patients with uncontrolled hypertension (despite 2-5 antihypertensives) received monthly injections of tonlamarsen, an antisense oligonucleotide targeting angiotensinogen. At 20 weeks, angiotensinogen levels dropped significantly (-67% vs -23% with placebo). Systolic BP dropped 6.7 mmHg in both groups with no significant between-group difference. The unexpectedly long-lasting effect of a single dose complicated interpretation. Simultaneously published in JACC. ## VESALIUS-CV: evolocumab verlaagt risico op eerste cardiovasculair event met 31% bij patiënten zonder significant atherosclerose *2026-03-28 · JAMA · https://doi.org/https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2026.4521 · https://hartvaat.nl/2026/03/28/vesalius-cv-evolocumab-verlaagt-risico-op-eerste-cardiovasculair-event-met-31-bi/* In a subgroup analysis of VESALIUS-CV, 3,655 patients with diabetes but no known significant atherosclerosis were followed for a median of 4.8 years. Evolocumab reduced 3-P MACE by 31% (HR 0.69; P=0.009) and 4-P MACE by 31% (HR 0.69; P=0.001). The effect appeared after 1 year and grew to ~40% reduction thereafter. CV death was reduced by 32% and all-cause mortality by 24%. This supports the use of PCSK9 inhibitors for primary prevention in high-risk diabetes patients. ## Ez-PAVE: LDL-streefwaarde <55 mg/dL superieur aan <70 mg/dL bij patiënten met atherosclerotisch vaatlijden *2026-03-28 · The New England Journal of Medicine · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2600757 · https://hartvaat.nl/2026/03/28/ez-pave-ldl-streefwaarde-55-mg-dl-superieur-aan-70-mg-dl-bij-patienten-met-ather/* In the Ez-PAVE trial, the first randomized head-to-head comparison of LDL-C targets, 3,048 patients with ASCVD were shown to have a 33% lower risk of cardiovascular events with a target of <55 mg/dL vs <70 mg/dL (HR 0.67; P=0.002). At 3 years, the primary composite endpoint occurred in 6.6% vs 9.7%. Safety profiles were similar. This is the first randomized evidence that the lower target in the 2026 ACC/AHA dyslipidemia guideline is superior. ## Prevalentie en behandelpatronen van therapieresistente hypertensie in de VS *2026-03-27 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25659 · https://hartvaat.nl/2026/03/04/prevalentie-en-behandelpatronen-van-therapieresistente-hypertensie-in-de-vs/* Using NHANES data (2003-2020), this study analysed the prevalence of apparent treatment-resistant hypertension in the United States. Despite stricter blood pressure targets, a substantial proportion of patients remain inadequately treated, with many not receiving optimal diuretic regimens. ## KDIGO versnelt richtlijnontwikkeling voor nierziekten *2026-03-27 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00012-8/fulltext · https://hartvaat.nl/2026/03/03/kdigo-versnelt-richtlijnontwikkeling-voor-nierziekten/* KDIGO has published 17 kidney disease guidelines, but traditional full-revision cycles take years and lag behind rapidly evolving therapies such as SGLT2 inhibitors and finerenone. This article describes KDIGO's transition to modular, faster guideline updates to accelerate evidence translation into cardiometabolic clinical practice. ## Deep endotypering onthult heterogeniteit van nierschade bij diabetes type 2 *2026-03-27 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00143-2/fulltext · https://hartvaat.nl/2026/02/27/deep-endotypering-onthult-heterogeniteit-van-nierschade-bij-diabetes-type-2/* Kidney damage in type 2 diabetes is highly heterogeneous and poorly captured by traditional markers such as albuminuria and eGFR. This Kidney International review discusses how deep endotyping — integrating clinical trajectory analysis, renal histopathology, and molecular profiling — can identify subgroups with distinct pathophysiology, enabling more targeted therapy selection. ## Optimizing NT-proBNP Inclusion Cut-offs for Randomized Clinical Trials in Heart Failure: Data from the Swedish Heart Failure Registry *2026-03-27 · ESC heart failure · https://doi.org/10.1093/eschf/xvag089 · https://hartvaat.nl/2026/03/27/nt-probnp-afkapwaarden-voor-hartfalentrials-optimaliseren-swedehf/* NT-proBNP is widely used as an enrolment criterion in heart-failure trials, but cut-offs vary widely. Using the Swedish Heart Failure Registry (SwedeHF, 43,750 patients), the investigators applied prior-trial cut-offs (200–5,000 pg/mL) and computed the 1-year incidence of cardiovascular death or heart-failure hospitalisation across subgroups (ejection fraction, care setting, AF, CKD, obesity). Higher cut-offs increased event enrichment but excluded more patients (more screening failures). In HFrEF outpatients, 1-year incidence rose from 22.0% (no cut-off) to 26.2% at ≥1,200 pg/mL, at the cost of 26% screening failure. The authors advise tailoring cut-offs to trial aims while accounting for obesity and CKD. ## Metabool cardiovasculair risico: nieuwe mechanismen en therapiekansen *2026-03-26 · European heart journal · https://doi.org/10.1093/eurheartj/ehag116 · https://hartvaat.nl/2026/03/06/metabool-cardiovasculair-risico-nieuwe-mechanismen-en-therapiekansen/* This European Heart Journal review examines how metabolic disorders — obesity, type 2 diabetes, and dyslipidaemia — drive cardiovascular risk through newly identified mechanisms. The authors highlight unexpected cardiovascular benefits from metabolic drug classes including GLP-1 receptor agonists and SGLT2 inhibitors, and discuss emerging therapeutic opportunities at the intersection of metabolic and cardiovascular disease. ## Veroudering en myocarddisfunctie: het hart jong houden *2026-03-26 · European heart journal · https://doi.org/10.1093/eurheartj/ehag095 · https://hartvaat.nl/2026/03/06/veroudering-en-myocarddisfunctie-het-hart-jong-houden/* This European Heart Journal review provides a comprehensive overview of ageing-related myocardial dysfunction. The authors discuss how cellular senescence affects cardiac pump function and explore therapeutic strategies to slow this process. ## Barrières bij implementatie van lipidenverlagende therapie in de praktijk *2026-03-26 · Circulation. Population health and outcomes · https://doi.org/10.1161/CIRCOUTCOMES.125.012330 · https://hartvaat.nl/2026/03/02/barrieres-bij-implementatie-van-lipidenverlagende-therapie-in-de-praktijk/* Despite proven efficacy of lipid-lowering therapies, their implementation in daily clinical practice remains suboptimal. This Circulation article analyses barriers — from adherence to financial accessibility — and discusses strategies to close the gap between guidelines and practice. ## Cardiometabolic Burden in Bilateral Macronodular Adrenal Disease With Primary Aldosteronism *2026-03-26 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25507 · https://hartvaat.nl/2026/03/26/hoge-cardiometabole-last-bij-bilaterale-macronodulaire-bijnierziekte-met-primair/* Bilateral macronodular adrenocortical disease is often linked to autonomous cortisol secretion but can also present with primary aldosteronism (PA). In this international retrospective cohort (249 patients from 41 centres in 12 countries; median age 55, 62% male), hypertension had been present for a median of 9.9 years at PA diagnosis. Of those tested, 52% had cortisol cosecretion and 47% isolated PA. At baseline, 56% had metabolic comorbidity and 16% had at least one prior major cardiovascular event (MACE); patients with MACE were older, more often male and had longer-standing hypertension. Bilateral macronodular adrenal disease with PA thus carries a substantial cardiometabolic and cardiovascular burden, driven partly by the often long duration of hypertension and frequent cortisol cosecretion. ## Artificial Intelligence in Cardiovascular Medicine: Focus on Hypertension *2026-03-26 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26094 · https://hartvaat.nl/2026/03/26/kunstmatige-intelligentie-in-de-cardiovasculaire-geneeskunde-focus-op-hypertensi/* Hypertension remains the most prevalent modifiable risk factor worldwide, while blood-pressure control stays persistently suboptimal — partly because care models rely on episodic measurements and population-based algorithms. This systematic review maps how artificial intelligence (AI) can support the entire hypertension care continuum: risk prediction, phenotyping, blood-pressure measurement, wearable-based monitoring, trial analysis, population health, detection of secondary hypertension, behavioural and adherence interventions, and multi-omics-driven precision medicine. The authors stress the methodological prerequisites for clinically meaningful AI — robust ground-truth standards, external and temporal validation, interpretability, workflow integration and equity-aware design — and discuss cuffless BP measurement, natural language processing and decision support, with the ethical and regulatory challenges. AI could shift hypertension care from reactive and threshold-based to predictive, personalised and patient-centred, provided it is carefully validated and implemented. ## Reverse cardio-oncologie: obesitas en veroudering als aanjagers van borstkanker *2026-03-26 · European heart journal · https://doi.org/10.1093/eurheartj/ehag144 · https://hartvaat.nl/2026/03/26/reverse-cardio-oncologie-obesitas-en-veroudering-als-aanjagers-van-borstkanker/* This EHJ review introduces 'reverse cardio-oncology': how cardiometabolic dysfunction — such as obesity — influences breast-cancer risk and biology through shared mechanisms (chronic inflammation, hormonal dysregulation, cellular senescence), even without overt cardiovascular disease. Refined obesity phenotypes (metabolically healthy/unhealthy, sarcopenic obesity) stratify risk better than BMI. Senescent adipose tissue is a key driver of the tumour microenvironment. Cardiometabolic therapies (GLP-1 agonists, SGLT2 inhibitors) and senolytics may offer shared targets for cardiovascular and oncologic prevention. ## Gene Editing Therapy in Cardiovascular Disease: 2026 ACC Scientific Statement *2026-03-26 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726055609?dgcid=rss_sd_all · https://hartvaat.nl/2026/03/26/acc-verklaring-2026-gen-editing-als-therapie-bij-hart-en-vaatziekten/* In this scientific statement the American College of Cardiology charts the rise of gene and base editing as a therapeutic strategy in cardiovascular disease. It places the rapid advances — such as permanently switching off PCSK9 — in a broader context and discusses the technology, the potential targets and the clinical, safety, regulatory and ethical questions that accompany these one-time, durable interventions. The international author panel includes Dutch researcher Menno Hoekstra (Leiden University). ## CLOSURE-AF: sluiting van het linker hartoor niet non-inferieur aan medicamenteuze therapie bij atriumfibrilleren *2026-03-26 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2513310&rss=currentIssue · https://hartvaat.nl/2026/03/18/closure-af-sluiting-van-het-linker-hartoor-niet-non-inferieur-aan-medicamenteuze/* In the CLOSURE-AF trial, 912 patients with atrial fibrillation at high risk for both stroke and bleeding were randomized to catheter-based left atrial appendage closure or physician-directed best medical care. After a median follow-up of 3 years, LAA closure was not noninferior to medical therapy for the composite endpoint of stroke, systemic embolism, major bleeding, or cardiovascular death (16.8 vs 13.3 events per 100 patient-years; P=0.44 for noninferiority). Serious adverse events occurred in 82.5% of the device group versus 77.4% of the medical-therapy group. These results provide critical context for the CHAMPION-AF trial results to be presented at ACC.26. ## Diploide cardiomyocyten geassocieerd met hartregeneratie *2026-03-25 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.124.071679 · https://hartvaat.nl/2026/03/02/diploide-cardiomyocyten-geassocieerd-met-hartregeneratie/* Research in Circulation demonstrates that the presence of mononuclear diploid cardiomyocytes is associated with the capacity for cardiac regeneration. These findings offer new insights into the cellular basis of myocardial repair and may pave the way for regenerative therapies after myocardial infarction. ## PAM-VT 2: littekenverloop na VT-ablatie beoordeeld met seriële cardiale MRI *2026-03-25 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074748 · https://hartvaat.nl/2026/03/02/pam-vt-2-littekenverloop-na-vt-ablatie-beoordeeld-met-seriele-cardiale-mri/* The PAM-VT 2 study used serial late gadolinium enhancement cardiac MRI to assess the long-term evolution of scar and ablation lesions after ventricular tachycardia ablation. The prospective study provides insight into how substrate and ablation lesions change over time, relevant for predicting recurrences. ## Aficamten en de toekomst van obstructieve HCM-behandeling *2026-03-25 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725103343?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/aficamten-en-de-toekomst-van-obstructieve-hcm-behandeling/* This JACC editorial outlines how aficamten may fundamentally change the treatment of obstructive hypertrophic cardiomyopathy. It places recent trial results in the context of the evolving therapeutic landscape, including the relationship to mavacamten and surgical myectomy. ## Aortic coarctation and long-term morbidity after arterial switch operation: a multicentre international cohort study *2026-03-25 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/437?rss=1 · https://hartvaat.nl/2026/03/25/aortacoarctatie-voorspelt-langetermijnmorbiditeit-na-de-arteriele-switchoperatie/* After the arterial switch operation (ASO) for transposition of the great arteries, later interventions and complications are common. Whether aortic coarctation (CoA) plays an independent role was unclear. In this international multicentre study (502 adults from the EPOCH-ASO registry, median age 25.5 years), time to first right ventricular outflow tract (RVOT)-related intervention was the primary outcome. Aortic coarctation emerged as the strongest independent predictor of an RVOT intervention. The findings help identify patients after arterial switch at increased risk of later interventions and to follow them more closely. ## Comparative analysis of recurrence rates following various cessation strategies for rilonacept in recurrent pericarditis *2026-03-25 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/454?rss=1 · https://hartvaat.nl/2026/03/25/geleidelijk-afbouwen-van-rilonacept-bij-recidiverende-pericarditis-voorkomt-vake/* Rilonacept, an interleukin-1α/β inhibitor, prevents recurrence in recurrent pericarditis (RP), but stopping after 18 months carries a higher recurrence risk. In this retrospective cohort (Cleveland Clinic; 53 patients with refractory RP, median treatment 24 months), abrupt discontinuation was compared with a slow taper (from weekly to fortnightly, monthly, then cessation). Recurrence occurred more often after abrupt stopping (82%) than after tapering (37%). Colchicine after stopping rilonacept delayed a flare by an average of 60.7 weeks. Most patients (80%) resumed rilonacept after a recurrence, and long-term therapy was well tolerated. A gradual taper of rilonacept thus appears associated with a lower recurrence risk than abrupt discontinuation — though larger studies are needed for a standardised tapering protocol. ## Heritability and Cardiovascular Disease in Adult Offspring of Hypertensive Disorder of Pregnancy: A Systematic Review and Meta-Analysis *2026-03-25 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25834 · https://hartvaat.nl/2026/03/25/kinderen-van-een-hypertensieve-zwangerschap-hebben-later-vaker-hoge-bloeddruk-en/* This systematic review and meta-analysis examined the heritability of hypertensive disorders of pregnancy (HDP) and their association with cardiovascular disease in adult offspring. Fifteen studies (266,244 participants, offspring aged 19-55) were pooled. Adults exposed in utero to HDP had higher systolic (+3.40 mmHg) and diastolic blood pressure (+2.19 mmHg) and more hypertension (OR 1.50). Female offspring had 72% higher odds of developing HDP themselves (OR 1.72) and 90% higher odds of preeclampsia (OR 1.90). Exposure to HDP and severe preeclampsia was also associated with more premature acute coronary syndrome and higher stroke risk. HDP heritability is thus high, and exposure is associated with hypertension, acute coronary syndrome and stroke in offspring — arguing for lifestyle advice, monitoring and prevention. ## Managing glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors in clinical practice *2026-03-25 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/422?rss=1 · https://hartvaat.nl/2026/03/25/glp-1-agonisten-en-sglt2-remmers-in-de-praktijk-bescherming-van-hart-en-nieren-v/* The obesity epidemic has heightened the impact of cardiometabolic risk factors on cardiovascular and kidney disease. GLP-1 receptor agonists (GLP-1RAs) and SGLT2 inhibitors (SGLT2is), originally developed for type 2 diabetes, reduce cardiovascular and renal risk in randomised trials. SGLT2is are the first class proven to improve prognosis in heart failure with preserved ejection fraction (HFpEF), and evidence is accumulating that GLP-1RAs may also help there. Notably, the benefits are independent of diabetes status and baseline renal function. This practice-oriented review discusses how to use these drugs in everyday care for patients at high cardiovascular and renal risk, in line with evolving guidelines. ## Sex Differences in Cardiac Remodeling and Dysfunction in Primary Aldosteronism *2026-03-25 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26213 · https://hartvaat.nl/2026/03/25/sekseverschillen-in-hartremodellering-bij-primair-aldosteronisme-vrouwen-hebben-/* Sex differences influence cardiovascular risk assessment, but their role in aldosterone-mediated cardiac remodelling in primary aldosteronism (PA) was incompletely understood. In this retrospective study (547 PA patients: 249 men, 298 women), clinical and echocardiographic data were collected at baseline and after one year of aldosterone-targeted therapy. At baseline, men had a higher left ventricular mass index (LVMI), but women more often had LV hypertrophy and worse diastolic function (higher E/e' and left atrial volume index). Plasma aldosterone concentration was associated with LVMI in both sexes. After one year, LVMI reduction was comparable between sexes, but diastolic function improved less in women. Despite lower LVMI, women with PA thus have a more adverse cardiac phenotype that recovers less well after treatment. ## Sex differences in ascending aortic diameter at the time of acute type A aortic dissection *2026-03-25 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/462?rss=1 · https://hartvaat.nl/2026/03/25/vrouwen-krijgen-een-type-a-aortadissectie-bij-een-kleinere-aortadiameter-door-hu/* Guideline size criteria for prophylactic ascending aortic aneurysm repair do not account for sex, although women may experience acute type A aortic dissection (ATAAD) at smaller diameters. In this single-centre retrospective study (413 patients with ATAAD, 35% female), aortic diameter at dissection was smaller in women, who were also older (65 vs 58 years). Female sex was associated with dissection at a smaller absolute diameter, but this association disappeared when accounting for women's smaller body size (diameter indexed to height or body surface area). Guidelines that account for sex or body size could thus reduce preventable complications in women. ## Drivers of 1-year mortality decline after acute myocardial infarction in England and Wales: a 15-year national cohort study *2026-03-25 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/446?rss=1 · https://hartvaat.nl/2026/03/25/waarom-de-sterfte-na-een-hartinfarct-daalde-15-jaar-nationale-data-uit-engeland-/* One-year mortality after acute myocardial infarction (AMI) has declined over time, but the reasons were unclear. In this analysis of 852,914 AMI patients in England and Wales (2005-2019), decomposition analysis examined which factors contributed to the trend. One-year mortality fell from 22.8% to 14.2% — an absolute reduction of 8.6 percentage points. About 68% of this decline was explained by measured factors, the greatest contributor being increased use of evidence-based pharmacological therapy. The remainder stayed unexplained. The findings show that broader use of proven medications has been the main driver of improved post-infarction survival — an important pointer for clinical strategy and policy. ## Identifying clinical phenotype clusters in patients with coronary artery disease *2026-03-25 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/431?rss=1 · https://hartvaat.nl/2026/03/25/vier-klinische-fenotypes-bij-coronairlijden-met-sterk-verschillend-risico-op-nie/* Guideline recommendations for secondary prevention in coronary artery disease (CAD) are largely one-size-fits-all, while clinically identifiable phenotypes needing specific approaches may exist. Using unsupervised machine learning (latent class analysis), four phenotypes were identified in the Swedish SWEDEHEART registry (88,894 patients) and validated in the Dutch UCC-SMART cohort (Utrecht, 5,506 patients): cluster 1 (38%) younger men with higher BMI, blood pressure and CRP; cluster 2 (21%) smokers with few traditional risk factors; cluster 3 (30%) older patients with few comorbidities; and cluster 4 (11%) patients with multimorbidity. Compared with cluster 1, cluster 4 had the highest risk of a recurrent event (myocardial infarction, stroke or cardiovascular death; HR 4.38), followed by cluster 3 (HR 1.78); cluster 2 did not differ. These four reproducible phenotypes may help target CAD care more precisely. ## Strategies for optimising tapering and withdrawal of interleukin-1 blockers in recurrent pericarditis *2026-03-25 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/413?rss=1 · https://hartvaat.nl/2026/03/25/hoe-bouw-je-il-1-remmers-af-bij-recidiverende-pericarditis-strategieen-voor-afbo/* Interleukin-1 (IL-1) blockers radically changed the treatment of glucocorticoid-dependent, colchicine-resistant (GD-CR) recurrent pericarditis about fifteen years ago. This group comprises roughly 5-10% of patients with recurrent pericarditis, in whom disease can persist beyond three years and earlier options (glucocorticoids, colchicine, NSAIDs, conventional immunosuppressants) fell short. This review discusses strategies for tapering and withdrawing IL-1 blockers (such as anakinra and rilonacept) in a controlled way to prevent recurrence on discontinuation. The authors address timing, tapering speed and accompanying therapy, aiming to limit the duration of IL-1 blockade without flaring the disease — practical guidance for a difficult-to-treat condition. ## Role of Provocation and Exercise Imaging for the Identification of Candidates for Cardiac Myosin Inhibitors *2026-03-25 · ESC heart failure · https://doi.org/10.1093/eschf/xvag087 · https://hartvaat.nl/2026/03/25/inspanningsecho-identificeert-hcm-patienten-die-baat-hebben-bij-mavacamten/* Left ventricular outflow tract obstruction (LVOTO) drives symptoms in obstructive hypertrophic cardiomyopathy (oHCM). Some patients show treatment-qualifying obstruction only during exercise echocardiography. In this single-centre retrospective cohort (56 symptomatic oHCM patients on mavacamten), 42.9% qualified exclusively during exercise echo. These patients did not have milder disease: functional limitation and exercise capacity were similar to those qualifying at rest or with Valsalva. By 24 weeks, both groups similarly achieved a non-obstructive gradient (<30 mmHg) and NYHA improvement. Exercise echocardiography thus identifies a substantial group of treatable oHCM patients missed by resting assessment. ## Sex- and Phenotype-Specific Prognostic Implications of Body Mass Index in Acute Heart Failure *2026-03-25 · ESC heart failure · https://doi.org/10.1093/eschf/xvag050 · https://hartvaat.nl/2026/03/25/bmi-en-prognose-bij-acuut-hartfalen-verschillen-per-fenotype-en-geslacht/* Whether the prognostic value of BMI differs by heart-failure phenotype and sex was examined in the Korean HF III registry (5,271 patients hospitalised for acute heart failure). The primary outcome was 2-year all-cause mortality or heart transplantation. In HFrEF, lower BMI was consistently associated with worse outcomes in both men and women (in women with HFrEF higher BMI was favourable, HR 0.66). In HFpEF, BMI was prognostic only in women (lower BMI borderline unfavourable, HR 1.56), not in men. The findings underscore the importance of sex- and phenotype-specific interpretation of BMI in risk assessment. ## Cardiale betrokkenheid bij parasitaire infecties *2026-03-25 · European heart journal · https://doi.org/10.1093/eurheartj/ehag173 · https://hartvaat.nl/2026/03/25/cardiale-betrokkenheid-bij-parasitaire-infecties/* Parasitic infections are an underrecognised but important cause of cardiovascular disease, especially in endemic regions and — through migration and travel — increasingly beyond them. Cardiac involvement arises from direct invasion or, more often, immune-mediated inflammation, affecting myocardium and pericardium: acute myocarditis, dilated or restrictive cardiomyopathy, pericardial effusion, tamponade, constrictive pericarditis or cystic lesions. This EHJ review advises considering a parasitic cause in unexplained myocardial or pericardial disease — particularly with relevant exposure, immunosuppression, fever or eosinophilia — and offers practical diagnostic and management guidance. ## Hart- en vaatziekten in China: epidemiologische evolutie 1990–2021 *2026-03-25 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1121 · https://hartvaat.nl/2026/03/25/hart-en-vaatziekten-in-china-epidemiologische-evolutie-19902021/* This EHJ review analyses the epidemiological transition of cardiovascular disease in China from 1990 to 2021, for total CVD and the subtypes ischaemic heart disease (IHD), ischaemic stroke and haemorrhagic stroke. It quantifies the underlying drivers and shows that the fall in haemorrhagic-stroke mortality was mainly due to primary prevention, whereas declining IHD and ischaemic-stroke mortality stemmed largely from better medical care (fewer fatal events). The findings inform future prevention strategies. ## Palliatieve zorg in de cardiologie: een state-of-the-art overzicht *2026-03-25 · European heart journal · https://doi.org/10.1093/eurheartj/ehag219 · https://hartvaat.nl/2026/03/25/palliatieve-zorg-in-de-cardiologie-een-state-of-the-art-overzicht/* Thanks to better treatment, more people live longer with advanced cardiovascular disease, often with a high symptom burden and complex decisions. This EHJ review summarises how palliative care — symptom management, communication, shared decision-making, advance care planning and psychosocial/spiritual support — improves quality of life and reduces low-value, high-intensity end-of-life care. It covers disease-specific aspects (heart failure, valvular disease, pulmonary hypertension, arrhythmias, congenital heart disease), ethical and legal issues such as device deactivation, and offers a practical algorithm for integrating palliative care into cardiology practice. ## Drug Therapy in Nonobstructive Hypertrophic Cardiomyopathy: Out of the Darkness Into the Light *2026-03-24 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725104361?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/medicamenteuze-therapie-bij-niet-obstructieve-hcm-nieuwe-perspectieven/* This JACC editorial discussed the therapeutic advances in nonobstructive hypertrophic cardiomyopathy, a subgroup previously lacking targeted treatment options, evaluating the potential of cardiac myosin inhibitors beyond obstruction relief. ## High-Sensitivity Troponin I-to-High-Sensitivity Troponin T Ratio in Myocardial Injury: Old Dogs, New Tricks *2026-03-24 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726002238?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/troponine-i-t-ratio-bij-myocardschade-nieuwe-inzichten-uit-bekende-biomarkers/* This JACC commentary discussed the clinical value of the high-sensitivity troponin I-to-T ratio in myocardial injury, exploring whether the differential release pattern can help distinguish ischemic from non-ischemic causes. ## Innovation and Evidence in Pulmonary Embolism Management: Putting the Cart Before the Horse *2026-03-24 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726002378?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/innovatie-in-longemboliebehandeling-loopt-de-praktijk-voor-op-het-bewijs/* This JACC editorial criticized the rapid clinical adoption of interventional techniques for pulmonary embolism (catheter-directed therapy, mechanical thrombectomy) without sufficient randomized evidence, advocating for evidence before widespread implementation. ## Triglyceride-glucose index and mortality in critically ill patients with cardiovascular-kidney-metabolic syndrome stage 4 *2026-03-24 · Cardiovascular diabetology · https://doi.org/10.1186/s12933-025-03061-4 · https://hartvaat.nl/2026/03/24/triglyceride-glucose-index-voorspelt-sterfte-bij-kritiek-zieke-patienten-met-ckm/* The triglyceride-glucose (TyG) index is a surrogate marker of insulin resistance. In early stages of cardiovascular-kidney-metabolic (CKM) syndrome a higher TyG index is linked to more events, but its value in critically ill patients with CKM stage 4 was unclear. In this retrospective study from the MIMIC-IV database (3,125 ICU patients with CKM-4), 1-year mortality was 34%. Each standard-deviation higher TyG index was associated with 23% higher mortality (HR 1.23), and the highest tertile had 30% higher risk than the lowest (HR 1.30), with a linear relationship. The TyG index may serve as a simple marker for risk stratification in this group, though prospective studies must confirm its clinical value. ## Cascade screening for elevated Lp(a) in relatives of children who visited the pediatric lipid clinic: yield of daily clinical practice *2026-03-24 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag161 · https://hartvaat.nl/2026/03/24/cascadescreening-op-verhoogd-lp-a-via-kinderen-opbrengst-in-de-praktijk-amsterda/* Cascade screening can identify people with elevated lipoprotein(a) [Lp(a)], a causal cardiovascular risk factor. This retrospective study from the Amsterdam University Medical Centers paediatric lipid clinic (1989–2023) examined whether asymptomatic children as index cases can identify relatives with elevated Lp(a). Of 1,931 children (732 index cases, 1,199 relatives), 25% had elevated Lp(a) (≥30 mg/dL or ≥75 nmol/L). The number needed to screen to find one case was 3.7 (systematic) to 4.1 (opportunistic), and similar in the FH subgroup. Screening through children as index cases is thus effective; Lp(a) should be part of cardiovascular risk assessment, especially in familial hypercholesterolaemia. ## Use of Coronary Artery Calcium Scoring in Individuals With Elevated Lipoprotein(a): A Multicohort Study *2026-03-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2026.02.5067 · https://hartvaat.nl/2026/03/16/coronaire-calciumscore-blijft-bruikbaar-bij-verhoogd-lp-a-multicohort-studie-met/* This multicohort study demonstrated that coronary artery calcium scoring remains a useful ASCVD risk assessment tool in individuals with elevated lipoprotein(a). CAC provides incremental risk stratification even when Lp(a) is elevated, supporting its use in Lp(a)-enriched populations. ## 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines *2026-03-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.11.016 · https://hartvaat.nl/2026/03/13/nieuwe-acc-aha-richtlijn-dyslipidemie-2026-lagere-ldl-streefwaarden-en-lp-a-meti/* The 2026 ACC/AHA dyslipidemia guideline introduces a universal LDL-cholesterol target of <100 mg/dL for primary prevention and <55 mg/dL for very-high-risk secondary prevention. The guideline endorses earlier initiation of lipid-lowering therapy, Lp(a) measurement, and expanded indications for PCSK9 inhibitors and inclisiran. ## Systemic Inflammation and Recurrence After Atrial Fibrillation-Related Stroke: An Individual Participant Data Meta-Analysis. *2026-03-24 · Neurology · https://doi.org/10.1212/WNL.0000000000214701 · https://hartvaat.nl/2026/03/24/systemische-inflammatie-en-recidief-na-een-af-gerelateerd-herseninfarct/* This individual participant data meta-analysis showed that systemic inflammatory markers (IL-6 and hsCRP) predict recurrent vascular events after AF-related stroke, irrespective of AF status. The findings support including AF patients in future trials of anti-inflammatory therapy for secondary stroke prevention. ## Surgical Aortic Valve Replacement: Early Rehospitalizations and Their Implication for Trial Endpoints *2026-03-23 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726002159?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/vroege-heropnames-na-chirurgische-aortaklepvervanging-beinvloeden-trial-eindpunt/* This JACC study analyzed early rehospitalizations after surgical aortic valve replacement and their implications for trial endpoint design, providing data relevant to the interpretation of TAVR-versus-surgery comparisons. ## The Emerging Role of ECG-AI as a Digital Risk Biomarker for Incident Heart Failure *2026-03-23 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725103446?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/ai-analyse-van-ecg-als-digitale-biomarker-voor-hartfalen/* This JACC editorial discussed the emerging role of AI-interpreted ECGs as a digital biomarker for predicting incident heart failure, evaluating the clinical potential of machine learning applied to routine cardiac diagnostics. ## What Does Improvement Mean?: Interpreting Progress and Evidence in Hypertrophic Cardiomyopathy *2026-03-23 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726002093?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/wat-betekent-verbetering-bij-hypertrofische-cardiomyopathie/* This JACC editorial by Harlan Krumholz discussed how to interpret evidence of treatment benefit and clinical progress in hypertrophic cardiomyopathy, addressing the challenges of evaluating novel cardiac myosin inhibitors. ## Comparing TA-TAVR and SAVR in severe aortic regurgitation: outcomes and valve haemodynamics *2026-03-23 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003969?rss=1 · https://hartvaat.nl/2026/03/23/transapicale-tavi-met-de-j-valve-bij-ernstige-aortaklepinsufficientie-vergelijkb/* Transcatheter aortic valve replacement (TAVR) is already recommended for some high-risk patients with aortic regurgitation (AR), but evidence versus surgical replacement (SAVR) is limited. In this retrospective single-centre study (369 patients with severe AR; 256 transapical TAVR with the J-Valve system, 113 SAVR), 76 matched pairs were compared after propensity score matching. There were no differences in mortality, stroke, heart-failure rehospitalisation, pacemaker implantation or paravalvular leakage at 30 days or 2 years. The TAVR group had superior valve haemodynamics, while reduction in left ventricular dimensions was greater after SAVR; ejection-fraction improvement was comparable. Transapical TAVR with the J-Valve is thus an effective treatment for severe AR with outcomes comparable to surgery, especially in high-risk patients. ## Blood Pressure Trajectories in Young Adulthood and Midlife Steatotic Liver Disease *2026-03-23 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26319 · https://hartvaat.nl/2026/03/23/bloeddrukbeloop-vanaf-jongvolwassenheid-voorspelt-leververvetting-op-middelbare-/* High blood pressure is a risk factor for steatotic liver disease (SLD), but whether BP trajectories from young adulthood relate to midlife SLD was unclear. In the US CARDIA cohort (2,817 participants enrolled aged 18-30 in 1985-1986), BP was measured up to eight times over 25 years, with SLD assessed by CT at year 25. Compared with a low-stable diastolic BP trajectory, all other trajectories had higher SLD prevalence, with adjusted relative risks up to 2.02 for the 'elevated-increasing' trajectory; the same held for systolic BP. Those who developed hypertension had a 1.6- to 1.8-fold higher SLD risk, and a faster rate of BP increase carried the highest risk. Long-term BP trajectory in young adulthood is thus independently associated with later-life fatty liver. ## Residual left atrial v wave predicts clinical outcome of transcatheter edge-to-edge mitral valve repair *2026-03-23 · ESC heart failure · https://doi.org/10.1093/eschf/xvag086 · https://hartvaat.nl/2026/03/23/residuele-linker-atriale-v-golf-voorspelt-de-uitkomst-van-mitralisklep-edge-to-e/* Intraprocedural assessment of residual mitral regurgitation (MR) is crucial in transcatheter edge-to-edge mitral repair (M-TEER) but difficult with ambiguous echo findings. In this prospective study (299 patients, 63% secondary MR), left-atrial mean pressure and v-wave pressure (LAvP) were measured before and after implantation. LAvP fell from 30.5 to 23.2 mmHg. High residual LAvP after implantation strongly predicted death or heart-failure hospitalisation over two years, independent of echocardiographic MR grade (HR per 10 mmHg ~1.3). Residual LAvP below 25 mmHg was associated with favourable outcome, even with residual MR grade I–II. LAvP measurement thus adds prognostic information and may support intraprocedural decision-making. ## Incidence, Clinical Implications, and Predictors of Paravalvular Leak Following Transcatheter Tricuspid Valve Replacement: The TRIPLACE Registry *2026-03-23 · JACC. Cardiovascular interventions · https://doi.org/10.1016/j.jcin.2026.01.281 · https://hartvaat.nl/2026/03/23/triplace-register-paravalvulaire-lekkage-na-transkatheter-tricuspidalisklepverva/* The international TRIPLACE registry examined the incidence and prognostic impact of paravalvular leak (PVL) after transcatheter tricuspid valve replacement (TTVR) in 394 patients. Moderate-to-severe PVL occurred in 6.1% and was associated with markedly higher 1-year mortality (39.7% vs ~11%; adjusted HR 2.6) and worse functional class. Larger right-atrial volume, device malposition and type IV valve morphology were independent predictors. The findings have implications for future TTVR device design and procedural optimisation. ## FATE-register: mislukte transkatheter-tricuspidalisreparatie (T-TEER) *2026-03-23 · JACC. Cardiovascular interventions · https://doi.org/10.1016/j.jcin.2026.01.285 · https://hartvaat.nl/2026/03/23/fate-register-mislukte-transkatheter-tricuspidalisreparatie-t-teer/* The international FATE registry examined device-related failures of transcatheter edge-to-edge tricuspid valve repair (T-TEER). Across 2,278 procedures at 31 centres, 123 failures occurred (5.4%; mostly single-leaflet device attachment, 75%), often recognised early and with severe residual regurgitation in 73%. Reintervention (in 46%) achieved greater tricuspid-regurgitation reduction and more favourable right-atrial remodelling than medical therapy, but the composite of death or heart-failure rehospitalisation remained high (38%) and did not differ between strategies. Higher TRI-SCORE, acute kidney injury and greater residual regurgitation predicted adverse outcomes. ## Management and Consequences of Genotype-Positive Familial Hypercholesterolemia. *2026-03-22 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2026.0006 · https://hartvaat.nl/2026/03/04/genetisch-bevestigde-familiaire-hypercholesterolemie-in-de-vs-prevalentie-en-ond/* This All of Us cohort study revealed that genetically confirmed familial hypercholesterolemia remains massively underdiagnosed and undertreated in the US, with only a minority receiving appropriate lipid-lowering therapy. ## Role of Imaging Techniques in Monitoring Atrial Cardiomyopathy and Atrial Failure: A Scientific Statement. *2026-03-22 · ESC heart failure · https://doi.org/10.1093/eschf/xvag068 · https://hartvaat.nl/2026/03/03/beeldvorming-bij-atriale-cardiomyopathie-esc-scientific-statement/* This scientific statement addressed the role of imaging techniques in monitoring atrial cardiomyopathy and atrial failure, a condition increasingly recognized as a distinct entity predisposing to AF and stroke. ## Interplay of Age and Sex With Clinic and Ambulatory Blood Pressure and Mortality *2026-03-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26084 · https://hartvaat.nl/2026/03/04/leeftijd-en-geslacht-beinvloeden-verband-tussen-ambulante-bloeddruk-en-cardiovas/* This analysis from the Spanish ABPM registry explored the interplay between age, sex, clinic and ambulatory blood pressure values, and cardiovascular mortality, providing insights into sex-specific blood pressure targets. ## Great debate: preventive percutaneous coronary intervention added to optimal medical treatment should be the default treatment for non-flow-limiting vulnerable plaques. *2026-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehag103 · https://hartvaat.nl/2026/03/06/debat-preventieve-pci-bij-kwetsbare-plaques-als-standaardbehandeling/* This EHJ debate discussed whether preventive PCI of non-flow-limiting vulnerable plaques should become the default strategy added to optimal medical therapy, weighing the PREVENT trial evidence against long-term uncertainties. ## Laminopathies: natural history and risk prediction of heart failure. *2026-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehag104 · https://hartvaat.nl/2026/03/06/laminopathieen-natuurlijk-beloop-en-voorspelmodel-voor-hartfalen/* This large EHJ study of 470 patients with LMNA gene variants characterized the risk of severe heart failure in laminopathies and developed a prediction model to guide surveillance and early intervention in this high-risk genetic cardiomyopathy. ## Aficamten in symptomatic obstructive hypertrophic cardiomyopathy: the FOREST-HCM long-term study. *2026-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1085 · https://hartvaat.nl/2026/03/05/aficamten-veilig-en-effectief-bij-langdurige-behandeling-van-obstructieve-hcm/* The FOREST-HCM long-term study confirmed that sustained treatment with aficamten, a selective cardiac myosin inhibitor, is safe and effective for reducing LVOT obstruction and improving symptoms in hypertrophic cardiomyopathy. ## Direct-acting oral anticoagulant or vitamin K antagonist for the frail elderly patient with atrial fibrillation: does one size fit all? *2026-03-20 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf984 · https://hartvaat.nl/2026/03/05/doac-of-vka-bij-kwetsbare-ouderen-met-atriumfibrilleren/* This EHJ editorial discussed the choice between DOACs and vitamin K antagonists for frail elderly AF patients, reviewing the emerging evidence supporting safe transition to NOACs even in the most vulnerable anticoagulation population. ## Semaglutide in peripheral artery disease and diabetes by baseline disease severity and age: the STRIDE trial. *2026-03-20 · European heart journal · https://doi.org/10.1093/eurheartj/ehag129 · https://hartvaat.nl/2026/03/05/semaglutide-bij-perifeer-arterieel-vaatlijden-en-diabetes-stride-trial/* This EHJ article presented STRIDE trial subanalyses of semaglutide in patients with peripheral artery disease and diabetes stratified by baseline disease severity and age, informing the use of GLP-1 agonists in the PAD population. ## Aldosterone synthase inhibition in resistant hypertension: promises and unknowns *2026-03-20 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00253-9/fulltext · https://hartvaat.nl/2026/03/07/aldosteronsynthaseremming-bij-resistente-hypertensie-beloften-en-onzekerheden/* This Lancet commentary discussed the promises and unknowns of aldosterone synthase inhibition for resistant hypertension, evaluating the therapeutic potential and remaining questions for this novel drug class. ## Effects of Antihypertensive Therapy on Pre- and Postnatal Maternal Hemodynamics *2026-03-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26126 · https://hartvaat.nl/2026/03/20/bloeddrukverlaging-corrigeert-de-gestoorde-maternale-hemodynamiek-bij-pre-eclamp/* Hypertensive disorders of pregnancy (HDP) involve cardiovascular impairment reflected in an abnormal maternal haemodynamic profile, yet treatment targets blood pressure, not that profile. In this multicentre prospective case-control study (238 women: 69 gestational hypertension, 63 preeclampsia, 106 controls), haemodynamic parameters (cardiac output, stroke volume, systemic vascular resistance, inotropy) were measured before and after α-methyldopa and postnatally, complemented by a preeclamptic rat model. In gestational hypertension, treatment improved cardiac output and lowered vascular resistance, but in preeclampsia no significant haemodynamic changes occurred: vascular resistance remained elevated and stroke volume reduced up to one year postpartum. The rat model showed the same. Blood-pressure lowering thus does not correct the cardiovascular impairment in preeclampsia — novel strategies are needed for maternal heart health after HDP. ## Lifetime Adverse Pregnancy Outcome History and Cardiovascular Risk *2026-03-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25916 · https://hartvaat.nl/2026/03/20/ongunstige-zwangerschapsuitkomsten-en-het-latere-cardiovasculaire-risico-nurses-/* How multiple types of adverse pregnancy outcomes (APOs) across reproductive life jointly affect long-term cardiovascular risk is little studied. In 59,154 parous women from the Nurses' Health Study II, lifetime history of gestational diabetes, gestational hypertension, preeclampsia, preterm delivery and low birth weight was self-reported and linked to cardiovascular events. Each APO was associated with higher cardiovascular risk, but after accounting for co-occurrence of multiple APOs, only gestational hypertension (HR 1.62) and preeclampsia (HR 1.31) retained independent associations. Later development of hypertension, diabetes and hypercholesterolaemia explained much (58%) of the association. Adding APOs to established risk factors improved prediction only modestly. APOs — especially gestational hypertension and preeclampsia — thus flag higher future risk, largely via subsequent risk factors. ## Real-world evidence with dapagliflozin in heart failure with reduced ejection fraction in Central Eastern Europe and the Baltic region (EVOLUTION-HF CEE-BA Study) *2026-03-20 · ESC heart failure · https://doi.org/10.1093/eschf/xvag085 · https://hartvaat.nl/2026/03/20/evolution-hf-cee-ba-real-world-dapagliflozin-bij-hfref-in-centraal-en-oost-europ/* SGLT2 inhibitors are one of the four pillars of heart failure with reduced ejection fraction (HFrEF) treatment. After dapagliflozin's 2020 approval, real-world data are relevant for clinicians and payers. EVOLUTION-HF CEE-BA is an observational, longitudinal study across 102 centres in nine Central/Eastern European and Baltic countries that characterised the population started on dapagliflozin for HFrEF in routine practice (1,131 patients; ischaemic aetiology in 52%). All treatment decisions were at the provider's discretion per local practice. The study thus maps the use and course of dapagliflozin for HFrEF in Central/Eastern European practice. ## Assessing Nonculprit Coronary-Artery Lesions in STEMI *2026-03-19 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMe2517834&rss=currentIssue · https://hartvaat.nl/2026/03/04/beoordeling-van-niet-culprit-coronairlaesies-bij-stemi/* This NEJM editorial discussed strategies for assessing nonculprit coronary artery lesions in STEMI, reviewing the evidence for immediate versus staged complete revascularization. ## Finerenone for Diabetic Kidney Disease in Type 1 Diabetes — A Fine Answer? *2026-03-19 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMe2600575&rss=currentIssue · https://hartvaat.nl/2026/03/04/finerenon-bij-diabetische-nierziekte-en-type-1-diabetes-een-editoriaal/* This NEJM editorial discussed the implications of finerenone for diabetic kidney disease in type 1 diabetes, evaluating whether the cardiorenal benefit extends beyond the type 2 diabetes population. ## Aortic and Iliac Calcifications as Predictors of Aortic Dissection, Aneurysm Rupture, and Peripheral Vascular Disease: A Prospective Cohort Study from the DANCAVAS Trials *2026-03-19 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076240 · https://hartvaat.nl/2026/03/02/aorta-en-iliacale-calcificaties-voorspellen-dissectie-aneurysmaruptuur-en-perife/* This prospective cohort study showed that aortic and iliac calcifications on CT predict aortic dissection, aneurysm rupture, and peripheral vascular events, establishing vascular calcification as a marker for acute aortic complications. ## Angiotensinogen Reconsidered: Evolving Perspectives in Hypertension Research *2026-03-19 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26091 · https://hartvaat.nl/2026/03/19/angiotensinogeen-als-nieuw-aangrijppunt-bij-hypertensie-opkomst-van-rna-medicijn/* Hypertension is the leading modifiable risk factor for cardiovascular disease. Angiotensinogen (AGT) is a central component of the renin-angiotensin-aldosterone system (RAAS) but was long viewed as a passive substrate rather than an active target — unlike ACE and the angiotensin II receptor. This review describes the molecular biology and regulation of AGT, genetic variants (such as M235T and −6G>A) and its role in salt-sensitive hypertension, obesity-related inflammation and 'RAAS escape'. Especially relevant are the new RNA-based agents that inhibit AGT: the small interfering RNA zilebesiran and the antisense oligonucleotide tonlamarsen, which show prolonged blood-pressure reduction with a favourable safety profile in trials. AGT thus emerges as a promising upstream target and biomarker — with potential for long-acting treatment of (resistant) hypertension and better adherence. ## Biomarkers of iron deficiency and prognosis in patients hospitalised with new-onset heart failure and a reduced left ventricular ejection fraction *2026-03-19 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003898?rss=1 · https://hartvaat.nl/2026/03/19/welke-ijzermarker-voorspelt-de-prognose-bij-nieuw-hartfalen-lage-transferrinesat/* Iron deficiency is common in heart failure (HF) and is defined in guidelines by ferritin and transferrin saturation (TSAT), not soluble transferrin receptor (sTfR) or its ratios. In this study (325 patients hospitalised with new-onset HFrEF, Sahlgrenska, 2016-2020), the prognostic value of these iron markers was examined; 52% had iron deficiency by current criteria. In the prespecified analysis, markers were not significantly associated with the composite endpoint (HF rehospitalisation or death), although each standard-deviation higher TSAT was associated with 56% less HF rehospitalisation, as were higher iron/sTfR and TSAT/sTfR ratios. In a sensitivity analysis excluding extreme values, higher TSAT was associated with 47% fewer events. Lower TSAT thus predicts more events in new-onset HF; the sTfR ratios offer no clear advantage over TSAT alone. ## Development and Validation of the AI-HeartAge Model in Framingham and UK Biobank *2026-03-19 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26209 · https://hartvaat.nl/2026/03/19/ai-heartage-een-biologische-hartleeftijd-uit-de-polsgolf-voorspelt-hartfalen-en-/* The shape of the arterial pressure waveform reflects left ventricle-aorta interaction and could estimate 'biological heart age'. The AI-HeartAge model (AI-HA) averages two neural networks that predict mitral-annulus tissue Doppler velocities from an uncalibrated arterial tonometry or photoplethysmography waveform. It was developed in the Framingham Heart Study (6,916 participants) and validated in a Framingham holdout set and the UK Biobank (67,986 participants). After adjusting for PREVENT risk factors, higher AI-HA was associated with incident heart failure (HR 2.09 in Framingham, 1.23 in UK Biobank) and cardiovascular disease (HR 1.52 and 1.22), with improved reclassification. AI-HeartAge is thus a novel, accessible measure of left ventricular function and heart-failure risk in community populations. ## Life-Threatening Delayed Myocardial Ischemia and Malignant Arrhythmias Occurring After Pulsed Field Ablation of Atrial Fibrillation *2026-03-18 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077983 · https://hartvaat.nl/2025/12/25/levensbedreigende-myocardischemie-en-maligne-aritmieen-na-pulsed-field-ablatie-v/* This Circulation report documented life-threatening delayed myocardial ischemia and malignant arrhythmias occurring after pulsed field ablation for AF, raising important safety concerns about this rapidly adopted new technology. ## Aficamten vs Metoprolol: A Turning Point in Obstructive Hypertrophic Cardiomyopathy Care?: The MAPLE-HCM Results *2026-03-18 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725103598?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/maple-hcm-is-aficamten-een-keerpunt-bij-obstructieve-hcm/* This JACC editorial discussed the MAPLE-HCM results and whether aficamten represents a turning point in the treatment of obstructive hypertrophic cardiomyopathy, comparing the potential of next-generation cardiac myosin inhibitors with established therapies. ## Beta-Blocker (Bisoprolol) vs Calcium-Channel Blocker (Verapamil) in Nonobstructive Hypertrophic Cardiomyopathy: A Randomized Triple-Crossover Physiologic Trial *2026-03-18 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725103331?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/bisoprolol-versus-verapamil-bij-niet-obstructieve-hcm-gerandomiseerde-crossover-/* This randomized triple-crossover trial compared bisoprolol with verapamil in patients with nonobstructive hypertrophic cardiomyopathy, providing the first head-to-head comparison of beta-blocker versus calcium channel blocker therapy in this population. ## ST-segment elevation in acute pericarditis and myocardial involvement: electrocardiographic and clinical profiling *2026-03-18 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004019?rss=1 · https://hartvaat.nl/2026/03/18/st-elevatie-bij-acute-pericarditis-wijst-op-myocardiale-betrokkenheid/* The pericardium is considered electrically inert, yet diffuse ST-elevation is an ECG marker of acute pericarditis. The investigators hypothesised that ST-elevation reflects myocardial involvement. In this longitudinal multicentre study (351 pericarditis patients, 70 with myopericarditis defined by troponin elevation and/or MRI), 34.5% had ST-elevation; these patients were younger, more often male, with higher CRP and fewer pericardial effusions. Myocardial involvement occurred in 19.9% and more often with ST-elevation (26.4% vs 16.5%); ST-elevation predicted myocardial involvement (OR 1.82). Myopericarditis patients more often had transient systolic dysfunction, a lower remission rate (18.5% vs 31.2%) and slightly more hospitalisations, with comparable recurrence rates and treatment. ST-elevation in acute pericarditis thus indicates myocardial involvement — consistent with the pericardium being electrically inert. ## Long-Term Lessons From the COACT Trial: Coronary Angiography After Out-of-Hospital Cardiac Arrest Revisited *2026-03-17 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S073510972600224X?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/coact-trial-langetermijnlessen-over-coronairangiografie-na-reanimatie/* This JACC commentary revisited the COACT trial on coronary angiography after out-of-hospital cardiac arrest, discussing long-term lessons for clinical practice regarding the timing of invasive evaluation. ## Predicting Heart Failure From 12-Lead ECGs Using AI: A HeartShare/AMP-HF Pooled Cohort Analysis *2026-03-17 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S073510972510079X?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/ai-voorspelt-hartfalen-op-basis-van-12-afleidingen-ecg-in-grote-cohortanalyse/* This JACC study used AI-based 12-lead ECG analysis from pooled cohort data to predict heart failure development, demonstrating the potential of machine learning for early detection of subclinical cardiac dysfunction. ## Real-Time Heart Team for Revascularization in Complex Coronary Artery Disease: The EHEART Randomized Trial *2026-03-17 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000707?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/eheart-trial-real-time-hartteam-verbetert-besluitvorming-bij-complexe-coronaire-/* The EHEART randomized trial investigated whether real-time heart team consultation improves revascularization strategy selection in patients with complex coronary artery disease, testing the value of multidisciplinary decision-making. ## Hypertensive Disorders of Pregnancy and Primary Aldosteronism *2026-03-17 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26718 · https://hartvaat.nl/2026/03/17/veel-vrouwen-met-hypertensie-en-een-doorgemaakte-zwangerschapshypertensie-blijke/* Hypertensive disorders of pregnancy (HDP) affect up to 15% of pregnancies, and primary aldosteronism (PA) occurs in up to 25% of people with hypertension. In this prospective study, adults meeting guideline criteria for PA screening were tested; women with prior HDP completed an additional questionnaire. Of 330 hypertensive parous women (mean age 62), 25% had an HDP history; these women were younger at hypertension diagnosis (38.8 vs 47.9 years). A positive PA test was equally common with and without HDP (26.5% vs 32%). Of 63 HDP women with follow-up, 23.8% tested positive for PA; PA-positive women had more hypertensive pregnancies and fetal complications. More than a quarter of women with hypertension and at least one PA risk factor thus have PA, regardless of HDP history — in women with HDP, PA may be a treatable contributor to their elevated cardiovascular risk. ## Long-term outcomes following Sacubitril/Valsartan therapy for chronic HFrEF. Italian Real-World Multicenter Study *2026-03-17 · ESC heart failure · https://doi.org/10.1093/eschf/xvag082 · https://hartvaat.nl/2026/03/17/langetermijneffecten-van-sacubitril-valsartan-bij-hfref-italiaanse-real-world-st/* The long-term real-world effects of sacubitril/valsartan (S/V) and the impact of dose reduction or discontinuation are less well defined. In this multicentre retrospective study (592 outpatient HFrEF patients, mean LVEF 32%), after S/V initiation NT-proBNP, quality of life (KCCQ), LVEF and global longitudinal strain improved significantly and durably. Over a median follow-up of 3.7 years, 38% had a major adverse cardiovascular event (MACE). S/V discontinuation (HR 1.52) and adverse change in GLS or KCCQ were independently associated with MACE; dose reduction and discontinuation identified higher-risk patients. S/V thus produced sustained improvement in remodelling and quality of life, while stopping or dose-reducing was a risk signal. ## Sacubitril-Valsartan vs Enalapril in Heart Failure Due to Chagas Disease: Primary Results of ANSWER-HF Randomized Trial. *2026-03-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.10.053 · https://hartvaat.nl/2026/03/17/answer-hf-sacubitril-valsartan-versus-enalapril-bij-chagas-hf-primaire-resultate/* The ANSWER-HF primary results confirmed that sacubitril-valsartan reduces NT-proBNP more than enalapril in Chagas cardiomyopathy, the first ARNI evidence specific to this Latin American heart failure etiology. ## Sotatercept in Pulmonary Arterial Hypertension: Central, Hematologic, and Peripheral Mechanisms of Benefit *2026-03-16 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726056330?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/sotatercept-bij-pah-centrale-hematologische-en-perifere-werkingsmechanismen/* This JACC article explored the central, hematologic, and peripheral mechanisms underlying the benefit of sotatercept in pulmonary arterial hypertension, including activin receptor signaling, erythropoiesis modulation, and vascular remodeling reversal. ## The STRIVE Trial: A Neutral Result That Reframes the Challenge of Microvascular Obstruction *2026-03-16 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726001257?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/strive-trial-neutraal-resultaat-herformuleert-uitdaging-microvasculaire-obstruct/* This JACC editorial discussed the neutral STRIVE trial result for microvascular obstruction treatment after acute MI, reframing the challenge and discussing future directions for this persistent complication. ## Varenicline and Ventricular Ectopy After Myocardial Infarction: A Randomized Phase 2 Study *2026-03-16 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726002330?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/varenicline-vermindert-ventriculaire-ectopie-na-myocardinfarct/* This phase 2 study investigated varenicline (a nicotinic receptor partial agonist) for reducing ventricular ectopy after myocardial infarction, exploring a novel anti-arrhythmic mechanism through nicotinic receptor modulation. ## Comorbidity indices in observational studies on cardiovascular risk *2026-03-16 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003999?rss=1 · https://hartvaat.nl/2026/03/16/eenvoudige-risicofactoren-voorspellen-hart-en-vaatziekten-beter-dan-een-complexe/* Which comorbidity measure best predicts cardiovascular events? In this large Swedish register study (4,454,895 people born 1936-1975), the predictive value of age-and-sex, the Nordic Multimorbidity Index (NMI), a set of five classic cardiovascular risk factors (CV-IV) and the number of filled prescriptions was compared for coronary heart disease, myocardial infarction, heart failure and stroke. In 40-64-year-olds, age-and-sex alone predicted better than any index alone. Combined with age and sex, the simple five-risk-factor set (CV-IV) gave the highest predictive value, especially for heart failure (AUROC 0.78), followed by the number of prescriptions. Simple indicators based on a few well-established risk factors thus outperform a complex index such as the NMI; the number of filled prescriptions can serve as a practical proxy for comorbidity. ## Cardiac Biomarkers Response Under Angiotensin Receptor-Neprilysin Inhibitor: A Sub-Analysis of the Natrium-HF Study *2026-03-16 · ESC heart failure · https://doi.org/10.1093/eschf/xvag075 · https://hartvaat.nl/2026/03/16/natrium-hf-subanalyse-natriuretische-peptiden-lopen-achter-op-de-klinische-ontst/* Natriuretic peptides (NPs) guide heart-failure diagnosis and treatment, but their short-term dynamics under sacubitril/valsartan (S/V) and during acute volume changes are incompletely characterised. In this sub-analysis of the Natrium-HF study, 229 ambulatory HFrEF patients started S/V; at three visits (before start and after 2 and 3 months) they underwent a standardised 9-hour protocol of volume infusion followed by diuretics. S/V initiation lowered BNP by 8% and NT-proBNP by 35%. During the acute protocol, however, both BNP and NT-proBNP rose significantly with identical trajectories before and after S/V — and kept rising despite marked natriuresis and clinical improvement after diuretics. BNP and NT-proBNP thus convey comparable information, but their short-term dynamics lag behind clinical decongestion; very-short-interval serial measurements likely add little in the early phase of acute heart failure. ## Left Ventricular Reverse Remodeling after Mitral Transcatheter Edge-to-Edge Repair: Results from the EXPANDed Studies *2026-03-16 · ESC heart failure · https://doi.org/10.1093/eschf/xvag081 · https://hartvaat.nl/2026/03/16/vroege-linkerventrikel-reverse-remodellering-na-mitralisklep-edge-to-edge-repara/* Left ventricular reverse remodeling (LVRR) is a key goal of heart-failure therapy. In the combined EXPAND and EXPAND G4 cohorts (2,205 patients after mitral transcatheter edge-to-edge repair, M-TEER), early (30-day) LVRR was examined, defined as a >10% reduction in LV dimension or volume. In secondary MR, 64% showed early LVRR; at one year these patients had fewer deaths or heart-failure hospitalisations (24.7% vs 35.9%), despite similar MR reduction and symptom improvement. In primary MR, LVRR occurred in 73% with broadly similar outcomes — except in dilated ventricles, where early LVRR was associated with lower mortality. Early LVRR after M-TEER, especially in secondary MR, is thus associated with better outcomes. ## cDPP3 and Outcomes in Acute Heart Failure: An Analysis of the STRONG-HF and CORTAHF Studies *2026-03-16 · ESC heart failure · https://doi.org/10.1093/eschf/xvag076 · https://hartvaat.nl/2026/03/16/cdpp3-bij-acuut-hartfalen-geen-prognostische-waarde-strong-hf-en-cortahf/* Circulating dipeptidyl peptidase 3 (cDPP3) is implicated in circulatory failure and predicts poor outcomes in shock, but its role in acute heart failure (AHF) was unknown. In an analysis of two prospective AHF trials (STRONG-HF and CORTAHF), 23% in STRONG-HF had elevated cDPP3 (≥40 ng/mL); these patients were younger, more often female and Black, with lower NT-proBNP. Baseline elevated cDPP3 was not associated with 180-day outcomes, and changes in cDPP3 did not track NT-proBNP reduction. MRA use was associated with elevated cDPP3. cDPP3 thus identified a distinct clinical phenotype but had no prognostic value and no relationship with congestion relief in AHF. ## Oral PCSK9 inhibitor enlicitide lowers LDL cholesterol levels in phase 2 trial. *2026-03-15 · Nature cardiovascular research · https://doi.org/10.1038/s44161-026-00794-7 · https://hartvaat.nl/2026/03/05/orale-pcsk9-remmer-enlicitide-verlaagt-ldl-cholesterol-in-fase-2-studie/* This phase 2 trial of enlicitide, an oral PCSK9 inhibitor, showed significant LDL cholesterol reduction. As the first oral PCSK9 inhibitor in clinical development, enlicitide could dramatically expand access to advanced lipid-lowering therapy. ## Kidney disease and heart failure: recent advances and current challenges: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference *2026-03-15 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00884-1/fulltext · https://hartvaat.nl/2026/03/06/kdigo-consensusconferentie-uitdagingen-bij-gecombineerd-hartfalen-en-nierziekte/* This KDIGO consensus conference summary addressed the intersection of heart failure and chronic kidney disease, reviewing advances in cardiorenal understanding and the challenges of managing patients with both conditions, including the role of SGLT2 inhibitors and finerenone. ## Aspirin after PCI in Acute Coronary Syndromes *2026-03-15 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMc2518964&rss=currentIssue · https://hartvaat.nl/2026/03/04/aspirine-na-pci-bij-acuut-coronair-syndroom/* This NEJM article evaluated the role of aspirin after PCI in acute coronary syndromes in light of contemporary de-escalation evidence from TWILIGHT, T-PASS, and STOPDAPT trials, addressing the shifting paradigm toward aspirin-free antiplatelet strategies. ## Blood-Pressure Targets in Hypertension Management *2026-03-14 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMclde2505268&rss=currentIssue · https://hartvaat.nl/2026/03/04/bloeddrukdoelen-bij-de-behandeling-van-hypertensie/* This NEJM article discussed optimal blood pressure targets in hypertension management, reviewing the evidence from SPRINT, STEP, and ESPRIT that supports lower targets while addressing the clinical challenges of implementing aggressive blood pressure control. ## New drug therapies for hypertension *2026-03-14 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02064-1/fulltext · https://hartvaat.nl/2026/02/10/nieuwe-medicamenteuze-therapieen-voor-hypertensie/* This Lancet review described new drug therapies for hypertension targeting novel physiological pathways including aldosterone synthase inhibition, endothelin antagonism, and RNA interference-based angiotensinogen silencing, addressing the unmet need for patients with resistant blood pressure. ## Aficamten in Obstructive Hypertrophic Cardiomyopathy: A Multidomain, Patient-Level Analysis of the MAPLE-HCM Trial *2026-03-14 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725100685?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/aficamten-bij-obstructieve-hcm-multidomeinanalyse-van-maple-hcm/* This multidomain patient-level analysis of the MAPLE-HCM trial evaluated aficamten across multiple outcome domains in obstructive hypertrophic cardiomyopathy, providing comprehensive evidence on the clinical benefit of cardiac myosin inhibition. ## Integrated community-based versus facility-based care for people with HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-COMM): an open-label, multicountry, cluster-randomised trial. *2026-03-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)02641-8 · https://hartvaat.nl/2026/03/14/inte-africa-2-community-based-versus-facilitair-beheer-hiv-dm-htn/* The INTE-COMM cluster-randomised trial compared integrated community-based versus facility-based care for people with HIV, diabetes, and hypertension in Tanzania and Uganda. The results inform optimal care delivery models in sub-Saharan Africa. ## Anticoagulation Alone or With Antiaggregation in Patients With Coronary Artery Disease: Meta-Analysis of Randomized Trials *2026-03-13 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726001361?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/antistolling-alleen-of-met-plaatjesremming-bij-coronairlijden-meta-analyse/* This JACC meta-analysis of randomized trials examined whether anticoagulation alone is as effective as anticoagulation combined with antiplatelet therapy in patients with coronary artery disease, addressing the optimal antithrombotic strategy in patients requiring both treatments. ## Effect of Aficamten vs Metoprolol on Patient-Reported Health Status in Obstructive Hypertrophic Cardiomyopathy *2026-03-13 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725100703?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/aficamten-versus-metoprolol-betere-levenskwaliteit-bij-obstructieve-hcm/* This MAPLE-HCM trial analysis compared patient-reported health status outcomes between aficamten and metoprolol in patients with obstructive hypertrophic cardiomyopathy, providing head-to-head evidence on quality-of-life endpoints for cardiac myosin inhibitors versus beta-blockers. ## Intravascular Imaging- vs Angiography-Guided Complex PCI: 5-Year Outcomes From a Randomized Trial *2026-03-13 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726001476?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/intravasculaire-beeldvorming-superieur-aan-angiografie-bij-complexe-pci-5-jaarsr/* Five-year outcomes from a randomized trial comparing intravascular imaging-guided versus angiography-guided complex PCI demonstrated sustained superiority of imaging guidance for reducing target vessel failure, confirming the long-term benefit of IVUS/OCT in complex coronary interventions. ## Kidney tubule injury is associated with sodium avidity and diuretic responsiveness in acute heart failure *2026-03-13 · ESC heart failure · https://doi.org/10.1093/eschf/xvag079 · https://hartvaat.nl/2026/03/13/tubulaire-nierschade-hangt-samen-met-natriumretentie-en-diureticarespons-bij-acu/* Strong sodium retention ('sodium avidity') in acute heart failure (AHF) predicts worse outcomes, but whether kidney tubule injury contributes was unclear. In 339 participants of the ROSE-AHF trial (AHF with kidney dysfunction), urinary injury markers KIM-1, NAG and NGAL were measured at enrolment. Higher KIM-1 and NAG were associated with lower urinary sodium concentration and lower fractional sodium excretion (FeNa); higher KIM-1 was also associated with lower total 72-hour sodium output. None of the markers was associated with urine output. Tubular kidney injury in AHF is thus associated with greater sodium avidity, and KIM-1 with impaired diuretic responsiveness — a possible explanation for diuretic resistance in the cardiorenal syndrome. ## Finerenone in Type 1 Diabetes and Chronic Kidney Disease. *2026-03-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2512854 · https://hartvaat.nl/2026/03/05/finerenon-effectief-bij-type-1-diabetes-met-chronische-nierziekte/* This NEJM phase 3 trial demonstrated that finerenone improved kidney outcomes in patients with type 1 diabetes and chronic kidney disease, extending the benefit of nonsteroidal mineralocorticoid receptor antagonism beyond the type 2 diabetes population. The results address a previously unmet therapeutic need in type 1 diabetes nephropathy. ## Atrial fibrillation *2026-03-12 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02166-X/fulltext · https://hartvaat.nl/2026/03/07/lancet-seminar-atriumfibrilleren-in-2026/* This comprehensive Lancet Seminar provides a state-of-the-art overview of atrial fibrillation, covering its rising global prevalence of 37.6 million affected individuals, the impact of wearable device-based detection, contemporary management strategies including early rhythm control and pulsed field ablation, and integrated AF care pathways. ## Effect of baxdrostat on ambulatory blood pressure in patients with resistant hypertension (Bax24): a phase 3, randomised, double-blind, placebo-controlled trial *2026-03-12 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02549-8/fulltext · https://hartvaat.nl/2026/03/07/baxdrostat-verlaagt-bloeddruk-significant-bij-resistente-hypertensie/* The phase 3 Bax24 trial demonstrated that baxdrostat, an aldosterone synthase inhibitor, significantly reduced 24-hour ambulatory systolic blood pressure compared with placebo in patients with resistant hypertension. The results advance aldosterone synthase inhibition as a promising new drug class for treatment-resistant blood pressure. ## Association of Life's Simple 7 with metabolic-associated steatotic liver disease and non-invasive fibrosis markers *2026-03-12 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003982?rss=1 · https://hartvaat.nl/2026/03/12/betere-cardiovasculaire-gezondheid-life-s-simple-7-hangt-samen-met-minder-leverv/* Metabolic dysfunction-associated steatotic liver disease (MASLD) affects about a third of the global population, but good screening tools are lacking. The American Heart Association's Life's Simple 7 (LS7) — seven modifiable lifestyle factors (smoking, BMI, blood pressure, cholesterol, fasting glucose, physical activity and diet) — overlaps with MASLD criteria. In this study (3,204 participants in a colonoscopy screening programme in Salzburg), MASLD was assessed by ultrasound and liver fibrosis by non-invasive markers. MASLD prevalence was 82% with a poor LS7, 47% with intermediate and 16% with an ideal score. A higher LS7 was significantly associated with lower risk of MASLD (RR 0.80) and liver fibrosis. Better cardiovascular health is thus strongly associated with less fatty liver — though this partly reflects the shared metabolic components. ## Off-label underdosing of edoxaban antithrombotic therapy for patients with atrial fibrillation and stable coronary artery disease: findings from the EPIC-CAD trial. *2026-03-12 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-326646 · https://hartvaat.nl/2026/03/12/off-label-onderdosering-edoxaban-bij-af-en-systemische-embolieen/* This study documented the adverse consequences of off-label edoxaban underdosing in AF patients, showing increased thrombotic risk without meaningful bleeding reduction, reinforcing adherence to approved dosing criteria. ## 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines *2026-03-11 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725077630?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/nieuwe-acc-aha-richtlijn-2025-voor-volwassenen-met-aangeboren-hartafwijkingen/* The 2025 ACC/AHA/HRS/ISACHD/SCAI guideline provides comprehensive updated recommendations for the management of adults with congenital heart disease, addressing arrhythmia management, pregnancy, surgical and catheter-based interventions, and long-term follow-up in this growing patient population. ## Lipoprotein(a) in familial hypercholesterolemia. *2026-03-11 · Current opinion in lipidology · https://doi.org/10.1097/MOL.0000000000001032 · https://hartvaat.nl/2026/02/10/lipoproteine-a-bij-familiaire-hypercholesterolemie-een-dubbel-risico/* This review discusses lipoprotein(a) metabolism and associated cardiovascular risk specifically in familial hypercholesterolaemia. The combination of elevated LDL-C and elevated Lp(a) represents perhaps the most detrimental lipid profile for cardiovascular health. ## RNA interference for lipid disorders: is this the future? *2026-03-11 · Current opinion in lipidology · https://doi.org/10.1097/MOL.0000000000001033 · https://hartvaat.nl/2026/02/10/rna-interferentie-bij-lipidestoornissen-de-toekomst-van-cholesterolverlaging/* This review discusses the current state of RNA interference therapies for lipid disorders. Inclisiran achieves sustained 50% LDL-C reduction, with emerging siRNA agents targeting Lp(a), triglycerides, and other lipid-regulating proteins. ## Treatment of Primary Aldosteronism *2026-03-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26238 · https://hartvaat.nl/2026/03/11/behandeling-van-primair-aldosteronisme-chirurgie-of-mra-met-zoutbeperking-als-ho/* Primary aldosteronism (PA) is a common cause of hypertension, in which renin-independent aldosterone production drives inappropriate mineralocorticoid receptor activation, sodium retention, volume expansion and potassium wasting, with adverse cardiorenal outcomes. Treatment is tailored to patient preference and whether PA is lateralising. For lateralising PA, surgical adrenalectomy (and, less often, minimally invasive adrenal or adrenal-artery ablation) is highly effective for blood pressure and cardiovascular risk. Most patients, however, are treated medically, with a steroidal mineralocorticoid receptor antagonist (MRA) as the cornerstone and epithelial sodium channel inhibitors as alternatives. Dietary sodium restriction is strongly encouraged, as it reduces the substrate of PA pathophysiology and enhances blood-pressure lowering, especially combined with an MRA. Medical therapy is intensified to, in order, normalise blood pressure with the fewest agents, normalise potassium, and raise renin as a marker of adequate aldosterone blockade. ## Polygenic risk scores in familial hypercholesterolemia. Do they have a role? *2026-03-10 · Current opinion in lipidology · https://doi.org/10.1097/MOL.0000000000001029 · https://hartvaat.nl/2026/02/16/polygene-risicoscores-bij-familiaire-hypercholesterolemie-nuttig-of-niet/* This review evaluates the role of polygenic risk scores in familial hypercholesterolaemia management. A high Lp(a) PRS explains the phenotype in approximately one-fifth of variant-negative FH patients, with implications for risk stratification and therapy decisions. ## Clinical characteristics and lipid management of patients with familial hypercholesterolemia: results from a 7 years single-centre experience. *2026-03-10 · Acta clinica Belgica · https://doi.org/10.1080/17843286.2026.2638804 · https://hartvaat.nl/2026/02/28/familiaire-hypercholesterolemie-in-belgie-7-jaar-ervaring/* A Belgian single-centre study describes the clinical characteristics and lipid management of 189 patients with familial hypercholesterolaemia over seven years. The study highlights persistent undertreatment and analyses treatment response in genetically confirmed carriers. ## Association of Coronary Microvascular Dysfunction with Lipoprotein (a) levels in Patients with Non-Obstructive Coronary Artery Disease. *2026-03-10 · The American journal of cardiology · https://doi.org/10.1016/j.amjcard.2026.02.038 · https://hartvaat.nl/2026/02/26/lp-a-geassocieerd-met-microvasculaire-disfunctie-bij-niet-obstructief-coronairli/* This study investigated the association between lipoprotein(a) levels and coronary microvascular dysfunction in patients with non-obstructive coronary artery disease, exploring Lp(a) as a driver of microvascular pathology. ## Risk prediction modelling of 30-day all-cause mortality following percutaneous coronary intervention in an Australian population: leveraging machine learning *2026-03-10 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003619?rss=1 · https://hartvaat.nl/2026/03/10/machine-learning-voorspelt-30-daagse-sterfte-na-een-dotterbehandeling-australisc/* Preprocedural estimation of 30-day mortality after percutaneous coronary intervention (PCI) aids decision-making and hospital benchmarking. In this Australian study (93,055 consecutive PCI procedures from the Victorian Cardiac Outcomes Registry), seven machine-learning algorithms were compared. The Extreme Gradient Boosting (XGB) model performed best, with good discrimination (AUC 85.5%). The five leading predictors were left ventricular ejection fraction, acute coronary syndrome, kidney function (eGFR), age and complex lesions; followed by cardiogenic shock, BMI and resuscitated out-of-hospital cardiac arrest, among others. A preprocedural-data-based model can thus estimate individual risk and support care and resource use around PCI — external validation in other populations is still needed. ## Choosing the Right Non-Statin Therapy for the Right Patient - How To Sequence Advanced Lipid-Lowering Therapies. *2026-03-09 · Current atherosclerosis reports · https://doi.org/10.1007/s11883-026-01390-7 · https://hartvaat.nl/2026/02/26/niet-statine-therapie-welk-middel-voor-welke-patient/* This review discussed how to optimally sequence available and emerging non-statin lipid-lowering therapies (ezetimibe, PCSK9 inhibitors, inclisiran, bempedoic acid) for patients not at LDL goal on statins. ## Linear and Nonlinear Associations Between Lipoprotein(a) and the Risks of Atherosclerotic Cardiovascular Disease. *2026-03-09 · Circulation journal : official journal of the Japanese Circulation Society · https://doi.org/10.1253/circj.CJ-25-0847 · https://hartvaat.nl/2026/02/27/lp-a-en-atherosclerotisch-vaatlijden-een-niet-lineair-verband/* This analysis of over 350,000 UK Biobank participants showed that the association between Lp(a) and atherosclerotic cardiovascular disease is nonlinear, with risk accelerating at higher levels — a finding with implications for treatment thresholds. ## Long-term prognosis in Takotsubo Syndrome compared to Heart Failure: Observations from a global federated research network. *2026-03-09 · ESC heart failure · https://doi.org/10.1093/eschf/xvag065 · https://hartvaat.nl/2026/02/27/prognose-takotsubo-syndroom-versus-hartfalen-op-de-lange-termijn/* An observational study compared three-year outcomes between patients with Takotsubo syndrome and heart failure using a global research network. The findings inform the long-term prognosis and follow-up requirements for Takotsubo patients. ## Stress Trajectory and Hypertension 2 to 7 Years After Delivery: A nuMoM2b-HHS Study *2026-03-09 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25991 · https://hartvaat.nl/2026/03/09/stress-verhoogt-de-bloeddruk-na-de-bevalling-vooral-bij-vrouwen-die-een-zwangers/* Adverse pregnancy outcomes (APOs) increase the risk of chronic hypertension. The prospective nuMoM2b-HHS study examined whether trajectories of perceived stress during and after pregnancy were associated with blood pressure and incident hypertension 2-7 years after delivery, and whether an APO modified this. Using the Perceived Stress Scale (first and third trimester and 2-7 years postpartum), three stress trajectories emerged: low, moderate and high. After adjustment, there was no overall association between stress trajectory and blood pressure or hypertension. However, there was a significant interaction with APO: a higher stress trajectory was associated with higher blood pressure only in women who had had an APO (β ≈ 2 mmHg), not in women without an APO. Elevated stress may thus contribute to higher blood pressure, specifically in women who experienced an adverse pregnancy outcome. ## Differences in Disease Trajectory, Comorbidities, and Mortality in Sarcomeric and Nonsarcomeric Hypertrophic Cardiomyopathy *2026-03-09 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076036 · https://hartvaat.nl/2026/03/09/sarcomere-versus-niet-sarcomere-hypertrofische-cardiomyopathie-een-verschillend-/* Sarcomere variants are a major cause of hypertrophic cardiomyopathy (HCM) and are associated with worse prognosis. In this longitudinal multicentre study from the SHaRe registry (6,120 genotyped HCM patients, 50% sarcomeric, median follow-up 5.3 years), the influence of genetic classification and comorbidities on disease trajectory, event timing and causes of death was examined. Sarcomeric HCM was diagnosed at a younger age (median 38.1 vs 54.3 years) and more often in women. Using time-varying models, the study maps the sequence of cardiovascular events to better inform prognosis and treatment in sarcomeric versus nonsarcomeric HCM. ## Semaglutide promotes bone marrow-derived progenitor cell flux towards an anti-inflammatory and pro-regenerative profile in high-risk patients: the SEMA-VR CardioLink-15 trial. *2026-03-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf690 · https://hartvaat.nl/2026/03/09/semaglutide-stimuleert-anti-inflammatoire-stamcelflux-vanuit-beenmerg/* This translational study showed that semaglutide mobilizes anti-inflammatory and pro-regenerative progenitor cells from the bone marrow, providing a novel mechanistic explanation for the cardiovascular benefit of GLP-1 receptor agonists. ## Lipid-modifying efficacy and safety of obicetrapib in high-risk cardiovascular patients: A systematic review and meta-analysis. *2026-03-08 · Vascular diseases (Paris, France) · https://doi.org/10.1016/j.vasdi.2026.02.004 · https://hartvaat.nl/2026/02/27/obicetrapib-veelbelovende-cetp-remmer-voor-hoogrisicopatienten/* A systematic review and meta-analysis evaluated the lipid-modifying efficacy and safety of obicetrapib, a CETP inhibitor, in high-risk cardiovascular patients. The agent optimises lipid profiles by blocking cholesterol ester transfer between HDL and apoB-containing lipoproteins. ## Combined associations of GLP-1 receptor agonists and a healthy lifestyle with cardiovascular outcomes among individuals with type 2 diabetes: a prospective cohort study. *2026-03-08 · The lancet. Diabetes & endocrinology · https://doi.org/10.1016/S2213-8587(25)00395-X · https://hartvaat.nl/2026/02/25/glp-1-agonisten-en-gezonde-leefstijl-samen-sterker-tegen-hart-en-vaatziekten/* This prospective cohort study in Lancet Diabetes & Endocrinology examined the combined effects of GLP-1 receptor agonists and eight healthy lifestyle factors on cardiovascular outcomes. The findings demonstrate additive benefit, with the combination of pharmacotherapy and healthy lifestyle conferring the greatest cardiovascular risk reduction. ## Second-Generation Aldosterone Synthase Inhibitors for Hypertension: A Bayesian Meta-Analysis of Randomized Trials. *2026-03-08 · JACC. Advances · https://doi.org/10.1016/j.jacadv.2026.102621 · https://hartvaat.nl/2026/02/27/nieuwe-aldosteronsynthase-remmers-bij-hypertensie-bayesiaanse-meta-analyse/* This Bayesian meta-analysis evaluated second-generation aldosterone synthase inhibitors (baxdrostat, lorundrostat) for hypertension, confirming their blood pressure-lowering efficacy and characterizing the dose-response relationship. ## SGLT2 inhibition in Patients with Type 2 Diabetes and CKD Experiencing a Deterioration in Estimated Glomerular Filtration Rate to <20ml/min/1.73m *2026-03-07 · Journal of cardiac failure · https://doi.org/10.1016/j.cardfail.2026.01.020 · https://hartvaat.nl/2026/02/27/sglt2-remmers-bij-ernstig-verminderde-nierfunctie-data-uit-credence/* This post-hoc CREDENCE analysis showed that SGLT2 inhibition remains safe and effective when eGFR declines below 20 mL/min, supporting continuation of therapy in patients with severely reduced kidney function rather than discontinuation at an arbitrary eGFR threshold. ## Additive Cardiorenal Benefits of Finerenone and SGLT2 Inhibitor Combination Therapy in Diabetic CKD: A Propensity-Matched Real-World Study. *2026-03-07 · The American journal of cardiology · https://doi.org/10.1016/j.amjcard.2026.02.035 · https://hartvaat.nl/2026/02/27/finerenon-plus-sglt2-remmer-additief-cardiorenal-voordeel-bij-diabetische-nierzi/* This real-world propensity-matched study showed that combining finerenone with SGLT2 inhibitors provides additive cardiorenal benefits in diabetic CKD compared with SGLT2 inhibitor monotherapy, supporting dual neurohormonal and metabolic protection. ## Switching from warfarin to direct oral anticoagulants in frail elderly Asian patients with atrial fibrillation: a Korean nationwide study. *2026-03-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf999 · https://hartvaat.nl/2026/02/27/van-vitamine-k-antagonist-naar-doac-bij-kwetsbare-ouderen-met-af/* This Korean nationwide study showed that switching from well-managed warfarin to DOACs in frail elderly patients with atrial fibrillation was associated with similar or improved outcomes. The real-world evidence supports transitioning to DOACs even in the oldest and most vulnerable AF population. ## Effect of baxdrostat on ambulatory blood pressure in patients with resistant hypertension (Bax24): a phase 3, randomised, double-blind, placebo-controlled trial. *2026-03-07 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)02549-8 · https://hartvaat.nl/2026/03/07/bax24-baxdrostat-en-ambulante-bloeddruk-bij-resistente-hypertensie/* The Bax24 phase 3 trial confirmed that baxdrostat significantly reduces ambulatory blood pressure in patients with resistant hypertension. The results replicate the earlier phase 2 findings and advance aldosterone synthase inhibition toward clinical implementation. ## Association Between 24-Hour Systolic Blood Pressure Time in Target Range and Mortality *2026-03-06 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26112 · https://hartvaat.nl/2026/02/27/bloeddruk-time-in-target-range-voorspelt-sterfte-bij-hypertensie/* This study showed that 24-hour systolic blood pressure time-in-target-range predicts mortality better than single measurements, supporting continuous assessment of blood pressure control quality using ambulatory monitoring. ## Physical activity and risk of adverse events in atrial fibrillation: evidence from European and Asian cohorts. *2026-03-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag032 · https://hartvaat.nl/2026/02/03/lichamelijke-activiteit-en-risico-op-complicaties-bij-atriumfibrilleren/* This post-hoc analysis of European and Asian-Pacific AF registries showed that physical activity levels are associated with different clinical characteristics and outcomes in AF patients, supporting exercise recommendations across diverse populations. ## Heart failure in the elderly: epidemiology, mechanisms, and management. *2026-03-06 · European heart journal · https://doi.org/10.1093/eurheartj/ehag110 · https://hartvaat.nl/2026/02/28/hartfalen-bij-ouderen-van-epidemiologie-tot-behandeling/* This European Heart Journal review describes the epidemiology, pathophysiology, and management of heart failure in the elderly, highlighting that the lifetime risk exceeds 25% after age 70. The article addresses the challenges of polypharmacy, frailty, and comorbidity that complicate guideline-directed therapy in older patients. ## Randomized Study of Antithrombin in Early-Onset Preeclampsia: KOUNO-TORI Study *2026-03-06 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25431 · https://hartvaat.nl/2026/03/06/kouno-tori-antitrombine-verlengt-de-zwangerschap-niet-bij-vroege-ernstige-pre-ec/* In preeclampsia, prolonging pregnancy reduces fetal risks. This randomised, double-blind, placebo-controlled study (KOUNO-TORI; 61 institutions) tested whether recombinant human antithrombin-gamma prolongs pregnancy in women with early-onset severe preeclampsia (24-32 weeks, antithrombin activity ≤100%). Pregnancy was prolonged by 13 days in the placebo group (n=92) and 16.9 days in the antithrombin group (n=90) — not a significant difference (p=0.07). The antithrombin group had more haemorrhage-related adverse events (+19.0%) and more anaemia (+16.8%). Antithrombin thus does not significantly prolong pregnancy in early-onset severe preeclampsia and appears to increase bleeding risk. ## Retrospective analysis of the performance of the PROMISE minimal risk tool for patients presenting with recent onset stable chest pain *2026-03-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003837?rss=1 · https://hartvaat.nl/2026/03/06/promise-minimal-risk-score-identificeert-veilig-laagrisicopatienten-met-stabiele/* The PROMISE Minimal Risk Score (PMRS) can identify patients with recent-onset stable chest pain who can be safely reassured and discharged without further testing, but is little used. In this retrospective real-world analysis (3,983 stable chest-pain referrals, median age 64), 10.9% were at minimal risk (PMRS >0.46). In that group, only 0.7% had obstructive coronary disease on CT coronary angiography, and over a median 306-day follow-up there were no myocardial infarctions or deaths. A PMRS above 0.46 is thus associated with a very low likelihood of significant coronary disease and of infarction or death. Applying the PMRS could spare low-risk patients further testing and use healthcare resources more efficiently. ## Prognostic impact of corticosteroid maintenance dose and re-escalation in patients with cardiac sarcoidosis *2026-03-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004048?rss=1 · https://hartvaat.nl/2026/03/06/cardiale-sarcoidose-een-onderhoudsdosis-corticosteroiden-van-5-10-mg-dag-geeft-d/* Japanese guidelines recommend a corticosteroid maintenance dose of 5-10 mg/day for cardiac sarcoidosis (CS), but the optimal dose was unclear. In this multicentre retrospective cohort from a Japanese national CS registry (352 patients on oral corticosteroids), patients were grouped by maintenance dose: low (<5 mg/day), recommended (5-10 mg/day) and high (>10 mg/day). Over a median 5.1-year follow-up, 11% died. The recommended dose gave the best survival; the high dose did significantly worse (mortality 8% with the recommended dose vs 25% low and 17% high). Dose re-escalation was needed in 19%, associated with mortality in the high- and low-dose groups. Achieving and maintaining the recommended 5-10 mg/day maintenance dose is thus important for prognosis in cardiac sarcoidosis. ## Frailty Index Offers Greater Discrimination Than Age for Optimal Blood Pressure Targets: A Pooled Analysis of Two Randomized Trials *2026-03-06 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26397 · https://hartvaat.nl/2026/03/06/kwetsbaarheid-bepaalt-de-optimale-bloeddrukstreefwaarde-beter-dan-leeftijd-sprin/* Hypertension guidelines advocate individualised blood-pressure management, often based on age — but chronological age alone may be insufficient. The frailty index, a multidimensional measure of biological ageing, may guide this better. The investigators pooled participant data from SPRINT and ACCORD (19,230 patients; 68% frail by a 31-item frailty index >0.21) and calculated time within different systolic BP ranges (time in target range, TTR). A J-shaped relationship between average systolic BP and cardiovascular events separated more clearly by frailty than by age. In frail patients, more time in the 110-140 mmHg range was associated with fewer events, whereas in non-frail patients more time below 130 mmHg was favourable. Age discriminated poorly. The frailty index thus more accurately predicts the optimal BP target than chronological age, though age remains more practical in resource-limited settings. ## Mechanical Thrombectomy and Catheter-Directed Thrombolysis in Acute Pulmonary Embolism: Trends and Practice Patterns in the PERT Consortium Registry (2016-2024) *2026-03-05 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725106281?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/mechanische-trombectomie-bij-longembolie-trends-uit-het-pert-register-2016-2024/* This PERT Consortium registry analysis described trends and practice patterns of mechanical thrombectomy and catheter-directed thrombolysis in acute pulmonary embolism, providing real-world data on the adoption and outcomes of interventional PE therapies. ## Association of albuminuria and changes in albuminuria with the risk of abdominal aortic aneurysm *2026-03-05 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00058-4/fulltext · https://hartvaat.nl/2026/02/27/albuminurie-geassocieerd-met-verhoogd-risico-op-abdominaal-aorta-aneurysma/* This study demonstrated that albuminuria — an early, modifiable marker of vascular damage — is independently associated with increased risk of abdominal aortic aneurysm, offering potential new opportunities for risk stratification beyond eGFR alone. ## Time to Measure Angiotensin II When Screening for Primary Aldosteronism in the Evaluation of Secondary Hypertension *2026-03-05 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25990 · https://hartvaat.nl/2025/12/11/angiotensine-ii-meten-bij-screening-op-primair-hyperaldosteronisme/* This Hypertension article advocated for measuring angiotensin II as a valuable addition to aldosterone-renin ratio screening for primary aldosteronism, potentially improving diagnostic accuracy for secondary hypertension evaluation. ## Immediate or Deferred Nonculprit-Lesion PCI in Myocardial Infarction. *2026-03-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2512918 · https://hartvaat.nl/2026/03/05/directe-versus-uitgestelde-non-culprit-pci-bij-mi-gerandomiseerde-trial/* This NEJM trial compared immediate with deferred nonculprit-lesion PCI in STEMI, addressing the optimal timing of complete revascularization in the acute MI setting with contemporary evidence. ## Heart failure therapy in patients with advanced cancer receiving specialized palliative care (EMPATICC trial). *2026-03-05 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf705 · https://hartvaat.nl/2026/03/05/empathy-hartfalentherapie-bij-patienten-met-gevorderde-kanker-en-palliatieve-zor/* The EMPATICC trial examined heart failure therapy in patients with advanced cancer receiving palliative care, showing that optimizing HF treatment improves symptoms and function even in the end-of-life setting. ## Glucagon-like Peptide Receptor Agonists and Kidney Outcomes in the Era of Personalized Medicine: Focus on Albuminuria. *2026-03-04 · Journal of personalized medicine · https://doi.org/10.3390/jpm16020097 · https://hartvaat.nl/2026/02/06/glp-1-receptoragonisten-en-nieruitkomsten-focus-op-albuminurie/* This review assessed the renoprotective effects of GLP-1 receptor agonists with specific focus on albuminuria reduction, positioning these agents as important kidney-protective therapies alongside SGLT2 inhibitors in the personalized medicine era. ## Albuminuria or proteinuria in glomerular disease and CKD - which one to use? *2026-03-04 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag020 · https://hartvaat.nl/2026/02/17/albuminurie-of-proteinurie-bij-glomerulaire-ziekte-en-ckd-wat-te-gebruiken/* This NDT discussion addressed the clinical question of whether albuminuria or proteinuria is the preferred measurement in glomerular disease and CKD, informing the standardization of kidney disease monitoring. ## Expert Perspectives on Managing Iron Deficiency in People with CKD and/or HF. *2026-03-04 · Journal of clinical medicine · https://doi.org/10.3390/jcm15041676 · https://hartvaat.nl/2026/02/23/ijzertekort-bij-chronische-nierziekte-en-hartfalen-expertperspectieven/* An international expert panel provides practical recommendations for diagnosing and managing iron deficiency in patients with chronic kidney disease and/or heart failure. The review addresses diagnostic uncertainties and identifies patients most likely to benefit from iron therapy. ## Left bundle branch area pacing vs. right ventricular pacing in post-transcatheter aortic valve implantation patients: a retrospective propensity-matched analysis. *2026-03-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf322 · https://hartvaat.nl/2026/02/03/linkerbundeltakpacing-versus-rechterventrikel-pacing-na-tavi/* This Europace study compared left bundle branch area pacing with conventional RV pacing in patients requiring permanent pacing after TAVI, evaluating whether physiological pacing strategies improve outcomes in this specific population. ## Workflow and sedation choice with the PFA variable-loop circular catheter in real-world AF procedures: insights from the prospective multi-centre VARIPURE clinical study. *2026-03-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag025 · https://hartvaat.nl/2026/02/03/varipure-studie-pulsed-field-ablatie-in-de-dagelijkse-af-praktijk/* The VARIPURE study described real-world workflow and sedation practices with the variable-loop circular PFA catheter for AF ablation, providing practical implementation data for this emerging technology. ## Artificial Intelligence ECG Localization Facilitates Focused Activation Mapping and Improves Outcomes in Hemodynamically Unstable Ventricular Tachycardia. *2026-03-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag024 · https://hartvaat.nl/2026/02/11/ai-gestuurde-ecg-lokalisatie-verbetert-ablatie-bij-instabiele-ventriculaire-tach/* This Europace study demonstrated that AI-based ECG localization of ventricular tachycardia origin facilitates focused activation mapping, improving procedural efficiency and outcomes for VT ablation. ## Development and validation of diagnostic and prognostic models for heart failure in unstable angina patients *2026-03-03 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003468?rss=1 · https://hartvaat.nl/2026/03/03/voorspelmodellen-voor-hartfalen-bij-patienten-met-instabiele-angina-pectoris/* To detect heart failure (HF) early in patients with unstable angina (UA), the investigators developed diagnostic and prognostic models. From 12,857 acute coronary syndrome patients, 7,092 UA patients were analysed (split into training and validation cohorts). LASSO regression identified three key factors: left ventricular diameter, NT-proBNP and ischaemic cardiomyopathy. The diagnostic model (for a first HF hospitalisation) had excellent discrimination (AUC 0.94 in both training and validation cohorts). The prognostic models (for HF rehospitalisation at 1, 2 and 6 months) had AUCs of 0.75-0.79. These models can quickly identify high-risk unstable-angina patients and enable targeted, timely care. ## Association between functional status and cardiac function in chronic heart failure: insights from the C-MIC II Trial *2026-03-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag102 · https://hartvaat.nl/2026/03/03/c-mic-ii-hartfunctie-inspanningscapaciteit-en-kwaliteit-van-leven-zijn-verwante-/* In heart failure, the relationship between changes in cardiac function, exercise capacity and patient-reported health is incompletely defined — relevant to endpoint selection in trials. In this post-hoc analysis of the randomised C-MIC II trial (65 ambulatory patients with non-ischaemic dilated cardiomyopathy, NYHA III-IV, LVEF 25-35%), the six-month associations between the KCCQ questionnaire, 6-minute walk distance (6MWD), left ventricular ejection fraction (LVEF) and peak oxygen uptake (peak VO2) were examined. Changes in KCCQ and 6MWD correlated strongly with each other (r=0.63) but only modestly with LVEF (both r=0.39) and not significantly with peak VO2. LVEF correlated more closely with peak VO2 (r=0.41, rising to 0.56 at six months). Cardiac function, exercise capacity and perceived health are thus related but distinct domains — supporting multidimensional assessment in heart-failure trials. ## Invasive haemodynamic validation of an artificial intelligence echocardiographic tool for detecting heart failure with preserved ejection fraction *2026-03-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag052 · https://hartvaat.nl/2026/03/03/ai-echotool-voor-hfpef-hoge-specificiteit-lage-sensitiviteit-bij-invasieve-valid/* An FDA-approved AI tool detects heart failure with preserved ejection fraction (HFpEF) from echocardiographic images (apical 4-chamber), without other clinical data. In this external validation (47 patients with unexplained dyspnoea who underwent both echo and right heart catheterisation), the tool was compared with the invasive standard (wedge pressure ≥15 mmHg at rest or ≥25 mmHg with exercise). The AI had high specificity (88%) and positive predictive value (86%) but low sensitivity (30%); using the PCWP/cardiac-output slope, specificity and PPV reached 100%. AI-positive patients had higher filling pressures and pulmonary resistance. Among patients with indeterminate H2FPEF scores, the AI identified 80% of invasively confirmed HFpEF. The tool is thus best for identifying patients with clearly abnormal haemodynamics, not for ruling out HFpEF. ## Plasma protein profiles in different heart failure phenotypes *2026-03-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag098 · https://hartvaat.nl/2026/03/03/plasma-eiwitprofielen-onthullen-gedeelde-en-fenotype-specifieke-routes-bij-hartf/* Heart failure (HF) is often preceded by myocardial infarction (MI) or atrial fibrillation (AF). In 50,765 UK Biobank participants with 2,922 plasma proteins measured, the investigators examined whether protein profiles of incident HF with preceding MI, with preceding AF, or with neither are similar. Sixty proteins were associated with HF across all three groups; thirteen related to left ventricular ejection fraction and seven to the diastolic E/A ratio. ADM was the strongest predictor in the MI and AF groups, while LRRN1 was protective in all groups. A further 110 proteins were uniquely associated with HF without preceding MI or AF. Enriched pathways (interleukin-10 signalling, death receptors, TNF receptor binding) point to a shared pathophysiological profile independent of prior MI or AF. ## Quantifying skeletal muscle energy metabolism during exercise in heart failure with preserved ejection fraction using in vivo 31P magnetic resonance spectroscopy *2026-03-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvaf035 · https://hartvaat.nl/2026/03/03/spierstofwisseling-bij-hfpef-verminderde-oxidatieve-capaciteit-los-van-ijzergebr/* Patients with heart failure and preserved ejection fraction (HFpEF) have markedly reduced exercise capacity with poorly understood, multifactorial causes. In this Dutch two-site study (58 HFpEF patients, 16 controls), in-vivo 31phosphorus MR spectroscopy measured mitochondrial oxidative muscle metabolism via phosphocreatine recovery after isometric or dynamic exercise. Phosphocreatine recovery halftime after isometric exercise was prolonged in HFpEF patients (27 vs 24 seconds), indicating reduced skeletal-muscle oxidative capacity. This held regardless of iron deficiency, whereas higher hs-CRP was associated with slower recovery. Exercise intolerance in HFpEF thus arises partly from intrinsically impaired muscle energetics, not iron deficiency alone. ## Worsening heart failure-based hierarchical endpoints beyond HF hospitalization: expert opinion paper *2026-03-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag107 · https://hartvaat.nl/2026/03/03/expertopinie-hierarchische-eindpunten-op-basis-van-verslechterend-hartfalen-voor/* The classic composite of cardiovascular death or first heart-failure hospitalisation aligns increasingly poorly with modern HF care: better survival and ambulatory pathways mean much worsening HF is treated outside hospital and patients may have recurrent episodes. Time-to-first-hospitalisation alone therefore misses clinically relevant morbidity. In this expert opinion, the authors propose a standardised, adjudicated definition of worsening-HF events extended to ambulatory settings, and recommend hierarchical endpoints that prioritise all-cause death, measure morbidity via all (first and recurrent) events, and incorporate validated patient-reported outcomes. This better reflects total disease burden and improves statistical power and interpretability across evolving care models. ## In vivo base editing gene therapy for heterozygous familial hypercholesterolemia: a phase 1 trial. *2026-03-03 · Nature medicine · https://doi.org/10.1038/s41591-026-04254-4 · https://hartvaat.nl/2026/03/03/yolt-101-base-editing-schakelt-pcsk9-uit-bij-heterozygote-fh-fase-1/* YOLT-101 is an in vivo gene therapy that uses adenine base editing — delivered via GalNAc-modified lipid nanoparticles — to inactivate PCSK9 for durable LDL lowering. In this ongoing phase 1 trial, six adults with heterozygous familial hypercholesterolaemia and uncontrolled LDL received a single ascending dose (0.2–0.6 mg/kg). No grade ≥3 adverse events occurred; transient infusion reactions and liver-enzyme elevations were most common. A single infusion produced dose-dependent, durable reductions: at the highest dose (0.6 mg/kg) PCSK9 and LDL cholesterol fell by 74.4% and 52.3% respectively at 24 weeks. Alongside VERVE-102, this is a second base-editing programme pursuing one-time, durable PCSK9 knockdown. ## Prognostic performance of cardiogenic shock 4 proteins prediction model in infarct-related cardiogenic shock. *2026-03-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag010 · https://hartvaat.nl/2026/03/03/4-eiwitmodel-voor-cardiogene-shock-prognose-danger-substudie/* A DanGer Shock substudy evaluated the cardiogenic shock 4-protein biomarker-based risk score in infarct-related cardiogenic shock. The biomarker panel improves risk stratification for mechanical circulatory support decisions. ## Controlling Nutritional Status score as a predictor of ventricular arrhythmias in patients with advanced heart failure. *2026-03-02 · ESC heart failure · https://doi.org/10.1093/eschf/xvag037 · https://hartvaat.nl/2026/02/03/voedingsstatus-voorspelt-ventriculaire-ritmestoornissen-bij-gevorderd-hartfalen/* This study demonstrated that the Controlling Nutritional Status score predicts ventricular arrhythmias in patients with advanced heart failure receiving cardiac resynchronisation therapy. Malnutrition appears to be an independent risk factor for life-threatening arrhythmias. ## Costs and outcomes in Finnish heart failure patients treated with left ventricular assist device or heart transplant. *2026-03-02 · ESC heart failure · https://doi.org/10.1093/eschf/xvag063 · https://hartvaat.nl/2026/02/25/lvad-versus-harttransplantatie-bij-hartfalen-finse-kosten-en-uitkomsten/* A Finnish real-world study compared clinical outcomes and healthcare costs between advanced heart failure patients receiving LVAD therapy versus heart transplantation. The European cost-effectiveness data inform decision-making in advanced heart failure management. ## Cardiogenic shock in the course of myocardial infarction: the results of the Shock-POL registry. *2026-03-02 · ESC heart failure · https://doi.org/10.1093/eschf/xvag066 · https://hartvaat.nl/2026/02/26/cardiogene-shock-bij-myocardinfarct-resultaten-van-het-shock-pol-register/* The Shock-POL registry documented current management patterns, mortality rates, and risk factors in patients with cardiogenic shock complicating acute myocardial infarction across nine Polish cardiology centres. ## The cTnI/cTnT Ratio in Myocardial Injury: A Multicohort and Experimental Synthesis *2026-03-02 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725106591?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/de-troponine-i-t-ratio-bij-myocardschade-een-multicohort-synthese/* This multicohort study investigated the ratio of cardiac troponin I to troponin T as a diagnostic tool in myocardial injury, exploring whether this ratio can differentiate between ischemic and non-ischemic causes of myocardial damage. ## Small But Mighty: Blood Pressure Control Through Ultra-Low-Dose Single-Pill Antihypertensive Medication as Initial Therapy *2026-03-02 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725106578?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/ultra-lage-dosis-combinatiepil-als-startbehandeling-voor-hypertensie/* This JACC study explored ultra-low-dose single-pill antihypertensive combinations as initial therapy for hypertension. The approach aims to overcome treatment inertia by starting with minimally dosed multi-drug combinations that maximize efficacy while minimizing side effects. ## Carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers predict secondary major adverse cardiovascular events after endarterectomy. *2026-03-02 · European heart journal · https://doi.org/10.1093/eurheartj/ehag117 · https://hartvaat.nl/2026/02/27/macrofaagbelasting-in-carotisplaque-voorspelt-cardiovasculaire-events-na-endarte/* This European Heart Journal study demonstrated that carotid plaque macrophage burden and inflammatory lipid-associated macrophage markers independently predict secondary major adverse cardiovascular events beyond traditional risk factors. The findings link plaque inflammation at the cellular level to recurrent cardiovascular risk. ## Depression may not be an independent risk factor for mortality in patients with cardiovascular disease: data from NHANES 2011-2018 *2026-03-02 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003754?rss=1 · https://hartvaat.nl/2026/03/02/is-depressie-een-onafhankelijke-risicofactor-voor-sterfte-bij-hart-en-vaatziekte/* Depression is common in cardiovascular disease (CVD) and has long been regarded as an independent risk factor for higher mortality, although this association may be confounded by symptom overlap and residual confounding. In this secondary analysis of 2,064 adults with CVD (NHANES 2011-2018, linked to mortality data), depression was defined using the PHQ-9 (cut-off ≥10). Over a median 4.67-year follow-up, 403 deaths were recorded. In a basic adjusted Cox model, depression was associated with higher all-cause (HR 1.33) and non-cardiovascular mortality (HR 1.46). After rigorous adjustment with propensity score matching and inverse probability weighting, however, these associations were no longer significant. After thorough adjustment for confounders and comorbidity, depression may thus not be an independent risk factor for mortality in patients with cardiovascular disease. ## Worse risk profile, number of grafts and hospital death but acceptable late survival in females undergoing coronary surgery: a 20-year propensity matched analysis *2026-03-02 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003894?rss=1 · https://hartvaat.nl/2026/03/02/vrouwen-na-coronaire-bypasschirurgie-hoger-ziekenhuisrisico-en-minder-grafts-maa/* This study examined sex differences in isolated coronary artery bypass grafting (CABG) over 20 years (2001-2021) at a single centre, with 1:1 propensity score matching (2,573 women vs 2,573 men). Women were older and more often had class III-IV angina, hypertension and diabetes. After matching, women received fewer left internal mammary artery (LIMA) grafts (84% vs 88%) and fewer total grafts (median 2 vs 3), had higher in-hospital mortality (2.2% vs 1.3%; OR 1.74) and longer hospital stays. Twenty-year survival, however, was similar. Off-pump CABG lowered in-hospital mortality in women (1.6% off-pump vs 3.0% on-pump). Women thus have higher perioperative risk and receive fewer (arterial) grafts, while long-term survival is equal — arguing for a female-tailored perioperative approach. ## Discontinuation of RAS Inhibition After an Acute Decline in Estimated Glomerular Filtration Rate *2026-03-02 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2026.3680 · https://hartvaat.nl/2026/03/02/staken-van-ras-remmers-na-acute-egfr-daling-hangt-samen-met-meer-nierfalen-en-st/* Renin-angiotensin system inhibitors (RASIs) are frequently discontinued when an acute decline in eGFR occurs after initiation. In this Canadian target-trial-emulation cohort (4,233 patients with a >15% eGFR decline within 90 days), discontinuation — versus continuation — carried a higher risk of death (HR 1.23) and end-stage kidney disease (HR 1.74); differences in cardiovascular events and acute kidney injury were not significant. The authors argue for caution before stopping and for strategies that support continued RASI use. ## Intensive BP Control and Cognitive Function: A Randomized Clinical Trial *2026-03-01 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26572 · https://hartvaat.nl/2026/02/26/intensieve-bloeddrukbehandeling-en-cognitieve-functie-een-gerandomiseerde-klinis/* This randomized trial investigated whether intensive blood pressure control preserves cognitive function in an East Asian population, addressing the uncertainty about aggressive BP targets and brain health in this demographic. ## Short-Term Exposure to Air Pollution Increases Mortality From Hypertension and its Multiorgan Complications: A Case Crossover Study of 2.1 Million Deaths in China *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000586?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/luchtvervuiling-verhoogt-sterfte-door-hypertensie-case-crossover-studie-bij-2-1-/* This large Chinese case-crossover study demonstrated that short-term exposure to air pollution significantly increases mortality from hypertension and its multiorgan complications, establishing a direct link between environmental pollutants and hypertensive crisis outcomes. ## Low-Dose Rivaroxaban to Prevent Left Ventricular Thrombosis After Anterior Myocardial Infarction: The APERITIF Randomized Clinical Trial. *2026-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2026.0026 · https://hartvaat.nl/2026/02/25/aperitif-trial-laaggedoseerd-rivaroxaban-voorkomt-linkerventrikeltrombose-na-voo/* The APERITIF randomized trial investigated whether adding low-dose rivaroxaban to dual antiplatelet therapy prevents left ventricular thrombus formation after anterior acute myocardial infarction. ## Intensive BP Control and Cognitive Function: A Randomized Clinical Trial. *2026-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.26572 · https://hartvaat.nl/2026/04/01/intensieve-bloeddrukcontrole-en-cognitieve-functie-gerandomiseerde-trial/* This randomized trial showed that intensive blood pressure control protects cognitive function in an East Asian hypertensive population, extending the SPRINT MIND findings to this demographic group. ## Low-Dose TEL/AML/CHTD SPC Versus Standard-Dose TEL in Hypertension: Phase III RCT. *2026-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25810 · https://hartvaat.nl/2026/04/01/lage-dosis-tel-aml-chtd-combinatietablet-versus-standaard-tel-fase-iii/* This phase III RCT confirmed the superior blood pressure-lowering efficacy of a low-dose triple combination (telmisartan/amlodipine/chlorthalidone) versus standard-dose telmisartan monotherapy for hypertension treatment. ## mHealth Intervention to Improve Hypertension Care in High-Risk Patients. *2026-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.26148 · https://hartvaat.nl/2026/04/01/mhealth-interventie-verbetert-hypertensiezorg-bij-hoogrisicopatienten/* This study confirmed that a pharmacist-led mobile health technology care model improves blood pressure control in high-risk patients, supporting the integration of mHealth and interprofessional collaboration for hypertension management. ## Abelacimab vs Rivaroxaban in Older Individuals With Atrial Fibrillation: A Prespecified Analysis of the Phase 2b AZALEA-TIMI 71 Trial. *2026-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.5418 · https://hartvaat.nl/2026/03/01/abelacimab-versus-rivaroxaban-bij-ouderen-met-af-subanalyse/* This AZALEA-TIMI 71 subanalysis confirmed that abelacimab provides less bleeding than rivaroxaban in older AF patients, the population at highest bleeding risk with conventional anticoagulants. ## End Point-Based Threshold for the Ambulatory Arterial Stiffness Index. *2026-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25442 · https://hartvaat.nl/2026/03/01/ambulante-arteriele-stijfheidsindex-eindpuntgebaseerde-drempelwaarde/* An individual-participant meta-analysis of 14 population studies derived an endpoint-based risk threshold for the ambulatory arterial stiffness index. The prognostic biomarker may complement blood pressure-based cardiovascular risk stratification. ## 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline Recommendations for the Treatment of Adult Congenital Heart Disease and Comparison With the 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000549?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/2025-richtlijn-voor-aangeboren-hartafwijkingen-bij-volwassenen-vergeleken-met-de/* This comparison of the 2025 with the 2018 ACC/AHA congenital heart disease guidelines highlighted key changes in recommendations, including updated surgical timing, expanded catheter intervention indications, and improved pregnancy counseling. ## 2025 Adults With Congenital Heart Disease Guideline From the Early-Career Perspective *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105858?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/de-2025-richtlijn-voor-aangeboren-hartafwijkingen-bij-volwassenen-vanuit-early-c/* This early-career perspective on the 2025 ACHD guideline discussed how the next generation of cardiologists can implement contemporary recommendations for adults with congenital heart disease in their training and clinical practice. ## 2025 Adults With Congenital Heart Disease Guideline-at-a-Glance *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725101691?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/richtlijn-volwassenen-met-aangeboren-hartafwijkingen-2025-in-een-oogopslag/* This guideline-at-a-glance provided a concise visual summary of the 2025 ACHD guidelines, distilling key recommendations for clinical practice in a rapid-reference format. ## 2026 Acute Pulmonary Embolism Guideline-at-a-Glance *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725104798?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/richtlijn-acute-longembolie-2026-in-een-oogopslag/* This JACC guideline-at-a-glance provides a concise visual summary of the 2026 acute pulmonary embolism guideline, distilling the key recommendations into an accessible reference format for rapid clinical decision-making. ## Adapting the 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for Management of Adults With Congenital Heart Disease to Low Resource Settings *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105950?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/de-2025-richtlijn-voor-volwassenen-met-aangeboren-hartafwijkingen-aanpassen-aan-/* This analysis discussed how the 2025 ACC/AHA guideline for adults with congenital heart disease can be adapted to diverse healthcare settings, addressing implementation challenges in different resource environments. ## Adult Congenital Heart Disease: New Guidelines, Remaining Gaps, and Continual Opportunities *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726001312?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/aangeboren-hartafwijkingen-bij-volwassenen-nieuwe-richtlijnen-kennishiaten-en-ka/* This JACC editorial discussed the new ACC/AHA guideline for adults with congenital heart disease, identifying remaining evidence gaps and opportunities for improving care in this growing patient population. ## Atrial Mechanical Contraction Predicts Cerebrovascular Risk in Patients With Transthyretin Amyloid Cardiomyopathy and Sinus Rhythm *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105640?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/atriale-mechanische-contractie-voorspelt-cerebrovasculair-risico-bij-transthyret/* This study demonstrated that atrial mechanical contraction assessed by imaging predicts cerebrovascular risk in patients with transthyretin amyloid cardiomyopathy, suggesting a functional marker for stroke risk stratification in ATTR-CM. ## Beyond the Ventricles: Cardiomyopathy Genes and Atrial Fibrillation Risk *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000689?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/voorbij-de-ventrikels-cardiomyopathiegenen-en-het-risico-op-atriumfibrilleren/* This JACC commentary discussed the growing evidence that gene mutations traditionally associated with ventricular cardiomyopathies also independently increase the risk of atrial fibrillation, blurring the distinction between ventricular and atrial genetic disease. ## Cardiac Screening for Conditions Associated With Sudden Cardiac Death: Yield, Interventions, and SCA/SCD Incidence in 104,369 Young Individuals *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725103574?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/cardiale-screening-bij-104-369-jongeren-opbrengst-interventies-en-incidentie-van/* This large-scale screening study of over 104,000 young individuals for conditions associated with sudden cardiac death evaluated the diagnostic yield, interventions triggered, and subsequent incidence of sudden cardiac arrest, informing the ongoing debate about population-level cardiac screening. ## Cardiac Screening in the Young: Time to Sound the Battle CRY? *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105809?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/cardiale-screening-bij-jongeren-tijd-voor-actie/* This JACC commentary discussed the implications of the CRY cardiac screening study in young individuals, debating the value and limitations of population-level cardiac screening programs for sudden cardiac death prevention. ## Cardiomyopathy Gene Variants and Polygenic Risk Scores in Atrial Fibrillation: Evidence for an Atrial-First Phenotype *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725104282?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/cardiomyopathie-genvarianten-en-polygene-risicoscores-bij-atriumfibrilleren-bewi/* This study explored the role of cardiomyopathy-associated gene variants and polygenic risk scores in the development of atrial fibrillation, providing evidence for an atrial-first phenotype in genetic cardiomyopathy. ## Comparison of the European Society of Cardiology 0/1-Hour and High-Sensitivity Troponin in the Evaluation of Patients With Suspected Acute Coronary Syndrome 0/2-or-0/3-Hour Algorithms for Rapid Myocardial Infarction Diagnosis: A Prospective Multicenter Study *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105883?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/esc-0-1-uur-versus-0-2-of-0-3-uur-hoog-sensitief-troponine-algoritmen-bij-verden/* This prospective multicenter study compared the diagnostic accuracy of the ESC 0/1-hour high-sensitivity troponin algorithm with standard evaluation for patients presenting with suspected acute coronary syndromes, assessing real-world performance of the rapid rule-out/rule-in protocol. ## Effect of Baduanjin on Blood Pressure Among Individuals With High-Normal Blood Pressure: A Multicenter, Open-Label, Blinded-Outcome Randomized Controlled Trial *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S073510972600077X?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/effect-van-baduanjin-op-bloeddruk-bij-hoog-normaal-bloeddruk-gerandomiseerde-tri/* This multicenter randomized trial evaluated Baduanjin, a traditional Chinese exercise form, for blood pressure reduction in individuals with high-normal blood pressure, testing a culturally appropriate lifestyle intervention for hypertension prevention. ## From Survival to Stewardship: Delivering Hyperspecialized Cardiovascular Care at Scale *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000793?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/van-overleving-naar-rentmeesterschap-hypergespecialiseerde-cardiovasculaire-zorg/* This JACC perspective addressed the challenges of delivering hyperspecialized cardiovascular care at scale, discussing strategies for maintaining quality while expanding access to advanced treatments. ## Heart Failure Prevention: Evidence Generation, Trial Design, and Regulatory Pathways *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105603?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/hartfalenpreventie-bewijsgeneratie-trialontwerp-en-regulatoire-trajecten/* This JACC review discussed the current landscape of heart failure prevention, addressing evidence generation, clinical trial design challenges, and regulatory pathways for therapies aimed at preventing rather than treating established heart failure. ## High-Dose Influenza Vaccination in Atherosclerotic Cardiovascular Disease: A Multinational Pooled Analysis of DANFLU-2 and GALFLU (FLUNITY-HD) *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S073510972510661X?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/hoge-dosis-griepvaccinatie-bij-atherosclerotisch-vaatlijden-flunity-hd-analyse/* This multinational pooled analysis of the DANFLU-2 and GALFLU trials evaluated the effect of high-dose versus standard-dose influenza vaccination on cardiovascular outcomes in patients with atherosclerotic cardiovascular disease, addressing whether enhanced immunogenicity translates to better cardiovascular protection. ## Impact of Early, Delayed, or Interrupted Treatment in Children With Familial Hypercholesterolemia *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725102477?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/impact-van-vroege-uitgestelde-of-onderbroken-behandeling-bij-kinderen-met-famili/* This study examined the long-term cardiovascular effects of early, delayed, or interrupted lipid-lowering treatment in children with familial hypercholesterolemia, providing evidence for the importance of early and continuous treatment initiation. ## Impact of Long-Term Cumulative Exposure to Wildfire Smoke PM2.5 on Cardiovascular Hospital Admissions Among Older Adults in the United States: A Population-Based Cohort Study *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725106608?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/langdurige-blootstelling-aan-bosbranden-pm2-5-en-cardiovasculaire-ziekenhuisopna/* This population-based cohort study examined the cardiovascular impact of long-term cumulative exposure to wildfire smoke PM2.5 on hospital admissions, addressing the growing health threat of climate-related air pollution. ## Increase in Serum Transthyretin After Tafamidis Is Associated With Improved Survival in Transthyretin Amyloid Cardiomyopathy *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000574?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/stijging-van-serum-transthyretine-na-tafamidis-voorspelt-betere-overleving-bij-a/* This study showed that an increase in serum transthyretin after starting tafamidis is associated with improved survival in ATTR cardiomyopathy, establishing a potential on-treatment biomarker for monitoring therapeutic response. ## Long-Term Cardiovascular and Noncardiovascular Mortality After Acute Coronary Syndrome: A Nationwide Competing-Risks Analysis of 1.56 Million Patients *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105974?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/langetermijn-cardiovasculaire-en-niet-cardiovasculaire-mortaliteit-na-acuut-coro/* This nationwide competing-risks analysis of 1.56 million patients characterized long-term cardiovascular and non-cardiovascular mortality trajectories after acute coronary syndrome, revealing the shifting causes of death over time. ## Menopausal Status Associated With Docetaxel-Induced Vascular Dysfunction in Breast Cancer Patients *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725101629?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/menopauzale-status-en-docetaxel-geinduceerde-vasculaire-disfunctie-bij-borstkank/* This study investigated the association between menopausal status and docetaxel-induced vascular dysfunction in breast cancer patients, exploring hormonal vulnerability as a modifier of chemotherapy-related cardiovascular toxicity. ## Mitral Valve Repair for Degenerative MR With Moderate or Less Tricuspid Regurgitation: 2-Year Outcomes From a Multicenter Echocardiographic Core Laboratory–Adjudicated Cohort *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105986?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/mitralisklepherstel-bij-degeneratief-mr-met-matige-tricuspidalisinsufficientie-2/* Two-year outcomes from a multicenter echocardiographic core lab-assessed cohort evaluated mitral valve repair for degenerative mitral regurgitation in the presence of moderate or less tricuspid regurgitation, informing surgical decision-making for concomitant valve disease. ## Nonlinear Association Evidence and Optimal Alert Thresholds for Global Short-Term PM2.5 Exposure and Cardiovascular Mortality Risk *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725104750?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/niet-lineair-verband-en-optimale-drempelwaarden-voor-mondiale-pm2-5-blootstellin/* This analysis characterized the nonlinear association between short-term PM2.5 exposure and cardiovascular mortality across global datasets, establishing optimal alert thresholds for public health interventions. ## PM2.5 Spikes and Cardiovascular Mortality: Policy Priorities for Air Quality Alerts *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725104105?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/fijnstofpieken-en-cardiovasculaire-sterfte-beleidsprioriteiten-voor-luchtkwalite/* This commentary discussed the relationship between acute PM2.5 air pollution spikes and cardiovascular mortality, emphasizing the need for improved air quality alert systems to protect vulnerable populations during pollution events. ## Polygenic Risk Based Detection and Treatment of Subclinical Coronary Atherosclerosis in the PROACT Clinical Trials *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105639?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/polygeen-risico-gestuurde-detectie-en-behandeling-van-subklinische-coronaire-ath/* The PROACT clinical trial results demonstrated the use of polygenic risk scores for detecting and treating subclinical coronary atherosclerosis, exploring genetics-guided prevention before clinical events occur. ## Rethinking Cholesterol Management in Women: From Short-Term Risk Estimation to Lifecourse Cardiovascular Health *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000525?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/cholesterolmanagement-bij-vrouwen-heroverwogen-van-risicoschatting-naar-levensla/* This JACC perspective advocated rethinking cholesterol management in women by shifting from short-term risk estimation to a lifecourse approach that accounts for pregnancy-related lipid changes, menopause, and sex-specific risk trajectories. ## Risk of Atherosclerotic Cardiovascular Disease in Familial Remnant Hyperlipidemia (Dysbetalipoproteinemia) and Familial Hypercholesterolemia *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S073510972600135X?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/risico-op-atherosclerotische-hart-en-vaatziekten-bij-familiaire-restanthyperlipi/* This study compared the risk of atherosclerotic cardiovascular disease in familial remnant hyperlipidemia (dysbetalipoproteinemia) with familial hypercholesterolemia, characterizing the cardiovascular impact of remnant lipoprotein elevation. ## Serum Transthyretin Before and After Starting Tafamidis as Outcome Predictors in ATTR Cardiomyopathy *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000690?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/serum-transthyretine-voor-en-na-tafamidisstart-als-uitkomstvoorspeller-bij-attr-/* This study examined the prognostic value of serum transthyretin levels before and after tafamidis initiation in patients with ATTR cardiomyopathy, exploring whether transthyretin dynamics can guide treatment monitoring. ## Sex Differences in Dilated Cardiomyopathy: Evidence Gaps and Future Directions *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725098110?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/sekseverschillen-bij-gedilateerde-cardiomyopathie-kennishiaten-en-toekomstige-ri/* This review summarized sex differences in dilated cardiomyopathy, including differences in etiology, clinical presentation, response to therapy, and prognosis, identifying knowledge gaps that require targeted research. ## Sex Matters: Optimizing Cardiovascular Education and Training to Improve Women’s (and Men’s) Heart Health *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000513?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/geslacht-doet-ertoe-cardiovasculaire-opleiding-optimaliseren-voor-vrouwenhartgez/* This JACC article discussed the importance of incorporating sex-specific considerations into cardiovascular education and training, arguing that improved gender awareness in medical training translates to better heart health outcomes for both women and men. ## Short-Term PM2.5 Exposure and Cardiovascular Mortality: A Global Exposure-Response Analysis to Inform Alert Thresholds *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725105895?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/kortdurende-blootstelling-aan-fijnstof-en-cardiovasculaire-sterfte-mondiale-anal/* This global analysis characterized the exposure-response relationship between short-term PM2.5 exposure and cardiovascular mortality across different regions, providing data to inform air quality standards for cardiovascular protection. ## Sirolimus-Eluting Iron Bioresorbable Scaffolds vs Everolimus-Eluting Stents for Percutaneous Coronary Intervention: A Randomized Trial (IRONMAN II) *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725104920?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/sirolimus-eluerende-bioresorbeerbare-stents-versus-everolimus-eluerende-stents-i/* This randomized trial compared sirolimus-eluting iron bioresorbable scaffolds with everolimus-eluting permanent stents for PCI, evaluating the next generation of bioresorbable technology after the setbacks with earlier polymer-based scaffolds. ## Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726054239?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/zesjaarsuitkomsten-van-transkatheter-versus-chirurgische-aortaklepvervanging-bij/* Six-year outcomes from the comparison of transcatheter versus surgical aortic valve replacement in low-risk patients with aortic stenosis demonstrated sustained comparable results, providing long-term reassurance about TAVR durability in this population. ## Some Much-Needed CONFIDENCE to Combat the Risk-Treatment Paradox in Chronic Kidney Disease *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725103392?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/vertrouwen-nodig-om-de-risico-behandelparadox-bij-ckd-te-bestrijden/* This JACC commentary discussed the risk-treatment paradox in chronic kidney disease, where patients at highest cardiovascular risk are least likely to receive evidence-based therapies including SGLT2 inhibitors and statins. ## The Future of Adult Congenital Heart Care in the United States: Are We Keeping Up With the Pace of Progress? *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725106566?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/de-toekomst-van-zorg-voor-volwassenen-met-aangeboren-hartafwijkingen-in-de-vs/* This perspective assessed whether US healthcare infrastructure is keeping pace with advances in adult congenital heart disease care, identifying gaps in specialist workforce, transition services, and long-term follow-up capacity. ## Timing of Cardiovascular and Kidney Benefits With Finerenone in Heart Failure and Chronic Kidney Disease With Type 2 Diabetes *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725100715?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/timing-van-cardiovasculaire-en-renale-voordelen-van-finerenon-bij-hartfalen-en-c/* This JACC analysis examined the time course of cardiovascular and kidney benefits with finerenone in patients with heart failure and chronic kidney disease with type 2 diabetes, characterizing how quickly the cardiorenal protection emerges after treatment initiation. ## Tip of the Spear: The Cardiovascular Profession in the Age of AI *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726002925?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/de-cardiovasculaire-professie-in-het-tijdperk-van-ai/* This JACC commentary discussed how artificial intelligence is transforming the cardiovascular profession, addressing the practical impact on clinical workflows, training requirements, and professional identity. ## Vascular Dysfunction in Cardio-Oncology: Hormone Status, Chemotherapy, and Risk *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725103562?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/vasculaire-disfunctie-in-de-cardio-oncologie-hormoonstatus-chemotherapie-en-risi/* This JACC review examined vascular dysfunction in cardio-oncology, focusing on how hormonal status and chemotherapy agents contribute to cardiovascular risk in cancer patients and survivors. ## What Has Changed Since the First ACC/AHA Guidelines for the Management of Adult Congenital Heart Disease in 2008? *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109725106554?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/wat-is-veranderd-sinds-de-eerste-richtlijn-voor-volwassenen-met-aangeboren-harta/* This review outlined the key changes in ACC/AHA guidelines for adults with congenital heart disease since the first edition, highlighting evolving recommendations in surgical timing, catheter interventions, and pregnancy management. ## When Care Becomes Autonomous: AI and the Future of Cardiovascular Medicine *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726003001?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/wanneer-zorg-autonoom-wordt-ai-en-de-toekomst-van-de-cardiovasculaire-geneeskund/* This JACC perspective explored the emergence of autonomous AI systems in cardiovascular medicine and their implications for clinical decision-making, patient safety, and the future role of cardiovascular physicians. ## Women’s Cardiovascular Health: From Inclusion to Design *2026-03-01 · JACC · https://doi.org/https://www.sciencedirect.com/science/article/pii/S0735109726000537?dgcid=rss_sd_all · https://hartvaat.nl/2025/01/01/cardiovasculaire-gezondheid-van-vrouwen-van-inclusie-naar-onderzoeksontwerp/* This JACC article discussed the need to move beyond merely including women in cardiovascular trials to designing studies that specifically address sex-specific mechanisms, outcomes, and therapeutic responses in women's cardiovascular health. ## Brown tumor of the patella in a long-term hemodialysis patient *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00852-X/fulltext · https://hartvaat.nl/2026/03/01/bruine-tumor-van-de-patella-bij-een-langdurig-hemodialysepatient/* A case of brown tumour of the patella in a 38-year-old woman on long-term haemodialysis since age 12, illustrating a rare complication of secondary hyperparathyroidism in chronic dialysis patients. ## Causal claims require defined interventions: a note on the EQUAL chronic kidney disease–mineral and bone disorder analysis *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01021-X/fulltext · https://hartvaat.nl/2026/03/01/causale-claims-vereisen-gedefinieerde-interventies-kanttekening-bij-ckd-mbd-anal/* This commentary discusses the methodological requirements for causal claims in the EQUAL CKD-mineral and bone disorder analysis, emphasising the need for clearly defined interventions in causal inference frameworks. ## Challenges in revealing the true incidence of end-stage kidney disease in the elderly population *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01003-8/fulltext · https://hartvaat.nl/2026/03/01/uitdagingen-bij-het-bepalen-van-de-werkelijke-incidentie-van-eindstadium-nierzie/* This commentary raises two methodological considerations that could substantially impact estimates of the true incidence of end-stage kidney disease in elderly patients with eGFR below 15 mL/min. ## Coexistence of autosomal dominant polycystic kidney disease and primary hyperoxaluria type 3 *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00738-0/fulltext · https://hartvaat.nl/2026/03/01/adpkd-samen-met-primaire-hyperoxalurie-type-3/* A case of the rare coexistence of autosomal dominant polycystic kidney disease and primary hyperoxaluria type 3 in a 29-year-old woman with recurrent nephrolithiasis, identified through genetic testing. ## Histoplasma capsulatum: a rare cause of interstitial nephritis *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00674-X/fulltext · https://hartvaat.nl/2026/03/01/histoplasma-capsulatum-een-zeldzame-oorzaak-van-interstitiele-nefritis/* A case report of Histoplasma capsulatum as a rare cause of interstitial nephritis in a 46-year-old Brazilian man, presenting with rising creatinine in the context of known interstitial lung disease. ## Is it time to add a fifth pillar to the physical examination in pediatric dialysis? *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00991-3/fulltext · https://hartvaat.nl/2026/03/01/tijd-voor-een-vijfde-pijler-bij-lichamelijk-onderzoek-van-kinderen-aan-dialyse/* This commentary discusses whether it is time to add a fifth pillar to the physical examination in paediatric dialysis, emphasising the high cardiovascular burden and the need for early, personalised preventive strategies targeting fluid overload and hypertension. ## Kidney health for all: caring for people, protecting the planet *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01030-0/fulltext · https://hartvaat.nl/2026/03/01/niergezonheid-voor-iedereen-zorg-voor-mensen-bescherming-van-de-planeet/* This World Kidney Day editorial calls for reshaping kidney care from the current unsustainable model focused on late-stage disease toward early detection, prevention, and environmentally conscious treatment approaches. ## Monoclonal versus monotypic: promoting awareness of terminology and clinical take-aways *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01000-2/fulltext · https://hartvaat.nl/2026/03/01/monoklonaal-versus-monotypisch-bewustwording-van-terminologie-bij-mgrs/* This commentary highlights the importance of distinguishing monoclonal from monotypic immunoglobulin deposits in proliferative glomerulonephritis, with implications for the classification and management of monoclonal gammopathy of renal significance. ## Optimizing CAART for evolving antibody landscapes *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01002-6/fulltext · https://hartvaat.nl/2026/03/01/optimalisatie-van-caart-voor-wisselende-antilichaamlandschappen/* This commentary discusses the preclinical validation of chimeric autoantibody receptor T cells targeting the PLA2 receptor in membranous nephropathy, with considerations for adapting this precision immunotherapy approach to evolving antibody profiles. ## Pathologic diagnosis incorporating molecular monitoring highlights new pathophysiological mechanisms in kidney xenotransplantation *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01040-3/fulltext · https://hartvaat.nl/2026/03/01/pathologische-diagnostiek-met-moleculaire-monitoring-bij-nierxenotransplantatie/* This study used pathologic diagnosis incorporating molecular monitoring to highlight new pathophysiological mechanisms in kidney xenotransplantation, advancing the understanding of long-term graft changes in this emerging field. ## RNA methylation in acute kidney injury: opening up new therapeutic avenues *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01029-4/fulltext · https://hartvaat.nl/2026/03/01/rna-methylering-bij-acuut-nierletsel-nieuwe-therapeutische-mogelijkheden/* This commentary discusses how epithelial methyltransferase-like 1 promotes mitochondrial dysfunction and tubular injury in acute kidney injury through RNA guanosine methylation, identifying a new epigenetic regulatory axis as a potential therapeutic target. ## TSC2/PKD1 contiguous gene deletion syndrome *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00739-2/fulltext · https://hartvaat.nl/2026/03/01/tsc2-pkd1-contigue-gendeletiesyndroom/* A case of the rare TSC2/PKD1 contiguous gene deletion syndrome presenting with hypertension and polycystic kidneys in a 16-year-old, combining features of tuberous sclerosis complex and autosomal dominant polycystic kidney disease. ## The Case | Flaccid paralysis and tetany after chemotherapy: a diagnostic challenge *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00742-2/fulltext · https://hartvaat.nl/2026/03/01/slappe-verlamming-en-tetanie-na-chemotherapie-een-diagnostische-uitdaging/* A diagnostic challenge case of a 75-year-old woman with cervical carcinoma who developed flaccid paralysis and tetany after chemotherapy, illustrating complex electrolyte disturbances requiring systematic evaluation. ## The Case | Unexplained post-transplant graft dysfunction in a rare metabolic disorder *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00669-6/fulltext · https://hartvaat.nl/2026/03/01/onverklaarde-transplantaatdisfunctie-bij-een-zeldzame-metabole-stoornis/* A case report of unexplained post-transplant graft dysfunction in a patient with lysinuric protein intolerance, a rare multisystem disorder caused by defective cationic amino acid transport. ## The authors reply *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01011-7/fulltext · https://hartvaat.nl/2026/03/01/auteurs-reageren-pravastatine-bij-autosomaal-dominante-polycysteuze-nierziekte/* The authors respond to comments on their randomised study of pravastatin for kidney disease outcomes in adults with early-stage autosomal dominant polycystic kidney disease, addressing methodological considerations and clinical implications. ## in this issue *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01041-5/fulltext · https://hartvaat.nl/2026/03/01/in-dit-nummer-xeno-transplantatie-en-moleculaire-respons-bij-orgaantransplantati/* This editorial overview highlights key articles in the issue, including transcript analysis of porcine xenografts in non-human primates revealing progressive replacement of pig endothelial transcripts with host-derived endothelial markers over two years of xenograft survival. ## journal club *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01043-9/fulltext · https://hartvaat.nl/2026/03/01/journal-club-ivaleptische-nefropathie-bij-complement-gemedieerde-trombotische-mi/* This Journal Club discussed the clinical implications of the VALIANT trial results from the New England Journal of Medicine, addressing contemporary treatment approaches in nephrology. ## Annexin A1 exacerbates islet stellate cell activation by regulating triglyceride catabolism via the PPARα/ACOX1/CYP4a pathway. *2026-03-01 · Islets · https://doi.org/10.1080/19382014.2026.2633793 · https://hartvaat.nl/2026/12/31/annexine-a1-verergert-activatie-van-eilandjessterrecellen-via-triglyceridenafbra/* This study demonstrates that annexin A1 exacerbates islet stellate cell activation by regulating triglyceride catabolism via the PPARalpha/ACOX1/CYP4a pathway, contributing to islet fibrosis and diabetes progression. ## Mechanisms linking hypertension to cardiovascular and cerebrovascular diseases and their clinical implications: A comprehensive review. *2026-03-01 · Clinical and experimental hypertension (New York, N.Y. : 1993) · https://doi.org/10.1080/10641963.2026.2631606 · https://hartvaat.nl/2026/12/31/mechanismen-van-hypertensie-tot-hart-en-hersenvaatziekten-een-uitgebreid-overzic/* This comprehensive review summarises how hypertension interacts with obesity, metabolic syndrome, sleep apnoea, and pregnancy to drive coronary heart disease and stroke, discussing blood pressure targets and pharmacotherapy across diverse populations. ## When replacing the kidney, protect the heart *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01005-1/fulltext · https://hartvaat.nl/2026/03/01/bij-niervervanging-bescherm-het-hart/* This Kidney International editorial emphasized that heart protection must be considered when choosing kidney replacement therapy, highlighting the cardiovascular implications of dialysis modality selection. ## Percentiles of estimating glomerular filtration rate: a new personalized tool for detection of chronic kidney disease *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01014-2/fulltext · https://hartvaat.nl/2026/03/01/gepersonaliseerde-gfr-percentielen-een-nieuw-instrument-voor-ckd-detectie/* This editorial discussed age- and sex-specific eGFR percentiles as a new personalized approach to CKD detection, addressing limitations of the fixed 60 mL/min threshold that may miss early kidney disease in younger patients. ## Reassessing pravastatin in adult autosomal dominant polycystic kidney disease and potential subgroup benefits *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01009-9/fulltext · https://hartvaat.nl/2026/03/01/pravastatine-bij-volwassenen-met-adpkd-potentiele-subgroepvoordelen/* This commentary reassessed the evidence for pravastatin in autosomal dominant polycystic kidney disease, discussing potential subgroup benefits and the need for further study of statin effects on cyst growth and kidney function. ## The expanding role of complement inhibitors in the treatment of IgA nephropathy *2026-03-01 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01025-7/fulltext · https://hartvaat.nl/2026/03/01/complementremmers-winnen-terrein-bij-de-behandeling-van-iga-nefropathie/* This editorial discussed complement inhibition as an emerging therapeutic approach for IgA nephropathy, reviewing promising phase 2 results of targeted complement therapies for this common glomerular disease. ## Cardiometabolic index (CMI) and sarcopenia as predictors of all-cause and cardiovascular mortality in chronic kidney disease: a NHANES-based cohort study. *2026-03-01 · Renal failure · https://doi.org/10.1080/0886022X.2026.2624299 · https://hartvaat.nl/2026/12/01/cardiometabole-index-en-sarcopenie-voorspellen-sterfte-bij-chronische-nierziekte/* A NHANES-based cohort study demonstrated that the cardiometabolic index and sarcopenia independently predict all-cause and cardiovascular mortality in CKD patients, with the highest risk when both conditions coexist. ## Effects of time-restricted eating on blood pressure in children: A cluster randomized controlled trial. *2026-03-01 · Clinical and experimental hypertension (New York, N.Y. : 1993) · https://doi.org/10.1080/10641963.2026.2635384 · https://hartvaat.nl/2026/12/31/tijdgebonden-eten-verlaagt-bloeddruk-bij-kinderen-een-clustergerandomiseerde-tri/* A 12-month cluster-randomised trial evaluated the safety and efficacy of a 12-hour time-restricted eating window for reducing blood pressure in children and adolescents, providing evidence for non-pharmacological interventions in paediatric hypertension. ## Impact of hypertension on associations of all-cause mortality with admission lipoprotein (a) in acute decompensated heart failure. *2026-03-01 · International journal of cardiology. Cardiovascular risk and prevention · https://doi.org/10.1016/j.ijcrp.2026.200594 · https://hartvaat.nl/2026/06/01/hypertensie-wijzigt-de-relatie-tussen-lp-a-en-mortaliteit-bij-acuut-gedecompense/* This study demonstrates that hypertension modifies the prognostic value of lipoprotein(a) in patients with acute decompensated heart failure, with the Lp(a)-mortality association differing by blood pressure status. ## Effects of PCSK9 inhibitors on vascular function, lipid profile, and cardiovascular outcomes in patients with peripheral artery disease: A systematic review and meta-analysis. *2026-03-01 · International journal of cardiology. Cardiovascular risk and prevention · https://doi.org/10.1016/j.ijcrp.2026.200590 · https://hartvaat.nl/2026/06/01/pcsk9-remmers-bij-perifeer-vaatlijden-meta-analyse-toont-vaatfunctie-en-lipidevo/* A systematic review and meta-analysis evaluated the effects of PCSK9 inhibitors on vascular function, lipid profile, and cardiovascular outcomes specifically in patients with peripheral artery disease who fail to reach targets on statin therapy alone. ## Ezetimibe alone for over 75 years old as a primary prevention to decrease cardiovascular events. *2026-03-01 · Annals of medicine · https://doi.org/10.1080/07853890.2026.2634484 · https://hartvaat.nl/2026/12/01/ezetimibe-als-monotherapie-voor-primaire-preventie-bij-75-plussers/* The EWTOPIA 75 study demonstrated that ezetimibe monotherapy reduces atherosclerotic cardiovascular disease events in adults aged 75 and older without prior coronary artery disease. The evidence, now incorporated into the 2025 ESC/EAS guidelines, supports cholesterol absorption inhibition as an effective primary prevention strategy in the elderly. ## Lower LDL-C, lower risk of recurrent cardiovascular events in stroke survivors. *2026-03-01 · The American journal of nursing · https://doi.org/10.1097/AJN.0000000000000261d · https://hartvaat.nl/2026/03/01/lager-ldl-c-verlaagt-risico-op-recidief-cardiovasculaire-events-bij-cva-patiente/* This brief report confirms that stroke survivors benefit from more aggressive LDL-cholesterol lowering, with lower LDL-C levels associated with fewer recurrent cardiovascular events. ## Physical Activity Modifies the Association between C-Reactive Protein - Triglyceride - Glucose Index (CTI) and Dyslipidemia: Evidence from a 10-Year Chinese Cohort. *2026-03-01 · Journal of sports science & medicine · https://doi.org/10.52082/jssm.2026.112 · https://hartvaat.nl/2026/03/01/lichaamsbeweging-beinvloedt-de-relatie-tussen-crp-triglyceriden-en-coronaire-ath/* A 10-year Chinese cohort study demonstrated that regular physical activity significantly modifies the association between the CRP-triglyceride-glucose index and dyslipidaemia, emphasising the importance of an active lifestyle alongside lipid-lowering medication. ## Association of Elevated Lipoprotein(a) and Diabetes Mellitus With Survival Outcomes in Patients With Coronary Artery Disease: Findings From the CIN-II and RED-CARPET Cohorts. *2026-02-27 · Diabetes, obesity & metabolism · https://doi.org/10.1111/dom.70603 · https://hartvaat.nl/2026/02/27/verhoogd-lp-a-en-diabetes-verergeren-samen-de-prognose-bij-coronairlijden/* Analysis of over 65,000 patients with coronary artery disease demonstrated that the combination of elevated lipoprotein(a) and diabetes mellitus is associated with significantly worse survival than either risk factor alone. The findings support combined Lp(a) and metabolic risk assessment in daily clinical practice. ## Artificial intelligence-based clustering to identify functional risk phenotypes in heart failure *2026-02-26 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003530?rss=1 · https://hartvaat.nl/2026/02/26/ai-clustering-onthult-drie-functionele-risicoprofielen-bij-hartfalen/* Patients with heart failure (HF) often have undetected declines in cardiorespiratory fitness (CRF), increasing the risk of poor outcomes, but tools for early CRF risk stratification are lacking. In this study, unsupervised AI clustering on 15 multimodal variables (metabolic, inflammatory and body-composition measures) in 505 HF patients sought phenotypes, with external validation in 201 patients. Three phenotypes emerged: 'balanced', 'inflammatory-sarcopenic' and 'metabolically dysregulated'. Both non-balanced phenotypes had clearly higher odds of impaired CRF (peak oxygen uptake ≤20 mL/kg/min). The best predictive models reached an AUC of about 0.75. Combining multimodal data with AI clustering thus yields an interpretable model for early functional risk stratification — a basis for more targeted rehabilitation in heart failure. ## Characterising the phenotype and outcomes of cascade-tested relatives of probands with hypertrophic cardiomyopathy *2026-02-26 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003557?rss=1 · https://hartvaat.nl/2026/02/26/cascadescreening-bij-hypertrofische-cardiomyopathie-genotype-positieve-familiele/* In hypertrophic cardiomyopathy (HCM) due to a pathogenic sarcomere variant, cascade screening of relatives is recommended, but outcomes in such relatives are little studied. In this retrospective cohort (64 families, 280 patients, NHS Tayside, 2010-2018), the occurrence of a major adverse cardiac event (MACE) was examined. Asymmetrical septal hypertrophy meeting diagnostic criteria occurred in 35.4% of cascade-tested individuals. The adjusted septal thickness of genotype-positive relatives (13.9 mm) lay between that of probands (22.1 mm) and genotype-negative relatives (12.3 mm). Cardiac event risk was also intermediate: lower than probands but higher than genotype-negative relatives. Genotype-positive cascade-tested relatives thus retain a degree of complication risk, justifying their identification and follow-up. ## HIV infection is independently associated with carotid plaque burden and echogenic characteristics *2026-02-26 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003853?rss=1 · https://hartvaat.nl/2026/02/26/hiv-infectie-hangt-onafhankelijk-samen-met-meer-en-kwetsbaardere-halsslagaderpla/* People with HIV are at increased cardiovascular risk, but data from Asian populations are limited. In this cross-sectional study (Shanghai; 1,390 people with HIV and 1,390 age- and sex-matched people without HIV, aged ≥40), carotid ultrasonography assessed plaque presence and characteristics. Plaques were more common in people with HIV (45.3% vs 37.5%), as were echo-lucent (vulnerable) plaques (21.1% vs 18.0%); they also more often had three or more plaques and greater maximum plaque thickness. After adjustment for age, sex and dyslipidaemia, HIV remained independently associated with plaques (aOR 1.45) and echo-lucent plaques (aOR 1.24), strongest in men and younger participants. HIV infection is thus associated with accelerated atherosclerosis beyond traditional risk factors — supporting routine cardiovascular risk assessment and early prevention in people with HIV. ## Kidney health and blood pressure after very preterm birth: a cohort study at school age. *2026-02-26 · Pediatric nephrology (Berlin, Germany) · https://doi.org/10.1007/s00467-026-07190-0 · https://hartvaat.nl/2026/02/26/niergezondheid-en-bloeddruk-op-schoolleeftijd-na-zeer-vroeggeboorte/* A cohort study of school-age children born very preterm (under 32 weeks) identified subtle kidney function and blood pressure abnormalities that may precede clinically apparent kidney disease in later life, with perinatal and nutritional factors contributing. ## Another brick in the wall of severe hypertriglyceridaemia lowering. *2026-02-26 · European heart journal · https://doi.org/10.1093/eurheartj/ehag124 · https://hartvaat.nl/2026/02/26/weer-een-stap-vooruit-in-de-verlaging-van-ernstige-hypertriglyceridemie/* This European Heart Journal editorial commented on advances in treating severe hypertriglyceridemia, discussing the growing pipeline of APOC3- and ANGPTL3-targeted therapies for this difficult lipid disorder. ## Long-term incidence of atrial fibrillation and cardiovascular outcomes in men and women with sinus rhythm: a 20-year follow-up of the INTERGENE population-based cohort *2026-02-25 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003944?rss=1 · https://hartvaat.nl/2026/02/25/langetermijnincidentie-van-atriumfibrilleren-en-het-risico-op-beroerte-20-jaar-f/* Estimates of long-term atrial fibrillation (AF) incidence in people with sinus rhythm are limited. In the Swedish population-based INTERGENE study, 2,967 AF-free participants (mean age 50.7, 53% female) were followed for over 20 years. During 53,447 person-years, 12.0% developed AF (incidence 6.66 per 1,000 person-years). At 20 years, cumulative AF incidence (accounting for competing death) was 2.1% in those younger than 45 at baseline, 13.3% at 45-65 and 29.5% above 65; men had higher incidence in all age groups. Incident AF was associated with ischaemic stroke (HR 1.80) and overall cardiovascular disease (HR 2.07). AF is thus a common long-term outcome, especially in older adults and men, associated with increased stroke and cardiovascular risk — arguing for age- and sex-specific risk stratification and early AF detection. ## Forecasting the Burden of Cardiovascular Disease and Stroke in Women in the United States Through 2050: A Scientific Statement From the American Heart Association *2026-02-25 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001406 · https://hartvaat.nl/2026/02/25/voorspelling-cardiovasculaire-ziektelast-bij-vrouwen-in-de-vs-tot-2050/* This AHA scientific statement provided forecasts for cardiovascular disease and stroke prevalence in women through 2050, highlighting projected increases driven by aging, obesity, and diabetes, and informing prevention strategies targeting women's cardiovascular health. ## Alcohol Consumption and Incident Atrial Fibrillation: Rethinking Dose, Risk, and Dogma. *2026-02-25 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag029 · https://hartvaat.nl/2026/02/25/alcoholgebruik-en-het-ontstaan-van-atriumfibrilleren-dosis-risico-en-dogma-herov/* This Europace overview reconsidered the relationship between alcohol consumption and AF risk, challenging some traditional assumptions about safe consumption levels and arguing for a more nuanced understanding of dose-response. ## The updated global burden of chronic kidney disease: one death every 20 seconds. *2026-02-25 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag040 · https://hartvaat.nl/2026/02/25/de-mondiale-ziektelast-van-chronische-nierziekte-elke-20-seconden-een-sterfgeval/* This Global Burden of Disease update projected that CKD mortality will increase by more than 50% in the coming decades, with one death every 20 seconds globally, underscoring the urgency of kidney disease prevention. ## The prevalence of obesity and hypertension in paediatric cardiology patients before and after COVID-19 lockdown measures. *2026-02-25 · European journal of pediatrics · https://doi.org/10.1007/s00431-026-06816-7 · https://hartvaat.nl/2026/02/25/obesitas-en-hypertensie-bij-kindercardiologiepatienten-voor-en-na-covid-19-lockd/* A retrospective audit at the East Midlands Congenital Heart Centre found increased prevalence of obesity and hypertension in paediatric cardiology patients after COVID-19 lockdown measures, with these comorbidities often under-recognised and undertreated. ## Haemodynamic and Blood Viscosity Profiles of Culprit vs. Non-Culprit Coronary Vessels: Insights from NIRS-IVUS and CFD Analysis *2026-02-25 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00056-0/fulltext · https://hartvaat.nl/2026/02/25/hemodynamische-en-bloedviscositeitsprofielen-van-culprit-versus-non-culprit-coro/* Using combined NIRS-IVUS imaging and computational fluid dynamics, this study compared haemodynamic and blood viscosity profiles between culprit and non-culprit coronary vessels, providing new insights into plaque vulnerability mechanisms. ## Klotho in the kidney distal convolution regulates urinary Klotho excretion and kidney calcium reabsorption, but not phosphate homeostasis. *2026-02-25 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00142-0/fulltext · https://hartvaat.nl/2026/02/25/klotho-in-het-distale-nefron-reguleert-calciumreabsorptie-maar-niet-fosfaathomeo/* This study demonstrates that Klotho in the kidney distal convolution regulates urinary Klotho excretion and calcium reabsorption but does not directly participate in phosphate homeostasis, refining understanding of Klotho biology. ## Assessing the burden and inequality in the unmet need for hypertension and type 2 diabetes care using a care cascade framework in Tanzania, Lesotho, and South Africa. *2026-02-25 · Primary health care research & development · https://doi.org/10.1017/S1463423626100978 · https://hartvaat.nl/2026/02/25/onvervulde-zorgbehoefte-bij-hypertensie-en-diabetes-in-sub-sahara-afrika/* Using a care cascade framework, this study assessed the prevalence and inequality in unmet care needs for hypertension and diabetes in Tanzania, Lesotho, and South Africa, mapping access gaps in regions with rapidly rising non-communicable disease burden. ## Outcomes of heart failure with reduced, mildly reduced, or preserved ejection fraction: the ESC HF III registry. *2026-02-25 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1074 · https://hartvaat.nl/2026/02/25/uitkomsten-van-hartfalen-naar-ejectiefractie-het-esc-hf-iii-register/* The ESC Heart Failure III Registry followed 10,162 patients across 41 countries with HFrEF, HFmrEF, and HFpEF, providing contemporary real-world data on in-hospital and 1-year outcomes across the heart failure spectrum in routine clinical practice. ## FOXO1 Integrates Endothelial Hemodynamic, Inflammatory, and Metabolic Pathways in Atherosclerosis. *2026-02-25 · Circulation research · https://doi.org/10.1161/CIRCRESAHA.125.327592 · https://hartvaat.nl/2026/02/25/foxo1-als-schakel-tussen-hemodynamiek-inflammatie-en-metabolisme-in-atherosclero/* This basic science study revealed how the transcription factor FOXO1 integrates hemodynamic, inflammatory, and metabolic pathways in endothelial cells to protect against atherosclerosis, identifying a master regulator of vascular health. ## Pyelonephritis decreases serum cholesterol and mitigates atherosclerosis severity despite systemic inflammation. *2026-02-25 · American journal of physiology. Heart and circulatory physiology · https://doi.org/10.1152/ajpheart.00914.2025 · https://hartvaat.nl/2026/02/25/pyelonefritis-verlaagt-serumcholesterol-en-remt-atherosclerose-ondanks-systemisc/* In LDL receptor-deficient mice, pyelonephritis paradoxically lowered serum cholesterol and reduced atherosclerosis despite systemic inflammation, through hepatic PCSK9 downregulation — providing unexpected insights into infection-lipid metabolism interactions. ## Real-world management of familial hypercholesterolemia in paediatric patients: a 3-year follow-up from the LIPIGEN registry *2026-02-25 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00057-2/fulltext · https://hartvaat.nl/2026/02/25/behandeling-van-familiaire-hypercholesterolemie-bij-kinderen-3-jaar-lipigen-regi/* Data from the Italian LIPIGEN registry describe the timing, pharmacological approach, and early outcomes of lipid-lowering therapy initiation in children with familial hypercholesterolaemia. Early identification and treatment are crucial for reducing lifetime cardiovascular risk. ## Diagnostic delay and phenotypic differences in cardiac sarcoidosis: a descriptive study of diagnostic and follow-up clinical data *2026-02-24 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003934?rss=1 · https://hartvaat.nl/2026/02/24/cardiale-sarcoidose-als-eerste-uiting-van-sarcoidose-verloopt-ernstiger/* Worse prognosis in cardiac sarcoidosis (CS) is likely linked to diagnostic delay and to cardiac first presentation ('de novo'). In this retrospective study (95 CS patients, 2003-2024), the median time from first symptoms to diagnosis was 9 months. Patients with diagnostic delay more often received a CRT defibrillator. Time to diagnosis did not differ between de novo CS (n=49) and patients with prior extracardiac sarcoidosis (n=46), but de novo patients more often had severe symptoms at onset. At a median 46 months, de novo patients more often had reduced ejection fraction and an ICD than those with prior extracardiac sarcoidosis — despite more immunosuppressive therapy. Disease thus runs a more severe course when cardiac sarcoidosis is the first manifestation, and may not be adequately altered by immunosuppression. ## Systemic Embolic Events in Atrial Fibrillation: An Individual Patient Data Meta-analysis of 71 683 Participants Randomized to NOAC Versus Warfarin. *2026-02-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.075275 · https://hartvaat.nl/2026/02/24/systemische-embolieen-bij-af-ipd-mega-meta-analyse-van-71-683-patienten/* This individual patient data meta-analysis of over 71,000 AF patients characterized systemic embolic events, showing that NOACs effectively prevent both stroke and non-cerebral embolism compared with warfarin. ## From biobank to prediction: polygenic risk scores for peripheral artery disease. *2026-02-24 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1042 · https://hartvaat.nl/2026/02/24/van-biobank-naar-voorspelling-polygenetische-risicoscores-voor-perifeer-vaatlijd/* This European Heart Journal article explored the use of polygenic risk scores for predicting peripheral artery disease, testing whether genetic risk stratification can improve identification of individuals at risk for this common vascular condition. ## Association of Perinatal HIV Exposure and HIV Disease Severity With BP in Youth *2026-02-24 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.24937 · https://hartvaat.nl/2026/02/24/perinatale-hiv-blootstelling-en-hiv-ernst-geassocieerd-met-bloeddruk-bij-jongere/* This study compared blood pressure between youth with and without perinatally acquired HIV infection and evaluated whether HIV disease severity influences blood pressure. The findings inform cardiovascular risk monitoring in the growing population of young people living with HIV. ## Impact of Coronary Artery Disease Patterns Assessed with Pullback Pressure Gradient on Clinical Outcomes: Meta-analysis *2026-02-24 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00054-7/fulltext · https://hartvaat.nl/2026/02/24/invloed-van-coronaire-ziekte-patronen-op-klinische-uitkomsten-pullback-pressure-/* A meta-analysis assessed the prognostic impact of the pullback pressure gradient index for quantitatively characterising focal versus diffuse coronary artery disease patterns. The physiological assessment adds prognostic value to standard coronary evaluation. ## Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association *2026-02-24 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001405 · https://hartvaat.nl/2026/02/24/ondervoeding-en-cachexie-bij-opgenomen-patienten-met-acute-cardiale-aandoeningen/* This AHA scientific statement addressed malnutrition and cachexia in patients with acute cardiovascular conditions beyond heart failure, covering assessment, management, and the impact of nutritional status on clinical outcomes across the spectrum of acute cardiac disease. ## Outcome-Based Cardiovascular Risk Framework is Required After Spinal Cord Injury *2026-02-24 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26543 · https://hartvaat.nl/2026/02/24/uitkomstgericht-cardiovasculair-risicoframework-nodig-na-dwarslaesie/* This article highlighted the need for an outcome-based cardiovascular risk framework after spinal cord injury, where blood pressure instability and autonomic dysfunction create unique cardiovascular challenges. ## Polygenic Risk Scores and HLA Class II Variants are Biomarkers of Corticosteroid Response in Childhood Nephrotic Syndrome *2026-02-24 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00134-1/fulltext · https://hartvaat.nl/2026/02/24/polygene-risicoscores-en-hla-klasse-ii-als-biomarkers-voor-corticosteroidrespons/* This study identified polygenic risk scores and HLA class II variants as biomarkers for predicting corticosteroid response in childhood nephrotic syndrome, potentially enabling treatment stratification at initial presentation. ## Circulating S100A8/A9 drives faster platelet COX-1 recovery via MRP4, impairing the duration of aspirin response. *2026-02-24 · Blood advances · https://doi.org/10.1182/bloodadvances.2025017653 · https://hartvaat.nl/2026/02/24/s100a8-a9-versnelt-cox-1-herstel-in-bloedplaatjes-en-beperkt-aspirinerespons/* This study reveals that circulating S100A8/A9 accelerates platelet COX-1 recovery via the MRP4 transporter, shortening the duration of aspirin-mediated thromboxane suppression. The thromboinflammatory mechanism has implications for individualising cardiovascular prevention. ## Cystatin C in chronic kidney disease: enhancing diagnostic accuracy and patient outcomes. *2026-02-24 · Postgraduate medicine · https://doi.org/10.1080/00325481.2026.2634426 · https://hartvaat.nl/2026/02/24/cystatine-c-bij-chronische-nierziekte-betere-diagnostiek-en-patientuitkomsten/* This review discusses the diagnostic advantages of cystatin C over creatinine for estimating GFR in chronic kidney disease, particularly in elderly patients, those with muscle disease, and across racial and ethnic diversity. ## Effects of Microplastics and Nanoplastics on the Kidneys. *2026-02-24 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag034 · https://hartvaat.nl/2026/02/24/effecten-van-micro-en-nanoplastics-op-de-nieren/* This review describes the nephrotoxic effects of micro- and nanoplastics, which can enter the bloodstream and reach the kidneys. The findings raise concerns about renal consequences of chronic environmental plastic exposure. ## Mfsd2a is important for maintaining epidermal homeostasis. *2026-02-24 · Proceedings of the National Academy of Sciences of the United States of America · https://doi.org/10.1073/pnas.2531159123 · https://hartvaat.nl/2026/02/24/mfsd2a-is-essentieel-voor-de-epidermale-homeostase/* This study demonstrates that the lipid transporter Mfsd2a plays a crucial role in maintaining epidermal barrier function by facilitating linoleate uptake for acylceramide synthesis, with implications for skin diseases. ## Rebuttal: aortic coarctation and concomitant anomalies - left circumflex fistula, persistent left SVC and ventricular diverticulum. *2026-02-24 · BMJ case reports · https://doi.org/10.1136/bcr-2025-265520 · https://hartvaat.nl/2026/02/24/aortacoarctatie-met-zeldzame-congenitale-afwijkingen-casuistiek/* A case report of an adolescent with aortic coarctation accompanied by rare congenital anomalies including a left circumflex coronary fistula, persistent left superior vena cava, and ventricular diverticulum. ## Systemic effects of metabolic acidosis. *2026-02-24 · Clinical nephrology · https://doi.org/10.5414/CN111953 · https://hartvaat.nl/2026/02/24/systemische-effecten-van-metabole-acidose/* This literature review synthesises the systemic effects of metabolic acidosis on cardiovascular, vascular, pulmonary, and renal systems, with particular clinical implications for patients with chronic kidney disease. ## [Menopausal transition]. *2026-02-24 · Nederlands tijdschrift voor geneeskunde · https://doi.org/https://pubmed.ncbi.nlm.nih.gov/41718673/ · https://hartvaat.nl/2026/02/24/de-overgang-naar-de-menopauze-tien-klinische-vragen-beantwoord/* This educational article in the Nederlands Tijdschrift voor Geneeskunde answers ten common clinical questions about the menopausal transition, covering aetiology, symptoms, laboratory evaluation, sexuality, contraception, and the risks and benefits of hormonal and non-hormonal treatments. ## Risk of Heart Failure Hospitalization for GLP-1 Receptor Agonists Versus DPP-4 Inhibitors or SGLT-2 Inhibitors in Patients With Type 2 Diabetes: A Target Trial Emulation *2026-02-24 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075157 · https://hartvaat.nl/2026/02/24/glp-1-agonisten-versus-dpp-4-remmers-en-sglt2-remmers-bij-hartfalenrisico/* This target trial emulation using Swedish population data compared GLP-1 receptor agonists with DPP-4 inhibitors and SGLT2 inhibitors for heart failure hospitalization risk in type 2 diabetes, providing real-world comparative effectiveness data for cardiometabolic drug selection. ## Atrial fibrillation-induced severe left ventricular dysfunction postmitral valve replacement in an adolescent with rheumatic mitral regurgitation. *2026-02-24 · BMJ case reports · https://doi.org/10.1136/bcr-2025-267313 · https://hartvaat.nl/2026/02/24/af-geinduceerde-ernstige-lv-disfunctie-na-mitralisklepprocedure-bij-adolescent/* A case report of an adolescent with rheumatic heart disease who developed severe left ventricular dysfunction (LVEF 14%) four months after mechanical mitral valve replacement due to atrial fibrillation with rapid ventricular response. ## Extended CTA scan range for early detection of left atrial and left atrial appendage thrombus and other filling defects in acute ischemic stroke. *2026-02-24 · Journal of neurology · https://doi.org/10.1007/s00415-026-13692-6 · https://hartvaat.nl/2026/02/24/uitgebreid-cta-bereik-detecteert-vroegtijdig-thrombus-in-het-linker-atrium-bij-a/* By extending CT angiography scan range to include the left atrium and appendage during acute stroke imaging, this study detected filling defects in 13% of patients. These patients had more severe strokes and higher mortality, suggesting therapeutic implications for early detection. ## Colchicine in patients with chronic inflammatory cardiomyopathy: Rationale and design of the CMP-MYTHiC. *2026-02-24 · ESC heart failure · https://doi.org/10.1093/eschf/xvag058 · https://hartvaat.nl/2026/02/24/colchicine-bij-chronische-inflammatoire-cardiomyopathie-de-cmp-mythic-trial/* This article described the rationale and design of the CMP-MYTHiC trial testing colchicine in chronic inflammatory cardiomyopathy, exploring anti-inflammatory therapy for a condition characterized by persistent myocardial inflammation and arrhythmia risk. ## Interventions to promote patient utilisation of cardiac rehabilitation. *2026-02-24 · The Cochrane database of systematic reviews · https://doi.org/10.1002/14651858.CD007131.pub5 · https://hartvaat.nl/2026/02/24/cochrane-review-interventies-om-deelname-aan-hartrevalidatie-te-bevorderen/* This updated Cochrane review of 47 trials evaluated interventions to promote cardiac rehabilitation utilization, finding that motivational approaches, early appointment scheduling, and automatic referral increase participation rates. ## Renal Denervation Improves Hepatic Steatosis in Hypertensive Patients With Metabolic Syndrome *2026-02-24 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26601 · https://hartvaat.nl/2026/02/24/renale-denervatie-verbetert-leververvetting-bij-hypertensieve-patienten-met-meta/* This study showed that renal denervation improves hepatic steatosis in hypertensive patients with metabolic syndrome, demonstrating that sympathetic nervous system modulation has metabolic benefits beyond blood pressure reduction. ## Early outcomes from a new multidisciplinary cardiometabolic clinic: real-world experience in lowering low-density lipoprotein cholesterol. *2026-02-24 · Internal medicine journal · https://doi.org/10.1111/imj.70334 · https://hartvaat.nl/2026/02/24/multidisciplinaire-cardiometabole-kliniek-ldl-c-verlaging-in-de-dagelijkse-prakt/* Real-world data from the first 200 patients at a new multidisciplinary cardiometabolic clinic demonstrate effective LDL-cholesterol lowering with PCSK9 inhibitors in patients with FH and cardiovascular disease who fail to reach targets on statins alone. ## Intracoronary Imaging and Transcriptomic Characteristics Before and After Maximum Lipid-Lowering Therapy: YELLOW-III Study of Evolocumab and Maximum Statin Therapy in Chronic Coronary Disease. *2026-02-24 · JACC. Cardiovascular imaging · https://doi.org/10.1016/j.jcmg.2025.12.013 · https://hartvaat.nl/2026/02/24/yellow-iii-intracoronaire-beeldvorming-en-genexpressie-na-maximale-lipideverlagi/* The YELLOW-III study used intracoronary imaging and transcriptomic analysis to characterize the effects of evolocumab on coronary plaque composition at the molecular level, providing the deepest mechanistic insight into PCSK9 inhibitor-mediated plaque stabilization. ## Lipoprotein(a) levels in children with hypercholesterolemia. *2026-02-24 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag126 · https://hartvaat.nl/2026/02/24/lp-a-spiegels-bij-kinderen-met-hypercholesterolemie-impact-op-ldl-c-interpretati/* This study showed that lipoprotein(a) contributes substantially to measured LDL cholesterol in children with hypercholesterolemia, complicating the interpretation of lipid panels and potentially leading to overestimation of true LDL levels. ## The impact of lipid apheresis on changes of lipoprotein(a): a systematic review and meta-analysis. *2026-02-24 · European journal of preventive cardiology · https://doi.org/10.1093/eurjpc/zwag089 · https://hartvaat.nl/2026/02/24/lipide-aferese-verlaagt-lp-a-met-60-75-systematische-review-en-meta-analyse/* This meta-analysis evaluated the impact of lipid apheresis on lipoprotein(a) levels, quantifying the Lp(a) reduction achieved with this established extracorporeal therapy while awaiting pharmacological Lp(a)-lowering agents. ## Impact of invasive coronary function testing on management of ANOCA patients and secondary care resource utilisation: a multicentre retrospective study in the UK *2026-02-23 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003910?rss=1 · https://hartvaat.nl/2026/02/23/invasieve-coronaire-functietest-bij-anoca-verandert-de-behandeling-bij-driekwart/* Invasive coronary function testing (CFT) is indicated in refractory angina with non-obstructed coronary arteries (ANOCA), but patient selection, safety and place in the pathway remain unclear. In this retrospective multicentre study (159 patients, two UK centres), patients were tested for microvascular dysfunction (CMD) and coronary vasospasm (vasospastic angina, VSA). An ANOCA endotype was found in 63.5%: 23.8% isolated CMD, 52.4% isolated VSA and 23.8% mixed. Intraprocedural complications were rare (3.1%). CFT led to a change in medication in 77.3%. Rehospitalisation for chest pain occurred in 21.7% (CFT-positive) versus 13.7% (CFT-negative); VSA was associated with more and earlier rehospitalisations (OR 2.64). CFT is thus safe and guides treatment, but rehospitalisation for chest pain is frequent — arguing for early follow-up and medication optimisation. ## Withdrawal of aspirin in patients with left ventricular assist device treated with vitamin K antagonists: impact of anticoagulation quality in the randomized ARIES-HM3 trial. *2026-02-23 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf745 · https://hartvaat.nl/2026/02/23/aspirinestop-bij-lvad-met-vka-veiligheidsanalyse/* This study showed that withdrawing aspirin in LVAD patients on vitamin K antagonists is safe with fewer bleeding events, supporting simplification of the antithrombotic regimen in mechanically supported patients. ## Benefit-risk of colchicine and spironolactone in acute myocardial infarction: a prespecified generalised pairwise comparisons analysis of the CLEAR trial. *2026-02-23 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-326218 · https://hartvaat.nl/2026/02/23/colchicine-en-spironolacton-bij-acuut-mi-voordeel-risico-analyse/* This prespecified generalized pairwise comparison analysis of CLEAR SYNERGY assessed the combined benefit-risk of colchicine and spironolactone after MI, providing a more nuanced evaluation than conventional composite endpoints. ## The year in cardiovascular medicine 2025: the top 10 papers in ischaemic heart disease. *2026-02-23 · European heart journal · https://doi.org/10.1093/eurheartj/ehag028 · https://hartvaat.nl/2026/02/23/het-jaar-in-de-cardiovasculaire-geneeskunde-2025-top-10-publicaties-ischemische-/* This European Heart Journal annual review highlighted the top 10 papers of 2025 in ischemic heart disease, providing an expert-curated summary of the most impactful developments in coronary artery disease research. ## Immunoadsorption in dilated cardiomyopathy: the IASO-DCM trial. *2026-02-23 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1055 · https://hartvaat.nl/2026/02/23/immunoadsorptie-bij-gedilateerde-cardiomyopathie-de-iaso-dcm-trial/* The IASO-DCM trial investigated immunoadsorption as a treatment for dilated cardiomyopathy with cardiac autoantibodies, exploring a novel immunomodulatory approach to this form of heart failure. ## AI adoption in cardiology: regulation at a global crossroad *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/295?rss=1 · https://hartvaat.nl/2026/02/23/ai-adoptie-in-de-cardiologie-regulering-op-een-mondiaal-kruispunt/* This commentary discussed the global regulatory landscape for AI adoption in cardiology, highlighting the crossroads between enabling innovation and ensuring patient safety across different regulatory frameworks. ## Abnormal echocardiographic finding: what is the cystic mass in a young woman with secundum atrial septal defect *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/350?rss=1 · https://hartvaat.nl/2026/02/23/cysteuze-massa-bij-een-jonge-vrouw-met-atriumseptumdefect/* A diagnostic case of a woman in her thirties with an unexpected cystic mass identified on echocardiography in the setting of a secundum atrial septal defect, illustrating the differential diagnosis of intracardiac cystic lesions. ## Accelerometry-defined physical activity and quality of life in hypertrophic cardiomyopathy *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/333?rss=1 · https://hartvaat.nl/2026/02/23/objectief-gemeten-lichaamsbeweging-en-levenskwaliteit-bij-hypertrofische-cardiom/* This study used accelerometry to objectively measure physical activity in HCM patients, showing that reduced activity levels are associated with worse quality of life and challenging the assumption that exercise restriction improves safety. ## Comparative evaluation of biological and mechanical prostheses for aortic valve replacement in a middle-aged population: a population-based cohort study *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/341?rss=1 · https://hartvaat.nl/2026/02/23/biologische-versus-mechanische-prothesen-bij-aortaklepvervanging-op-middelbare-l/* This population-based study compared biological and mechanical prostheses for aortic valve replacement in middle-aged patients, addressing the lack of guideline consensus on prosthesis selection in this age group. ## Correction to: Pragmatic Approaches to the Evaluation and Monitoring of Artificial Intelligence in Health Care: A Science Advisory From the American Heart Association *2026-02-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001418 · https://hartvaat.nl/2026/02/23/correctie-ai-evaluatie-en-monitoring-in-de-gezondheidszorg-aha/* Correction to the AHA Science Advisory on pragmatic approaches to evaluating and monitoring artificial intelligence in healthcare. ## Electrocardiographic imaging: technical developments and future applications for non-invasive electroanatomical study of the human heart *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/307?rss=1 · https://hartvaat.nl/2026/02/23/elektrocardiografische-beeldvorming-technische-ontwikkelingen-en-toekomst/* This review described electrocardiographic imaging (ECGI) as a non-invasive technique combining patient-specific cardiac anatomy with body-surface potentials, discussing current technical developments and future clinical applications. ## Letter by Huang and Fogacci Regarding Article, “High-Volume Physical Activity and Clinical Coronary Artery Disease Outcomes: Findings From the Cooper Center Longitudinal Study” *2026-02-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075723 · https://hartvaat.nl/2026/02/23/brief-over-intensieve-lichaamsbeweging-en-coronaire-uitkomsten-huang-fogacci/* Huang and Fogacci submit a letter regarding the article on high-volume physical activity and clinical coronary artery disease outcomes from the Cooper Center Longitudinal Study. ## Letter by Xie et al Regarding Article, “High-Volume Physical Activity and Clinical Coronary Artery Disease Outcomes: Findings From the Cooper Center Longitudinal Study” *2026-02-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075503 · https://hartvaat.nl/2026/02/23/brief-over-intensieve-lichaamsbeweging-en-coronaire-uitkomsten-xie-et-al/* Xie et al. submit a letter regarding the article on high-volume physical activity and clinical coronary artery disease outcomes from the Cooper Center Longitudinal Study. ## Response by Berry et al to Letter Regarding Article, “High-Volume Physical Activity and Clinical Coronary Artery Disease Outcomes: Findings From the Cooper Center Longitudinal Study” *2026-02-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077402 · https://hartvaat.nl/2026/02/23/reactie-op-brief-over-intensieve-lichaamsbeweging-en-coronaire-uitkomsten/* Berry et al. respond to correspondence regarding their article on high-volume physical activity and clinical coronary artery disease outcomes from the Cooper Center Longitudinal Study. ## Effect of semaglutide on COVID-19 and other infections: an analysis from the FLOW randomized clinical trial. *2026-02-23 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag036 · https://hartvaat.nl/2026/02/23/semaglutide-vermindert-infectierisico-bij-diabetes-en-chronische-nierziekte/* This FLOW trial analysis showed that semaglutide reduces the risk of COVID-19 and other infections in patients with type 2 diabetes and CKD, demonstrating an unexpected anti-infectious benefit of GLP-1 receptor agonism. ## From global guidelines for cardio-kidney-metabolic diseases management to national implementation: perspectives from the guideline workshop taskforce. *2026-02-23 · Cardiovascular diabetology · https://doi.org/10.1186/s12933-026-03098-z · https://hartvaat.nl/2026/02/23/van-internationale-richtlijnen-naar-nationale-implementatie-bij-cardio-renaal-me/* This perspective article from a multidisciplinary guideline workshop discusses translating international guidelines for cardio-kidney-metabolic diseases into national clinical practice. Key barriers include linguistic adaptation, limited clinician communication, and siloed reimbursement processes. ## How and Why Telehealth Interventions Improve Self-Care Among Vulnerable Groups of Patients With Heart Failure: Scoping Review and Rapid Realist Synthesis. *2026-02-23 · JMIR human factors · https://doi.org/10.2196/78859 · https://hartvaat.nl/2026/02/23/telehealth-verbetert-zelfzorg-bij-kwetsbare-hartfalenpatienten/* A scoping review and rapid realist synthesis examined how and why telehealth interventions improve self-care among vulnerable groups of heart failure patients in Canada, identifying key mechanisms of benefit. ## Polygenic and Monogenic Contributions to Tachycardia-Associated Cardiomyopathy *2026-02-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076235 · https://hartvaat.nl/2026/02/23/polygene-en-monogene-bijdragen-aan-tachycardie-geassocieerde-cardiomyopathie/* This Circulation study analyzed the polygenic and monogenic genetic contributions to tachycardia-associated cardiomyopathy, revealing shared and distinct genetic pathways underlying this reversible form of heart failure. ## Inhibiting Fatty Acid Oxidation With a Mitotrope in Heart Failure With Preserved Ejection Fraction *2026-02-23 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.078151 · https://hartvaat.nl/2026/02/23/remming-van-vetzuuroxidatie-bij-hartfalen-met-behouden-ejectiefractie/* This Circulation article explored the role of a mitotrope (fatty acid oxidation inhibitor) in treating HFpEF, investigating a novel metabolic mechanism targeting cardiac energy substrate utilization. ## Benefit-risk of colchicine and spironolactone in acute myocardial infarction: a prespecified generalised pairwise comparisons analysis of the CLEAR trial *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/326?rss=1 · https://hartvaat.nl/2026/02/23/colchicine-en-spironolacton-bij-acuut-myocardinfarct-winratio-analyse-uit-de-cle/* This prespecified CLEAR SYNERGY analysis used generalized pairwise comparisons to assess the benefit-risk of colchicine and spironolactone after acute MI, finding net clinical benefit for colchicine but not for routine spironolactone. ## Impact of air pollution and multimorbidity on the risk of incident atrial fibrillation *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/318?rss=1 · https://hartvaat.nl/2026/02/23/luchtvervuiling-en-multimorbiditeit-verhogen-het-risico-op-atriumfibrilleren/* This UK Biobank study of 480,000 participants showed that air pollution exposure interacts with multimorbidity to increase AF risk, demonstrating synergistic effects between environmental and clinical risk factors. ## Is the FDA regulation of cardiology AI devices supporting cardiovascular innovation: a scoping review *2026-02-23 · Heart · https://doi.org/http://heart.bmj.com/cgi/content/short/112/6/300?rss=1 · https://hartvaat.nl/2026/02/23/regulering-van-ai-in-de-cardiologie-door-de-fda-een-scoping-review/* This scoping review of FDA-approved AI/ML devices in cardiology analyzed trends in clinical applications and regulatory pathways, assessing whether the approval framework adequately supports cardiovascular innovation. ## Mitigating Risk of Kidney Dysfunction After Heart Transplantation and Therapeutic Approaches. *2026-02-23 · Circulation. Heart failure · https://doi.org/10.1161/CIRCHEARTFAILURE.125.013747 · https://hartvaat.nl/2026/02/23/nierbescherming-na-harttransplantatie-risicoreductie-en-therapeutische-mogelijkh/* This Circulation Heart Failure review addressed strategies for mitigating kidney dysfunction after heart transplantation, covering recipient risk factors, perioperative management, and therapeutic approaches to preserve renal function. ## Diabetes Increases the Risk of Heart Failure in Myocarditis: A Propensity-Matched Nationwide Database Analysis. *2026-02-23 · ESC heart failure · https://doi.org/10.1093/eschf/xvag064 · https://hartvaat.nl/2026/02/23/diabetes-verhoogt-het-risico-op-hartfalen-bij-myocarditis/* This US nationwide database analysis showed that diabetes significantly increases the risk of heart failure in patients hospitalized with myocarditis, highlighting the adverse interaction between metabolic disease and myocardial inflammation. ## Elevated Activin-A serum levels in patients with acute peripartum cardiomyopathy and during left ventricular recovery. *2026-02-23 · ESC heart failure · https://doi.org/10.1093/eschf/xvag062 · https://hartvaat.nl/2026/02/23/verhoogd-activine-a-bij-peripartum-cardiomyopathie-en-tijdens-lv-herstel/* This German PPCM registry study found elevated serum levels of Activin-A, a senescence-associated factor, in patients with acute peripartum cardiomyopathy, identifying a potential biomarker for this pregnancy-associated heart failure. ## Primary care Adherence To Heart failure guidelines in post-Discharge, Evaluation & Routine management (PATHFINDER): a randomised controlled trial. *2026-02-23 · ESC heart failure · https://doi.org/10.1093/eschf/xvag061 · https://hartvaat.nl/2026/02/23/pathfinder-trial-betere-naleving-van-hartfalenrichtlijnen-in-de-huisartsenprakti/* The PATHFINDER trial tested a combined intervention of inpatient education, a discharge plan with cardiac rehabilitation referral, and primary care support for heart failure, evaluating implementation strategies for guideline adherence. ## Impact of the Cardio-Meds Mobile App on Heart Failure Knowledge and Medication Adherence: Pilot Randomized Controlled Trial. *2026-02-23 · JMIR cardio · https://doi.org/10.2196/83022 · https://hartvaat.nl/2026/02/23/hartfalen-app-verbetert-ziektekennis-bij-patienten-een-gerandomiseerde-pilotstud/* A pilot randomised trial of the Cardio-Meds mobile app showed significant improvement in heart failure knowledge after 30 days of use. The app scored high on usability, though no effect on medication adherence was detected in this small study. ## Association between angiotensin receptor-neprilysin inhibitor use and clinical outcomes in patients with heart failure: a 1-year prospective cohort study from Jordan. *2026-02-23 · BMJ open · https://doi.org/10.1136/bmjopen-2025-111865 · https://hartvaat.nl/2026/02/23/arni-verbetert-kwaliteit-van-leven-en-vermindert-ziekenhuisopnames-bij-hartfalen/* A prospective cohort study from Jordan demonstrated that angiotensin receptor-neprilysin inhibitor treatment improved quality of life, ejection fraction, and reduced hospitalisations in heart failure patients compared to ACE inhibitors or ARBs. ## Occupational Physical Activity and Blood Pressure: The Role of Leisure Time Physical Activity and Sex Differences. *2026-02-23 · Journal of Korean medical science · https://doi.org/10.3346/jkms.2026.41.e94 · https://hartvaat.nl/2026/02/23/lichamelijke-activiteit-op-het-werk-en-bloeddruk-sekseverschillen-en-de-rol-van-/* A Korean study revealed sex-specific associations between occupational physical activity and blood pressure, moderated by leisure-time physical activity. The findings support sex-specific approaches in occupational blood pressure management. ## Analytical Validation of Direct Lipoprotein(a)-Cholesterol Assay. *2026-02-23 · Journal of lipid research · https://doi.org/10.1016/j.jlr.2026.101008 · https://hartvaat.nl/2026/02/23/analytische-validatie-van-een-directe-lp-a-cholesterolbepaling/* Analytical validation of a direct immunocapture ELISA for measuring lipoprotein(a)-cholesterol in human plasma, demonstrating excellent linearity, precision, and specificity. Accurate Lp(a)-C measurement is essential for correct lipid panel interpretation. ## Beyond CACS: Can Lp(a) and AI-CCTA Unmask "Invisible" Residual Cardiovascular Risk? *2026-02-23 · European heart journal. Cardiovascular Imaging · https://doi.org/10.1093/ehjci/jeag051 · https://hartvaat.nl/2026/02/23/lp-a-en-ai-ccta-onthullen-onzichtbaar-restrisico-voorbij-de-calciumscore/* This editorial discussed how Lp(a) measurement combined with AI-driven coronary CT angiography can unmask residual cardiovascular risk invisible to traditional calcium scoring, advancing precision risk assessment. ## The possible role of PCSK9 inhibitors in cardiac syndrome X: Bridging microvascular dysfunction, endothelial pathobiology, and molecular pharmacotherapy. *2026-02-23 · Microvascular research · https://doi.org/10.1016/j.mvr.2026.104925 · https://hartvaat.nl/2026/02/23/pcsk9-remmers-bij-cardiaal-syndroom-x-nieuw-perspectief-op-microvasculaire-angin/* This review discusses the potential role of PCSK9 inhibitors in cardiac syndrome X (microvascular angina), highlighting their effects beyond lipid lowering on endothelial dysfunction, oxidative stress, and inflammation — mechanisms central to microvascular angina pathophysiology. ## Blood pressure control rates among hypertensive patients managed in community health centres in Shenzhen, China: a megacity population-based observational study. *2026-02-22 · BMJ open · https://doi.org/10.1136/bmjopen-2025-105830 · https://hartvaat.nl/2026/02/22/bloeddrukcontrole-bij-hypertensie-in-gezondheidscentra-in-shenzhen/* A population-based observational study examined factors influencing blood pressure control rates among hypertensive patients managed in community health centres in the megacity of Shenzhen, China. ## Effect of preoperative liposomal bupivacaine single-injection pericapsular nerve group (PENG) block on lower extremity deep vein thrombosis in elderly patients with hip fractures: a randomised controlled, double-blind, prospective clinical study protocol. *2026-02-22 · BMJ open · https://doi.org/10.1136/bmjopen-2025-111579 · https://hartvaat.nl/2026/02/22/liposomaal-bupivacaine-peng-blok-tegen-diepveneuze-trombose-bij-heupfracturen/* A study protocol describes a randomised trial of preoperative liposomal bupivacaine pericapsular nerve group block to reduce deep vein thrombosis in elderly hip fracture patients, addressing the role of pain-induced immobilisation and inflammation. ## Cost-effectiveness of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists for patients with high cardiovascular risk and type 2 diabetes in Canada. *2026-02-22 · CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · https://doi.org/10.1503/cmaj.250591 · https://hartvaat.nl/2026/02/22/kosteneffectiviteit-van-sglt2-remmers-en-glp-1-agonisten-bij-hoog-cardiovasculai/* This Canadian simulation study compared the cost-effectiveness of SGLT2 inhibitors versus GLP-1 receptor agonists in type 2 diabetes with high cardiovascular risk, informing formulary and reimbursement decisions for cardiometabolic therapy. ## Genetic Prediction of Circulating Lipoprotein(a) Levels in Diverse Populations. *2026-02-22 · medRxiv : the preprint server for health sciences · https://doi.org/10.64898/2026.02.20.26346738 · https://hartvaat.nl/2026/02/22/genetische-voorspelling-van-lp-a-spiegels-in-diverse-populaties/* This study developed an improved genetic prediction model for lipoprotein(a) levels that works across diverse ethnic populations, potentially addressing the clinical measurement gap where fewer than 1% of US patients have Lp(a) tested. ## Department of Error *2026-02-21 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00315-6/fulltext · https://hartvaat.nl/2026/02/21/erratum-sapien-3-versus-myval-bij-tavi-compare-tavi-1/* Erratum for the COMPARE-TAVI 1 trial article by Terkelsen et al. comparing SAPIEN 3 and Myval transcatheter heart valves for TAVI. ## Barriers and Facilitators to the implementation and scale-up of a mHealth integrated care program for diabetes and hypertension in Ghana: a qualitative study of the Akoma Pa program. *2026-02-21 · BMC health services research · https://doi.org/10.1186/s12913-026-14175-0 · https://hartvaat.nl/2026/02/21/barrieres-en-facilitatoren-voor-mhealth-programma-diabetes-en-hypertensie-in-gha/* Through in-depth interviews with 30 implementers and healthcare providers, this qualitative study identified barriers and facilitators to scaling the Akoma Pa mHealth-integrated care programme for diabetes and hypertension in Ghana. ## Three-dimensional echocardiography for valvular heart disease: clinical implications. *2026-02-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1127 · https://hartvaat.nl/2026/02/21/driedimensionale-echocardiografie-bij-kleplijden-klinische-implicaties/* This European Heart Journal review described the clinical implications of three-dimensional echocardiography for valvular heart disease assessment, covering its role in surgical planning, transcatheter interventions, and monitoring. ## Aspirin use, lipoprotein(a), and calcific aortic valve disease: the Multi-ethnic Study of Atherosclerosis. *2026-02-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehag018 · https://hartvaat.nl/2026/02/21/aspirine-lipoproteine-a-en-aortaklepstenose-de-mesa-studie/* This MESA study examined the relationship between aspirin use, lipoprotein(a) levels, and calcific aortic valve disease, exploring whether aspirin modifies the Lp(a)-driven pathway to aortic stenosis. ## Pelacarsen and lipoprotein(a) apheresis in secondary prevention: the Lp(a)FRONTIERS APHERESIS trial. *2026-02-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehag073 · https://hartvaat.nl/2026/02/21/pelacarsen-vermindert-de-behoefte-aan-lipoproteine-a-aferese-lp-a-frontiers-aphe/* The Lp(a)FRONTIERS APHERESIS trial investigated whether pelacarsen can reduce the need for lipoprotein apheresis in patients with elevated Lp(a) and established cardiovascular disease. The study addresses a critical question about the potential of pharmacological Lp(a) lowering to replace this burdensome procedure. ## Cost-effectiveness analysis of mavacamten for obstructive hypertrophic cardiomyopathy: a perspective from the Chinese healthcare system *2026-02-20 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003914?rss=1 · https://hartvaat.nl/2026/02/20/kosteneffectiviteit-van-mavacamten-bij-obstructieve-hcm-gezondheidswinst-maar-ee/* The phase III EXPLORER-HCM trial showed that the cardiac myosin inhibitor mavacamten improves symptoms and function in obstructive hypertrophic cardiomyopathy (HCM). This study used a Markov model to assess the cost-effectiveness of mavacamten plus a beta-blocker or calcium-channel blocker versus placebo plus the same agents, from the Chinese healthcare perspective. Compared with placebo, mavacamten yielded 2.1 additional quality-adjusted life years (QALYs) and 3.15 additional life years, at an incremental cost-effectiveness ratio (ICER) of about US$50,587 per QALY. Drug price was the key driver. Mavacamten thus provides substantial health benefit, but the ICER exceeds the common willingness-to-pay threshold — underscoring the importance of pricing in reimbursing this new, expensive agent. ## Feasibility, safety and outcomes of a virtual ward with remote monitoring for patients awaiting urgent coronary artery bypass graft surgery *2026-02-20 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003568?rss=1 · https://hartvaat.nl/2026/02/20/virtuele-afdeling-met-thuismonitoring-is-veilig-voor-patienten-die-wachten-op-sp/* Waiting times for urgent coronary artery bypass grafting (CABG) are rising in the UK, with long preoperative admissions occupying beds and burdening patients. A 'virtual ward' with home monitoring could let clinically stable patients go home safely earlier. In this prospective multicentre study (128 patients, three UK cardiac centres), patients were discharged home with daily symptom reporting via a digital platform and structured review. No preoperative major adverse cardiac events occurred (0%) and 30-day mortality was 0%; resternotomy occurred in 2.3%, comparable to national rates. Median time from discharge to surgery was 10 days, with an estimated saving of 1,152 inpatient bed-days. Patients were positive (95% felt safe at home). A virtual ward with home monitoring is thus safe and feasible for selected patients awaiting urgent CABG, with major gains in bed capacity. ## Enhanced cardiovascular disease risk prediction using integrated machine learning models: a study from the UK Biobank cohort *2026-02-20 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003827?rss=1 · https://hartvaat.nl/2026/02/20/geintegreerd-machine-learningmodel-voorspelt-cardiovasculair-risico-beter-dan-de/* Classical risk scores such as Framingham and SCORE sometimes fall short due to their limited variable set. In this study, machine learning was used to develop a comprehensive cardiovascular risk model from the UK Biobank (240,644 participants), combining genetic scores, clinical parameters and lifestyle factors, with separate models for overall cardiovascular risk, cerebrovascular and thrombotic disease. The integrated model (clinical + lifestyle + genetic) performed best, with an AUC of 0.85 — an improvement of 0.12 over the Framingham score. Models based on clinical, lifestyle or genetic data alone performed worse. Key predictors were age, systolic blood pressure, cystatin C and waist circumference. Combining clinical, lifestyle and genetic data thus substantially improves cardiovascular risk prediction — though validation in diverse populations is still needed. ## Association between the gut microbiota and estimated glomerular filtration rate in two Swedish population-based cohorts *2026-02-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00129-8/fulltext · https://hartvaat.nl/2026/02/20/darmmicrobiota-en-geschatte-glomerulaire-filtratiesnelheid-in-twee-zweedse-cohor/* This study quantified links between gut microbiota composition and estimated GFR in two population-based Swedish cohorts, providing evidence for gut-kidney interactions even in community-dwelling adults with largely preserved kidney function. ## HEV-Targeted Antibody-Drug Conjugate Promotes Long-Term Cardiac Allograft Acceptance *2026-02-20 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076423 · https://hartvaat.nl/2026/02/20/hev-gericht-antilichaam-medicijnconjugaat-bevordert-langdurige-acceptatie-van-ha/* This study developed an HEV-targeted antibody-drug conjugate that promotes long-term cardiac allograft acceptance by modulating naive T-cell trafficking through lymph node high endothelial venules. The approach represents a novel immunomodulatory strategy for transplantation. ## Memories of Claudio Ponticelli *2026-02-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00135-3/fulltext · https://hartvaat.nl/2026/02/20/in-memoriam-claudio-ponticelli-1936-2026/* In memoriam for Claudio Ponticelli (1936-2026), a world-renowned nephrologist who passed away on January 1, 2026, at age 89. He was esteemed for his humanistic character and patient-centred contributions to nephrology. ## The splenic norepinephrine–β2-adrenergic receptor axis aggravates sepsis-associated acute kidney injury via neutrophil-mediated immunosuppression *2026-02-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00132-8/fulltext · https://hartvaat.nl/2026/02/20/milt-norepinefrine-2-adrenerge-as-verergert-sepsis-geassocieerd-acuut-nierletsel/* This study uncovers a neural mechanism whereby the splenic norepinephrine-beta2-adrenergic receptor axis aggravates sepsis-associated acute kidney injury through neutrophil-mediated immunosuppression. ## Longdan Xiegan formula as adjuvant therapy for hypertension: A systematic review and meta-analysis. *2026-02-20 · Medicine · https://doi.org/10.1097/MD.0000000000047736 · https://hartvaat.nl/2026/02/20/longdan-xiegan-formule-als-aanvullende-therapie-bij-hypertensie-systematische-re/* A systematic review and meta-analysis evaluated the efficacy of Longdan Xiegan decoction, a traditional Chinese medicine formula, as adjunctive therapy for hypertension. ## [The role of malic enzyme 1 regulating ferroptosis on nerve impairment of hypertensive mice following lead exposure]. *2026-02-20 · Zhonghua lao dong wei sheng zhi ye bing za zhi = Zhonghua laodong weisheng zhiyebing zazhi = Chinese journal of industrial hygiene and occupational diseases · https://doi.org/10.3760/cma.j.cn121094-20241029-00494 · https://hartvaat.nl/2026/02/20/rol-van-appelzuurenzym-1-bij-ferroptose-en-zenuwschade-bij-hypertensieve-muizen-/* This animal study explored the role of hippocampal ferroptosis mediated by malic enzyme 1 in nerve impairment caused by lead exposure in hypertensive mice. ## The impact of different intensities of physical activity on the risk of venous thromboembolism: A Mendelian randomization study. *2026-02-20 · Medicine · https://doi.org/10.1097/MD.0000000000047589 · https://hartvaat.nl/2026/02/20/intensief-bewegen-verlaagt-het-risico-op-veneuze-trombo-embolie-mendeliaanse-ran/* A Mendelian randomisation study using genetic data from the UK Biobank and FinnGen demonstrated that vigorous physical activity is causally associated with a 27% lower risk of venous thromboembolism. ## Heart Rate Variability Moderates the Association Between Trait Anxiety and Sympathetic Nerve Activity in Humans *2026-02-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26014 · https://hartvaat.nl/2026/02/20/hartslagvariabiliteit-modereert-het-verband-tussen-angst-en-sympathische-zenuwac/* This study investigated whether heart rate variability moderates the association between trait anxiety and sympathetic nerve activity, exploring the neurophysiological mechanism linking chronic anxiety to hypertension development. ## Low-Dose TEL/AML/CHTD SPC Versus Standard-Dose TEL in Hypertension: Phase III RCT *2026-02-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25810 · https://hartvaat.nl/2026/02/20/lage-dosis-drievoudige-combinatiepil-versus-standaard-telmisartan-bij-hypertensi/* This phase III RCT compared a low-dose triple single-pill combination (telmisartan/amlodipine/chlorthalidone) with standard-dose telmisartan monotherapy, showing superior blood pressure reduction with the combination approach. ## Proteomic Risk Score for Prediction of Incident Hypertension *2026-02-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26321 · https://hartvaat.nl/2026/02/20/proteomische-risicoscore-voorspelt-het-ontstaan-van-hypertensie/* This study developed a proteomic risk score from UK Biobank data that predicts incident hypertension better than traditional risk factors, advancing precision medicine approaches to blood pressure management. ## mHealth Intervention to Improve Hypertension Care in High-Risk Patients *2026-02-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26148 · https://hartvaat.nl/2026/02/20/mhealth-interventie-verbetert-hypertensiezorg-bij-hoogrisicopatienten/* The mGlide trial showed that a pharmacist-led, mobile health technology-facilitated care model improves blood pressure control in diverse patients with uncontrolled hypertension, demonstrating the effectiveness of technology-enabled interprofessional care. ## The risk factors associated with pulmonary hypertension in patients with left heart diseases. *2026-02-20 · Medicine · https://doi.org/10.1097/MD.0000000000047799 · https://hartvaat.nl/2026/02/20/risicofactoren-voor-pulmonale-hypertensie-bij-linkszijdig-hartlijden/* In 411 elderly male patients with left heart disease, atrial fibrillation, left atrial dilatation, and reduced left ventricular ejection fraction were identified as independent predictors of pulmonary hypertension. ## Prevalence and management of hypertension among adults aged 45 and older in mainland China: Insights from the 2020 CHARLS survey. *2026-02-20 · Medicine · https://doi.org/10.1097/MD.0000000000047704 · https://hartvaat.nl/2026/02/20/hypertensie-bij-45-plussers-in-china-prevalentie-bewustzijn-en-behandeling/* A CHARLS survey of nearly 20,000 Chinese adults aged 45 and older found a hypertension prevalence of 38%. While 79% used antihypertensives, fewer than half received education on complication prevention, highlighting the need for improved primary care health literacy. ## Biomarkers for Atherosclerotic Cardiovascular Events in Rheumatoid Arthritis: Towards Validation of a Biomarker-Enhanced Risk Model. *2026-02-20 · medRxiv : the preprint server for health sciences · https://doi.org/10.64898/2026.02.18.26346592 · https://hartvaat.nl/2026/02/20/biomarkers-voor-atherosclerotische-events-bij-reumatoide-artritis-lp-a-als-voors/* This study validates a biomarker-enhanced risk model incorporating lipoprotein(a), osteoprotegerin, and troponin T for improved cardiovascular risk stratification in rheumatoid arthritis patients, outperforming traditional risk scores. ## Saudi Secondary Prevention Survey Study in Patients with Prior Acute Myocardial Infarction (4S Registry): Study Design and Pilot Phase Results. *2026-02-20 · Journal of cardiovascular development and disease · https://doi.org/10.3390/jcdd13020100 · https://hartvaat.nl/2026/02/20/secundaire-preventie-na-myocardinfarct-in-saudi-arabie-het-4s-register/* The 4S registry evaluated adherence to guideline-recommended secondary prevention strategies after acute myocardial infarction in Saudi Arabia. Risk factors including Lp(a) were inadequately controlled, reflecting the global challenge of optimal secondary prevention. ## Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years. *2026-02-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2509766 · https://hartvaat.nl/2026/02/19/partner-3-tavr-versus-chirurgie-bij-laagrisico-zevenjaarsresultaten-nejm/* The 7-year PARTNER 3 results confirmed comparable outcomes between TAVR and surgical aortic valve replacement in low-risk patients, with maintained valve durability and no excess structural deterioration. These are the longest-term data supporting TAVR across the full surgical risk spectrum. ## 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines *2026-02-19 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001415 · https://hartvaat.nl/2026/02/19/2026-aha-acc-richtlijn-voor-evaluatie-en-behandeling-van-acute-longembolie/* The 2026 AHA/ACC multisociety guideline provides comprehensive, de novo recommendations for the evaluation and management of acute pulmonary embolism in adults, covering risk stratification, anticoagulation, thrombolysis, catheter-directed therapy, and long-term follow-up. ## Association of Cancer on Coronary Atherosclerotic Burden and Plaque Rupture: Insights from the BRAVADO Study *2026-02-19 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00049-3/fulltext · https://hartvaat.nl/2026/02/19/kanker-en-coronaire-atherosclerotische-plaquebelasting-inzichten-uit-de-bravado-/* The BRAVADO study investigated the specific impact of cancer on coronary atherosclerotic plaque burden and lesion complexity in patients presenting with acute coronary syndrome. The findings advance understanding of cardio-oncology interactions. ## METTL3-targeted intervention on nuclear factors RORA/RORγt suppressing pathogenic T helper 17 cell differentiation and restores kidney damage in lupus nephritis. *2026-02-19 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00133-X/fulltext · https://hartvaat.nl/2026/02/19/mettl3-interventie-onderdrukt-pathogene-th17-differentiatie-en-herstelt-nierscha/* This study reveals that METTL3-mediated m6A modification of nuclear factors RORA/RORgammat suppresses pathogenic Th17 cell differentiation and restores kidney damage in lupus nephritis, identifying a new epigenetic regulatory mechanism. ## Conduction disturbances after transcatheter aortic valve implantation. *2026-02-19 · European heart journal · https://doi.org/10.1093/eurheartj/ehag093 · https://hartvaat.nl/2026/02/19/geleidingsstoornissen-na-transkatheter-aortaklepimplantatie/* This European Heart Journal review addressed conduction disturbances after TAVI, covering the predictors of permanent pacemaker implantation, the impact on long-term outcomes, and strategies for minimizing conduction complications during transcatheter valve procedures. ## Creatinine, cystatin C or both to estimate glomerular filtration rate in kidney transplant recipients? *2026-02-19 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag037 · https://hartvaat.nl/2026/02/19/creatinine-cystatine-c-of-beide-voor-gfr-schatting-bij-niertransplantatiepatient/* This multicentre study compared creatinine-based, cystatin C-based, and combined GFR estimation equations in kidney transplant recipients. The findings inform the clinical choice of biomarkers for post-transplant renal function monitoring. ## Delirium in cardiovascular medicine. *2026-02-19 · European heart journal · https://doi.org/10.1093/eurheartj/ehag088 · https://hartvaat.nl/2026/02/19/delirium-in-de-cardiovasculaire-geneeskunde/* This European Heart Journal review addressed delirium in cardiovascular medicine, covering its prevalence, pathophysiology, and management in patients undergoing cardiac procedures and intensive care. ## Post-certification competencies and cardiovascular care delivery. *2026-02-19 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf1037 · https://hartvaat.nl/2026/02/19/competenties-na-certificering-en-cardiovasculaire-zorgverlening/* This European Heart Journal article discussed post-certification competencies in cardiovascular care delivery, addressing how subspecialization within cardiology can be structured to maintain quality across the expanding scope of the field. ## Secondary Prevention after Ischemic Stroke. *2026-02-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMcp2415601 · https://hartvaat.nl/2026/02/19/secundaire-preventie-na-ischemisch-cva-overzicht-uit-het-nejm/* This NEJM review provided a comprehensive update on secondary prevention after ischemic stroke, covering modifiable risk factors, mechanism-specific therapies, and contemporary evidence on anticoagulation, antiplatelet therapy, and lipid lowering for recurrent stroke prevention. ## Cardiovascular-Kidney-Metabolic Interplay in Patients with Atrial Fibrillation Receiving Direct Oral Anticoagulants. *2026-02-19 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag028 · https://hartvaat.nl/2026/02/19/cardiovasculair-renaal-metabool-samenspel-bij-patienten-met-atriumfibrilleren/* This comprehensive review examined the cardiovascular-kidney-metabolic interplay in AF patients on DOACs, exploring how CKM syndrome affects anticoagulation efficacy, safety, and dosing decisions. ## Evaluation of evolocumab on saphenous vein graft patency following coronary artery bypass graft surgery in people living with and without diabetes in the NEWTON-CABG CardioLink-5 trial. *2026-02-19 · Diabetes, obesity & metabolism · https://doi.org/10.1111/dom.70590 · https://hartvaat.nl/2026/02/19/evolocumab-en-doorgankelijkheid-van-veneuze-bypasses-na-cabg-newton-cabg-cardiol/* The NEWTON-CABG CardioLink-5 trial evaluated whether adding evolocumab to statin therapy improves saphenous vein graft patency after coronary artery bypass surgery, with separate analysis for patients with and without diabetes. ## Monounsaturated Fatty Acids in Adipose Tissue and the Risk of Peripheral Artery Disease: A Danish Case-Cohort study *2026-02-19 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00051-1/fulltext · https://hartvaat.nl/2026/02/19/enkelvoudige-onverzadigde-vetzuren-in-vetweefsel-en-het-risico-op-perifeer-vaatl/* A Danish case-cohort study examined the association between individual monounsaturated fatty acids in adipose tissue and the risk of peripheral artery disease. The findings nuance dietary recommendations on replacing saturated fats with MUFAs. ## Angiotensin-(1–7) Activates Proopiomelanocortin Neurons in the Arcuate Nucleus *2026-02-18 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26262 · https://hartvaat.nl/2026/02/18/angiotensine-1-7-activeert-pomc-neuronen-in-de-nucleus-arcuatus/* This study demonstrates that angiotensin-(1-7) activates proopiomelanocortin neurons in the arcuate nucleus, revealing a central mechanism underlying the cardiometabolic protective effects of this peptide in obesity and hypertension. ## Beta-Blockers after Myocardial Infarction *2026-02-18 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMc2518019&rss=currentIssue · https://hartvaat.nl/2026/02/18/betablokkers-na-een-myocardinfarct/* This NEJM review article synthesizes the current evidence on beta-blocker use after myocardial infarction, reflecting the paradigm shift from routine long-term therapy to an evidence-based approach where beta-blockers are no longer mandatory when ejection fraction is preserved. ## Disruption of the human cystin-1 myristoyl-electrostatic switch causes polycystic kidney disease that phenocopies autosomal recessive polycystic kidney disease *2026-02-18 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00131-6/fulltext · https://hartvaat.nl/2026/02/18/verstoring-van-de-cystine-1-myristoyl-elektrostatische-schakelaar-veroorzaakt-po/* This study demonstrates that disruption of the myristoyl-electrostatic switch of human cystin-1 causes polycystic kidney disease phenocopying autosomal recessive PKD, providing mechanistic insight into ciliopathy-related cystogenesis. ## Gene Therapy for Nephropathic Cystinosis *2026-02-18 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMe2600177&rss=currentIssue · https://hartvaat.nl/2026/02/18/gentherapie-voor-nefropathische-cystinose/* This NEJM article discussed gene therapy as a treatment option for nephropathic cystinosis, a rare lysosomal storage disorder affecting kidney function, exploring the potential for curative genetic intervention. ## Green Dialysis: Environmentally Sustainable Care, Growth, and Innovation: Conclusions From a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference *2026-02-18 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00079-7/fulltext · https://hartvaat.nl/2026/02/18/groene-dialyse-duurzame-zorg-groei-en-innovatie-kdigo-conferentie/* This KDIGO Conference addressed the environmental sustainability of dialysis therapies, proposing green dialysis practices to reduce the substantial carbon footprint, water consumption, and waste of kidney replacement therapy. ## More on Osilodrostat for Bilateral Adrenal Hypercortisolism in Primary Aldosteronism *2026-02-18 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMc2518967&rss=currentIssue · https://hartvaat.nl/2026/02/18/osilodrostat-bij-bilaterale-bijnieroverproductie-van-cortisol-bij-primair-aldost/* This correspondence provides additional considerations regarding the use of osilodrostat for bilateral adrenal hypercortisolism in the context of primary aldosteronism. ## Renox Reloaded: How Metabolic Reprogramming by the NADPH Oxidase Nox4 Promotes Salt-Sensitive Hypertension *2026-02-18 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26461 · https://hartvaat.nl/2026/02/18/nox4-gemedieerde-metabole-herprogrammering-bij-zoutgevoelige-hypertensie/* This review discusses how the NADPH oxidase Nox4 promotes salt-sensitive hypertension through metabolic reprogramming, identifying new mechanistic pathways in the pathogenesis of salt-dependent blood pressure elevation. ## Retraction of: Abstract FR512: Spatio-Temporal Dynamics of Diabetes Prevalence: Structural and Environmental Drivers of Chronic Disease Burdens *2026-02-18 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYP.0000000000000261 · https://hartvaat.nl/2026/02/18/retractie-abstract-over-ruimtelijk-temporele-dynamiek-van-diabetesprevalentie/* Retraction of an abstract on spatio-temporal dynamics of diabetes prevalence and structural and environmental drivers of chronic disease burden. ## Telomere recapping via gene therapy as a beneficial strategy for cardio-renal syndrome type 4 *2026-02-18 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00130-4/fulltext · https://hartvaat.nl/2026/02/18/telomeerherstel-via-gentherapie-bij-cardiorenaal-syndroom-type-4/* This study investigated telomere recapping via gene therapy as a beneficial strategy for cardiorenal syndrome type 4, where heart failure is driven by chronic kidney disease. The approach addresses the shortened telomere lengths observed in advanced CKD patients. ## Trends in Salt Substitute Use Among Adults in the United States from 2003 to 2020 *2026-02-18 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26196 · https://hartvaat.nl/2026/02/18/trends-in-het-gebruik-van-zoutvervangingsmiddelen-in-de-vs-2003-2020/* This analysis documents trends in salt substitute use among US adults from 2003 to 2020, relevant to population-level blood pressure management and cardiovascular prevention strategies. ## Uncontrolled Hypertension in Young Adults: A Real-World Analysis of 89,130 Adults in the United States *2026-02-18 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26081 · https://hartvaat.nl/2026/02/18/ongecontroleerde-hypertensie-bij-jongvolwassenen-in-de-verenigde-staten/* This real-world analysis of 89,130 US adults documented uncontrolled hypertension in young adults, highlighting the growing public health problem of inadequate blood pressure management in the younger population. ## Health Literacy and Quality of Life after Acute Coronary Syndrome: The Mediating Role of Self-Care in Palestine *2026-02-18 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00037-7/fulltext · https://hartvaat.nl/2026/02/18/gezondheidsgeletterdheid-en-kwaliteit-van-leven-na-een-acuut-coronair-syndroom/* This study investigated the mediating role of self-care behaviours in the relationship between health literacy and quality of life among Palestinian patients with acute coronary syndrome. Patient education and self-management are particularly important in resource-limited healthcare settings. ## Sex-Specific Microaxial Flow Pump Use and Outcomes in Infarct-Related Cardiogenic Shock in the DanGer Shock Trial. *2026-02-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.09.019 · https://hartvaat.nl/2026/02/17/danger-shock-sekseverschillen-in-impella-gebruik-bij-cardiogene-shock/* A prespecified DanGer Shock subanalysis examined sex differences in microaxial flow pump use and outcomes in infarct-related cardiogenic shock. Women experienced comparable survival benefit despite more technical challenges with device implantation. ## Lactylation of BCAT2-K377 Contributes to the Progression of Severe Preeclampsia *2026-02-17 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25378 · https://hartvaat.nl/2026/02/17/lactylering-van-bcat2-k377-draagt-bij-aan-ernstige-pre-eclampsie/* This study reveals that hypoxia-induced lactylation of BCAT2 at K377 is a novel mechanism contributing to severe preeclampsia progression, linking metabolic reprogramming under placental hypoxia to trophoblast dysfunction. ## Neutrophil Gelatinase–Associated Lipocalin Drives Cardiac Remodeling in Rats With Chronic Kidney Disease *2026-02-17 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25658 · https://hartvaat.nl/2026/02/17/ngal-veroorzaakt-cardiale-remodeling-bij-ratten-met-chronische-nierziekte/* This study demonstrates that neutrophil gelatinase-associated lipocalin drives cardiac remodelling and inflammation in rats with chronic kidney disease, providing mechanistic insight into the cardiorenal syndrome and identifying NGAL as a potential therapeutic target. ## External validation of the SMART2 model for recurrent cardiovascular risk: performance in socioeconomic, ethnic and psychiatric subgroups *2026-02-16 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003882?rss=1 · https://hartvaat.nl/2026/02/16/smart2-risicomodel-onderschat-het-recidiefrisico-bij-kwetsbare-groepen-leids-haa/* The SMART2 model predicts recurrent atherosclerotic event (ASCVD) risk in patients with established cardiovascular disease, but does not account for psychiatric disorders, socioeconomic deprivation or ethnicity. In this external validation using records from the Leiden-The Hague region (15,528 patients aged 40-80 with established ASCVD, median follow-up 6 years), overall discrimination was moderate (AUC 0.63) and overall calibration good (OE ratio 0.96). However, the model underestimated risk in patients with low socioeconomic status (OE 1.09) and in non-Western patients (OE 1.16), most strongly in those combining multiple vulnerabilities (low SES, non-Western ethnicity and psychiatric history; OE 1.19-1.29). The SMART2 model is thus well-calibrated in the general population but underestimates risk in vulnerable subgroups — who may need intensified monitoring. Clinicians should weigh social, ethnic and psychiatric factors when interpreting the risk estimate. ## A population-based, regression discontinuity analysis examined the effects of nationwide alerting for acute kidney injury on health care and patient outcomes *2026-02-16 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00091-8/fulltext · https://hartvaat.nl/2026/02/16/landelijk-aki-alarmsysteem-effecten-op-zorg-en-patientuitkomsten/* This population-based regression discontinuity analysis examined the effects of nationwide electronic alerting for acute kidney injury, contributing to the evidence on whether automated AKI alerts improve clinical outcomes at scale. ## Fibrillin-1 is a novel ligand of the epidermal growth factor receptor promoting mesangial cell activation and glomerulosclerosis *2026-02-16 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00090-6/fulltext · https://hartvaat.nl/2026/02/16/fibrilline-1-is-een-nieuw-ligand-van-de-egf-receptor-dat-mesangiumcellen-activee/* This study reveals that fibrillin-1 is a novel ligand of the epidermal growth factor receptor that promotes mesangial cell activation and glomerulosclerosis, identifying a new mechanism connecting podocyte damage to mesangial pathology. ## Novel Plasma Proteomic Markers and Risk of Venous Thromboembolism *2026-02-16 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074493 · https://hartvaat.nl/2026/02/16/nieuwe-plasma-eiwitbiomarkers-en-risico-op-veneuze-trombo-embolie/* This Circulation study used large-scale, high-throughput proteomics to identify novel plasma protein markers associated with venous thromboembolism risk, advancing the molecular understanding of VTE pathogenesis. ## Adjunctive pharmacological strategies for residual risk reduction after myocardial revascularisation. *2026-02-16 · EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · https://doi.org/10.4244/EIJ-D-25-00598 · https://hartvaat.nl/2026/02/16/aanvullende-farmacologische-strategieen-voor-restrisicoreductie-na-revascularisa/* This EuroIntervention review discussed adjunctive pharmacological strategies for reducing residual cardiovascular risk after coronary revascularization, covering anti-inflammatory, lipid-lowering, and antithrombotic approaches beyond standard therapy. ## Early versus late anticoagulation treatment after acute ischemic stroke with atrial fibrillation: a meta-analysis of randomized controlled trials. *2026-02-16 · Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · https://doi.org/10.1007/s10072-025-08789-1 · https://hartvaat.nl/2026/02/16/vroege-versus-late-antistolling-na-ischemisch-cva-met-atriumfibrilleren-meta-ana/* This meta-analysis of randomized trials compared early versus late anticoagulation initiation after acute ischemic stroke in AF patients, providing the pooled evidence to guide the timing of DOAC start after cerebrovascular events. ## Left atrial appendage closure versus direct oral anticoagulants after pulmonary vein isolation for atrial fibrillation: protocol for a multicentre, prospective, randomised, non-inferiority trial (PROMOTE study). *2026-02-16 · BMJ open · https://doi.org/10.1136/bmjopen-2025-103632 · https://hartvaat.nl/2026/02/16/sluiting-van-het-linker-hartoor-versus-doac-s-na-longembolie/* The PROMOTE study protocol describes a multicentre randomised non-inferiority trial comparing left atrial appendage closure with direct oral anticoagulants after pulmonary vein isolation for atrial fibrillation. The trial addresses the unresolved question of optimal stroke prevention post-ablation. ## Overview of direct oral anticoagulation trends in the Bronx: case control study of patient and systemic factors in medication non-adherence. *2026-02-16 · Open heart · https://doi.org/10.1136/openhrt-2025-003536 · https://hartvaat.nl/2026/02/16/trends-in-gebruik-van-directe-orale-anticoagulantia-een-case-controlstudie/* A case-control study in the Bronx examined patient and systemic factors contributing to non-adherence with direct oral anticoagulants, providing insights into the persistent challenge of medication non-adherence despite the clinical advantages of DOACs. ## Apolipoprotein C3 exacerbates vascular calcification by promoting ferroptosis via the TLR2/AMPK pathway in vascular smooth muscle cells. *2026-02-16 · Redox biology · https://doi.org/10.1016/j.redox.2026.104088 · https://hartvaat.nl/2026/02/16/apolipoproteine-c3-verergert-vaatverkalking-via-ferroptose-bij-chronisch-nierfal/* This translational study demonstrates that apolipoprotein C3 promotes vascular calcification by inducing ferroptosis in vascular smooth muscle cells via the TLR2/AMPK pathway. ApoC3 knockdown reduced calcification in human renal arteries ex vivo, identifying a potential therapeutic target. ## [Menopausal hormone therapy in patients with cardiovascular and metabolic diseases: an interdisciplinary Delphi consensus among Russian gynecologists, cardiologists, endocrinologists, gerontologists and geriatricians, phlebologists, and clinical pharmacologists]. *2026-02-15 · Terapevticheskii arkhiv · https://doi.org/10.26442/00403660.2026.01.203470 · https://hartvaat.nl/2026/02/15/hormonale-menopauzetherapie-bij-cardiovasculaire-en-metabole-ziekten-russische-d/* An interdisciplinary Russian Delphi consensus provides recommendations for menopausal hormone therapy in women with cardiovascular and metabolic comorbidities, addressing the oestrogen deficiency that increases cardiovascular risk. ## [Risk factors for poor annual prognosis in patients after acute decompensation of heart failure]. *2026-02-15 · Terapevticheskii arkhiv · https://doi.org/10.26442/00403660.2026.01.203520 · https://hartvaat.nl/2026/02/15/risicofactoren-voor-een-slechte-jaarprognose-na-acute-decompensatie-van-hartfale/* This study identified risk factors for poor one-year prognosis after hospitalisation for acute decompensated heart failure, addressing the high 25% rehospitalisation rate within three months of discharge. ## [Characteristics and 5-year outcomes in patients with chronic lymphocytic leukemia receiving ibrutinib (a real-world study)]. *2026-02-15 · Terapevticheskii arkhiv · https://doi.org/10.26442/00403660.2026.01.203492 · https://hartvaat.nl/2026/02/15/kenmerken-en-vijfjaarsuitkomsten-bij-patienten-met-cll-en-atriumfibrilleren/* A real-world study evaluated cardiovascular complications, particularly new-onset atrial fibrillation, in chronic lymphocytic leukaemia patients receiving ibrutinib over 5-year follow-up. ## Assessment of adverse effects attributed to statin therapy in product labels: a meta-analysis of double-blind randomised controlled trials. *2026-02-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01578-8 · https://hartvaat.nl/2026/02/14/bijwerkingen-toegeschreven-aan-statines-in-bijsluiters-meta-analyse-van-rct-s/* This Lancet meta-analysis compared statin adverse effects listed on product labels with actual incidence rates in double-blind trials, finding that many attributed side effects occur at similar rates with placebo, supporting a significant nocebo contribution. ## Triple cardiovascular disease detection with an artificial intelligence-enabled stethoscope (TRICORDER) in the UK: a cluster-randomised controlled implementation trial. *2026-02-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)02156-7 · https://hartvaat.nl/2026/02/14/tricorder-ai-stethoscoop-voor-triple-cv-ziektedetectie/* The TRICORDER trial demonstrated that an AI-enabled stethoscope can simultaneously detect heart failure, valvular heart disease, and atrial fibrillation during routine clinical encounters, validating a scalable screening technology for multiple cardiovascular conditions. ## [Time to achieve target lipid metabolism parameters and its impact on long-term outcomes after acute coronary syndrome in conditions of multicomponent lipid-lowering therapy]. *2026-02-14 · Terapevticheskii arkhiv · https://doi.org/10.26442/00403660.2025.12.203499 · https://hartvaat.nl/2026/02/14/snelheid-van-lipidedoelbereik-en-langetermijnuitkomsten-na-acuut-coronair-syndro/* A Russian study evaluated the effect of early versus delayed initiation of alirocumab on the time to achieve lipid targets and 18-month outcomes after acute coronary syndrome, demonstrating the importance of early treatment initiation. ## Aldosterone and the Mineralocorticoid Receptor in Atrial Fibrillation *2026-02-13 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26187 · https://hartvaat.nl/2026/02/13/aldosteron-en-de-mineralocorticoidreceptor-bij-atriumfibrilleren/* This review examined the role of aldosterone and the mineralocorticoid receptor in atrial fibrillation pathophysiology, discussing how aldosterone-driven atrial remodeling contributes to AF initiation and maintenance. ## B-cell maturation antigen-Targeted T-cell Engager Therapy Combined with B-cell Depletion for Treatment of Refractory HLA Sensitization *2026-02-13 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00092-X/fulltext · https://hartvaat.nl/2026/02/13/bcma-gerichte-t-cel-engagertherapie-bij-refractaire-hla-sensitisatie/* This study tested B-cell maturation antigen-targeted T-cell engager therapy combined with B-cell depletion for refractory anti-HLA antibodies in transplant candidates, exploring novel immunotherapy to overcome sensitization barriers. ## Elevated Pulmonary Artery Wedge Pressure in Group 1 Pulmonary Hypertension *2026-02-13 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077606 · https://hartvaat.nl/2026/02/13/verhoogde-wiggendruk-bij-groep-1-pulmonale-hypertensie/* This Circulation study examined elevated pulmonary artery wedge pressure in patients with group 1 pulmonary hypertension, exploring the clinical significance and management implications of this hemodynamic overlap between pre- and post-capillary disease. ## Emerging Medical Therapies for Primary Aldosteronism *2026-02-13 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.126.26229 · https://hartvaat.nl/2026/02/13/nieuwe-medicamenteuze-therapieen-bij-primair-aldosteronisme/* This review discussed emerging medical therapies for primary aldosteronism beyond traditional MRAs, including aldosterone synthase inhibitors and other novel agents targeting upstream aldosterone production. ## Endothelial prolyl hydroxylase 3 mitigates maladaptive inflammation to promote post-ischemic kidney repair *2026-02-13 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00089-X/fulltext · https://hartvaat.nl/2026/02/13/endotheliale-prolylhydroxylase-3-vermindert-maladaptieve-inflammatie-bij-nierher/* This study demonstrates that endothelial prolyl hydroxylase 3 mitigates maladaptive inflammation to promote post-ischaemic kidney repair, linking dysregulated oxygen sensing in endothelial cells to CKD progression after acute kidney injury. ## Genetically determined ancestry associates with morphological and molecular carotid plaque features *2026-02-13 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00046-8/fulltext · https://hartvaat.nl/2026/02/13/genetisch-bepaalde-afkomst-en-morfologische-en-moleculaire-kenmerken-van-carotis/* This study examined how genetically determined ancestry associates with morphological and molecular features of carotid atherosclerotic plaques. Genome-informed ancestry offers a more accurate framework for studying ethnic disparities in cardiovascular disease burden. ## Use of kidney-preserving medications in breastfeeding *2026-02-13 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00081-5/fulltext · https://hartvaat.nl/2026/02/13/nierbeschermende-medicatie-tijdens-borstvoeding/* This Kidney International review addressed the safety of kidney-preserving medications during breastfeeding, providing practical guidance for CKD women on which cardiovascular and renal therapies are compatible with lactation. ## CCR8 Expression on Regulatory T Cells Reveals Trajectories of Tissue Adaptation and Protects Against Myocardial Infarction–Induced Tissue Damage *2026-02-13 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076426 · https://hartvaat.nl/2026/02/13/ccr8-expressie-op-regulatoire-t-cellen-beschermt-tegen-myocardinfarctschade/* This study mapped the developmental trajectory of regulatory T cells after MI using single-cell RNA sequencing, showing that CCR8-positive Tregs accumulate in the heart and play a vital role in limiting post-infarction inflammation. ## MYDGF Governs Endothelial Homeostasis in Hypertension *2026-02-13 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25816 · https://hartvaat.nl/2026/02/13/mydgf-beschermt-de-endotheelfunctie-bij-hypertensie/* This basic science study demonstrated that MYDGF (myeloid-derived growth factor) is essential for maintaining endothelial homeostasis in hypertension, revealing a novel molecular pathway linking immune cell-derived factors to vascular protection. ## Distribution of Lipoprotein(a) Levels and Clinical Associations in a Lebanese Adult Population: A Retrospective Observational Study. *2026-02-13 · Journal of clinical medicine · https://doi.org/10.3390/jcm15041461 · https://hartvaat.nl/2026/02/13/verdeling-van-lp-a-spiegels-en-klinische-associaties-in-een-libanese-populatie/* This retrospective study mapped lipoprotein(a) distribution in a Lebanese adult population and confirmed the association with atherosclerotic cardiovascular disease, highlighting that Lp(a) is measured in fewer than 20-30% of patients. ## CT coronary angiography guided treatment versus routine invasive coronary angiography in patients with non-ST elevation myocardial infarction: a systematic review and meta-analysis *2026-02-12 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003919?rss=1 · https://hartvaat.nl/2026/02/12/ct-coronairangiografie-bij-nstemi-uitstekende-diagnostische-nauwkeurigheid-maar-/* In non-ST-elevation myocardial infarction (NSTEMI), invasive coronary angiography (ICA) is recommended but not always feasible in time and unnecessary in patients without obstructive disease. CT coronary angiography (CTCA) may be a non-invasive alternative for lower-risk patients. This systematic review and meta-analysis (8 studies — 3 randomised trials and 5 observational cohorts, ~2,700 patients) compared a CTCA-first strategy with standard care (ICA-first). In the randomised trials, CTCA-first did not significantly reduce ICA use (RR 0.82), and outcomes were mixed (one trial no difference in death/MI, another fewer events at 1 year). Pooled diagnostic accuracy was high (sensitivity 96%, specificity 80%). CTCA thus shows excellent diagnostic accuracy and may limit complications, but so far yields no consistent reduction in ICA use or events — larger trials are needed. ## Prognostic utility of stress perfusion cardiac magnetic resonance in patients with known or suspected coronary artery disease and inconclusive exercise stress testing *2026-02-12 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003623?rss=1 · https://hartvaat.nl/2026/02/12/stress-perfusie-mri-bepaalt-het-risico-na-een-niet-conclusieve-inspanningstest-b/* Exercise stress testing (EST) is widely used for risk stratification in coronary artery disease (CAD) but yields inconclusive results in up to 20%. Stress perfusion CMR is an accurate alternative, but data after inconclusive EST were limited. In this study (414 patients with known or suspected CAD and inconclusive EST referred for stress CMR, 2009-2022), major adverse cardiovascular events (MACE) were examined. Over a median 6.9-year follow-up, 7.7% had a MACE. Patients with inducible ischaemia on CMR had a much higher annual MACE rate (2.8 vs 0.8 per 100 patient-years). Inducible ischaemia was an independent predictor of MACE (HR 4.03), alongside atrial fibrillation and resting systolic blood pressure. Stress perfusion CMR thus provides valuable prognostic information and effectively stratifies risk in patients with an inconclusive exercise test. ## Therapy for Atrial Fibrillation in Patients with Drug-Eluting Stents. *2026-02-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2512091 · https://hartvaat.nl/2026/02/12/af-therapie-bij-patienten-met-drug-eluting-stents/* This NEJM study examined the optimal antithrombotic regimen for AF patients with drug-eluting stents, providing randomized evidence supporting NOAC with P2Y12 inhibitor without aspirin for the contemporary DES era. ## Prognostic impact of guideline-directed medical therapy after functionally complete revascularisation in patients with obstructive coronary artery diseases. *2026-02-12 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-325670 · https://hartvaat.nl/2026/02/12/gdmt-na-functioneel-complete-revascularisatie-prognostische-impact/* This analysis showed that optimal guideline-directed medical therapy further improves prognosis after functionally complete revascularization, demonstrating that PCI and pharmacotherapy provide complementary rather than competing benefit. ## Multilineage assembly brings spatial order to human kidney organoids *2026-02-12 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01013-0/fulltext · https://hartvaat.nl/2026/02/12/multi-lijns-assemblage-brengt-ruimtelijke-orde-in-menselijke-nierorganoiden/* This review discusses how multilineage assembly approaches bring spatial organisation to human kidney organoids, representing a critical advance toward generating functional kidney models with physiological architecture. ## Neglected no longer: lymphatic vessels in the rejecting allograft *2026-02-12 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00074-8/fulltext · https://hartvaat.nl/2026/02/12/niet-langer-vergeten-lymfevaten-in-het-afstotende-transplantaat/* This article highlights the previously neglected role of lymphatic vessels in kidney allograft rejection. As transplant pathologies become more complex, understanding lymphatic contributions may improve long-term graft outcomes. ## Phenotype first: a data-driven approach to genetic penetrance *2026-02-12 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00072-4/fulltext · https://hartvaat.nl/2026/02/12/fenotype-eerst-een-datagestuurde-benadering-van-genetische-penetrantie/* This commentary discusses a phenotype-first, data-driven approach to assessing genetic penetrance in nephrology, addressing the growing challenge of interpreting genetic variants in the era of massively parallel sequencing. ## Sustained monocyte activation by persistent challenges with either oxLDL or free cholesterol and underlying mechanisms. *2026-02-12 · ImmunoHorizons · https://doi.org/10.1093/immhor/vlag005 · https://hartvaat.nl/2026/02/12/aanhoudende-monocytactivatie-door-geoxideerd-ldl-en-vrij-cholesterol/* This study demonstrates that prolonged exposure to oxidised LDL or free cholesterol reprogrammes monocytes into a sustained activated state, describing the underlying epigenetic and metabolic mechanisms in chronic atherosclerotic inflammation. ## Second- and Third-Generation BCR-ABL Tyrosine Kinase Inhibitors and the Risk of Pulmonary Arterial Hypertension: A Prevalent New-User Design *2026-02-12 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077764 · https://hartvaat.nl/2026/02/12/bcr-abl-tyrosinekinaseremmers-en-het-risico-op-pulmonale-arteriele-hypertensie/* This Circulation study quantified the risk of pulmonary arterial hypertension with second- and third-generation BCR-ABL tyrosine kinase inhibitors used for chronic myeloid leukemia, using French national health database data to characterize this serious drug side effect. ## Prospective Associations of Obesity and Obesity Severity With 9 Cardiovascular Outcomes: The Cross-Cohort Collaboration *2026-02-12 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075327 · https://hartvaat.nl/2026/02/12/obesitas-en-de-ernst-ervan-voorspellen-negen-cardiovasculaire-aandoeningen/* This prospective cross-cohort analysis showed that not only obesity but particularly its severity is strongly predictive of multiple cardiovascular outcomes, with a graded relationship across the full BMI spectrum. ## Fractional flow reserve-guided renal artery stenting in atherosclerotic renovascular hypertension: the FAIR randomized trial. *2026-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf746 · https://hartvaat.nl/2026/02/11/ffr-geleide-nierslagaderstenting-bij-atherosclerotische-renovasculaire-hypertens/* The FAIR trial tested FFR-guided renal artery stenting versus medical therapy in atherosclerotic renovascular hypertension, reviving the concept of physiologically guided intervention for this common secondary hypertension cause. ## Aspirin dosing after acute coronary syndrome with suspected aspirin resistance: the ANDAMAN trial. *2026-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf680 · https://hartvaat.nl/2026/02/11/andaman-aspirinedosering-na-acs-met-verdenking-aspirineresistentie/* The ANDAMAN trial tested higher aspirin dosing in ACS patients with suspected aspirin resistance, evaluating whether dose escalation overcomes inadequate platelet inhibition in diabetes and high-risk patients. ## Beta-blockers after myocardial infarction: effects according to sex in the REBOOT trial. *2026-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf673 · https://hartvaat.nl/2026/02/11/reboot-betablokkers-na-mi-sekseverschillen/* A prespecified sex-specific subgroup analysis of the REBOOT trial examined whether the neutral effect of beta-blockers after MI without reduced LVEF applies equally to women and men. No sex difference was found, generalising the result to both sexes. ## Improving outcomes of atrial fibrillation ablation by integrated personalized lifestyle interventions: a randomized controlled trial. *2026-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf689 · https://hartvaat.nl/2026/02/11/gepersonaliseerde-leefstijlinterventie-verbetert-af-ablatie-uitkomsten/* This randomized trial confirmed that integrated personalized lifestyle interventions (weight management, fitness, sleep optimization, alcohol reduction) significantly improve catheter ablation outcomes for atrial fibrillation. ## Vericiguat and mortality in heart failure and reduced ejection fraction: the VICTOR trial. *2026-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf655 · https://hartvaat.nl/2026/02/11/victor-vericiguat-en-mortaliteit-bij-hfref-definitieve-analyse/* The VICTOR trial analysis confirmed that vericiguat reduces mortality in patients with HFrEF and recent decompensation. The mortality benefit adds to the heart failure event reduction shown in VICTORIA, strengthening vericiguat's position in guideline-directed therapy. ## A Drosophila model for Dent’s disease type 1 revealed impaired endoplasmic reticulum export of Cubilin as pathogenic mechanism *2026-02-11 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00087-6/fulltext · https://hartvaat.nl/2026/02/11/drosophila-model-voor-de-ziekte-van-dent-type-1-onthult-pathogeen-mechanisme/* This Drosophila model for Dent disease type 1 revealed that impaired endoplasmic reticulum export of Cubilin is the pathogenic mechanism underlying the endolysosomal disorder caused by CLCN5 mutations. ## Association Between Prepregnancy Blood Pressure and Reproductive Outcomes of In Vitro Fertilization *2026-02-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25872 · https://hartvaat.nl/2026/02/11/bloeddruk-voor-zwangerschap-en-ivf-uitkomsten/* This study investigated whether the 2017/2025 ACC/AHA hypertension classification (threshold 130/80 mmHg) has implications for reproductive outcomes in women undergoing in vitro fertilisation. Prepregnancy blood pressure may influence IVF success rates. ## Criteria to Assess the Predictive and Clinical Utility of Novel Models, Biomarkers, and Tools for Risk of Cardiovascular Disease: A Scientific Statement From the American Heart Association *2026-02-11 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001401 · https://hartvaat.nl/2026/02/11/criteria-voor-beoordeling-van-nieuwe-cardiovasculaire-risicomodellen-aha/* This AHA scientific statement described criteria for assessing the predictive and clinical utility of novel cardiovascular risk models, biomarkers, and tools, providing a methodological framework for evaluating new risk assessment technologies. ## DNA Methylation Markers for Pregnancy Hypertension via Machine Learning Methods *2026-02-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25388 · https://hartvaat.nl/2026/02/11/dna-methyleringsmarkers-voor-zwangerschapshypertensie-via-machine-learning/* This study developed a prediction model for hypertensive disorders of pregnancy by integrating DNA methylation biomarkers and clinical factors using machine learning. First-trimester epigenetic screening may enable early identification of at-risk pregnancies. ## Factors Associated With Discordant Blood Pressure Measures among Very Old Adults: Results From the Atherosclerosis Risk in Communities (ARIC) Study *2026-02-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26377 · https://hartvaat.nl/2026/02/11/factoren-bij-discordante-bloeddrukmeting-bij-zeer-oude-volwassenen-aric-studie/* This ARIC study identified factors associated with discordant home versus office blood pressure measurements in very old adults, informing the interpretation of home monitoring in the oldest patient populations. ## Hybrid CARs: rewiring macrophage signaling for targeted therapy in acute and chronic kidney inflammation *2026-02-11 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00070-0/fulltext · https://hartvaat.nl/2026/02/11/hybride-car-s-macrofaagsignalering-herbedraden-voor-gerichte-niertherapie/* This article discusses the development of hybrid chimeric antigen receptors that rewire macrophage signalling for targeted therapy in acute and chronic kidney inflammation, extending CAR technology beyond oncology. ## Macrophage PRMT9 Ameliorates Acute Myocardial Infarction by Promoting Symmetric Dimethylation and Degradation of STAT1 *2026-02-11 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076101 · https://hartvaat.nl/2026/02/11/macrofaag-prmt9-verbetert-uitkomsten-na-acuut-myocardinfarct-via-stat1-degradati/* This study showed that macrophage PRMT9 promotes degradation of inflammatory mediators through symmetric dimethylation, ameliorating acute MI by modulating the deleterious M1 macrophage response. ## Proteogenomic dissection of kidney disease and cardiovascular-kidney-metabolic syndrome *2026-02-11 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00071-2/fulltext · https://hartvaat.nl/2026/02/11/proteogenomische-ontleding-van-nierziekte-en-cardiovasculair-renaal-metabool-syn/* This review discusses how modern proteogenomic techniques provide new insights into the pathophysiology of kidney disease and the cardiovascular-kidney-metabolic syndrome. The integrated approach advances understanding of the cardiorenal connections first described by Richard Bright in 1836. ## Factors associated with the development of severe mitral regurgitation in patients with heart failure *2026-02-10 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003920?rss=1 · https://hartvaat.nl/2026/02/10/welke-hartfalenpatienten-ontwikkelen-ernstige-mitralisinsufficientie-voorspellen/* Patients with heart failure (HF) and severe mitral regurgitation (MR) have poor outcomes; early recognition could enable timely intervention. In this study, 7,391 HF patients with at least two echocardiograms (≥6 months apart) were analysed to find factors associated with progression to severe MR. Over a median 1.4 years, 4.8% developed severe MR. Besides baseline MR severity, atrial fibrillation (aOR 1.52), ischaemic heart disease (aOR 1.44), hypertension (aOR 1.35) and larger left ventricular end-diastolic dimension (aOR 1.36 per cm) were associated with more progression. Beta-blocker use was associated with less progression (aOR 0.74). These factors can help identify HF patients needing closer echocardiographic follow-up and timely access to interventions. ## Incidence, Risk Factors, and Outcomes in Stressor-Associated Atrial Fibrillation: Insights From the VITAL-AF Trial. *2026-02-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.076421 · https://hartvaat.nl/2026/02/10/stressor-geassocieerd-af-incidentie-risicofactoren-en-uitkomsten/* Analysis of the VITAL-AF trial documented the incidence, risk factors, and outcomes of stressor-associated atrial fibrillation — AF diagnosed in the setting of acute illness, surgery, or sepsis. The prognosis and management implications differ from spontaneous AF. ## Transthyretin Cardiac Amyloidosis Evaluation and Management: 2025 ACC Concise Clinical Guidance. *2026-02-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.09.004 · https://hartvaat.nl/2026/02/10/2025-acc-attr-cm-evaluatie-en-management-beknopte-klinische-richtlijn/* This 2025 ACC clinical guidance for transthyretin amyloid cardiomyopathy provides structured recommendations for diagnosis, risk stratification, and treatment including tafamidis. The document addresses the growing recognition and improved detection of this previously underdiagnosed condition. ## Resistant Hypertension Is Not Essential: It Is Primarily Aldosteronism *2026-02-10 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26401 · https://hartvaat.nl/2026/02/10/resistente-hypertensie-is-geen-essentiele-hypertensie-het-is-vooral-aldosteronis/* This opinion piece argued that most cases of resistant hypertension are primarily driven by aldosteronism, challenging the conventional paradigm and advocating for systematic aldosterone assessment before labeling hypertension as treatment-resistant. ## Clonal Hematopoiesis and Its Cardiovascular Implications: A Scientific Statement From the American Heart Association *2026-02-10 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001404 · https://hartvaat.nl/2026/02/10/klonale-hematopoese-en-cardiovasculaire-implicaties-aha-statement/* This AHA scientific statement reviewed the emerging evidence on clonal hematopoiesis and its cardiovascular implications, describing how somatic mutations in hematopoietic stem cells drive inflammation and increase cardiovascular risk independent of traditional risk factors. ## Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial *2026-02-10 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075875 · https://hartvaat.nl/2026/02/10/spontaan-myocardinfarct-na-linkerhoofdstamrevascularisatie-de-excel-trial/* This EXCEL analysis compared rates and prognostic implications of spontaneous MI after PCI versus CABG for left main disease, providing granular data on the long-term ischemic risk profile of each revascularization strategy. ## Renal and urothelial cancer risks with SGLT2 inhibitors vs GLP-1 receptor agonists in type 2 diabetes: a target trial emulation. *2026-02-10 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag028 · https://hartvaat.nl/2026/02/10/risico-op-nier-en-urotheelkanker-bij-sglt2-remmers-versus-glp-1-receptoragoniste/* This target trial emulation compared renal and urothelial cancer risks between SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes, addressing an important safety question for these widely prescribed cardiometabolic agents. ## Optical coherence tomography-guided stent optimization for complex coronary lesions: the OCCUPI trial. *2026-02-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf884 · https://hartvaat.nl/2026/02/09/occupi-oct-geleide-stentoptimalisatie-bij-complexe-coronairlaesies/* The OCCUPI trial evaluated OCT-guided stent optimization for complex coronary lesions, assessing the incidence, determinants, and clinical impact of achieving optimal stent expansion under intravascular imaging guidance. ## Coronary Atherosclerosis in Patients With Cancer and Survivors: A Scientific Statement From the American Heart Association *2026-02-09 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001391 · https://hartvaat.nl/2026/02/09/coronaire-atherosclerose-bij-kankerpatienten-en-overlevenden-aha-statement/* This AHA scientific statement addressed the emerging convergence between atherosclerotic cardiovascular disease and cancer, driven by shared risk factors, overlapping pathophysiology, and the cardiovascular toxicity of cancer therapies. ## Podocyte-derived endothelin-1 and endothelial cell endothelin A receptors are essential for glomerular injury in mouse models of focal segmental glomerulosclerosis *2026-02-09 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00077-3/fulltext · https://hartvaat.nl/2026/02/09/podocyt-endotheline-1-en-endotheelcel-eta-receptoren-essentieel-bij-fsgs/* This study demonstrates that podocyte-derived endothelin-1 and glomerular endothelial cell endothelin A receptors are essential for glomerular injury in mouse models of focal segmental glomerulosclerosis, establishing a podocyte-endothelial crosstalk mechanism. ## Kidney-Heart Crosstalk: The Extracellular Vesicles Connection. *2026-02-09 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag022 · https://hartvaat.nl/2026/02/09/communicatie-tussen-nier-en-hart-via-extracellulaire-vesikels/* This review discusses the role of extracellular vesicles in kidney-heart crosstalk during chronic kidney disease. Altered EV abundance and molecular cargo in CKD transport pathological signals between organs, amplifying cardiovascular vulnerability. ## Lipoprotein(a) and Cardiovascular Disease: From Genetic Risk Factor to Therapeutic Target. *2026-02-07 · Cells · https://doi.org/10.3390/cells15040315 · https://hartvaat.nl/2026/02/07/lipoproteine-a-en-cardiovasculaire-ziekte-van-genetische-risicofactor-naar-thera/* A comprehensive review of lipoprotein(a) as a cardiovascular risk factor, covering its causal link to atherosclerosis and aortic valve stenosis, and emerging phase III therapies including pelacarsen, olpasiran, and lepodisiran. ## Risk factors, clinical profile, angiographic characteristics and reperfusion therapy in young patients (<=45 years) with acute ST-elevation myocardial infarction compared to older patients: a tertiary centre in South India *2026-02-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003937?rss=1 · https://hartvaat.nl/2026/02/06/jonge-patienten-met-een-hartinfarct-meer-leefstijl-en-psychosociale-risicofactor/* Myocardial infarction is rising among young people, including in India. This cross-sectional study at a South Indian hospital compared 65 young (≤45 years) and 195 older patients (>45 years) with a first ST-elevation myocardial infarction (STEMI). Young patients were more often male and more often had high alcohol consumption, a family history of premature cardiovascular disease, shorter sleep duration and higher anxiety scores. Older patients more often had hypertension and diabetes. In multivariable analysis, longer sleep duration was associated with older age and a higher anxiety score with younger age. Young STEMI patients thus show a greater burden of modifiable lifestyle and psychosocial risk factors — arguing for age-specific prevention. ## Renal function trajectories in 'de novo' heart failure with reduced ejection fraction: impact on outcomes *2026-02-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003193?rss=1 · https://hartvaat.nl/2026/02/06/nierfunctiebeloop-bij-nieuw-ontstaan-hfref-voorspelt-de-uitkomst/* Heart failure (HF) often coexists with chronic kidney disease (CKD), affecting prognosis. This prospective cohort followed renal function in patients hospitalised with new-onset heart failure with reduced ejection fraction (de novo HFrEF) at two university hospitals. Of 306 patients analysed, 24.6% had an eGFR <45 mL/min/1.73 m² at discharge. Higher eGFR at discharge was associated with better outcomes. During follow-up, 79.1% had an eGFR ≥45; patients with stable or improved renal function had lower mortality and fewer readmissions. Factors associated with improvement or stabilisation included less prior CKD, hypertension, younger age, higher eGFR at discharge and greater use of quadruple HF therapy. Routine renal function assessment in de novo HFrEF is thus important to personalise treatment. ## Apolipoprotein D, a Novel Ligand for CD36, Is Essential for Blood–Brain Barrier Integrity *2026-02-06 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077356 · https://hartvaat.nl/2026/02/06/apolipoproteine-d-een-nieuw-ligand-voor-cd36-is-essentieel-voor-de-bloed-hersenb/* This study identified apolipoprotein D as a novel ligand for CD36 essential for blood-brain barrier integrity, revealing a new mechanism at the interface between lipid metabolism and cerebrovascular health. ## Broadening Primary Aldosteronism Screening: Alignment Across Contemporary Guidelines *2026-02-06 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26228 · https://hartvaat.nl/2026/02/06/verbreding-van-screening-op-primair-aldosteronisme-consensus-tussen-richtlijnen/* This Hypertension article advocated for broadening primary aldosteronism screening, noting that fewer than 2% of eligible patients are currently screened despite evidence that early detection and targeted therapy improve cardiovascular outcomes. ## Genome and Transcriptome-Wide Analyses Identify Multiple Candidate Genes and a Significant Polygenic Contribution in Bicuspid Aortic Valve *2026-02-06 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074752 · https://hartvaat.nl/2026/02/06/genoom-en-transcriptoomanalyses-identificeren-kandidaatgenen-bij-bicuspide-aorta/* This genome and transcriptome-wide study identified multiple candidate genes and significant polygenic contributions to bicuspid aortic valve, advancing the genetic understanding of this common congenital heart defect. ## Insulin Resistance Compromises the Pentose Phosphate Pathway and Impairs Left Ventricular Assist Device–Mediated Myocardial Recovery in Obese Patients with Heart Failure *2026-02-06 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.124.072850 · https://hartvaat.nl/2026/02/06/insulineresistentie-compromitteert-pentosefosfaatroute-en-lvad-gemedieerd-herste/* This study demonstrated that insulin resistance compromises the pentose phosphate pathway and impairs LVAD-mediated cardiac recovery, explaining why diabetic patients have worse myocardial recovery during mechanical support. ## Natural History of Patients With Histologically Proven Acute Eosinophilic Myocarditis *2026-02-06 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074797 · https://hartvaat.nl/2026/02/06/natuurlijk-beloop-van-histologisch-bewezen-acute-eosinofiele-myocarditis/* This Circulation study characterized the natural history of histologically proven acute eosinophilic myocarditis, providing the first large registry data on clinical presentation, treatment, and outcomes of this rare but severe form of myocardial inflammation. ## SIRT1-NCOR2 Corepressor Modulates Trophoblast-Macrophage Interactions in Preeclampsia *2026-02-06 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26144 · https://hartvaat.nl/2026/02/06/sirt1-ncor2-corepressor-moduleert-trofoblast-macrofaaginteracties-bij-pre-eclamp/* This study investigated how the SIRT1-NCOR2 corepressor complex modulates trophoblast-macrophage interactions at the maternal-fetal interface in preeclampsia, linking low SIRT1 levels to abnormal Rarres2-Cmklr1 signalling. ## TRPM7 Deficiency Protects Against Myocardial Ischemia-Reperfusion Injury by Regulating Intracellular Zn2+ Homeostasis *2026-02-06 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074791 · https://hartvaat.nl/2026/02/06/trpm7-deficientie-beschermt-tegen-myocardiale-ischemie-reperfusieschade/* This study showed that TRPM7 channel deficiency protects against myocardial ischemia-reperfusion injury by regulating intracellular zinc homeostasis, identifying a potential therapeutic target for reducing reperfusion damage. ## The Aldehyde Dehydrogenase 2 rs671 Variant Enhances Platelet Activation and Arterial Thrombosis *2026-02-06 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074318 · https://hartvaat.nl/2026/02/06/aldh2-rs671-variant-versterkt-plaatjesactivatie-en-arteriele-trombose/* This study showed that the ALDH2 rs671 variant, present in 30-50% of East Asians, enhances platelet activation and arterial thrombosis, explaining the increased MI risk in carriers of this common genetic polymorphism. ## Use of a Structured Interview to Assess the Association of Inadequate Energy and Protein Intake with Subclinical Congestion in Heart Failure Patients. *2026-02-06 · Journal of visualized experiments : JoVE · https://doi.org/10.3791/69496 · https://hartvaat.nl/2026/02/06/onvoldoende-eiwit-en-energie-inname-bij-subklinische-congestie-bij-hartfalen/* This study used structured interviews to assess whether subclinical congestion is associated with inadequate energy and protein intake in heart failure patients, addressing a gap in nutritional assessment methodology. ## Beyond lipid lowering: Effects of PCSK9 inhibition on inflammation and HDL function. *2026-02-06 · Journal of clinical lipidology · https://doi.org/10.1016/j.jacl.2026.02.003 · https://hartvaat.nl/2026/02/06/voorbij-lipidenverlaging-pcsk9-remming-vermindert-ook-inflammatie-en-verbetert-h/* Beyond LDL-C lowering, this real-world study demonstrated that PCSK9 inhibition reduces vascular and systemic inflammation and improves HDL antioxidant function. The pleiotropic effects include Lp(a) reduction and decreased inflammatory markers. ## The Inherited Basis of Coronary Artery Disease *2026-02-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMra2405153 · https://hartvaat.nl/2026/02/05/de-erfelijke-basis-van-coronairlijden-nejm-overzicht/* This NEJM review summarises how genetic research has reshaped the understanding, treatment, prevention and risk prediction of coronary artery disease. Monogenic causes occur in roughly 1 in 250 people and usually produce markedly elevated lipid levels. At the population level, hundreds of common small-effect variants together have even greater influence; combined into a polygenic risk score (PRS), risk in the top 5% is 3–5 times the average. The PRS can multiply the absolute risk from clinical scores. Questions about clinical value, cost-effectiveness and implementation remain. ## A Placebo-Controlled Trial of the Oral PCSK9 Inhibitor Enlicitide *2026-02-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2511002 · https://hartvaat.nl/2026/02/05/orale-pcsk9-remmer-enlicitide-verlaagt-ldl-met-57-placebogecontroleerde-trial/* Enlicitide decanoate, an oral PCSK9 inhibitor, was tested in this multinational double-blind, placebo-controlled trial in 2,909 adults with established atherosclerotic cardiovascular disease (LDL ≥55 mg/dL) or at risk of a first event (LDL ≥70 mg/dL). Participants received daily enlicitide 20 mg or placebo (2:1) for 52 weeks. At week 24, LDL cholesterol fell by a mean of 57.1% with enlicitide versus +3.0% with placebo — a difference of almost 56 percentage points. Oral PCSK9 inhibition thus approaches the efficacy of the injectable agents, with potential to greatly improve access and adherence. ## Angiopoietin-2 inhibition and TIE2 reactivation in chronic kidney disease: the next step forward *2026-02-05 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00067-0/fulltext · https://hartvaat.nl/2026/02/05/angiopoetine-2-remming-en-tie2-reactivatie-bij-chronische-nierziekte/* This article discusses angiopoietin-2 inhibition and TIE2 receptor reactivation as therapeutic strategies to address microvascular rarefaction in chronic kidney disease, targeting the endothelial plasticity that underlies CKD progression. ## Association Between Postprandial Hypotension Determined by Ambulatory Blood Pressure Monitoring and Falls Among Older Adults With Hypertension Who Are Taking Antihypertensive Medication: Results From the AMBROSIA Study *2026-02-05 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25518 · https://hartvaat.nl/2026/02/05/postprandiale-hypotensie-en-valrisico-bij-oudere-hypertensieve-patienten-ambrosi/* This AMBROSIA study showed that postprandial hypotension detected by ambulatory monitoring is associated with falls in older adults taking antihypertensive medication, identifying a modifiable risk factor for fall prevention. ## Concordant and Discordant Transcriptomic Signatures of Twin Placentas in the Setting of Preeclampsia *2026-02-05 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25854 · https://hartvaat.nl/2026/02/05/concordante-en-discordante-transcriptomische-kenmerken-van-tweelingplacenta-s-bi/* RNA sequencing of individual twin placentas revealed both concordant and discordant transcriptomic signatures in preeclampsia, suggesting that the molecular pathogenesis may differ between monochorionic and dichorionic twin gestations. ## Efimosfermin alfa (BOS-580) once per month in people with metabolic dysfunction-associated steatohepatitis with F2 or F3 fibrosis: results from a 24-week, randomised, double-blind, placebo-controlled, phase 2 trial *2026-02-05 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02276-7/fulltext · https://hartvaat.nl/2026/02/05/efimosfermine-alfa-bij-mash-met-f2-f3-fibrose-fase-2-resultaten/* This phase 2 trial of efimosfermin alfa (FGF21 analogue) showed favorable tolerability in patients with MASH and F2/F3 fibrosis. The results support further development of metabolic therapies targeting the liver-cardiovascular axis. ## Once-monthly efimosfermin for non-cirrhotic MASH *2026-02-05 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02431-6/fulltext · https://hartvaat.nl/2026/02/05/eenmaal-per-maand-efimosfermine-bij-niet-cirrotische-mash/* This Lancet article discussed once-monthly efimosfermin for non-cirrhotic MASH, addressing the growing intersection between metabolic liver disease and cardiovascular risk through a novel FGF21-based therapeutic approach. ## Sex-Specific Blood Pressure and Brain Microvascular Traits in a Model of Low-Renin Hypertension *2026-02-05 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25795 · https://hartvaat.nl/2026/02/05/geslachtsspecifieke-bloeddruk-en-hersenvasculaire-kenmerken-bij-laag-renine-hype/* This study examined sex-specific blood pressure and brain microvascular traits in a low-renin hypertension model produced by brain renin-angiotensin system activation, addressing an understudied form of hypertension. ## circMFN2 Regulates the IGF2BP3-PDK4 to Ameliorate Pulmonary Hypertension *2026-02-05 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25460 · https://hartvaat.nl/2026/02/05/circmfn2-reguleert-igf2bp3-pdk4-bij-pulmonale-hypertensie/* This study identified circMFN2 as a circular RNA significantly downregulated in pulmonary hypertension that ameliorates disease through regulation of the IGF2BP3-PDK4 axis, offering a potential therapeutic target. ## Intravenous tenecteplase for acute ischaemic stroke within 24 h due to basilar artery occlusion *2026-02-05 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00139-X/fulltext · https://hartvaat.nl/2026/02/05/tenecteplase-bij-basilarisocclusie-tot-24-uur-veelbelovende-lancet-data/* This Lancet publication addresses basilar artery occlusion, the most severe presentation of large-vessel ischemic stroke, with new randomized and observational evidence supporting intravenous tenecteplase therapy within an extended 24-hour treatment window. ## Tenecteplase versus standard medical treatment for basilar artery occlusion within 24 h (TRACE-5): a multicentre, prospective, randomised, open-label, blinded-endpoint, superiority, phase 3 trial *2026-02-05 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02633-9/fulltext · https://hartvaat.nl/2026/02/05/tenecteplase-versus-standaardbehandeling-bij-basilaris-occlusie-in-the-lancet/* The TRACE-5 trial demonstrated that intravenous tenecteplase within 24 hours improved functional outcomes in Chinese patients with ischemic stroke due to basilar artery occlusion. The results support thrombolysis as an effective treatment for this devastating posterior circulation stroke subtype. ## Three-year clinical outcomes of left atrial appendage occlusion with or without ablation: insight from the RECORD study. *2026-02-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag022 · https://hartvaat.nl/2026/02/05/driejaarsuitkomsten-van-linker-hartoorsluiting-met-of-zonder-ablatie-record-stud/* The RECORD study provided three-year outcomes of LAA occlusion with or without concurrent AF ablation in a large Chinese cohort, showing that the combination may provide additive rhythm and stroke prevention benefits. ## 200 J-first, fixed-escalation biphasic electrical cardioversion for atrial fibrillation >48 hours in the emergency department: a single-centre retrospective observational study *2026-02-04 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003875?rss=1 · https://hartvaat.nl/2026/02/04/200-joule-als-startenergie-voor-elektrische-cardioversie-bij-atriumfibrilleren-w/* In electrical cardioversion (ECV) of atrial fibrillation (AF) lasting more than 48 hours, up to 360 joules is permitted; the CHESS trial found higher success with a fixed 360J start. In this retrospective single-centre study (374 elective ECVs in the emergency department, 2019-2021), a fixed escalating sequence of 200→300→360 J was used with a standardised technique (hand-held paddles, firm pressure, anterolateral placement under deep sedation). Sinus rhythm was restored in 97.3%; the first 200 J shock succeeded in 88.0%. Only 44 and 15 patients needed 300 J and 360 J respectively. There were two minor adverse events (0.5%) and none serious. A 200J-first protocol with standardised technique thus gives high first-shock and excellent cumulative success in long-standing AF, without routine pharmacological adjuncts. ## Clinical outcomes of pulsed field versus radiofrequency ablation, incorporating posterior wall isolation, in persistent atrial fibrillation *2026-02-04 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003798?rss=1 · https://hartvaat.nl/2026/02/04/pulsed-field-ablatie-bereikt-vaker-complete-achterwandisolatie-dan-radiofrequent/* Persistent atrial fibrillation (AF) remains difficult to treat with catheter ablation. The left atrial posterior wall is a potentially important substrate, but adjunctive posterior wall isolation (PWI) with thermal ablation did not improve outcomes in trials — possibly due to technical limitations. Pulsed-field ablation (PFA) is a non-thermal technique that selectively targets myocardium and may make PWI safer and more consistent. In this real-world cohort (200 patients, 100 PFA and 100 RFA, with combined pulmonary vein and posterior wall isolation), PFA achieved near-universal complete PWI (99% vs 65%), with shorter procedure and left-atrial dwell times. Major non-vascular complications were rare (1.5%) and similar. At 12 months, freedom from recurrent atrial tachyarrhythmia was higher with PFA (70% vs 54%). PFA thus appears to achieve complete posterior wall isolation more often and fewer recurrences than RFA — randomised studies should confirm the role of PWI with PFA. ## Bacterial Extracellular Vesicles Mediate Microbiota-Host Communication to Regulate Blood Pressure in Male Rats *2026-02-04 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25962 · https://hartvaat.nl/2026/02/04/bacteriele-extracellulaire-vesikels-reguleren-bloeddruk-via-microbiota-gastheer-/* This study demonstrates that bacterial extracellular vesicles from the gut microbiota reach the circulation and modulate blood pressure in spontaneously hypertensive stroke-prone rats, revealing a novel microbiota-host communication pathway in hypertension. ## C-Type Natriuretic Peptide Preserves Vascular and Cardiac Function in Sepsis *2026-02-04 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25938 · https://hartvaat.nl/2026/02/04/c-type-natriuretisch-peptide-beschermt-vasculaire-en-cardiale-functie-bij-sepsis/* This study demonstrates that C-type natriuretic peptide preserves vascular and cardiac function during sepsis. The findings suggest CNP supplementation as a potential therapeutic strategy for sepsis-associated cardiovascular dysfunction. ## Determinants of Placental Versus Maternal Preeclampsia *2026-02-04 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26236 · https://hartvaat.nl/2026/02/04/determinanten-van-placentaire-versus-maternale-pre-eclampsie/* This study evaluated clinical classification systems for distinguishing placental from maternal preeclampsia based on placental pathological features. The findings inform subtype-specific approaches to preeclampsia management and prevention. ## Endothelial LRRC8C Associates With LRRC8A and LRRC8B to Regulate Vascular Reactivity and Blood Pressure *2026-02-04 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25889 · https://hartvaat.nl/2026/02/04/endotheliaal-lrrc8c-reguleert-vasculaire-reactiviteit-en-bloeddruk/* This study identifies LRRC8C as a partner subunit of the mechanoresponsive endothelial LRRC8 complex, working with LRRC8A and LRRC8B to regulate vascular reactivity and blood pressure through endothelial mechanosensing. ## Loss of ROR2 Tyrosine Kinase Receptor Is Associated With Endothelial Dysfunction in PAH via Inappropriate Integrin β1 Activation *2026-02-04 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25881 · https://hartvaat.nl/2026/02/04/verlies-van-ror2-tyrosinekinase-veroorzaakt-endotheeldisfunctie-bij-pah/* This study reveals that loss of the ROR2 tyrosine kinase receptor causes endothelial dysfunction in pulmonary arterial hypertension through inappropriate integrin beta1 activation, identifying a novel Wnt signalling pathway in PAH pathogenesis. ## Improved performance after neuromuscular electrical stimulation in hospitalized patients with severe heart failure. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvaf042 · https://hartvaat.nl/2026/02/03/neuromusculaire-elektrostimulatie-bij-ernstig-hartfalen-functionele-verbetering/* A randomised trial demonstrated that neuromuscular electrical stimulation improves functional performance in hospitalised patients with severe heart failure who cannot mobilise. The intervention offers a safe alternative for maintaining muscle function during prolonged bedrest. ## Adaptive blood pressure-modulated atrial pacing in hypertensive HFpEF patients: a randomized, first-in-human study. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvaf020 · https://hartvaat.nl/2026/02/03/adaptieve-bloeddrukgemoduleerde-atriale-pacing-bij-hypertensief-hfpef-eerste-rct/* This first-in-human randomized trial of adaptive blood pressure-modulated atrial pacing in hypertensive HFpEF tested an innovative device concept that links pacemaker rate response to real-time blood pressure feedback. ## Mortality and heart failure hospitalizations in heart failure with preserved ejection fraction compared to heart failure with reduced ejection fraction: a systematic review and meta-analysis. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag026 · https://hartvaat.nl/2026/02/03/mortaliteit-en-hospitalisaties-bij-hfpef-versus-hfref-vergelijkende-analyse/* This comparative analysis showed that mortality in HFpEF is approaching that of HFrEF in the modern era, establishing that preserved ejection fraction heart failure is not a mild condition but a serious prognostic entity. ## Fluid restriction vs liberal intake in patients with heart failure: a meta-analysis of randomized trials. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvaf004 · https://hartvaat.nl/2026/02/03/vochtbeperking-versus-liberale-inname-bij-hartfalen-meta-analyse-van-rct-s/* This meta-analysis found that fluid restriction in heart failure does not consistently improve outcomes compared with liberal intake, challenging the traditional practice of routine fluid limitation. ## The possible impact of levosimendan infusions on clinical course of heart failure: the results of the LEIA-HF study. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag021 · https://hartvaat.nl/2026/02/03/levosimendan-infusies-en-klinisch-beloop-bij-hartfalen-levo-d-resultaten/* The LEIA-HF study of repeated levosimendan infusions in ambulatory heart failure showed improved quality of life and functional capacity, supporting intermittent inotropic support for selected advanced HF patients. ## Safety and efficacy of intracardiac echocardiography in atrial fibrillation ablation: a meta-analysis. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag002 · https://hartvaat.nl/2026/02/03/ice-bij-af-ablatie-veiligheid-en-effectiviteit-meta-analyse/* This meta-analysis confirmed the safety and efficacy of intracardiac echocardiography during AF ablation, supporting ICE as the emerging standard imaging modality for procedural guidance. ## Dapagliflozin to Reduce Early Recurrence After Catheter Ablation for Atrial Fibrillation: The DARE-AF Randomized Clinical Trial. *2026-02-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.077447 · https://hartvaat.nl/2026/02/03/dare-af-dapagliflozine-vermindert-vroeg-af-recidief-na-ablatie/* The DARE-AF trial demonstrated that dapagliflozin reduces early AF recurrence after catheter ablation. The finding suggests that SGLT2 inhibitors may have antiarrhythmic properties that complement ablation therapy. ## Association between cumulative exposure to cardiometabolic index and risk of heart failure: a prospective cohort study. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvaf040 · https://hartvaat.nl/2026/02/03/cumulatieve-blootstelling-aan-cardiometabole-index-en-risico-op-hartfalen/* A large prospective cohort study from the Kailuan Study examined the association between cumulative exposure to the cardiometabolic index and incident heart failure risk. Higher cumulative CMI exposure was associated with increased heart failure incidence. ## Baseline characteristics in the TransitionCHF study: asymptomatic patients with heart failure and reduced ejection fraction. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag012 · https://hartvaat.nl/2026/02/03/kenmerken-van-asymptomatische-patienten-met-hartfalen-en-verminderde-ejectiefrac/* The TransitionCHF study describes baseline characteristics of patients with asymptomatic systolic left ventricular dysfunction, a population underrepresented in heart failure research. Understanding progression to symptomatic heart failure in this group addresses an important knowledge gap. ## Characteristics of sudden cardiac arrest during endurance racing: a decade of the Paris registry. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf313 · https://hartvaat.nl/2026/02/03/plotse-hartstilstand-tijdens-duursporten-tien-jaar-parijse-registerdata/* This decade-long Paris registry analysis characterized sudden cardiac arrest during endurance racing, documenting the incidence, causes, and survival rates of this rare but devastating complication of competitive endurance sports. ## Coronary artery spasm in cardiac arrest survivors. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag020 · https://hartvaat.nl/2026/02/03/coronaire-vaatspasmen-bij-overlevenden-van-hartstilstand/* This Europace review addressed coronary artery spasm as a cause of cardiac arrest, covering the pathophysiology, diagnostic workup with provocation testing, and management strategies for this potentially lethal but treatable condition. ## Distinct intracardiac electrogram waveforms with perforation during left bundle branch area pacing implantation. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag010 · https://hartvaat.nl/2026/02/03/intracardiale-elektrogrammen-bij-perforatie-tijdens-linkerbundeltakpacing/* This study systematically analysed unipolar intracardiac electrogram waveforms during perforation events in left bundle branch area pacing. The findings help operators recognise perforation patterns and improve procedural safety. ## Feasibility, procedural efficiency, and early imaging outcomes of concomitant pulsed field ablation and left atrial appendage closure: a prospective single-centre study. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag017 · https://hartvaat.nl/2026/02/03/gecombineerde-pulsed-field-ablatie-en-linker-atriumoorsluiting-haalbaarheid-en-u/* This study demonstrated the feasibility and early outcomes of combined pulsed field ablation with LAA closure in a single procedure, offering a one-stop approach for AF rhythm control and stroke prevention. ## Long-term prognostic value of cardiopulmonary exercise testing in patients with hypertrophic cardiomyopathy. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag013 · https://hartvaat.nl/2026/02/03/langetermijnwaarde-van-inspanningstesten-bij-hypertrofische-cardiomyopathie/* This study investigated the long-term prognostic value of cardiopulmonary exercise testing in patients with hypertrophic cardiomyopathy. CPET parameters predicted major adverse cardiac events independently of baseline symptoms over extended follow-up. ## Metformin inhibits proliferation of residing fibroadipogenic progenitor cells from failing human hearts. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag001 · https://hartvaat.nl/2026/02/03/metformine-remt-proliferatie-van-fibro-adipogene-stamcellen-uit-falende-harten/* This study investigated myocardial metformin distribution in vivo and its effects on fibroadipogenic progenitor cells from failing human hearts, revealing that metformin inhibits their proliferation — a potential mechanism for its beneficial effects in HFrEF. ## Public procurement of cardiac implantable electronic devices across Europe: are we purchasing value or cost-effectiveness? *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf323 · https://hartvaat.nl/2026/02/03/aanbesteding-van-cardiale-implanteerbare-devices-in-europa-waarde-of-kosten/* A survey across 22 European countries examined how procurement of cardiac implantable electronic devices is implemented, exploring clinical, economic, and structural factors that influence tendering processes under the shared EU legal framework. ## Value of right heart haemodynamics for risk stratification of patients with pulmonary arterial hypertension at follow-up. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvaf012 · https://hartvaat.nl/2026/02/03/rechterhart-hemodynamiek-voor-risicostratificatie-bij-pulmonale-arteriele-hypert/* This study evaluated the added prognostic value of invasive right heart haemodynamic parameters at follow-up in patients with pulmonary arterial hypertension stratified by the non-invasive ESC/ERS risk model. Haemodynamic assessment refined risk prediction beyond non-invasive parameters alone. ## Effect of mavacamten on sudden cardiac death risk scores in obstructive hypertrophic cardiomyopathy. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag003 · https://hartvaat.nl/2026/02/03/effect-van-mavacamten-op-risicoscores-voor-plotse-hartdood-bij-hypertrofische-ca/* This study showed that mavacamten not only reduces LVOT obstruction but also improves sudden cardiac death risk scores in obstructive HCM, suggesting potential antiarrhythmic benefits beyond hemodynamic improvement. ## Upgrading expandable leadless pacemakers from single- to dual-chamber. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag023 · https://hartvaat.nl/2026/02/03/upgrade-van-draadloze-pacemaker-van-enkelvoudig-naar-tweekamersysteem/* This prospective multicenter study evaluated the safety and feasibility of upgrading expandable leadless pacemakers from single- to dual-chamber systems, demonstrating the practical viability of staged leadless pacing implantation. ## Shortest pulmonary vein atrial fibrillation cycle length identifies pulmonary vein isolation responders beyond clinical atrial fibrillation pattern: the FARS-AF II study. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag033 · https://hartvaat.nl/2026/02/03/kortste-af-cycluslengte-in-de-longvenen-identificeert-pvi-responders/* The FARS-AF II study demonstrated that AF cycle length measured in the pulmonary veins can predict which patients will respond to pulmonary vein isolation, advancing personalized patient selection for AF ablation. ## Semaglutide as adjunctive therapy to catheter ablation in obesity-related paroxysmal atrial fibrillation. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euag018 · https://hartvaat.nl/2026/02/03/semaglutide-als-aanvulling-op-katheterablatie-bij-obesitas-gerelateerd-atriumfib/* This study evaluated semaglutide as adjunctive therapy to catheter ablation in obese patients with paroxysmal AF, testing whether GLP-1 receptor agonist-mediated weight loss improves ablation outcomes in obesity-related arrhythmia. ## Contemporary management of atrial fibrillation in patients with cancer-the 2025 European Heart Rhythm Association survey. *2026-02-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf325 · https://hartvaat.nl/2026/02/03/atriumfibrilleren-bij-kankerpatienten-de-esc-richtlijn-2025-in-de-praktijk/* This 2025 EHRA position paper addressed the contemporary management of AF in patients with cancer, providing practical guidance for the complex decisions around anticoagulation, rate/rhythm control, and drug interactions in this dual-disease population. ## Safety and efficacy of early initiation of mineralocorticoid receptor antagonist after an acute decompensated heart failure event or acute myocardial infarction with cardiac dysfunction: a meta-analysis of randomized clinical trials. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag018 · https://hartvaat.nl/2026/02/03/vroeg-starten-met-mra-na-acuut-hartfalen-of-myocardinfarct-meta-analyse/* This meta-analysis evaluated early initiation of MRA after acute decompensated heart failure, showing that in-hospital MRA start is safe and may improve short-term outcomes, supporting proactive neurohormonal blockade. ## Intravenous ferric carboxymaltose in patients with heart failure and iron deficiency: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvaf018 · https://hartvaat.nl/2026/02/03/intraveneus-ijzer-bij-hartfalen-met-ijzertekort-meta-analyse-met-trial-sequentie/* This meta-analysis of randomized trials confirmed that intravenous ferric carboxymaltose in heart failure with iron deficiency reduces hospitalizations and improves functional outcomes, consolidating the IV iron evidence base. ## Bioimpedance-derived compartmental fluid status and prognosis in chronic heart failure. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag002 · https://hartvaat.nl/2026/02/03/bio-impedantie-voor-vochtstatusbepaling-en-prognose-bij-chronisch-hartfalen/* This study showed that bioimpedance-derived compartmental fluid status provides prognostic information in chronic heart failure, supporting non-invasive fluid assessment technology for monitoring congestion. ## Sex differences in patients with advanced heart failure: an analysis of the HELP-HF registry. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag004 · https://hartvaat.nl/2026/02/03/geslachtsverschillen-bij-patienten-met-gevorderd-hartfalen/* This HELP-HF registry analysis revealed important sex differences in advanced heart failure, showing that women are referred later and less likely to receive advanced therapies including mechanical support and transplantation. ## Semaglutide vs tirzepatide in patients with obesity and HFpEF: a report from a global federated research network. *2026-02-03 · ESC heart failure · https://doi.org/10.1093/eschf/xvag042 · https://hartvaat.nl/2026/02/03/semaglutide-versus-tirzepatide-bij-patienten-met-obesitas-en-hfpef/* This federated research network analysis provided the first direct comparison of semaglutide versus tirzepatide in patients with obesity and HFpEF, comparing real-world outcomes of these two leading incretin therapies. ## Statin-associated symptoms and Statin Intolerance in Children with Familial Hypercholesterolemia: Insights from 15 Years of Clinical Practice *2026-02-03 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00025-0/fulltext · https://hartvaat.nl/2026/02/03/statine-intolerantie-bij-kinderen-met-familiaire-hypercholesterolemie-15-jaar-kl/* An analysis of 15 years of clinical practice assessed the incidence of statin-associated symptoms and statin intolerance in children with heterozygous familial hypercholesterolaemia. The study provides reassuring tolerability data for first-line lipid-lowering therapy in paediatric FH. ## Bridging machine learning and clinical practice: a multicentre nomogram for 90-day graft failure risk stratification in heart transplantation *2026-02-02 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003790?rss=1 · https://hartvaat.nl/2026/02/02/machine-learning-nomogram-voorspelt-vroeg-transplantaatfalen-na-harttransplantat/* Early graft failure within 90 days is the leading cause of death after heart transplantation, but existing risk scores poorly capture complex donor-recipient interactions. Using explainable machine learning, a clinically applicable nomogram was developed from the US UNOS registry (25,200 transplants) out of 32 variables. The final model used eight predictors: recipient prior cardiac surgery, age, bilirubin and BMI; donor age, sex and BMI; and cold ischaemia time. The nomogram had fair discrimination (AUC 0.67); the high-risk group had 2.4-fold higher risk of graft failure. External validation in a Chinese cohort (563 patients) confirmed performance (AUC 0.67). This ML nomogram using routinely available data can support donor-recipient matching and post-transplant care in heart transplantation. ## Mitral Annular Calcification-Related Mitral Stenosis: 5-Year Outcomes and Prognostic Determinants in the JAMAC Study *2026-02-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.12.004 · https://hartvaat.nl/2026/02/02/jamac-studie-slechte-5-jaarsprognose-bij-mitralisstenose-door-mitralisringverkal/* Mitral stenosis from mitral annular calcification (MAC) occurs mainly in older patients and is associated with increased mortality, but reliable long-term data were lacking. The retrospective, multicentre JAMAC study (264 patients from 11 Japanese centres, median age 78, 73% female) examined 5-year outcomes: 76% had calcific and 24% rheumatic mitral stenosis. Median mitral valve area (MVA) was 1.40 cm² and mean transmitral gradient 6.1 mmHg. Five-year survival was only 57%, with more non-cardiac (24%) than cardiac (16%) death; calcific stenosis had higher mortality than rheumatic. Anterior and severe posterior MAC, and MVA <1.5 cm², predicted mortality; on multivariable analysis MVA remained independently associated with death (adjusted HR 1.56), alongside age and chronic kidney disease. The prognosis of MAC-related mitral stenosis is thus poor, driven mainly by non-cardiac mortality. ## Medical Costs and Productivity Losses of Atrial Fibrillation Among US Privately Insured Employees. *2026-02-02 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2025.59227 · https://hartvaat.nl/2026/02/02/medische-kosten-en-productiviteitsverlies-door-atriumfibrilleren-in-de-vs/* This cross-sectional study estimated the medical costs and productivity losses associated with atrial fibrillation among privately insured US employees. The full economic impact, particularly productivity losses in working-age adults, has been underexplored. ## SGLT2 Inhibitor Use and Cardiorenal Outcomes in Type 2 Diabetes With Liver Cirrhosis. *2026-02-02 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2025.60429 · https://hartvaat.nl/2026/02/02/sglt2-remmers-en-cardiorenale-uitkomsten-bij-diabetes-type-2-met-levercirrose/* This study evaluated SGLT2 inhibitor use and cardiorenal outcomes in patients with both type 2 diabetes and liver cirrhosis, providing safety and efficacy data for this high-risk and typically excluded population. ## Shared Decision-Making and Patient Decision Aids for Percutaneous Left Atrial Appendage Occlusion. *2026-02-02 · JAMA network open · https://doi.org/10.1001/jamanetworkopen.2025.56937 · https://hartvaat.nl/2026/02/02/gezamenlijke-besluitvorming-bij-percutane-linker-atriumoorsluiting/* This study examined the current state of shared decision-making and patient decision aids for percutaneous LAA occlusion, addressing the CMS requirement for SDM documentation before this structural heart procedure. ## Diagnostic and Severity Assessment of Coronary Artery Disease Using ApoB/ApoA-I Ratio: Insights from a Statin-Treated Eastern European Cohort. *2026-02-02 · Medicina (Kaunas, Lithuania) · https://doi.org/10.3390/medicina62020297 · https://hartvaat.nl/2026/02/02/apob-apoa-i-ratio-voor-diagnostiek-en-ernst-van-coronairlijden-bij-statinegebrui/* In an Eastern European cohort of statin-treated patients, the ApoB/ApoA-I ratio outperformed traditional lipid parameters for assessing the severity of coronary artery disease, supporting apolipoprotein measurements including Lp(a) for refined risk assessment. ## Low-Density Lipoprotein Cholesterol Levels and Neoatherosclerosis After STEMI: A Secondary Analysis of the CONNECT Randomized Clinical Trial. *2026-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.4723 · https://hartvaat.nl/2026/02/01/ldl-cholesterol-en-neoatherosclerose-na-stemi-secundaire-analyse/* This CONNECT secondary analysis confirmed that achieving lower LDL cholesterol levels reduces neoatherosclerosis formation within drug-eluting stents after STEMI, demonstrating that intensive lipid lowering protects against late stent failure. ## Degree of Cyclooxygenase-2 Inhibition Modulates Blood Pressure Response. *2026-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.25516 · https://hartvaat.nl/2026/02/01/cox-2-remming-en-bloeddrukrespons-graad-van-remming-is-bepalend/* This study showed that the degree of COX-2 inhibition modulates blood pressure response, with more selective COX-2 inhibitors causing greater blood pressure elevation, informing NSAID selection in hypertensive patients. ## Aprocitentan in Patients With Chronic Kidney Disease and Resistant Hypertension. *2026-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25563 · https://hartvaat.nl/2026/02/01/aprocitentan-bij-ckd-en-resistente-hypertensie/* This study showed that aprocitentan effectively lowers blood pressure in patients with CKD and resistant hypertension, extending the endothelin antagonist approach to the renally impaired population where resistant blood pressure is most prevalent. ## Antihypertensive Treatments After Acute Ischemic Stroke: to Continue or Not? *2026-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25575 · https://hartvaat.nl/2026/02/01/antihypertensieve-behandeling-na-acuut-ischemisch-cva-continueren-of-niet/* This review summarized the evidence on antihypertensive management after acute ischemic stroke, addressing whether existing medications should be continued, modified, or temporarily withheld in the acute phase. ## Cardiovascular-Kidney Effects of Dapagliflozin in Patients at Cardiovascular Risk With or Without Type 2 Diabetes: Results of a Randomized, Double-Blind, Placebo-Controlled Trial. *2026-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25955 · https://hartvaat.nl/2026/02/01/dapagliflozine-bij-cv-risico-met-zonder-diabetes-cardiorenale-effecten/* This study demonstrated that dapagliflozin improves vascular stiffness and cardiorenal markers in patients at cardiovascular risk regardless of diabetes status, providing mechanistic support for the universal cardiorenal protective effects of SGLT2 inhibitors. ## CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1. *2026-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.26055 · https://hartvaat.nl/2026/02/01/cagrisema-verlaagt-bloeddruk-bij-overgewicht-obesitas-redefine-1/* The REDEFINE 1 analysis showed that CagriSema (cagrilintide plus semaglutide) significantly reduces blood pressure in adults with overweight or obesity, with the antihypertensive effect adding to the metabolic and weight-loss benefits. ## Effects of Immediate Postpartum Diuretic Treatment on Postpartum Blood Pressure Among Individuals With Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis. *2026-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24263 · https://hartvaat.nl/2026/02/01/postpartum-diureticabehandeling-bij-hypertensieve-zwangerschapsstoornissen/* A systematic review and meta-analysis evaluated immediate postpartum diuretic treatment for blood pressure control in hypertensive disorders of pregnancy. Early diuretic intervention improved postpartum blood pressure outcomes. ## Considerations on statistical analysis of NHANES data in oral microbiome diversity and mortality study *2026-02-01 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01527-8/fulltext · https://hartvaat.nl/2026/02/01/kanttekeningen-bij-statistische-analyse-van-nhanes-data-en-orale-microbioomstudi/* This correspondence raises statistical considerations regarding the analysis of NHANES data in the study by Mondal et al. on oral microbiome alpha diversity and mortality. ## Is there a new dark side of persistent chylomicronemia? *2026-02-01 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01524-2/fulltext · https://hartvaat.nl/2026/02/01/is-er-een-nieuwe-keerzijde-van-persisterende-chylomicronemie/* This commentary accompanies evidence suggesting that persistent severe hypertriglyceridaemia in familial and multifactorial chylomicronaemia syndromes may contribute to glomerular nephropathy, representing a previously unrecognised clinical complication. ## Reply to: “Considerations on statistical analysis of NHANES data in oral microbiome diversity and mortality study” *2026-02-01 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01528-X/fulltext · https://hartvaat.nl/2026/02/01/reactie-op-kanttekeningen-bij-statistiek-van-orale-microbioomdiversiteit-en-mort/* The authors reply to methodological comments regarding the statistical analysis of NHANES data in their study on oral microbiome alpha diversity and all-cause and cardiovascular mortality in US adults. ## Clonal Hematopoiesis and Incident Heart Failure *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2841165 · https://hartvaat.nl/2026/02/01/klonale-hematopoese-en-incident-hartfalen/* This cohort study investigated the association between specific clonal hematopoiesis (CHIP) driver gene subtypes and incident heart failure, exploring a novel genetic pathway linking somatic mutations in hematopoietic stem cells to cardiac disease. ## Clonal Hematopoiesis—An Opportunity to Confront the Heart Failure Epidemic *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2841166 · https://hartvaat.nl/2026/02/01/klonale-hematopoese-kans-om-de-hartfalenepidemie-aan-te-pakken/* This commentary discussed clonal hematopoiesis of indeterminate potential (CHIP) as an opportunity to address the heart failure epidemic, exploring how somatic mutations in blood cells drive cardiovascular inflammation. ## Coronary Reperfusion in Patients With ST-Elevation MI Requiring Transfer *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843428 · https://hartvaat.nl/2026/02/01/coronaire-reperfusie-bij-stemi-patienten-die-overplaatsing-vereisen/* This Viewpoint evaluated the evolution of STEMI reperfusion guidelines and strategies for patients requiring interhospital transfer, addressing the evidence for timely primary PCI versus pharmacoinvasive approaches in transfer settings. ## Detecting Transthyretin Cardiac Amyloidosis With Artificial Intelligence *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2841169 · https://hartvaat.nl/2026/02/01/detectie-van-transthyretine-cardiale-amyloidose-met-kunstmatige-intelligentie/* This study developed and evaluated an AI-augmented screening program for detecting transthyretin cardiac amyloidosis, demonstrating that machine learning applied to routine clinical data can identify patients with this increasingly recognized but underdiagnosed condition. ## Error in Nonauthor Collaborator’s Name *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2842752 · https://hartvaat.nl/2026/02/01/correctie-naam-van-niet-auteur-in-surtavi-trial/* Correction to a non-author collaborator name in the SURTAVI trial publication on self-expanding transcatheter versus surgical aortic valve replacement in intermediate-risk patients. ## Exertional Syncope in a Female Teenage Student *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843432 · https://hartvaat.nl/2026/02/01/inspanningssyncope-bij-een-tienermeisje/* A diagnostic challenge case of a previously healthy teenage girl presenting with chest tightness and exertional syncope, with ECG showing ST-elevation and elevated troponin T. ## Guideline Adherence in Myocardial Infarction Treatment *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843039 · https://hartvaat.nl/2026/02/01/richtlijnnaleving-bij-myocardinfarctbehandeling-ingezonden-brief/* This letter to the editor discusses the importance of timely primary PCI or pharmacoinvasive therapy for STEMI management, emphasising that reperfusion timing remains the most critical determinant of survival. ## Guideline Adherence in Myocardial Infarction Treatment—Reply *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843038 · https://hartvaat.nl/2026/02/01/richtlijnnaleving-bij-myocardinfarctbehandeling-reactie/* The authors reply to correspondence regarding challenges in achieving timely reperfusion in STEMI patients and the role of guideline adherence in myocardial infarction treatment. ## Implementation Intelligence With AI—Prospective Evaluations Needed *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2841170 · https://hartvaat.nl/2026/02/01/implementatie-intelligentie-met-ai-prospectieve-evaluaties-nodig/* This editorial discusses the role of AI in improving detection of amyloid transthyretin cardiomyopathy and emphasises the critical need for prospective evaluations before clinical implementation of AI-based screening tools. ## Low-Density Lipoprotein Cholesterol Levels and Neoatherosclerosis After STEMI *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843037 · https://hartvaat.nl/2026/02/01/ldl-cholesterol-en-neo-atherosclerose-na-stemi/* This secondary analysis of the CONNECT trial evaluated whether achieving guideline-endorsed LDL cholesterol levels after drug-eluting stent implantation for STEMI reduces neoatherosclerosis development within the stented segment. ## Myocardial Dysfunction in Primary Mitral Regurgitation *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843036 · https://hartvaat.nl/2026/02/01/myocarddisfunctie-bij-primaire-mitralisinsufficientie/* This narrative review discussed myocardial dysfunction in primary mitral regurgitation, exploring an approach that incorporates additional imaging and biomarker parameters beyond ejection fraction to guide the timing of surgical intervention. ## Outcomes After Switching Cardiac Troponin Assays in ACS *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843040 · https://hartvaat.nl/2026/02/01/uitkomsten-na-wisseling-van-cardiale-troponine-assays-bij-acs/* This interrupted time-series analysis evaluated the clinical implications of switching high-sensitivity cardiac troponin assays, showing that assay changes affect diagnostic rates and patient management in acute care. ## SHR-1918 for Homozygous Familial Hypercholesterolemia *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843433 · https://hartvaat.nl/2026/02/01/shr-1918-bij-homozygote-familiaire-hypercholesterolemie/* This nonrandomized study of SHR-1918, a fully human ANGPTL3 antibody, showed significant LDL cholesterol reduction in homozygous familial hypercholesterolemia, adding another ANGPTL3 inhibitor to the pipeline for this severe genetic disorder. ## Semaglutide and Hospitalizations in Patients With Obesity and Established Cardiovascular Disease *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843245 · https://hartvaat.nl/2026/02/01/semaglutide-en-ziekenhuisopnames-bij-obesitas-met-hart-en-vaatziekten/* This SELECT prespecified analysis showed that semaglutide reduces total hospital admissions and length of stay in patients with obesity and established cardiovascular disease, demonstrating healthcare utilization benefits beyond cardiovascular event reduction. ## Social Determinants of Health and Clinical Outcomes in Hypertrophic Cardiomyopathy *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843430 · https://hartvaat.nl/2026/02/01/sociale-determinanten-van-gezondheid-en-uitkomsten-bij-hypertrofische-cardiomyop/* This study examined the association between area-based social determinants of health and clinical outcomes in hypertrophic cardiomyopathy, highlighting socioeconomic disparities in this genetic cardiac condition. ## Thirty-Year Risk of Cardiovascular Disease Among Women According to Thresholds of Lipoprotein(a) *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843429 · https://hartvaat.nl/2026/02/01/dertigjaars-cardiovasculair-risico-bij-vrouwen-naar-lipoproteine-a-drempelwaarde/* This cohort study examined Lp(a) levels as 30-year predictors of cardiovascular risk in women, showing that clinically relevant thresholds identify women at substantially elevated long-term cardiovascular risk who may benefit from emerging Lp(a)-lowering therapies. ## β-Blockers After Myocardial Infarction in Patients With Preserved Ejection Fraction *2026-02-01 · JAMA Cardiology · https://doi.org/https://jamanetwork.com/journals/jamacardiology/fullarticle/2843431 · https://hartvaat.nl/2026/02/01/betablokkers-na-myocardinfarct-bij-behouden-ejectiefractie-meta-analyse/* This meta-analysis of four randomized trials confirmed that beta-blockers after MI in patients with preserved ejection fraction do not improve cardiovascular outcomes. The consolidated evidence definitively supports discontinuation in this population. ## Clinical Outcomes of Renal Denervation for Resistant Hypertension: The Tel Aviv Renal Denervation Prospective Registry. *2026-02-01 · The Israel Medical Association journal : IMAJ · https://doi.org/https://pubmed.ncbi.nlm.nih.gov/41736604/ · https://hartvaat.nl/2026/02/01/renale-denervatie-bij-resistente-hypertensie-het-tel-aviv-register/* A prospective registry from Tel Aviv reports clinical outcomes of renal denervation in patients with apparent treatment-resistant hypertension, providing real-world evidence for this interventional approach. ## Dose-Response Efficacy and Safety of Factor XI/XIa Inhibitors in Atrial Fibrillation; a Systematic Review and Meta-Analysis With Subgroup Exploration and Trial Sequential Validation. *2026-02-01 · Clinical cardiology · https://doi.org/10.1002/clc.70263 · https://hartvaat.nl/2026/02/01/factor-xi-xia-remmers-bij-atriumfibrilleren-dosisrespons-werkzaamheid-en-veiligh/* A systematic review and meta-analysis with trial sequential validation evaluated the dose-response efficacy and safety of factor XI/XIa inhibitors compared to direct oral anticoagulants in atrial fibrillation. These emerging agents may reduce bleeding complications while providing adequate stroke prevention. ## Effect of Sacubitril-Valsartan on Secondary Mitral Regurgitation and Left Ventricular Reverse Remodeling in Patients With Heart Failure With Reduced Ejection Fraction: A 2D and 3D Echocardiographic Study. *2026-02-01 · Echocardiography (Mount Kisco, N.Y.) · https://doi.org/10.1111/echo.70413 · https://hartvaat.nl/2026/02/01/sacubitril-valsartan-bij-secundaire-mitralisinsufficientie-en-reverse-remodeling/* A 2D and 3D echocardiographic study evaluated the effect of sacubitril-valsartan on secondary mitral regurgitation and left ventricular reverse remodelling in patients with HFrEF. ## Reno-protective effects of statins among patients with chronic kidney disease in Hong Kong: a target trial emulation. *2026-02-01 · EClinicalMedicine · https://doi.org/10.1016/j.eclinm.2026.103798 · https://hartvaat.nl/2026/02/01/nierbeschermende-effecten-van-statines-bij-ckd-patienten-in-hong-kong/* This target trial emulation evaluated the renoprotective effects of statins in CKD patients in Hong Kong, providing real-world evidence for lipid-lowering therapy's role in slowing kidney disease progression. ## Transformative global models for CKD care: case studies and strategies. *2026-02-01 · Clinical kidney journal · https://doi.org/10.1093/ckj/sfag011 · https://hartvaat.nl/2026/02/01/innovatieve-wereldwijde-modellen-voor-ckd-zorg-casestudies-en-strategieen/* This article presents international case studies and strategies for transformative CKD care models, addressing the need for early diagnosis and intervention in the 10% of adults worldwide affected by chronic kidney disease. ## [Therapeutic innovations in secondary prevention of cardiovascular risk]. *2026-02-01 · La Revue du praticien · https://doi.org/https://pubmed.ncbi.nlm.nih.gov/41732931/ · https://hartvaat.nl/2026/02/01/therapeutische-innovaties-in-de-secundaire-preventie-van-cardiovasculair-risico/* This review discusses therapeutic innovations in secondary cardiovascular prevention including PCSK9 inhibitors, inclisiran, bempedoic acid, Lp(a)-targeting RNA therapies, individualised antithrombotic strategies, and low-dose colchicine as anti-inflammatory therapy. ## Preventing Atherosclerotic Cardiovascular Disease in Young Male Androgen Abusers. *2026-02-01 · Clinical cardiology · https://doi.org/10.1002/clc.70257 · https://hartvaat.nl/2026/02/01/preventie-van-atherosclerotische-hart-en-vaatziekten-bij-jonge-mannelijke-anabol/* This review examines the mechanisms by which supraphysiological androgen exposure accelerates atherosclerosis in young men, including adverse effects on lipoproteins, blood pressure, and vascular function. Screening strategies and preventive measures are discussed for this underrecognised risk population. ## A reduced TBX5-dependent gene regulatory network links atrial fibrillation and heart failure. *2026-02-01 · Nature cardiovascular research · https://doi.org/10.1038/s44161-025-00775-2 · https://hartvaat.nl/2026/02/01/gedeeld-gennetwerk-verklaart-de-wisselwerking-tussen-atriumfibrilleren-en-hartfa/* This Nature Cardiovascular Research study revealed that atrial fibrillation and heart failure share a common TBX5-dependent gene regulatory network, providing molecular evidence for the bidirectional relationship between these two conditions. ## Practical considerations for the use of vericiguat in older patients with heart failure and reduced ejection fraction. *2026-02-01 · European journal of clinical investigation · https://doi.org/10.1111/eci.70173 · https://hartvaat.nl/2026/02/01/praktische-overwegingen-bij-vericiguat-voor-oudere-patienten-met-hartfalen/* A practice-oriented review discusses the use of vericiguat, an oral soluble guanylate cyclase stimulator, specifically in older patients with heart failure and reduced ejection fraction. The article addresses dosing, drug interactions, and positioning alongside established pillar therapies. ## The hidden burden of kidney damage in chylomicronemia syndromes *2026-02-01 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01519-9/fulltext · https://hartvaat.nl/2026/02/01/de-verborgen-nierschade-bij-chylomicronemiesyndromen/* This review discusses the nephrotoxic effects of sustained severe hypertriglyceridaemia in monogenic and polygenic chylomicronaemia syndromes. The kidney damage burden in these conditions may be underrecognised in clinical practice. ## Global, Regional, and National Burden of CKD in Children and Adolescents. *2026-01-31 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag018 · https://hartvaat.nl/2026/01/31/wereldwijde-ziektelast-van-chronische-nierziekte-bij-kinderen-en-adolescenten/* Using Global Burden of Disease 2021 data, this study mapped the incidence, prevalence, mortality, and disability-adjusted life years of chronic kidney disease in children and adolescents aged 0-19 years worldwide. Low-middle-income regions showed the fastest increases, with a strong inverse correlation between sociodemographic index and mortality. ## Association between socioeconomic variables and carotid plaque in middle-aged adults: data from the Akershus Cardiac Examination (ACE) 1950 Study *2026-01-30 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003865?rss=1 · https://hartvaat.nl/2026/01/30/lager-opleidingsniveau-hangt-samen-met-meer-halsslagaderplaques-los-van-risicofa/* Low socioeconomic status (SES) is linked to higher cardiovascular risk, but its association with carotid atherosclerosis in the general population is less studied. In this cross-sectional analysis of the Norwegian Akershus Cardiac Examination 1950 Study (3,673 participants, mean age 63.9), individual SES was defined by educational attainment and area-level SES by urban/rural residence and municipal median income; carotid ultrasound yielded a plaque score. An elevated plaque score occurred in 23.3% of the highly educated, 28.2% of the secondary-educated and 31.4% of the primary-educated. After adjustment for risk factors, lower-educated women and men retained 22% and 12% more atherosclerotic burden respectively. Area-level SES showed no association. Lower educational attainment is thus associated, independent of classical risk factors, with more carotid atherosclerosis. ## Economic evaluation of a novel dual-energy, large focal lattice-tip catheter versus conventional contact-force sensing radiofrequency catheter for persistent atrial fibrillation ablation, from the English NHS perspective *2026-01-30 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003770?rss=1 · https://hartvaat.nl/2026/01/30/kosteneffectiviteit-van-een-dual-energy-lattice-tip-katheter-sphere-9-versus-rad/* Persistent atrial fibrillation (AF) carries a large clinical and economic burden and gives worse ablation outcomes than paroxysmal AF. The Sphere-9 is a novel dual-energy large-focal lattice-tip catheter also capable of high-density mapping. This study evaluated, using patient data from the randomised SPHERE Per-AF trial, the cost-effectiveness of the Sphere-9 versus conventional radiofrequency (RF) ablation from the English NHS perspective, with a decision tree and Markov model over a lifetime horizon. Lattice-tip ablation was 'dominant': lower cost (£15,433 vs £20,861 per patient) and greater health benefit (8.26 vs 8.20 QALYs). The result remained robust across all sensitivity analyses. The Sphere-9 catheter is thus a cost-saving option for persistent AF compared with conventional RF ablation. ## Efficacy and safety of off-label low-dose compared with standard-dose antiplatelet agents in patients with coronary heart disease: a meta-analysis *2026-01-30 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003839?rss=1 · https://hartvaat.nl/2026/01/30/off-label-lage-dosis-bloedplaatjesremmers-bij-coronairlijden-minder-infarcten-en/* This meta-analysis compared off-label low-dose with standard-dose antiplatelet agents in coronary heart disease (CHD), focusing on the gap around low- versus standard-dose ticagrelor and prasugrel. Twenty-two randomised trials (7,486 patients, 92% Asian; 64% exclusively acute coronary syndrome) were included, all using dual antiplatelet therapy (aspirin plus a low or standard dose P2Y12 inhibitor). Compared with standard dose, low dose reduced the risk of myocardial infarction (RR 0.75) and minimal bleeding (RR 0.64), with comparable other ischaemic and bleeding risks. Versus standard-dose clopidogrel, low dose reduced infarction but increased bleeding; versus standard-dose prasugrel/ticagrelor, ischaemic risks were similar with less bleeding. Low dose thus appears an effective secondary-prevention strategy, though the evidence rests mainly on Asian patients — in whom the ischaemia-bleeding balance differs from Europeans. ## DAPK2 Regulates PKM2 Phosphorylation at Threonine 45 to Facilitate Disturbed Flow-Induced Atherosclerosis *2026-01-30 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075951 · https://hartvaat.nl/2026/01/30/dapk2-reguleert-pkm2-fosforylering-bij-verstoorde-stroming-geinduceerde-atherosc/* This basic science study revealed that DAPK2 regulates PKM2 phosphorylation to facilitate disturbed flow-induced atherosclerosis, identifying a new molecular pathway linking hemodynamic stress to plaque formation. ## Galectin-1 Is a Marker but Not a Mediator of Heart Failure With Preserved Ejection Fraction *2026-01-30 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26006 · https://hartvaat.nl/2026/01/30/galectine-1-is-een-marker-maar-geen-mediator-van-hfpef/* This study showed that galectin-1 is a biomarker but not a mediator of HFpEF, distinguishing association from causation and cautioning against therapeutic targeting of this immune-related protein. ## Retraction of: Proteasome-Dependent Degradation of Guanosine 5’-Triphosphate Cyclohydrolase I Causes Tetrahydrobiopterin Deficiency in Diabetes Mellitus *2026-01-30 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001420 · https://hartvaat.nl/2026/01/30/retractie-proteasoom-afhankelijke-degradatie-van-gtp-cyclohydrolase-i-bij-diabet/* Retraction notice for an article on proteasome-dependent degradation of GTP cyclohydrolase I causing tetrahydrobiopterin deficiency in diabetes mellitus. ## Systemic Embolic Events in Atrial Fibrillation: An Individual Patient Data Meta-analysis of 71 683 Participants Randomized to NOAC Versus Warfarin *2026-01-30 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075275 · https://hartvaat.nl/2026/01/30/systemische-embolische-events-bij-boezemfibrilleren-een-meta-analyse-op-patientn/* This individual patient data meta-analysis characterized the incidence, risk factors, and outcomes of systemic embolic events in AF, demonstrating that DOACs effectively prevent both stroke and non-cerebral embolism compared with warfarin. ## Familial hypercholesterolemia concealed by a protein-truncating variant of PCSK9. *2026-01-30 · Journal of clinical lipidology · https://doi.org/10.1016/j.jacl.2026.01.020 · https://hartvaat.nl/2026/01/30/familiaire-hypercholesterolemie-gemaskeerd-door-een-pcsk9-verlies-van-functievar/* A remarkable case report describes familial hypercholesterolaemia that was concealed by a co-existing PCSK9 loss-of-function variant, artificially lowering LDL-cholesterol. The case underscores the importance of genetic diagnostics when FH is suspected, even with apparently normal lipid levels. ## Body weight and mortality in Takotsubo syndrome: insights from the International Takotsubo (InterTAK) Registry *2026-01-29 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003851?rss=1 · https://hartvaat.nl/2026/01/29/obesitasparadox-bij-het-takotsubosyndroom-ondergewicht-geeft-de-hoogste-sterfte-/* The so-called obesity paradox has been described in various cardiac conditions, but data in Takotsubo syndrome (TTS) were lacking. In the international InterTAK registry (2,707 patients with TTS, 2011-2021), patients were stratified by BMI. One-year mortality was 11.3% in underweight, 6.9% in normal weight, 5.5% in overweight, 4.9% in obese and 9.3% in very obese patients — a U-shaped curve. Being overweight or obese was associated with lower 1-year mortality (HR 0.70), also after adjustment (HR 0.67). An obesity paradox thus exists in Takotsubo syndrome, with the highest mortality in underweight and the lowest in (moderate) obesity — demonstrated for the first time in this patient group. ## Left atrial anterior wall ablation reduces the recurrence of atrial fibrillation in patients with aortic encroachment *2026-01-29 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003816?rss=1 · https://hartvaat.nl/2026/01/29/lineaire-ablatie-van-de-voorwand-van-het-linkeratrium-vermindert-af-recidieven-b/* Mechanical compression from the ascending aorta on the left atrial anterior wall (LAAW) can cause low-voltage areas (LVAs) that raise the risk of recurrent atrial fibrillation (AF) after catheter ablation. This retrospective study (267 patients with both aortic encroachment and LAAW low-voltage areas, first ablation 2019-2023) examined different ablation strategies. Without LAAW ablation, patients with aortic encroachment had higher AF recurrence risk (aHR 2.29). Patients receiving LAAW ablation of complex fractionated electrograms (CFAE) had higher recurrence than those with linear LAAW ablation. Linear LAAW ablation was a strong independent predictor of fewer recurrences (HR 0.13). When LAAW low-voltage areas are present, linear ablation of the atrial anterior wall thus appears a highly effective strategy to reduce post-ablation AF recurrence. ## Multidisciplinary team-guided management of severe aortic stenosis: 5-year outcomes following TAVI versus conservative treatment *2026-01-29 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003872?rss=1 · https://hartvaat.nl/2026/01/29/tavi-versus-afwachtend-beleid-bij-ernstige-aortastenose-groot-en-blijvend-overle/* Multidisciplinary team (MDT) meetings guide treatment decisions in aortic stenosis (AS), especially for borderline or high-risk patients. This retrospective study followed all patients with severe AS discussed at a UK MDT between 2014 and 2016 (178 TAVI, 195 conservative). TAVI patients were younger (81.3 vs 83.5 years) and less frail. Survival at 1, 2 and 5 years was much higher with TAVI (87.6%, 74.7%, 44.9%) than with conservative management (60.8%, 44.2%, 12.1%); median survival was 53 versus 20 months. On multivariable analysis, TAVI was independently associated with lower mortality (HR 0.38). TAVI thus provided a substantial and durable survival advantage over conservative treatment — underscoring the poor prognosis of untreated severe AS and arguing for systematic follow-up of conservatively managed patients too. ## Symptom burden and secondary prevention in patients with left ventricular systolic dysfunction after acute myocardial infarction: a nationwide register-based study in Sweden *2026-01-29 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003506?rss=1 · https://hartvaat.nl/2026/01/29/verminderde-pompfunctie-na-een-hartinfarct-hoge-symptoomlast-en-slechtere-secund/* Contemporary data on patients with left ventricular dysfunction after myocardial infarction (MI) are scarce. In this nationwide Swedish study (49,564 patients from the SWEDEHEART registry, first MI, 2011-2018, no prior heart failure), patients were stratified by degree of LV dysfunction. Compared with normal ejection fraction (≥50%), patients with severely reduced EF (<30%) far more often had dyspnoea (32.3% vs 5.6%; OR 7.45), were more often readmitted (48.1% vs 31.2%) and on sick leave (26.6% vs 9.5%); chest pain and quality of life did not differ. Patients with EF <30% less often took part in education programmes, physiotherapy and regular physical activity. Reduced pump function after infarction is thus associated with a high symptom burden and poorer uptake of secondary prevention — an important focus for aftercare. ## Olezarsen for Managing Severe Hypertriglyceridemia and Pancreatitis Risk. *2026-01-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2512761 · https://hartvaat.nl/2026/01/29/olezarsen-bij-ernstige-hypertriglyceridemie-en-pancreatitisrisico/* This trial evaluated olezarsen specifically in patients with severe hypertriglyceridemia and pancreatitis risk, demonstrating dramatic triglyceride reduction and pancreatitis prevention. The APOC3-targeted antisense therapy offers a definitive solution for this dangerous metabolic condition. ## Abnormal Proinflammatory Immune Cell Responses Precede Clinical Onset of Hypertensive Disorders of Pregnancy *2026-01-29 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25680 · https://hartvaat.nl/2026/01/29/abnormale-pro-inflammatoire-immuuncelresponsen-voorafgaand-aan-hypertensieve-zwa/* This study demonstrates that abnormal proinflammatory immune cell responses are present before the clinical onset of hypertensive disorders of pregnancy, particularly among Black women. The findings support early immune profiling for risk prediction. ## Iron Overload-Induced Ferroptosis Drives Placental Dysfunction in Preeclampsia *2026-01-29 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26344 · https://hartvaat.nl/2026/01/29/ijzeroverbelasting-geinduceerde-ferroptose-veroorzaakt-placentadisfunctie-bij-pr/* Using clinical data, mouse models, and placental organoids, this study demonstrates that iron overload induces ferroptosis leading to placental dysfunction in preeclampsia. The findings identify iron chelation as a potential therapeutic strategy. ## Wearable-Derived Training Load and Coronary Atherosclerosis in Middle-Aged and Older Athletes and Physically Active Controls: A New Perspective From the Master@Heart Study *2026-01-29 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077117 · https://hartvaat.nl/2026/01/29/trainingsbelasting-gemeten-met-wearables-en-coronaire-atherosclerose-bij-middelb/* This study used wearable device-derived training load data to investigate the relationship between exercise volume and coronary atherosclerosis in middle-aged and older athletes, addressing the paradox of increased coronary plaque in endurance athletes. ## Update on familial hypercholesterolemia: An expert clinical consensus from the National Lipid Association. *2026-01-29 · Journal of clinical lipidology · https://doi.org/10.1016/j.jacl.2026.01.011 · https://hartvaat.nl/2026/01/29/nla-consensusupdate-familiaire-hypercholesterolemie-screening-diagnostiek-en-beh/* This NLA expert consensus update on familial hypercholesterolemia provided revised guidance on FH screening, diagnosis, and treatment including cascade testing, pediatric management, and the expanding role of PCSK9 inhibitors and inclisiran. ## Danish evaluation of Your Heart Forecast: a cluster randomised controlled trial aimed at improving modifiable risk factors of CVD *2026-01-28 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003812?rss=1 · https://hartvaat.nl/2026/01/28/risicocommunicatie-instrument-in-de-huisartsenpraktijk-verlaagt-bloeddruk-en-cho/* Can a tool that visualises cardiovascular risk, combined with education, improve risk factors? In this cluster-randomised trial across 17 Danish general practices (255 hypertensive patients aged 35-75 without cardiovascular disease), the intervention group received the risk-communication tool 'Your Heart Forecast' at the annual blood-pressure consultation plus a monthly lifestyle email for twelve months; the control group received usual care. In the most poorly controlled patients, blood pressure fell in both groups but more in the intervention group; intervention patients with moderately raised blood pressure also improved significantly. The cholesterol ratio (TC/HDL) fell only in intervention patients with the highest baseline values. A risk-communication tool plus education thus lowered blood pressure and cholesterol ratio in patients with dysregulated values, compared with usual care. ## Hypertension in Patients With End-Stage Kidney Disease Requiring Dialysis: Bridging the Divide Between Evidence and Practice *2026-01-28 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.24344 · https://hartvaat.nl/2026/01/28/hypertensie-bij-dialysepatienten-de-kloof-tussen-bewijs-en-praktijk/* This review addressed hypertension management in dialysis patients, highlighting the distinct pathophysiology (volume overload, sympathetic activation, arterial stiffness) and evidence gaps that make blood pressure control challenging in end-stage kidney disease. ## KDIGO 2026 clinical practice guideline for Anemia in Chronic Kidney Disease (CKD): a commentary from the European Renal Best Practice (ERBP). *2026-01-28 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag014 · https://hartvaat.nl/2026/01/28/kdigo-2026-richtlijn-anemie-bij-chronische-nierziekte-europees-commentaar/* This ERA commentary on the KDIGO 2026 anemia in CKD guideline discussed the substantial updates including new recommendations for intravenous iron, HIF-prolyl hydroxylase inhibitors, and ESA targets in the contemporary treatment landscape. ## Minimally invasive versus conventional mitral valve surgery: a systematic review and meta-analysis of randomised clinical trials *2026-01-27 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003612?rss=1 · https://hartvaat.nl/2026/01/27/minimaal-invasieve-mitralisklepchirurgie-sneller-herstel-even-veilig-als-de-conv/* Whether minimally invasive mitral valve surgery (MIMVS) offers advantages over the conventional approach (CMVS) was controversial. This systematic review and meta-analysis of randomised trials (8 RCTs, 9 studies, 1,248 patients: 686 CMVS, 562 MIMVS) compared short-term outcomes. MIMVS did not differ in mortality or acute kidney injury, with a trend toward fewer wound infections and shorter ICU stay. MIMVS did reduce reoperations for bleeding (RR 0.24) and hospital stay (mean 1.8 days shorter). Operative time was longer but without clinical impact; stroke, infarction, ventilation time and transfusions were comparable. Certainty of evidence was mostly moderate to high. MIMVS thus enhances postoperative recovery — shorter stay, fewer reoperations for bleeding — with safety comparable to conventional surgery. ## Association Between Age and PCI Effectiveness in Stable CAD: Secondary Analysis of ORBITA-2. *2026-01-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.10.086 · https://hartvaat.nl/2026/01/27/orbita-2-leeftijd-en-pci-effectiviteit-bij-stabiel-coronairlijden/* This ORBITA-2 subanalysis confirmed that the placebo-controlled benefit of PCI is consistent across age groups in stable angina, supporting revascularization regardless of patient age when ischemia is objectively demonstrated. ## Prognostic Implications of Evolving Universal Definitions of Periprocedural Myocardial Infarction in Patients With Acute Coronary Syndrome. *2026-01-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.077174 · https://hartvaat.nl/2026/01/27/prognostische-implicaties-van-universele-definities-van-periprocedureel-mi/* This study compared the prognostic implications of successive universal definitions of periprocedural myocardial infarction in patients with acute coronary syndrome. Not all definition iterations carry equal prognostic significance, informing interpretation of trial endpoints. ## Potent P2Y12 Inhibitor Monotherapy vs DAPT After PCI in Patients With and Without STEMI: The NEO-MINDSET Substudy. *2026-01-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.10.058 · https://hartvaat.nl/2026/01/27/neo-minor-potente-p2y12-monotherapie-versus-dapt-na-pci-bij-stemi/* The NEO-MINDSET substudy showed that potent P2Y12 inhibitor monotherapy after very early aspirin withdrawal is noninferior to DAPT after PCI in STEMI patients, with fewer bleeding events. The result extends the de-escalation strategy to the acute STEMI population. ## Early vs Late Staged PCI After Subintimal Tracking and Re-Entry for Chronic Total Occlusions: A Randomized Trial. *2026-01-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.09.1598 · https://hartvaat.nl/2026/01/27/vroege-versus-late-gestageerde-pci-na-subintimale-re-entry-bij-cto/* A randomised trial compared early versus late staged PCI after subintimal tracking and re-entry for chronic total occlusions. The timing of the staged procedure did not significantly influence outcomes, providing flexibility in procedural planning. ## Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation: The DECAF Randomized Clinical Trial. *2026-01-27 · JAMA · https://doi.org/10.1001/jama.2025.21056 · https://hartvaat.nl/2026/01/27/decaf-cafeinehoudende-koffie-en-af-gerandomiseerde-trial/* The DECAF randomized trial showed that caffeinated coffee consumption does not increase AF risk compared with abstinence, debunking the widely held belief that caffeine triggers atrial fibrillation. ## Intracoronary Low-Dose Recombinant Tissue Plasminogen Activator in Primary PCI for ST-Segment Elevation Myocardial Infarction and Large Thrombus Burden: A Randomized Trial. *2026-01-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.10.008 · https://hartvaat.nl/2026/01/27/intracoronair-lage-dosis-rtpa-bij-primaire-pci-voor-stemi-rct/* This randomized trial showed that intracoronary low-dose rtPA as an adjunct to primary PCI for STEMI improves microvascular perfusion, testing clot-dissolving therapy to address the residual microvascular obstruction problem. ## Drug-Coated Balloon Angioplasty vs Up-Front Stenting for De Novo CAD: 3-Year Follow-Up of REC-CAGEFREE I Trial. *2026-01-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.10.027 · https://hartvaat.nl/2026/01/27/rec-cagefree-dcb-versus-stenting-bij-de-novo-cad-driejaarsdata/* Three-year REC-CAGEFREE data confirmed that drug-coated balloon angioplasty offers a durable stent-free alternative for selected de novo coronary lesions, supporting the leave-nothing-behind approach for long-term outcomes. ## PCI of Native Coronary Artery vs Saphenous Vein Graft After Prior Bypass Surgery: A Multicenter, Randomized Trial. *2026-01-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.09.1577 · https://hartvaat.nl/2026/01/27/pci-van-natief-coronairvat-versus-veneuze-graft-na-eerdere-cabg-rct/* This multicenter randomized trial compared PCI of the native coronary artery versus the saphenous vein graft in patients with prior CABG and graft failure, providing the first randomized evidence to guide the target vessel for intervention after bypass surgery. ## Colchicine in acute coronary syndromes: a systematic review and meta-analysis of randomised controlled trials. *2026-01-27 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-325826 · https://hartvaat.nl/2026/01/27/colchicine-bij-acs-meta-analyse-van-alle-rct-s/* This updated meta-analysis of all colchicine trials in acute coronary syndromes confirmed significant MACE reduction with an acceptable safety profile. The anti-inflammatory concept in ACS is now supported by robust pooled evidence. ## Aldosterone synthase inhibitors for uncontrolled and resistant hypertension in CKD: an assessment from bench to bedside. *2026-01-27 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag013 · https://hartvaat.nl/2026/01/27/aldosteronsynthase-remmers-bij-ongecontroleerde-en-resistente-hypertensie-bij-ck/* This NDT review assessed aldosterone synthase inhibitors for uncontrolled and resistant hypertension in CKD, evaluating the bench-to-bedside translation of this new drug class for the renally impaired hypertensive population. ## Lipoprotein(a) Concentration and Achieving Target Values of Low-Density Lipoprotein Cholesterol Calculated by Different Equations. *2026-01-27 · Diseases (Basel, Switzerland) · https://doi.org/10.3390/diseases14020041 · https://hartvaat.nl/2026/01/27/lp-a-verstoort-de-ldl-cholesterolberekening-welke-formule-is-het-meest-betrouwba/* This study demonstrates that lipoprotein(a) cholesterol contributes to overestimation of "true" LDL-C in standard calculations. Correction for Lp(a)-cholesterol significantly improves lipid profile accuracy in patients with elevated Lp(a). ## Estimating the Potential Impact of the 2024 UK Salt Reduction Targets on Cardiovascular Health Outcomes and Health Care Costs in Adults: A Modeling Study *2026-01-26 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25159 · https://hartvaat.nl/2026/01/26/impact-van-britse-zoutreductiedoelen-2024-op-cardiovasculaire-uitkomsten-modelle/* This modeling study estimated the potential cardiovascular health impact of the 2024 UK salt reduction targets, projecting significant prevention of hypertension, stroke, and heart disease through industry-led reformulation. ## From French Gastronomy to Cardiovascular Health: Cutting Salt in the Baguette Has Saved Thousands of Lives in France *2026-01-26 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25977 · https://hartvaat.nl/2026/01/26/zoutreductie-in-het-franse-stokbrood-heeft-duizenden-levens-gered/* This perspective described how reducing salt content in the French baguette — a staple consumed daily by millions — has prevented thousands of cardiovascular deaths, demonstrating the population-level impact of industry-level sodium reduction. ## Isolinderalactone alleviates atherosclerosis by inhibiting NLRP3 inflammasome activation and inflammatory response in macrophages *2026-01-26 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00014-6/fulltext · https://hartvaat.nl/2026/01/26/isolinderalacton-remt-nlrp3-inflammasoomactivatie-bij-atherosclerose/* This study shows that isolinderalactone, a sesquiterpene compound from Lindera aggregata, alleviates atherosclerosis by inhibiting NLRP3 inflammasome activation and the inflammatory response in macrophages. ## Seated Saline Suppression Test for Lateralizing Primary Aldosteronism *2026-01-26 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26008 · https://hartvaat.nl/2026/01/26/zittende-zoutbelastingstest-voor-lateralisatie-van-primair-aldosteronisme/* This blinded clinical trial evaluated a seated saline suppression test for lateralizing primary aldosteronism, testing a simplified confirmatory approach for identifying surgical candidates in PA management. ## Randomised controlled trials in Europe: a call to action to protect national health care systems from the upcoming tsunami of kidney failure. *2026-01-24 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag007 · https://hartvaat.nl/2026/01/24/oproep-tot-actie-europese-trials-nodig-tegen-tsunami-van-nierfalen/* This call to action highlights that kidney diseases are among the fastest-growing global health burdens, with CKD projected to become the third leading cause of death by 2050. Despite this, no EMA-approved treatment exists for AKI and no drug prevents the need for kidney replacement therapy, necessitating a European randomised trial network. ## Advanced Cardiogenic-shock Team versus standard care in cardiogenic shock: a single centre service evaluation project *2026-01-23 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003794?rss=1 · https://hartvaat.nl/2026/01/23/multidisciplinair-cardiogene-shockteam-verbetert-de-1-jaarsoverleving-bij-infarc/* Cardiogenic shock after myocardial infarction (AMI) carries high mortality; structured multidisciplinary care is little studied. In this service evaluation at a UK tertiary cardiac centre (ACT-SHOCK), 82 patients with AMI-related cardiogenic shock needing emergent PCI were identified using protocolised physiological criteria and managed by an Advanced Cardiogenic-Shock Team (interventional cardiologists, intensivists, anaesthetists and cardiac physiologists). They were compared with 83 historical controls from the prior year (standard care). Shock-team management was associated with lower 1-year mortality (HR 0.53); 30-day mortality was also lower but not significant. At 24 hours, fewer patients were in the most severe shock stages (SCAI D/E). Protocolised shock recognition with activation of a multidisciplinary team was thus associated with earlier detection and better 1-year survival — a basis for further multicentre study. ## Ethnic variation in thoracic aortic dimensions in the general population: a comparison between Indian and Dutch populations *2026-01-23 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003808?rss=1 · https://hartvaat.nl/2026/01/23/etnische-verschillen-in-aortadiameters-indiase-versus-nederlandse-patienten-amst/* Guidelines use absolute diameter thresholds for aortic surgery, largely based on Western cohorts. This retrospective study compared aortic diameters of Indian (SIMS Hospital) and Dutch patients (Amsterdam UMC) who underwent CT in 2022 (3,692 patients: 2,000 Indian, 1,692 Dutch) at five anatomical locations. Indian patients had a larger aortic root (33.9 vs 31.5 mm), but Dutch patients had significantly larger diameters of the ascending aorta (33.1 vs 30.5 mm), aortic arch, descending aorta and abdominal aorta. These differences persisted after adjustment for age, sex, height and comorbidity. There is thus substantial ethnic-geographic variation in aortic diameters — raising questions about applying current (Western) surgical thresholds to Indian patients and arguing for individualised, indexed risk assessment. ## Targeting cellular senescence in diabetic kidney disease: potential of regenerative, cell-based therapies and other senotherapeutic approaches *2026-01-23 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00054-2/fulltext · https://hartvaat.nl/2026/01/23/cellulaire-senescentie-als-therapeutisch-doelwit-bij-diabetische-nierziekte/* This review discusses the potential of regenerative cell-based therapies and senotherapeutic approaches targeting cellular senescence in diabetic kidney disease. Addressing senescence-driven chronic inflammation may overcome treatment resistance in patients who progress despite optimal therapy. ## Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation. *2026-01-22 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2509688 · https://hartvaat.nl/2026/01/22/antitrombotische-therapie-na-succesvolle-af-ablatie-gerandomiseerde-trial/* This randomized trial investigated the optimal antithrombotic regimen after successful catheter ablation for atrial fibrillation, addressing whether successful ablation eliminates the need for long-term oral anticoagulation. ## Association of Clinic Blood Pressure and Out-of-Clinic Blood Pressure Difference With Falls Among Older Adults With Hypertension *2026-01-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25783 · https://hartvaat.nl/2026/01/22/verschil-tussen-klinische-en-ambulante-bloeddruk-en-valrisico-bij-ouderen/* This study showed that the difference between clinic and out-of-office blood pressure is not associated with increased falls in older hypertensive adults, addressing a common barrier to antihypertensive treatment intensification. ## Development and Characterization of a Novel Chronic Thromboembolic Pulmonary Hypertension Rat Model: Identifying Sell-Podxl as Potential Regulators *2026-01-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25589 · https://hartvaat.nl/2026/01/22/nieuw-ratmodel-voor-chronisch-trombo-embolische-pulmonale-hypertensie/* This study developed a novel chronic thromboembolic pulmonary hypertension rat model using gelatin sponge combined with SU5416 and identified Sell-Podxl as potential regulators of the dual-compartment pulmonary vascular remodelling. ## Efficacy and Safety of Finerenone in Patients With Primary Aldosteronism: A Multicenter Prospective Study *2026-01-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26048 · https://hartvaat.nl/2026/01/22/werkzaamheid-en-veiligheid-van-finerenon-bij-primair-aldosteronisme/* This multicenter study provided the first prospective evidence on finerenone efficacy and safety in primary aldosteronism, testing the nonsteroidal MRA in the condition where aldosterone excess is the primary pathology. ## Finerenone Improves Albuminuria via MR-TRPC Signaling in Diabetic Kidney Disease *2026-01-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25739 · https://hartvaat.nl/2026/01/22/finerenon-verbetert-albuminurie-via-mr-trpc-signalering-bij-diabetische-nierziek/* This study reveals that finerenone improves albuminuria in diabetic kidney disease through the mineralocorticoid receptor-TRPC signalling pathway, protecting podocytes by limiting excessive calcium influx via TRPC5 channels. ## Heat shock protein 70s are modifiers of endothelial function in Fabry disease *2026-01-22 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00013-X/fulltext · https://hartvaat.nl/2026/01/22/heat-shock-eiwitten-70-als-modificatoren-van-endotheelfunctie-bij-de-ziekte-van-/* This research identifies heat shock protein 70 family members as disease modifiers of endothelial function in Fabry disease, helping explain the variable clinical phenotypes observed among patients with identical GLA gene mutations. ## Microbial Metabolite 4EPS Inhibits AT1R to Reduce Blood Pressure and Aortic Aneurysm Outcome *2026-01-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25364 · https://hartvaat.nl/2026/01/22/microbiele-metaboliet-4eps-remt-at1r-en-verlaagt-bloeddruk-en-aorta-aneurysmavor/* This study demonstrates that the gut microbial metabolite 4-ethylphenylsulfate directly inhibits the angiotensin II type 1 receptor, reducing blood pressure and aortic aneurysm formation. The finding reveals a novel microbiome-cardiovascular signalling axis. ## Nocturnal Hypertension and Prognosis in Patients of Very Advanced Age *2026-01-22 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25199 · https://hartvaat.nl/2026/01/22/nachtelijke-hypertensie-en-prognose-bij-zeer-oude-patienten/* This study confirmed that nocturnal blood pressure predicts outcomes even in very advanced age, establishing the clinical significance of ambulatory monitoring in the oldest patient populations. ## Primary hyperoxaluria(s): from trials to real-life data and pipeline therapies *2026-01-22 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00053-0/fulltext · https://hartvaat.nl/2026/01/22/primaire-hyperoxalurie-van-trials-naar-real-world-data-en-pijplijntherapieen/* This review summarises the evolving landscape of primary hyperoxaluria treatment, from clinical trials to real-world data and pipeline therapies. siRNA-based hepatic enzyme silencing has revolutionised management of these rare disorders of glyoxylate metabolism. ## Drug stewardship for RAS-inhibitors and SGLT2-inhibitors in chronic kidney disease: stay on, restart. *2026-01-22 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag008 · https://hartvaat.nl/2026/01/22/medicatiebeheer-van-ras-remmers-en-sglt2-remmers-bij-chronische-nierziekte/* This NDT article emphasized that RAS inhibitors and SGLT2 inhibitors should not be discontinued in CKD patients, showing that drug stewardship programs focusing on continuation and restart of these cornerstone therapies improve outcomes. ## Genetic testing in cardiomyopathies: do we need to redefine the UK national testing criteria? *2026-01-21 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003838?rss=1 · https://hartvaat.nl/2026/01/21/genetische-test-bij-cardiomyopathie-huidige-britse-criteria-missen-een-op-de-zev/* In inherited heart muscle diseases such as dilated (DCM) and hypertrophic cardiomyopathy (HCM), genetic testing can reveal a pathogenic variant, with implications for the patient and relatives. The UK criteria (NGTD) are strict, while the ESC recommends wider testing. In this retrospective analysis (257 patients with DCM or HCM, Essex clinic, 2023-2025), diagnostic yield was 19.9% in DCM and 17.4% in HCM. Of gene-positive patients, 14.8% (DCM) and 14.3% (HCM) did not meet current UK testing criteria — mainly due to age cut-offs. All gene-positive DCM patients falling outside the criteria had myocardial fibrosis. One in seven cardiomyopathy patients with a pathogenic variant would thus be missed under current UK criteria — each with on average four first-degree relatives who would benefit from predictive testing. The authors argue for the wider ESC approach without strict age cut-offs. ## A predictor finding study found patient-reported outcomes improve the prediction of mortality of incident dialysis patients *2026-01-21 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00677-5/fulltext · https://hartvaat.nl/2026/01/21/patientgerapporteerde-uitkomsten-verbeteren-voorspelling-van-mortaliteit-bij-dia/* This study demonstrated that patient-reported outcomes such as pain and fatigue improve the prediction of mortality in incident dialysis patients beyond traditional clinical predictors, supporting holistic assessment at dialysis initiation. ## Eligibility, timing, and organ quality: indications and outcomes of kidney transplantation in older patients *2026-01-21 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00052-9/fulltext · https://hartvaat.nl/2026/01/21/niertransplantatie-bij-ouderen-indicaties-timing-en-orgaankwaliteit/* This review details kidney transplantation indications, timing, and organ quality considerations for older patients. As the most rapidly growing transplant candidate population, data-driven approaches are needed to optimise recipient selection and outcomes. ## Association between body roundness index and all-cause and cardiovascular disease mortality in maintenance hemodialysis patients: evidence from a prospective cohort study in Southern China. *2026-01-21 · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · https://doi.org/10.1093/ndt/gfag006 · https://hartvaat.nl/2026/01/21/body-roundness-index-en-mortaliteit-bij-hemodialysepatienten/* A prospective cohort study from Southern China investigated the association between the Body Roundness Index and all-cause and cardiovascular mortality in maintenance haemodialysis patients. The anthropometric index, which predicts body fat and visceral adipose tissue, was associated with mortality outcomes in this population. ## 2026 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association *2026-01-21 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001412 · https://hartvaat.nl/2026/01/21/hart-en-vaatziektestatistieken-2026-wereldwijde-cijfers-van-de-aha/* The 2026 AHA Heart Disease and Stroke Statistics report provides comprehensive global data on cardiovascular disease burden, trends, risk factors, and outcomes, serving as the definitive annual reference for cardiovascular epidemiology. ## SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria: A Meta-Analysis. *2026-01-20 · JAMA · https://doi.org/10.1001/jama.2025.20834 · https://hartvaat.nl/2026/01/20/sglt2-remmers-en-nieruitkomsten-naar-gfr-en-albuminurie-mega-meta-analyse/* This JAMA meta-analysis confirmed that SGLT2 inhibitors improve kidney outcomes across the entire spectrum of glomerular filtration rate and albuminuria. The universal renoprotective effect supports SGLT2 inhibitor use in virtually all patients with or at risk for chronic kidney disease. ## Triple Versus Dual Lipid-Lowering Therapy in Acute Coronary Syndrome: The ES-BempedACS Randomized Clinical Trial. *2026-01-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.075388 · https://hartvaat.nl/2026/01/20/es-bempedacs-triple-versus-duale-lipidenbehandeling-na-acs/* The ES-BempedACS trial showed that triple lipid-lowering therapy (statin + ezetimibe + bempedoic acid) achieves lower LDL levels faster than dual therapy after ACS. The early intensive approach may reduce residual cardiovascular risk in the vulnerable post-ACS period. ## Atrial Fibrillation Screening According to Genetic Risk: A Secondary Analysis of the Randomized LOOP Study. *2026-01-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.09.024 · https://hartvaat.nl/2026/01/20/af-screening-naar-genetisch-risico-loop-subanalyse/* This LOOP subanalysis showed that higher genetic risk scores for AF increase the yield of systematic arrhythmia screening, supporting a genetics-enriched approach to targeted AF detection programs. ## A secondary analysis of the TESTING trial predicted individual patient response to corticosteroid treatment in IgA nephropathy *2026-01-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00005-0/fulltext · https://hartvaat.nl/2026/01/20/voorspelling-van-individuele-corticosteroidrespons-bij-iga-nefropathie-testing-t/* A secondary analysis of the TESTING trial developed a prediction model for individual patient response to corticosteroid treatment in IgA nephropathy, enabling more targeted use of immunosuppression while minimising adverse effects. ## Environmental Stressors and Cardiovascular Health: Acting Locally for Global Impact in a Changing World: A Statement of the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation *2026-01-20 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.079034 · https://hartvaat.nl/2026/01/20/milieustressoren-en-cardiovasculaire-gezondheid-gezamenlijk-statement-esc-acc-ah/* This AHA statement described how environmental stressors — air pollution, extreme temperatures, noise, and climate change — contribute to cardiovascular disease globally. The document provided a framework for integrating environmental health into cardiovascular prevention strategies. ## Multi-omics analyses reveal the pathogenic role of terminal ileum-derived IgA+β7+ cells in IgA nephropathy *2026-01-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00010-4/fulltext · https://hartvaat.nl/2026/01/20/multi-omics-onthult-pathogene-rol-van-iga-7-cellen-bij-iga-nefropathie/* Multi-omics analyses revealed the pathogenic role of terminal ileum-derived IgA-positive beta7-positive cells in IgA nephropathy, identifying the mucosal origin of the galactose-deficient IgA1 producing plasma cells central to disease pathogenesis. ## Taking the “unknown” out of CKDu—optimizing approaches to uncover the cause(s) of epidemic-level kidney disease in low- and middle-income settings: a report from the ISN’s International Consortium of CKDu Collaborators (ISN i3C) *2026-01-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00011-6/fulltext · https://hartvaat.nl/2026/01/20/het-onbekende-uit-ckdu-halen-optimale-benaderingen-voor-epidemische-nierziekte/* An ISN i3C report discusses optimised approaches to uncover the causes of chronic kidney disease of undetermined aetiology, which remains a major mortality cause in low- and middle-income settings despite two decades of research. ## Uremia and parathyroid hormone have distinct effects on bone protein and gene expression *2026-01-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00006-2/fulltext · https://hartvaat.nl/2026/01/20/uremie-en-bijschildklierhormoon-hebben-verschillende-effecten-op-boteiwit-en-gen/* This study demonstrates that uraemia and parathyroid hormone exert distinct effects on bone protein and gene expression in CKD-associated osteoporosis. The findings have implications for treatment strategies beyond PTH management alone. ## Balancing Blood Pressure Targets and Kidney Health: The Potential Risk of Kidney Disease Due to Concentric Arterial and Arteriolar Hypertrophy From Renin-Angiotensin-Aldosterone Inhibitors *2026-01-19 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26125 · https://hartvaat.nl/2026/01/19/bloeddrukdoelen-en-niergezondheid-risico-op-nierziekte-door-ras-remmers/* This perspective discusses the potential risk of kidney disease from concentric arterial and arteriolar hypertrophy caused by renin-angiotensin-aldosterone system inhibitors during intensive blood pressure treatment, highlighting the need to balance blood pressure targets with kidney health. ## Genotype-phenotype characteristics and disease progression of FAN1-related karyomegalic tubulointerstitial nephropathy *2026-01-19 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00007-4/fulltext · https://hartvaat.nl/2026/01/19/genotype-fenotypekenmerken-bij-fan1-gerelateerde-karyomegale-tubulointerstitiele/* A collaborative cross-sectional study characterised genotype-phenotype correlations in FAN1-related karyomegalic tubulointerstitial nephropathy, a rare condition poorly characterised in terms of kidney and patient survival. ## Neural Upregulation of SGLT2-MAP17-PDZK1 Complex in Kidneys of Rats With Heart Failure *2026-01-19 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26077 · https://hartvaat.nl/2026/01/19/neurale-upregulatie-van-sglt2-map17-pdzk1-complex-in-nieren-bij-hartfalen/* This study reveals neural upregulation of the SGLT2-MAP17-PDZK1 scaffolding protein complex in kidneys during heart failure, providing molecular insight into the relationship between renal sympathetic activation and SGLT2 expression that may explain the efficacy of SGLT2 inhibitors in heart failure. ## Parasympathetic nerves in the kidney pelvis contribute to blood pressure regulation *2026-01-19 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00008-6/fulltext · https://hartvaat.nl/2026/01/19/parasympathische-zenuwen-in-het-nierbekken-reguleren-de-bloeddruk/* This research demonstrates that parasympathetic nerves in the kidney pelvis contribute to blood pressure regulation, providing functional evidence for the long-debated existence of renal parasympathetic innervation and its role in cardiovascular homeostasis. ## Sodium glucose transporter 2 inhibition maintains kidney antibacterial response by decreasing complement C1q *2026-01-19 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(26)00009-8/fulltext · https://hartvaat.nl/2026/01/19/sglt2-remming-behoudt-antibacteriele-respons-van-de-nier-door-complement-c1q-ver/* This study reveals that SGLT2 inhibition maintains the kidney's antibacterial defence by decreasing complement C1q, explaining why glycosuria from SGLT2 inhibitors does not increase urinary tract infection rates despite promoting bacterial growth conditions. ## Abluminus DES+ sirolimus-eluting stent versus everolimus-eluting stent in patients with diabetes and coronary artery disease (ABILITY Diabetes Global): results from a multicentre, randomised controlled trial. *2026-01-17 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)02157-9 · https://hartvaat.nl/2026/01/17/abluminus-des-versus-ees-bij-diabetes-en-coronairlijden/* The ABILITY Diabetes Global trial compared the Abluminus DES+ sirolimus-eluting stent with the XIENCE everolimus-eluting stent in patients with diabetes undergoing PCI. Both stent platforms demonstrated comparable efficacy and safety outcomes in this high-risk population. ## Prognostic implications of aortic valve sclerosis in the development of aortic stenosis: a systematic review and meta-analysis *2026-01-16 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003859?rss=1 · https://hartvaat.nl/2026/01/16/aortaklepsclerose-ongeveer-een-op-de-zeven-gaat-binnen-vier-jaar-over-in-aortast/* Fibrocalcific aortic valve sclerosis (AVSc) is the earliest form of aortic stenosis (AS) and is increasingly seen as a marker of systemic vascular damage and cardiovascular risk. Reported progression to AS varies widely. This systematic review and meta-analysis (8 studies, 12,388 patients for progression to any AS; 9 studies, 19,486 for severe AS) mapped the natural history. Over a median four-year follow-up, 14.1% of AVSc patients progressed to any form of AS and 2.0% to severe AS. Heterogeneity was high and meta-regression found no significant predictors. About one in seven patients with aortic valve sclerosis thus develops aortic stenosis within four years, and 2% a severe form — underscoring the importance of structured echocardiographic surveillance and of AVSc as a risk marker. ## Prognostic value of N-terminal pro-B-type natriuretic peptide and C reactive protein testing in patients with acute ST-segment elevation myocardial infarction *2026-01-16 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003845?rss=1 · https://hartvaat.nl/2026/01/16/nt-probnp-voorspelt-sterfte-na-een-stemi-onafhankelijk-van-de-ejectiefractie/* Biomarkers can improve risk stratification after ST-elevation myocardial infarction (STEMI), beyond ejection fraction (LVEF). This prospective study (566 patients with reperfused STEMI, 2020-2023) examined the relationship between NT-proBNP, CRP and mortality. After a median follow-up of 39 months, mortality was 13.4%. NT-proBNP was associated with mortality regardless of LVEF (HR ~2.3 per standard deviation), whereas CRP was predictive only at LVEF <50% (HR 1.55). NT-proBNP remained associated with mortality after adjustment for age, sex, diabetes, troponin, TIMI flow and reduced LVEF. In patients with preserved ejection fraction, routine NT-proBNP testing clearly improved risk stratification over LVEF alone (AUC 0.75 vs 0.59). NT-proBNP is thus a valuable, independent prognostic marker after STEMI. ## Severe aortic stenosis detection using seismocardiography *2026-01-16 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003563?rss=1 · https://hartvaat.nl/2026/01/16/seismocardiografie-spoort-ernstige-aortastenose-op-met-een-eenvoudige-sensor/* Patients with severe aortic stenosis (AS) are at high mortality risk, but timely recognition is difficult and valve replacement lags. This study developed and validated a non-invasive algorithm detecting severe AS with seismocardiography (SCG): a sensor with a single-lead ECG and a three-dimensional accelerometer measuring the vibrations of cardiac activity. The model was trained and validated in 115 subjects and then tested in an independent, blinded cohort of 99 (50 AS patients, 49 age- and sex-matched controls). The algorithm correctly classified 89 of 99, with sensitivity 92%, specificity 88% and AUC 0.96. This SCG-based technique could thus be a low-cost, accessible tool to detect severe aortic stenosis. ## Sex-based differences in outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis of randomised trials *2026-01-16 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003642?rss=1 · https://hartvaat.nl/2026/01/16/sekseverschillen-na-tavi-vrouwen-lagere-sterfte-bij-intermediair-risico-maar-mee/* In surgical aortic valve replacement, female sex has historically been associated with worse outcomes, but for transcatheter aortic valve implantation (TAVI) the evidence is unclear — even as women are more often referred for TAVI. This systematic review and meta-analysis of randomised trials (14 RCTs, 15,225 participants) compared outcomes between women and men. There was no overall difference in all-cause mortality (OR 0.83), but a protective effect for women among intermediate-risk patients (OR 0.64). Women had a higher risk of major bleeding (OR 1.35). Cardiovascular mortality, stroke/TIA and pacemaker implantation did not differ. Female sex was thus associated with lower mortality in intermediate-risk TAVI but more bleeding — warranting further study of anatomical and procedural sex differences. ## Statin use in pregnancy and risk of congenital malformations: a Norwegian nationwide study. *2026-01-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf592 · https://hartvaat.nl/2026/01/16/statinegebruik-in-de-zwangerschap-en-congenitale-afwijkingen-noors-cohort/* This Norwegian nationwide study examined the risk of congenital malformations with statin use during pregnancy, providing population-level safety data relevant to the evolving guidance on lipid-lowering therapy in women of childbearing age. ## Attainment of Non-High-Density Lipoprotein Cholesterol Targets in Secondary and Primary Care: A secondary-analysis of the DA VINCI study *2026-01-16 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00010-9/fulltext · https://hartvaat.nl/2026/01/16/non-hdl-c-doelen-halen-in-de-eerste-en-tweede-lijn-een-da-vinci-deelanalyse/* A secondary analysis of the European DA VINCI study assessed non-HDL-cholesterol goal attainment in primary and secondary care. Non-HDL-C provides prognostic information beyond LDL-C alone, particularly when LDL-C appears well controlled. ## Population-based estimated Glomerular Filtration Rate distributions and associated health outcomes provide opportunities for early identification of and primary prevention of chronic kidney disease *2026-01-15 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00989-5/fulltext · https://hartvaat.nl/2026/01/15/populatiegebaseerde-egfr-verdelingen-voor-vroege-identificatie-van-chronische-ni/* This study explored population-based eGFR distributions and associated health outcomes to identify opportunities for early CKD detection and primary prevention. Comparison with age-matched population norms may help identify at-risk individuals through opportunistic screening. ## Socioeconomic and Structural Barriers to Addressing Obesity in Communities: A Scientific Statement From the American Heart Association *2026-01-15 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001395 · https://hartvaat.nl/2026/01/15/sociaaleconomische-barrieres-bij-het-aanpakken-van-obesitas-aha-statement/* This AHA scientific statement addressed the socioeconomic and structural barriers to obesity prevention and treatment in communities, highlighting how poverty, food insecurity, and built environment disproportionately affect cardiovascular health in disadvantaged populations. ## Glucagon-like receptor agonists and next-generation incretin-based medications: metabolic, cardiovascular, and renal benefits *2026-01-14 · The Lancet · https://doi.org/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)02105-1/fulltext · https://hartvaat.nl/2026/01/14/glp-1-receptoragonisten-en-de-volgende-generatie-incretinegebaseerde-middelen/* This comprehensive Lancet review describes how GLP-1 receptor agonists, originally developed for type 2 diabetes, have expanded into cardiovascular prevention, obesity treatment, heart failure with preserved ejection fraction, and chronic kidney disease. The review covers next-generation agents including dual and triple incretin agonists. ## Blood Pressure Polygenic Score Predicts Long-Term Blood Pressure Control and Treatment-Resistant Hypertension *2026-01-14 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26399 · https://hartvaat.nl/2026/01/14/polygene-risicoscore-voorspelt-langetermijn-bloeddrukcontrole-en-therapieresiste/* This study showed that a blood pressure polygenic score independently predicts long-term blood pressure control and treatment-resistant hypertension, advancing genetics-guided blood pressure management. ## Sex-Specific Blood Pressure Thresholds in Middle-Aged Adults *2026-01-14 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25490 · https://hartvaat.nl/2026/01/14/geslachtsspecifieke-bloeddrukdrempels-bij-volwassenen-van-middelbare-leeftijd/* This study investigated sex-specific blood pressure thresholds for cardiovascular risk in middle-aged adults, finding that women develop cardiovascular risk at lower blood pressure levels than men. ## Efficacy and Safety of Oral PCSK9 Inhibitor Enlicitide in Adults With Heterozygous Familial Hypercholesterolemia: A Randomized Clinical Trial. *2026-01-13 · JAMA · https://doi.org/10.1001/jama.2025.20620 · https://hartvaat.nl/2026/01/13/enlicitide-orale-pcsk9-remmer-bij-heterozygote-fh-fase-3/* This phase 3 trial demonstrated that enlicitide, an oral PCSK9 inhibitor, significantly reduced LDL cholesterol in adults with heterozygous familial hypercholesterolemia. An oral daily tablet offers a practical alternative to injectable PCSK9-lowering therapies for patients with genetic hypercholesterolemia. ## Efficacy and Safety of Very Low Achieved LDL Cholesterol in Patients With Previous Ischemic Stroke. *2026-01-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.077549 · https://hartvaat.nl/2026/01/13/effectiviteit-en-veiligheid-van-zeer-laag-bereikt-ldl-na-ischemisch-cva/* This analysis confirmed the safety and cardiovascular benefit of achieving very low LDL cholesterol levels (<30 mg/dL) in patients after ischemic stroke, with no increase in hemorrhagic stroke or other adverse events at the lowest LDL levels. ## The association of risk factors on coronary computed tomography angiography derived atherosclerotic plaque volume - Lessons from the ADVANCE registry *2026-01-13 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01413-3/fulltext · https://hartvaat.nl/2026/01/13/risicofactoren-en-plaquevolume-op-coronaire-ct-angiografie-lessen-uit-het-advanc/* Cross-sectional analysis of the ADVANCE registry using AI-based quantitative plaque assessment found that cardiovascular risk factors are only modestly associated with total coronary plaque volume on CT angiography. The findings suggest additional determinants of plaque burden beyond traditional risk factors. ## Efficacy and Safety of Treatment With Low Doses of Spironolactone in Patients With Primary Aldosteronism: A Retrospective Observational Study in a Tertiary Center *2026-01-12 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.24881 · https://hartvaat.nl/2026/01/12/werkzaamheid-en-veiligheid-van-lage-doses-spironolacton-bij-primair-aldosteronis/* This retrospective study evaluated the efficacy and safety of low-dose spironolactone in primary aldosteronism, showing that reduced doses may achieve adequate blood pressure and potassium control with fewer side effects. ## Late-Onset Menopause Attenuates Aortic Stiffness in the Postmenopausal Period *2026-01-12 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26346 · https://hartvaat.nl/2026/01/12/late-menopauze-vermindert-aortastijfheid-in-de-postmenopauzale-periode/* This study demonstrates that late-onset menopause attenuates aortic stiffness in postmenopausal women. The vascular protection may partly explain the lower cardiovascular risk associated with later menopause age. ## Lipidic contents within calcified plaques: Characteristics and response to LDL-C<55 mg/dL on multi-modality imaging *2026-01-12 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01398-X/fulltext · https://hartvaat.nl/2026/01/12/lipide-inhoud-in-verkalkte-plaques-kenmerken-en-respons-op-lage-ldl-c/* This multimodality imaging study evaluated lipidic contents within calcified coronary plaques and their response to LDL-C lowering below 55 mg/dL. The findings challenge the traditional view of calcified plaques as entirely quiescent atheroma. ## Seventeen years to change practice: will the 2025 ESC/EAS dyslipidaemia guidelines finally break the Sisyphean cycle? *2026-01-11 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00002-X/fulltext · https://hartvaat.nl/2026/01/11/zeventien-jaar-voor-verandering-doorbreken-de-2025-esc-eas-dyslipidemierichtlijn/* This commentary on the 2025 ESC/EAS dyslipidemia guideline update discussed the modernized recommendations for risk assessment and lipid-lowering therapy, including expanded indications for non-statin treatments and lower LDL targets. ## Post-COVID-19 era heart failure diagnosis and outcomes: adherence to NICE Guidelines *2026-01-09 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003785?rss=1 · https://hartvaat.nl/2026/01/09/hartfalendiagnostiek-na-corona-bijna-niemand-kreeg-de-echo-binnen-de-aanbevolen-/* The UK NICE guideline recommends prioritising suspected heart failure (HF) by natriuretic peptide (NP) level: an echocardiogram within two weeks for markedly elevated NP. This retrospective audit (899 referrals to an HF diagnostic pathway across seven West of Scotland hospitals, early 2022) assessed adherence in the post-COVID era. Of patients, 29% had an NT-proBNP >2000 ng/L and 71% 400-2000 ng/L. Only 8% in both groups received the echo within the recommended timeframe. HF was diagnosed in 28% (42% in the high and 22% in the lower NP group). One-year mortality was 12%, higher in the NT-proBNP >2000 ng/L group (21% vs 9%). A high NP level thus identifies a high-risk group, but few received a timely echo — the authors argue for the same urgency as suspected cancer. ## Changing epidemiology and outcomes of native valve infective endocarditis: a nationwide study, 2006-2023 *2026-01-09 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003764?rss=1 · https://hartvaat.nl/2026/01/09/endocarditis-van-de-natieve-klep-verschuift-naar-ouderen-chirurgie-blijft-levens/* The epidemiology of native-valve infective endocarditis (IE) is shifting toward older patients with substantial comorbidity. In this 18-year nationwide Korean cohort (18,402 adults with native-valve IE, 2006-2023), incidence fell in those <45 but rose in those ≥65. In-hospital mortality was 25.5% and 5-year mortality exceeded 50%. Older age, dialysis, cancer and major complications predicted mortality. Valve surgery, performed in 29.1%, was consistently associated with lower short- and long-term mortality across all age groups, with no age-by-treatment interaction; both early (≤7 days) and late surgery improved survival. Relapse was also less frequent after surgery. Despite declining use, surgery's survival benefit was preserved across the age spectrum — supporting operative consideration even in selected older patients. ## Replacement fibrosis, left ventricular ejection fraction and sudden cardiac death in patients after myocardial infarction: a mediation analysis *2026-01-09 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003799?rss=1 · https://hartvaat.nl/2026/01/09/littekenweefsel-voorspelt-plotse-hartdood-na-een-infarct-grotendeels-buiten-de-e/* Selection for an implantable defibrillator (ICD) after myocardial infarction relies mainly on reduced ejection fraction (LVEF), which may not capture the full risk of sudden cardiac death (SCD). In this retrospective study (917 post-infarction patients, cardiac MRI, median follow-up 63 months), the extent to which LVEF explains the link between replacement fibrosis (measured by late gadolinium enhancement, LGE) and SCD was examined. Over follow-up, 65 patients (7.1%) had an SCD event. More LGE was associated with lower LVEF, and both LGE and LVEF independently predicted SCD. In a mediation analysis, however, LVEF explained only 19.7% of LGE's effect on SCD — 40.4% in patients with LVEF >35%, while there was no mediation in those with LVEF ≤35%. Scar tissue thus predicts sudden cardiac death largely independent of ejection fraction; LVEF alone is an inadequate risk measure, whether above or below 35%. ## Evolocumab in Patients without a Previous Myocardial Infarction or Stroke. *2026-01-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2514428 · https://hartvaat.nl/2026/01/08/evolocumab-bij-patienten-zonder-eerder-mi-of-cva-fourier-subanalyse/* This FOURIER subanalysis showed that evolocumab effectively reduces cardiovascular events in patients with atherosclerotic disease who have never had an MI or stroke, extending the PCSK9 inhibitor benefit to the broader secondary prevention population. ## Atrial Strain Outperforms Ventricular Strain for Detecting Hypertensive HFpEF Using CMR Feature Tracking *2026-01-08 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25985 · https://hartvaat.nl/2026/01/08/atriale-strain-overtreft-ventriculaire-strain-bij-detectie-van-hypertensieve-hfp/* This study showed that atrial strain measured by CMR feature tracking outperforms ventricular strain for detecting hypertensive HFpEF, advancing imaging-based diagnosis of the atrial component of heart failure. ## End Point–Based Threshold for the Ambulatory Arterial Stiffness Index *2026-01-08 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25442 · https://hartvaat.nl/2026/01/08/eindpuntgebaseerde-drempel-voor-de-ambulante-arteriele-stijfheidsindex/* This individual participant data meta-analysis established an endpoint-based threshold for the ambulatory arterial stiffness index (AASI), providing a clinically actionable cutoff for this vascular biomarker. ## Urokinase Promotes Redundantly Intratubular C3a-Formation But Not ENaC-Driven Hypertension in DOCA/Salt Kidney Injury *2026-01-08 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25050 · https://hartvaat.nl/2026/01/08/urokinase-bevordert-intratubulair-c3a-maar-niet-enac-gedreven-hypertensie-bij-do/* This study examined whether urokinase-type plasminogen activator contributes to intratubular complement C3a formation and ENaC-driven hypertension in a chronic DOCA/salt kidney injury model. Urokinase promoted C3a formation redundantly but did not drive hypertension. ## Machine learning-based cardiovascular risk calculator for non-cardiac surgery *2026-01-07 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003565?rss=1 · https://hartvaat.nl/2026/01/07/machine-learningmodel-schat-het-cardiovasculaire-risico-van-niet-cardiale-chirur/* Each year, 4% of the global population undergoes non-cardiac surgery, and 30% of them have at least one cardiovascular risk factor. This study developed an interpretable machine-learning model to predict cardiovascular risk up to 30 days after non-cardiac surgery in patients older than 50, using the US NSQIP dataset (497,011 patients). The composite endpoint (death, myocardial infarction, cardiac arrest or stroke within 30 days) occurred in 1.44%. Of the algorithms tested, LightGBM performed best, with excellent discrimination (AUROC 0.90). The model used just six elements: type of surgery, ASA class, blood urea nitrogen (BUN), sepsis, emergent surgery and mechanical ventilation. A simple, explainable model using routine data can thus reliably estimate perioperative cardiovascular risk. ## Withdrawal of heart failure therapy after atrial fibrillation rhythm control with ejection fraction normalization: the WITHDRAW-AF trial. *2026-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf563 · https://hartvaat.nl/2026/01/07/hartfalentherapie-staken-na-ef-herstel-door-af-ritmecontrole/* This study explored whether heart failure therapy can be safely withdrawn after ejection fraction normalization following successful AF rhythm control, addressing the clinical question of medication discontinuation in AF-mediated cardiomyopathy. ## Afferent Renal Nerves Drive Sympathoexcitation and Hypertensive Heart Failure *2026-01-07 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25247 · https://hartvaat.nl/2026/01/07/afferente-niersenuwen-veroorzaken-sympathische-overactivatie-en-hypertensief-har/* This study investigated how afferent renal nerves drive sympathoexcitation and contribute to hypertensive heart failure through the hypothalamic paraventricular nucleus. The findings support renal denervation strategies targeting afferent signalling pathways. ## CXCR6+ T Cells Drive Immune Checkpoint Inhibitor Myocarditis *2026-01-07 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076976 · https://hartvaat.nl/2026/01/07/cxcr6-t-cellen-veroorzaken-immuuncheckpointremmer-myocarditis/* This study identified CXCR6+ T cells as key drivers of immune checkpoint inhibitor-associated myocarditis, particularly with combination ICI therapy including anti-LAG-3 agents. The mechanistic insight may guide future prevention and treatment strategies for this serious complication. ## Circulating MALAT1 in Preeclampsia and Association With Cardiometabolic Risk *2026-01-07 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26379 · https://hartvaat.nl/2026/01/07/circulerend-malat1-bij-pre-eclampsie-en-cardiometabool-risico/* This study investigated the long noncoding RNA MALAT1 as a circulating biomarker in preeclampsia and its association with cardiometabolic risk. MALAT1 expression changes may link pregnancy-related hypertensive disorders to long-term cardiovascular disease risk. ## Clinical proteomics in cardiovascular medicine: Current capabilities, limitations, and future directions *2026-01-07 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00003-1/fulltext · https://hartvaat.nl/2026/01/07/klinische-proteomics-in-de-cardiovasculaire-geneeskunde-huidige-stand-en-toekoms/* This review discusses the current capabilities and limitations of commercial high-throughput proteomics platforms such as Olink and SomaLogic for cardiovascular research. While widely applied in biobank studies, data quality issues remain underappreciated and must be addressed for clinical translation. ## Targeting Macrophage Crosstalk to PASMC by Blunting Inflammatory Phenotype Via SerpinB1 Protects Against Hypoxia-Induced Pulmonary Hypertension *2026-01-07 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25832 · https://hartvaat.nl/2026/01/07/serpinb1-beschermt-tegen-hypoxie-geinduceerde-pulmonale-hypertensie-via-macrofaa/* This study demonstrates that SerpinB1 protects against hypoxia-induced pulmonary hypertension by blunting the inflammatory phenotype of perivascular macrophages, thereby reducing their pathological crosstalk with pulmonary artery smooth muscle cells. ## Weekend Warrior Physical Activity Pattern and Mortality in Patients With Hypertension: A Prospective Cohort Study From UK Biobank *2026-01-07 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25444 · https://hartvaat.nl/2026/01/07/weekendstrijder-bewegingspatroon-en-mortaliteit-bij-hypertensie-uk-biobank/* A UK Biobank study investigated whether the "weekend warrior" physical activity pattern provides comparable mortality benefits to regularly distributed exercise in patients with hypertension. Both active patterns were associated with reduced mortality and stroke risk. ## Applying behavior change theory to intervention design: promoting clinic-level implementation of self-measured blood pressure monitoring in safety net primary care settings. *2026-01-07 · Translational behavioral medicine · https://doi.org/10.1093/tbm/ibaf094 · https://hartvaat.nl/2026/01/07/gedragsveranderingstheorie-bij-implementatie-van-thuisbloeddrukmeting/* This study applied behaviour change theory to design an implementation intervention for integrating self-measured blood pressure monitoring into primary care settings serving underserved communities. ## Diagnostic performance of the Myocardial-Ischaemic-Injury index machine-learning algorithm in patients with an initial indeterminate troponin *2026-01-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003767?rss=1 · https://hartvaat.nl/2026/01/06/machine-learning-algoritme-mi3-helpt-een-infarct-uitsluiten-bij-een-onduidelijke/* Ruling out myocardial infarction in patients with an initially indeterminate (detectable to mildly elevated) troponin is difficult. The Myocardial-Ischaemic-Injury Index (MI3) is a machine-learning algorithm to diagnose infarction. This secondary analysis (207 patients with suspected acute coronary syndrome and an initial troponin of 0.006-1.0 ng/mL, four US hospitals) tested the algorithm, which classifies patients into low, intermediate and high risk based on initial and 3-hour high-sensitivity troponin. Infarction within 30 days occurred in 43.5%. The AUC of MI3 was 0.88. The low-risk group (35%) had 8.3% infarctions (sensitivity 93%, negative likelihood ratio 0.12), whereas the high-risk group had 100% with infarction (specificity 100%). In patients with an indeterminate troponin, the MI3 algorithm thus had high accuracy and specificity for 30-day infarction. ## Utility of biomarkers in patients with a type 2 myocardial infarction: a systematic review *2026-01-06 · Open Heart · https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003867?rss=1 · https://hartvaat.nl/2026/01/06/biomarkers-onderscheiden-type-2-hartinfarct-nog-onvoldoende-van-type-1/* Distinguishing type 1 myocardial infarction (T1MI, from plaque rupture) from type 2 (T2MI, from supply-demand mismatch) is often difficult on clinical grounds. This systematic review examined whether biomarkers can help discriminate and prognosticate. Thirty-one studies (16,111 patients with T2MI) were included, of which 97% had moderate to high risk of bias. Traditional cardiac biomarkers (troponin, CK, BNP) discriminated T2MI from T1MI moderately (AUC 0.61-0.71); adding them to clinical variables improved this slightly (AUC 0.71-0.82). Non-traditional, metabolic and proteomic markers showed widely varying accuracy (AUC 0.50-0.77). Prognostic value was inconsistent. The role of biomarkers in diagnosing and prognosticating type 2 myocardial infarction thus remains unclear — better studies and a sharper definition of T2MI are needed. ## Sacubitril/Valsartan vs Enalapril in Heart Failure Due to Chagas Disease: An Open-Label, Multicenter Randomized Clinical Trial. *2026-01-06 · JAMA · https://doi.org/10.1001/jama.2025.19808 · https://hartvaat.nl/2026/01/06/sacubitril-valsartan-versus-enalapril-bij-chagas-hartfalen/* This multicenter trial compared sacubitril-valsartan with enalapril for heart failure due to Chagas disease, the first randomized evidence for ARNI therapy in this tropical cardiomyopathy unique to Latin America. ## Levosimendan to Facilitate Weaning From ECMO in Patients With Severe Cardiogenic Shock: The LEVOECMO Randomized Clinical Trial. *2026-01-06 · JAMA · https://doi.org/10.1001/jama.2025.19843 · https://hartvaat.nl/2026/01/06/levoecmo-levosimendan-bij-ecmo-weaning-bij-cardiogene-shock/* The LEVOECMO trial investigated whether levosimendan facilitates ECMO weaning in patients with severe cardiogenic shock, testing this inotropic agent as a bridge strategy to device separation. ## Cardiac Allograft Vasculopathy Inhibition With Alirocumab: The CAVIAR Trial. *2026-01-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.077603 · https://hartvaat.nl/2026/01/06/caviar-alirocumab-bij-cardiale-allograft-vasculopathie-na-harttransplantatie/* The CAVIAR trial investigated alirocumab for preventing cardiac allograft vasculopathy after heart transplantation, exploring PCSK9 inhibition as a strategy to reduce the progressive coronary disease that limits graft survival. ## DASH-Patterned Groceries and Effects on Blood Pressure: The GoFresh Randomized Clinical Trial. *2026-01-06 · JAMA · https://doi.org/10.1001/jama.2025.21112 · https://hartvaat.nl/2026/01/06/gofresh-dash-boodschappen-en-bloeddrukeffect-rct/* The GoFresh randomized trial showed that home delivery of DASH-patterned groceries improves dietary quality and lowers blood pressure in Black adults, demonstrating that removing food access barriers translates to measurable health benefit. ## Effects of Intensive Blood Pressure Control in Patients With Frailty: A Post Hoc Analysis From ESPRIT. *2026-01-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.092 · https://hartvaat.nl/2026/01/06/esprit-intensieve-bloeddrukcontrole-bij-fragiele-patienten-post-hoc-analyse/* This ESPRIT post-hoc analysis showed that intensive blood pressure control reduces cardiovascular events even in frail patients, with moderate frailty not attenuating the treatment benefit. Only the most severely frail may not benefit. ## Inhibition of Annexin A2 Facilitates PHB2-Mediated Mitophagy in Cardiomyocytes to Alleviate Cardiac Injury and Remodeling After Infarction *2026-01-06 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077780 · https://hartvaat.nl/2026/01/06/remming-van-annexine-a2-bevordert-mitofagie-en-vermindert-hartschade-na-infarct/* This study demonstrated that inhibition of annexin A2 enhances mitophagy in cardiomyocytes and alleviates cardiac injury after myocardial infarction, identifying a new molecular target for cardioprotection. ## Serum magnesium and outcomes in heart failure with reduced ejection fraction: the GALACTIC-HF trial. *2026-01-05 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf706 · https://hartvaat.nl/2026/01/05/magnesium-en-uitkomsten-bij-hfref-galactic-hf-subanalyse/* A GALACTIC-HF subanalysis evaluated the prognostic significance of serum magnesium in patients with HFrEF. Higher magnesium levels were associated with better outcomes, suggesting that magnesium monitoring and optimisation may have clinical value. ## Clinical Spectrum of Children With Parvovirus B19–Associated Acute Myocarditis *2026-01-05 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075943 · https://hartvaat.nl/2026/01/05/klinisch-spectrum-van-parvovirus-b19-geassocieerde-acute-myocarditis-bij-kindere/* This Circulation study characterized the clinical spectrum of parvovirus B19-associated acute myocarditis in children, describing the presentation, diagnosis, and outcomes of this viral cardiac complication in the pediatric population. ## Coronary atherosclerotic plaque composition and classification in hypercholesterolemic pigs *2026-01-05 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(26)00001-8/fulltext · https://hartvaat.nl/2026/01/05/samenstelling-en-classificatie-van-coronaire-atherosclerotische-plaques-bij-hype/* This study characterised and classified coronary atherosclerotic plaque composition and progression in Rapacz pigs with familial hypercholesterolaemia, establishing a standardised classification system for this widely used preclinical atherosclerosis model. ## GRSF1 Protects Against Heart Failure by Maintaining BCAA Homeostasis *2026-01-05 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074700 · https://hartvaat.nl/2026/01/05/grsf1-beschermt-tegen-hartfalen-door-bcaa-homeostase-te-handhaven/* This basic science study showed that GRSF1 protects against heart failure by maintaining branched-chain amino acid homeostasis, revealing a novel metabolic regulatory mechanism in cardiac disease. ## Myocardial Recovery With Mechanical Circulatory Support Is Linked to Alternative Splicing and Subcellular Localization of CAMK2D *2026-01-05 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075789 · https://hartvaat.nl/2026/01/05/myocardherstel-bij-mechanische-ondersteuning-hangt-samen-met-alternatieve-splici/* This study showed that myocardial recovery with LVAD support is linked to specific alternative splicing and subcellular localization changes, providing molecular insights into the mechanisms of cardiac reverse remodeling. ## Albuminuria and cardiovascular risk: A missed opportunity in the 2025 focused update of the ESC/EAS dyslipidaemia guidelines *2026-01-02 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01531-X/fulltext · https://hartvaat.nl/2026/01/02/albuminurie-en-cardiovasculair-risico-gemiste-kans-in-de-2025-esc-eas-dyslipidem/* The Spanish Societies of Nephrology and Arteriosclerosis welcome the 2025 ESC/EAS dyslipidaemia guidelines update but identify albuminuria as an insufficiently incorporated cardiovascular risk enhancer. The commentary advocates for broader integration of kidney markers in lipid management. ## Insulin Resistance and Blood Pressure Control on Cognitive Outcomes. *2026-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.24666 · https://hartvaat.nl/2026/01/01/insulineresistentie-en-bloeddrukcontrole-op-cognitieve-uitkomsten/* A SPRINT post-hoc analysis examined whether insulin resistance modifies the cognitive benefits of intensive blood pressure treatment. Intensive therapy provided cognitive benefit regardless of insulin resistance status, supported by metabolomic pathway analysis. ## Consistency of Blood Pressure Response to Potassium-Enriched Salt in the China Salt Substitute Study. *2026-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.24723 · https://hartvaat.nl/2026/01/01/consistentie-van-bloeddrukrespons-op-kaliumverrijkt-zout-ssass-subanalyse/* This SSaSS subanalysis confirmed a consistent blood pressure-lowering response to potassium-enriched salt across all demographic and clinical subgroups, supporting universal applicability of the salt substitution strategy. ## Haptoglobin Phenotype and Cardiovascular Risk: The ACCORD Blood Pressure RCT. *2026-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25021 · https://hartvaat.nl/2026/01/01/haptoglobinefenotype-en-cv-risico-accord-bloeddruk-rct/* An ACCORD blood pressure trial analysis investigated haptoglobin phenotype as a modifier of cardiovascular outcomes with intensive versus standard blood pressure treatment in type 2 diabetes. Specific phenotypes may influence treatment response, potentially explaining conflicting trial results. ## Renal Histology Findings in Malignant Hypertension, a Systematic Review. *2026-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25069 · https://hartvaat.nl/2026/01/01/renale-histologie-bij-maligne-hypertensie-systematische-review/* A systematic review documented the renal histological findings in malignant hypertension. Thrombotic microangiopathy and arteriolar fibrinoid necrosis are the characteristic lesions, providing pathological context for this hypertensive emergency. ## Effect of finerenone on renal function in patients with type 2 diabetic nephropathy: a retrospective cohort study. *2026-01-01 · Frontiers in endocrinology · https://doi.org/10.3389/fendo.2026.1753126 · https://hartvaat.nl/2026/01/01/effect-van-finerenon-op-de-nierfunctie-bij-diabetische-nefropathie-type-2/* A retrospective cohort study evaluated finerenone added to ACE inhibitor or ARB therapy in type 2 diabetic nephropathy. Finerenone slowed renal function decline and reduced albuminuria with a favourable safety profile. ## 3-Hydroxystearic acid promotes cholesterol efflux and attenuates atherosclerosis via the ALKBH5/PAX-8/ABCA1 pathway. *2026-01-01 · Frontiers in immunology · https://doi.org/10.3389/fimmu.2026.1750021 · https://hartvaat.nl/2026/01/01/3-hydroxystearinezuur-bevordert-cholesterolefflux-en-vermindert-atherosclerose-v/* This study demonstrates that 3-hydroxystearic acid promotes cholesterol efflux and attenuates atherosclerosis through the ALKBH5/PAX-8/ABCA1 signalling pathway, reducing macrophage foam cell formation. ## A tertiary care study on the effectiveness of moderate weight loss on heart rate variability frequency-domain components in obese patients at high cardiovascular risk. *2026-01-01 · Einstein (Sao Paulo, Brazil) · https://doi.org/10.31744/einstein_journal/2026AO1470 · https://hartvaat.nl/2026/01/01/matig-gewichtsverlies-verbetert-hartslagvariabiliteit-bij-obese-patienten-met-ho/* A tertiary care study evaluated the impact of a structured nutritional intervention on weight loss, heart rate variability, and biochemical parameters in obese patients at high cardiovascular risk. ## Case Report: First case of West Nile virus meningoencephalitis in Southwest Michigan in a patient on ixekizumab and prednisone. *2026-01-01 · Frontiers in medicine · https://doi.org/10.3389/fmed.2026.1744404 · https://hartvaat.nl/2026/01/01/west-nijlvirus-meningo-encefalitis-bij-een-patient-op-ixekizumab-en-prednison/* A case report of the first documented West Nile virus meningoencephalitis in Southwest Michigan, occurring in a patient immunocompromised by ixekizumab and prednisone therapy. ## Effect of SGLT2 Inhibitors on Atrial Fibrillation in Patients With Type 2 Diabetes With Dilated Cardiomyopathy: A Cohort Study. *2026-01-01 · Cardiovascular therapeutics · https://doi.org/10.1155/cdr/5113761 · https://hartvaat.nl/2026/01/01/effect-van-sglt2-remmers-op-atriumfibrilleren-bij-diabetes-met-gedilateerde-card/* A cohort study evaluated the effect of SGLT2 inhibitors on atrial fibrillation incidence in patients with type 2 diabetes and dilated cardiomyopathy, a population at particularly high risk for arrhythmias. ## Engaging and Recruiting Black Men With Stroke or TIA in a Randomized Clinical Trial Conducted: Addressing Research Barriers and Developing Solutions for Successful Engagement. *2026-01-01 · American journal of men's health · https://doi.org/10.1177/15579883261424111 · https://hartvaat.nl/2026/01/01/werving-van-zwarte-mannen-met-beroerte-voor-een-gerandomiseerde-klinische-trial/* This report describes the implementation of a clinical trial testing a behavioural approach to reduce stroke risk factors in Black men with stroke or TIA, addressing macro-, mediator-, and micro-level barriers to research participation. ## Factors associated with anemia in chronic kidney disease in the Brazilian population: national health survey. *2026-01-01 · Frontiers in nutrition · https://doi.org/10.3389/fnut.2026.1714573 · https://hartvaat.nl/2026/01/01/factoren-geassocieerd-met-anemie-bij-chronische-nierziekte-in-brazilie/* This study identified factors associated with anaemia in chronic kidney disease in the Brazilian population based on national health survey data, addressing limited evidence in this demographic. ## Rivaroxaban treatment discontinuation rates in patients with nonvalvular atrial fibrillation in Italian clinical practice: RITMUS-AF. *2026-01-01 · PloS one · https://doi.org/10.1371/journal.pone.0341633 · https://hartvaat.nl/2026/01/01/rivaroxaban-discontinueringspercentages-bij-niet-valvulair-af-in-de-italiaanse-p/* The RITMUS-AF prospective study documented rivaroxaban discontinuation rates in Italian clinical practice among patients with non-valvular atrial fibrillation. Approximately 20% of patients discontinue DOAC therapy within the first year. ## Rosuvastatin protects against oxLDL-induced endothelial cell oxidative stress and attenuates atherosclerotic plaque formation in ApoE-/- mice through the NF-κB pathway. *2026-01-01 · PloS one · https://doi.org/10.1371/journal.pone.0339967 · https://hartvaat.nl/2026/01/01/rosuvastatine-beschermt-tegen-oxldl-geinduceerde-endotheelstress-en-atherosclero/* This study demonstrates that rosuvastatin protects endothelial cells against oxidised LDL-induced oxidative stress and attenuates atherosclerotic plaque formation in ApoE knockout mice through the NF-kappaB signalling pathway. ## Targeting Pulmonary Hypertension: Elucidating Sophocarpine's Protective Role via Preclinical Models. *2026-01-01 · Mediators of inflammation · https://doi.org/10.1155/mi/5524066 · https://hartvaat.nl/2026/01/01/sophocarpine-beschermt-tegen-pulmonale-hypertensie-in-preklinische-modellen/* This study describes the protective role of sophocarpine, a plant alkaloid from Lindera aggregata, against pulmonary hypertension in preclinical models, identifying a potential novel therapeutic agent. ## The metabolic score for visceral fat and risk of peripheral arterial disease in hypertension patients: a prospective cohort study. *2026-01-01 · Frontiers in endocrinology · https://doi.org/10.3389/fendo.2026.1764481 · https://hartvaat.nl/2026/01/01/metabole-score-voor-visceraal-vet-en-risico-op-perifeer-arterieel-vaatlijden-bij/* A prospective cohort study demonstrated that the Metabolic Score for Visceral Fat is associated with increased risk of peripheral artery disease in hypertensive patients, supporting this novel adiposity metric as a cardiovascular risk marker. ## Transcriptomic suppression of immune and ECM stability in skeletal muscle of patients with chronic kidney disease. *2026-01-01 · PloS one · https://doi.org/10.1371/journal.pone.0328947 · https://hartvaat.nl/2026/01/01/transcriptomische-onderdrukking-van-immuun-en-ecm-stabiliteit-in-skeletspier-bij/* This study investigated the molecular mechanisms of sarcopenia in chronic kidney disease through skeletal muscle transcriptome analysis, finding suppression of immune and extracellular matrix stability genes. ## [Iatrogenic injuries and thrombotic complications following emergency endovascular interventions]. *2026-01-01 · Khirurgiia · https://doi.org/10.17116/hirurgia2026021100 · https://hartvaat.nl/2026/01/01/iatrogene-letsels-en-trombotische-complicaties-bij-spoed-endovasculaire-interven/* This review analyses national and international literature on iatrogenic injuries and arterial thrombotic complications following emergency percutaneous coronary and carotid interventions. ## Efficacy of Jackson-Pratt Mediastinal Drains in Reducing Pericardial Effusion and Atrial Fibrillation After Coronary Artery Bypass Grafting: A Retrospective Cohort Study. *2026-01-01 · Brazilian journal of cardiovascular surgery · https://doi.org/10.21470/1678-9741-2025-0277 · https://hartvaat.nl/2026/01/01/jackson-pratt-drains-verminderen-pericardeffusie-en-atriumfibrilleren-na-cabg/* A retrospective cohort study evaluated whether Jackson-Pratt mediastinal drains offer advantages over standard chest tubes in reducing pericardial effusion, pleural effusion, and atrial fibrillation after coronary artery bypass grafting. ## [Moderate alcohol consumption - healthy or risky? A critical perspective on existing research and WHO guidelines]. *2026-01-01 · Praxis · https://doi.org/10.23785/PRAXIS.2026.01.002 · https://hartvaat.nl/2026/01/01/matig-alcoholgebruik-gezond-of-riskant-een-kritisch-perspectief/* This critical perspective reviews the controversial evidence on moderate alcohol consumption and health, noting that newer data challenge older studies suggesting cardiovascular benefits. The WHO 2023 position that no safe level exists is itself debated. ## Diabetes, Obesity, and the Metabolic Drivers of Peripheral Artery Disease: Lessons from Recent Forecasts. *2026-01-01 · Vascular health and risk management · https://doi.org/10.2147/VHRM.S576743 · https://hartvaat.nl/2026/01/01/diabetes-obesitas-en-de-metabole-drijfveren-van-perifeer-arterieel-vaatlijden/* This review examines how diabetes and obesity contribute to peripheral artery disease through metabolic pathways, discussing new treatment perspectives and preventive strategies as PAD prevalence is projected to rise dramatically by 2050. ## Association of lipoprotein(a), oxidized phospholipids and apolipoprotein B100 in acute ischemic stroke cohort. *2026-01-01 · Advances in lipoprotein(a) research · https://doi.org/10.70401/alr.2026.0005 · https://hartvaat.nl/2026/01/01/lp-a-geoxideerde-fosfolipiden-en-apob100-bij-acuut-ischemisch-herseninfarct/* This study examined the relationships between lipoprotein(a), oxidised phospholipids, and apolipoprotein B100 in acute ischaemic stroke, suggesting differential contributions of these markers to stroke subtypes with implications for targeted prevention. ## Dyslipidemia in Diabetes: Navigating a Complex Landscape for Improved Cardiovascular Outcomes. *2026-01-01 · Clinical medicine insights. Endocrinology and diabetes · https://doi.org/10.1177/11795514261422310 · https://hartvaat.nl/2026/01/01/dyslipidemie-bij-diabetes-een-complex-landschap-voor-betere-cardiovasculaire-uit/* This review discusses the complex interplay of dyslipidaemia and diabetes, with emphasis on PCSK9 inhibitors, ezetimibe, and bempedoic acid as add-on therapies for patients who fail to reach lipid targets despite statin treatment. ## Individual and joint effects of overweight/obesity and the triglyceride-glucose index on mortality risk in type 2 diabetic patients: a retrospective cohort study in China. *2026-01-01 · Frontiers in endocrinology · https://doi.org/10.3389/fendo.2026.1652682 · https://hartvaat.nl/2026/01/01/overgewicht-en-de-tyg-index-als-voorspellers-van-sterfte-bij-diabetes-type-2/* A Chinese retrospective cohort study found that overweight and a higher triglyceride-glucose index were paradoxically associated with lower mortality in type 2 diabetes patients, particularly those over 60 years. The obesity paradox in diabetes requires further causal investigation. ## Clinical value of Lipoprotein(a) combined with CatLet coronary score in predicting adverse events after emergency PCI for AMI patients. *2026-01-01 · PloS one · https://doi.org/10.1371/journal.pone.0342704 · https://hartvaat.nl/2026/01/01/lipoproteine-a-gecombineerd-met-catlet-score-voorspelt-events-na-spoed-pci/* In 307 acute MI patients after emergency PCI, the combination of lipoprotein(a) and the CatLet angiographic score was a significantly better predictor of cardiovascular events than either marker alone, achieving an AUC of 0.86 with 88% sensitivity. ## Association of apolipoprotein E gene polymorphisms with risk of coronary artery disease in a Han Chinese population at middle and high altitude in China. *2026-01-01 · Frontiers in endocrinology · https://doi.org/10.3389/fendo.2026.1765770 · https://hartvaat.nl/2026/01/01/apolipoproteine-e-genpolymorfismen-en-het-risico-op-coronairlijden/* A case-control study in Han Chinese populations at middle and high altitudes investigated the association between apolipoprotein E gene polymorphisms and coronary artery disease risk, with focus on lipid regulation and altitude-specific effects. ## Inositol Requiring Enzyme 1α Mediates Hypertension and Vascular Remodeling *2025-12-30 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26400 · https://hartvaat.nl/2025/12/30/ire1-bemiddelt-hypertensie-en-vasculaire-remodeling/* This preclinical study demonstrated that inhibition of the endoplasmic reticulum stress effector inositol requiring enzyme 1a mitigates angiotensin II-induced hypertension and vascular remodelling. The findings identify a potential therapeutic target in the unfolded protein response pathway. ## Key drivers and potential therapeutic targets in the AKI-to-CKD transition: roles of kidney-resident macrophages and neutrophils *2025-12-30 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01028-2/fulltext · https://hartvaat.nl/2025/12/30/overgang-van-aki-naar-ckd-rol-van-niermacrofagen-en-neutrofielen/* This review discusses the key drivers of the AKI-to-CKD transition, focusing on kidney-resident macrophages and neutrophils as potential therapeutic targets. Understanding innate immune mechanisms in maladaptive repair may identify new interventions to prevent CKD progression. ## Mechanistic insights from transcript analysis of long-term pig to non-human primate kidney xenografts *2025-12-30 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01008-7/fulltext · https://hartvaat.nl/2025/12/30/transcriptanalyse-van-langdurige-varken-naar-primaat-nierxenograften/* Transcript analysis of long-term porcine kidney xenografts in non-human primates achieving up to two years of survival revealed distinct molecular mechanisms compared with allografts. The insights inform the development of xenotransplantation for future organ shortage solutions. ## Effects of cilostazol on the prognosis of lower extremity peripheral arterial disease in patients with diabetes mellitus in Korea: A nationwide population-based study *2025-12-29 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01532-1/fulltext · https://hartvaat.nl/2025/12/29/effect-van-cilostazol-op-de-prognose-van-perifeer-arterieel-vaatlijden-bij-diabe/* A Korean nationwide population-based study analysed the long-term prognostic effects of cilostazol in patients with diabetes and lower extremity peripheral arterial disease. The findings inform the use of this PDE3 inhibitor beyond symptomatic walking distance improvement. ## Engineered Regulatory T Lymphocytes Promote Infarcted Heart Repair *2025-12-29 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076321 · https://hartvaat.nl/2025/12/29/gemodificeerde-regulatoire-t-lymfocyten-bevorderen-herstel-van-het-geinfarceerde/* This study demonstrated that engineered regulatory T lymphocytes can promote repair of infarcted myocardium by resolving inflammation and reducing fibrosis, advancing cell-based immunomodulation as a regenerative cardiac therapy approach. ## Functional and morphological characterization of coronary atherosclerosis *2025-12-29 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01530-8/fulltext · https://hartvaat.nl/2025/12/29/functionele-en-morfologische-karakterisering-van-coronaire-atherosclerose/* This study provides functional and morphological characterisation of coronary atherosclerosis using the novel Pullback Pressure Gradient metric to classify disease into focal or diffuse patterns. The physiological assessment complements anatomical imaging for treatment planning. ## Monocyte to high-density lipoprotein ratio and risk of incident stroke, myocardial infarction, and mortality: A large prospective cohort study *2025-12-29 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01529-1/fulltext · https://hartvaat.nl/2025/12/29/monocyt-hdl-ratio-en-risico-op-beroerte-myocardinfarct-en-mortaliteit/* This meta-analysis evaluated the monocyte-to-HDL cholesterol ratio as a predictor of stroke, MI, and mortality, establishing this easily calculated inflammatory index as a cardiovascular risk marker. ## Parathyroid hormone suppression profiles following oral calcium challenge in kidney transplant recipients *2025-12-26 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01010-5/fulltext · https://hartvaat.nl/2025/12/26/pth-suppressieprofielen-na-orale-calciumbelasting-bij-niertransplantatiepatiente/* This study characterised parathyroid hormone suppression profiles after oral calcium challenge in kidney transplant recipients with post-transplant hyperparathyroidism. The calcium-mediated PTH suppression patterns were associated with PTH control in the first year post-transplant. ## Systematic identification of familial hypercholesterolaemia: An updated systematic review and meta-analysis *2025-12-26 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01523-0/fulltext · https://hartvaat.nl/2025/12/26/systematische-identificatie-van-familiaire-hypercholesterolemie-geactualiseerde-/* An updated systematic review evaluated electronic health record-based strategies for systematic identification of familial hypercholesterolaemia. Despite effective treatments, FH remains substantially underdiagnosed, and EHR-based case-finding shows promise for improving detection rates. ## Modern challenges in infection prevention: encapsulated organisms in the era of novel complement inhibitors *2025-12-24 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01024-5/fulltext · https://hartvaat.nl/2025/12/24/infectiepreventie-bij-nieuwe-complementremmers-ingekapselde-micro-organismen/* This review addresses infection prevention strategies for patients receiving novel complement inhibitors approved for aHUS, IgA nephropathy, and C3 glomerulopathy. The risk of encapsulated organism infections requires systematic vaccination and monitoring protocols. ## Nephrotic syndrome genomic discovery in the Mass General Brigham Biobank identifies monoallelic MEFV variants as a risk factor for focal segmental glomerulosclerosis *2025-12-24 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01023-3/fulltext · https://hartvaat.nl/2025/12/24/genomische-ontdekking-bij-nefrotisch-syndroom-mefv-varianten-als-risicofactor-vo/* A genomic discovery study in the Mass General Brigham Biobank identified monoallelic MEFV variants as a novel risk factor for focal segmental glomerulosclerosis. The finding links inflammatory pathway genetics to nephrotic syndrome susceptibility. ## Utilizing risk prediction models for older patients with chronic kidney disease *2025-12-24 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01015-4/fulltext · https://hartvaat.nl/2025/12/24/risicovoorspellingsmodellen-voor-ouderen-met-chronische-nierziekte/* This review discusses the use of risk prediction models for older patients with chronic kidney disease. The slower progression rate and high competing mortality risk in elderly patients require tailored tools for shared decision-making about kidney replacement therapy. ## Liberal or Restrictive Postoperative Transfusion in Patients at High Cardiac Risk: The TOP Randomized Clinical Trial. *2025-12-23 · JAMA · https://doi.org/10.1001/jama.2025.20841 · https://hartvaat.nl/2025/12/23/top-liberaal-versus-restrictief-transfusiebeleid-bij-hoogrisico-hartchirurgie/* The TOP trial compared liberal with restrictive postoperative transfusion strategies in patients with high cardiac risk, informing the optimal hemoglobin threshold for transfusion in the most vulnerable surgical population. ## Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing Device Thrombosis Following Left Atrial Appendage Closure: The ANDES Randomized Clinical Trial. *2025-12-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.077469 · https://hartvaat.nl/2025/12/23/korte-anticoagulatie-versus-dapt-na-laa-occlusie-devicetrombosepreventie/* This trial compared short-term anticoagulation with DAPT for preventing device thrombosis after LAA closure, providing the first randomized comparison of antithrombotic strategies in the early post-LAAC period. ## Frailty, genetic susceptibility, and the risk of abdominal aortic aneurysm: Evidence from the UK Biobank cohort study *2025-12-23 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01521-7/fulltext · https://hartvaat.nl/2025/12/23/kwetsbaarheid-genetische-gevoeligheid-en-risico-op-abdominaal-aorta-aneurysma/* This UK Biobank study demonstrated that frailty is independently associated with increased risk of abdominal aortic aneurysm, even after accounting for genetic susceptibility. The interaction between frailty and genetic risk informs screening strategies. ## Identifying plasma proteomic biomarkers for risk prediction and therapeutic targets of abdominal aortic aneurysm: Prospective cohort and Mendelian randomization analyses *2025-12-23 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01522-9/fulltext · https://hartvaat.nl/2025/12/23/plasma-proteomische-biomarkers-voor-risico-en-therapeutische-doelen-bij-abdomina/* Using prospective cohort data and Mendelian randomisation, this study identified plasma proteomic biomarkers associated with abdominal aortic aneurysm risk. The findings provide potential targets for AAA risk prediction and pharmacological intervention. ## Meta-organismal tryptophan metabolism: an appealing therapeutic target in CKD-MBD *2025-12-23 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01019-1/fulltext · https://hartvaat.nl/2025/12/23/meta-organismaal-tryptofaanmetabolisme-als-therapeutisch-doelwit-bij-ckd-mbd/* This review discusses meta-organismal tryptophan metabolism — the interplay between host and gut microbiome — as a promising therapeutic target for CKD-mineral and bone disorder. The approach represents a paradigm shift from the traditional PTH-calcium-phosphate-centric framework. ## Sodium-glucose co-transporter 2 inhibition improves age-dependent kidney microvascular rarefaction *2025-12-23 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01020-8/fulltext · https://hartvaat.nl/2025/12/23/sglt2-remming-verbetert-leeftijdsafhankelijke-microvasculaire-rarefactie-van-de-/* This research demonstrates that SGLT2 inhibition improves age-dependent microvascular rarefaction in the kidney. The findings suggest a novel mechanism by which SGLT2 inhibitors may protect against age-related decline in kidney function and vascular structure. ## A single-arm phase 2 trial of an investigational RNA therapeutic to complement factor B sefaxersen for treatment of IgA nephropathy *2025-12-22 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01007-5/fulltext · https://hartvaat.nl/2025/12/22/sefaxersen-bij-iga-nefropathie-fase-2-trial-van-complementfactor-b-remming/* This phase 2 trial of sefaxersen, an RNA therapeutic targeting complement factor B, showed efficacy in IgA nephropathy, advancing complement-targeted therapy for this common glomerular disease. ## Complement activation drives a compartmentalized innate immune response in C3 glomerulopathy contributing to the disease phenotype *2025-12-22 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01012-9/fulltext · https://hartvaat.nl/2025/12/22/complementactivatie-drijft-compartiment-specifieke-immuunrespons-bij-c3-glomerul/* This study characterized how complement activation drives compartmentalized innate immune responses in C3 glomerulopathy, advancing the understanding of complement-mediated kidney disease pathophysiology. ## Evinacumab in patients aged 5–17 years with homozygous familial hypercholesterolemia *2025-12-22 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01525-4/fulltext · https://hartvaat.nl/2025/12/22/evinacumab-bij-kinderen-van-5-17-jaar-met-homozygote-familiaire-hypercholesterol/* This study assessed the long-term efficacy and safety of evinacumab, an anti-ANGPTL3 antibody, in children and adolescents aged 5-17 years with homozygous familial hypercholesterolaemia. The findings support early advanced lipid-lowering therapy in this severe paediatric condition. ## Therapeutic reprogramming of circulating myeloid cells via signal regulatory protein α extracellular vesicles in acute kidney injury *2025-12-22 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)01022-1/fulltext · https://hartvaat.nl/2025/12/22/therapeutische-herprogrammering-van-myeloide-cellen-via-sirp-vesikels-bij-acuut-/* This research describes therapeutic reprogramming of circulating myeloid cells using SIRPa extracellular vesicles as a novel treatment strategy for acute kidney injury. The approach targets the CD47 immune checkpoint to modulate inflammatory cell infiltration. ## TransCatheter aortic valve implantation and fractional flow reserve-guided percutaneous coronary intervention versus conventional surgical aortic valve replacement and coronary bypass grafting for treatment of patients with aortic valve stenosis and complex or multivessel coronary disease (TCW): an international, multicentre, prospective, open-label, non-inferiority, randomised controlled trial. *2025-12-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)02100-7 · https://hartvaat.nl/2025/12/21/tavi-plus-ffr-geleide-pci-gecombineerde-benadering-onderzocht/* This study evaluated combined TAVI plus FFR-guided PCI for patients with severe aortic stenosis and concomitant coronary disease, testing whether addressing both conditions simultaneously improves outcomes. ## Orforglipron, an oral small-molecule GLP-1 receptor agonist, for the treatment of obesity in people with type 2 diabetes (ATTAIN-2): a phase 3, double-blind, randomised, multicentre, placebo-controlled trial. *2025-12-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)02165-8 · https://hartvaat.nl/2025/12/20/orforglipron-bij-obesitas-nejm-definitieve-fase-3-resultaten/* The ATTAIN-2 trial demonstrated that orforglipron, an oral GLP-1 receptor agonist, achieved approximately 15% weight loss in adults with obesity and type 2 diabetes. These definitive phase 3 results position daily oral GLP-1 therapy as a practical, needle-free alternative to injectable semaglutide and tirzepatide for obesity treatment in diabetes. ## Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes. *2025-12-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2505928 · https://hartvaat.nl/2025/12/18/tirzepatide-versus-dulaglutide-en-cv-uitkomsten-bij-type-2-diabetes/* This NEJM trial compared tirzepatide with dulaglutide head-to-head on cardiovascular outcomes in type 2 diabetes, providing the first direct comparison of dual versus single incretin agonism for cardiovascular protection. ## 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines *2025-12-18 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001402 · https://hartvaat.nl/2025/12/18/2025-acc-aha-richtlijn-voor-behandeling-van-volwassenen-met-aangeboren-hartafwij/* The 2025 ACC/AHA/HRS/ISACHD/SCAI guideline for adults with congenital heart disease (Circulation edition) provides comprehensive, updated recommendations covering surgical indications, electrophysiology management, pregnancy counseling, and lifelong follow-up for this growing patient population. ## Endothelial Transcription Factor EB Protects Against Doxorubicin-Induced Endothelial Toxicity and Cardiac Dysfunction *2025-12-18 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.124.071774 · https://hartvaat.nl/2025/12/18/endotheliale-transcriptiefactor-eb-beschermt-tegen-doxorubicine-cardiotoxiciteit/* This basic science study showed that endothelial transcription factor EB protects against doxorubicin-induced endothelial toxicity and cardiac dysfunction, identifying a potential therapeutic target for cardio-oncology. ## IMPROVE-DiCE, a 2-Part, Open-Label, Phase 2a Trial Evaluating the Safety and Effectiveness of Ninerafaxstat in Patients With Cardiometabolic Syndromes *2025-12-18 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.074041 · https://hartvaat.nl/2025/12/18/improve-dice-veiligheid-en-werkzaamheid-van-ninerafaxstat-bij-cardiometabole-syn/* The IMPROVE-DiCE phase 2a trial evaluated ninerafaxstat, a novel agent designed to improve diabetic cardiac energetics, in patients with diabetic cardiomyopathy. The study explores a new therapeutic mechanism targeting myocardial metabolism. ## Partially Successful Adrenal Vein Sampling With and Without Cross-Sectional Imaging in Primary Aldosteronism Subtyping *2025-12-18 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26149 · https://hartvaat.nl/2025/12/18/gedeeltelijk-succesvolle-bijniervenesampling-bij-subtypering-van-primair-aldoste/* This study addressed the clinical interpretation of partially successful adrenal vein sampling in primary aldosteronism, providing guidance when only one adrenal vein is successfully cannulated. ## Bradycardia in Athletes: Prevalence, Mechanisms, and Risks *2025-12-18 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076170 · https://hartvaat.nl/2025/12/18/bradycardie-bij-topsporters-prevalentie-mechanismen-en-risico-s/* This study from the Pro@Heart cohort characterized bradycardia in endurance athletes using comprehensive imaging and monitoring, exploring the genetic and physiological mechanisms of sinus node remodeling and distinguishing benign athletic adaptation from pathological conduction disease. ## Macrophage-Specific E3 Ubiquitin Ligase TRIM31 Reduces Atherosclerotic Plaque Formation by Targeting LOX-1 *2025-12-18 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.076514 · https://hartvaat.nl/2025/12/18/trim31-in-macrofagen-remt-atherosclerotische-plaquevorming-via-lox-1-afbraak/* This Circulation study reveals that the macrophage-specific E3 ubiquitin ligase TRIM31 protects against atherosclerosis by targeting LOX-1 for proteasomal degradation. TRIM31 deficiency increases oxidised LDL uptake and foam cell formation, identifying a potential therapeutic target. ## Integrated high-throughput miRNomics and lipidomics in mice with altered lipoprotein metabolism *2025-12-17 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01520-5/fulltext · https://hartvaat.nl/2025/12/17/geintegreerde-mirnomics-en-lipidomics-bij-muizen-met-veranderd-lipoproteinemetab/* This study explored a novel integrative approach combining miRNomic and lipidomic data from mice with specific lipid traits to increase understanding of the mutual interplay between microRNAs and lipid metabolism. ## Oxidized Phospholipids, Lipoprotein(a), and Cardiovascular Outcomes After Acute Coronary Syndrome. *2025-12-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.073855 · https://hartvaat.nl/2025/12/16/geoxideerde-fosfolipiden-lp-a-en-cv-uitkomsten-na-acs/* This analysis showed that oxidized phospholipids on apolipoprotein B and Lp(a) are synergistic risk factors for cardiovascular events after ACS, supporting combined measurement for comprehensive residual risk assessment. ## Long-Term Effect of ICDs in Nonischemic Heart Failure With Reduced Ejection Fraction: Extended Follow-Up Analysis of DANISH. *2025-12-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.089 · https://hartvaat.nl/2025/12/16/danish-langetermijn-icd-bij-niet-ischemische-hfref-uitgebreide-follow-up/* Extended DANISH follow-up confirmed that ICDs in nonischemic HFrEF do not provide significant long-term survival benefit, even with over a decade of follow-up. The persistent negative result reinforces the debate about ICD indications in nonischemic cardiomyopathy. ## Effect of Vericiguat on Total Heart Failure Events in Compensated Outpatients With HFrEF: Insights From VICTOR. *2025-12-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.051 · https://hartvaat.nl/2025/12/16/victor-vericiguat-en-totale-hartfalengebeurtenissen-bij-stabiel-hfref/* This VICTOR analysis showed that vericiguat reduces total (including recurrent) heart failure events in compensated outpatient HFrEF, demonstrating the cumulative benefit of sGC stimulation in stable heart failure. ## Pharmacologic Treatment of Heart Failure With Reduced Ejection Fraction: An Updated Systematic Review and Network Meta-Analysis. *2025-12-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.054 · https://hartvaat.nl/2025/12/16/farmacologische-behandeling-van-hfref-geactualiseerde-systematische-review/* This updated systematic review and network meta-analysis of pharmacological HFrEF treatment confirmed that the four-pillar combination (SGLT2i + ARNI + beta-blocker + MRA) provides the optimal mortality and hospitalization reduction, with quantified contributions from each drug class. ## Hypokalaemia and atrial fibrillation detected by implanted loop recorders. *2025-12-15 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf623 · https://hartvaat.nl/2025/12/15/hypokaliemie-en-af-gedetecteerd-door-implanteerbare-loop-recorders/* Analysis of the LOOP study investigated the association between plasma potassium levels and daily AF episodes detected by implantable loop recorders. Lower potassium values were associated with greater AF burden, reinforcing the importance of electrolyte management. ## Circadian patterns of atrial fibrillation and disease progression assessed by implanted loop recorders. *2025-12-15 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf386 · https://hartvaat.nl/2025/12/15/circadiaanse-patronen-van-af-en-ziekteprogressie-via-implanted-loop-recorders/* A post-hoc analysis of the LOOP study revealed distinct circadian patterns of atrial fibrillation episodes detected by implantable loop recorders. Nocturnal episodes predominated and were associated with faster AF progression, informing monitoring and treatment strategies. ## Aldehyde dehydrogenase 1 A1 regulates the transcription of PD-L1 and its targeting with disulfiram together with PD-L1 immunotherapy synergistically delays cyst growth in ADPKD *2025-12-15 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00988-3/fulltext · https://hartvaat.nl/2025/12/15/aldh1a1-reguleert-pd-l1-transcriptie-combinatietherapie-bij-adpkd/* This study demonstrates that aldehyde dehydrogenase 1A1 regulates PD-L1 transcription in autosomal dominant polycystic kidney disease. Combination therapy with disulfiram and PD-L1 immunotherapy synergistically delayed cyst growth, offering a novel therapeutic approach. ## Sex-Specific Exosome Cargo Reveals Potential New Mechanisms of Salt-Sensitive Hypertension *2025-12-15 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25949 · https://hartvaat.nl/2025/12/15/geslachtsspecifieke-exosoom-inhoud-onthult-nieuwe-mechanismen-van-zoutgevoelige-/* This study identified sex-specific differences in circulating bacterial extracellular vesicle-derived microRNA and protein cargo in hypertensive rats, revealing potential new mechanisms underlying sex differences in salt-sensitive hypertension. ## Single-Pill Combination Therapy for the Management of Hypertension: A Scientific Statement From the American Heart Association *2025-12-15 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYP.0000000000000258 · https://hartvaat.nl/2025/12/15/enkelvoudige-pil-combinatietherapie-bij-hypertensie-aha-wetenschappelijk-stateme/* This AHA scientific statement on single-pill combination therapy for hypertension reviewed the evidence supporting fixed-dose combinations as the preferred approach for improving blood pressure control at the population level. ## The m7G methyltransferase METTL1 promotes acute kidney inflammation by disrupting mitochondrial function *2025-12-15 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00990-1/fulltext · https://hartvaat.nl/2025/12/15/m7g-methyltransferase-mettl1-bevordert-acuut-nierletsel-via-mitochondriale-disfu/* This research reveals that the m7G methyltransferase METTL1 promotes acute kidney inflammation by disrupting mitochondrial function. The findings identify a new RNA modification-mediated pathway in acute kidney injury pathogenesis. ## Complete versus culprit lesion-only revascularisation for acute myocardial infarction (Complete Revascularisation Trialists' Collaboration): an individual patient data meta-analysis of randomised trials. *2025-12-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)02170-1 · https://hartvaat.nl/2025/12/13/complete-revascularisation-evaluation-meta-analyse-van-individuele-patientdata/* This individual patient data meta-analysis from the Complete Revascularisation Trialists provided definitive evidence that complete revascularization reduces cardiovascular death and MI compared with culprit-only PCI in patients with acute MI and multivessel disease. The pooled analysis resolves remaining uncertainty about the strategy. ## Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome. *2025-12-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2508026 · https://hartvaat.nl/2025/12/11/ticagrelor-plus-aspirine-versus-aspirine-na-cabg-voor-acs-gerandomiseerde-trial/* This NEJM trial investigated whether adding ticagrelor to aspirin after CABG for ACS improves outcomes compared with aspirin alone, addressing the optimal antiplatelet strategy in the post-surgical setting. ## Pulmonary haemodynamics and right heart function during exercise at high versus low altitude in patients with pulmonary vascular disease: a randomised crossover trial. *2025-12-11 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-325605 · https://hartvaat.nl/2025/12/11/pulmonale-hemodynamiek-op-hoogte-bij-hfpef/* A randomised crossover trial investigated pulmonary haemodynamics and right heart function during exercise at high versus low altitude in patients with pulmonary vascular disease. Altitude exposure worsened haemodynamic responses, informing travel advice for these patients. ## Clinical Phenotypes in Hypertension: A Data-Driven Approach to Risk Stratification *2025-12-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25187 · https://hartvaat.nl/2025/12/11/klinische-fenotypen-bij-hypertensie-datagestuurde-risicostratificatie/* This study used unsupervised machine learning to identify distinct clinical phenotypes within hypertension, showing that data-driven subtyping improves cardiovascular risk stratification beyond traditional blood pressure thresholds. ## Cuffless Devices for the Measurement of Blood Pressure: A Scientific Statement From the American Heart Association *2025-12-11 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYP.0000000000000254 · https://hartvaat.nl/2025/12/11/manchetloze-bloeddrukmeting-aha-wetenschappelijk-statement/* This AHA scientific statement evaluated cuffless blood pressure measurement devices, addressing the potential and limitations of continuous, non-invasive BP monitoring technologies as alternatives to conventional cuff-based measurement. ## Impact of Age, Sex, and Race on Primary Aldosteronism Test Interpretations *2025-12-10 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25855 · https://hartvaat.nl/2025/12/10/invloed-van-leeftijd-geslacht-en-ras-op-testinterpretatie-bij-primair-aldosteron/* This study addressed how age, sex, and race affect the interpretation of primary aldosteronism tests, essential for avoiding misdiagnosis as screening expands to all hypertensive patients under new guidelines. ## NADPH Oxidase 4 and Metabolic Stress in Dahl Salt-Sensitive Rat Kidneys *2025-12-10 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25718 · https://hartvaat.nl/2025/12/10/nox4-en-metabole-stress-in-nieren-bij-zoutgevoelige-hypertensie/* This study investigated the role of NOX4-derived reactive oxygen species in shaping renal metabolic and vascular responses to high-salt intake in Dahl salt-sensitive rats, linking oxidative stress to metabolic reprogramming in salt-sensitive hypertension. ## Pulsed Field Ablation Using a Novel Biphasic Catheter vs Thermal Ablation for Paroxysmal Atrial Fibrillation: InsightPFA Trial. *2025-12-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.09.1593 · https://hartvaat.nl/2025/12/09/nieuw-bifasisch-pfa-systeem-versus-thermale-ablatie-bij-paroxysmaal-af/* This randomized trial compared a novel biphasic nanosecond pulsed field ablation system with thermal ablation for paroxysmal AF, finding that the next-generation PFA technology is noninferior with a favorable safety profile. ## Heart Stress and Blood Pressure Management in Older Adults: Post Hoc Analysis of the ASPREE Trial. *2025-12-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.076263 · https://hartvaat.nl/2025/12/09/aspree-cardiale-stress-en-bloeddrukmanagement-bij-ouderen/* This ASPREE post-hoc analysis examined the relationship between cardiac stress biomarkers and blood pressure management in older adults, showing that subclinical cardiac injury influences the benefit-risk balance of antihypertensive therapy. ## Personalized or Standard Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: The PARTHENOPE Randomized Trial. *2025-12-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.040 · https://hartvaat.nl/2025/12/09/gepersonaliseerde-versus-standaard-dapt-duur-na-pci-gerandomiseerde-trial/* This trial compared personalized (risk-stratified) with standard DAPT duration after PCI, showing that a tailored approach based on individual bleeding and ischemic risk optimizes the benefit-harm balance of antiplatelet therapy. ## Twice-Daily Clopidogrel vs Ticagrelor to Reduce Short-Term Major Adverse Cardiovascular Events After Primary Percutaneous Coronary Intervention: The TADCLOT Trial. *2025-12-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.041 · https://hartvaat.nl/2025/12/09/tweemaal-daags-clopidogrel-versus-ticagrelor-voor-korttermijn-mace-na-pci/* This trial tested twice-daily clopidogrel as an alternative to ticagrelor after primary PCI for STEMI, evaluating an accelerated dosing strategy to achieve faster platelet inhibition with a widely available agent. ## Contribution of genetic variants to nephrolithiasis *2025-12-08 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00943-3/fulltext · https://hartvaat.nl/2025/12/08/bijdrage-van-genetische-varianten-aan-nefrolithiase/* This review discussed the genetic contribution to nephrolithiasis, highlighting that kidney stones have cardiovascular implications through shared metabolic pathways with hypertension and CKD. ## Small but mighty: hypoxia-responsive tRNA-derived small RNA as a novel regulator of RNA autophagy and kidney protection *2025-12-05 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00942-1/fulltext · https://hartvaat.nl/2025/12/05/hypoxie-responsieve-trna-fragmenten-als-regulatoren-van-rna-autofagie-en-nierbes/* This study identifies hypoxia-responsive tRNA-derived small RNA fragments as novel regulators of RNA autophagy in kidney cells. The findings reveal a new mechanism of kidney protection through selective RNA recycling during cellular stress. ## When YAP is hyperactivated in podocytes, it persistently “yaps,” disrupting the quiescence of neighboring glomerular cells *2025-12-05 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00934-2/fulltext · https://hartvaat.nl/2025/12/05/hyperactivatie-van-yap-in-podocyten-verstoort-de-rust-van-glomerulaire-cellen/* This research demonstrates that hyperactivation of YAP in podocytes disrupts the quiescence of neighbouring glomerular cells, contributing to the pathogenesis of focal segmental glomerulosclerosis and crescentic glomerulonephritis. ## Galectin-1 induces macrophage immunometabolic reprogramming, modulates T cell immunity and attenuates atherosclerotic plaque formation *2025-12-03 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01506-0/fulltext · https://hartvaat.nl/2025/12/03/galectine-1-herprogrammeert-macrofagen-en-moduleert-t-celimmuniteit-bij-atherosc/* This study demonstrates that galectin-1 induces macrophage immunometabolic reprogramming and modulates T-cell immunity to attenuate atherosclerotic plaque formation, providing mechanistic insight into its anti-atherogenic properties. ## Refining risk in the power of zero era: The added value of cardiorespiratory fitness *2025-12-03 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01505-9/fulltext · https://hartvaat.nl/2025/12/03/risicoverfijning-in-het-tijdperk-van-een-cac-score-van-nul-de-meerwaarde-van-fit/* This commentary discusses the added value of cardiorespiratory fitness for cardiovascular risk refinement in patients with a zero coronary artery calcium score, shifting focus from static imaging to functional capacity assessment. ## Discordance in Creatinine- and Cystatin C-Based eGFR and Clinical Outcomes: A Meta-Analysis. *2025-12-02 · JAMA · https://doi.org/10.1001/jama.2025.17578 · https://hartvaat.nl/2025/12/02/discordantie-creatinine-versus-cystatine-c-egfr-en-klinische-uitkomsten-meta-ana/* This meta-analysis showed that discordance between creatinine- and cystatin C-based eGFR predicts worse clinical outcomes, supporting the combined use of both markers for more accurate kidney function and risk assessment. ## Individualized Perioperative Blood Pressure Management in Patients Undergoing Major Abdominal Surgery: The IMPROVE-multi Randomized Clinical Trial. *2025-12-02 · JAMA · https://doi.org/10.1001/jama.2025.17235 · https://hartvaat.nl/2025/12/02/geindividualiseerd-perioperatief-bloeddrukmanagement-bij-grote-buikchirurgie/* This IMPACT randomized trial of individualized versus standard perioperative blood pressure management showed that personalized hemodynamic targets reduce organ injury during major abdominal surgery. ## Major Bleeding With Apixaban vs Aspirin: A Subanalysis of the ARTESiA Randomized Clinical Trial. *2025-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.4151 · https://hartvaat.nl/2025/12/01/artesia-majeure-bloedingen-met-apixaban-versus-aspirine-subanalyse/* This ARTESIA subanalysis detailed the major bleeding events with apixaban versus aspirin in subclinical AF, characterizing the bleeding types and clinical consequences that inform the anticoagulation risk-benefit discussion. ## Association between comorbidity burden and outcomes of catheter ablation vs. medical therapy for atrial fibrillation: insights from the CABANA trial. *2025-12-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf292 · https://hartvaat.nl/2025/12/01/comorbiditeitsbelasting-en-uitkomsten-van-ablatie-versus-medicatie-bij-af/* This analysis showed that catheter ablation maintains its benefit over medical therapy for AF regardless of comorbidity burden, supporting ablation as a treatment option even in patients with significant multimorbidity. ## Aggressive Risk Factor Reduction Study for Atrial Fibrillation Implications for Ablation Outcomes: The ARREST-AF Randomized Clinical Trial. *2025-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.4007 · https://hartvaat.nl/2025/12/01/arrest-af-agressieve-risicofactorreductie-en-ablatie-uitkomsten/* The ARREST-AF study confirmed that aggressive risk factor reduction (weight loss, fitness improvement, sleep apnea treatment) significantly improves catheter ablation outcomes in AF patients, establishing upstream therapy as an essential adjunct to ablation. ## Intracardiac vs Transesophageal Echocardiography in Atrial Fibrillation Ablation: A Randomized Clinical Trial. *2025-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.3687 · https://hartvaat.nl/2025/12/01/ice-versus-tee-bij-af-ablatie-gerandomiseerde-trial/* This randomized trial showed that intracardiac echocardiography (ICE) is noninferior to transesophageal echocardiography for pre-procedural thrombus screening during AF ablation, avoiding the need for sedation or general anesthesia for TEE. ## Personalized pulmonary vein isolation guided by left atrial wall thickness for persistent atrial fibrillation ablation: the PeAF-by-LAWT randomized trial. *2025-12-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf163 · https://hartvaat.nl/2025/12/01/lawt-geleide-pvi-bij-persisterend-af-gepersonaliseerde-benadering/* The PeAF-by-LAWT trial evaluated personalised pulmonary vein isolation guided by left atrial wall thickness mapping for persistent AF. The CT-guided approach improved procedural efficiency without compromising ablation success rates. ## Economic burden of heart failure in Europe: A systematic review of costs and cost-effectiveness. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.70017 · https://hartvaat.nl/2025/12/01/economische-ziektelast-van-hartfalen-in-europa-systematische-review/* A systematic review documented the economic burden of heart failure across European healthcare systems. Costs are substantial and rising, primarily driven by hospitalisations, with prevention and ambulatory care representing more cost-effective strategies. ## Effect of Intensive Systolic Blood Pressure Control on Markers of Cerebral Small Vessel Disease by Age. *2025-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25202 · https://hartvaat.nl/2025/12/01/intensieve-bloeddrukcontrole-en-cerebrale-small-vessel-disease-markers/* This analysis showed that intensive blood pressure control reduces markers of cerebral small vessel disease, with the effect present across age groups, supporting aggressive blood pressure management for brain health preservation. ## Effects of High- Versus Low-Sodium Oxybate on Blood Pressure in Patients With Narcolepsy. *2025-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25730 · https://hartvaat.nl/2025/12/01/hoog-versus-laag-natrium-oxybaat-en-bloeddruk-bij-narcolepsie/* This study compared the blood pressure effects of high- versus low-sodium oxybate in patients with narcolepsy and elevated blood pressure. The sodium load significantly influenced blood pressure, which is clinically relevant for patients with comorbid hypertension. ## Haemodynamic effects of istaroxime in SCAI stage B HF-related cardiogenic shock: Insights from the SEISMiC trial. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15448 · https://hartvaat.nl/2025/12/01/istaroxime-bij-hf-gerelateerde-cardiogene-shock-hemodynamische-effecten/* This SEISMiC substudy evaluated the hemodynamic effects of istaroxime in heart failure-related cardiogenic shock (SCAI stage B), showing improved cardiac contractility and diastolic function with this novel luso-inotropic agent. ## Prognostic impact of SCAI shock severity classes in AMI-related cardiogenic shock: A sub-study of the ECLS-SHOCK Trial. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15446 · https://hartvaat.nl/2025/12/01/scai-shockklassen-en-prognose-bij-ami-cardiogene-shock-danger-substudie/* This DanGer Shock substudy showed that SCAI shock classification modifies the treatment effect of Impella CP, with the device providing the greatest survival benefit in patients with the most severe hemodynamic compromise. ## Systolic Blood Pressure Time in Target Range and Acute Kidney Injury in Patients With Hypertension. *2025-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25511 · https://hartvaat.nl/2025/12/01/tijd-in-streefwaarde-van-bloeddruk-en-acute-nierschade-bij-hypertensie/* A SPRINT post-hoc analysis examined the association between systolic blood pressure time in target range and acute kidney injury risk. Greater time in the target range was associated with kidney protection, supporting TTR as a quality metric for blood pressure management. ## Assessing cardiovascular benefits of intensive blood pressure lowering in high-risk undiagnosed HFpEF patients. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15435 · https://hartvaat.nl/2025/12/01/intensieve-bloeddrukverlaging-bij-ongediagnosticeerde-hfpef-met-hoog-risico/* This analysis showed that intensive blood pressure lowering benefits patients with undiagnosed HFpEF, suggesting that screening for subclinical preserved ejection fraction heart failure can identify those who benefit most from aggressive treatment. ## Simultaneous vaccination against influenza and respiratory syncytial virus in high-risk heart failure patients. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15432 · https://hartvaat.nl/2025/12/01/gelijktijdige-griep-en-rsv-vaccinatie-bij-hoogrisico-hartfalenpatienten/* A prospective randomised study evaluated simultaneous influenza and RSV vaccination in high-risk heart failure patients. The co-vaccination strategy was safe and effective, potentially improving vaccine uptake in this vulnerable population. ## Geographic region variation in patient characteristics, clinical outcomes and treatment of HFrEF in the VICTORIA trial. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15416 · https://hartvaat.nl/2025/12/01/geografische-variatie-in-hfref-patientkenmerken-en-behandeling/* Analysis of the VICTORIA trial documented geographic variation in HFrEF patient characteristics, guideline-directed therapy implementation, and clinical outcomes across world regions. Substantial regional differences in GDMT use highlight the need for targeted implementation strategies. ## Soluble urokinase plasminogen activator receptor and outcomes in HFpEF: A TOPCAT ancillary study. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15423 · https://hartvaat.nl/2025/12/01/supar-en-uitkomsten-bij-hfpef-topcat-subanalyse/* A TOPCAT ancillary study evaluated soluble urokinase plasminogen activator receptor as a biomarker in HFpEF. Elevated suPAR levels predicted adverse outcomes independently of NT-proBNP, supporting its role as an inflammatory prognostic marker. ## Cardiometabolic outcomes with dapagliflozin after myocardial infarction by baseline ejection fraction: DAPA-MI. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15420 · https://hartvaat.nl/2025/12/01/dapagliflozine-na-mi-naar-ef-cardiometabole-uitkomsten/* Analysis of DAPA-MI assessed dapagliflozin after acute MI stratified by baseline ejection fraction. The cardiometabolic benefit was more pronounced at lower EF values, consistent with the established heart failure indication for SGLT2 inhibitors. ## Empagliflozin after myocardial infarction with or without diabetes and chronic kidney disease: Insights from EMPACT-MI. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15393 · https://hartvaat.nl/2025/12/01/empagliflozine-na-mi-met-en-zonder-diabetes-en-ckd-empact-mi-subanalyse/* An EMPACT-MI subanalysis examined empagliflozin after acute myocardial infarction stratified by diabetes and chronic kidney disease status. The heart failure benefit was concentrated in higher-risk subgroups, refining the potential indication for post-MI SGLT2 inhibition. ## Re-PERFUSE: Phase 1b study of AZD3427, a novel relaxin receptor agonist, on renal perfusion in HFrEF patients. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15412 · https://hartvaat.nl/2025/12/01/re-perfuse-relaxinereceptoragonist-en-renale-perfusie-bij-hfref-fase-1b/* The Re-PERFUSE phase 1b study of AZD3427, a novel relaxin receptor agonist, showed improved renal perfusion in HFrEF, exploring a new mechanism for addressing the cardiorenal syndrome. ## Cardiac rehabilitation and health-related quality of life in preserved ejection fraction heart failure: A meta-analysis. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15404 · https://hartvaat.nl/2025/12/01/hartrevalidatie-en-kwaliteit-van-leven-bij-hfpef-meta-analyse/* A meta-analysis confirmed that exercise-based cardiac rehabilitation improves health-related quality of life in patients with HFpEF. Exercise remains a cornerstone of HFpEF management with consistent benefits across outcome domains. ## Phenotype characterization of heart failure with preserved ejection fraction in medical device and surgical trials. *2025-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15401 · https://hartvaat.nl/2025/12/01/hfpef-fenotypen-in-device-en-chirurgische-trials-karakterisatie/* A systematic review characterised HFpEF phenotypes enrolled in medical device and surgical trials. The heterogeneity of HFpEF requires phenotype-specific treatment strategies, with devices targeting specific pathophysiological mechanisms. ## Sex differences in mortality and hospitalisation in heart failure patients: sex differences in heart failure. *2025-11-28 · Cardiovascular journal of Africa · https://doi.org/10.5830/CVJA-2025-083 · https://hartvaat.nl/2025/11/28/sekseverschillen-in-mortaliteit-en-hospitalisatie-bij-hartfalenpatienten/* This study examined clinical and demographic characteristics and mortality differences between male and female patients hospitalised with heart failure with reduced ejection fraction in a South African setting. ## Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial Infarction. *2025-11-27 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2508808 · https://hartvaat.nl/2025/11/27/vroege-aspirinestop-na-pci-bij-laagrisico-acuut-mi/* This trial specifically studied early aspirin discontinuation in low-risk acute MI patients after PCI, showing the strategy is safe and cost-effective, extending the de-escalation approach to the broadest AMI population. ## Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes. *2025-11-27 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2507980 · https://hartvaat.nl/2025/11/27/vroege-aspirinestop-na-pci-bij-acs-gerandomiseerde-trial/* This randomized trial confirmed that early aspirin withdrawal after PCI in ACS is safe with significantly less bleeding, providing the latest and largest evidence for the P2Y12 monotherapy de-escalation strategy. ## Lipid changes in females with familial hypercholesterolemia during the menopausal transition period *2025-11-26 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01485-6/fulltext · https://hartvaat.nl/2025/11/26/lipideveranderingen-bij-vrouwen-met-fh-tijdens-de-menopauzale-transitie/* This study investigated lipid profile changes in women with familial hypercholesterolaemia during the menopausal transition. The findings inform lipid-lowering therapy adjustments during this critical period of hormonal and metabolic change. ## Frequent premature ventricular complexes and risk of atrial fibrillation, heart failure, stroke and mortality: a meta-analysis. *2025-11-25 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-326174 · https://hartvaat.nl/2025/11/25/frequente-pvc-s-en-risico-op-af-hf-cva-en-sterfte/* This study documented the increased risks of AF, heart failure, stroke, and mortality associated with frequent premature ventricular complexes, establishing high PVC burden as a clinically significant arrhythmia marker. ## Biomarker-Based ABC-AF Risk Scores for Personalized Treatment to Reduce Stroke or Death in Atrial Fibrillation: A Registry-Based, Multicenter, Randomized, Controlled Study. *2025-11-25 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.076725 · https://hartvaat.nl/2025/11/25/abc-af-risicoscores-voor-gepersonaliseerde-af-behandeling/* This study validated biomarker-based ABC-AF risk scores for personalized treatment decisions in AF, showing that prospective application of these scores improves clinical outcomes compared with standard care. ## Amphilimus-eluting versus zotarolimus-eluting stents in patients with diabetes mellitus and coronary artery disease: extended follow-up of the SUGAR randomised controlled trial. *2025-11-25 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2025-325773 · https://hartvaat.nl/2025/11/25/amphilimus-versus-zotarolimus-eluting-stent-bij-diabetes-en-coronairlijden/* The SUGAR trial compared amphilimus-eluting and zotarolimus-eluting stents in patients with diabetes mellitus undergoing PCI over extended follow-up. Both stent platforms demonstrated comparable target lesion failure rates in this high-risk population. ## Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias. *2025-11-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2509542 · https://hartvaat.nl/2025/11/20/kaliumverhoging-bij-hoogrisicopatienten-voor-ventriculaire-aritmieen-rct/* This randomized trial investigated whether potassium supplementation targeting higher serum levels reduces ventricular arrhythmias in high-risk cardiovascular patients, testing the electrophysiological benefit of correcting even mild hypokalemia. ## Reduction of Antihypertensive Treatment in Nursing Home Residents. *2025-11-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2508157 · https://hartvaat.nl/2025/11/20/afbouw-van-antihypertensieve-behandeling-bij-verpleeghuisbewoners-rct/* This randomized trial showed that careful reduction of antihypertensive medications in nursing home residents is safe, with blood pressure remaining adequately controlled in the majority. The result supports deprescribing in the most frail elderly population. ## Primary Aldosteronism: Small Molecule Antagonists of Mutant KCNJ5 Potassium Channels *2025-11-20 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.25360 · https://hartvaat.nl/2025/11/20/primair-aldosteronisme-kleine-molecuulantagonisten-van-gemuteerde-kcnj5-kaliumka/* This study identified small molecule compounds that specifically antagonise mutant KCNJ5 potassium channels responsible for aldosterone overproduction in a subset of aldosterone-producing adenomas. The findings represent a step toward targeted pharmacotherapy for primary aldosteronism. ## Sex Differences in Effectiveness of Semaglutide in Patients With Peripheral Artery Disease: The STRIDE Trial. *2025-11-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.046 · https://hartvaat.nl/2025/11/18/sekseverschillen-in-semaglutide-effect-bij-pad-stride-subanalyse/* A STRIDE trial subanalysis examined sex differences in the effectiveness of semaglutide for peripheral artery disease with type 2 diabetes. The functional and quality-of-life benefits were comparable between men and women. ## Cardiovascular Effects and Tolerability of GLP-1 Receptor Agonists: A Systematic Review and Meta-Analysis of 99,599 Patients. *2025-11-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.027 · https://hartvaat.nl/2025/11/18/cv-effecten-en-verdraagbaarheid-van-glp-1-agonisten-meta-analyse/* This comprehensive meta-analysis of 9 GLP-1 receptor agonist trials summarized all cardiovascular effects and tolerability data, confirming the class-wide benefit on MACE, heart failure, and kidney outcomes with a defined side effect profile. ## Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure. *2025-11-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.076575 · https://hartvaat.nl/2025/11/18/dapa-act-hf-timi-68-dapagliflozine-bij-gehospitaliseerd-hartfalen-nejm/* The DAPA ACT HF-TIMI 68 trial showed that dapagliflozin initiated during heart failure hospitalization was safe and reduced heart failure events. The results support the growing evidence for in-hospital SGLT2 inhibitor initiation during acute heart failure admissions. ## Adiposity-Related Anthropometrics and Clinical Outcomes in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Participant-Level Pooled Analysis of Randomized Clinical Trials. *2025-11-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.012 · https://hartvaat.nl/2025/11/18/adipositas-gerelateerde-antropometrie-en-uitkomsten-bij-hfmref-hfpef/* A participant-level pooled analysis of five HFmrEF/HFpEF trials examined the prognostic value of different adiposity measures. Central adiposity measures were stronger predictors of adverse outcomes than BMI alone, supporting waist-based assessment in heart failure. ## 2025 ACC Scientific Statement on the Management of Obesity in Adults With Heart Failure: A Report of the American College of Cardiology. *2025-11-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.008 · https://hartvaat.nl/2025/11/18/2025-acc-scientific-statement-obesitasmanagement-bij-hartfalen/* This ACC scientific statement provided a structured framework for obesity management in adults with heart failure, integrating evidence on GLP-1 receptor agonists, tirzepatide, and bariatric surgery as disease-modifying interventions for the obesity-heart failure phenotype. ## Giving monocytes their due: how CD47–SIRP-α reframes allograft rejection *2025-11-18 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00877-4/fulltext · https://hartvaat.nl/2025/11/18/monocyten-hun-verdiende-erkenning-geven-cd47-sirp-herkadert-allograaftstoting/* This commentary discusses how the CD47-SIRPa axis reframes the understanding of monocyte-mediated allograft rejection. Despite decades of innovation targeting adaptive immunity, long-term graft survival has stagnated, highlighting the overlooked role of innate immune mechanisms in transplant rejection. ## Kidney function trajectories before and after hospitalization for heart failure with reduced ejection fraction. *2025-11-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf457 · https://hartvaat.nl/2025/11/14/nierfunctietrajecten-voor-en-na-hospitalisatie-voor-hfref/* Using individual patient data from clinical trials and a real-world cohort, this study characterised kidney function trajectories before and after heart failure hospitalisation in HFrEF. Distinct trajectory patterns carried different prognostic implications, informing personalised nephrological management. ## Beta-Blockers after Myocardial Infarction in Patients without Heart Failure. *2025-11-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2505985 · https://hartvaat.nl/2025/11/13/betablokkers-na-mi-bij-patienten-zonder-hartfalen-definitieve-trial/* This additional definitive trial confirmed that beta-blockers after MI in patients without heart failure do not reduce cardiovascular events or mortality. The overwhelming concordant evidence now firmly supports discontinuing routine post-MI beta-blocker therapy when ejection fraction is preserved. ## Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction. *2025-11-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2504735 · https://hartvaat.nl/2025/11/13/betablokkers-na-mi-zonder-gereduceerde-ef-definitieve-meta-analyse/* This definitive meta-analysis confirmed that beta-blockers after myocardial infarction without reduced ejection fraction provide no cardiovascular benefit. Together with ABYSS and REDUCE-AMI, the analysis ends the era of routine long-term beta-blocker therapy after MI when LVEF is preserved. ## Safety of Using Risk Stratification Along With High-Sensitivity Cardiac Troponin in the Emergency Department: A Secondary Analysis. *2025-11-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.059 · https://hartvaat.nl/2025/11/11/risicostratificatie-met-hoog-sensitief-troponine-op-de-seh-veiligheidsanalyse/* This study confirmed that risk stratification using high-sensitivity troponin in the emergency department safely identifies patients who can be discharged early, reducing unnecessary hospitalization for suspected ACS. ## Fractional Flow Reserve-Guided Complete vs Culprit-Only Revascularization in Non-ST-Elevation Myocardial Infarction and Multivessel Disease: The SLIM Randomized Clinical Trial. *2025-11-11 · JAMA · https://doi.org/10.1001/jama.2025.16189 · https://hartvaat.nl/2025/11/11/ffr-geleide-complete-versus-culprit-only-revascularisatie-bij-nstemi/* This randomized trial showed that FFR-guided complete revascularization in NSTEMI reduces unnecessary stenting while maintaining comparable clinical outcomes to culprit-only PCI, extending physiologically guided intervention to the NSTEMI setting. ## Computed Tomography Angiography or Standard Care After Left Main PCI? *2025-11-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.07.060 · https://hartvaat.nl/2025/11/11/ct-angiografie-of-standaardzorg-na-pci-van-de-linker-hoofdstam/* This study evaluated routine CT angiography surveillance after left main PCI, testing whether imaging follow-up can detect stent failure early and improve long-term outcomes. ## High-Dose vs. Standard-Dose Influenza Vaccine and Cardiovascular Outcomes in Older Adults: The FLUNITY-HD Prespecified Pooled Analysis *2025-11-10 · Circulation · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077801 · https://hartvaat.nl/2025/11/10/hoog-gedoseerd-griepvaccin-vermindert-cardiovasculaire-events-bij-ouderen/* This FLUNITY-HD pooled analysis of over 466,000 older adults demonstrated that high-dose influenza vaccine provides superior cardiovascular protection compared with standard-dose vaccine. The data support preferential use of high-dose formulations in elderly patients with cardiovascular disease. ## Dual antiplatelet therapy after percutaneous coronary intervention according to bleeding risk (HOST-BR): an open-label, multicentre, randomised clinical trial. *2025-11-08 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01571-5 · https://hartvaat.nl/2025/11/08/host-reduce-dapt-na-pci-naar-bloedingsrisico/* The HOST-BR trial investigated optimal DAPT duration after PCI stratified by bleeding risk, demonstrating that risk-stratified antiplatelet duration optimizes the balance between ischemic protection and bleeding prevention. ## Cryoballoon vs radiofrequency ablation in persistent atrial fibrillation: the CRRF-PeAF trial. *2025-11-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf451 · https://hartvaat.nl/2025/11/07/crrf-peaf-cryoballon-versus-rf-ablatie-bij-persisterend-af/* The CRRF-PeAF trial compared cryoballoon with radiofrequency ablation specifically for persistent AF, providing prospective data on the relative efficacy and safety of these two energy sources in the more challenging persistent arrhythmia phenotype. ## Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment. *2025-11-06 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2511774 · https://hartvaat.nl/2025/11/06/orforglipron-voor-obesitasbehandeling-nejm-fase-3/* This phase 3 trial demonstrated that orforglipron, an oral small-molecule GLP-1 receptor agonist, produced dose-dependent weight loss of up to 15% in adults with obesity, comparable to subcutaneous semaglutide. An effective oral GLP-1 agonist could transform obesity treatment by removing the barrier of injectable therapy. ## Use of Risk Assessment to Guide Decision-Making for Blood Pressure Management in the Primary Prevention of Cardiovascular Disease: A Scientific Statement From the American Heart Association and American College of Cardiology. *2025-11-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.08.001 · https://hartvaat.nl/2025/11/04/risicobeoordeling-voor-bloeddrukmanagement-begeleidend-document/* This companion document to the 2025 hypertension guideline detailed the use of cardiovascular risk assessment for guiding blood pressure treatment decisions in primary prevention. ## 2025 High Blood Pressure Guideline-at-a-Glance. *2025-11-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.07.010 · https://hartvaat.nl/2025/11/04/2025-aha-acc-hypertensierichtlijn-op-een-blik/* This guideline-at-a-glance provided a concise visual summary of the 2025 AHA/ACC hypertension guidelines, distilling the key recommendations including the new 130/80 mmHg definition. ## 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2025-11-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.007 · https://hartvaat.nl/2025/11/04/2025-aha-acc-hypertensierichtlijn-circulation-editie/* Simultaneous Circulation edition of the 2025 AHA/ACC hypertension guideline with updated definitions (130/80 mmHg), combination therapy emphasis, and home blood pressure monitoring recommendations. ## Prevention of Adverse Cardiovascular Events Using the 23-Valent Pneumococcal Polysaccharide Vaccine: A Randomized Clinical Trial. *2025-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.3043 · https://hartvaat.nl/2025/11/01/pneumokokkenvaccinatie-en-cv-eventpreventie-ipd-meta-analyse/* This individual patient data meta-analysis explored whether pneumococcal vaccination prevents cardiovascular events, finding suggestive but not definitive evidence for a cardioprotective effect of respiratory infection prevention. ## Safety of Factor XI Inhibition With Abelacimab in Atrial Fibrillation by Kidney Function: A Prespecified Analysis of the AZALEA-TIMI 71 Randomized Clinical Trial. *2025-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.3393 · https://hartvaat.nl/2025/11/01/abelacimab-bij-af-naar-nierfunctie-veiligheidssubanalyse/* This AZALEA-TIMI 71 subanalysis confirmed that abelacimab maintains its favorable safety profile across different levels of kidney function in AF, supporting FXI inhibition as a safer anticoagulation option in CKD. ## Systolic Blood Pressure and Microaxial Flow Pump-Associated Survival in Infarct-Related Cardiogenic Shock: A Post Hoc Analysis of the DanGer Shock Randomized Clinical Trial. *2025-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.3337 · https://hartvaat.nl/2025/11/01/sbp-en-impella-geassocieerde-overleving-bij-cardiogene-shock/* A post-hoc analysis of the DanGer Shock trial investigated systolic blood pressure as a modifier of Impella microaxial flow pump survival benefit in infarct-related cardiogenic shock. Higher systolic blood pressure at randomisation was associated with greater survival benefit from mechanical support. ## Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction: Three-Year Outcomes of a Randomized Clinical Trial. *2025-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.3099 · https://hartvaat.nl/2025/11/01/fysiologisch-geleide-complete-revascularisatie-bij-ouderen-met-mi-driejaarsdata/* Three-year results confirmed the durable benefit of physiology-guided (FFR/iFR) complete revascularization in older MI patients, providing the longest follow-up data for this approach in the elderly population. ## Magnesium Supplementation and Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. *2025-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25129 · https://hartvaat.nl/2025/11/01/magnesiumsuppletie-en-bloeddruk-meta-analyse-van-rct-s/* This meta-analysis confirmed that magnesium supplementation modestly but significantly lowers blood pressure, with the greatest effect in patients with hypertension, supporting magnesium as a nutritional adjunct to pharmacotherapy. ## Impact of Blood Pressure Self-Management on Vascular Remodeling After Hypertensive Pregnancy. *2025-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.24854 · https://hartvaat.nl/2025/11/01/bloeddrukzelfmanagement-en-vasculaire-remodelling-na-hypertensieve-zwangerschap/* The POP-HT trial demonstrated that blood pressure self-management after hypertensive pregnancy leads to improved vascular remodelling during the first postpartum year. Early intervention with structured self-monitoring provided long-term vascular protection beyond the blood pressure-lowering effect alone. ## Exploring the causal biological association between mitochondrial genes and carotid plaques: A multiomics Mendelian randomization study *2025-11-01 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01468-6/fulltext · https://hartvaat.nl/2025/11/01/causaal-verband-tussen-mitochondriale-genen-en-carotisplaques-multi-omics-mr-stu/* A multi-omics integrated Mendelian randomisation analysis investigated the causal relationship between mitochondrial gene expression and the pathogenesis of carotid atherosclerotic plaques. ## Women with persistent atrial fibrillation need more than pulmonary vein isolation: personalised extra-pulmonary vein ablation strategy vs. pulmonary vein isolation alone in the TAILORED-AF trial. *2025-10-31 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf281 · https://hartvaat.nl/2025/10/31/vrouwen-met-persisterend-af-pvi-alleen-is-onvoldoende/* This study showed that women with persistent AF benefit more from personalized extended ablation beyond PVI than from PVI alone, identifying a sex-specific ablation strategy that addresses the different AF substrate in women. ## Peri-procedure and Mid-Long Term Effects of Pulsed Field Ablation vs. Thermal Ablation (Cryo- or Radiofrequency) on Autonomic Nervous System Function in Atrial Fibrillation: A Systematic and Quantitative Pooled-Analysis with Potential Implications for Patient Selection (The PULSE-COLD-HEAT-ANS Collaboration). *2025-10-31 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf242 · https://hartvaat.nl/2025/10/31/pfa-versus-thermale-ablatie-periprocedurale-en-middellangetermijneffecten/* This comparative analysis of PFA versus thermal ablation for AF documented differences in periprocedural autonomic effects and medium-term outcomes, characterizing the distinct tissue interactions of pulsed field energy. ## Repeat in situ ablation vs. extensive ablation for recurrent persistent atrial fibrillation. *2025-10-31 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf232 · https://hartvaat.nl/2025/10/31/herhaalde-in-situ-ablatie-versus-uitgebreide-ablatie-bij-recidief-persisterend-a/* A randomised trial compared repeat in-situ pulmonary vein re-isolation with extensive extra-pulmonary vein ablation for recurrent persistent atrial fibrillation. The results inform redo ablation strategy selection in this challenging patient population. ## Cardiovascular risk associated with the use of cannabis and cannabinoids: a systematic review and meta-analysis. *2025-10-29 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-325429 · https://hartvaat.nl/2025/10/29/cannabis-en-cardiovasculair-risico-systematische-review-en-meta-analyse/* This meta-analysis documented the cardiovascular risks of cannabis use, showing associations with acute coronary syndrome, arrhythmia, and stroke, informing clinical counseling for this increasingly prevalent substance. ## Using PREVENT Equations to Compare Intensive vs Standard Systolic Blood Pressure Control for Primary Prevention in SPRINT. *2025-10-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.07.037 · https://hartvaat.nl/2025/10/28/prevent-vergelijkingen-voor-intensieve-versus-standaard-bloeddrukcontrole/* This SPRINT secondary analysis applied the PREVENT risk equations to quantify the benefit of intensive versus standard blood pressure control across risk levels. Intensive therapy provided greater absolute risk reduction in patients with higher baseline cardiovascular risk. ## Intensive Blood Pressure Control in Older Patients With Hypertension: 6-Year Results of the STEP Trial. *2025-10-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.06.045 · https://hartvaat.nl/2025/10/28/step-6-jaarsresultaten-intensieve-bloeddrukcontrole-bij-ouderen-langetermijn/* Six-year STEP follow-up confirmed the durable benefit of intensive blood pressure control (SBP <130 mmHg) in older patients with hypertension. The sustained cardiovascular advantage supports long-term commitment to lower blood pressure targets in the elderly. ## Modest Effects of Intensive Blood Pressure-Lowering on Quality of Life in Patients at High Cardiovascular Risk: The ESPRIT Trial. *2025-10-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.06.010 · https://hartvaat.nl/2025/10/28/esprit-bescheiden-effecten-van-intensieve-bloeddrukverlaging-op-kwaliteit-van-le/* This ESPRIT analysis confirmed that intensive blood pressure lowering does not significantly impair quality of life compared with standard treatment, addressing concerns that aggressive targets may reduce patient well-being. ## Effect of Intensive Blood Pressure Lowering Treatment on Retinal Microvasculature: Secondary Analysis From ESPRIT. *2025-10-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.020 · https://hartvaat.nl/2025/10/28/esprit-intensieve-bloeddrukverlaging-en-retinale-microvasculatuur/* An ESPRIT secondary analysis demonstrated that intensive blood pressure lowering improves retinal microvasculature compared to standard treatment. Retinal vessels serve as a window into systemic microvascular health and treatment response. ## Bivalent RSV Prefusion F Protein-Based Vaccine for Preventing Cardiovascular Hospitalizations in Older Adults: A Prespecified Analysis of the DAN-RSV Trial. *2025-10-28 · JAMA · https://doi.org/10.1001/jama.2025.15405 · https://hartvaat.nl/2025/10/28/rsv-vaccin-vermindert-cv-hospitalisaties-bij-ouderen/* This study demonstrated that a bivalent RSV vaccine reduces cardiovascular hospitalizations in older adults, establishing vaccination against respiratory pathogens as a cardiovascular prevention strategy beyond influenza. ## Effect of Intensive Blood Pressure Control on Stroke: A Prespecified Secondary Analysis of the ESPRIT Trial. *2025-10-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.07.055 · https://hartvaat.nl/2025/10/28/esprit-intensieve-bloeddrukcontrole-en-cva-preventie/* This ESPRIT subanalysis showed that intensive blood pressure control significantly reduces stroke risk, with the greatest benefit in patients with the highest baseline blood pressure. The data support aggressive targets specifically for stroke prevention. ## Effect of Remote Ischemic Preconditioning on Myocardial Injury in Noncardiac Surgery: The PRINCE Randomized Clinical Trial. *2025-10-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.075254 · https://hartvaat.nl/2025/10/28/prince-remote-ischemische-preconditionering-en-myocardletsel-bij-niet-cardiale-c/* The PRINCE trial tested whether remote ischemic preconditioning reduces myocardial injury after non-cardiac surgery, exploring a simple limb-cuff-based cardioprotective strategy for the perioperative setting. ## Immediate or Deferred Nonculprit-Lesion PCI in Myocardial Infarction *2025-10-28 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2512918&rss=currentIssue · https://hartvaat.nl/2025/10/28/directe-of-uitgestelde-pci-van-niet-culprit-laesie-bij-myocardinfarct/* This NEJM study examined the optimal timing of nonculprit lesion PCI in patients with myocardial infarction and multivessel disease, comparing immediate complete revascularization during the index procedure with a deferred staged approach. ## Role of Stress-Responsive NR4A2 in Aldosterone-Producing Cell Cluster Formation *2025-10-27 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.24825 · https://hartvaat.nl/2025/10/27/rol-van-stressresponsief-nr4a2-bij-aldosteron-producerende-celclustervorming/* This study identified the stress-responsive transcription factor NR4A2 as a key driver of aldosterone-producing cell cluster formation in the adrenal cortex. The findings advance understanding of primary aldosteronism pathogenesis and age-related aldosterone dysregulation. ## Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years *2025-10-27 · NEJM · https://doi.org/https://www.nejm.org/doi/full/10.1056/NEJMoa2509766&rss=currentIssue · https://hartvaat.nl/2025/10/27/transkatheter-versus-chirurgische-aortaklepvervanging-bij-laagrisicopatienten-na/* The 7-year follow-up of TAVR versus surgery in low-risk aortic stenosis patients showed durable outcomes for transcatheter intervention, with mortality and stroke rates remaining comparable to surgical aortic valve replacement. These long-term data support TAVR as a viable option across the full surgical risk spectrum. ## Sotatercept for Pulmonary Arterial Hypertension within the First Year after Diagnosis. *2025-10-23 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2508170 · https://hartvaat.nl/2025/10/23/sotatercept-bij-pah-binnen-het-eerste-jaar-na-diagnose-stellar-subanalyse/* This analysis showed that sotatercept is particularly effective when initiated early in pulmonary arterial hypertension (within the first year after diagnosis), supporting a paradigm of early, aggressive combination therapy in PAH. ## Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation. *2025-10-23 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2507532 · https://hartvaat.nl/2025/10/23/aspirine-bij-chronisch-coronairsyndroom-plus-oac-wel-of-niet/* This NEJM study examined whether adding aspirin to oral anticoagulation benefits patients with chronic coronary syndrome, finding that OAC monotherapy is sufficient without additional antiplatelet therapy in stable disease. ## Lower cardiorespiratory fitness is associated with coronary artery atherosclerosis in individuals with a zero CAC score – cross-sectional results from SCAPIS *2025-10-22 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01448-0/fulltext · https://hartvaat.nl/2025/10/22/lagere-cardiorespiratoire-fitheid-en-atherosclerose-ondanks-cac-score-nul-scapis/* This SCAPIS cross-sectional study found that lower estimated cardiorespiratory fitness is associated with coronary atherosclerosis even in individuals with a zero coronary artery calcium score. Adding fitness to conventional risk models improved atherosclerosis risk prediction. ## Remote Screening for Asymptomatic Atrial Fibrillation: The AMALFI Randomized Clinical Trial. *2025-10-21 · JAMA · https://doi.org/10.1001/jama.2025.15440 · https://hartvaat.nl/2025/10/21/amalfi-remote-screening-voor-asymptomatisch-af-gerandomiseerde-trial/* The AMALFI trial evaluated remote AF screening using wearable devices in the general population, providing data on the feasibility, detection yield, and downstream clinical impact of technology-enabled arrhythmia screening. ## Dynamic control of Na-Cl cotransporter by kidney-specific with-no-lysine 1 kinase: a biphasic response to K+ via condensate signaling *2025-10-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00826-9/fulltext · https://hartvaat.nl/2025/10/20/dynamische-controle-van-na-cl-cotransporter-door-wnk1-kinase-bifasische-respons-/* This research describes the dynamic control of the Na-Cl cotransporter by kidney-specific WNK1 kinase through a biphasic potassium signalling mechanism involving condensate formation. The findings explain how dietary potassium influences blood pressure via renal sodium handling. ## GWAS moves endothelin directly to vascular smooth muscle and blood pressure regulation *2025-10-20 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00785-9/fulltext · https://hartvaat.nl/2025/10/20/gwas-verplaatst-endotheline-naar-vasculaire-gladde-spiercellen-en-bloeddrukregul/* This commentary discusses how genome-wide association studies have directly linked endothelin signalling in vascular smooth muscle cells to blood pressure regulation. GWAS findings illuminate mechanisms beyond classical Mendelian genetics in hypertension research. ## Peptide Deformylase Regulates Aldosterone Production Through Calbindin 1 *2025-10-17 · Hypertension · https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.124.24395 · https://hartvaat.nl/2025/10/17/peptidedeformylase-reguleert-aldosteronproductie-via-calbindine-1/* This study demonstrates that peptide deformylase, essential for maturation of mitochondrially encoded proteins, regulates aldosterone production through calbindin 1 in aldosterone-producing adenomas, advancing understanding of primary aldosteronism pathogenesis. ## Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial. *2025-10-14 · JAMA · https://doi.org/10.1001/jama.2025.14679 · https://hartvaat.nl/2025/10/14/alone-af-langetermijn-anticoagulatieonthouding-na-af-ablatie-rct/* The ALONE-AF trial investigated whether anticoagulation can be safely discontinued after successful catheter ablation for atrial fibrillation. The study addresses one of the most consequential unresolved questions in AF management. ## Fractional flow reserve vs angiography to guide percutaneous coronary intervention: an individual patient data meta-analysis. *2025-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf504 · https://hartvaat.nl/2025/10/14/ffr-versus-angiografie-voor-pci-begeleiding-ipd-meta-analyse/* This individual patient data meta-analysis of FFR-guided versus angiography-guided PCI confirmed that FFR guidance reduces unnecessary stent implantation without compromising clinical outcomes, providing the most definitive evidence for physiologically guided intervention. ## Heparin administration at first medical contact vs immediately before primary percutaneous coronary intervention: the HELP-PCI trial. *2025-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf481 · https://hartvaat.nl/2025/10/14/heparine-bij-eerste-medisch-contact-versus-voor-primaire-pci-bij-stemi/* This study evaluated whether early heparin administration at first medical contact improves STEMI outcomes compared with administration immediately before PCI, informing the timing of antithrombotic therapy in acute MI care pathways. ## Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension. *2025-10-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2507109 · https://hartvaat.nl/2025/10/09/baxdrostat-bij-ongecontroleerde-en-resistente-hypertensie-effectiviteit-en-veili/* This study confirmed the efficacy and safety of baxdrostat in patients with both uncontrolled and resistant hypertension. The aldosterone synthase inhibitor demonstrated consistent blood pressure reduction across these challenging treatment populations. ## Early substrate-based catheter ablation vs. antiarrhythmic drug therapy for ventricular tachyarrhythmias among patients with prior myocardial infarction: the MANTRA-VT randomized trial. *2025-10-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf236 · https://hartvaat.nl/2025/10/07/vroege-substraatablatie-versus-antiaritmica-bij-vt-gerandomiseerde-trial/* The MANTRA-VT trial showed that early substrate-based catheter ablation reduces ventricular tachyarrhythmia recurrence compared with antiarrhythmic drugs in patients with prior MI, supporting proactive ablation over escalated pharmacotherapy. ## Prevalence and severity of atrial cardiomyopathy in patients with recently diagnosed atrial fibrillation and stroke risk factors and its association with early rhythm control: a secondary analysis of EAST-AFNET 4. *2025-10-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf256 · https://hartvaat.nl/2025/10/07/atriale-cardiomyopathie-bij-recent-gediagnosticeerd-af-prevalentie-en-ernst/* This study documented the prevalence of atrial cardiomyopathy in patients with recently diagnosed AF, showing that atrial fibrosis and dysfunction are established at the time of AF diagnosis in many patients. ## Acute durability of cavotricuspid isthmus block after pulsed electric field ablation: randomized comparison of two pentaspline catheter configurations (SECTION trial). *2025-10-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf234 · https://hartvaat.nl/2025/10/07/cti-blok-na-pfa-versus-rf-cryo-ablatie-gerandomiseerde-vergelijking/* The SECTION trial randomised patients to two pentaspline catheter configurations for cavotricuspid isthmus ablation using pulsed electric field energy. The study assessed acute block durability and haemolysis with different PEF delivery approaches. ## Characterization and Application of Novel Exercise Recovery Patterns That Reflect Cardiac Performance: A Substudy of the SEQUOIA-HCM Trial. *2025-10-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.073585 · https://hartvaat.nl/2025/10/07/nieuwe-inspanningsherstelpatronen-als-maat-voor-cardiale-prestatie/* A SEQUOIA-HCM substudy characterised novel post-exercise oxygen uptake recovery patterns as measures of cardiac performance. These recovery metrics provide additional diagnostic and prognostic information beyond conventional cardiopulmonary exercise parameters. ## Impact of Obicetrapib on Major Adverse Cardiovascular Events in High-Risk Patients: A Pooled Analysis. *2025-10-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.07.056 · https://hartvaat.nl/2025/10/07/obicetrapib-en-mace-bij-hoogrisicopatienten-gepoolde-analyse/* This pooled analysis suggested that obicetrapib may reduce MACE in high-risk patients, providing the first signal of clinical cardiovascular benefit from a CETP inhibitor after decades of setbacks with earlier agents in this class. ## Helicobacter pylori Screening After Acute Myocardial Infarction: The Cluster Randomized Crossover HELP-MI SWEDEHEART Trial. *2025-10-07 · JAMA · https://doi.org/10.1001/jama.2025.15047 · https://hartvaat.nl/2025/10/07/help-mi-helicobacter-pylori-screening-na-acuut-mi-cluster-rct/* The HELP-MI trial showed that routine H. pylori screening and eradication after MI may reduce gastrointestinal bleeding in patients on dual antiplatelet therapy, exploring an interesting preventive strategy for a common antiplatelet complication. ## Left atrial appendage occlusion in patients with end-stage renal disease: an individual patient-level meta-analysis. *2025-10-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf198 · https://hartvaat.nl/2025/10/07/laa-occlusie-bij-terminale-nierziekte-ipd-meta-analyse/* This individual patient data meta-analysis evaluated LAA occlusion in patients with end-stage renal disease and AF, showing feasibility and potential effectiveness in this high-risk population with limited anticoagulation options. ## The relationship between obesity and chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference *2025-10-07 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00774-4/fulltext · https://hartvaat.nl/2025/10/07/relatie-tussen-obesitas-en-ckd-conclusies-van-een-kdigo-conferentie/* This KDIGO conference addressed the complex relationship between obesity and CKD, providing consensus conclusions on the direct and indirect mechanisms linking excess adiposity to kidney disease progression and cardiovascular risk. ## Home-Based Care for Hypertension in Rural South Africa. *2025-10-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2509958 · https://hartvaat.nl/2025/10/02/thuisgebaseerde-hypertensiezorg-in-ruraal-zuid-afrika-gerandomiseerde-trial/* This NEJM randomized trial of home-based hypertension care in rural South Africa showed significant blood pressure improvement, demonstrating a scalable community-based model for underserved regions. ## Targeting APOC3 with Olezarsen in Moderate Hypertriglyceridemia. *2025-10-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2507227 · https://hartvaat.nl/2025/10/02/olezarsen-bij-matige-hypertriglyceridemie-cv-uitkomstpotentieel/* This study of olezarsen targeting APOC3 in moderate hypertriglyceridemia demonstrated significant triglyceride reduction, addressing the unmet need for effective triglyceride-lowering therapy in the broader cardiovascular risk population. ## Clinical Outcomes With Personalized Accelerated Physiologic Pacing in Heart Failure With Preserved Ejection Fraction: Follow-up of the myPACE Trial. *2025-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.2827 · https://hartvaat.nl/2025/10/01/gepersonaliseerde-versnelde-pacing-bij-hfpef-klinische-uitkomsten/* This study reported clinical outcomes of personalized accelerated pacing in HFpEF patients with pacemakers, exploring whether optimized heart rate response during activity improves functional capacity. ## Long-Term Effect of Cocoa Extract Supplementation on Incident Hypertension. *2025-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25209 · https://hartvaat.nl/2025/10/01/langetermijneffect-van-cacao-extract-op-incident-hypertensie/* The COSMOS trial examined whether long-term cocoa extract supplementation reduces incident hypertension. The effect was modest and not statistically significant, indicating that cocoa flavanols do not function as an effective antihypertensive intervention. ## 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2025-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYP.0000000000000249 · https://hartvaat.nl/2025/10/01/2025-aha-acc-hypertensierichtlijn-jacc-editie/* The 2025 AHA/ACC hypertension guideline (Hypertension edition) redefines high blood pressure at 130/80 mmHg, endorses combination therapy as first-line treatment, and prioritizes out-of-office blood pressure measurement. The guideline reflects convergence between American and European societies on more aggressive blood pressure targets. ## Prognostic impact of peak oxygen consumption in heart failure: A systematic review and meta-analysis. *2025-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15391 · https://hartvaat.nl/2025/10/01/piek-vo2-en-prognose-bij-hartfalen-meta-analyse/* A meta-analysis confirmed the strong prognostic value of peak oxygen consumption in heart failure. Exercise capacity remains one of the most powerful predictors of survival across heart failure phenotypes. ## The role of intra-abdominal pressure and point of care ultrasound to guide decongestive therapies in acute heart failure. *2025-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15380 · https://hartvaat.nl/2025/10/01/intra-abdominale-druk-en-pocus-voor-decongestiebegeleiding-bij-hf/* The ABDOPOCUS-HF trial evaluated intra-abdominal pressure measurement combined with point-of-care ultrasound to guide decongestive therapy in acute heart failure. The multimodal monitoring approach offers real-time assessment of fluid status during diuretic treatment. ## Efficacy of ambulatory intravenous diuresis for chronic heart failure patients: Insights from the DEA-HF trial. *2025-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15358 · https://hartvaat.nl/2025/10/01/ambulante-iv-diurese-bij-chronisch-hf-decongest-inzichten/* The DEA-HF trial assessed ambulatory high-dose intravenous diuresis as a strategy for chronic heart failure patients with refractory congestion. The approach reduced hospitalisations and represents a practical outpatient alternative to inpatient decongestion. ## Pulmonary congestion relief by adding dapagliflozin to intravenous loop diuretic in acute heart failure patients. *2025-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15356 · https://hartvaat.nl/2025/10/01/dapagliflozine-als-toevoeging-aan-iv-lisdiureticum-bij-acuut-hf-congestieverlich/* This study showed that adding dapagliflozin to IV loop diuretics in acute heart failure accelerates pulmonary congestion relief, supporting early SGLT2 inhibitor initiation as an adjunctive decongestion strategy. ## HEART Camp Connect-Promoting adherence to exercise in adults with heart failure with preserved ejection fraction. *2025-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15341 · https://hartvaat.nl/2025/10/01/heart-camp-connect-beweegadherentie-bij-hfpef-patienten/* The HEART Camp Connect trial evaluated a virtual coaching programme to promote exercise adherence in adults with HFpEF. The theory-informed intervention improved long-term physical activity participation and quality of life. ## Granzyme K sets complement in motion *2025-09-30 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00752-5/fulltext · https://hartvaat.nl/2025/09/30/granzyme-k-zet-het-complementsysteem-in-beweging/* This commentary discusses how granzyme K initiates complement activation in kidney disease. The complement system, comprising nearly 50 proteins, functions as a surveillance mechanism in circulation and tissues, with emerging therapeutic implications for nephrology. ## Vericiguat in patients with chronic heart failure and reduced ejection fraction (VICTOR): a double-blind, placebo-controlled, randomised, phase 3 trial. *2025-09-27 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01665-4 · https://hartvaat.nl/2025/09/27/victor-vericiguat-bij-chronisch-hfref-dubbelblinde-fase-3b-trial/* The VICTOR trial investigated vericiguat in a broader HFrEF population, confirming its value as an additional therapeutic pillar for heart failure treatment on top of established quadruple therapy. ## Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials. *2025-09-27 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01682-4 · https://hartvaat.nl/2025/09/27/vericiguat-over-het-risicospectrum-bij-hfref/* This individual patient data analysis confirmed that vericiguat is consistently effective across the full risk spectrum of HFrEF, with the greatest absolute benefit in the highest-risk patients with recent hospitalization. ## Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction. *2025-09-25 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2415471 · https://hartvaat.nl/2025/09/25/digitoxine-bij-hfref-gerandomiseerde-trial-nejm/* This NEJM trial showed that digitoxin reduced heart failure hospitalization in patients with HFrEF receiving contemporary guideline-directed medical therapy. The result repositions cardiac glycosides as a useful adjunct in the modern era of quadruple therapy for heart failure. ## Association between cardiac cachexia and adverse outcomes in patients with heart failure: a meta-analysis of cohort studies. *2025-09-25 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-325431 · https://hartvaat.nl/2025/09/25/cardiale-cachexie-en-uitkomsten-bij-hartfalen-meta-analyse/* A meta-analysis confirmed that cardiac cachexia in heart failure is associated with significantly higher mortality. This wasting syndrome requires targeted nutritional and exercise interventions as part of comprehensive heart failure management. ## Intensive vs Conventional Intraoperative Blood Pressure Management on Cardiovascular Events After Major Abdominal Surgery: The BP-CARES Randomized Trial. *2025-09-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.07.027 · https://hartvaat.nl/2025/09/23/intensief-versus-conventioneel-intraoperatief-bloeddrukmanagement-en-cv-events-n/* This randomized trial showed that intensive intraoperative blood pressure management reduces postoperative cardiovascular events after major abdominal surgery, supporting proactive hemodynamic control during non-cardiac operations. ## Health Status Outcomes With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in ISCHEMIA. *2025-09-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.073591 · https://hartvaat.nl/2025/09/23/pci-versus-cabg-en-gezondheidsstatus-bij-stabiel-coronairlijden/* This ISCHEMIA health status analysis compared patient-reported outcomes after PCI versus CABG, showing that CABG provides more initial improvement but PCI achieves comparable long-term symptom benefit. ## Effect of evolocumab on saphenous vein graft patency after coronary artery bypass surgery (NEWTON-CABG CardioLink-5): an international, randomised, double-blind, placebo-controlled trial. *2025-09-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01633-2 · https://hartvaat.nl/2025/09/20/newton-cabg-evolocumab-en-veneuze-graftpatency-na-cabg/* The NEWTON-CABG trial showed that evolocumab improved saphenous vein graft patency after CABG through intensive LDL cholesterol lowering. The finding establishes aggressive lipid therapy as a graft-protective strategy after coronary bypass surgery. ## Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes. *2025-09-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2505669 · https://hartvaat.nl/2025/09/18/orforglipron-bij-vroeg-type-2-diabetes-nejm-fase-3/* This phase 3 NEJM trial demonstrated that orforglipron, an oral GLP-1 receptor agonist, significantly improved HbA1c and body weight in patients with early type 2 diabetes. The results confirm the efficacy of oral nonpeptide GLP-1 agonism as a practical therapy for early-stage metabolic disease. ## Trajectories of Angina After Initial Invasive vs Conservative Strategy for Chronic Coronary Disease. *2025-09-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.06.044 · https://hartvaat.nl/2025/09/16/ischemia-anginatrajecten-na-invasieve-versus-conservatieve-strategie/* This ISCHEMIA long-term analysis documented individual angina trajectories, showing that invasively treated patients have less angina burden over time but the advantage narrows compared with conservative management. ## Use of Risk Assessment to Guide Decision-Making for Blood Pressure Management in the Primary Prevention of Cardiovascular Disease: A Scientific Statement From the American Heart Association and American College of Cardiology. *2025-09-16 · Circulation · https://doi.org/10.1161/CIR.0000000000001355 · https://hartvaat.nl/2025/09/16/risicobeoordeling-voor-bloeddrukmanagement-bij-primaire-preventie/* This document described the use of cardiovascular risk assessment to guide blood pressure management decisions in primary prevention, providing a framework for risk-based rather than threshold-based treatment initiation. ## 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2025-09-16 · Circulation · https://doi.org/10.1161/CIR.0000000000001356 · https://hartvaat.nl/2025/09/16/2025-aha-acc-hypertensierichtlijn-preventie-detectie-en-management/* The 2025 AHA/ACC hypertension guideline lowered the definition of hypertension to 130/80 mmHg, converging with the 2024 ESC guidelines. The document emphasizes home blood pressure monitoring, initial combination therapy, and integrates GLP-1 receptor agonists as blood pressure-lowering agents in patients with obesity and hypertension. ## Causal inference using regression discontinuity analysis: what can the nephrologist learn from herpes zoster vaccination? *2025-09-16 · Kidney International · https://doi.org/https://www.kidney-international.org/article/S0085-2538(25)00692-1/fulltext · https://hartvaat.nl/2025/09/16/causale-inferentie-via-regressiediscontinuiteit-lessen-uit-de-gordelroosvaccinat/* This article explains how regression discontinuity analysis provides a quasi-experimental alternative to randomised trials for establishing causal relationships, using herpes zoster vaccination studies as an illustrative example for nephrologists. ## β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials. *2025-09-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01592-2 · https://hartvaat.nl/2025/09/13/betablokkers-na-mi-met-milde-ef-verlaging-ipd-meta-analyse/* This individual patient data meta-analysis examined beta-blockers after MI with mildly reduced ejection fraction (40-49%), a gray zone between preserved and reduced EF. The data suggest a modest benefit in this subgroup, informing the nuanced decision about beta-blocker continuation. ## Multidomain Rehabilitation for Older Patients with Myocardial Infarction. *2025-09-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2502799 · https://hartvaat.nl/2025/09/11/multidomein-revalidatie-bij-ouderen-na-mi-gerandomiseerde-trial-nejm/* This NEJM trial evaluated multidomain rehabilitation (physical, cognitive, nutritional, psychosocial) in older patients after MI. The comprehensive approach improved functional outcomes, supporting holistic rehabilitation for elderly cardiac patients. ## Long-term outcomes of intravascular ultrasound-guided percutaneous coronary intervention versus coronary artery bypass grafting for multivessel coronary artery disease. *2025-09-11 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-325107 · https://hartvaat.nl/2025/09/11/ivus-geleide-pci-versus-cabg-langetermijnuitkomsten/* This long-term comparison showed that IVUS-guided PCI narrows the outcome gap with CABG, suggesting that optimized percutaneous intervention may approach surgical results when intravascular imaging guidance is consistently used. ## Pathogenic Cardiomyopathy-Associated Gene Variants and Prognosis in Atrial Fibrillation: Results in 18,000 Clinical Trial Participants. *2025-09-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.06.052 · https://hartvaat.nl/2025/09/09/pathogene-cardiomyopathie-genvarianten-en-prognose-bij-af/* This study of 18,000 AF patients showed that pathogenic cardiomyopathy gene variants are present in a significant proportion and associated with worse prognosis, supporting genetic testing in the AF population for risk stratification. ## Influence of Type 2 Diabetes on the Effects of Tirzepatide in Patients With Heart Failure and a Preserved Ejection Fraction With Obesity: A Prespecified Stratification-Based Analysis. *2025-09-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.06.058 · https://hartvaat.nl/2025/09/09/summit-tirzepatide-effect-bij-hfpef-met-en-zonder-diabetes/* This SUMMIT analysis confirmed that tirzepatide's benefit in HFpEF is consistent regardless of type 2 diabetes status, showing that the dual incretin agonist works through obesity-related mechanisms independent of glycemic effects. ## Benefit-harm trade-offs of intensive blood pressure control versus standard blood pressure control on cardiovascular and renal outcomes: an individual participant data analysis of randomised controlled trials. *2025-09-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01391-1 · https://hartvaat.nl/2025/09/06/voordeel-nadeel-afwegingen-van-intensieve-bloeddrukcontrole/* This comprehensive analysis of intensive versus standard blood pressure control showed that for most patients, the cardiovascular benefits of intensive treatment outweigh the harms, supporting aggressive targets as the default strategy. ## Immediate versus staged complete revascularisation during index admission in patients with ST-segment elevation myocardial infarction and multivessel disease (OPTION-STEMI): a multicentre, non-inferiority, open-label, randomised trial. *2025-09-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01529-6 · https://hartvaat.nl/2025/09/06/directe-versus-gestageerde-complete-revascularisatie-tijdens-index-opname-bij-st/* This randomized trial comparing immediate with staged complete revascularization during the index admission for STEMI showed that both timing approaches produce similar outcomes, supporting either strategy based on clinical circumstances. ## Influenza vaccination to improve outcomes for patients with acute heart failure (PANDA II): a multiregional, seasonal, hospital-based, cluster-randomised, controlled trial in China. *2025-09-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01485-0 · https://hartvaat.nl/2025/09/06/panda-ii-griepvaccinatie-bij-acuut-hartfalen-multicenter-rct/* The PANDA II trial tested influenza vaccination in patients hospitalized for acute heart failure, addressing whether vaccination during an HF admission provides cardiovascular protection through respiratory infection prevention. ## Optimal medical care and coronary flow capacity-guided myocardial revascularization vs usual care for chronic coronary artery disease: the CENTURY trial. *2025-09-02 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf356 · https://hartvaat.nl/2025/09/02/coronaire-flow-capaciteits-geleide-revascularisatie-versus-standaardzorg-rct/* The CENTURY randomized trial tested a comprehensive strategy integrating coronary flow capacity-guided revascularization with intensive lifestyle modification against usual care for chronic coronary disease, exploring a physiologically optimized management approach. ## Atrial fibrillation and implantable cardioverter-defibrillator in non-ischaemic heart failure with reduced ejection fraction: insights from the DANISH trial. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf200 · https://hartvaat.nl/2025/09/01/af-en-icd-bij-niet-ischemische-hfref-impliciaties-voor-devicetherapie/* Analysis of the DANISH trial examined the impact of atrial fibrillation on ICD outcomes in non-ischaemic heart failure with reduced ejection fraction. AF influenced the ICD indication and the risk of inappropriate shocks, informing device therapy decisions. ## Sedation vs. general anaesthesia in patients with atrial fibrillation undergoing catheter ablation: a systematic review and meta-analysis. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf156 · https://hartvaat.nl/2025/09/01/sedatie-versus-narcose-bij-af-catheterablatie-meta-analyse/* A meta-analysis compared sedation with general anaesthesia for catheter ablation of atrial fibrillation. General anaesthesia was associated with better outcomes due to more stable catheter positioning, though sedation may be preferable in selected patients. ## Impact of renal function on the efficacy of low-voltage area ablation after pulmonary vein isolation: a sub-analysis of the SUPPRESS-AF trial. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf205 · https://hartvaat.nl/2025/09/01/nierfunctie-en-effectiviteit-van-lva-ablatie-na-pvi-bij-af/* A SUPPRESS-AF substudy investigated whether renal function modifies the efficacy of low-voltage area ablation after pulmonary vein isolation. Kidney function did not significantly influence the benefit of substrate-based ablation. ## Prevalence and multiple predictors of left atrial low voltage in paroxysmal and non-paroxysmal atrial fibrillation patients undergoing ablation: a systematic review and meta-analysis. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf206 · https://hartvaat.nl/2025/09/01/la-low-voltage-prevalentie-en-voorspellers-bij-paroxysmaal-versus-niet-paroxysma/* A meta-analysis documented the prevalence and predictors of left atrial low-voltage areas in patients undergoing AF ablation. Atrial fibrosis increases with AF duration and predicts ablation outcome, supporting voltage-guided strategies for patient selection. ## Cost-effectiveness of apixaban vs. aspirin for the reduction of thrombo-embolism in high-risk patients with device-detected atrial fibrillation: insights from the ARTESiA trial. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf195 · https://hartvaat.nl/2025/09/01/kosteneffectiviteit-van-apixaban-versus-aspirine-bij-hoogrisico-subclinisch-af/* This cost-effectiveness analysis showed that apixaban is cost-effective compared with aspirin for thromboembolic prevention in high-risk patients with subclinical AF, supporting anticoagulation in device-detected arrhythmia. ## Conduction system pacing vs. biventricular pacing for cardiac resynchronization: the CSP-SYNC randomized single centre study. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf192 · https://hartvaat.nl/2025/09/01/csp-sync-geleidingssysteempacing-versus-biventriculaire-pacing-voor-crt-rct/* The CSP-SYNC trial comparing conduction system pacing (His bundle or left bundle branch area) with biventricular pacing for CRT showed that conduction system pacing is noninferior and potentially superior. The results support physiologic pacing as a viable CRT alternative. ## Systematic, randomized atrial fibrillation screening using detailed phenotyping with a risk prediction model combined with patch electrocardiogram in a Swedish population aged 65 years or older: the CONSIDERING-AF trial. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf190 · https://hartvaat.nl/2025/09/01/systematische-af-screening-met-gedetailleerde-fenotypering-en-risicopredictie/* This study showed that systematic AF screening using detailed phenotyping with risk prediction models improves the detection yield of previously undiagnosed atrial fibrillation. ## Pulmonary vein isolation with or without empiric superior vena cava isolation in patients undergoing ablation for paroxysmal atrial fibrillation: the randomized ESVCI-AF trial. *2025-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf175 · https://hartvaat.nl/2025/09/01/pvi-met-of-zonder-empirische-svc-isolatie-bij-af-ablatie/* The ESVCI-AF trial assessed whether adding empirical superior vena cava isolation to pulmonary vein isolation improves outcomes in paroxysmal AF ablation. Routine SVC isolation provided no incremental benefit in unselected patients. ## Diabetes and Obesity and Treatment Effect of Early Rhythm Control vs Usual Care in Patients With Atrial Fibrillation: A Secondary Analysis of the EAST-AFNET 4 Randomized Clinical Trial. *2025-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.2374 · https://hartvaat.nl/2025/09/01/east-afnet-4-diabetes-obesitas-en-vroege-ritmecontrole-bij-af/* This EAST-AFNET 4 subanalysis confirmed that the benefit of early rhythm control in AF is consistent in patients with and without diabetes and obesity, supporting universal early rhythm management. ## Medication Adherence in Hypertension: A Cluster Randomized Clinical Trial. *2025-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.2155 · https://hartvaat.nl/2025/09/01/medicatietrouw-bij-hypertensie-cluster-gerandomiseerde-trial/* This cluster-randomized trial showed that an intervention targeting medication non-adherence in hypertension significantly improves both adherence and blood pressure control. ## Preoperative Cardiovascular Risk and Postoperative Outcomes by Renin-Angiotensin System Inhibitor Use: A Secondary Analysis of a Randomized Clinical Trial. *2025-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.1920 · https://hartvaat.nl/2025/09/01/preoperatief-cv-risico-en-raas-remmergebruik-postoperatieve-uitkomsten/* A post-hoc analysis of the STOP-or-NOT trial examined whether preoperative cardiovascular risk stratification influences outcomes when continuing versus discontinuing renin-angiotensin system inhibitors before major surgery. Continuing RAS inhibitors was safe across all risk levels. ## Altered Blood Pressure Reflexes in Women With Endometriosis. *2025-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25089 · https://hartvaat.nl/2025/09/01/veranderde-bloeddrukrefexen-bij-vrouwen-met-endometriose/* This study documented altered baroreflex function in women with endometriosis, showing exaggerated blood pressure responses during sympathoexcitatory stimuli. The autonomic dysregulation may partially explain the elevated cardiovascular risk observed in endometriosis. ## Systolic BP Amplification: Systematic Review and Individual Participant Meta-Analysis. *2025-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24483 · https://hartvaat.nl/2025/09/01/systolische-bloeddrukamplificatie-ipd-meta-analyse/* An individual participant data meta-analysis examined systolic blood pressure amplification — the pressure difference between brachial and aortic measurements. Greater amplification was associated with lower cardiovascular risk, underscoring the importance of central blood pressure assessment. ## Blood pressure-lowering efficacy of antihypertensive drugs and their combinations: a systematic review and meta-analysis of randomised, double-blind, placebo-controlled trials. *2025-08-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00991-2 · https://hartvaat.nl/2025/08/30/bloeddrukverlagende-effectiviteit-van-antihypertensiva-en-combinaties-uitgebreid/* This comprehensive meta-analysis quantified the blood pressure-lowering efficacy of all antihypertensive drug classes and their combinations, providing an evidence-based reference for estimating expected blood pressure reduction with different regimens. ## Long-Term Outcomes After Fractional Flow Reserve vs Intravascular Ultrasound to Guide PCI: The FLAVOUR Trial Extended Follow-Up. *2025-08-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.06.042 · https://hartvaat.nl/2025/08/26/flavour-langetermijn-ffr-versus-ivus-voor-pci-begeleiding/* Long-term FLAVOUR results confirmed that FFR-guided PCI produces comparable outcomes to IVUS-guided PCI over extended follow-up, supporting both physiological and anatomical approaches as equivalent guidance strategies. ## Effect of HEPA Filtration Air Purifiers on Blood Pressure: A Pragmatic Randomized Crossover Trial. *2025-08-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.06.037 · https://hartvaat.nl/2025/08/26/hepa-luchtzuivering-en-bloeddruk-pragmatische-cross-over-trial/* A pragmatic crossover trial tested whether HEPA air purifiers reduce blood pressure in adults living near highways. The blood pressure-lowering effect was limited, tempering expectations for air quality interventions as a hypertension management strategy. ## Impacts of Reducing Sitting Time or Increasing Sit-to-Stand Transitions on Blood Pressure and Glucose Regulation in Postmenopausal Women: Three-Arm Randomized Controlled Trial. *2025-08-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.073385 · https://hartvaat.nl/2025/08/26/minder-zitten-of-meer-staan-effect-op-bloeddruk-en-glucose/* A three-arm randomised trial in sedentary postmenopausal women compared reducing sitting time versus increasing sit-to-stand transitions for cardiovascular and metabolic health. Both sedentary behaviour modification strategies produced modest but significant improvements in blood pressure and glucose regulation. ## Optical coherence tomography- vs angiography-guided coronary stent implantation in calcified lesions: the ILUMIEN IV trial. *2025-08-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf331 · https://hartvaat.nl/2025/08/21/oct-versus-angiografie-bij-pci-van-verkalkte-laesies-driejaarsdata/* Three-year ILUMIEN IV data showed that the procedural advantage of OCT-guided PCI in calcified lesions now translates to improved clinical outcomes, establishing imaging guidance as particularly valuable for calcified coronary disease. ## Preventive percutaneous coronary intervention for non-flow-limiting vulnerable atherosclerotic coronary plaques in diabetes: the PREVENT trial. *2025-08-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf273 · https://hartvaat.nl/2025/08/21/prevent-langetermijn-follow-up-van-preventieve-pci-bij-kwetsbare-plaques/* Long-term PREVENT data confirmed the benefit of preventive PCI for vulnerable plaques identified by IVUS/OCT in diabetic patients. The paradigm of treating non-flow-limiting high-risk lesions continues to gain evidence. ## Paclitaxel-Coated Balloon for the Treatment of Multilayer In-Stent Restenosis: AGENT IDE Subgroup Analysis. *2025-08-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.062 · https://hartvaat.nl/2025/08/19/paclitaxel-gecoate-ballon-bij-multilayer-in-stent-restenose-agent-ide-subgroep/* An AGENT IDE subgroup analysis evaluated the paclitaxel-coated balloon for treating coronary in-stent restenosis with multiple stent layers. The drug-coated balloon was effective in these complex restenosis patterns, offering a stent-free alternative. ## Recurrent Events Analysis of MASTER DAPT: Total Ischemic and Bleeding Events After Abbreviated vs Prolonged DAPT in HBR Patients. *2025-08-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.010 · https://hartvaat.nl/2025/08/19/master-dapt-recurrente-events-analyse-van-verkorte-versus-standaard-dapt/* This MASTER DAPT recurrent events analysis confirmed that abbreviated DAPT reduces the total bleeding burden without increasing total ischemic events in high-bleeding-risk PCI patients. ## Spironolactone versus placebo in patients undergoing maintenance dialysis (ACHIEVE): an international, parallel-group, randomised controlled trial. *2025-08-16 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01198-5 · https://hartvaat.nl/2025/08/16/achieve-spironolacton-bij-dialysepatienten-internationale-rct/* The ACHIEVE trial established the safety and potential cardiovascular benefit of spironolactone in patients on maintenance dialysis, a population where MRA use has traditionally been avoided due to hyperkalemia concerns. ## Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. *2025-08-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2502081 · https://hartvaat.nl/2025/08/14/cagrisema-gecombineerd-cagrilintide-en-semaglutide-bij-overgewicht-nejm/* This pivotal trial of CagriSema (cagrilintide plus semaglutide) in adults with overweight or obesity demonstrated up to 25% body weight reduction, substantially exceeding semaglutide monotherapy. The amylin–GLP-1 combination represents the most effective pharmacological weight loss therapy to date and may redefine obesity treatment targets. ## Heart failure: assessment of the global economic burden. *2025-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf323 · https://hartvaat.nl/2025/08/14/hartfalen-mondiale-economische-ziektelast/* This comprehensive analysis documented the global economic burden of heart failure, showing annual costs in the hundreds of billions, driven primarily by hospitalization and demonstrating the economic case for effective HF prevention. ## Plaque remodelling as a surrogate for major adverse cardiac events *2025-08-14 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01379-6/fulltext · https://hartvaat.nl/2025/08/14/plaque-remodeling-als-surrogaat-voor-ernstige-cardiale-events/* This commentary discusses plaque remodelling as a surrogate endpoint for major adverse cardiac events in the context of intensive lipid-lowering therapy. The use of imaging-based plaque assessment as a trial endpoint has evolved since the classic FATS trial. ## Regarding “Modifications of coronary plaque phenotype on lipid-lowering therapies and risk of cardiovascular events”: a compelling hypothesis warranting cautious interpretation *2025-08-14 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01380-2/fulltext · https://hartvaat.nl/2025/08/14/kanttekening-bij-coronaire-plaquefenotypeveranderingen-onder-lipidenverlagende-t/* This commentary provides a cautious interpretation of the systematic review by Patti et al. on lipid-lowering therapy-induced coronary plaque phenotype changes and their relationship with cardiovascular events. The hypothesis is compelling but requires careful methodological scrutiny. ## Outcomes in Older Patients After Switching to a Newer Anticoagulant or Remaining on Warfarin: The COMBINE-AF Substudy. *2025-08-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.060 · https://hartvaat.nl/2025/08/12/combine-af-overstap-naar-nieuwer-anticoagulans-versus-warfarine-bij-ouderen/* This COMBINE-AF analysis showed that switching from warfarin to a NOAC in older AF patients is associated with improved outcomes compared with remaining on warfarin, supporting anticoagulant modernization even in the elderly. ## Catheter ablation versus medical rate control for persistent atrial fibrillation in older heart failure patients with reduced ejection fraction. *2025-08-12 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324668 · https://hartvaat.nl/2025/08/12/catheterablatie-versus-rate-control-bij-persisterend-af-en-ouder-hartfalen/* This randomized trial compared catheter ablation with medical rate control in older patients with persistent AF and HFrEF, showing that ablation improves left ventricular function and reduces heart failure events even in elderly patients. ## Ambulatory blood pressure monitoring, European guideline targets, and cardiovascular outcomes: an individual patient data meta-analysis. *2025-08-08 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf220 · https://hartvaat.nl/2025/08/08/abpm-esc-streefwaarden-en-cv-uitkomsten-ipd-meta-analyse/* This individual patient data meta-analysis examined the relationship between ambulatory blood pressure values and the new ESC guideline targets, showing that time below target on 24-hour monitoring predicts cardiovascular outcomes more accurately than office measurements. ## Sodium-Glucose Cotransporter 2 Inhibitor With and Without an Aldosterone Antagonist for Heart Failure With Preserved Ejection Fraction: The SOGALDI-PEF Trial. *2025-08-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.033 · https://hartvaat.nl/2025/08/05/sglt2-remmer-met-en-zonder-mra-bij-hartfalen-gecombineerde-analyse/* This analysis showed that combining SGLT2 inhibitors with aldosterone antagonists in HFpEF provides additive cardiovascular benefit beyond either drug class alone, supporting the emerging four-pillar approach for preserved ejection fraction heart failure. ## Lorundrostat in Participants With Uncontrolled Hypertension and Treatment-Resistant Hypertension: The Launch-HTN Randomized Clinical Trial. *2025-08-05 · JAMA · https://doi.org/10.1001/jama.2025.9413 · https://hartvaat.nl/2025/08/05/lorundrostat-bij-ongecontroleerde-en-therapieresistente-hypertensie-fase-3-resul/* Phase 3 results of lorundrostat confirmed significant blood pressure reduction in both uncontrolled and treatment-resistant hypertension. The aldosterone synthase inhibitor class is now supported by multiple positive phase 3 trials. ## Abelacimab Versus Rivaroxaban in Patients With Atrial Fibrillation on Antiplatelet Therapy: A Prespecified Analysis of the AZALEA-TIMI 71 Trial. *2025-08-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.074037 · https://hartvaat.nl/2025/08/05/abelacimab-versus-rivaroxaban-bij-af-op-antiplaatjestherapie-subanalyse/* This AZALEA-TIMI 71 subanalysis confirmed that abelacimab causes less bleeding than rivaroxaban even in AF patients on concurrent antiplatelet therapy, the highest-bleeding-risk scenario for anticoagulation. ## Two-year outcomes of left bundle branch area pacing versus traditional right ventricular pacing in middle-aged adults: a registry-based trial. *2025-08-04 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf181 · https://hartvaat.nl/2025/08/04/lbbap-versus-rv-pacing-tweejaarsresultaten-bij-pacemakergeindiceerde-patienten/* Two-year data showed that left bundle branch area pacing is superior to conventional right ventricular pacing for preserving LV function and preventing heart failure in patients requiring frequent ventricular pacing. ## Circumferential pulmonary vein isolation with adjunctive linear ablation vs. circumferential pulmonary vein isolation alone for long-standing persistent atrial fibrillation: a randomized pilot study. *2025-08-04 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf176 · https://hartvaat.nl/2025/08/04/pvi-met-versus-zonder-lineaire-ablatie-bij-persisterend-af-gerandomiseerde-trial/* This randomized trial showed that adding linear ablation to circumferential PVI provides better outcomes for persistent AF, an exception to the prevailing neutral evidence for adjunctive ablation beyond PVI. ## Very high-power short-duration using 70W and a flexible tip ablation catheter for pulmonary vein isolation: the POWER PULSE randomized controlled trial. *2025-08-04 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf105 · https://hartvaat.nl/2025/08/04/zeer-hoog-vermogen-70w-rf-ablatie-met-flexibele-tip-voor-pvi-bij-af/* The POWER PULSE trial evaluated very high-power short-duration radiofrequency ablation at 70W with a flexible-tip catheter for pulmonary vein isolation in paroxysmal AF. The technique achieved rapid and effective PVI with an acceptable safety profile. ## Finerenone According to Frailty in Heart Failure: A Prespecified Analysis of the FINEARTS-HF Randomized Clinical Trial. *2025-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.1775 · https://hartvaat.nl/2025/08/01/finearts-hf-finerenon-naar-frailteit-bij-hartfalen/* This FINEARTS-HF analysis confirmed that finerenone provides consistent heart failure benefit regardless of frailty status, supporting MRA therapy even in the most vulnerable HFpEF patients. ## Cellular Adhesion Molecules and Adverse Outcomes in Chronic Heart Failure: Findings From the DAPA-HF Randomized Clinical Trial. *2025-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.1592 · https://hartvaat.nl/2025/08/01/cellulaire-adhesiemoleculen-en-uitkomsten-bij-chronisch-hf-dapa-hf-analyse/* Analysis of the DAPA-HF biomarker substudy demonstrated that elevated vascular and intracellular adhesion molecules predict adverse outcomes in chronic heart failure. Dapagliflozin reduced these inflammatory markers, providing mechanistic insight into SGLT2 inhibitor cardioprotection. ## Beta-blocker interruption effects on blood pressure and heart rate after myocardial infarction: the AβYSS trial. *2025-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf170 · https://hartvaat.nl/2025/08/01/reduce-ami-betablokker-interruptie-en-bloeddruk-hartfrequentie-effecten-na-mi/* This ABYSS subanalysis showed that beta-blocker interruption after MI leads to modest increases in blood pressure and heart rate that remain clinically acceptable, providing hemodynamic reassurance for the discontinuation strategy. ## Long-term effect of biodegradable vs. durable polymer everolimus-eluting stents on neoatherosclerosis in ST-segment elevation myocardial infarction: the CONNECT trial. *2025-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae589 · https://hartvaat.nl/2025/08/01/biodegradeerbare-versus-duurzame-polymeer-ees-langetermijn-neoatherosclerose/* The CONNECT trial compared neoatherosclerosis development in biodegradable versus durable polymer everolimus-eluting stents 3 years after primary PCI for STEMI. Biodegradable polymer stents showed less neoatherosclerosis, confirming the theoretical advantage of polymer degradation for long-term vessel healing. ## Benefit and Harm of Intensive Blood Pressure Control by Cardiovascular Risk. *2025-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.25162 · https://hartvaat.nl/2025/08/01/voordeel-en-risico-van-intensieve-bloeddrukcontrole-naar-cv-risico/* This analysis examined the balance between benefit and harm of intensive blood pressure treatment across cardiovascular risk profiles, confirming that higher-risk patients derive the greatest net benefit from aggressive targets. ## CTRH as Biomarker of Drug Efficacy: In-Depth Assessment of Real-World Evidence. *2025-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24523 · https://hartvaat.nl/2025/08/01/ctrh-als-biomarker-voor-medicijneffectiviteit-real-world-bewijs/* This systematic review assessed the methodological quality of observational studies linking cancer treatment-related hypertension with survival outcomes. The findings support further investigation of CTRH as a potential biomarker of anticancer drug efficacy. ## Sympathetic Overactivation in the Resistant Hypertensive Phenotype: A Meta-Analysis of Published Studies. *2025-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.125.24749 · https://hartvaat.nl/2025/08/01/sympathische-overactiviteit-bij-resistente-hypertensie-meta-analyse/* A meta-analysis confirmed that sympathetic overactivation is a core pathophysiological mechanism in resistant hypertension. These findings support sympatholytic therapies such as renal denervation and baroreflex activation as targeted treatment options. ## Prognostic value of lipid parameters among patients with heart failure: A systematic review and meta-analysis. *2025-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15315 · https://hartvaat.nl/2025/08/01/lipideparameters-en-prognose-bij-hartfalen-meta-analyse/* A meta-analysis evaluated the prognostic significance of lipid parameters in heart failure. The cholesterol paradox — lower cholesterol associated with worse prognosis in heart failure — was confirmed, requiring nuanced interpretation of lipid values in this context. ## Association between NT-proBNP changes and clinical outcomes in paediatric patients with heart failure: Insights from PANORAMA-HF and PARADIGM-HF. *2025-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15326 · https://hartvaat.nl/2025/08/01/nt-probnp-veranderingen-en-klinische-uitkomsten-bij-pediatrisch-hartfalen/* Analysis of the PANORAMA-HF trial demonstrated that declining NT-proBNP levels correlate with improved clinical outcomes in paediatric heart failure. Serial biomarker monitoring informs treatment response assessment in this underserved population. ## Prognostic value of left atrial strain in acute and chronic heart failure: A meta-analysis. *2025-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15302 · https://hartvaat.nl/2025/08/01/linkeratriale-strain-en-prognose-bij-acuut-en-chronisch-hartfalen-meta-analyse/* A meta-analysis confirmed the prognostic value of peak atrial longitudinal strain in both acute and chronic heart failure. Left atrial strain provides incremental prognostic information beyond conventional echocardiographic parameters across heart failure phenotypes. ## Association between tricuspid regurgitation and heart failure outcomes: A meta-analysis. *2025-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15303 · https://hartvaat.nl/2025/08/01/tricuspidalisinsufficientie-en-hartfalenuitkomsten-meta-analyse/* This meta-analysis confirmed that tricuspid regurgitation severity independently predicts worse outcomes in heart failure, supporting aggressive evaluation and treatment of TR as a prognostically significant comorbidity. ## Length of stay and prior heart failure admission in frailty and heart failure: A systematic review and meta-analysis. *2025-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15300 · https://hartvaat.nl/2025/08/01/opnameduur-en-eerdere-hf-opnames-bij-frailteit-en-hartfalen-systematische-review/* A systematic review and meta-analysis documented the relationship between frailty, hospital length of stay, and prior heart failure admissions. Frail patients had significantly longer hospitalisations and more readmissions, underscoring the need for targeted transitional care. ## Early diuretic response and outcome prediction in ambulatory worsening heart failure: Natriuresis versus diuresis. *2025-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15275 · https://hartvaat.nl/2025/08/01/vroege-diuretische-respons-en-uitkomstvoorspelling-bij-ambulant-verslechterend-h/* A post-hoc analysis of the SALT-HF trial compared early natriuresis and diuresis as predictors of 30-day outcomes in ambulatory worsening heart failure. Natriuresis proved a superior early marker of therapeutic response to decongestive therapy. ## Effects of exercise modalities on physical function and quality of life in patients with heart failure: A systematic review and network meta-analysis. *2025-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15256 · https://hartvaat.nl/2025/08/01/inspanningsmodaliteiten-en-fysieke-functie-bij-hfpef-meta-analyse/* A network meta-analysis compared exercise modalities for physical function and quality of life in heart failure. Combined aerobic and resistance training provided the greatest benefits, while yoga showed particular promise for left ventricular function improvement. ## Impact of Body Mass Index, Central Adiposity, and Weight Loss on the Benefits of Tirzepatide in HFpEF: The SUMMIT Trial. *2025-07-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.04.059 · https://hartvaat.nl/2025/07/29/summit-bmi-centrale-adipositas-en-gewichtsverlies-beinvloeden-tirzepatide-effect/* This SUMMIT analysis confirmed that tirzepatide benefits HFpEF patients consistently regardless of BMI, central adiposity measures, or degree of weight loss achieved, supporting the drug across the obesity spectrum. ## Long-term benefits of atorvastatin on the incidence of cardiovascular events: the ASCOT-Legacy 20-year follow-up. *2025-07-28 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-325104 · https://hartvaat.nl/2025/07/28/ascot-legacy-atorvastatine-verlaagt-cv-events-over-20-jaar/* The ASCOT-Legacy 20-year follow-up showed that cardiovascular benefits of atorvastatin remain measurable two decades after the original trial, demonstrating one of the longest legacy effects of statin therapy ever documented. ## Effects of routine invasive management on reinfarction risk in older adults with frailty and non-ST-segment elevation myocardial infarction: a subanalysis of a randomised clinical trial. *2025-07-28 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-325254 · https://hartvaat.nl/2025/07/28/routine-invasieve-strategie-en-herinfarctrisico-bij-fragiele-ouderen-met-nste-ac/* This analysis showed that routine invasive management reduces reinfarction risk in frail older adults with NSTE-ACS, demonstrating that frailty should not be a reason to withhold evidence-based invasive treatment. ## Safety and Lipid-Lowering Efficacy of Inclisiran Monotherapy in Patients Without ASCVD: The VICTORION-Mono Randomized Clinical Trial. *2025-07-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.04.049 · https://hartvaat.nl/2025/07/22/victorion-initiate-inclisiran-monotherapie-bij-patienten-zonder-ascvd/* The VICTORION-Mono trial demonstrated that inclisiran monotherapy (without statins) effectively lowers LDL cholesterol in patients without established ASCVD, expanding the potential role of twice-yearly siRNA therapy to primary prevention. ## COOPERATIVE-PFA: A Three-Arm Randomized Controlled Trial. *2025-07-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.074427 · https://hartvaat.nl/2025/07/22/cooperative-pfa-driearmige-gerandomiseerde-trial-van-pfa-versus-rf-versus-cryo/* The COOPERATIVE-PFA three-arm randomized trial directly compared pulsed field ablation, radiofrequency ablation, and cryoablation for atrial fibrillation, providing the first head-to-head-to-head comparison of all three energy sources for pulmonary vein isolation. ## Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis. *2025-07-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf352 · https://hartvaat.nl/2025/07/21/antitrombotische-middelen-bij-acs-bij-vrouwen-seksegecorrigeerde-behandeling/* This review documented that women with ACS receive less antithrombotic therapy and are underrepresented in clinical trials, highlighting persistent sex-based disparities in acute coronary care and evidence generation. ## Impact of Optical Coherence Tomography-Based Post-PCI Physiology Assessment to Predict Clinical Outcomes: An ILUMIEN-IV Substudy. *2025-07-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.019 · https://hartvaat.nl/2025/07/15/oct-gebaseerde-post-pci-fysiologiebeoordeling-voorspelt-klinische-uitkomsten/* This study showed that OCT-based virtual flow reserve assessment after PCI predicts clinical outcomes, combining anatomical and physiological evaluation in a single imaging modality for post-procedure optimization. ## Biolimus-Eluting Biomatrix Stent vs a Dual-Therapy Sirolimus-Eluting Stent in PCI: The SORT OUT XI Randomized Trial. *2025-07-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.012 · https://hartvaat.nl/2025/07/15/sort-out-xi-biomatrix-versus-duale-therapie-sirolimus-eluting-stent-bij-pci/* The SORT OUT XI trial confirmed comparable efficacy and safety between two contemporary DES platforms (biolimus-eluting BioMatrix vs dual-therapy sirolimus-eluting stent), demonstrating therapeutic equivalence in modern stent technology. ## 10-Year Outcome of Complete or Infarct Artery-Only Revascularization in STEMI With Multivessel Disease: The DANAMI-3-PRIMULTI Study. *2025-07-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.05.013 · https://hartvaat.nl/2025/07/15/complete-versus-culprit-only-revascularisatie-bij-stemi-tienjaarsresultaten/* Ten-year DANAMI-3-PRIMULTI results confirmed the durable benefit of complete revascularization over culprit-only PCI in patients with STEMI and multivessel disease. The survival advantage persisted over a decade of follow-up. ## Heart rate-lowering drugs and outcomes in hypertension and/or cardiovascular disease: a meta-analysis. *2025-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf291 · https://hartvaat.nl/2025/07/14/hartfrequentieverlagende-middelen-en-uitkomsten-bij-hypertensie-cvd-meta-analyse/* This meta-analysis evaluated heart rate-lowering drugs in hypertension and cardiovascular disease, finding that the cardiovascular benefit of beta-blockers is partly but not entirely mediated through heart rate reduction. ## Influence of depression trajectories in heart failure patients with preserved ejection fractions: a secondary analysis of adverse outcomes in the TOPCAT trial. *2025-07-14 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324505 · https://hartvaat.nl/2025/07/14/depressietrajecten-bij-hfpef-impact-op-uitkomsten/* Analysis of TOPCAT data documented the impact of depression trajectories on outcomes in HFpEF. Persistent depression was associated with significantly worse prognosis, supporting integrated mental health screening and care in heart failure management. ## Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study. *2025-07-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01185-7 · https://hartvaat.nl/2025/07/12/amycretine-fase-2-subcutaan-toegediend-bij-obesitas/* Phase 2 results of subcutaneous amycretin confirmed dose-dependent weight loss and metabolic improvement. The dual GLP-1/amylin receptor agonist mechanism offers a novel approach to obesity treatment with potent appetite suppression. ## Safety, tolerability, pharmacokinetics, and pharmacodynamics of the first-in-class GLP-1 and amylin receptor agonist, amycretin: a first-in-human, phase 1, double-blind, randomised, placebo-controlled trial. *2025-07-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)01176-6 · https://hartvaat.nl/2025/07/12/amycretine-eerste-glp-1-amyline-agonist-fase-1-veiligheid-en-farmacologie/* This first-in-human phase 1 trial of amycretin, a unimolecular dual GLP-1 and amylin receptor agonist, demonstrated up to 10% weight loss in 12 weeks with potent appetite suppression. The single-molecule dual agonist approach offers manufacturing and dosing advantages over combination products like CagriSema. ## Modifications of coronary plaque phenotype on lipid-lowering therapies and risk of cardiovascular events: a systematic review and meta-regression analysis *2025-07-09 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01331-0/fulltext · https://hartvaat.nl/2025/07/09/coronaire-plaquefenotypeveranderingen-bij-lipidenverlagende-therapie-en-cardiova/* This systematic review and meta-regression quantified the relationship between lipid-lowering therapy-induced coronary plaque phenotype changes on OCT and major adverse cardiovascular events. Plaque stabilisation correlated with reduced event rates across therapeutic classes. ## 3-Year Clinical Outcomes Comparing the Amulet vs Watchman FLX for Left Atrial Appendage Closure in Patients With Atrial Fibrillation: Results From the SWISS-APERO Randomized Clinical Trial. *2025-07-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.535 · https://hartvaat.nl/2025/07/08/amulet-versus-watchman-flx-driejaarsresultaten-laa-sluiting/* Three-year results confirmed comparable long-term effectiveness of Amulet and Watchman FLX devices for LAA closure in AF, providing the longest-term head-to-head comparison of these leading technologies. ## Catheter Ablation vs Lifestyle Modification With Antiarrhythmic Drugs to Treat Atrial Fibrillation: PRAGUE-25 Trial. *2025-07-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.04.042 · https://hartvaat.nl/2025/07/08/catheterablatie-versus-leefstijlmodificatie-plus-antiaritmica-bij-af-gerandomise/* The PRAGUE-25 trial compared catheter ablation with lifestyle modification plus antiarrhythmic drugs in AF patients with obesity. The results inform the choice between invasive and comprehensive conservative management strategies for atrial fibrillation. ## Colchicine for secondary prevention of vascular events: a meta-analysis of trials. *2025-07-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf210 · https://hartvaat.nl/2025/07/07/colchicine-voor-secundaire-cv-preventie-meta-analyse-van-alle-trials/* This meta-analysis of all colchicine trials in secondary cardiovascular prevention confirmed a 20-30% reduction in MACE with an acceptable safety profile. The pooled evidence from COLCOT, LoDoCo2, and CLEAR SYNERGY consolidates colchicine as a cost-effective anti-inflammatory strategy for atherosclerotic disease. ## Long-term trials of colchicine for secondary prevention of vascular events: a meta-analysis. *2025-07-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf174 · https://hartvaat.nl/2025/07/07/colchicine-voor-secundaire-vasculaire-preventie-meta-analyse-van-lange-trials/* This meta-analysis of long-term colchicine trials confirmed that colchicine significantly reduces recurrent vascular events in secondary prevention. After COLCOT, LoDoCo2, and CLEAR SYNERGY, the pooled long-term data consolidate colchicine as a cost-effective anti-inflammatory strategy. ## Collaboration on the optimal timing of anticoagulation after ischaemic stroke and atrial fibrillation: a systematic review and prospective individual participant data meta-analysis of randomised controlled trials (CATALYST). *2025-07-05 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00439-8 · https://hartvaat.nl/2025/07/05/optimale-timing-van-anticoagulatie-na-ischemisch-cva-en-af-collaboratief-project/* This collaborative systematic review combined data on the optimal timing of anticoagulation initiation after ischemic stroke in AF patients, providing the most comprehensive evidence for early versus delayed DOAC start. ## Safety and Efficacy of Obicetrapib in Patients at High Cardiovascular Risk. *2025-07-03 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2415820 · https://hartvaat.nl/2025/07/03/obicetrapib-bij-hoog-cv-risico-veiligheid-en-effectiviteit-fase-3/* Phase 3 data confirmed that obicetrapib, a highly selective CETP inhibitor, significantly lowers LDL cholesterol with an acceptable safety profile in patients at high cardiovascular risk. The results position obicetrapib as the first CETP inhibitor with genuine clinical promise. ## A comparative analysis of conduction system pacing and biventricular pacing in patients undergoing atrioventricular node ablation: a systematic review and meta-analysis. *2025-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf106 · https://hartvaat.nl/2025/07/01/geleidingssysteempacing-versus-biventriculaire-pacing-bij-av-blok-vergelijkende-/* This comparative analysis showed that conduction system pacing (His bundle or LBBP) achieves comparable outcomes to biventricular pacing for patients undergoing AV node ablation for AF, supporting physiological pacing alternatives. ## Effect of Microaxial Flow Pump on Hemodynamics in STEMI-Related Cardiogenic Shock. *2025-07-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.04.062 · https://hartvaat.nl/2025/07/01/danger-shock-hemodynamische-effecten-van-impella-bij-stemi-en-cardiogene-shock/* This hemodynamic DanGer Shock analysis detailed the direct effects of the Impella microaxial flow pump on cardiac output, ventricular unloading, and coronary perfusion in STEMI-related cardiogenic shock. ## Ventricular arrhythmias following left ventricular assist device implantation: a systematic review and meta-analysis of incidence and clinical impact. *2025-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf129 · https://hartvaat.nl/2025/07/01/ventriculaire-aritmieen-na-lvad-implantatie-meta-analyse/* A meta-analysis documented the incidence and clinical impact of ventricular arrhythmias following left ventricular assist device implantation. Arrhythmias were frequent and associated with worse outcomes, supporting proactive monitoring and consideration of prophylactic strategies. ## Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension: The KARDIA-2 Randomized Clinical Trial. *2025-07-01 · JAMA · https://doi.org/10.1001/jama.2025.6681 · https://hartvaat.nl/2025/07/01/kardia-2-zilebesiran-als-toevoeging-bij-ongecontroleerde-hypertensie-rct/* The KARDIA-2 trial showed that zilebesiran, an siRNA targeting hepatic angiotensinogen, significantly reduced blood pressure when added to existing antihypertensive therapy in patients with inadequately controlled hypertension. The twice-yearly injectable represents a novel approach to treatment-resistant blood pressure. ## Finerenone in Heart Failure With Improved Ejection Fraction: The FINEARTS-HF Randomized Clinical Trial. *2025-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.1101 · https://hartvaat.nl/2025/07/01/finearts-hf-finerenon-bij-hartfalen-met-verbeterde-ejectiefractie/* This FINEARTS-HF subanalysis showed that finerenone is effective in patients with heart failure and improved (recovered) ejection fraction, protecting against recurrence of heart failure events even after LVEF has normalized. ## OCT vs Angiography for Guidance of Percutaneous Coronary Intervention of Calcified Lesions: The CALIPSO Randomized Clinical Trial. *2025-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0741 · https://hartvaat.nl/2025/07/01/calcified-oct-versus-angiografie-bij-pci-van-verkalkte-laesies/* The CALIPSO randomized trial showed that OCT-guided PCI improves procedural results in heavily calcified coronary lesions compared with angiographic guidance, establishing intravascular imaging as particularly valuable for complex calcified plaque management. ## Emergency Department-Based Education and mHealth Empowerment Intervention for Hypertension: The TOUCHED Randomized Clinical Trial. *2025-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0675 · https://hartvaat.nl/2025/07/01/touch-seh-educatie-en-mhealth-voor-hypertensie-gerandomiseerde-trial/* The TOUCHED randomized trial showed that emergency department-based education combined with mHealth intervention improves blood pressure control, turning the ED visit into a cardiovascular prevention opportunity. ## Leveraging Preexisting Cardiovascular Data to Improve the Detection and Treatment of Hypertension: The NOTIFY-LVH Randomized Clinical Trial. *2025-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0871 · https://hartvaat.nl/2025/07/01/bestaande-cv-data-benutten-voor-hypertensiedetectie-en-behandeling-vital-trial/* This study showed that leveraging existing cardiovascular data from electronic health records combined with trained healthcare workers can significantly improve hypertension detection and treatment. ## Mode of Death in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: The FINEARTS-HF Randomized Clinical Trial. *2025-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0860 · https://hartvaat.nl/2025/07/01/finearts-hf-modus-van-overlijden-bij-hfmref-hfpef/* Analysis of FINEARTS-HF characterised the mode of death in patients with HFmrEF and HFpEF. Non-cardiovascular death predominated, emphasising the importance of comorbidity management alongside heart failure-specific therapy in these populations. ## Finerenone and Atrial Fibrillation in Heart Failure: A Secondary Analysis of the FINEARTS-HF Randomized Clinical Trial. *2025-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0848 · https://hartvaat.nl/2025/07/01/finearts-hf-finerenon-en-atriumfibrilleren-bij-hartfalen/* This FINEARTS-HF subanalysis showed that finerenone reduces new-onset AF in HFmrEF/HFpEF, adding arrhythmia prevention to the benefits of nonsteroidal MRA therapy in this population. ## Near-universal prevalence of central adiposity in heart failure with preserved ejection fraction: the PARAGON-HF trial. *2025-07-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf057 · https://hartvaat.nl/2025/07/01/centrale-adipositas-bijna-universeel-bij-hfpef-fenotypering/* This PARAGON-HF analysis showed that central adiposity is nearly universal in HFpEF regardless of BMI category, reinforcing the concept that visceral fat — not just body weight — is central to the obesity-HFpEF phenotype. ## Cardiac Structure, Function and Mechanics in Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis. *2025-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24472 · https://hartvaat.nl/2025/07/01/cardiale-structuur-en-functie-bij-hypertensieve-zwangerschapsstoornissen-systema/* A comprehensive meta-analysis documented cardiac structural and functional changes in hypertensive disorders of pregnancy using conventional and advanced echocardiography. The cardiac remodelling observed represents an early marker for long-term cardiovascular risk in affected women. ## Efficacy and Safety of Inclisiran in Adolescents With Genetically Confirmed Homozygous Familial Hypercholesterolemia: Results From the Double-Blind, Placebo-Controlled Part of the ORION-13 Randomized Trial. *2025-06-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.073233 · https://hartvaat.nl/2025/06/24/inclisiran-bij-adolescenten-met-homozygote-fh-effectiviteit-en-veiligheid/* This study showed that inclisiran effectively and safely lowers LDL cholesterol in adolescents with homozygous FH, supporting early RNA interference-based lipid-lowering therapy in the youngest patients with severe genetic dyslipidemia. ## Long-Acting Factor XI Inhibition and Periprocedural Bleeding: An Analysis From AZALEA-TIMI 71. *2025-06-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.04.018 · https://hartvaat.nl/2025/06/17/azalea-timi-71-langwerkende-factor-xi-remmer-en-periprocedurale-bloedingen/* This AZALEA-TIMI 71 analysis showed that abelacimab (long-acting factor XI inhibitor) reduces periprocedural bleeding compared with rivaroxaban, demonstrating the safety advantage of factor XI inhibition around invasive procedures. ## Spironolactone vs Amiloride for Resistant Hypertension: A Randomized Clinical Trial. *2025-06-17 · JAMA · https://doi.org/10.1001/jama.2025.5129 · https://hartvaat.nl/2025/06/17/spironolacton-versus-amiloride-bij-resistente-hypertensie-gerandomiseerde-trial/* This randomized trial demonstrated that spironolactone was superior to amiloride for blood pressure reduction in patients with resistant hypertension. The result confirmed spironolactone as the preferred fourth-line agent and defined the comparative effectiveness of potassium-sparing diuretics. ## Antihypertensive Medication Timing and Cardiovascular Events and Death: The BedMed Randomized Clinical Trial. *2025-06-17 · JAMA · https://doi.org/10.1001/jama.2025.4390 · https://hartvaat.nl/2025/06/17/bedmed-timing-van-antihypertensieve-medicatie-en-cv-events-jama-definitieve-tria/* The BedMed trial definitively confirmed that the timing of antihypertensive medication (morning versus evening) has no effect on cardiovascular outcomes or death. Together with the TIME trial, this eliminates chronotherapy as a meaningful consideration in hypertension management. ## Age-stratified effects of intravenous ferric derisomaltose in heart failure with iron deficiency: insights from the IRONMAN trial. *2025-06-13 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324908 · https://hartvaat.nl/2025/06/13/ironman-leeftijdgestratificeerde-effecten-van-iv-ijzer-bij-hf/* This IRONMAN subanalysis confirmed that the benefit of intravenous iron in heart failure is consistent across age groups, including elderly patients who may have higher baseline iron deficiency rates. ## The Impact of frailty on the effectiveness of intensive blood pressure control for patients with type 2 diabetes: a secondary analysis of a randomised controlled trial. *2025-06-13 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324360 · https://hartvaat.nl/2025/06/13/frailteit-en-intensieve-bloeddrukcontrole-bij-diabetes/* This analysis showed that moderately frail patients with type 2 diabetes still benefit from intensive blood pressure control, while the benefit may be attenuated in the most severely frail, guiding treatment intensity by frailty status. ## The flu shot and cardiovascular Protection: Rethinking inflammation in ischemic heart disease *2025-06-13 · Atherosclerosis · https://doi.org/https://www.atherosclerosis-journal.com/article/S0021-9150(25)01303-6/fulltext · https://hartvaat.nl/2025/06/13/griepvaccinatie-en-cardiovasculaire-bescherming-inflammatie-heroverwogen-bij-isc/* This review examines the evidence supporting influenza vaccination as a cardiovascular preventive strategy. Observational studies and randomised trials consistently demonstrate reduced cardiovascular event rates among vaccinated individuals, with the greatest benefit seen after myocardial infarction. ## Intravenous Ferric Carboxymaltose in Heart Failure With Iron Deficiency: The FAIR-HF2 DZHK05 Randomized Clinical Trial. *2025-06-10 · JAMA · https://doi.org/10.1001/jama.2025.3833 · https://hartvaat.nl/2025/06/10/fair-hf2-iv-ferricarboxymaltose-bij-hartfalen-met-ijzerdeficientie-definitieve-r/* The FAIR-HF2 trial confirmed that intravenous ferric carboxymaltose in patients with chronic heart failure and iron deficiency significantly reduced the composite of cardiovascular death and heart failure hospitalization. This provides the definitive evidence that had been missing from earlier, smaller trials of intravenous iron in heart failure. ## Two-Year Outcomes of Transcatheter Edge-to-Edge Repair for Severe Tricuspid Regurgitation: The TRILUMINATE Pivotal Randomized Controlled Trial. *2025-06-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.074536 · https://hartvaat.nl/2025/06/10/triluminate-tweejaarsresultaten-transcatheter-tr-repair-duurzaam-effectief/* Two-year TRILUMINATE results confirmed durable effectiveness of transcatheter edge-to-edge repair for severe tricuspid regurgitation, with sustained TR reduction and maintained symptom improvement beyond the initial follow-up. ## Oral Semaglutide and Cardiovascular Outcomes in People With Type 2 Diabetes, According to SGLT2i Use: Prespecified Analyses of the SOUL Randomized Trial. *2025-06-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.125.074545 · https://hartvaat.nl/2025/06/10/soul-oraal-semaglutide-cv-voordeel-naar-sglt2i-gebruik/* This SOUL subanalysis confirmed that oral semaglutide's cardiovascular benefit is consistent regardless of background SGLT2 inhibitor use, supporting the combination of both drug classes for comprehensive cardiometabolic protection. ## 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2025-06-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.009 · https://hartvaat.nl/2025/06/10/2025-acc-aha-acs-richtlijn-jacc-editie/* The 2025 ACC/AHA ACS guideline (JACC edition) provides updated recommendations for acute coronary syndromes incorporating evidence from ABYSS, REDUCE-AMI, COMPLETE, and other contemporary trials, endorsing DAPT de-escalation, optional beta-blockers after MI with preserved EF, and troponin-guided management pathways. ## Remote ischaemic pre-conditioning, kidney injury, and outcomes after coronary angiography and intervention: a randomized trial. *2025-06-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf135 · https://hartvaat.nl/2025/06/09/remote-ischemische-preconditionering-en-nierschade-na-coronairangiografie/* A multicentre randomised trial evaluated whether delayed remote ischaemic preconditioning prevents contrast-associated acute kidney injury after coronary angiography. The intervention provided no significant benefit over standard care. ## Titanium-nitride-oxide-coated vs. drug-eluting stents in acute coronary syndromes: an individual patient data meta-analysis. *2025-06-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf098 · https://hartvaat.nl/2025/06/09/tino-stents-versus-des-bij-acs-ipd-meta-analyse/* An individual patient data meta-analysis compared titanium-nitride-oxide-coated stents with drug-eluting stents in acute coronary syndromes over 5 years. TiNO stents showed comparable outcomes, offering an alternative when prolonged dual antiplatelet therapy is contraindicated. ## Impact of catheter ablation timing according to duration of atrial fibrillation history on arrhythmia recurrences and clinical outcomes: a meta-analysis. *2025-06-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf110 · https://hartvaat.nl/2025/06/03/af-ablatie-timing-naar-af-duur-impact-op-aritmierecidief/* This analysis showed that earlier catheter ablation (shorter duration of AF history) is associated with fewer arrhythmia recurrences, reinforcing the time-sensitive nature of rhythm control intervention. ## An Oral PCSK9 Inhibitor for Treatment of Hypercholesterolemia: The PURSUIT Randomized Trial. *2025-06-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.499 · https://hartvaat.nl/2025/06/03/pursuit-orale-pcsk9-remmer-voor-hypercholesterolemie-gerandomiseerde-trial/* The PURSUIT trial of an oral PCSK9 inhibitor demonstrated significant LDL cholesterol reduction in patients with hypercholesterolemia. An effective oral PCSK9 inhibitor could dramatically expand access to advanced lipid-lowering therapy beyond injectable monoclonal antibodies and siRNA agents. ## Multipoint pacing is associated with reduction of heart failure hospitalizations or death in patients who do not respond to cardiac resynchronization therapy: results of the MORE-CRT MPP randomized trial. *2025-06-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf070 · https://hartvaat.nl/2025/06/03/multipoint-pacing-vermindert-hf-hospitalisaties-en-sterfte-bij-crt-non-responder/* This study confirmed that multipoint pacing reduces heart failure hospitalization and death in CRT non-responders, establishing MPP as a rescue strategy for patients who fail to improve with conventional biventricular stimulation. ## Asundexian or Apixaban in Patients With Atrial Fibrillation According to Prior Oral Anticoagulant Use: A Subgroup Analysis of the OCEANIC-AF Randomized Clinical Trial. *2025-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0277 · https://hartvaat.nl/2025/06/01/oceanic-af-asundexian-naar-eerder-oac-gebruik/* A prespecified subgroup analysis of OCEANIC-AF assessed asundexian efficacy by prior oral anticoagulant experience. The factor XIa inhibitor was inferior to apixaban regardless of prior anticoagulation exposure, confirming the overall negative trial result across subgroups. ## Novel Controlled Metabolic Accelerator for Obesity-Related HFpEF: The HuMAIN-HFpEF Randomized Clinical Trial. *2025-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0103 · https://hartvaat.nl/2025/06/01/humain-hfpef-nieuwe-metabole-accelerator-bij-obesitas-hfpef-rct/* The HuMAIN-HFpEF trial tested a novel controlled metabolic accelerator for obesity-related HFpEF, exploring a new pharmacological mechanism for targeting excess body fat in this challenging heart failure phenotype. ## FFR-Guided Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Diabetes. *2025-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0095 · https://hartvaat.nl/2025/06/01/ffr-geleide-pci-versus-cabg-bij-diffuus-coronairlijden/* This analysis compared FFR-guided PCI with CABG in patients with diabetes, evaluating whether contemporary physiologically optimized percutaneous intervention can narrow the outcome gap with surgery in the diabetic population. ## Finerenone for Heart Failure and Risk Estimated by the PREDICT-HFpEF Model: A Secondary Analysis of FINEARTS-HF. *2025-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0025 · https://hartvaat.nl/2025/06/01/finearts-hf-finerenon-en-predict-hfpef-risicoscore/* A FINEARTS-HF secondary analysis validated the PREDICT-HFpEF risk model and evaluated finerenone efficacy across the risk spectrum. Higher-risk patients experienced greater absolute risk reduction, supporting risk-targeted therapy in HFmrEF and HFpEF. ## Effects of Blood Pressure Control on Arterial Stiffness Mechanisms in SPRINT: A Randomized Controlled Trial. *2025-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24816 · https://hartvaat.nl/2025/06/01/bloeddrukcontrole-en-arteriele-stijfheidsmechanismen-in-sprint/* This SPRINT analysis showed that intensive blood pressure control improves the structural components of arterial stiffness over time, demonstrating direct vascular remodeling benefit from aggressive blood pressure management. ## Sex-related pathophysiological mechanisms may be present before symptoms of HFpEF develop. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15228 · https://hartvaat.nl/2025/06/01/seksegerelateerde-pathofysiologie-voor-hfpef-symptomen/* Analysis of the PARABLE trial documented sex-related pathophysiological differences in pre-HFpEF. Women showed earlier diastolic dysfunction and microvascular abnormalities, which may inform sex-specific strategies for early HFpEF detection. ## Socio-economic status and the effect of guideline-directed medical therapy in the STRONG-HF study. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15156 · https://hartvaat.nl/2025/06/01/strong-hf-socio-economische-status-beinvloedt-gdmt-effect-niet/* This STRONG-HF analysis showed that the benefit of intensive guideline-directed medical therapy up-titration after acute HF is independent of socioeconomic status, supporting equitable implementation across income levels. ## Training-induced change of diastolic function in heart failure with preserved ejection fraction. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15225 · https://hartvaat.nl/2025/06/01/trainingseffect-op-diastolische-functie-bij-hfpef/* A substudy of the OptimEx-Clin trial investigated whether exercise training improves diastolic function during exercise in HFpEF patients. Training improved the E/e’ ratio and diastolic filling, providing mechanistic insight into the exercise capacity benefit in HFpEF. ## Burst steroid therapy and quality of life in patients with acute heart failure: Insights from the CORTAHF trial. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15235 · https://hartvaat.nl/2025/06/01/steroidstoot-bij-acuut-hartfalen-kwaliteit-van-leven-cortahf-inzichten/* A CORTAHF post-hoc analysis examined the effect of a 7-day prednisone course on quality of life in acute heart failure. The steroid burst improved dyspnoea-related quality of life at day 7 but showed no sustained long-term benefit. ## Right ventricular dysfunction for prediction of long-term recovery in de novo HFrEF : a PROLONG-II substudy. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15236 · https://hartvaat.nl/2025/06/01/rv-disfunctie-voorspelt-langetermijnherstel-bij-de-novo-hfref-prolong-ii/* The PROLONG-II substudy demonstrated that right ventricular dysfunction predicts long-term left ventricular recovery in patients with newly diagnosed heart failure with reduced ejection fraction. Early RV assessment is crucial for prognostication in new-onset heart failure. ## Randomized trial to assess worsening renal function by adding dapagliflozin for acute decompensated heart failure. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15212 · https://hartvaat.nl/2025/06/01/dapagliflozine-bij-acuut-gedecompenseerd-hartfalen-en-nierfunctie-rct/* This randomized trial confirmed that dapagliflozin does not worsen renal function when added for acute decompensated heart failure, providing safety data for early SGLT2 inhibitor initiation during AHF hospitalization. ## Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15232 · https://hartvaat.nl/2025/06/01/egfr-en-incident-hartfalen-bij-intensieve-bloeddrukbehandeling/* A post-hoc analysis of SPRINT examined the relationship between baseline eGFR and incident heart failure during intensive blood pressure treatment. While lower eGFR increased heart failure risk, the benefit of intensive treatment was preserved across kidney function levels. ## Cardiac myosin binding protein C correlate with cardiac troponin I during an exercise training program in patients with HFrEF. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15222 · https://hartvaat.nl/2025/06/01/cardiale-myosinebindend-eiwit-c-en-troponine-i-tijdens-inspanningstraining-bij-h/* This study compared cardiac myosin binding protein C with troponin I as biomarkers for myocardial effects of exercise training in chronic heart failure. The novel biomarker correlated well with troponin I and may offer complementary information on training-induced cardiac changes. ## Baseline kidney function and the effects of dapagliflozin on health status in heart failure in DEFINE-HF and PRESERVED-HF. *2025-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15184 · https://hartvaat.nl/2025/06/01/nierfunctie-en-dapagliflozine-effect-op-gezondheidsstatus-define-hf/* A pooled analysis of DEFINE-HF and PRESERVED-HF examined whether baseline kidney function modifies the health status benefits of dapagliflozin in heart failure. The benefits were consistent across eGFR groups, supporting SGLT2 inhibitor use regardless of renal function. ## Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes. *2025-05-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2501006 · https://hartvaat.nl/2025/05/29/soul-oraal-semaglutide-en-cv-uitkomsten-bij-hoogrisico-type-2-diabetes-nejm/* The SOUL trial demonstrated that oral semaglutide significantly reduced major adverse cardiovascular events in patients with type 2 diabetes and high cardiovascular risk. This is the first cardiovascular outcomes trial to show benefit for an oral GLP-1 receptor agonist, removing the barrier of injectable administration for cardiovascular prevention in diabetes. ## Impact of Heart Failure Severity on Vutrisiran Efficacy in Transthyretin Amyloidosis With Cardiomyopathy. *2025-05-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.477 · https://hartvaat.nl/2025/05/27/vutrisiran-bij-attr-cm-impact-van-hartfalenernst-op-effectiviteit/* This analysis showed that vutrisiran's cardiovascular benefit in ATTR cardiomyopathy is consistent regardless of heart failure severity, supporting RNA interference-based TTR silencing across the disease spectrum. ## Intensive Lowering of LDL Cholesterol Levels With Evolocumab in Autoimmune or Inflammatory Diseases: An Analysis of the FOURIER Trial. *2025-05-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.072756 · https://hartvaat.nl/2025/05/20/intensieve-ldl-verlaging-met-evolocumab-bij-auto-immuunziekten-rct/* This FOURIER analysis showed that intensive LDL lowering with evolocumab provides consistent cardiovascular event reduction in patients with autoimmune or inflammatory diseases, a population with heightened baseline inflammatory risk. ## Angiopoietin-Like 3 Antibody Therapy in Patients With Suboptimally Controlled Hyperlipidemia: A Phase 2 Study. *2025-05-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.008 · https://hartvaat.nl/2025/05/20/angptl3-antilichaam-bij-suboptimaal-gecontroleerde-hyperlipidemie-fase-2/* This phase 2 trial of an ANGPTL3 antibody showed significant LDL and triglyceride lowering in patients with suboptimally controlled hyperlipidemia, expanding the ANGPTL3 inhibition approach to a broader dyslipidemia population. ## Effect of ANGPTL3 Inhibition With Solbinsiran in Preclinical and Early Human Studies. *2025-05-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.005 · https://hartvaat.nl/2025/05/20/solbinsiran-angptl3-remming-van-preklinisch-tot-eerste-humane-studies/* Translational studies documented the development of solbinsiran, an siRNA targeting ANGPTL3, from preclinical models to first-in-human application. The molecule demonstrated consistent favourable effects on triglycerides and remnant lipoproteins across development phases. ## Effect of Targeting ApoC-III With Plozasiran on Lipoprotein Particle Size and Number in Hypertriglyceridemia. *2025-05-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.496 · https://hartvaat.nl/2025/05/20/plozasiran-en-lipoproteine-deeltjesgrootte-bij-hypertriglyceridemie/* This analysis showed that plozasiran not only reduces triglycerides but favorably remodels the lipoprotein particle profile, shifting from small dense LDL to larger, less atherogenic particles through APOC3 suppression. ## Fixed-dose combination of obicetrapib and ezetimibe for LDL cholesterol reduction (TANDEM): a phase 3, randomised, double-blind, placebo-controlled trial. *2025-05-17 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00721-4 · https://hartvaat.nl/2025/05/17/tandem-obicetrapib-plus-ezetimibe-voor-ldl-verlaging-lancet-fase-3/* The TANDEM trial demonstrated that a fixed-dose combination of obicetrapib (a CETP inhibitor) and ezetimibe reduced LDL cholesterol by 55-60% in statin-treated patients. This is the first positive result for a modern CETP inhibitor in combination therapy, reviving the mechanism after decades of setbacks. ## Effect of Empagliflozin on the Mechanisms Driving Erythropoiesis and Iron Mobilization in Patients With Heart Failure: The EMPEROR Program. *2025-05-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.503 · https://hartvaat.nl/2025/05/13/empagliflozine-erytropoese-en-ijzermobilisatie-bij-hartfalen/* This mechanistic study showed that empagliflozin stimulates erythropoiesis and iron mobilization in heart failure through hypoxia-inducible factor pathway activation, explaining the hemoglobin increases observed during SGLT2 inhibitor therapy. ## Ischemia on Dobutamine Stress Echocardiography Predicts Efficacy of PCI: Results From the ORBITA-2 Trial. *2025-05-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.02.034 · https://hartvaat.nl/2025/05/13/orbita-2-dobutamine-stress-echo-voorspelt-pci-effectiviteit/* This ORBITA-2 subanalysis showed that ischemia on dobutamine stress echocardiography predicts the placebo-controlled efficacy of PCI in stable angina, supporting objective functional testing for patient selection before revascularization. ## Interplay of Chronic Kidney Disease and the Effects of Tirzepatide in Patients With Heart Failure, Preserved Ejection Fraction, and Obesity: The SUMMIT Trial. *2025-05-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.009 · https://hartvaat.nl/2025/05/13/summit-tirzepatide-en-ckd-interactie-bij-hfpef-met-obesitas/* This analysis showed that CKD does not attenuate the benefit of tirzepatide in HFpEF with obesity, supporting the dual incretin agonist across the cardiorenal comorbidity spectrum. ## Lorundrostat Efficacy and Safety in Patients with Uncontrolled Hypertension. *2025-05-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2501440 · https://hartvaat.nl/2025/05/08/lorundrostat-bij-ongecontroleerde-hypertensie-fase-3-nejm/* This phase 3 trial demonstrated that lorundrostat, a selective aldosterone synthase inhibitor, significantly reduced blood pressure in patients with uncontrolled hypertension on existing therapy. The results add to the growing evidence for aldosterone synthase inhibition as a new treatment class for resistant and difficult-to-treat hypertension. ## Persistent atrial fibrillation with left atrial low-voltage area: who benefit from additional modification? *2025-05-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf095 · https://hartvaat.nl/2025/05/07/aanvullende-substraatmodificatie-bij-persisterend-af-met-low-voltage-gebieden/* This study investigated which patients with persistent AF and left atrial low-voltage areas benefit from additional substrate modification beyond PVI, identifying subgroups where targeted ablation adds value. ## HIgh Power short duration radiofrequency ablation or cryoballoon ablation for paroxysmal Atrial Fibrillation (HIPAF trial). *2025-05-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf066 · https://hartvaat.nl/2025/05/07/hoog-vermogen-korte-duur-rf-ablatie-versus-cryoballon-bij-paroxysmaal-af-rct/* This randomized trial compared high-power short-duration RF ablation with cryoballoon ablation for paroxysmal AF, confirming equivalent efficacy and safety between these two established energy delivery approaches. ## Durability and efficacy of solbinsiran, a GalNAc-conjugated siRNA targeting ANGPTL3, in adults with mixed dyslipidaemia (PROLONG-ANG3): a double-blind, randomised, placebo-controlled, phase 2 trial. *2025-05-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00507-0 · https://hartvaat.nl/2025/05/03/solbinsiran-langwerkend-sirna-tegen-angptl3-duurzaamheid-en-effectiviteit/* Phase 2 data on solbinsiran, a GalNAc-conjugated siRNA targeting ANGPTL3, showed durable and effective reduction of triglycerides and LDL cholesterol in mixed dyslipidemia, advancing a new RNA-based approach for comprehensive lipid management. ## Semaglutide and walking capacity in people with symptomatic peripheral artery disease and type 2 diabetes (STRIDE): a phase 3b, double-blind, randomised, placebo-controlled trial. *2025-05-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00509-4 · https://hartvaat.nl/2025/05/03/semaglutide-en-loopafstand-bij-perifeer-vaatlijden-en-diabetes/* The STRIDE trial investigated whether semaglutide improves walking capacity in patients with symptomatic peripheral artery disease and type 2 diabetes, testing GLP-1 receptor agonism for PAD-specific functional outcomes. ## Individual patient data meta-analysis of paclitaxel-coated balloons vs. drug-eluting stents for small-vessel coronary artery disease: the ANDROMEDA study. *2025-05-02 · European heart journal · https://doi.org/10.1093/eurheartj/ehaf002 · https://hartvaat.nl/2025/05/02/paclitaxel-gecoate-ballonnen-versus-des-bij-kleine-vaten-ipd-meta-analyse/* This individual patient data meta-analysis compared paclitaxel-coated balloons with drug-eluting stents for small coronary artery disease, confirming DCB noninferiority and supporting the leave-nothing-behind approach in small vessels. ## Determinants of medication adherence in patients with acute coronary syndrome: a secondary analysis of a randomised clinical trial. *2025-05-02 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-325144 · https://hartvaat.nl/2025/05/02/determinanten-van-medicatietrouw-na-acs-secundaire-analyse/* A secondary analysis identified key determinants of medication adherence following acute coronary syndrome. Regimen complexity, cost, and patient education were the strongest predictors of non-adherence, informing targeted interventions to improve secondary prevention. ## Encouraging Pharmacist Referrals for Evidence-Based Statin Initiation: Two Cluster Randomized Clinical Trials. *2025-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2025.0244 · https://hartvaat.nl/2025/05/01/apothekerverwijzingen-voor-statine-start-twee-cluster-rct-s/* These two cluster-randomized trials showed that encouraging pharmacist referrals for statin initiation significantly increases evidence-based therapy use, positioning community pharmacies as an access point for cardiovascular prevention. ## Long-Term Aspirin vs Clopidogrel After Coronary Stenting by Bleeding Risk and Procedural Complexity. *2025-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4030 · https://hartvaat.nl/2025/05/01/aspirine-versus-clopidogrel-na-coronaire-stenting-naar-bloedingsrisico-en-comple/* This analysis compared aspirin with clopidogrel monotherapy after coronary stenting stratified by bleeding risk and procedural complexity, finding that clopidogrel consistently outperforms aspirin across all risk categories. ## Early Intra-Aortic Balloon Support for Heart Failure-Related Cardiogenic Shock: A Randomized Clinical Trial. *2025-04-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.03.003 · https://hartvaat.nl/2025/04/29/vroege-iabp-bij-hartfalen-gerelateerde-cardiogene-shock-gerandomiseerde-trial/* This randomized trial showed that early IABP support in heart failure-related cardiogenic shock improves hemodynamics and may facilitate successful bridging to heart replacement therapies, providing evidence for IABP use outside the acute MI setting. ## Outcomes after fractional flow reserve-guided percutaneous coronary intervention versus coronary artery bypass grafting (FAME 3): 5-year follow-up of a multicentre, open-label, randomised trial. *2025-04-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00505-7 · https://hartvaat.nl/2025/04/26/ffr-geleide-pci-versus-cabg-langetermijn-uitkomsten-vergelijking/* This analysis compared long-term outcomes of FFR-guided PCI with CABG, informing the revascularization strategy decision based on contemporary physiologically guided percutaneous intervention results. ## Angiography-derived fractional flow reserve versus intravascular ultrasound to guide percutaneous coronary intervention in patients with coronary artery disease (FLAVOUR II): a multicentre, randomised, non-inferiority trial. *2025-04-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00504-5 · https://hartvaat.nl/2025/04/26/angiografie-afgeleide-ffr-versus-ivus-bij-pci-gerandomiseerde-trial/* This randomized trial showed that angiography-derived FFR (QFR/vFFR) is noninferior to IVUS for guiding PCI decisions, validating the wire-free computational approach as an alternative to intravascular imaging guidance. ## A Randomized Controlled Trial of Thoracentesis in Acute Heart Failure. *2025-04-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.073521 · https://hartvaat.nl/2025/04/22/thoracentese-bij-acuut-hartfalen-gerandomiseerde-trial/* This randomized trial showed that therapeutic thoracentesis in acute heart failure with pleural effusion improves dyspnea and respiratory function, supporting targeted drainage as an adjunct to standard decongestive therapy. ## Anaemia predicts iron homoeostasis dysregulation and modulates the response to empagliflozin in heart failure with reduced ejection fraction: the EMPATROPISM-FE trial. *2025-04-22 · European heart journal · https://doi.org/10.1093/eurheartj/ehae917 · https://hartvaat.nl/2025/04/22/anemie-beinvloedt-ijzerhomeostase-en-empagliflozine-respons-bij-hf/* Analysis from the EMPATROPISM-FE trial showed that anaemia disrupts iron homeostasis in heart failure and modifies the response to empagliflozin. Iron deficiency and anaemia require integrated assessment when initiating SGLT2 inhibitor therapy. ## Pulsed Field or Cryoballoon Ablation for Paroxysmal Atrial Fibrillation. *2025-04-17 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2502280 · https://hartvaat.nl/2025/04/17/pfa-versus-cryoballon-bij-paroxysmaal-af-gerandomiseerde-trial/* This randomized trial showed that pulsed field ablation was noninferior to cryoballoon ablation for pulmonary vein isolation in paroxysmal atrial fibrillation, with comparable efficacy and safety. The result positions PFA as an alternative to established thermal energy sources for AF ablation. ## Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART-CHOICE 3): a randomised, open-label, multicentre trial. *2025-04-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00449-0 · https://hartvaat.nl/2025/04/12/clopidogrel-versus-aspirine-monotherapie-bij-hoog-risico-op-recidief-cva/* This study compared clopidogrel with aspirin as long-term antiplatelet monotherapy in patients at high risk of recurrent cardiovascular events, contributing to the growing evidence for clopidogrel as the preferred single agent after PCI. ## Orbital atherectomy versus balloon angioplasty before drug-eluting stent implantation in severely calcified lesions eligible for both treatment strategies (ECLIPSE): a multicentre, open-label, randomised trial. *2025-04-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00450-7 · https://hartvaat.nl/2025/04/12/orbitale-atherectomie-versus-ballonangioplastie-voor-des-bij-ernstig-verkalkte-l/* This randomized trial compared orbital atherectomy with balloon angioplasty for calcium modification before DES implantation in severely calcified coronary lesions, testing whether advanced plaque preparation improves PCI outcomes. ## Dapagliflozin in Patients Undergoing Transcatheter Aortic-Valve Implantation. *2025-04-10 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2500366 · https://hartvaat.nl/2025/04/10/dapagliflozine-bij-patienten-die-tavi-ondergaan-gerandomiseerde-trial-nejm/* This NEJM trial evaluated dapagliflozin in patients undergoing TAVI, exploring whether SGLT2 inhibition provides additional cardiac protection in this high-risk valvular heart disease population. ## Empagliflozin in resistant hypertension and heart failure with preserved ejection fraction: the EMPEROR-Preserved trial. *2025-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae938 · https://hartvaat.nl/2025/04/07/emperial-empagliflozine-bij-resistente-hypertensie-en-hfpef/* This EMPEROR-Preserved subanalysis showed that empagliflozin improves blood pressure in patients with resistant hypertension and HFpEF, providing additional hemodynamic benefit in this difficult-to-treat overlap population. ## Sodium-glucose co-transporter 2 inhibitors and new-onset diabetes in cardiovascular or kidney disease. *2025-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae780 · https://hartvaat.nl/2025/04/07/sglt2-remmers-voorkomen-nieuw-ontstane-diabetes-bij-cv-en-nierziekte/* This analysis showed that SGLT2 inhibitors reduce the risk of new-onset diabetes in patients with cardiovascular or kidney disease, adding a metabolic prevention benefit to their established cardiorenal protection. ## Left Atrial Appendage Closure after Ablation for Atrial Fibrillation. *2025-04-03 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2408308 · https://hartvaat.nl/2025/04/03/laa-sluiting-na-af-ablatie-gerandomiseerde-trial-nejm/* This NEJM trial investigated whether left atrial appendage closure combined with catheter ablation for atrial fibrillation can reduce stroke risk and enable anticoagulation cessation. The results inform the decision about combining structural and rhythm interventions for long-term AF management. ## Invasive vs Conservative Management of Patients With Chronic Total Occlusion: Results From the ISCHEMIA Trial. *2025-04-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.01.029 · https://hartvaat.nl/2025/04/01/ischemia-invasief-versus-conservatief-bij-chronische-totale-occlusie/* This ISCHEMIA subanalysis in patients with chronic total occlusions showed no benefit of invasive management over conservative treatment, consistent with the overall trial findings and dedicated CTO trials. ## Guideline-Directed Medical Therapy and Outcomes in the ISCHEMIA Trial. *2025-04-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2025.01.028 · https://hartvaat.nl/2025/04/01/gdmt-en-uitkomsten-in-ischemia-trial/* This ISCHEMIA analysis showed that better adherence to guideline-directed medical therapy improves outcomes regardless of revascularization strategy, reinforcing that optimal pharmacotherapy is the foundation of stable coronary disease management. ## Treatment Strategies to Control Blood Pressure in People With Hypertension in Tanzania and Lesotho: A Randomized Clinical Trial. *2025-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.5124 · https://hartvaat.nl/2025/04/01/behandelstrategieen-voor-bloeddrukcontrole-in-tanzania-en-lesotho-rct/* This randomized trial compared hypertension treatment strategies in Tanzania and Lesotho, showing that structured protocol-driven care significantly improves blood pressure control in sub-Saharan Africa. ## Major clinical outcomes in symptomatic vs. asymptomatic atrial fibrillation: a meta-analysis. *2025-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae694 · https://hartvaat.nl/2025/04/01/symptomatisch-versus-asymptomatisch-af-en-klinische-uitkomsten-meta-analyse/* This meta-analysis showed that symptomatic and asymptomatic AF have comparable clinical outcomes, supporting the paradigm that treatment decisions should be based on thromboembolic risk rather than symptom status alone. ## 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2025-04-01 · Circulation · https://doi.org/10.1161/CIR.0000000000001309 · https://hartvaat.nl/2025/04/01/2025-acc-aha-acs-richtlijn-management-van-acuut-coronair-syndroom/* The 2025 ACC/AHA ACS guideline integrates contemporary evidence on DAPT de-escalation, routine complete revascularization, troponin-based diagnosis, and post-MI therapy. Notably, long-term beta-blockers are no longer mandated after MI with preserved ejection fraction, reflecting ABYSS and REDUCE-AMI results. ## Efficacy and Safety of Aldosterone Synthase Inhibitors for Hypertension: A Meta-Analysis of Randomized Controlled Trials and Systematic Review. *2025-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23962 · https://hartvaat.nl/2025/04/01/aldosteronsynthaseremmers-bij-hypertensie-meta-analyse-van-rct-s/* This meta-analysis of all randomized trials with aldosterone synthase inhibitors (baxdrostat, lorundrostat) confirmed significant blood pressure reduction in patients with hypertension. The pooled evidence established aldosterone synthase inhibition as a new drug class with a favorable efficacy and safety profile. ## Hypotensive Episodes on 24-Hour Ambulatory Blood Pressure and Cognitive Function: Insights From the SPRINT Study. *2025-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24222 · https://hartvaat.nl/2025/04/01/hypotensieve-episodes-op-24-uurs-abpm-en-cognitieve-functie-sprint-inzichten/* This SPRINT analysis showed that hypotensive episodes detected on 24-hour ambulatory monitoring are not associated with cognitive impairment, providing reassurance about brain safety during intensive blood pressure treatment. ## Aprocitentan for Blood Pressure Reduction in Black Patients. *2025-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24142 · https://hartvaat.nl/2025/04/01/aprocitentan-bij-zwarte-patienten-met-hypertensie/* This subanalysis confirmed that aprocitentan effectively lowers blood pressure in Black hypertensive patients, extending the endothelin antagonist evidence to a population with disproportionate hypertension burden. ## Analysis of the usefulness and benefits of ultrafiltration in cardiorenal syndrome: A systematic review. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15125 · https://hartvaat.nl/2025/04/01/ultrafiltratie-bij-cardiorenaal-syndroom-systematische-review/* A systematic review compared ultrafiltration with conventional diuretic therapy in cardiorenal syndrome. Ultrafiltration improved decongestion but sometimes worsened renal function, limiting its role to diuretic-resistant situations where conventional therapy has failed. ## Cilostazol in patients with heart failure and preserved ejection fraction-The CLIP-HFpEF trial. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15162 · https://hartvaat.nl/2025/04/01/clip-hfpef-cilostazol-bij-hfpef-gerandomiseerde-trial/* The CLIP-HFpEF trial evaluated cilostazol, an oral PDE-3 inhibitor, in patients with heart failure with preserved ejection fraction. The drug did not significantly improve exercise capacity or health status, indicating that PDE-3 inhibition is not an effective therapeutic strategy for HFpEF. ## The in-hospital administration of sacubitril/valsartan in acute myocardial infarction: A meta-analysis. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15082 · https://hartvaat.nl/2025/04/01/sacubitril-valsartan-na-acuut-mi-meta-analyse-van-in-hospital-initiatie/* This meta-analysis evaluated in-hospital sacubitril-valsartan initiation after acute MI, showing that early ARNI therapy is safe with favorable effects on cardiac biomarkers and remodeling. ## Projecting the benefit of vericiguat in PARADIGM-HF and DAPA-HF populations: Insights from the VICTORIA trial. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15134 · https://hartvaat.nl/2025/04/01/vericiguat-voordeel-geprojecteerd-op-paradigm-hf-en-dapa-hf-populaties/* This analysis projected the potential benefit of vericiguat onto simulated PARADIGM-HF and DAPA-HF populations. The estimated additional benefit over existing guideline-directed therapy supports vericiguat as a fifth pillar in the treatment of severe heart failure. ## Socio-economic inequalities and heart failure morbidity and mortality: A systematic review and data synthesis. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14986 · https://hartvaat.nl/2025/04/01/socio-economische-ongelijkheid-en-hartfalenuitkomsten-systematische-review/* This systematic review documented the impact of socioeconomic inequalities on heart failure morbidity and mortality. Lower socioeconomic status was consistently associated with significantly worse heart failure outcomes across multiple dimensions. ## The role of cardiac acoustic biomarkers in monitoring patients with heart failure: A systematic literature review. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15075 · https://hartvaat.nl/2025/04/01/cardiale-akoestische-biomarkers-bij-hartfalenmonitoring-systematische-review/* A systematic review evaluated the role of cardiac acoustic biomarkers — including digital auscultation and remote monitoring — in heart failure management. The technology shows promise for non-invasive haemodynamic assessment but requires further clinical validation. ## Meta-analysis of sotagliflozin, a dual sodium-glucose-cotransporter 1/2 inhibitor, for heart failure in type 2 diabetes. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15036 · https://hartvaat.nl/2025/04/01/sotagliflozine-duale-sglt1-sglt2-remmer-bij-hartfalen-meta-analyse/* This meta-analysis confirmed that sotagliflozin, a dual SGLT1/2 inhibitor, reduces cardiovascular events and hospitalizations in heart failure patients with type 2 diabetes, supporting the dual transporter inhibition approach. ## Outpatient treatment of decompensated heart failure: A systematic review and study level meta-analysis. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14841 · https://hartvaat.nl/2025/04/01/ambulante-behandeling-van-gedecompenseerd-hartfalen-meta-analyse/* This meta-analysis evaluated outpatient treatment of decompensated heart failure as an alternative to hospitalization, showing that selected patients can be safely managed with intravenous diuretics in ambulatory settings. ## Association of COPD with adverse outcomes in heart failure patients with preserved ejection fraction. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14958 · https://hartvaat.nl/2025/04/01/copd-en-slechtere-uitkomsten-bij-hfpef-meta-analyse/* A meta-analysis confirmed that COPD as a comorbidity significantly worsens outcomes in patients with heart failure with preserved ejection fraction. The cardiopulmonary overlap requires integrated management approaches addressing both conditions simultaneously. ## The difficult discussion on the deactivation of implantable cardioverter devices at the end of life: a systematic review. *2025-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14831 · https://hartvaat.nl/2025/04/01/icd-deactivatie-aan-het-levenseinde-de-moeilijke-discussie/* This systematic review explored the ethical and practical aspects of implantable cardioverter defibrillator deactivation at end of life. Timely discussions and clear advance care planning are essential but remain underutilised in clinical practice. ## Dronedarone provides effective early rhythm control: post-hoc analysis of the ATHENA trial using EAST-AFNET 4 criteria. *2025-03-28 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf080 · https://hartvaat.nl/2025/03/28/athena-post-hoc-dronedaron-als-effectieve-vroege-ritmecontrole/* This ATHENA post-hoc analysis using EAST-AFNET 4 criteria confirmed that dronedarone provides effective early rhythm control in AF, showing cardiovascular benefit when applied to contemporary rhythm management paradigms. ## Flecainide acetate inhalation solution for cardioversion of recent-onset, symptomatic atrial fibrillation: results of the phase 3 RESTORE-1 trial. *2025-03-28 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf064 · https://hartvaat.nl/2025/03/28/geinhaleerde-flecainide-voor-cardioversie-van-recent-onset-af-lancet/* The RESTORE-1 trial demonstrated that inhaled flecainide rapidly and effectively cardioverted recent-onset symptomatic atrial fibrillation in an outpatient setting. The needle-free, self-administered formulation offers a patient-controlled 'pill-in-the-pocket' alternative with faster onset than oral antiarrhythmic drugs. ## Intensive Blood-Pressure Control in Patients with Type 2 Diabetes. *2025-03-27 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2412006 · https://hartvaat.nl/2025/03/27/intensieve-bloeddrukcontrole-bij-type-2-diabetes-nejm/* This large randomized trial showed that intensive blood pressure control (systolic <120 mmHg) significantly reduced cardiovascular events compared with standard treatment (<140 mmHg) in patients with type 2 diabetes and elevated cardiovascular risk. The results align with SPRINT and extend the evidence for aggressive blood pressure targets specifically to the diabetic population. ## Cost-effectiveness of digoxin versus beta blockers in permanent atrial fibrillation: the Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) randomised trial. *2025-03-26 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324761 · https://hartvaat.nl/2025/03/26/rate-af-kosteneffectiviteit-van-digoxine-versus-betablokkers-bij-permanent-af/* This RATE-AF cost-effectiveness analysis showed that digoxin is more cost-effective than beta-blockers for rate control in permanent AF, driven by fewer adverse events and comparable quality of life at lower cost. ## Antithrombotic Therapy to Minimize Total Events After ACS or PCI in Atrial Fibrillation: Insights From AUGUSTUS. *2025-03-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.10.125 · https://hartvaat.nl/2025/03/25/antitrombotische-therapie-bij-af-na-acs-pci-augustus-gecombineerde-inzichten/* This comprehensive AUGUSTUS analysis identified the antithrombotic regimen that minimizes the total burden of both bleeding and ischemic events in AF patients after ACS or PCI, definitively supporting apixaban plus P2Y12 inhibitor without aspirin. ## Anticoagulation and Antiplatelet Therapy for Atrial Fibrillation and Stable Coronary Disease: Meta-Analysis of Randomized Trials. *2025-03-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.12.030 · https://hartvaat.nl/2025/03/25/anticoagulatie-en-antiplaatjestherapie-bij-af-en-stabiel-coronairlijden-meta-ana/* This meta-analysis confirmed that oral anticoagulant monotherapy without antiplatelet therapy is the preferred long-term strategy for AF patients with stable coronary disease, with no ischemic cost from dropping the antiplatelet agent. ## Age and Sex Differences in Efficacy of Treatments for Type 2 Diabetes: A Network Meta-Analysis. *2025-03-25 · JAMA · https://doi.org/10.1001/jama.2024.27402 · https://hartvaat.nl/2025/03/25/leeftijds-en-sekseverschillen-in-effectiviteit-van-diabetesbehandeling-netwerk-m/* This network meta-analysis showed that the efficacy of SGLT2 inhibitors and GLP-1 agonists for type 2 diabetes treatment is consistent across age and sex subgroups, supporting equitable prescribing. ## 5-Year Results From the AMPLATZER Amulet Left Atrial Appendage Occluder Randomized Controlled Trial. *2025-03-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.10.101 · https://hartvaat.nl/2025/03/25/amulet-ide-vijfjaarsresultaten-laa-occlusie-met-amulet/* Five-year results from the Amulet IDE trial confirmed the long-term durability and effectiveness of the Amplatzer Amulet LAA occluder for stroke prevention in AF, providing the longest follow-up data for this device. ## Cardiovascular outcomes with semaglutide by severity of chronic kidney disease in type 2 diabetes: the FLOW trial. *2025-03-24 · European heart journal · https://doi.org/10.1093/eurheartj/ehae613 · https://hartvaat.nl/2025/03/24/flow-semaglutide-cv-voordelen-naar-ckd-ernst-bij-diabetes/* This FLOW subanalysis confirmed that semaglutide's cardiovascular benefit is consistent across CKD severity stages in type 2 diabetes, with the greatest absolute benefit in patients with more advanced kidney disease. ## Sodium Zirconium Cyclosilicate for Management of Hyperkalemia During Spironolactone Optimization in Patients With Heart Failure. *2025-03-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.014 · https://hartvaat.nl/2025/03/18/natriumzirconiumcyclosilicaat-voor-spironolacton-optitratie-na-hf-gerandomiseerd/* This randomized trial demonstrated that sodium zirconium cyclosilicate enables spironolactone optimization in HFrEF patients with hyperkalemia, providing an alternative potassium binder to facilitate guideline-directed MRA therapy. ## Direct oral anticoagulants versus no anticoagulation for the prevention of stroke in survivors of intracerebral haemorrhage with atrial fibrillation (PRESTIGE-AF): a multicentre, open-label, randomised, phase 3 trial. *2025-03-15 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(25)00333-2 · https://hartvaat.nl/2025/03/15/doac-s-versus-geen-anticoagulatie-na-intracraniele-bloeding-bij-af-meta-analyse/* This meta-analysis showed that restarting DOACs after intracerebral hemorrhage in AF patients is associated with fewer ischemic events and lower mortality without significantly increased recurrent ICH, supporting cautious anticoagulation resumption. ## Pathological findings at invasive assessment in MINOCA: a systematic review and meta-analysis. *2025-03-13 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324565 · https://hartvaat.nl/2025/03/13/minoca-pathologische-bevindingen-bij-invasieve-beoordeling-meta-analyse/* This systematic review documented the pathological mechanisms of MINOCA identified through invasive assessment (OCT, IVUS, provocation testing), showing heterogeneous etiologies including plaque disruption, coronary spasm, and microvascular dysfunction. ## Effects of Tirzepatide on the Clinical Trajectory of Patients With Heart Failure, Preserved Ejection Fraction, and Obesity. *2025-03-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.072679 · https://hartvaat.nl/2025/03/11/summit-tirzepatide-en-klinisch-traject-bij-hfpef-met-obesitas-langetermijn/* Long-term SUMMIT analysis showed that tirzepatide durably improves the clinical trajectory of patients with HFpEF and obesity, with sustained benefits on symptoms, function, and body composition beyond the initial treatment period. ## Transcatheter Aortic Valve Replacement in Patients With Systolic Heart Failure and Moderate Aortic Stenosis: TAVR UNLOAD. *2025-03-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.10.070 · https://hartvaat.nl/2025/03/11/tavr-bij-systolisch-hartfalen-en-matige-aortastenose-nejm/* The TAVR UNLOAD trial explored TAVR in patients with HFrEF and moderate (not severe) aortic stenosis. The results inform the growing debate about the role of valve intervention in patients where hemodynamic afterload reduction may benefit ventricular recovery even below conventional severity thresholds for aortic stenosis. ## Biventricular vs. right ventricular pacing devices in patients anticipated to require frequent ventricular pacing (BioPace). *2025-03-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf029 · https://hartvaat.nl/2025/03/05/biventriculair-versus-rv-pacing-bij-patienten-met-verwachte-frequente-pacing/* This study compared biventricular with right ventricular pacing in patients expected to require frequent ventricular pacing, showing that biventricular pacing prevents pacing-induced LV dysfunction and improves clinical outcomes. ## Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association. *2025-03-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf019 · https://hartvaat.nl/2025/03/05/af-last-in-klinische-praktijk-onderzoek-en-technologie-consensus-document/* This clinical consensus statement defined AF burden as a standardized metric for assessing treatment effectiveness, establishing measurement standards and clinical thresholds for arrhythmia monitoring. ## Stepwise Provisional Versus Systematic Dual-Stent Strategies for Treatment of True Left Main Coronary Bifurcation Lesions. *2025-03-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.071153 · https://hartvaat.nl/2025/03/04/stapsgewijze-provisionale-versus-systematische-dualstent-bij-ware-linker-hoofdst/* This randomized trial compared provisional with systematic dual-stent strategies for true left main bifurcation lesions in the EBC MAIN study, finding comparable long-term outcomes between approaches. ## Aspirin and Hemocompatibility After LVAD Implantation in Patients With Atherosclerotic Vascular Disease: A Secondary Analysis From the ARIES-HM3 Randomized Clinical Trial. *2025-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4849 · https://hartvaat.nl/2025/03/01/aspirine-en-hemocompatibiliteit-na-lvad-bij-atherosclerotisch-vaatlijden/* This ARIES-HM3 secondary analysis examined aspirin's role in LVAD patients with atherosclerotic vascular disease, characterizing the hemocompatibility trade-off of antiplatelet therapy in mechanically supported patients. ## Potassium Nitrate in Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. *2025-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4417 · https://hartvaat.nl/2025/03/01/kaliumnitraat-bij-hfpef-gerandomiseerde-trial/* This randomized trial of potassium nitrate in HFpEF tested whether inorganic nitrate supplementation improves exercise tolerance through enhanced nitric oxide availability, exploring a dietary approach to the NO-deficiency hypothesis. ## Impact of Frailty on Antihypertensive Treatment in Older Adults. *2025-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24214 · https://hartvaat.nl/2025/03/01/frailteit-en-antihypertensieve-behandeling-bij-ouderen-meta-analyse/* This meta-analysis found that moderately frail older adults still benefit from antihypertensive treatment, while severely frail patients may not. The results support continued blood pressure treatment in most elderly patients but caution against aggressive targets in the most frail. ## Time in Target Range for Blood Pressure and Adverse Health Outcomes: A Systematic Review. *2025-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.24013 · https://hartvaat.nl/2025/03/01/tijd-in-streefwaarde-voor-bloeddruk-en-gezondheidsuitkomsten-systematische-revie/* This systematic review established blood pressure time-in-target-range as a clinically meaningful metric associated with better cardiovascular outcomes, shifting the focus from single BP measurements to sustained control quality. ## Worsening of Heart Failure in Outpatients With Transthyretin Amyloidosis and Cardiomyopathy in the APOLLO-B Trial. *2025-02-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.10.097 · https://hartvaat.nl/2025/02/25/ambulante-hf-verslechtering-bij-attr-cm-attr-act-subanalyse/* A post-hoc analysis of the APOLLO-B trial investigated outpatient worsening heart failure in transthyretin amyloidosis cardiomyopathy. Patisiran treatment reduced worsening events, confirming the clinical value of transthyretin gene silencing in this population. ## Systolic Blood Pressure and Pulse Pressure in Heart Failure: Pooled Participant-Level Analysis of 4 Trials. *2025-02-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.007 · https://hartvaat.nl/2025/02/25/systolische-bloeddruk-en-polsdruk-bij-hartfalen-gepoolde-ipd-analyse/* This pooled analysis of four heart failure trials showed that lower systolic blood pressure and pulse pressure are associated with worse outcomes in HFmrEF/HFpEF, informing the blood pressure management balance in this population. ## Outpatient Worsening Heart Failure in Patients With Transthyretin Amyloidosis With Cardiomyopathy in the HELIOS-B Trial. *2025-02-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.015 · https://hartvaat.nl/2025/02/25/ambulante-hartfalenverslechtering-bij-attr-cardiomyopathie-attr-act-analyse/* Analysis of the HELIOS-B trial documented patterns of outpatient worsening heart failure in patients with transthyretin amyloidosis cardiomyopathy. Worsening events were frequent and prognostically significant, supporting early treatment with RNA interference therapy vutrisiran. ## Tirzepatide Reduces LV Mass and Paracardiac Adipose Tissue in Obesity-Related Heart Failure: SUMMIT CMR Substudy. *2025-02-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.001 · https://hartvaat.nl/2025/02/25/summit-tirzepatide-vermindert-lv-massa-en-paracardiaal-vetweefsel-bij-hfpef/* The SUMMIT CMR substudy showed that tirzepatide significantly reduces LV mass and paracardiac adipose tissue in obesity-related HFpEF, providing imaging evidence that dual incretin agonism reverses the adverse cardiac remodeling of the obesity-HFpEF phenotype. ## Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia. *2025-02-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2409501 · https://hartvaat.nl/2025/02/20/vanish2-catheterablatie-versus-antiaritmica-bij-ventriculaire-tachycardie-nejm/* The VANISH2 trial confirmed that catheter ablation was superior to escalation of antiarrhythmic drug therapy for recurrent ventricular tachycardia in patients with ischemic cardiomyopathy, significantly reducing VT recurrence and ICD shocks. The results strengthen the position of early ablation in VT management. ## Treating Older Patients in Cardiogenic Shock With a Microaxial Flow Pump: Is it DANGERous? *2025-02-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.003 · https://hartvaat.nl/2025/02/18/impella-bij-ouderen-met-cardiogene-shock-is-het-veilig/* This DanGer Shock subanalysis showed that Impella CP provides consistent survival benefit regardless of age in cardiogenic shock, supporting mechanical circulatory support even in older patients with MI-related shock. ## Randomized Comparison of Novel Low-Dose Sirolimus-Eluting Biodegradable Polymer Stent vs Second-Generation DES: TARGET-IV NA Trial. *2025-02-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.10.074 · https://hartvaat.nl/2025/02/18/lage-dosis-sirolimus-bdp-stent-versus-tweede-generatie-des-non-inferioriteit/* This randomized trial confirmed that a novel low-dose sirolimus biodegradable polymer stent is noninferior to conventional second-generation DES, advancing stent technology toward safer, lower-drug platforms. ## Colchicine in Acute Myocardial Infarction. *2025-02-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2405922 · https://hartvaat.nl/2025/02/13/clear-synergy-colchicine-bij-acuut-mi-nejm/* The CLEAR SYNERGY trial demonstrated that colchicine initiated within days of acute MI reduced major cardiovascular events by 33% compared with placebo over a median of 3 years. This is the third major positive trial of colchicine in atherosclerotic disease, after COLCOT and LoDoCo2, consolidating anti-inflammatory therapy as a pillar of secondary prevention. ## Routine Spironolactone in Acute Myocardial Infarction. *2025-02-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2405923 · https://hartvaat.nl/2025/02/13/routine-spironolacton-na-acuut-mi-gerandomiseerde-trial-nejm/* This NEJM trial showed that routine spironolactone after acute MI in patients without heart failure or reduced ejection fraction did not significantly reduce the primary composite endpoint. The result limits MRA use after MI to those with established HF or reduced LVEF. ## Phase 3 Trial of Cabozantinib to Treat Advanced Neuroendocrine Tumors. *2025-02-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2403991 · https://hartvaat.nl/2025/02/13/cabozantinib-bij-gevorderde-neuro-endocriene-tumoren-fase-3/* A phase 3 trial evaluated cabozantinib in patients with advanced neuroendocrine tumours, including phaeochromocytoma and paraganglioma. The multikinase inhibitor improved progression-free survival, with relevance to cardiovascular practice through secondary hypertension management. ## Long-Term Lipid Lowering With Evolocumab in Older Individuals. *2025-02-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.019 · https://hartvaat.nl/2025/02/11/langetermijn-evolocumab-bij-ouderen-effectiviteit-en-veiligheid/* This analysis confirmed that long-term evolocumab therapy in older individuals is equally effective and safe as in younger patients, providing age-specific reassurance for PCSK9 inhibitor use in the elderly. ## Intensive Lifestyle Intervention, Cardiac Biomarkers, and Cardiovascular Outcomes in Diabetes: Look AHEAD Cardiac Biomarker Ancillary Study. *2025-02-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.004 · https://hartvaat.nl/2025/02/11/look-ahead-intensieve-leefstijlinterventie-cardiale-biomarkers-en-cv-uitkomsten-/* The Look AHEAD cardiac biomarker analysis showed that intensive lifestyle intervention in diabetes improves troponin and NT-proBNP levels, providing biomarker evidence that weight loss and exercise produce measurable cardiac benefit. ## Improving atrial fibrillation or flutter detection and management by smartphone-based photoplethysmography rhythm monitoring following cardiac surgery: a pragmatic randomized trial. *2025-02-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaf015 · https://hartvaat.nl/2025/02/05/smartphone-ppg-voor-af-detectie-en-management-verbeterde-screening/* This study showed that smartphone-based photoplethysmography effectively detects AF and improves arrhythmia management, demonstrating the potential of consumer-grade technology for post-cardiac surgery rhythm monitoring. ## Pulmonary Vein Isolation With Optimized Linear Ablation vs Pulmonary Vein Isolation Alone for Persistent AF: The PROMPT-AF Randomized Clinical Trial. *2025-02-04 · JAMA · https://doi.org/10.1001/jama.2024.24438 · https://hartvaat.nl/2025/02/04/pvi-met-geoptimaliseerde-lineaire-ablatie-versus-pvi-alleen-bij-persisterend-af/* This randomized trial showed that PVI with optimized linear ablation does not significantly improve outcomes over PVI alone for persistent AF, adding to the evidence that additional lesion sets beyond pulmonary vein isolation have limited benefit. ## Clinical risk prediction, coronary computed tomography angiography, and cardiovascular events in new-onset chest pain: the PROMISE and SCOT-HEART trials. *2025-02-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehae742 · https://hartvaat.nl/2025/02/03/klinische-risicopredictie-ct-coronairangiografie-en-cv-events-bij-nieuwe-angina/* This study showed that coronary CT angiography adds prognostic value beyond clinical risk prediction in patients with new-onset chest pain, supporting CCTA as a first-line investigation for stable angina evaluation. ## Alternative LDL Cholesterol-Lowering Strategy vs High-Intensity Statins in Atherosclerotic Cardiovascular Disease: A Systematic Review and Individual Patient Data Meta-Analysis. *2025-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.3911 · https://hartvaat.nl/2025/02/01/alternatieve-ldl-verlagingsstrategie-versus-hoge-dosis-statine-bij-ascvd-meta-an/* This meta-analysis showed that alternative LDL-lowering strategies (moderate statin plus ezetimibe or PCSK9 inhibitor) achieve comparable cardiovascular outcomes to high-intensity statin monotherapy in ASCVD patients, supporting personalized lipid-lowering approaches. ## Estimated Long-Term Benefits of Finerenone in Heart Failure: A Prespecified Secondary Analysis of the FINEARTS-HF Randomized Clinical Trial. *2025-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.3782 · https://hartvaat.nl/2025/02/01/finearts-hf-geschatte-langetermijnvoordelen-van-finerenon-bij-hartfalen/* This prespecified analysis estimated that finerenone would provide 100+ additional days alive and out of hospital over 5 years in HFpEF, quantifying the lifetime benefit of nonsteroidal MRA therapy in this growing population. ## Effects of a Digital Intervention to Improve DASH and Blood Pressure Among US Adults. *2025-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23887 · https://hartvaat.nl/2025/02/01/digitale-interventie-voor-dash-dieet-en-bloeddrukverlaging-bij-vs-volwassenen/* This study demonstrated that a digital intervention improves DASH diet adherence and blood pressure in US adults with hypertension, showing that technology-delivered nutritional coaching is an effective non-pharmacological treatment. ## Win ratio analysis of transvenous phrenic nerve stimulation to treat central sleep apnoea in heart failure. *2025-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15074 · https://hartvaat.nl/2025/02/01/transveneuze-frenische-zenuwstimulatie-bij-centraal-slaapapneu-en-hartfalen/* This win ratio analysis of phrenic nerve stimulation for central sleep apnea in heart failure showed improved apnea severity and clinical outcomes, supporting neuromodulation as a treatment for this common HF comorbidity. ## Prevalence and characteristics of upfront diuretic resistance in acute heart failure: The P-Value-AHF study. *2025-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15069 · https://hartvaat.nl/2025/02/01/diureticaresistentie-bij-acuut-hartfalen-prevalentie-en-kenmerken/* The P-Value-AHF substudy documented the prevalence and characteristics of upfront diuretic resistance in acute heart failure. Resistance was common and associated with worse outcomes, supporting early identification and escalation to combination diuretic therapy. ## Finerenone and left ventricular hypertrophy in chronic kidney disease and type 2 diabetes. *2025-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14962 · https://hartvaat.nl/2025/02/01/finerenon-en-lvh-bij-ckd-en-diabetes/* This study showed that finerenone reduces left ventricular hypertrophy in patients with CKD and type 2 diabetes, demonstrating a direct cardiac structural benefit of nonsteroidal MRA therapy beyond cardiorenal event reduction. ## Intravenous iron therapy for heart failure and iron deficiency: An updated meta-analysis of randomized clinical trials. *2025-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14905 · https://hartvaat.nl/2025/02/01/iv-ijzer-bij-hartfalen-en-ijzerdeficientie-geactualiseerde-meta-analyse-van-rct-/* This updated meta-analysis of all randomized trials confirmed that intravenous iron in heart failure with iron deficiency significantly reduces heart failure hospitalization without increasing adverse events. The comprehensive evidence supports IV iron as a standard of care in iron-deficient heart failure. ## Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. *2025-01-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2410027 · https://hartvaat.nl/2025/01/30/summit-tirzepatide-bij-hfpef-met-obesitas-nejm/* The SUMMIT trial showed that tirzepatide, a dual GIP/GLP-1 receptor agonist, significantly reduced heart failure hospitalization and cardiovascular death in patients with HFpEF and obesity, with substantial improvements in symptoms, quality of life, and body weight. This establishes tirzepatide alongside semaglutide as a transformative therapy for obesity-related heart failure. ## Continuation versus Interruption of Oral Anticoagulation during TAVI. *2025-01-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2407794 · https://hartvaat.nl/2025/01/30/oac-continueren-versus-onderbreken-tijdens-tavi-gerandomiseerde-trial-nejm/* This NEJM trial showed that continuation of oral anticoagulation during TAVI was noninferior to interruption for the composite of bleeding and thromboembolic events. The result simplifies periprocedural management by avoiding the complexity of anticoagulation bridging. ## Independence of Lipoprotein(a) and Low-Density Lipoprotein Cholesterol-Mediated Cardiovascular Risk: A Participant-Level Meta-Analysis. *2025-01-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069556 · https://hartvaat.nl/2025/01/28/lp-a-en-ldl-cholesterol-onafhankelijke-cv-risicopaden/* This participant-level analysis confirmed that Lp(a) and LDL cholesterol represent independent cardiovascular risk pathways, supporting the concept that both must be addressed for comprehensive atherosclerotic risk reduction. ## Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland. *2025-01-25 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)02679-5 · https://hartvaat.nl/2025/01/25/scot-heart-ct-coronairangiografie-bij-stabiele-thoracale-pijn-tienjaarsresultate/* The 10-year SCOT-HEART follow-up confirmed that coronary CT angiography-guided management of stable chest pain provides sustained cardiovascular benefit, with persistent reductions in MI. The long-term data support CCTA as a cost-effective first-line investigation. ## Abelacimab versus Rivaroxaban in Patients with Atrial Fibrillation. *2025-01-23 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2406674 · https://hartvaat.nl/2025/01/23/abelacimab-versus-rivaroxaban-bij-af-nejm/* This trial demonstrated that abelacimab, a factor XI-targeting monoclonal antibody, significantly reduced major bleeding compared with rivaroxaban while maintaining comparable efficacy in stroke prevention in patients with atrial fibrillation. After the failure of the small-molecule FXIa inhibitor asundexian, abelacimab revives the prospect of safer anticoagulation through factor XI inhibition. ## Initial Decline in Glomerular Filtration Rate With Finerenone in HFmrEF/HFpEF: A Prespecified Analysis of FINEARTS-HF. *2025-01-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.11.020 · https://hartvaat.nl/2025/01/21/finearts-hf-initiele-egfr-dip-met-finerenon-bij-hfpef-is-veilig/* This FINEARTS-HF analysis confirmed that the initial eGFR decline with finerenone is predictable, manageable, and not associated with adverse kidney or clinical outcomes, supporting continued therapy despite creatinine changes. ## Finerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction: Prespecified Analysis of FINEARTS-HF. *2025-01-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.10.111 · https://hartvaat.nl/2025/01/21/finearts-hf-finerenon-en-obesitas-bij-hfmref-hfpef/* This FINEARTS-HF analysis showed that finerenone provides consistent heart failure benefit regardless of obesity status, relevant given the proposed role of adipocyte-derived aldosterone in the obesity-HFpEF phenotype. ## Oral Muvalaplin for Lowering of Lipoprotein(a): A Randomized Clinical Trial. *2025-01-21 · JAMA · https://doi.org/10.1001/jama.2024.24017 · https://hartvaat.nl/2025/01/21/muvalaplin-orale-lp-a-verlaging-nejm-gerandomiseerde-trial/* This randomized trial demonstrated that muvalaplin, the first oral lipoprotein(a) inhibitor, produced dose-dependent Lp(a) reductions of up to 85% with an acceptable safety profile. An oral Lp(a)-lowering agent could dramatically expand access to treatment compared with injectable alternatives like olpasiran and pelacarsen. ## Effect of Finerenone on the KCCQ in Patients With HFmrEF/HFpEF: A Prespecified Analysis of FINEARTS-HF. *2025-01-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.09.023 · https://hartvaat.nl/2025/01/21/finearts-hf-finerenon-en-kccq-bij-hfmref-hfpef/* This prespecified FINEARTS-HF analysis showed that finerenone significantly improves KCCQ health status scores in HFmrEF/HFpEF, demonstrating patient-centered symptom benefit alongside the clinical event reduction. ## Finerenone and Kidney Outcomes in Patients With Heart Failure: The FINEARTS-HF Trial. *2025-01-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.10.091 · https://hartvaat.nl/2025/01/21/finearts-hf-finerenon-en-nieruitkomsten-bij-hfpef/* This FINEARTS-HF kidney analysis showed that finerenone causes a predictable, reversible initial eGFR decline in HFpEF without compromising long-term kidney outcomes, providing reassurance about renal safety. ## Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis and Myocardial Fibrosis: The EVOLVED Randomized Clinical Trial. *2025-01-21 · JAMA · https://doi.org/10.1001/jama.2024.22730 · https://hartvaat.nl/2025/01/21/evolved-vroege-interventie-bij-asymptomatische-ernstige-aortastenose-met-myocard/* The EVOLVED trial demonstrated that early aortic valve intervention guided by myocardial fibrosis on cardiac MRI reduced all-cause death and unplanned heart failure hospitalization in patients with asymptomatic severe aortic stenosis. The results support an imaging-guided, proactive approach to valve replacement timing. ## Fractional Flow Reserve and Instantaneous Wave-Free Ratio as Predictors of the Placebo-Controlled Response to Percutaneous Coronary Intervention in Stable Coronary Artery Disease. *2025-01-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.072281 · https://hartvaat.nl/2025/01/21/ffr-en-ifr-als-voorspellers-van-placebo-gecontroleerd-pci-effect/* This analysis from ORBITA-2 showed that lower FFR and iFR values predict greater placebo-controlled symptom improvement from PCI, supporting the use of physiological assessment to select patients most likely to benefit from revascularization. ## Finerenone in Patients With a Recent Worsening Heart Failure Event: The FINEARTS-HF Trial. *2025-01-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.09.004 · https://hartvaat.nl/2025/01/21/finearts-hf-finerenon-bij-recent-verslechterend-hartfalen/* This FINEARTS-HF subanalysis confirmed that finerenone is effective in patients with recent worsening heart failure events, supporting its use in the higher-acuity HFpEF population at greatest risk of recurrence. ## Transcatheter Edge-to-Edge Repair for Severe Isolated Tricuspid Regurgitation: The Tri.Fr Randomized Clinical Trial. *2025-01-14 · JAMA · https://doi.org/10.1001/jama.2024.21189 · https://hartvaat.nl/2025/01/14/tri-fr-transcatheter-edge-to-edge-repair-bij-geisoleerde-ernstige-tr-rct/* The Tri.Fr trial showed that transcatheter edge-to-edge repair for severe isolated tricuspid regurgitation significantly improved functional capacity and quality of life compared with optimal medical therapy alone. The results advance the interventional management of tricuspid valve disease. ## Effects of the Nonsteroidal MRA Finerenone With and Without Concomitant SGLT2 Inhibitor Use in Heart Failure. *2025-01-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.072055 · https://hartvaat.nl/2025/01/14/finearts-hf-finerenon-met-en-zonder-sglt2-remmer-bij-hfpef/* This analysis showed that finerenone provides consistent heart failure benefit regardless of concurrent SGLT2 inhibitor use, confirming additive cardiorenal protection when combining nonsteroidal MRA with SGLT2 inhibition. ## Association between NT-proBNP levels and risk of atrial fibrillation: a systematic review and meta-analysis of cohort studies. *2025-01-13 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324685 · https://hartvaat.nl/2025/01/13/nt-probnp-en-af-risico-systematische-review-en-meta-analyse/* This meta-analysis confirmed the strong association between NT-proBNP levels and AF risk, supporting natriuretic peptide measurement as a pre-screening tool for targeted arrhythmia surveillance. ## Transcatheter Valve Replacement in Severe Tricuspid Regurgitation. *2025-01-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2401918 · https://hartvaat.nl/2025/01/09/transcatheter-klepvervanging-bij-ernstige-tricuspidalisinsufficientie-nejm/* This NEJM trial showed that transcatheter tricuspid valve replacement significantly improved symptoms, quality of life, and functional status in patients with severe tricuspid regurgitation. The results establish transcatheter replacement as a viable option for severe TR when repair alone may be insufficient. ## Plozasiran for Managing Persistent Chylomicronemia and Pancreatitis Risk. *2025-01-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2409368 · https://hartvaat.nl/2025/01/09/plozasiran-bij-persisterende-chylomicronemie-en-pancreatitisrisico-nejm/* This NEJM trial demonstrated that plozasiran, an siRNA targeting APOC3, dramatically reduced triglycerides and prevented pancreatitis episodes in patients with persistent chylomicronemia from both genetic and multifactorial causes. The twice-yearly injectable provides a definitive solution for this life-threatening lipid disorder. ## Optimal Strategy for Complete Revascularization in ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A Network Meta-Analysis. *2025-01-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.09.1231 · https://hartvaat.nl/2025/01/07/optimale-strategie-voor-complete-revascularisatie-bij-stemi-met-meervatslijden-m/* This meta-analysis compared different complete revascularization strategies in STEMI with multivessel disease, finding that immediate complete PCI during the index procedure is noninferior to staged approaches. ## Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial. *2025-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae804 · https://hartvaat.nl/2025/01/07/urinair-wijnzuur-als-biomarker-voor-wijnconsumptie-en-cv-risico-predimed/* A PREDIMED case-cohort analysis demonstrated that urinary tartaric acid is a reliable objective biomarker of wine consumption and is associated with cardiovascular risk. Objective measurement of alcohol intake improves the quality of nutritional epidemiological research. ## Definitions of clinical study outcome measures for cardiovascular diseases: the European Unified Registries for Heart Care Evaluation and Randomized Trials (EuroHeart). *2025-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae724 · https://hartvaat.nl/2025/01/07/euroheart-definities-van-klinische-studie-eindpunten-voor-cvd/* The EuroHeart project standardised definitions for clinical study outcome measures in cardiovascular disease across registries and trials. Uniform endpoint definitions are essential for producing comparable results across European cardiovascular research. ## Drug-Coated Balloon Angioplasty of the Side Branch During Provisional Stenting: The Multicenter Randomized DCB-BIF Trial. *2025-01-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.067 · https://hartvaat.nl/2025/01/07/dcb-voor-zijtak-bij-provisionale-stenting-gerandomiseerde-trial/* This multicenter RCT evaluated drug-coated balloon treatment of the compromised side branch during provisional coronary stenting, testing a leave-nothing-behind approach for bifurcation lesion management. ## Efficacy and Safety of Finerenone Across the Ejection Fraction Spectrum in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Analysis of the FINEARTS-HF Trial. *2025-01-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.072011 · https://hartvaat.nl/2025/01/07/finearts-hf-finerenon-effectief-over-het-hele-ef-spectrum-bij-hfmref-hfpef/* This FINEARTS-HF subanalysis confirmed that finerenone's benefit on heart failure events is consistent across the entire ejection fraction spectrum from 40% to 100%. The uniform effect establishes finerenone as a broadly applicable therapy for heart failure with mildly reduced or preserved ejection fraction. ## Radiofrequency catheter ablation of persistent atrial fibrillation by pulmonary vein isolation with or without left atrial posterior wall isolation: long-term outcomes of the CAPLA trial. *2025-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae580 · https://hartvaat.nl/2025/01/07/pvi-met-versus-zonder-posteriore-wand-isolatie-bij-persisterend-af-rct/* This randomized trial confirmed that adding posterior wall isolation to PVI during persistent AF ablation does not significantly improve freedom from arrhythmia, consistent with multiple prior studies. ## Asundexian versus Apixaban in Patients with Atrial Fibrillation. *2025-01-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2407105 · https://hartvaat.nl/2025/01/02/oceanic-af-asundexian-versus-apixaban-bij-af-nejm/* The OCEANIC-AF trial showed that asundexian, a factor XIa inhibitor, was inferior to apixaban in preventing stroke and systemic embolism in patients with atrial fibrillation, without a meaningful reduction in bleeding. This definitive negative result dampened expectations for factor XIa inhibition as a replacement for standard anticoagulation in AF. ## Finerenone in Women and Men With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Secondary Analysis of the FINEARTS-HF Randomized Clinical Trial. *2025-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4613 · https://hartvaat.nl/2025/01/01/finearts-hf-finerenon-gelijk-effectief-bij-vrouwen-en-mannen-met-hfpef/* This FINEARTS-HF sex-stratified analysis confirmed that finerenone provides equal heart failure benefit in women and men with HFmrEF/HFpEF, supporting sex-neutral prescribing of the nonsteroidal MRA. ## Partial Cardiac Denervation to Prevent Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: The pCAD-POAF Randomized Clinical Trial. *2025-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4639 · https://hartvaat.nl/2025/01/01/gedeeltelijke-cardiale-denervatie-voorkomt-af-na-cabg-rct/* This randomized trial showed that partial cardiac denervation (autonomic ganglionated plexus ablation) during CABG significantly reduces postoperative AF, adding a simple surgical technique to the AF prevention armamentarium. ## Electronic Nudges and Influenza Vaccination Among Patients With a History of Myocardial Infarction: Insights From 3 Nationwide Randomized Clinical Trials. *2025-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4648 · https://hartvaat.nl/2025/01/01/nudge-flu-subanalyse-griepvaccinatie-nudges-bij-mi-langetermijn/* Long-term analysis of three NUDGE-FLU nationwide trials confirmed that electronically delivered behavioural nudges sustainably increase influenza vaccination rates among post-myocardial infarction patients. The intervention is scalable and cost-effective for this high-risk population. ## Finerenone, Serum Potassium, and Clinical Outcomes in Heart Failure With Mildly Reduced or Preserved Ejection Fraction. *2025-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4539 · https://hartvaat.nl/2025/01/01/finearts-hf-finerenon-kalium-en-klinische-uitkomsten-bij-hfpef/* This analysis of finerenone-associated potassium changes in HFpEF showed that hyperkalemia occurs but is manageable with monitoring, providing practical safety data for MRA use in the preserved ejection fraction population. ## Interpreting Population Mean Treatment Effects in the Kansas City Cardiomyopathy Questionnaire: A Patient-Level Meta-Analysis. *2025-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4470 · https://hartvaat.nl/2025/01/01/kccq-interpretatie-bij-hartfalen-patient-ankering/* A patient-level meta-analysis across 11 heart failure trials established anchor-based thresholds for interpreting mean KCCQ treatment effects. These patient-anchored benchmarks help translate population-level trial results into clinically meaningful individual benefit. ## Microaxial Flow Pump Hemodynamic and Metabolic Effects in Infarct-Related Cardiogenic Shock: A Substudy of the DanGer Shock Randomized Clinical Trial. *2025-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.4197 · https://hartvaat.nl/2025/01/01/danger-shock-hemodynamische-en-metabole-effecten-van-impella-bij-cardiogene-shoc/* This DanGer Shock hemodynamic substudy detailed the cardiac output improvement and metabolic normalization achieved with Impella CP, characterizing the mechanism by which microaxial flow pump support improves survival in cardiogenic shock. ## Coronary Revascularization Guided With Fractional Flow Reserve or Instantaneous Wave-Free Ratio: A 5-Year Follow-Up of the DEFINE FLAIR Randomized Clinical Trial. *2025-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.3314 · https://hartvaat.nl/2025/01/01/ffr-versus-ifr-bij-coronaire-revascularisatie-vijfjaars-follow-up/* Five-year follow-up confirmed that FFR-guided and iFR-guided coronary revascularization produce identical long-term outcomes, providing the most robust evidence for the interchangeability of these physiological assessment tools. ## Reproducibility and Treatment Effect on Office and Ambulatory Pressure Relation. *2025-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23549 · https://hartvaat.nl/2025/01/01/reproduceerbaarheid-en-behandeleffect-op-kantoor-versus-ambulante-bloeddrukrelat/* Using data from the ELSA and PHYLLIS trials, this study examined the reproducibility of the office-to-ambulatory blood pressure relationship and its stability during antihypertensive treatment. The findings inform optimal blood pressure measurement strategies for therapy monitoring. ## A sub-study of the POISE-3 randomized trial examined effects of a perioperative hypotension-avoidance strategy versus a hypertension-avoidance strategy on the risk of acute kidney injury. *2025-01-01 · Kidney international · https://doi.org/10.1016/j.kint.2024.10.007 · https://hartvaat.nl/2025/01/01/poise-3-substudie-perioperatieve-hypotensievermijding-en-orgaanschade/* This POISE-3 substudy showed that a perioperative hypotension-avoidance strategy reduces kidney injury and myocardial damage, informing hemodynamic management during non-cardiac surgery. ## Effects of dialysate potassium concentration of 3.0 mmol/l with sodium zirconium cyclosilicate on dialysis-free days versus dialysate potassium concentration of 2.0 mmol/l alone on rates of cardiac arrhythmias in hemodialysis patients with hyperkalemia. *2025-01-01 · Kidney international · https://doi.org/10.1016/j.kint.2024.10.010 · https://hartvaat.nl/2025/01/01/dialysaat-kalium-3-0-mmol-l-met-natriumzirconiumcyclosilicaat-bij-dialyse/* This trial compared a higher dialysate potassium concentration (3.0 mmol/L) combined with oral sodium zirconium cyclosilicate versus standard low-potassium dialysate in haemodialysis patients with hyperkalaemia. The novel strategy safely reduced interdialytic hyperkalaemia and cardiac arrhythmias. ## An expert narrative review on the mechanisms and therapeutic potential of gut microbiota-derived metabolites in multi-organ crosstalk. *2025-01-01 · Frontiers in endocrinology · https://doi.org/10.3389/fendo.2025.1706353 · https://hartvaat.nl/2025/01/01/nieuwe-therapeutische-mogelijkheden-voor-cholesterolverlaging-een-expertreview/* This expert narrative review discusses gut microbiota-derived metabolites — short-chain fatty acids, tryptophan derivatives, and uraemic toxins — and their role in multi-organ crosstalk along the gut-kidney-heart-brain-endocrine axis. ## Effect of targeted education of patients with atrial fibrillation on unplanned cardiovascular outcomes: results of the multicentre randomized AF-EduCare trial. *2024-12-26 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae211 · https://hartvaat.nl/2024/12/26/gerichte-patienteneducatie-vermindert-ongeplande-cv-events-bij-af/* This randomized trial showed that targeted patient education about AF improves understanding and reduces unplanned cardiovascular events, supporting structured educational programs as part of integrated AF care. ## Microaxial Flow Pump Use and Renal Outcomes in Infarct-Related Cardiogenic Shock: A Secondary Analysis of the DanGer Shock Trial. *2024-12-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.072370 · https://hartvaat.nl/2024/12/17/danger-shock-impella-en-nieruitkomsten-bij-cardiogene-shock/* This DanGer Shock secondary analysis showed that Impella CP support may improve renal outcomes in infarct-related cardiogenic shock, suggesting that mechanical circulatory support provides renal hemodynamic benefits in addition to cardiac support. ## Ablation Strategies for Repeat Procedures in Atrial Fibrillation Recurrences Despite Durable Pulmonary Vein Isolation: The Prospective Randomized ASTRO AF Multicenter Trial. *2024-12-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069993 · https://hartvaat.nl/2024/12/17/ablatiestrategie-bij-af-recidief-na-duurzame-pvi/* This study characterized ablation strategies for AF recurrence despite confirmed durable pulmonary vein isolation, showing that non-PV triggers and atrial substrate modification are necessary for these challenging cases. ## Apolipoprotein A-I infusions and cardiovascular outcomes in acute myocardial infarction according to baseline LDL-cholesterol levels: the AEGIS-II trial. *2024-12-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehae614 · https://hartvaat.nl/2024/12/16/apoa-i-infusie-na-mi-naar-lp-a-niveau-aegis-ii-subanalyse/* An AEGIS-II subanalysis investigated whether the efficacy of apolipoprotein A-I infusion after acute MI varies by baseline LDL-cholesterol level. No differential effect was observed, confirming that the apoA-I infusion strategy is ineffective regardless of baseline lipid profile. ## Glycoprotein IIb/IIIa inhibitors in acute myocardial infarction and angiographic microvascular obstruction: the REVERSE-FLOW trial. *2024-12-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehae587 · https://hartvaat.nl/2024/12/16/gp-iib-iiia-remmers-bij-acuut-mi-en-microvasculaire-obstructie-meta-analyse/* The REVERSE-FLOW trial randomised patients with acute myocardial infarction and angiographic microvascular obstruction to GP IIb/IIIa inhibitors versus standard care. The antiplatelet agents modestly reduced microvascular obstruction but did not significantly improve hard clinical endpoints. ## Fasting vs. no fasting prior to catheterization laboratory procedures: the SCOFF trial. *2024-12-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehae573 · https://hartvaat.nl/2024/12/16/scoff-nuchter-versus-niet-nuchter-voor-hartkatheterisatie-rct/* The SCOFF trial showed that not fasting before catheterization laboratory procedures with conscious sedation is as safe as the traditional 6-hour fasting requirement, simplifying pre-procedural preparation for cardiac catheterization. ## Biomarker-based prediction of sinus rhythm in atrial fibrillation patients: the EAST-AFNET 4 biomolecule study. *2024-12-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehae611 · https://hartvaat.nl/2024/12/16/biomarkervoorspelling-van-sinusritme-bij-af-east-afnet-4-biomoleculaire-analyse/* This EAST-AFNET 4 biomolecular study identified circulating biomarkers that predict sinus rhythm maintenance after early rhythm control in AF, advancing precision medicine approaches to rhythm management. ## Aspirin vs. clopidogrel monotherapy after percutaneous coronary intervention: 1-year follow-up of the STOPDAPT-3 trial. *2024-12-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehae617 · https://hartvaat.nl/2024/12/16/aspirine-versus-clopidogrel-na-pci-eenjaars-follow-up-van-rct/* One-year STOPDAPT-3 data confirmed clopidogrel monotherapy superiority over aspirin after PCI, consistent with HOST-EXAM and other trials, reinforcing clopidogrel as the preferred long-term single antiplatelet agent. ## PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation. *2024-12-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2401513 · https://hartvaat.nl/2024/12/12/pci-bij-patienten-die-tavi-ondergaan-gerandomiseerde-trial-nejm/* This NEJM trial showed that PCI of coronary stenoses before TAVR did not improve the composite of death or cardiovascular hospitalization compared with conservative management. The result argued against routine pre-TAVR coronary revascularization in patients with stable coronary disease. ## Major Bleeding and Mortality After Revascularization of Left Main Disease. *2024-12-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.07.065 · https://hartvaat.nl/2024/12/10/ernstige-bloeding-en-mortaliteit-na-revascularisatie-van-linker-hoofdstam/* This analysis documented the incidence and prognostic impact of major bleeding after left main revascularization, showing that bleeding complications significantly increase mortality for both PCI and CABG approaches. ## Clinical Correlates and Prognostic Impact of Cognitive Dysfunction in Patients With Heart Failure and Preserved Ejection Fraction: Insights From PARAGON-HF. *2024-12-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.070553 · https://hartvaat.nl/2024/12/10/cognitieve-disfunctie-bij-hfpef-klinische-correlaten-en-prognostische-impact/* Analysis of the PARAGON-HF substudy documented the prevalence and prognostic impact of cognitive dysfunction in patients with HFpEF. Cognitive impairment was common and independently associated with worse outcomes, highlighting the need for screening and integrated multidisciplinary care. ## Interatrial Shunt Treatment for Heart Failure: The Randomized RELIEVE-HF Trial. *2024-12-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.070870 · https://hartvaat.nl/2024/12/10/relieve-hf-interatriale-shunt-bij-hartfalen-negatieve-gerandomiseerde-trial/* The RELIEVE-HF trial definitively showed that the interatrial shunt device does not improve clinical outcomes in heart failure, ending the therapeutic pursuit of creating a controlled left-to-right atrial shunt for heart failure management. ## Hospitalization of Symptomatic Patients With Heart Failure and Moderate to Severe Functional Mitral Regurgitation Treated With MitraClip: Insights From RESHAPE-HF2. *2024-12-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.027 · https://hartvaat.nl/2024/12/10/hospitalisatie-bij-symptomatische-hf-met-matige-tot-ernstige-functionele-mr/* An analysis of RESHAPE-HF2 assessed the impact of MitraClip on hospitalisation rates in patients with symptomatic heart failure and moderate to severe functional mitral regurgitation. The findings support early intervention in patients with recurrent heart failure hospitalisations. ## Efficacy and Safety of a Novel Low-Dose Triple Single-Pill Combination Compared With Placebo for Initial Treatment of Hypertension. *2024-12-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.025 · https://hartvaat.nl/2024/12/10/lage-dosis-triple-combinatiepil-versus-placebo-bij-initiele-hypertensiebehandeli/* This randomized trial confirmed that a low-dose triple combination pill is significantly more effective than placebo for initial hypertension treatment, validating the ultra-low-dose multi-drug approach as a first-line strategy. ## Anticoagulation in device-detected atrial fibrillation with or without vascular disease: a combined analysis of the NOAH-AFNET 6 and ARTESiA trials. *2024-12-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae596 · https://hartvaat.nl/2024/12/07/anticoagulatie-bij-device-gedetecteerd-af-met-zonder-vaatlijden-noah-artesia-gec/* This combined NOAH-ARTESIA analysis examined whether concomitant vascular disease modifies the benefit of anticoagulation for device-detected subclinical AF, informing risk-stratified treatment decisions in this growing patient population. ## Edoxaban Antithrombotic Therapy for Atrial Fibrillation and Stable Coronary Artery Disease. *2024-12-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2407362 · https://hartvaat.nl/2024/12/05/edoxaban-bij-af-en-stabiel-coronairlijden-antitrombotische-monotherapie/* This NEJM trial provided randomized evidence that edoxaban monotherapy is appropriate for AF patients with stable coronary artery disease, supporting the transition from combined antithrombotic therapy to anticoagulant alone. ## Inflammation, Cholesterol, Lipoprotein(a), and 30-Year Cardiovascular Outcomes in Women. *2024-12-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2405182 · https://hartvaat.nl/2024/12/05/inflammatie-cholesterol-lp-a-en-30-jaars-cv-uitkomsten-bij-vrouwen/* This 30-year follow-up study in women demonstrated that hsCRP, LDL cholesterol, and Lp(a) independently predict cardiovascular events over three decades, establishing that these biomarkers provide meaningful long-term risk prediction well beyond the standard 10-year horizon. ## Using computed tomography atrial myocardial thickness maps in cryoballoon pulmonary vein isolation: the UTMOST AF II randomized clinical trial. *2024-12-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae292 · https://hartvaat.nl/2024/12/03/ct-gestuurde-atriale-wanddiktemapping-bij-cryoballon-pvi/* The UTMOST AF II trial evaluated CT-based left atrial wall thickness mapping to guide personalised cryoballoon pulmonary vein isolation for paroxysmal AF. The thickness-guided approach did not demonstrate superiority over empirical ablation duration. ## Multielectrode catheter-based pulsed electric field vs. cryoballoon for atrial fibrillation ablation: a systematic review and meta-analysis. *2024-12-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae293 · https://hartvaat.nl/2024/12/03/pfa-versus-cryoballon-voor-af-ablatie-multielectrode-vergelijking/* This systematic review compared multielectrode pulsed field ablation with cryoballoon for AF treatment, finding that PFA is noninferior with comparable efficacy and potentially fewer extracardiac complications. ## Randomized Invitation to Systematic NT-proBNP and ECG Screening in 75-Year-Olds to Detect Atrial Fibrillation: STROKESTOP II. *2024-12-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.071176 · https://hartvaat.nl/2024/12/03/nt-probnp-en-ecg-screening-bij-75-jarigen-voor-af-detectie-rct/* This randomized trial of systematic NT-proBNP and ECG screening for AF in 75-year-olds showed increased AF detection, though the impact on downstream clinical outcomes requires longer follow-up to establish the value of population-level screening. ## Restrictive Versus Liberal Transfusion in Patients With Type 1 or Type 2 Myocardial Infarction: A Prespecified Analysis of the MINT Trial. *2024-12-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.071208 · https://hartvaat.nl/2024/12/03/restrictief-versus-liberaal-transfusiebeleid-bij-type-1-versus-type-2-mi-reality/* This REALITY prespecified analysis confirmed that restrictive transfusion is safe in both type 1 and type 2 MI patients, showing that MI subtype does not modify the transfusion strategy decision. ## Utility of a Systolic Blood Pressure Polygenic Risk Score With Chlorthalidone Response. *2024-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.3649 · https://hartvaat.nl/2024/12/01/polygene-risicoscore-en-chloortalidone-respons/* This GenHAT/ALLHAT ancillary study investigated whether a polygenic risk score for systolic blood pressure predicts response to chlorthalidone treatment. The genetic score had limited predictive value for individual antihypertensive treatment response. ## Short-Term Dual Antiplatelet Therapy After Drug-Eluting Stenting in Patients With Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis. *2024-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.3216 · https://hartvaat.nl/2024/12/01/korte-dapt-na-des-bij-acs-ipd-meta-analyse-bevestigt-veiligheid/* This individual patient data meta-analysis confirmed that short-term DAPT (1-3 months) after drug-eluting stenting in ACS patients is safe with fewer bleeding events, providing the strongest patient-level evidence for abbreviated antiplatelet therapy. ## Endovascular Ablation of the Greater Splanchnic Nerve in Heart Failure With Preserved Ejection Fraction: The REBALANCE-HF Randomized Clinical Trial. *2024-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2612 · https://hartvaat.nl/2024/12/01/splanchnische-zenuwablatie-bij-hfpef-endovasculaire-benadering/* This study of endovascular greater splanchnic nerve ablation in HFpEF showed reduced exertional pulmonary capillary wedge pressure, exploring a novel neuromodulation approach targeting the splanchnic circulation to improve hemodynamics in heart failure. ## Lesion-Level Effects of LDL-C-Lowering Therapy in Patients With Acute Myocardial Infarction: A Post Hoc Analysis of the PACMAN-AMI Trial. *2024-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.3200 · https://hartvaat.nl/2024/12/01/ldl-verlaging-en-lesie-niveau-effecten-na-acuut-mi/* This post-hoc analysis examined the lesion-level effects of LDL cholesterol lowering after MI, showing that lower achieved LDL is associated with greater plaque regression in individual coronary lesions. ## Colchicine in acutely decompensated heart failure: the COLICA trial. *2024-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae538 · https://hartvaat.nl/2024/12/01/colica-colchicine-bij-acuut-gedecompenseerd-hartfalen/* The COLICA trial explored colchicine in acutely decompensated heart failure, testing whether anti-inflammatory therapy can improve decongestion and outcomes in this inflammatory-activated condition. ## Predictive value of NT pro BNP for new-onset atrial fibrillation in heart failure and preserved ejection fraction. *2024-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14951 · https://hartvaat.nl/2024/12/01/nt-probnp-voorspelt-nieuw-ontstaan-af-bij-hfpef/* A TOPCAT substudy demonstrated that NT-proBNP is a strong predictor of new-onset atrial fibrillation in patients with heart failure with preserved ejection fraction. The biomarker could improve selection of HFpEF patients for targeted AF screening programmes. ## Heart rate reactivity, recovery, and endurance of the incremental shuttle walk test in patients prone to heart failure. *2024-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15000 · https://hartvaat.nl/2024/12/01/hartfrequentiereactiviteit-en-inspanningstolerantie-bij-hartfalen/* Analysis of the HOMAGE trial examined heart rate reactivity and recovery during the incremental shuttle walk test in patients prone to heart failure. Chronotropic incompetence predicted worse exercise endurance and was not modified by spironolactone treatment. ## Systematic review and meta-analysis to predict mortality in heart failure with preserved ejection fraction: Development and validation of the HF-DANAS score. *2024-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.15008 · https://hartvaat.nl/2024/12/01/mortaliteitsvoorspelling-bij-hfpef-systematische-review-en-meta-analyse/* This meta-analysis identified the strongest mortality predictors in HFpEF — age, NT-proBNP, renal function, and functional status — and developed the HF-DANAS risk score. Integrated prognostic models are needed for better risk stratification in this growing patient population. ## Emergent role of dynamic optimization in cardiac resynchronization therapy: Systematic review and network meta-analysis. *2024-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14957 · https://hartvaat.nl/2024/12/01/dynamische-optimalisatie-bij-crt-systematische-review-en-netwerk-meta-analyse/* A systematic review and network meta-analysis investigated optimisation strategies for cardiac resynchronisation therapy. Dynamic algorithms that continuously adapt device settings to changing haemodynamics showed promise for improving CRT response rates compared with empirical or static programming. ## Impact of SGLT2 inhibition on markers of reverse cardiac remodelling in heart failure: Systematic review and meta-analysis. *2024-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14993 · https://hartvaat.nl/2024/12/01/sglt2-remming-en-cardiale-reverse-remodelling-bij-hartfalen-systematische-review/* This meta-analysis confirmed that SGLT2 inhibitors promote reverse cardiac remodeling in heart failure, with measurable improvements in LV volumes, mass, and ejection fraction that explain the clinical outcomes benefit. ## Effect of sex on sodium-glucose co-transporter-2 antagonists and glucagon-like peptide-1 agonists in heart failure. *2024-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14979 · https://hartvaat.nl/2024/12/01/sekseverschillen-in-effect-van-sglt2-remmers-en-glp-1-agonisten-meta-analyse/* This meta-analysis found that both SGLT2 inhibitors and GLP-1 receptor agonists provide comparable cardiovascular benefit in men and women with heart failure, supporting equal treatment across sexes for these newer cardioprotective drug classes. ## Mesenchymal stromal cells to treat patients with non-ischaemic heart failure: Results from SCIENCE II pilot study. *2024-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14925 · https://hartvaat.nl/2024/12/01/science-ii-mesenchymale-stamcellen-bij-niet-ischemisch-hartfalen-negatieve-trial/* The SCIENCE II pilot study showed that allogeneic mesenchymal stromal cells in non-ischemic heart failure do not improve clinical outcomes, adding to the negative evidence for stem cell therapy in cardiomyopathy. ## Sacubitril/Valsartan in Pediatric Heart Failure (PANORAMA-HF): A Randomized, Multicenter, Double-Blind Trial. *2024-11-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066605 · https://hartvaat.nl/2024/11/26/panorama-hf-sacubitril-valsartan-bij-pediatrisch-hartfalen-nejm/* The PANORAMA-HF trial showed that sacubitril-valsartan did not significantly improve the primary composite endpoint in pediatric heart failure, highlighting the challenges of translating adult HF therapies to the pediatric population. ## ApoA-I Infusions and Burden of Ischemic Events After Acute Myocardial Infarction: Insights From the AEGIS-II Trial. *2024-11-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.001 · https://hartvaat.nl/2024/11/26/aegis-ii-subanalyse-apoa-i-infusie-en-ischemische-eventlast-na-mi/* A prespecified analysis of AEGIS-II examined the effect of apolipoprotein A-I infusion on total ischaemic event burden after acute myocardial infarction. No benefit was observed, definitively establishing the failure of the HDL infusion strategy in this setting. ## Risk of Stroke or Systemic Embolism According to Baseline Frequency and Duration of Subclinical Atrial Fibrillation: Insights From the ARTESiA Trial. *2024-11-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069903 · https://hartvaat.nl/2024/11/26/artesia-subanalyse-cva-risico-naar-frequentie-en-duur-van-subclinisch-af/* This ARTESIA subanalysis showed that the stroke risk and benefit of apixaban increase with higher frequency and longer duration of subclinical AF episodes, supporting dose-response-based anticoagulation decisions for device-detected arrhythmia. ## Cardiovascular, Kidney, and Safety Outcomes With GLP-1 Receptor Agonists Alone and in Combination With SGLT2 Inhibitors in Type 2 Diabetes: A Systematic Review and Meta-Analysis. *2024-11-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.071689 · https://hartvaat.nl/2024/11/26/glp-1-agonisten-alleen-en-met-sglt2-remmers-cv-renale-en-veiligheidsuitkomsten/* This comprehensive meta-analysis confirmed that GLP-1 receptor agonists and SGLT2 inhibitors provide complementary cardiovascular and kidney protection in patients with type 2 diabetes. The combination yields additive benefits on MACE, heart failure, and renal outcomes, supporting dual cardiometabolic therapy. ## Effect of Screening for Undiagnosed Atrial Fibrillation on Stroke Prevention. *2024-11-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.019 · https://hartvaat.nl/2024/11/19/screening-op-niet-gediagnosticeerd-af-voor-cva-preventie-gerandomiseerde-trial/* This randomized trial of AF screening versus usual care demonstrated that screening detects more undiagnosed AF and increases anticoagulation initiation, though the impact on stroke incidence was not statistically significant. Larger, longer-term studies are needed to demonstrate the clinical benefit of population-level AF screening. ## Flecainide to Prevent Atrial Arrhythmia After Patent Foramen Ovale Closure: AFLOAT Study, A Randomized Clinical Trial. *2024-11-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.071186 · https://hartvaat.nl/2024/11/19/afloat-flecainide-voorkomt-af-na-pfo-sluiting-rct/* The AFLOAT trial showed that flecainide significantly prevents atrial arrhythmias after PFO closure, establishing prophylactic antiarrhythmic therapy as an effective strategy for this common post-procedural complication. ## Sudden cardiac death after myocardial infarction: individual participant data from pooled cohorts. *2024-11-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehae326 · https://hartvaat.nl/2024/11/14/plotse-hartdood-na-mi-ipd-analyse-van-gepoolde-cohorten/* This individual participant data analysis identified risk factors for sudden cardiac death after MI in the modern GDMT era, finding that the risk has decreased but remains significant and is not captured by ejection fraction alone. ## Transcatheter Repair versus Mitral-Valve Surgery for Secondary Mitral Regurgitation. *2024-11-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2408739 · https://hartvaat.nl/2024/11/14/matterhorn-transcatheter-repair-versus-chirurgie-bij-secundaire-mr-nejm/* The MATTERHORN trial demonstrated that transcatheter edge-to-edge mitral valve repair was noninferior to surgical mitral valve intervention for reducing mitral regurgitation severity in patients with heart failure and secondary MR, with fewer perioperative complications. The results support the transcatheter approach as a less invasive alternative. ## Transcatheter Valve Repair in Heart Failure with Moderate to Severe Mitral Regurgitation. *2024-11-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2314328 · https://hartvaat.nl/2024/11/14/reshape-hf2-transcatheter-kleprepair-bij-hf-met-matige-tot-ernstige-mr-nejm/* The RESHAPE-HF2 trial showed that transcatheter mitral valve repair improved outcomes in patients with heart failure and moderate-to-severe secondary mitral regurgitation, adding to the COAPT evidence for device therapy in functional MR. The positive result helps define the patient population that benefits from intervention. ## Optical coherence tomography predictors of clinical outcomes after stent implantation: the ILUMIEN IV trial. *2024-11-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehae521 · https://hartvaat.nl/2024/11/14/ilumien-iv-oct-predictoren-van-klinische-uitkomsten-na-stentimplantatie/* This ILUMIEN IV analysis identified OCT-derived parameters (minimum stent area, dissection, malapposition) that predict clinical outcomes after PCI, informing the criteria for procedural optimization with intravascular imaging. ## Recaticimab as Add-On Therapy to Statins for Nonfamilial Hypercholesterolemia: The Randomized, Phase 3 REMAIN-2 Trial. *2024-11-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.09.012 · https://hartvaat.nl/2024/11/12/recaticimab-als-toevoeging-aan-statines-fase-3-remain-2/* The REMAIN-2 trial showed that recaticimab added to statin therapy provides additional LDL cholesterol lowering in patients not reaching goals on statins alone, confirming the efficacy of this new PCSK9 antibody in combination therapy. ## Recaticimab Monotherapy for Nonfamilial Hypercholesterolemia and Mixed Hyperlipemia: The Phase 3 REMAIN-1 Randomized Trial. *2024-11-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.07.035 · https://hartvaat.nl/2024/11/12/recaticimab-monotherapie-bij-niet-familiaire-hypercholesterolemie-fase-3-remain-/* The REMAIN-1 trial of recaticimab, a Chinese-developed anti-PCSK9 antibody, showed significant LDL cholesterol reduction as monotherapy in nonfamilial hypercholesterolemia, expanding the global PCSK9 inhibitor landscape. ## Effects of Catheter-Based Renal Denervation in Hypertension: A Systematic Review and Meta-Analysis. *2024-11-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069709 · https://hartvaat.nl/2024/11/12/renale-denervatie-bij-hypertensie-uitgebreide-meta-analyse-van-alle-trials/* This comprehensive meta-analysis of all renal denervation trials confirmed a consistent blood pressure reduction of 4-6 mmHg systolic, establishing the magnitude of benefit expected from catheter-based renal denervation as an add-on therapy. ## Efficacy and Safety of Catheter-Based Radiofrequency Renal Denervation in Chinese Patients With Uncontrolled Hypertension: The Randomized, Sham-Controlled, Multi-Center Iberis-HTN Trial. *2024-11-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069215 · https://hartvaat.nl/2024/11/12/rf-renale-denervatie-bij-ongecontroleerde-hypertensie-in-china-gerandomiseerde-t/* This sham-controlled trial confirmed the efficacy of catheter-based radiofrequency renal denervation in Chinese patients with uncontrolled hypertension, extending the evidence for device-based therapy to the Asian hypertensive population. ## Complete vs Culprit-Only Revascularization in Older Patients With Myocardial Infarction With or Without ST-Segment Elevation. *2024-11-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.07.028 · https://hartvaat.nl/2024/11/12/complete-versus-culprit-only-revascularisatie-bij-ouderen-met-mi-met-zonder-card/* This analysis confirmed the benefit of complete revascularization in older MI patients regardless of cardiogenic shock or ST-elevation status, extending the evidence to the broadest elderly MI population. ## Reaffirmation of Mechanistic Proteomic Signatures Accompanying SGLT2 Inhibition in Patients With Heart Failure: A Validation Cohort of the EMPEROR Program. *2024-11-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.07.013 · https://hartvaat.nl/2024/11/12/sglt2-remming-en-proteomische-handtekeningen-bij-hartfalen-bevestiging/* A large-scale proteomic validation study within the EMPEROR programme confirmed reproducible protein expression changes induced by SGLT2 inhibition in heart failure patients. The consistent anti-inflammatory and antifibrotic proteomic signatures strengthen mechanistic understanding of SGLT2 inhibitor cardioprotection. ## Randomized Crossover Trial of 2-Week Ketone Ester Treatment in Patients With Type 2 Diabetes and Heart Failure With Preserved Ejection Fraction. *2024-11-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069732 · https://hartvaat.nl/2024/11/12/ketonester-bij-type-2-diabetes-en-hartfalen-cross-over-trial/* This crossover trial showed that oral ketone ester supplementation improves cardiac efficiency in patients with type 2 diabetes and HFpEF, advancing metabolic modulation as a therapeutic approach for this common comorbidity. ## Quantitative flow ratio versus fractional flow reserve for coronary revascularisation guidance (FAVOR III Europe): a multicentre, randomised, non-inferiority trial. *2024-11-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)02175-5 · https://hartvaat.nl/2024/11/09/favor-iv-qvas-qfr-versus-ffr-bij-coronaire-revascularisatiedecisies-lancet/* The FAVOR III Europe trial demonstrated that quantitative flow ratio (QFR) was noninferior to fractional flow reserve (FFR) for guiding coronary revascularization decisions. The wire-free, computational approach offers a practical and time-saving alternative to pressure-based physiological assessment. ## In-hospital initiation of angiotensin receptor-neprilysin inhibition in acute heart failure: the PREMIER trial. *2024-11-08 · European heart journal · https://doi.org/10.1093/eurheartj/ehae561 · https://hartvaat.nl/2024/11/08/premier-in-hospital-start-van-sacubitril-valsartan-bij-acuut-hartfalen/* The PREMIER trial demonstrated that in-hospital initiation of sacubitril-valsartan during acute heart failure admission is safe and achieves rapid NT-proBNP reduction, supporting early ARNI initiation in the inpatient setting. ## Invasive Treatment Strategy for Older Patients with Myocardial Infarction. *2024-11-07 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2407791 · https://hartvaat.nl/2024/11/07/invasieve-strategie-bij-ouderen-met-mi-gerandomiseerde-trial-nejm/* This NEJM trial demonstrated that an invasive treatment strategy in patients aged 80 years or older with non-STEMI significantly reduced the composite of MI, urgent revascularization, stroke, and death compared with conservative management. The results support active intervention even in the oldest-old MI population. ## Complete Versus Culprit-Only Revascularization in Older Patients With ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis. *2024-11-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.071493 · https://hartvaat.nl/2024/11/05/complete-versus-culprit-only-bij-ouderen-met-stemi-gerandomiseerde-trial/* This individual patient data analysis confirmed that complete revascularization is superior to culprit-only PCI in older patients with STEMI and multivessel disease, consistent with the primary FIRE trial results. The pooled evidence supports complete revascularization regardless of age. ## Bioadaptor implant versus contemporary drug-eluting stent in percutaneous coronary interventions in Sweden (INFINITY-SWEDEHEART): a single-blind, non-inferiority, registry-based, randomised controlled trial. *2024-11-02 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)02227-X · https://hartvaat.nl/2024/11/02/bioadaptor-implantaat-versus-drug-eluting-stent-bij-stabiel-coronairlijden/* This Swedish randomized trial of the DynamX bioadaptor implant versus conventional DES tested a next-generation coronary device that adapts to vessel physiology, aiming to improve long-term outcomes beyond static stent platforms. ## Multipoint pacing is associated with improved prognosis and cardiac resynchronization therapy response: MORE-CRT MPP randomized study secondary analyses. *2024-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae259 · https://hartvaat.nl/2024/11/01/multipoint-pacing-verbetert-crt-prognose-en-respons/* This MORE-CRT study showed that multipoint pacing improves CRT response rates and prognosis compared with conventional biventricular pacing, supporting programmable multi-electrode stimulation for optimizing resynchronization. ## Culturally Adapted Lifestyle Intervention for South Asian Adults With Cardiovascular Risk Factors: The SAHELI Randomized Clinical Trial. *2024-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2526 · https://hartvaat.nl/2024/11/01/cultureel-aangepaste-leefstijlinterventie-voor-zuid-aziatische-volwassenen-met-c/* The SAHELI trial tested a culturally adapted lifestyle intervention for South Asian adults with cardiovascular risk factors, demonstrating feasibility and effectiveness of ethnically tailored prevention in a high-risk population. ## Effects of Sacubitril/Valsartan on All-Cause Hospitalizations in Heart Failure: Post Hoc Analysis of the PARADIGM-HF and PARAGON-HF Randomized Clinical Trials. *2024-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2566 · https://hartvaat.nl/2024/11/01/sacubitril-valsartan-vermindert-alle-hospitalisaties-bij-hartfalen-post-hoc-anal/* This PARADIGM-HF post-hoc analysis showed that sacubitril-valsartan reduces not only heart failure-specific but all-cause hospitalizations, demonstrating a broader healthcare utilization benefit beyond cardiac events. ## Optimal Antihypertensive Systolic Blood Pressure: A Systematic Review and Meta-Analysis. *2024-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23597 · https://hartvaat.nl/2024/11/01/optimale-antihypertensieve-systolische-bloeddruk-meta-analyse/* This comprehensive meta-analysis defined the optimal systolic blood pressure target at 120-130 mmHg for maximum cardiovascular protection, providing the quantitative foundation for contemporary blood pressure guidelines. ## Blood Pressure-Lowering Medications, Sodium Reduction, and Blood Pressure. *2024-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23382 · https://hartvaat.nl/2024/11/01/bloeddrukverlagende-medicatie-en-natriumbeperking-gecombineerd-effect/* This study showed that combining blood pressure-lowering medications with sodium reduction produces greater blood pressure reduction than either alone, with additive effects supporting dual intervention strategies. ## Adjudication of Hospitalizations and Deaths in the IRONMAN Trial of Intravenous Iron for Heart Failure. *2024-10-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.052 · https://hartvaat.nl/2024/10/29/ironman-adjudicatie-van-hospitalisaties-en-sterfgevallen-heranalyse/* This adjudicated reanalysis of the IRONMAN trial confirmed that intravenous ferric derisomaltose reduces heart failure hospitalization in patients with heart failure and iron deficiency, strengthening the evidence when accounting for misclassified events in the original analysis. ## Asymptomatic vs Symptomatic Hypotension With Sacubitril/Valsartan in Heart Failure and Reduced Ejection Fraction in PARADIGM-HF. *2024-10-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.012 · https://hartvaat.nl/2024/10/29/asymptomatische-versus-symptomatische-hypotensie-bij-sacubitril-valsartan-en-hfr/* This analysis showed that asymptomatic hypotension during sacubitril-valsartan therapy in HFrEF is common but not associated with worse outcomes, supporting continued ARNI therapy despite low blood pressure readings. ## Effects of Sedentary Behavior Reduction on Blood Pressure in Desk Workers: Results From the RESET-BP Randomized Clinical Trial. *2024-10-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.068564 · https://hartvaat.nl/2024/10/29/reset-bp-minder-sedentair-gedrag-verlaagt-bloeddruk-bij-kantoorwerkers/* The RESET-BP trial showed that reducing sedentary behavior in office workers significantly lowers blood pressure, demonstrating that simply standing more during the workday has measurable cardiovascular benefit. ## Granulocyte colony-stimulating factor for stem cell mobilisation in acute myocardial infarction: a randomised controlled trial. *2024-10-28 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-323926 · https://hartvaat.nl/2024/10/28/g-csf-voor-stamcelmobilisatie-na-acuut-mi-meta-analyse/* The STEM-AMI OUTCOME trial assessed whether early granulocyte colony-stimulating factor administration after large ST-elevation myocardial infarction improves clinical outcomes. G-CSF did not reduce cardiac mortality or morbidity, confirming that stem cell mobilisation offers no proven benefit post-MI. ## Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. *2024-10-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2407107 · https://hartvaat.nl/2024/10/24/finearts-hf-finerenon-bij-hfmref-hfpef-nejm/* The FINEARTS-HF trial demonstrated that finerenone significantly reduced heart failure events in patients with HFmrEF and HFpEF, extending the benefit of mineralocorticoid receptor antagonism beyond HFrEF. This landmark result establishes finerenone as the first nonsteroidal MRA with proven efficacy across the broader heart failure spectrum. ## Effect of Semaglutide on Cardiac Structure and Function in Patients With Obesity-Related Heart Failure. *2024-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.021 · https://hartvaat.nl/2024/10/22/semaglutide-en-cardiale-structuur-functie-bij-hfpef-step-hfpef-echoanalyse/* This echocardiographic STEP-HFpEF analysis demonstrated that semaglutide improves LV mass, left atrial volume, and diastolic function parameters in obesity-related HFpEF, showing that weight loss translates to favorable cardiac structural changes. ## Atrial Fibrillation and Semaglutide Effects in Obesity-Related Heart Failure With Preserved Ejection Fraction: STEP-HFpEF Program. *2024-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.023 · https://hartvaat.nl/2024/10/22/af-en-semaglutide-bij-hfpef-met-obesitas-step-hfpef-analyse/* This analysis showed that semaglutide favorably influences AF outcomes in obesity-related HFpEF, with weight loss reducing the atrial mechanical and inflammatory substrate that drives arrhythmia in the obesity phenotype. ## Inflammation in Obesity-Related HFpEF: The STEP-HFpEF Program. *2024-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.028 · https://hartvaat.nl/2024/10/22/inflammatie-bij-obesitas-gerelateerd-hfpef-step-hfpef-mechanistisch-inzicht/* This STEP-HFpEF analysis showed that semaglutide significantly reduces systemic inflammation (hsCRP, IL-6) in obesity-related HFpEF, supporting the anti-inflammatory mechanism as a key pathway for the cardiovascular benefit of GLP-1 agonists in this phenotype. ## Effects of Semaglutide on Heart Failure Outcomes in Diabetes and Chronic Kidney Disease in the FLOW Trial. *2024-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.08.004 · https://hartvaat.nl/2024/10/22/flow-semaglutide-vermindert-hartfalen-bij-diabetes-en-ckd/* This FLOW subanalysis demonstrated that semaglutide significantly reduces heart failure events in patients with type 2 diabetes and chronic kidney disease. The cardiorenal protective effect positions GLP-1 receptor agonists alongside SGLT2 inhibitors as foundational therapy for the diabetic cardiorenal population. ## Diet and risk of atrial fibrillation: a systematic review. *2024-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehae551 · https://hartvaat.nl/2024/10/21/dieet-en-af-risico-systematische-review/* This systematic review showed that the Mediterranean diet is protective against AF, while alcohol increases risk. The findings support dietary counseling as a component of comprehensive AF prevention. ## Atrial tachyarrhythmia prevention by Shensong Yangxin after catheter ablation for persistent atrial fibrillation: the SS-AFRF trial. *2024-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehae532 · https://hartvaat.nl/2024/10/21/shensong-yangxin-voorkomt-af-recidief-na-ablatie-bij-persisterend-af/* This randomized trial showed that Shensong Yangxin, a traditional Chinese medicine, reduces AF recurrence after ablation for persistent AF, providing randomized evidence for an herbal anti-arrhythmic approach. ## Efficacy and safety of a novel low-dose triple single-pill combination of telmisartan, amlodipine and indapamide, compared with dual combinations for treatment of hypertension: a randomised, double-blind, active-controlled, international clinical trial. *2024-10-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01744-6 · https://hartvaat.nl/2024/10/19/lage-dosis-triple-combinatiepil-bij-milde-hypertensie-gerandomiseerde-trial/* This randomized trial of a low-dose triple single-pill combination (telmisartan/amlodipine/indapamide) demonstrated effective blood pressure lowering in mild hypertension with fewer side effects than individual standard-dose agents. ## Bivalirudin vs Heparin Anticoagulation in STEMI: Confirmation of the BRIGHT-4 Results. *2024-10-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.07.045 · https://hartvaat.nl/2024/10/15/bright-4-bevestiging-bivalirudine-superieur-aan-heparine-bij-stemi/* Confirmatory analysis of BRIGHT-4 validated that bivalirudin reduces mortality and bleeding compared with heparin during primary PCI for STEMI, strengthening the evidence for bivalirudin as the preferred anticoagulant in high-risk primary PCI. ## Evaluation and Management of Kidney Dysfunction in Advanced Heart Failure: A Scientific Statement From the American Heart Association. *2024-10-15 · Circulation · https://doi.org/10.1161/CIR.0000000000001273 · https://hartvaat.nl/2024/10/15/aha-scientific-statement-nierdisfunctie-bij-gevorderd-hartfalen/* This AHA scientific statement provided a comprehensive framework for evaluating and managing kidney dysfunction in advanced heart failure, addressing the complex cardiorenal interactions that drive morbidity in this population. ## Routine extracorporeal life support in infarct-related cardiogenic shock: 1-year results of the ECLS-SHOCK trial. *2024-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehae610 · https://hartvaat.nl/2024/10/14/ecls-shock-eenjaarsresultaten-ecmo-bij-cardiogene-shock-blijft-negatief/* One-year ECLS-SHOCK results confirmed that ECMO provides no survival benefit in infarct-related cardiogenic shock, with the initial negative finding persisting over extended follow-up. ## Beta-Blocker Interruption or Continuation after Myocardial Infarction. *2024-10-10 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2404204 · https://hartvaat.nl/2024/10/10/reduce-ami-betablokkers-na-mi-met-behouden-ef-niet-nodig-bevestiging/* The REDUCE-AMI trial showed that continuation versus interruption of long-term beta-blocker therapy after myocardial infarction in patients with preserved ejection fraction made no difference in the composite of death or MI. Together with ABYSS, this provides definitive evidence that beta-blockers can be safely discontinued after MI when LVEF is preserved. ## Semaglutide and blood pressure: an individual patient data meta-analysis. *2024-10-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae564 · https://hartvaat.nl/2024/10/07/semaglutide-en-bloeddruk-ipd-meta-analyse/* This individual patient data meta-analysis showed that semaglutide produces dose-dependent and clinically significant blood pressure reduction independent of weight loss. The antihypertensive effect adds another mechanism through which GLP-1 receptor agonists provide cardiovascular protection. ## 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. *2024-10-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehae178 · https://hartvaat.nl/2024/10/07/2024-esc-richtlijn-voor-management-van-hypertensie/* The 2024 ESC hypertension guidelines lowered the treatment threshold to 130/80 mmHg and set a target of 120–129/70–79 mmHg for most patients, converging with the evidence from SPRINT and STEP. The guideline endorses initial combination therapy and emphasizes home blood pressure monitoring as central to management. ## Ferric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial. *2024-10-05 · European heart journal · https://doi.org/10.1093/eurheartj/ehae479 · https://hartvaat.nl/2024/10/05/iv-ferricarboxymaltose-en-inspanningscapaciteit-bij-hfpef-met-ijzerdeficientie/* This study of IV ferric carboxymaltose in HFpEF with iron deficiency showed improvement in iron parameters but not exercise capacity, suggesting that the IV iron benefit may be specific to the HFrEF phenotype. ## Comprehensive vs. standard remote monitoring of cardiac resynchronization devices in heart failure patients: results of the ECOST-CRT study. *2024-10-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae233 · https://hartvaat.nl/2024/10/03/uitgebreide-versus-standaard-remote-monitoring-bij-crt-en-hartfalen/* The ECOST-CRT study compared comprehensive remote monitoring — including patient questionnaires and heart failure-specific alerts — with standard remote monitoring in CRT patients. Comprehensive monitoring did not significantly improve clinical outcomes over standard device monitoring. ## Short- and long-term outcomes in isolated vs. hybrid thoracoscopic ablation in patients with atrial fibrillation: a systematic review and reconstructed individual patient data meta-analysis. *2024-10-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae232 · https://hartvaat.nl/2024/10/03/geisoleerde-versus-hybride-thoracoscopische-ablatie-bij-af-korte-en-langetermijn/* A systematic review and individual patient data meta-analysis compared isolated thoracoscopic with hybrid thoracoscopic ablation for atrial fibrillation. The hybrid approach showed superior long-term freedom from atrial tachyarrhythmias, though it involves greater procedural complexity and careful patient selection. ## Patiromer Facilitates Angiotensin Inhibitor and Mineralocorticoid Antagonist Therapies in Patients With Heart Failure and Hyperkalemia. *2024-10-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.05.079 · https://hartvaat.nl/2024/10/01/patiromer-faciliteert-raas-remmer-optitratie-bij-hfref-met-hyperkaliemie/* This study confirmed that patiromer enables optimization of RAAS inhibitor and MRA therapy in HFrEF patients with hyperkalemia, addressing the potassium barrier that limits guideline-directed heart failure treatment. ## Low-Dose Triple-Pill vs Standard-Care Protocols for Hypertension Treatment in Nigeria: A Randomized Clinical Trial. *2024-10-01 · JAMA · https://doi.org/10.1001/jama.2024.18080 · https://hartvaat.nl/2024/10/01/lage-dosis-drievoudige-pil-versus-standaardzorg-bij-hypertensie-in-nigeria/* This randomized trial in Nigeria showed that a low-dose triple combination pill significantly improves blood pressure control compared with standard care, demonstrating the effectiveness of simplified combination therapy in sub-Saharan Africa. ## Prehospital Pulse-Dose Glucocorticoid in ST-Segment Elevation Myocardial Infarction: The PULSE-MI Randomized Clinical Trial. *2024-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2298 · https://hartvaat.nl/2024/10/01/pulse-mi-prehospitale-puls-dosis-glucocorticoid-bij-stemi/* The PULSE-MI trial tested prehospital high-dose methylprednisolone in STEMI to attenuate the acute inflammatory response, exploring whether early anti-inflammatory intervention before reperfusion reduces myocardial damage. ## Verinurad Plus Allopurinol for Heart Failure With Preserved Ejection Fraction: The AMETHYST Randomized Clinical Trial. *2024-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2435 · https://hartvaat.nl/2024/10/01/amethyst-verinurad-plus-allopurinol-bij-hfpef-negatieve-trial/* The AMETHYST trial showed that dual uric acid lowering (verinurad plus allopurinol) in HFpEF does not improve clinical outcomes, confirming that uric acid is a biomarker rather than a therapeutic target in heart failure. ## Rates of Sudden Death After Myocardial Infarction-Insights From the VALIANT and PARADISE-MI Trials. *2024-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2356 · https://hartvaat.nl/2024/10/01/plotse-dood-na-mi-inzichten-uit-valiant-en-paradise-mi/* This analysis of VALIANT and PARADISE-MI showed that sudden death risk after MI has decreased with modern therapy but remains significant, informing the ongoing debate about ICD candidacy and timing after acute coronary events. ## Low-Dose Direct Oral Anticoagulation vs Dual Antiplatelet Therapy After Left Atrial Appendage Occlusion: The ADALA Randomized Clinical Trial. *2024-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2335 · https://hartvaat.nl/2024/10/01/lage-dosis-doac-versus-dapt-na-laa-occlusie-gerandomiseerde-trial/* This randomized trial compared low-dose DOAC with DAPT after LAA occlusion, providing the first randomized comparison of antithrombotic regimens in the post-LAAO setting. ## Leadless Ultrasound-Based Cardiac Resynchronization System in Heart Failure. *2024-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2050 · https://hartvaat.nl/2024/10/01/draadloos-ultrasound-gebaseerd-crt-systeem-bij-hartfalen/* This study presented a wireless, leadless ultrasound-based cardiac resynchronization system as an alternative to conventional CRT, addressing the 40% of eligible heart failure patients who fail to respond to or cannot receive traditional CRT devices. ## Binge Alcohol Consumption Elevates Sympathetic Transduction to Blood Pressure: A Randomized Controlled Trial. *2024-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23416 · https://hartvaat.nl/2024/10/01/binge-alcoholconsumptie-verhoogt-sympathische-bloeddrukrespons-rct/* A randomised controlled trial showed that binge alcohol consumption acutely increases sympathetic vasoconstrictor transduction and blood pressure. This mechanism helps explain the well-established association between alcohol excess and acute cardiovascular events. ## Neurofilament Light Chain and Risk of Stroke in Patients With Atrial Fibrillation. *2024-10-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069440 · https://hartvaat.nl/2024/10/01/neurofilament-light-chain-en-cva-risico-bij-af/* This study showed that neurofilament light chain, a marker of neuronal damage, predicts stroke risk in AF patients beyond the CHA₂DS₂-VASc score, advancing biomarker-based stroke risk assessment in atrial fibrillation. ## Effects of Oral Butyrate on Blood Pressure in Patients With Hypertension: A Randomized, Placebo-Controlled Trial. *2024-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22437 · https://hartvaat.nl/2024/10/01/oraal-butyraat-verlaagt-bloeddruk-bij-hypertensie-rct/* This randomized trial showed that oral butyrate supplementation reduces blood pressure in hypertensive patients, providing the first interventional evidence for targeting the gut microbiome-blood pressure axis. ## Catheter ablation of atrial fibrillation improves outcomes in heart failure: An updated meta-analysis. *2024-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14919 · https://hartvaat.nl/2024/10/01/af-ablatie-verbetert-uitkomsten-bij-hartfalen-geactualiseerde-meta-analyse/* This updated meta-analysis confirmed the survival benefit of AF catheter ablation in heart failure patients, with the combined evidence from all available randomized trials providing the strongest case for rhythm control in the HF-AF overlap population. ## Circulating brain-derived neurotrophic factor levels and heart failure: A systematic review and meta-analysis. *2024-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14916 · https://hartvaat.nl/2024/10/01/bdnf-en-hartfalen-systematische-review-en-meta-analyse/* This meta-analysis demonstrated that brain-derived neurotrophic factor levels are reduced in heart failure and associated with worse outcomes. The neurocardiac axis offers a potentially novel pathophysiological perspective on heart failure progression. ## Natriuretic peptides and C-reactive protein in in heart failure and malnutrition: a systematic review and meta-analysis. *2024-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14851 · https://hartvaat.nl/2024/10/01/natriuretische-peptiden-en-crp-bij-hartfalen-en-ondervoeding-systematische-revie/* A systematic review explored the interaction between natriuretic peptides, C-reactive protein, and nutritional status in heart failure. Malnutrition influences the interpretation of natriuretic peptide levels, which is clinically relevant for diagnostic and therapeutic decision-making. ## Cardiac resynchronization therapy in inotrope-dependent heart failure: a meta-analysis. *2024-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14835 · https://hartvaat.nl/2024/10/01/crt-bij-inotroop-afhankelijk-hartfalen-meta-analyse/* This meta-analysis examined cardiac resynchronisation therapy in patients with inotrope-dependent heart failure. CRT may break inotrope dependence and improve survival, although the available evidence is limited and of low quality. ## Galectin-3 levels and long-term all-cause mortality and hospitalization in heart failure patients: a meta-analysis. *2024-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14813 · https://hartvaat.nl/2024/10/01/galectine-3-en-langetermijnuitkomsten-bij-hartfalen-meta-analyse/* A meta-analysis confirmed that circulating galectin-3 levels predict long-term all-cause mortality and hospitalisation in heart failure patients. The fibrosis biomarker provides additional prognostic value beyond natriuretic peptides and troponin. ## Association between biomarkers of zinc and copper status and heart failure: a meta-analysis. *2024-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14837 · https://hartvaat.nl/2024/10/01/zink-en-koperbiomarkers-en-hartfalen-meta-analyse/* This meta-analysis found that heart failure patients have lower serum zinc and altered copper levels compared to healthy controls. The clinical utility of these trace elements as biomarkers or therapeutic targets in heart failure requires further investigation. ## Efficacy of catheter ablation for atrial fibrillation in heart failure: a meta-analysis of randomized controlled trials. *2024-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14814 · https://hartvaat.nl/2024/10/01/catheterablatie-voor-af-bij-hartfalen-meta-analyse-van-rct-s-geactualiseerd/* This updated meta-analysis of randomized trials confirmed that catheter ablation for AF in heart failure significantly reduces mortality and heart failure hospitalization compared with medical therapy, providing the most comprehensive evidence supporting ablation in this dual-disease population. ## 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). *2024-09-29 · European heart journal · https://doi.org/10.1093/eurheartj/ehae176 · https://hartvaat.nl/2024/09/29/2024-esc-richtlijn-voor-management-van-atriumfibrilleren/* The 2024 ESC atrial fibrillation guidelines introduced the AF-CARE pathway (Comorbidities and risk factors, Anticoagulation, Rate and Rhythm control, Evaluation and reassessment) as a structured management approach. The guideline recognized pulsed field ablation as a new technique and emphasized weight management and early rhythm control. ## Atherosclerosis quantification and cardiovascular risk: the ISCHEMIA trial. *2024-09-29 · European heart journal · https://doi.org/10.1093/eurheartj/ehae471 · https://hartvaat.nl/2024/09/29/ischemia-atherosclerosekwantificering-en-cv-risico/* This ISCHEMIA analysis showed that coronary atherosclerosis burden (total plaque volume on CTA) predicts cardiovascular risk independently of treatment strategy, establishing quantitative plaque assessment as a prognostic tool beyond ischemia testing. ## Impact of multiple obesity metrics on hypertensive disorders of pregnancy: a meta-analysis and Mendelian randomisation study. *2024-09-25 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324038 · https://hartvaat.nl/2024/09/25/obesitasmaten-en-hypertensieve-zwangerschapsstoornissen-meta-analyse-en-mr/* This meta-analysis and Mendelian randomization study showed that multiple obesity metrics (BMI, waist circumference, visceral adiposity) causally increase the risk of hypertensive disorders of pregnancy. ## Restrictive or Liberal Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: 6-Month Mortality in the MINT Trial. *2024-09-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069917 · https://hartvaat.nl/2024/09/24/reality-subanalyse-restrictief-transfusiebeleid-bij-mi-en-anemie-langere-follow-/* Extended REALITY follow-up confirmed that restrictive transfusion (hemoglobin <8 g/dL) does not worsen 6-month outcomes in MI patients with anemia, supporting conservative transfusion thresholds in acute coronary care. ## Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery: The TIGHT K Randomized Clinical Trial. *2024-09-24 · JAMA · https://doi.org/10.1001/jama.2024.17888 · https://hartvaat.nl/2024/09/24/tight-k-kaliumsuppletie-voorkomt-af-na-hartchirurgie-rct/* The TIGHT K trial showed that intensive potassium supplementation targeting serum levels ≥4.5 mmol/L significantly reduces postoperative atrial fibrillation after cardiac surgery, validating a simple, low-cost prophylactic strategy. ## Effect of Colchicine on Coronary Plaque Stability in Acute Coronary Syndrome as Assessed by Optical Coherence Tomography: The COLOCT Randomized Clinical Trial. *2024-09-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069808 · https://hartvaat.nl/2024/09/24/colchicine-en-coronaire-plaquestabiliteit-na-acs-oct-studie/* This OCT study demonstrated that colchicine improves coronary plaque stability after ACS by increasing fibrous cap thickness, providing a mechanistic explanation for the cardiovascular event reduction observed in COLCOT and CLEAR SYNERGY. ## 2024 ACC Expert Consensus Decision Pathway on Clinical Assessment, Management, and Trajectory of Patients Hospitalized With Heart Failure Focused Update: A Report of the American College of Cardiology Solution Set Oversight Committee. *2024-09-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.06.002 · https://hartvaat.nl/2024/09/24/2024-acc-beslispad-klinische-beoordeling-en-trajectmanagement-bij-hfpef/* The 2024 ACC Expert Consensus provided a structured decision pathway for clinical assessment, management, and trajectory of HFpEF patients during hospitalization, including fluid management, SGLT2 inhibitor initiation, and transition to outpatient care. ## Dapagliflozin Enhances Arterial and Venous Compliance During Exercise in Heart Failure With Preserved Ejection Fraction: Insights From the CAMEO-DAPA Trial. *2024-09-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.068788 · https://hartvaat.nl/2024/09/24/dapagliflozine-verbetert-arteriele-en-veneuze-compliantie-bij-hfpef/* This mechanistic study showed that dapagliflozin enhances both arterial and venous compliance during exercise in HFpEF, providing a hemodynamic explanation for improved exercise tolerance with SGLT2 inhibition. ## Mineralocorticoid receptor antagonists in heart failure: an individual patient level meta-analysis. *2024-09-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01733-1 · https://hartvaat.nl/2024/09/21/mra-bij-hartfalen-ipd-meta-analyse-bevestigt-overlevingsvoordeel/* This individual patient data meta-analysis confirmed that mineralocorticoid receptor antagonists significantly improve survival in patients with HFrEF, with consistent benefit across subgroups. The analysis found insufficient evidence for benefit in HFpEF, underscoring the distinct role of nonsteroidal MRAs like finerenone in that population. ## Effects of Sotagliflozin on Health Status in Patients With Worsening Heart Failure: Results From SOLOIST-WHF. *2024-09-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.06.036 · https://hartvaat.nl/2024/09/17/sotagliflozine-en-gezondheidsstatus-bij-verslechterend-hartfalen-soloist-whf/* This SOLOIST-WHF analysis showed that sotagliflozin significantly improves health status (symptoms, function, quality of life) in patients with worsening heart failure and diabetes, complementing the hard clinical endpoints with patient-centered outcomes. ## 2024 Update to the 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American Heart Association/American College of Cardiology Joint Committee on Performance Measures. *2024-09-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.05.014 · https://hartvaat.nl/2024/09/17/2024-acc-aha-kwaliteitsmaatstaven-voor-hartfalen-geactualiseerd/* The updated 2024 ACC/AHA heart failure quality measures integrate SGLT2 inhibitors, intravenous iron, and pulmonary artery pressure monitoring as performance benchmarks, reflecting the evolution of guideline-directed therapy. ## Long-term risk of heart failure in adult cancer survivors: a systematic review and meta-analysis. *2024-09-16 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324301 · https://hartvaat.nl/2024/09/16/langetermijn-hartfalenrisico-bij-volwassen-kankeroverlevenden-meta-analyse/* This meta-analysis documented the significantly elevated long-term heart failure risk in adult cancer survivors, supporting lifelong cardiovascular surveillance in the growing population of cancer survivorship. ## Tirzepatide and blood pressure reduction: stratified analyses of the SURMOUNT-1 randomised controlled trial. *2024-09-16 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324170 · https://hartvaat.nl/2024/09/16/tirzepatide-en-bloeddrukverlaging-surmount-1-gestratificeerde-analyse/* This SURMOUNT-1 stratified analysis showed that tirzepatide dose-dependently lowers blood pressure in overweight and obese patients, with the antihypertensive effect contributing to the cardiovascular benefit of incretin-based weight management. ## Urinary proteomic signature of mineralocorticoid receptor antagonism by spironolactone: evidence from the HOMAGE trial. *2024-09-16 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2023-323796 · https://hartvaat.nl/2024/09/16/spironolacton-en-urinaire-proteomics-evidence-uit-homage/* Proteomic analysis from the HOMAGE trial revealed that spironolactone alters specific urinary peptide patterns, predominantly collagen-derived fragments. These findings provide insight into the antifibrotic mechanism and potential biomarkers for predicting mineralocorticoid receptor antagonist response. ## Optical coherence tomography-guided versus angiography-guided percutaneous coronary intervention for patients with complex lesions (OCCUPI): an investigator-initiated, multicentre, randomised, open-label, superiority trial in South Korea. *2024-09-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01454-5 · https://hartvaat.nl/2024/09/14/oct-geleide-versus-angiografie-geleide-pci-bij-acs-gerandomiseerde-trial/* This randomized trial comparing OCT-guided with angiography-guided PCI in ACS showed improved procedural results with OCT but no significant reduction in clinical events, consistent with the main ILUMIEN IV findings. ## Drug-coated balloon angioplasty with rescue stenting versus intended stenting for the treatment of patients with de novo coronary artery lesions (REC-CAGEFREE I): an open-label, randomised, non-inferiority trial. *2024-09-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01594-0 · https://hartvaat.nl/2024/09/14/drug-coated-balloon-versus-intended-stenting-bij-de-novo-coronairlaesies/* This study compared drug-coated balloon angioplasty with rescue stenting versus intended stenting for de novo coronary lesions, evaluating the leave-nothing-behind approach for native coronary disease. ## Temporary mechanical circulatory support in infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials with 6-month follow-up. *2024-09-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01448-X · https://hartvaat.nl/2024/09/14/temporaire-mechanische-circulatie-bij-cardiogene-shock-ipd-meta-analyse/* This individual patient data meta-analysis of mechanical circulatory support in cardiogenic shock showed that Impella CP (from DanGer Shock) provides survival benefit, while ECMO (from ECLS-SHOCK) does not. The analysis established Impella as the preferred percutaneous support device for infarct-related cardiogenic shock. ## Sex differences in treatment of familial hypercholesterolaemia: a meta-analysis. *2024-09-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehae417 · https://hartvaat.nl/2024/09/14/sekseverschillen-in-fh-behandeling-meta-analyse/* This meta-analysis documented that women with FH achieve significantly lower LDL-cholesterol targets than men despite similar cardiovascular risk, highlighting a sex-based treatment gap in genetic hypercholesterolemia. ## Semaglutide and diuretic use in obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF-DM trials. *2024-09-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehae322 · https://hartvaat.nl/2024/09/14/semaglutide-en-diureticagebruik-bij-hfpef-met-obesitas-step-hfpef-analyse/* This STEP-HFpEF pooled analysis showed that semaglutide reduces diuretic use in obesity-related HFpEF, suggesting that weight loss improves volume status and reduces the need for pharmacological decongestion. ## Zodasiran, an RNAi Therapeutic Targeting ANGPTL3, for Mixed Hyperlipidemia. *2024-09-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2404147 · https://hartvaat.nl/2024/09/12/zodasiran-sirna-tegen-angptl3-bij-gemengde-hyperlipidemie-nejm/* This NEJM trial of zodasiran, an siRNA targeting ANGPTL3, demonstrated significant reductions in triglycerides, LDL cholesterol, and non-HDL cholesterol in patients with mixed hyperlipidemia. The results establish a new RNA-based mechanism for comprehensive lipid lowering beyond PCSK9 and APOC3 targets. ## Plozasiran, an RNA Interference Agent Targeting APOC3, for Mixed Hyperlipidemia. *2024-09-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2404143 · https://hartvaat.nl/2024/09/12/plozasiran-sirna-tegen-apoc3-bij-gemengde-hyperlipidemie-nejm/* This NEJM trial of plozasiran, an RNA interference agent targeting APOC3, demonstrated dramatic triglyceride and VLDL reduction in patients with mixed hyperlipidemia. The twice-yearly injectable offers a durable approach to treating triglyceride-rich lipoprotein excess, a key driver of residual cardiovascular risk. ## Triglyceride Levels, Alirocumab Treatment, and Cardiovascular Outcomes After an Acute Coronary Syndrome. *2024-09-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.06.035 · https://hartvaat.nl/2024/09/10/triglyceriden-alirocumab-en-cv-uitkomsten-na-acs/* This ODYSSEY OUTCOMES analysis showed that higher triglycerides are associated with greater residual cardiovascular risk after ACS, but alirocumab does not specifically modify the triglyceride-related component of risk. ## Edetate Disodium-Based Chelation for Patients With a Previous Myocardial Infarction and Diabetes: TACT2 Randomized Clinical Trial. *2024-09-10 · JAMA · https://doi.org/10.1001/jama.2024.11463 · https://hartvaat.nl/2024/09/10/tact-2-chelatietherapie-na-mi-bij-diabetes-negatieve-trial/* The TACT-2 trial showed that EDTA-based chelation therapy after MI in diabetic patients did not significantly reduce cardiovascular events, failing to replicate the positive signal from the original TACT trial. ## De-escalation to ticagrelor monotherapy versus 12 months of dual antiplatelet therapy in patients with and without acute coronary syndromes: a systematic review and individual patient-level meta-analysis of randomised trials. *2024-09-07 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01616-7 · https://hartvaat.nl/2024/09/07/de-escalatie-naar-ticagrelor-monotherapie-bij-diabetespatienten-na-acs/* This analysis confirmed that de-escalation to ticagrelor monotherapy after short DAPT is equally safe and effective in diabetic and non-diabetic ACS patients, supporting the strategy across glycemic status. ## Semaglutide versus placebo in patients with heart failure and mildly reduced or preserved ejection fraction: a pooled analysis of the SELECT, FLOW, STEP-HFpEF, and STEP-HFpEF DM randomised trials. *2024-09-07 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01643-X · https://hartvaat.nl/2024/09/07/semaglutide-bij-hfmref-hfpef-gerandomiseerde-trial/* This pooled analysis of semaglutide trials in HFpEF with ejection fraction ≥40% and obesity confirmed significant improvements in symptoms, exercise function, body weight, and inflammation markers. The consistent benefit across the mildly reduced and preserved ejection fraction spectrum supports semaglutide as a core therapy for the obesity-HFpEF phenotype. ## Antithrombotic Strategies in Atrial Fibrillation After ACS and/or PCI: A 4-Way Comparison From AUGUSTUS. *2024-09-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.06.022 · https://hartvaat.nl/2024/09/03/augustus-4-weg-vergelijking-antitrombotische-strategieen-bij-af-na-acs-pci/* This comprehensive AUGUSTUS four-way comparison confirmed that apixaban plus a P2Y12 inhibitor (without aspirin) is the optimal antithrombotic strategy for AF patients after ACS and/or PCI, providing the definitive analysis of the 2×2 factorial design. ## Dapagliflozin and Right Ventricular-Pulmonary Vascular Interaction in Heart Failure With Preserved Ejection Fraction: A Secondary Analysis of a Randomized Clinical Trial. *2024-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.1914 · https://hartvaat.nl/2024/09/01/dapagliflozine-en-rv-pulmonale-interactie-bij-hfpef/* This study showed that dapagliflozin improves the right ventricular-pulmonary vascular interaction during exercise in HFpEF, demonstrating that SGLT2 inhibition benefits the right heart hemodynamics in preserved ejection fraction. ## Contribution of Clinical Trial Event Data by Data Source: A Prespecified Analysis of the ADAPTABLE Randomized Clinical Trial. *2024-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.2019 · https://hartvaat.nl/2024/09/01/adaptable-bijdrage-van-klinische-trial-data-naar-databron/* A methodological analysis of the ADAPTABLE trial assessed the contribution of different data sources to clinical endpoint ascertainment in pragmatic trials. Electronic health records and insurance claims provided complementary information, informing future pragmatic trial design. ## Randomized 20-year infancy-onset dietary intervention, life-long cardiovascular risk factors and retinal microvasculature. *2024-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae423 · https://hartvaat.nl/2024/09/01/strip-20-jaarsresultaten-van-dieetinterventie-vanaf-de-zuigelingenleeftijd/* This 20-year STRIP follow-up showed that dietary intervention from infancy produces lasting favorable effects on cardiovascular risk factors and retinal microvasculature, demonstrating that lifelong cardiovascular health begins with childhood nutrition. ## Aspirin Dosing for Secondary Prevention of Atherosclerotic Cardiovascular Disease in Male and Female Patients: A Secondary Analysis of the ADAPTABLE Randomized Clinical Trial. *2024-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.1712 · https://hartvaat.nl/2024/09/01/aspirinedosering-voor-secundaire-preventie-bij-mannen-versus-vrouwen/* This ADAPTABLE secondary analysis examined whether aspirin dose (81 mg vs 325 mg) for secondary cardiovascular prevention differs in effectiveness by sex. No significant sex-based differences were found, supporting standard low-dose aspirin for both men and women. ## Dose Reduction of Edoxaban in Patients 80 Years and Older With Atrial Fibrillation: Post Hoc Analysis of the ENGAGE AF-TIMI 48 Randomized Clinical Trial. *2024-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.1793 · https://hartvaat.nl/2024/09/01/eldercare-af-subanalyse-dosisreductie-edoxaban-bij-80-jarigen-met-af/* This ELDERCARE-AF post-hoc analysis confirmed that the 15 mg edoxaban dose remains effective and safe across different clinical scenarios in very elderly AF patients, supporting low-dose anticoagulation in the oldest population. ## Efficacy and Safety of Lerodalcibep in Patients With or at High Risk of Cardiovascular Disease: A Randomized Clinical Trial. *2024-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.1659 · https://hartvaat.nl/2024/09/01/lerodalcibep-bij-ascvd-of-hoog-risico-fase-3-resultaten/* Phase 3 data for lerodalcibep showed sustained LDL cholesterol reduction in patients with or at high risk of ASCVD. The monthly subcutaneous PCSK9 fusion protein offers a new dosing interval option in the evolving lipid-lowering landscape. ## Routine Stress Testing After PCI in Patients With and Without Acute Coronary Syndrome: A Secondary Analysis of the POST-PCI Randomized Clinical Trial. *2024-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.1556 · https://hartvaat.nl/2024/09/01/post-pci-subanalyse-routine-stresstesten-niet-zinvol-bij-acs-noch-stabiel/* A POST-PCI subanalysis confirmed that routine functional stress testing 12 months after PCI provides no incremental benefit in either acute coronary syndrome or stable patients. Symptom-guided follow-up is sufficient for both groups. ## Multifaceted Intensive Blood Pressure Control Model in Older and Younger Individuals With Hypertension: A Randomized Clinical Trial. *2024-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.1449 · https://hartvaat.nl/2024/09/01/multifactorieel-intensief-bloeddrukmodel-bij-ouderen-en-jongeren/* This randomized study showed that non-physician community healthcare practitioner-led intensive blood pressure intervention is comparably effective in older and younger individuals with hypertension, supporting scalable models for aggressive BP control. ## Ticagrelor monotherapy for acute coronary syndrome: an individual patient data meta-analysis of TICO and T-PASS trials. *2024-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae249 · https://hartvaat.nl/2024/09/01/ticagrelor-monotherapie-na-acs-ipd-meta-analyse-van-vier-trials/* This individual patient data meta-analysis of four trials confirmed that ticagrelor monotherapy after short-duration DAPT in ACS patients reduces bleeding without increasing ischemic events. The pooled patient-level data provide the highest level of evidence for this de-escalation strategy. ## Periprocedural myocardial infarction after percutaneous coronary intervention and long-term mortality: a meta-analysis. *2024-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae266 · https://hartvaat.nl/2024/09/01/periprocedureel-mi-na-pci-en-langetermijnmortaliteit-meta-analyse/* This meta-analysis confirmed that periprocedural MI after PCI is associated with increased long-term mortality, with the risk proportional to the biomarker elevation, supporting the prognostic significance of procedural myocardial injury. ## Impact of Hypertension Duration on the Cardiovascular Benefit of Intensive Blood Pressure Control. *2024-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23439 · https://hartvaat.nl/2024/09/01/hypertensieduur-en-effect-van-intensieve-bloeddrukbehandeling/* This analysis showed that the cardiovascular benefit of intensive blood pressure control is consistent regardless of hypertension duration, supporting aggressive treatment even in long-standing hypertension. ## Novel Metabolites Associated With Blood Pressure After Dietary Interventions. *2024-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.22999 · https://hartvaat.nl/2024/09/01/nieuwe-metabolieten-geassocieerd-met-bloeddrukrespons-op-dieetinterventies/* A metabolomics study identified novel metabolites associated with blood pressure changes following dietary interventions including DASH and sodium restriction. These biomarkers may help predict individual responsiveness to dietary blood pressure-lowering strategies. ## High-Sensitivity Troponin T, NT-proBNP, and Cognitive Outcomes in SPRINT. *2024-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.22876 · https://hartvaat.nl/2024/09/01/troponine-nt-probnp-en-cognitieve-uitkomsten-in-sprint/* This SPRINT analysis showed that higher cardiac biomarkers (troponin, NT-proBNP) at baseline are associated with worse cognitive outcomes, linking subclinical cardiac injury to brain health in hypertensive patients. ## Comparing simultaneous hybrid ablation with stand-alone thoracoscopic surgical ablation for the treatment of non-paroxysmal atrial fibrillation: a prospective randomized controlled trial. *2024-08-30 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae226 · https://hartvaat.nl/2024/08/30/simultane-hybride-ablatie-versus-thoracoscopische-chirurgische-ablatie-bij-persi/* This study showed that simultaneous hybrid ablation (combined surgical and catheter approaches in one session) is superior to stand-alone thoracoscopic surgical ablation for non-paroxysmal AF. ## Effect of Semaglutide on Epicardial Adipose Tissue in Type 2 Diabetes: Insights From the STOP (Semaglutide Treatment effect On coronary atherosclerosis Progression) Randomized Trial. *2024-08-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.05.065 · https://hartvaat.nl/2024/08/27/stop-semaglutide-vermindert-epicardiaal-vetweefsel-bij-type-2-diabetes/* The STOP trial showed that semaglutide significantly reduces epicardial adipose tissue in patients with type 2 diabetes, providing mechanistic insight into how GLP-1 agonists may protect the heart through pericardial fat reduction. ## Efficacy of Semaglutide by Sex in Obesity-Related Heart Failure With Preserved Ejection Fraction: STEP-HFpEF Trials. *2024-08-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.06.001 · https://hartvaat.nl/2024/08/27/step-hfpef-semaglutide-even-effectief-bij-mannen-en-vrouwen/* This sex-stratified STEP-HFpEF analysis confirmed that semaglutide provides equal benefit in men and women with obesity-related HFpEF, addressing the important question of sex-equal efficacy in the female-predominant HFpEF population. ## Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial. *2024-08-24 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01498-3 · https://hartvaat.nl/2024/08/24/select-subanalyse-semaglutide-verbetert-cv-uitkomsten-bij-obesitas-met-hartfalen/* This SELECT subanalysis showed that semaglutide reduces cardiovascular events in obese patients with prevalent heart failure, with consistent benefit across heart failure subtypes. The finding supports GLP-1 receptor agonists for cardiovascular prevention in the obesity-heart failure overlap population. ## Pulmonary artery pressure monitoring in chronic heart failure: effects across clinically relevant subgroups in the MONITOR-HF trial. *2024-08-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehae323 · https://hartvaat.nl/2024/08/21/pa-drukmonitoring-bij-chronisch-hartfalen-effecten-over-klinische-subgroepen/* This MONITOR-HF analysis showed that pulmonary artery pressure monitoring provides benefit across all clinically relevant heart failure subgroups, including HFrEF, HFmrEF, and HFpEF, supporting universal hemodynamic-guided management. ## Tadalafil for Treatment of Combined Postcapillary and Precapillary Pulmonary Hypertension in Patients With Heart Failure and Preserved Ejection Fraction: A Randomized Controlled Phase 3 Study. *2024-08-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069340 · https://hartvaat.nl/2024/08/20/tadalafil-bij-gecombineerde-post-en-precapillaire-ph-en-hfpef/* This study evaluated tadalafil for combined pre- and post-capillary pulmonary hypertension in HFpEF, showing modest hemodynamic improvement but failing to demonstrate robust clinical benefit for phosphodiesterase-5 inhibition in this phenotype. ## Weekly Journal Scan: Impella CP in myocardial infarction complicated by cardiogenic shock. *2024-08-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehae306 · https://hartvaat.nl/2024/08/16/impella-cp-bij-door-mi-gecompliceerde-cardiogene-shock-journal-scan/* An overview of the DanGer Shock trial results discussed the clinical implications of Impella CP mechanical circulatory support in myocardial infarction complicated by cardiogenic shock. Impella CP is the first mechanical support device with demonstrated mortality benefit in this setting. ## Results of International, Double-Blind, Randomized, Placebo-Controlled, Phase IIa Study of Interleukin-1 Blockade With RPH-104 (Goflikicept) in Patients With ST-Segment-Elevation Myocardial Infarction (STEMI). *2024-08-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069396 · https://hartvaat.nl/2024/08/13/anti-il-6-therapie-bij-acuut-mi-fase-iia-trial/* This phase IIa trial of interleukin-6 blockade in acute MI demonstrated significant reduction in hsCRP, testing a more targeted anti-inflammatory approach than IL-1β inhibition for attenuating the acute inflammatory response after myocardial infarction. ## Perioperative Management of Antithrombotic Therapy. *2024-08-06 · JAMA · https://doi.org/10.1001/jama.2024.5880 · https://hartvaat.nl/2024/08/06/perioperatief-management-van-antitrombotische-therapie-actueel-overzicht/* This JAMA Clinical Guidelines Synopsis summarized the ACCP guidelines on perioperative management of antithrombotic therapy, providing practical guidance for bridging anticoagulants and managing antiplatelets around surgical procedures. ## Randomized Trial for Evaluation in Secondary Prevention Efficacy of Combination Therapy-Statin and Eicosapentaenoic Acid (RESPECT-EPA). *2024-08-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.065520 · https://hartvaat.nl/2024/08/06/racing-subanalyse-matige-statine-plus-ezetimibe-voor-secundaire-preventie/* This RACING subanalysis confirmed that moderate-intensity statin plus ezetimibe is equally effective as high-intensity statin for secondary cardiovascular prevention, with consistent results across different patient subgroups. ## A Prospective Randomized Trial of Direct Oral Anticoagulant Therapy With a Fully Magnetically Levitated LVAD: The DOT-HM3 Study. *2024-08-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069726 · https://hartvaat.nl/2024/08/06/doac-bij-heartmate-3-lvad-eerste-gerandomiseerde-trial/* This first randomized trial of DOAC therapy in patients with the HeartMate 3 LVAD explored whether direct oral anticoagulants can replace warfarin for anticoagulation in mechanically supported patients, potentially simplifying long-term management. ## Systematic review and meta-analysis on the impact on outcomes of device algorithms for minimizing right ventricular pacing. *2024-08-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae212 · https://hartvaat.nl/2024/08/03/device-algoritmen-voor-rv-pacingminimalisatie-meta-analyse-van-uitkomsten/* This meta-analysis showed that device algorithms minimizing right ventricular pacing improve clinical outcomes including reduced AF and heart failure, supporting the programming of RV pacing avoidance modes in pacemaker patients. ## Same-day discharge vs. overnight stay following catheter ablation for atrial fibrillation: a comprehensive review and meta-analysis by the European Heart Rhythm Association Health Economics Committee. *2024-08-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae200 · https://hartvaat.nl/2024/08/03/dagontslag-versus-overnachting-na-af-ablatie-uitgebreide-meta-analyse/* This comprehensive meta-analysis confirmed that same-day discharge after AF catheter ablation is safe and equivalent to overnight observation, supporting outpatient ablation as a standard approach. ## Cardiac shockwave therapy in addition to coronary bypass surgery improves myocardial function in ischaemic heart failure: the CAST-HF trial. *2024-08-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehae341 · https://hartvaat.nl/2024/08/03/cardiale-shockwave-therapie-bij-cabg-verbetert-myocardfunctie/* This study showed that cardiac shockwave therapy as an adjunct to CABG improves myocardial function in ischemic regions, exploring a non-invasive mechanical stimulation approach for enhancing surgical revascularization outcomes. ## Anticoagulation for post-operative atrial fibrillation after isolated coronary artery bypass grafting: a meta-analysis. *2024-08-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehae267 · https://hartvaat.nl/2024/08/03/anticoagulatie-bij-postoperatief-af-na-geisoleerde-cabg-meta-analyse/* This meta-analysis evaluated anticoagulation for post-operative AF after CABG, finding limited but suggestive evidence that anticoagulation may reduce stroke risk in patients who develop AF after cardiac surgery. ## Catheter ablation for persistent atrial fibrillation: patterns of recurrence and impact on quality of life and health care utilization. *2024-08-03 · European heart journal · https://doi.org/10.1093/eurheartj/ehae291 · https://hartvaat.nl/2024/08/03/catheterablatie-bij-persisterend-af-recidiefpatronen-en-kwaliteit-van-leven/* This study characterised recurrence patterns following catheter ablation for persistent atrial fibrillation and their impact on quality of life. Despite arrhythmia recurrences, quality of life improved significantly, broadening the definition of ablation success beyond rhythm control alone. ## Sham-Controlled Randomized Pilot Trial on Baroreflex Activation Therapy in Resistant Hypertension. *2024-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23088 · https://hartvaat.nl/2024/08/01/baroreflexactivatietherapie-bij-resistente-hypertensie-sham-gecontroleerde-pilot/* This sham-controlled pilot study of baroreflex activation therapy in resistant hypertension showed significant blood pressure reduction, providing early evidence for this device-based neuromodulation approach. ## Impact of Social Determinants of Health on Hypertension Outcomes: A Systematic Review. *2024-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22571 · https://hartvaat.nl/2024/08/01/sociale-determinanten-en-hypertensie-uitkomsten-systematische-review/* This systematic review documented the impact of social determinants of health on hypertension outcomes. Socioeconomic status, race/ethnicity, and healthcare access significantly influence blood pressure control, underscoring the need for targeted public health interventions. ## Relationship Between Sarcopenia and Intensive Blood Pressure Control Efficacy and Safety: A Secondary Analysis of SPRINT. *2024-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.23011 · https://hartvaat.nl/2024/08/01/sarcopenie-en-intensieve-bloeddrukbehandeling-sprint-subanalyse/* A SPRINT secondary analysis assessed whether sarcopenia modifies the efficacy and safety of intensive blood pressure treatment. Sarcopenic patients experienced comparable cardiovascular benefit and safety, supporting intensive blood pressure targets in this vulnerable population. ## Alcohol Intake and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Nonexperimental Cohort Studies. *2024-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.22703 · https://hartvaat.nl/2024/08/01/alcohol-en-hypertensierisico-dosis-respons-meta-analyse-van-niet-experimentele-s/* This comprehensive dose-response meta-analysis confirmed that any alcohol consumption increases hypertension risk with no safe threshold, reinforcing alcohol reduction as a blood pressure management strategy. ## Safety and efficacy of adaptive atrial pacing regulated by blood pressure during low-level exercise: a proof-of-concept study. *2024-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14854 · https://hartvaat.nl/2024/08/01/adaptieve-atriale-pacing-gereguleerd-door-bloeddruk-pilotstudie/* This proof-of-concept study evaluated a novel pacing algorithm that modulates atrial pacing rate based on blood pressure measurements during exercise. The approach was feasible and may improve physiological responses in pacemaker patients with heart failure with preserved ejection fraction. ## Achieved dose and treatment discontinuation of candesartan in men and women with chronic heart failure: data from CHARM. *2024-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14715 · https://hartvaat.nl/2024/08/01/candesartan-dosering-bij-mannen-versus-vrouwen-met-chronisch-hartfalen/* Analysis of the CHARM programme showed that women with heart failure achieved lower doses of candesartan than men yet experienced comparable clinical benefit. These findings support consideration of lower dose targets in women with heart failure. ## Impact of coronary microvascular dysfunction in heart failure with preserved ejection fraction: a meta-analysis. *2024-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14626 · https://hartvaat.nl/2024/08/01/coronaire-microvasculaire-disfunctie-bij-hfpef-meta-analyse/* This meta-analysis documented that coronary microvascular dysfunction is highly prevalent in HFpEF and is associated with worse exercise capacity and prognosis, supporting the microvascular hypothesis of HFpEF pathophysiology. ## Echocardiographic haemodynamic monitoring in the context of HeartMate 3™ therapy: a systematic review. *2024-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14759 · https://hartvaat.nl/2024/08/01/echocardiografische-monitoring-bij-heartmate-3-systematische-review/* A systematic review summarised echocardiographic haemodynamic monitoring strategies in patients with the HeartMate 3 left ventricular assist device. Standardised echocardiographic protocols are essential for optimal device management and early detection of complications. ## Apixaban vs Aspirin According to CHA2DS2-VASc Score in Subclinical Atrial Fibrillation: Insights From ARTESiA. *2024-07-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.05.002 · https://hartvaat.nl/2024/07/23/artesia-apixaban-versus-aspirine-naar-cha2ds2-vasc-bij-subclinisch-af/* This ARTESIA subanalysis showed that the benefit of apixaban over aspirin for device-detected subclinical AF increases with higher CHA₂DS₂-VASc scores, supporting risk-stratified anticoagulation decisions for subclinical arrhythmia. ## Effects of Rapid Uptitration of Neurohormonal Blockade on Effective, Sustainable Decongestion and Outcomes in STRONG-HF. *2024-07-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.055 · https://hartvaat.nl/2024/07/23/snelle-optitratie-van-neurohormonale-blokkade-en-duurzame-decongestie-bij-hf/* This study showed that rapid up-titration of neurohormonal blockade during heart failure hospitalization durably improves decongestion and reduces residual congestion, supporting the STRONG-HF approach of aggressive inpatient optimization. ## Effect of Sacubitril/Valsartan on Cognitive Function in Patients With Heart Failure With Preserved Ejection Fraction: A Prespecified Analysis of PARAGON-HF. *2024-07-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.068774 · https://hartvaat.nl/2024/07/23/sacubitril-valsartan-en-cognitieve-functie-bij-hfpef/* This analysis confirmed that sacubitril-valsartan does not impair cognitive function in HFpEF patients, addressing the theoretical concern that neprilysin inhibition might affect amyloid-beta clearance in the brain. ## OCT-Guided vs Angiography-Guided Coronary Stent Implantation in Complex Lesions: An ILUMIEN IV Substudy. *2024-07-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.037 · https://hartvaat.nl/2024/07/23/ilumien-iv-oct-geleide-pci-bij-complexe-laesies-subanalyse/* This ILUMIEN IV substudy in complex lesions showed a trend toward better outcomes with OCT-guided PCI, suggesting that intravascular imaging may be most valuable when anatomical complexity demands optimized stent deployment. ## Impact of Anatomical and Viability-Guided Completeness of Revascularization on Clinical Outcomes in Ischemic Cardiomyopathy. *2024-07-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.043 · https://hartvaat.nl/2024/07/23/anatomische-versus-viabiliteitsgerichte-completeness-van-revascularisatie/* This analysis compared anatomical versus viability-guided complete revascularization in ischemic cardiomyopathy, showing that viability-guided strategy is at least as effective, supporting targeted intervention based on myocardial viability. ## Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial. *2024-07-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)01028-6 · https://hartvaat.nl/2024/07/20/sbp-120-versus-140-mmhg-bij-hoog-cv-risico-meta-analyse-van-intensieve-behandeli/* This meta-analysis confirmed that targeting a systolic blood pressure below 120 mmHg versus below 140 mmHg significantly reduces cardiovascular events and mortality in patients with high cardiovascular risk, including those with diabetes. The data reinforce aggressive blood pressure targets. ## Equitable Care for Hypertension: Blood Pressure and Patient-Reported Outcomes of the RICH LIFE Cluster Randomized Trial. *2024-07-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069622 · https://hartvaat.nl/2024/07/16/rich-life-gelijkwaardige-hypertensiezorg-voor-achtergestelde-populaties/* The RICH LIFE cluster-randomized trial demonstrated that a multifactorial intervention targeting health equity improves blood pressure control and patient-reported outcomes in underserved communities with hypertension disparities. ## Percutaneous Coronary Revascularization Strategies After Myocardial Infarction: A Systematic Review and Network Meta-Analysis. *2024-07-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.051 · https://hartvaat.nl/2024/07/16/revascularisatiestrategieen-na-mi-systematische-review-en-meta-analyse/* This systematic review and network meta-analysis compared PCI strategies after MI (complete vs culprit, FFR-guided vs routine), confirming that complete revascularization provides the best outcomes with either physiological or angiographic guidance. ## Effects of an Intervention to Improve Evidence-Based Care for People With Diabetes and Cardiovascular Disease Across Sex, Race, and Ethnicity Subgroups: Insights From the COORDINATE-Diabetes Trial. *2024-07-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.068962 · https://hartvaat.nl/2024/07/16/interventie-voor-evidence-based-zorg-bij-diabetes-en-cv-risico/* This study evaluated an intervention to improve evidence-based therapy in diabetic patients with cardiovascular risk, demonstrating that structured cardiology clinic-based programs increase prescription of cardiometabolic medications. ## Semaglutide and NYHA Functional Class in Obesity-Related Heart Failure With Preserved Ejection Fraction: The STEP-HFpEF Program. *2024-07-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.038 · https://hartvaat.nl/2024/07/16/semaglutide-en-nyha-klasse-bij-hfpef-met-obesitas-step-hfpef-analyse/* This STEP-HFpEF analysis showed that semaglutide significantly improves NYHA functional class in obesity-related HFpEF, with more patients achieving NYHA class I and fewer remaining in class III, demonstrating meaningful functional improvement. ## Long-term colchicine for the prevention of vascular recurrent events in non-cardioembolic stroke (CONVINCE): a randomised controlled trial. *2024-07-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)00968-1 · https://hartvaat.nl/2024/07/13/convince-langetermijn-colchicine-voor-preventie-van-recidief-niet-cardioembolisc/* The CONVINCE trial showed that long-term colchicine did not significantly reduce recurrent vascular events after non-cardioembolic stroke. The negative result suggested that the anti-inflammatory benefit of colchicine in coronary disease may not extend to all atherothrombotic vascular beds. ## Evinacumab in homozygous familial hypercholesterolaemia: long-term safety and efficacy. *2024-07-12 · European heart journal · https://doi.org/10.1093/eurheartj/ehae325 · https://hartvaat.nl/2024/07/12/evinacumab-bij-homozygote-fh-langetermijn-veiligheid-en-effectiviteit/* Long-term data confirmed the sustained safety and efficacy of evinacumab in homozygous FH, with durable LDL cholesterol reduction and no emergence of late adverse effects, supporting long-term ANGPTL3 inhibition for this severe genetic disorder. ## Aerobic, resistance, or combined exercise training and its outcomes on cardiovascular risk profile in overweight or obese adults via a CardioRACE trial: a gap. *2024-07-12 · European heart journal · https://doi.org/10.1093/eurheartj/ehae233 · https://hartvaat.nl/2024/07/12/aerobe-kracht-of-gecombineerde-training-en-cv-risicoprofiel-bij-obesitas/* This review summarised the cardiovascular risk reduction effects of aerobic, resistance, and combined exercise training in overweight or obese adults. Combined aerobic and resistance training offered the broadest benefits across blood pressure, lipids, and insulin sensitivity. ## Non-ST-elevation acute coronary syndromes with previous coronary artery bypass grafting: a meta-analysis of invasive vs. conservative management. *2024-07-12 · European heart journal · https://doi.org/10.1093/eurheartj/ehae245 · https://hartvaat.nl/2024/07/12/nste-acs-na-cabg-meta-analyse-van-behandelstrategieen/* A meta-analysis compared invasive versus conservative management of non-ST-elevation acute coronary syndromes in patients with previous coronary artery bypass grafting. Outcomes were worse than in native coronary disease, and the optimal strategy varies by individual patient characteristics. ## Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. *2024-07-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2403347 · https://hartvaat.nl/2024/07/11/flow-semaglutide-beschermt-nieren-bij-type-2-diabetes-en-ckd-nejm-gerelateerd/* The FLOW trial demonstrated that semaglutide significantly slowed kidney disease progression in patients with type 2 diabetes and CKD, reducing the composite of sustained eGFR decline, kidney failure, and renal or cardiovascular death. The trial was stopped early for efficacy, establishing GLP-1 receptor agonists as a new renoprotective therapy alongside SGLT2 inhibitors. ## Intracoronary thrombolysis in ST-elevation myocardial infarction: a systematic review and meta-analysis. *2024-07-10 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2024-324078 · https://hartvaat.nl/2024/07/10/intracoronaire-trombolyse-bij-stemi-meta-analyse/* This meta-analysis evaluated adjunctive intracoronary thrombolytic therapy during primary PCI for ST-elevation myocardial infarction. While intracoronary thrombolysis reduced microvascular obstruction, clinical outcomes were not consistently improved. ## Comparative Cardiovascular Benefits of Bempedoic Acid and Statin Drugs. *2024-07-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.048 · https://hartvaat.nl/2024/07/09/bempedoinezuur-versus-statines-vergelijking-van-cv-voordelen/* This comparative analysis showed that bempedoic acid provides similar cardiovascular risk reduction per unit of LDL cholesterol lowering as statins, confirming that the LDL-lowering hypothesis holds regardless of the pharmacological mechanism. ## Effect of Cangrelor on Infarct Size in ST-Segment-Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention: A Randomized Controlled Trial (The PITRI Trial). *2024-07-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.068938 · https://hartvaat.nl/2024/07/09/cangrelor-en-infarctgrootte-bij-stemi-gerandomiseerde-trial/* This randomized trial showed that cangrelor at reperfusion does not significantly reduce infarct size in STEMI compared with standard care, a negative result for intravenous antiplatelet therapy as a cardioprotective adjunct. ## Randomized Trial of a Selective Aldose Reductase Inhibitor in Patients With Diabetic Cardiomyopathy. *2024-07-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.380 · https://hartvaat.nl/2024/07/09/selectieve-aldosereductaseremmer-bij-diabetische-cardiomyopathie-rct/* This randomized trial of a selective aldose reductase inhibitor in diabetic cardiomyopathy showed improvement in diastolic function, exploring a metabolic mechanism targeting the polyol pathway for preventing diabetic heart failure. ## Benefits of upgrading right ventricular to biventricular pacing in heart failure patients with atrial fibrillation. *2024-07-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae179 · https://hartvaat.nl/2024/07/02/upgrade-rv-naar-crt-pacing-bij-hartfalen-met-af-voordelen-bevestigd/* This study confirmed that upgrading from RV pacing to biventricular CRT in heart failure patients with AF improves LV function and clinical outcomes, supporting resynchronization in the pacing-dependent AF population. ## Closed loop stimulation reduces the incidence of atrial high-rate episodes compared with conventional rate-adaptive pacing in patients with sinus node dysfunctions. *2024-07-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae175 · https://hartvaat.nl/2024/07/02/closed-loop-stimulatie-vermindert-ahre-s-versus-conventionele-rate-adaptieve-pac/* This study showed that closed-loop stimulation pacing reduces atrial high-rate episodes compared with conventional rate-adaptive pacing, suggesting that physiological heart rate adaptation may have antiarrhythmic properties. ## Pulsed Field vs Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation: Recurrent Atrial Arrhythmia Burden. *2024-07-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.05.001 · https://hartvaat.nl/2024/07/02/pfa-versus-thermale-ablatie-bij-paroxysmaal-af-aritmielastanalyse/* This ADVENT analysis showed that the arrhythmia burden after pulsed field ablation is comparable to thermal ablation for paroxysmal AF, confirming equivalent rhythm control with the newer tissue-selective technology. ## Home Blood Pressure Telemonitoring and Nurse Case Management in Black and Hispanic Patients With Stroke: A Randomized Clinical Trial. *2024-07-02 · JAMA · https://doi.org/10.1001/jama.2024.6609 · https://hartvaat.nl/2024/07/02/thuisbloeddruktelemonitoring-en-nurse-case-management-na-cva-jama-rct/* This JAMA trial demonstrated that home blood pressure telemonitoring combined with nurse case management significantly improves blood pressure control in Black and Hispanic stroke survivors, addressing the persistent disparities in hypertension management. ## Semaglutide and NT-proBNP in Obesity-Related HFpEF: Insights From the STEP-HFpEF Program. *2024-07-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.022 · https://hartvaat.nl/2024/07/02/semaglutide-en-nt-probnp-bij-hfpef-met-obesitas-step-hfpef-programma/* This STEP-HFpEF analysis showed that semaglutide significantly reduces NT-proBNP in patients with obesity-related HFpEF, providing a biomarker-based confirmation of the drug's cardiac benefit beyond symptoms and weight loss. ## Symptoms as a Predictor of the Placebo-Controlled Efficacy of PCI in Stable Coronary Artery Disease. *2024-07-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.016 · https://hartvaat.nl/2024/07/02/orbita-2-subanalyse-symptomen-voorspellen-pci-effect-bij-stabiel-coronairlijden/* This ORBITA-2 subanalysis showed that patients with more severe symptoms derive greater placebo-controlled benefit from PCI, supporting symptom severity as a selection criterion for revascularization in stable coronary disease. ## Early Versus Late Initiation of Direct Oral Anticoagulants After Ischemic Stroke in People With Atrial Fibrillation and Hemorrhagic Transformation: Prespecified Subanalysis of the Randomized Controlled ELAN Trial. *2024-07-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069324 · https://hartvaat.nl/2024/07/02/vroege-versus-late-doac-na-cva-met-hemorrhagische-transformatie-bij-af/* This analysis showed that early DOAC initiation after ischemic stroke with hemorrhagic transformation in AF patients is safe, even in the presence of bleeding changes on brain imaging, supporting a move toward earlier anticoagulation. ## N-of-1 Trial of Angina Verification Before Percutaneous Coronary Intervention. *2024-07-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.001 · https://hartvaat.nl/2024/07/02/n-of-1-trial-voor-anginaverificatie-voor-pci/* This innovative N-of-1 trial used blinded placebo-controlled medication phases to verify whether symptoms attributed to angina were truly medication-responsive before PCI. The approach identified patients most likely to benefit from revascularization. ## Dual vs Single Cardioversion of Atrial Fibrillation in Patients With Obesity: A Randomized Clinical Trial. *2024-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.1091 · https://hartvaat.nl/2024/07/01/dubbele-versus-enkele-cardioversie-bij-af-en-obesitas-jama-cardiology-rct/* This randomized trial showed that dual simultaneous cardioversion using two defibrillators improves success rates for AF termination in obese patients, providing a practical solution for the common problem of cardioversion failure in obesity. ## Plozasiran (ARO-APOC3) for Severe Hypertriglyceridemia: The SHASTA-2 Randomized Clinical Trial. *2024-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0959 · https://hartvaat.nl/2024/07/01/plozasiran-sirna-tegen-apoc3-bij-ernstige-hypertriglyceridemie-shasta-2/* The SHASTA-2 trial demonstrated that plozasiran, an siRNA targeting APOC3, dramatically reduces triglycerides in patients with severe hypertriglyceridemia. The twice-yearly injectable offers a transformative approach for this hard-to-treat lipid disorder and its associated pancreatitis risk. ## Influence of Blood Pressure Reduction on Pulse Wave Velocity in Primary Hypertension: A Meta-Analysis and Comparison With an Acute Modulation of Transmural Pressure. *2024-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22436 · https://hartvaat.nl/2024/07/01/bloeddrukverlaging-en-polsgolfsnelheid-meta-analyse/* A meta-analysis examined the effect of antihypertensive treatment on aortic pulse wave velocity. Blood pressure reduction lowered PWV, but less than expected from the pressure change alone, suggesting a blood pressure-independent component of vascular stiffening. ## Cardiovascular Outcomes in Hypertension-Treated Patients With Peripheral Artery Disease: The VALUE Trial. *2024-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.124.22832 · https://hartvaat.nl/2024/07/01/value-trial-cv-uitkomsten-bij-hypertensie-met-perifeer-vaatlijden/* This VALUE trial subanalysis revealed that hypertensive patients with peripheral artery disease carry a very high cardiovascular risk. Intensive blood pressure treatment proved particularly valuable in this population with combined vascular disease. ## Atrial Fibrillation Screening During Routine Automated Office, Home, and Ambulatory Blood Pressure Measurement: A Diagnostic Test Accuracy Systematic Review and Meta-Analysis. *2024-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22563 · https://hartvaat.nl/2024/07/01/af-screening-tijdens-bloeddrukmeting-diagnostische-nauwkeurigheid/* This diagnostic study evaluated AF screening during routine blood pressure measurements in office, home, and ambulatory settings, showing that automated AF detection can be effectively integrated into standard BP monitoring. ## Randomized Trial of a Vascular Care Team vs Education for Patients With Peripheral Artery Disease. *2024-06-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.04.034 · https://hartvaat.nl/2024/06/25/vasculair-zorgteam-versus-educatie-bij-perifeer-arterieel-vaatlijden/* This randomized trial showed that a multidisciplinary vascular care team significantly improves secondary prevention medication use and outcomes in PAD patients compared with standard education alone. ## Revisiting Race and the Benefit of RAS Blockade in Heart Failure: A Meta-Analysis of Randomized Clinical Trials. *2024-06-25 · JAMA · https://doi.org/10.1001/jama.2024.6774 · https://hartvaat.nl/2024/06/25/raas-blokkade-bij-hartfalen-voordeel-onafhankelijk-van-etniciteit-jama-meta-anal/* This JAMA meta-analysis demonstrated that RAAS blockade provides equal mortality benefit in Black and non-Black patients with HFrEF, debunking the long-held assumption that RAAS inhibitors are less effective in Black patients. The finding supports equitable heart failure treatment regardless of race. ## Randomized, Multicenter Study to Assess the Effects of Different Doses of Sildenafil on Mortality in Adults With Pulmonary Arterial Hypertension. *2024-06-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.068107 · https://hartvaat.nl/2024/06/18/sildenafil-dosisvergelijking-bij-pulmonale-arteriele-hypertensie/* This randomized study compared different sildenafil doses for pulmonary arterial hypertension, finding that higher doses do not provide significantly better outcomes than the approved dose, informing optimal dosing strategies. ## Mineralocorticoid Receptor Antagonists in Patients With Heart Failure and Impaired Renal Function. *2024-06-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.426 · https://hartvaat.nl/2024/06/18/mra-bij-hartfalen-met-nierfunctiestoornissen-veiligheid-en-effectiviteit/* This analysis showed that MRA therapy can be safely used in heart failure patients with impaired renal function when potassium and creatinine are monitored, addressing a common barrier to optimal neurohormonal blockade in CKD patients. ## Invasive vs. conservative management of older patients with non-ST-elevation acute coronary syndrome: individual patient data meta-analysis. *2024-06-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehae151 · https://hartvaat.nl/2024/06/14/invasief-versus-conservatief-bij-ouderen-met-nste-acs-ipd-meta-analyse/* This individual patient data meta-analysis confirmed that early invasive management reduces MI and repeat revascularization in older patients with NSTE-ACS compared with conservative management. The pooled evidence supports active intervention in elderly ACS patients. ## Ertugliflozin for Functional Mitral Regurgitation Associated With Heart Failure: EFFORT Trial. *2024-06-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069144 · https://hartvaat.nl/2024/06/11/effort-ertugliflozine-bij-functionele-mitralisinsufficientie-en-hartfalen/* The EFFORT trial explored whether the SGLT2 inhibitor ertugliflozin reduces functional mitral regurgitation in heart failure, testing the hypothesis that volume management through SGLT2 inhibition can improve secondary valvular disease. ## Left Ventricular Function, Congestion, and Effect of Empagliflozin on Heart Failure Risk After Myocardial Infarction. *2024-06-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.405 · https://hartvaat.nl/2024/06/11/empact-mi-lv-functie-congestie-en-empagliflozine-effect-na-mi/* This analysis showed that empagliflozin after MI primarily benefits patients with LV dysfunction and congestion, refining the target population for post-MI SGLT2 inhibitor therapy. ## Randomized Trial of Remote Assessment of Patients After an Acute Coronary Syndrome. *2024-06-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.398 · https://hartvaat.nl/2024/06/11/remote-beoordeling-na-acs-gerandomiseerde-trial/* This randomized trial demonstrated that remote follow-up after ACS is as safe as conventional clinic visits, supporting telecardiology as a viable model for post-acute coronary care delivery. ## Effect of Alcohol-Mediated Renal Denervation on Blood Pressure in the Presence of Antihypertensive Medications: Primary Results From the TARGET BP I Randomized Clinical Trial. *2024-06-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069291 · https://hartvaat.nl/2024/06/11/target-bp-i-alcohol-gemedieerde-renale-denervatie-bij-hypertensie/* The TARGET BP I trial evaluated alcohol-mediated renal denervation, a novel technique, showing significant blood pressure reduction in patients on antihypertensive medications. The approach offers a new energy source for the renal denervation armamentarium. ## Self-Expanding or Balloon-Expandable TAVR in Patients with a Small Aortic Annulus. *2024-06-06 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2312573 · https://hartvaat.nl/2024/06/06/smart-zelf-expanderend-versus-ballonexpandeerbaar-tavr-bij-kleine-annulus-nejm/* The SMART trial showed that balloon-expandable TAVR achieved significantly better hemodynamic performance than self-expanding TAVR in patients with a small aortic annulus. The results provided guidance for device selection in this challenging anatomical subset. ## Effect of Reconstituted Human Apolipoprotein A-I on Recurrent Ischemic Events in Survivors of Acute MI. *2024-06-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.396 · https://hartvaat.nl/2024/06/04/apoa-i-infusie-na-mi-geen-effect-op-recidief-ischemische-events/* This AEGIS-II confirmation trial showed that reconstituted apoA-I infusion does not reduce recurrent ischemic events after MI, definitively closing the therapeutic approach of acute HDL augmentation for secondary prevention. ## Effects of Sacubitril/Valsartan Across the Spectrum of Renal Impairment in Patients With Heart Failure. *2024-06-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.392 · https://hartvaat.nl/2024/06/04/sacubitril-valsartan-bij-hartfalen-over-het-nierfunctiespectrum/* This analysis confirmed that sacubitril-valsartan is effective and safe across the full spectrum of renal impairment in heart failure, with consistent benefit maintained even in advanced CKD. ## Randomized Evaluation of a Remote Management Program to Improve Guideline-Directed Medical Therapy: The DRIVE Trial. *2024-06-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069494 · https://hartvaat.nl/2024/06/04/drive-remote-management-verbetert-richtlijnmedicatie-bij-hartfalen/* The DRIVE trial showed that a remote management program significantly improves guideline-directed medication use and dosing in heart failure patients, demonstrating that technology-assisted remote optimization can bridge the gap between guidelines and practice. ## Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes: A SMART-C Collaborative Meta-Analysis. *2024-06-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069568 · https://hartvaat.nl/2024/06/04/sglt2-remmers-en-mace-smart-c-collaboratieve-mega-meta-analyse/* This SMART-C collaborative meta-analysis of all major SGLT2 inhibitor trials confirmed that the class reduces heart failure hospitalization and kidney outcomes across all patient populations, while MACE reduction was primarily seen in patients with type 2 diabetes and atherosclerotic disease. The analysis provides the definitive summary of SGLT2 inhibitor cardiovascular evidence. ## Safety and efficacy of long-term sodium channel blocker therapy for early rhythm control: the EAST-AFNET 4 trial. *2024-06-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae121 · https://hartvaat.nl/2024/06/03/east-afnet-4-natriumkanaalblokkers-veilig-en-effectief-voor-langetermijn-ritmeco/* This EAST-AFNET 4 analysis confirmed that sodium channel blockers (flecainide, propafenone) are safe and effective for long-term early rhythm control in AF patients with cardiovascular comorbidities, addressing concerns about proarrhythmic effects. ## Complete vs Culprit-Only Revascularization in Older Patients With Myocardial Infarction and High Bleeding Risk: A Randomized Clinical Trial. *2024-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0804 · https://hartvaat.nl/2024/06/01/complete-versus-culprit-only-revascularisatie-bij-ouderen-met-mi-en-hoog-bloedin/* This RCT showed that complete revascularization reduces ischemic events compared with culprit-only PCI even in older MI patients with high bleeding risk, demonstrating that the benefit persists despite the higher procedural risk. ## Atrial Fibrillation Ablation in Heart Failure With Reduced vs Preserved Ejection Fraction: A Systematic Review and Meta-Analysis. *2024-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0675 · https://hartvaat.nl/2024/06/01/af-ablatie-bij-hfref-versus-hfpef-meta-analyse/* This meta-analysis compared AF ablation efficacy in HFrEF versus HFpEF, finding that ablation improves outcomes in both phenotypes, extending the evidence for rhythm control across the heart failure ejection fraction spectrum. ## Atrial Shunt Device Effects on Cardiac Structure and Function in Heart Failure With Preserved Ejection Fraction: The REDUCE LAP-HF II Randomized Clinical Trial. *2024-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0520 · https://hartvaat.nl/2024/06/01/reduce-lap-hf-ii-atriaal-shuntdevice-bij-hfpef-cardiale-effecten/* This REDUCE LAP-HF II subanalysis examined the cardiac structural effects of the atrial shunt device in HFpEF, showing favorable hemodynamic changes despite the neutral primary clinical endpoint. ## Extended Clopidogrel Monotherapy vs DAPT in Patients With Acute Coronary Syndromes at High Ischemic and Bleeding Risk: The OPT-BIRISK Randomized Clinical Trial. *2024-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0534 · https://hartvaat.nl/2024/06/01/opt-birisk-clopidogrel-monotherapie-bij-acs-met-hoog-ischemisch-en-bloedingsrisi/* The OPT-BIRISK trial showed that extended clopidogrel monotherapy is as effective as DAPT in ACS patients with both high ischemic and high bleeding risk, supporting a simplified single-agent approach in this challenging dual-risk population. ## Influenza Vaccine Immune Response in Patients With High-Risk Cardiovascular Disease: A Secondary Analysis of the INVESTED Randomized Clinical Trial. *2024-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0468 · https://hartvaat.nl/2024/06/01/invested-griepvaccin-immuunrespons-bij-hoog-risico-cv-patienten/* Secondary analysis of the INVESTED trial compared immune responses to high-dose trivalent versus standard-dose quadrivalent influenza vaccine in patients with high-risk cardiovascular disease. The comparable humoral immune responses support the use of standard-dose vaccination in this population. ## Pulmonary arterial hypertension treatment: an individual participant data network meta-analysis. *2024-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae049 · https://hartvaat.nl/2024/06/01/pah-behandeling-ipd-netwerk-meta-analyse-van-alle-therapieen/* This individual participant data network meta-analysis of all PAH therapies demonstrated that initial combination therapy, including regimens with sotatercept, was superior to monotherapy for improving exercise capacity and clinical outcomes. The results support upfront combination treatment as the standard of care in PAH. ## Blood Pressure Lowering in Patients With Central Hypertension: A Randomized Clinical Trial. *2024-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21653 · https://hartvaat.nl/2024/06/01/bloeddrukverlaging-bij-centrale-hypertensie-gerandomiseerde-trial/* This randomized trial investigated blood pressure lowering specifically in patients with central hypertension (elevated aortic pressure despite normal brachial readings), testing a targeted approach to vascular-specific blood pressure management. ## Long-Term Blood Pressure Reductions Following Catheter-Based Renal Denervation: A Systematic Review and Meta-Analysis. *2024-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22314 · https://hartvaat.nl/2024/06/01/renale-denervatie-langetermijn-bloeddrukeffect-bevestigd-meta-analyse/* This meta-analysis confirmed the long-term blood pressure-lowering effect of catheter-based renal denervation, with sustained reductions maintained for at least 3 years, supporting the durability of the device-based approach. ## Association Between Gestational Diabetes Mellitus and Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies With a Quantitative Bias Analysis of Uncontrolled Confounding. *2024-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22418 · https://hartvaat.nl/2024/06/01/zwangerschapsdiabetes-en-hypertensierisico-meta-analyse-met-dosis-respons/* This meta-analysis confirmed a significant association between gestational diabetes and subsequent hypertension development, with a dose-dependent relationship that identifies GDM as a long-term cardiovascular risk marker. ## Comparison of cardiovascular outcomes of new antihyperglycemic agents in Type 2 Diabetes Mellitus: a meta-analysis. *2024-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14726 · https://hartvaat.nl/2024/06/01/nieuwe-antihyperglycemische-middelen-en-cv-uitkomsten-bij-diabetes-meta-analyse/* This meta-analysis compared cardiovascular outcomes of new antihyperglycemic agents in type 2 diabetes, showing that SGLT2 inhibitors and GLP-1 receptor agonists both reduce cardiovascular events while DPP-4 inhibitors are cardiovascularly neutral. ## S2I2N0-3 score predicts short- and long-term mortality and morbidity in HFrEF: a post-hoc analysis of the GUIDE-IT trial. *2024-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14689 · https://hartvaat.nl/2024/06/01/s2i2n0-3-score-voorspelt-mortaliteit-bij-hfref-guide-it-subanalyse/* Post-hoc analysis of the GUIDE-IT trial validated the S2I2N0-3 score — incorporating stroke history, insulin-treated diabetes, and NT-proBNP — as a reliable predictor of short- and long-term mortality and morbidity in patients with heart failure with reduced ejection fraction. ## Prognostic models for patients suffering a heart failure with a preserved ejection fraction: a systematic review. *2024-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14696 · https://hartvaat.nl/2024/06/01/prognostische-modellen-voor-hfpef-systematische-review/* This systematic review evaluated prognostic models for heart failure with preserved ejection fraction. Most existing models had limited external validation and were derived from selected populations, highlighting the urgent need for better HFpEF-specific prognostic tools. ## Triglyceride-glucose index's link to cardiovascular outcomes post-percutaneous coronary intervention in China: a meta-analysis. *2024-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14679 · https://hartvaat.nl/2024/06/01/triglyceride-glucose-index-en-cv-uitkomsten-na-pci-chinese-meta-analyse/* A meta-analysis of Chinese studies demonstrated that the triglyceride-glucose index, a simple surrogate marker of insulin resistance, predicts major adverse cardiovascular events after percutaneous coronary intervention. This readily available marker could improve post-PCI risk stratification. ## A meta-analysis of the relationship between glycaemic variability and the mortality of patients with heart failure. *2024-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14627 · https://hartvaat.nl/2024/06/01/glycemische-variabiliteit-en-mortaliteit-bij-hartfalen-meta-analyse/* This meta-analysis found that greater glycaemic variability is associated with increased mortality in patients with heart failure. The findings suggest that stable glucose control may be prognostically more favourable than aggressive glucose lowering accompanied by fluctuations. ## Intensive Ambulance-Delivered Blood-Pressure Reduction in Hyperacute Stroke. *2024-05-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2314741 · https://hartvaat.nl/2024/05/30/right-2-ambulancebloeddrukverlaging-bij-hyperacuut-cva-nejm-vervolgresultaten/* This NEJM trial evaluated intensive ambulance-delivered blood pressure reduction in the hyperacute stroke phase, before distinction between ischemic and hemorrhagic subtypes. The prehospital intervention approach represents a novel strategy to improve neurological outcomes through very early blood pressure management. ## Clinical Impact of Routine Assessment of Patient-Reported Health Status in Heart Failure Clinic: The PRO-HF Trial. *2024-05-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069624 · https://hartvaat.nl/2024/05/28/pro-hf-routine-prom-meting-in-hartfalenpolikliniek-verbetert-uitkomsten/* The PRO-HF trial showed that routine assessment of patient-reported outcome measures in heart failure clinics improves quality of life without increasing healthcare utilization, supporting the integration of PROMs into standard heart failure care. ## Electronic nudges increase influenza vaccination utilization after myocardial infarction: the nationwide NUDGE-FLU implementation trial. *2024-05-27 · European heart journal · https://doi.org/10.1093/eurheartj/ehae235 · https://hartvaat.nl/2024/05/27/nudge-flu-elektronische-nudges-verhogen-griepvaccinatie-na-mi/* The NUDGE-FLU nationwide implementation trial showed that simple electronic nudges significantly increase influenza vaccination rates in post-MI patients, demonstrating a scalable behavioral intervention for cardiovascular prevention. ## Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial. *2024-05-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.124.069217 · https://hartvaat.nl/2024/05/21/empact-mi-empagliflozine-en-hartfalenuitkomsten-na-mi/* This EMPACT-MI subanalysis showed that empagliflozin after acute MI did not significantly reduce heart failure-specific outcomes, consistent with the neutral primary endpoint and limiting the role of early post-MI SGLT2 inhibition to patients with established heart failure. ## Dapagliflozin and Days of Full Health Lost in the DAPA-HF Trial. *2024-05-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.385 · https://hartvaat.nl/2024/05/21/dapa-hf-dapagliflozine-en-dagen-in-volledige-gezondheid/* This DAPA-HF analysis quantified the benefit of dapagliflozin in terms of days of full health gained, showing meaningful improvements in health-adjusted time alive beyond traditional event-based endpoints. ## Andexanet for Factor Xa Inhibitor-Associated Acute Intracerebral Hemorrhage. *2024-05-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2313040 · https://hartvaat.nl/2024/05/16/annexa-i-andexanet-alfa-bij-factor-xa-remmer-geassocieerde-intracerebrale-bloedi/* The ANNEXA-I trial demonstrated that andexanet alfa, a factor Xa inhibitor reversal agent, significantly reduced hematoma expansion compared with usual care in patients with acute intracerebral hemorrhage while taking factor Xa inhibitors. This provides the first randomized evidence for a specific reversal strategy in anticoagulant-associated intracranial bleeding. ## Olezarsen for Hypertriglyceridemia in Patients at High Cardiovascular Risk. *2024-05-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2402309 · https://hartvaat.nl/2024/05/16/olezarsen-bij-hypertriglyceridemie-en-hoog-cv-risico-nejm/* This NEJM trial showed that olezarsen reduced triglycerides by more than 50% in patients with hypertriglyceridemia and high cardiovascular risk. Unlike fibrates (PROMINENT), APOC3 inhibition reduces both triglycerides and apolipoprotein B-containing lipoproteins, positioning it as a more promising triglyceride-lowering strategy. ## Olezarsen, Acute Pancreatitis, and Familial Chylomicronemia Syndrome. *2024-05-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2400201 · https://hartvaat.nl/2024/05/16/olezarsen-bij-familiaire-chylomicronemie-nejm-fase-3/* This NEJM trial demonstrated that olezarsen, an antisense oligonucleotide targeting APOC3, dramatically reduced triglyceride levels and virtually eliminated acute pancreatitis episodes in patients with familial chylomicronemia syndrome. The results represent a transformative therapy for this severe, previously intractable genetic condition. ## Inorganic nitrate benefits contrast-induced nephropathy after coronary angiography for acute coronary syndromes: the NITRATE-CIN trial. *2024-05-13 · European heart journal · https://doi.org/10.1093/eurheartj/ehae100 · https://hartvaat.nl/2024/05/13/nitrate-cin-nitraat-beschermt-tegen-contrastnefropathie-na-acs/* The NITRATE-CIN trial demonstrated that inorganic nitrate reduces contrast-induced nephropathy after coronary angiography in ACS patients, providing a simple, cost-effective renal protective strategy during contrast-enhanced procedures. ## Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): a two-stage, multicentre, randomised trial. *2024-05-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)00282-4 · https://hartvaat.nl/2024/05/11/ivus-acs-ivus-geleide-pci-bij-acs-superieur-lancet/* The IVUS-ACS trial showed that IVUS-guided PCI significantly reduced target vessel failure compared with angiography-guided PCI in patients with acute coronary syndromes. This was the first randomized trial demonstrating the superiority of intravascular imaging guidance specifically in the ACS setting. ## Ticagrelor alone versus ticagrelor plus aspirin from month 1 to month 12 after percutaneous coronary intervention in patients with acute coronary syndromes (ULTIMATE-DAPT): a randomised, placebo-controlled, double-blind clinical trial. *2024-05-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)00473-2 · https://hartvaat.nl/2024/05/11/ticagrelor-monotherapie-versus-dapt-na-1-maand-bij-acs-lancet-rct/* This Lancet trial confirmed that ticagrelor monotherapy after 1 month of DAPT in ACS patients reduces bleeding without increasing ischemic events, adding to the robust evidence for early aspirin discontinuation in P2Y12-based antiplatelet strategies. ## Mandibular Advancement vs CPAP for Blood Pressure Reduction in Patients With Obstructive Sleep Apnea. *2024-05-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.359 · https://hartvaat.nl/2024/05/07/mandibulaire-advancementsplint-versus-cpap-voor-bloeddrukverlaging-bij-osa/* This study showed that mandibular advancement devices are noninferior to CPAP for blood pressure reduction in obstructive sleep apnea, providing a practical alternative for the common hypertension-OSA overlap. ## Sacubitril/Valsartan-Related Hypotension in Patients With Heart Failure and Preserved or Mildly Reduced Ejection Fraction. *2024-05-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.02.035 · https://hartvaat.nl/2024/05/07/sacubitril-valsartan-en-hypotensie-bij-hfpef-hfmref/* This analysis characterized hypotension with sacubitril-valsartan in HFpEF, showing that symptomatic hypotension occurs but is manageable and does not negate the clinical benefit of ARNI therapy. ## Cardiovascular Effects of Oral Ketone Ester Treatment in Patients With Heart Failure With Reduced Ejection Fraction: A Randomized, Controlled, Double-Blind Trial. *2024-05-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067971 · https://hartvaat.nl/2024/05/07/orale-ketonester-bij-hfref-gerandomiseerde-trial/* This randomized trial of oral ketone ester therapy in HFrEF showed that exogenous ketone supplementation increases cardiac output, exploring metabolic modulation as a novel heart failure treatment approach. ## Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial. *2024-05-04 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)00413-6 · https://hartvaat.nl/2024/05/04/prevent-preventieve-pci-versus-medicatie-bij-kwetsbare-coronaire-plaques-lancet/* The PREVENT trial demonstrated that preventive PCI of vulnerable atherosclerotic plaques identified by intravascular imaging (IVUS/OCT) reduced future coronary events compared with optimal medical therapy alone. This landmark result established a new treatment paradigm of prophylactic intervention for high-risk non-flow-limiting lesions. ## Impact of preventive substrate catheter ablation on implantable cardioverter-defibrillator interventions in patients with ischaemic cardiomyopathy and infarct-related coronary chronic total occlusion. *2024-05-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae109 · https://hartvaat.nl/2024/05/02/preventieve-substraatablatie-vermindert-icd-interventies-bij-ischemische-cmp/* This study showed that preventive substrate ablation in patients with ischemic cardiomyopathy and coronary chronic total occlusion significantly reduces ICD interventions, supporting prophylactic ablation in this high-risk device population. ## Venous vascular closure system vs. figure-of-eight suture following atrial fibrillation ablation: the STYLE-AF Study. *2024-05-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae105 · https://hartvaat.nl/2024/05/02/style-af-veneuze-closure-device-versus-figuur-van-acht-hechting-na-af-ablatie/* The STYLE-AF study compared a venous vascular closure system with the standard figure-of-eight suture technique for achieving haemostasis following single-shot pulmonary vein isolation. The closure device reduced time to haemostasis and improved patient comfort without increasing vascular access complications. ## Comprehensive atrial fibrillation burden and symptom reduction post-ablation: insights from DECAAF II. *2024-05-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae104 · https://hartvaat.nl/2024/05/02/decaaf-ii-af-last-en-symptoomreductie-na-ablatie/* Analysis of the DECAAF II trial demonstrated that catheter ablation significantly reduces atrial fibrillation burden and symptom severity in persistent AF patients, regardless of whether fibrosis-guided or standard pulmonary vein isolation was performed. The clinical benefit of ablation extends beyond simple rhythm control to meaningful improvements in patient-reported outcomes. ## Apolipoprotein A1 Infusions and Cardiovascular Outcomes after Acute Myocardial Infarction. *2024-05-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2400969 · https://hartvaat.nl/2024/05/02/aegis-ii-apoa1-infusie-na-acuut-mi-verbetert-uitkomsten-niet-nejm/* The AEGIS-II trial showed that infusion of recombinant apolipoprotein A1 (CSL112) after acute MI did not reduce the risk of MACE compared with placebo. The HDL-mimetic approach to reverse cholesterol transport did not translate to clinical cardiovascular benefit. ## Intravascular Imaging-Guided Optimization of Complex Percutaneous Coronary Intervention by Sex: A Subgroup Analysis of the RENOVATE-COMPLEX-PCI Trial. *2024-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0291 · https://hartvaat.nl/2024/05/01/renovate-complex-pci-beeldvorming-geleide-pci-bij-vrouwen-versus-mannen/* This RENOVATE-COMPLEX-PCI subanalysis showed that the benefit of intravascular imaging-guided PCI for complex lesions is consistent in both men and women, supporting sex-equal use of imaging guidance. ## Ticagrelor or Clopidogrel Monotherapy vs Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: A Systematic Review and Patient-Level Meta-Analysis. *2024-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0133 · https://hartvaat.nl/2024/05/01/p2y12-monotherapie-versus-dapt-na-pci-ipd-meta-analyse/* This patient-level meta-analysis confirmed that P2Y12 inhibitor monotherapy (ticagrelor or clopidogrel) after a short course of DAPT reduces major bleeding compared with standard 12-month DAPT without increasing ischemic events. The pooled evidence definitively supports de-escalation to single antiplatelet therapy. ## Quantitative Coronary Angiography vs Intravascular Ultrasonography to Guide Drug-Eluting Stent Implantation: A Randomized Clinical Trial. *2024-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0059 · https://hartvaat.nl/2024/05/01/angiografie-versus-ivus-voor-des-implantatie-gerandomiseerde-trial/* This randomized trial confirmed that IVUS-guided DES implantation achieves better procedural results than angiography-guided PCI, supporting routine intravascular imaging for coronary stenting optimization. ## Therapeutic Inertia With Initial Low-Dose Quadruple Combination Therapy for Hypertension: Results From the QUARTET Trial. *2024-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22284 · https://hartvaat.nl/2024/05/01/quartet-therapeutische-inertie-bij-lage-dosis-viervoudige-combinatietherapie/* This QUARTET analysis showed that initial low-dose quadruple combination therapy for hypertension reduces therapeutic inertia compared with standard care, as clinicians are less reluctant to continue simplified combination treatment. ## Secondary Analysis of the Salt Substitute and Stroke Study (SSaSS): Effects of Potassium-Enriched Salt on Cardiac Outcomes. *2024-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22410 · https://hartvaat.nl/2024/05/01/ssass-secundaire-analyse-kaliumverrijkt-zout-en-cardiale-uitkomsten/* This secondary SSaSS analysis showed that potassium-enriched salt substitution reduces cardiac events in addition to the previously demonstrated stroke reduction, broadening the cardiovascular benefit of this simple dietary intervention. ## Revisiting Cardiovascular Benefits of Blood Pressure Reduction in Primary and Secondary Prevention: Focus on Targets and Residual Risk-A Systematic Review and Meta-Analysis. *2024-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22610 · https://hartvaat.nl/2024/05/01/bloeddrukstreefwaarden-en-residueel-risico-systematische-review-en-meta-regressi/* This systematic review examined residual cardiovascular risk after achieving blood pressure targets, finding that even at optimal blood pressure levels, significant residual risk remains, supporting comprehensive risk factor management. ## Impact of Antihypertensive Medication Changes After Renal Denervation Among Different Patient Groups: SPYRAL HTN-ON MED. *2024-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22251 · https://hartvaat.nl/2024/05/01/spyral-htn-on-med-renale-denervatie-en-medicatiewijzigingen/* This SPYRAL HTN-ON MED subanalysis showed that renal denervation reduces the need for antihypertensive medications, with some patients able to decrease their pill burden after the procedure. ## Limb Outcomes With Ticagrelor Plus Aspirin in Patients With Diabetes Mellitus and Atherosclerosis. *2024-04-30 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.03.377 · https://hartvaat.nl/2024/04/30/ticagrelor-plus-aspirine-en-ledematenuitkomsten-bij-diabetes-met-atherosclerose/* This analysis showed that ticagrelor plus aspirin reduces adverse limb outcomes in diabetic patients with atherosclerosis, extending the dual antiplatelet benefit to peripheral vascular events in the diabetic population. ## Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials. *2024-04-27 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)00469-0 · https://hartvaat.nl/2024/04/27/semaglutide-bij-hfpef-met-obesitas-lancet-gepoolde-analyse-van-twee-nejm-trials/* This pooled analysis of STEP-HFpEF and STEP-HFpEF DM confirmed that semaglutide consistently improves quality of life, body weight, CRP, and NT-proBNP in patients with obesity-related HFpEF regardless of diabetes status. The combined data strengthened the evidence for GLP-1 receptor agonists in this population. ## FFR-Guided Complete or Culprit-Only PCI in Patients with Myocardial Infarction. *2024-04-25 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2314149 · https://hartvaat.nl/2024/04/25/frame-ami-ffr-geleide-versus-complete-pci-bij-mi-nejm/* The FRAME-AMI trial showed that FFR-guided complete revascularization of nonculprit lesions resulted in fewer stent implantations with comparable clinical outcomes versus routine angiography-guided complete PCI in patients with STEMI and multivessel disease. FFR guidance may reduce overtreatment without compromising safety. ## Empagliflozin after Acute Myocardial Infarction. *2024-04-25 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2314051 · https://hartvaat.nl/2024/04/25/dapa-mi-empagliflozine-na-acuut-mi-zonder-hf-of-diabetes-nejm/* The DAPA-MI trial showed that empagliflozin after acute MI in patients without heart failure or diabetes did not significantly improve the hierarchical composite of cardiovascular outcomes. The result suggested that the benefit of SGLT2 inhibitors in MI may be limited to patients with established heart failure or diabetes. ## Lipoprotein(a) Blood Levels and Cardiovascular Risk Reduction With Icosapent Ethyl. *2024-04-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.02.016 · https://hartvaat.nl/2024/04/23/lp-a-en-cv-risicoreductie-met-icosapent-ethyl-reduce-it-analyse/* This REDUCE-IT analysis showed that higher Lp(a) levels are associated with increased cardiovascular risk but that the benefit of icosapent ethyl is consistent regardless of Lp(a) status. ## Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With and Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials. *2024-04-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.065571 · https://hartvaat.nl/2024/04/23/pci-versus-cabg-bij-linker-hoofdstam-met-en-zonder-diabetes-precombat-follow-up/* This long-term analysis comparing PCI with CABG for left main disease stratified by diabetes confirmed that CABG remains superior in diabetic patients, consistent with the overall evidence favoring surgery for complex coronary disease with diabetes. ## Intravenous iron for heart failure, iron deficiency definitions, and clinical response: the IRONMAN trial. *2024-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehae086 · https://hartvaat.nl/2024/04/21/ironman-ijzerdeficientiedefinities-en-klinische-respons-op-iv-ijzer-bij-hf/* This IRONMAN subanalysis explored which iron deficiency definition best predicts clinical response to IV iron in heart failure, informing patient selection for iron repletion therapy. ## Coronary sinus reducer for the treatment of refractory angina (ORBITA-COSMIC): a randomised, placebo-controlled trial. *2024-04-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(24)00256-3 · https://hartvaat.nl/2024/04/20/orbita-cosmic-coronaire-sinusreducer-bij-refractaire-angina-sham-gecontroleerd/* The ORBITA-COSMIC placebo-controlled trial showed that the coronary sinus reducer device did not significantly improve angina compared with a sham procedure in patients with refractory angina, calling into question this structural approach to symptom relief. ## Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction. *2024-04-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2401479 · https://hartvaat.nl/2024/04/18/abyss-betablokkers-na-mi-met-behouden-ef-niet-nodig-nejm/* The ABYSS trial showed that long-term beta-blocker therapy after myocardial infarction in patients with preserved left ventricular ejection fraction did not reduce the composite of death, MI, or stroke. This challenges the decades-long standard of routine post-MI beta-blocker therapy in the modern era of early reperfusion and comprehensive secondary prevention. ## Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. *2024-04-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2312572 · https://hartvaat.nl/2024/04/18/danger-shock-impella-versus-standaardzorg-bij-cardiogene-shock-nejm/* The DanGer Shock trial demonstrated that the Impella CP microaxial flow pump significantly reduced 180-day all-cause mortality compared with standard care in patients with STEMI-related cardiogenic shock. This is the first positive randomized trial of a percutaneous mechanical circulatory support device in cardiogenic shock. ## Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes. *2024-04-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2313917 · https://hartvaat.nl/2024/04/18/step-hfpef-dm-semaglutide-bij-hfpef-met-obesitas-en-type-2-diabetes-nejm/* The STEP-HFpEF-DM trial demonstrated that semaglutide 2.4 mg significantly improved heart failure symptoms, physical limitations, and body weight in patients with HFpEF, obesity, and type 2 diabetes. The findings extended the benefit seen in STEP-HFpEF to the diabetes subpopulation, confirming that GLP-1 receptor agonists address the obesity-HFpEF phenotype regardless of glycemic status. ## Water Conservation Overrides Osmotic Diuresis During SGLT2 Inhibition in Patients With Heart Failure. *2024-04-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.02.020 · https://hartvaat.nl/2024/04/16/sglt2-remming-waterconservatie-domineert-over-osmotische-diurese-bij-hf/* This mechanistic study showed that the osmotic diuretic potential of SGLT2 inhibitors in heart failure is attenuated by compensatory renal water conservation, suggesting that the cardiac benefit operates through mechanisms beyond volume reduction. ## 2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. *2024-04-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.12.024 · https://hartvaat.nl/2024/04/16/2024-acc-expert-consensus-behandeling-van-hfref-beslispad-geactualiseerd/* The 2024 ACC Expert Consensus for HFrEF endorsed simultaneous initiation of four-pillar therapy (SGLT2 inhibitor, ARNI, beta-blocker, MRA) rather than sequential titration, with practical algorithms for rapid optimization, including in-hospital initiation during heart failure admissions. ## Postprocedural Anticoagulation After Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction: A Multicenter, Randomized, Double-Blind Trial. *2024-04-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067079 · https://hartvaat.nl/2024/04/16/postprocedurale-anticoagulatie-na-primaire-pci-voor-stemi-multicenter-studie/* This study showed that routine post-procedural anticoagulation after primary PCI for STEMI does not reduce ischemic events but increases bleeding, arguing against this common practice. ## Efficacy and Safety of Dapagliflozin in Patients With Acute Heart Failure. *2024-04-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.02.009 · https://hartvaat.nl/2024/04/09/dapagliflozine-bij-acuut-hartfalen-effectiviteit-en-veiligheid/* This study confirmed the efficacy and safety of dapagliflozin started during acute heart failure hospitalization, showing improved decongestion and favorable effects on guideline-directed therapy optimization during the index admission. ## Pragmatic Trial of Hospitalization Rate in Chronic Kidney Disease. *2024-04-04 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2311708 · https://hartvaat.nl/2024/04/04/pragmatische-trial-van-hospitalisatieratio-bij-ckd-nejm/* This NEJM pragmatic trial evaluated whether structured CKD care with nephrological involvement reduces hospitalization in patients with chronic kidney disease, type 2 diabetes, and hypertension, testing a disease management approach for the cardiorenal population. ## Pulmonary Vein Isolation With or Without Left Atrial Appendage Ligation in Atrial Fibrillation: The aMAZE Randomized Clinical Trial. *2024-04-02 · JAMA · https://doi.org/10.1001/jama.2024.3026 · https://hartvaat.nl/2024/04/02/amaze-pvi-met-of-zonder-laa-ligatie-bij-af-jama-rct/* The aMAZE trial showed that adding epicardial left atrial appendage ligation to pulmonary vein isolation during AF catheter ablation did not significantly reduce AF recurrence, arguing against routine LAA ligation as an adjunct to rhythm control. ## Coronary Angiography, Intravascular Ultrasound, and Optical Coherence Tomography for Guiding of Percutaneous Coronary Intervention: A Systematic Review and Network Meta-Analysis. *2024-04-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067583 · https://hartvaat.nl/2024/04/02/ivus-versus-oct-versus-angiografie-voor-pci-begeleiding-meta-analyse/* This comprehensive meta-analysis comparing IVUS, OCT, and angiography-guided PCI confirmed that both intravascular imaging modalities are superior to angiography alone, with IVUS and OCT showing comparable outcomes to each other. ## Novel Polygenic Risk Score and Established Clinical Risk Factors for Risk Estimation of Aortic Stenosis. *2024-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2024.0011 · https://hartvaat.nl/2024/04/01/polygene-risicoscore-voor-aortastenose-naast-klinische-risicofactoren/* This study developed a novel polygenic risk score for aortic stenosis that improves risk prediction beyond clinical factors alone, advancing the potential for genetics-guided screening in valvular disease. ## Interventions for Optimization of Guideline-Directed Medical Therapy: A Systematic Review. *2024-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.5627 · https://hartvaat.nl/2024/04/01/interventies-voor-optimalisatie-van-richtlijnmedicatie-bij-hartfalen-systematisc/* This systematic review identified that multidisciplinary team-based approaches and clinical decision support are the most effective interventions for optimizing guideline-directed medical therapy in heart failure. ## Lipoprotein(a), C-Reactive Protein, and Cardiovascular Risk in Primary and Secondary Prevention Populations. *2024-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.5605 · https://hartvaat.nl/2024/04/01/lp-a-en-hscrp-als-cv-risicofactoren-primaire-en-secundaire-preventie/* This analysis showed that Lp(a) and hsCRP independently predict cardiovascular risk in both primary and secondary prevention populations, supporting measurement of both biomarkers for comprehensive residual risk assessment. ## β-Blocker Withdrawal and Functional Capacity Improvement in Patients With Heart Failure With Preserved Ejection Fraction. *2024-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.5500 · https://hartvaat.nl/2024/04/01/betablokkerstaken-verbetert-inspanningscapaciteit-bij-hfpef/* This study showed that withdrawing beta-blockers in HFpEF patients improves exercise capacity and chronotropic response, supporting the concept that beta-blocker-induced chronotropic incompetence contributes to exercise limitation in this population. ## Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial. *2024-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehae043 · https://hartvaat.nl/2024/04/01/notion-10-jaar-tavr-versus-chirurgie-bij-laagrisico-aortastenose/* The 10-year NOTION results showed comparable survival between TAVR and surgical aortic valve replacement in low-risk patients, though more TAVR patients required reintervention for valve degeneration. The long-term data raised questions about structural valve durability that newer-generation devices may address. ## Icosapent ethyl following acute coronary syndrome: the REDUCE-IT trial. *2024-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad889 · https://hartvaat.nl/2024/04/01/icosapent-ethyl-na-acs-reduce-it-subanalyse/* This REDUCE-IT subanalysis in patients with recent ACS confirmed the cardiovascular benefit of icosapent ethyl in this high-risk post-acute setting. ## Aerobic, resistance, or combined exercise training and cardiovascular risk profile in overweight or obese adults: the CardioRACE trial. *2024-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad827 · https://hartvaat.nl/2024/04/01/cardiorace-aeroob-krachttraining-of-gecombineerd-en-cardiovasculair-risicoprofie/* The CardioRACE trial compared aerobic, resistance, and combined exercise training on cardiovascular risk profile in overweight adults, finding that combined training provides the most comprehensive cardiovascular risk factor improvement. ## Discontinuation vs. continuation of renin-angiotensin system inhibition before non-cardiac surgery: the SPACE trial. *2024-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad716 · https://hartvaat.nl/2024/04/01/space-raas-remmers-stoppen-versus-continueren-voor-niet-cardiale-chirurgie/* The SPACE trial showed that continuing RAAS inhibitors before non-cardiac surgery is safe with comparable hemodynamic stability, addressing the common clinical dilemma of perioperative medication management. ## Exercise training and high-sensitivity cardiac troponin-I in patients with heart failure with reduced ejection fraction. *2024-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14674 · https://hartvaat.nl/2024/04/01/inspanningstraining-en-hoog-sensitief-troponine-i-bij-hfref/* This SMARTEX substudy found that exercise training does not significantly reduce high-sensitivity troponin I in HFrEF, suggesting that the exercise benefit operates through mechanisms other than subclinical myocardial injury reduction. ## Association between haemoglobin, albumin, lymphocytes, and platelets and mortality in patients with heart failure. *2024-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14662 · https://hartvaat.nl/2024/04/01/halp-score-hemoglobine-albumine-lymfocyten-trombocyten-en-mortaliteit-bij-hartfa/* This study showed that the HALP score (combining hemoglobin, albumin, lymphocytes, and platelets) predicts mortality in heart failure, establishing a simple, widely available composite laboratory marker for HF prognosis. ## Safety of sodium-glucose cotransporter 2 inhibitors drugs among heart failure patients: a systematic review and meta-analysis. *2024-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14633 · https://hartvaat.nl/2024/04/01/veiligheid-van-sglt2-remmers-bij-hartfalen-meta-analyse/* This meta-analysis confirmed the favorable safety profile of SGLT2 inhibitors in heart failure, with no increase in serious adverse events including diabetic ketoacidosis, genital infections, or hypotension-related events. ## Improvement in left atrial strain following ferric carboxymaltose in heart failure: an analysis of the Myocardial-IRON trial. *2024-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14630 · https://hartvaat.nl/2024/04/01/iv-ferricarboxymaltose-verbetert-linkeratriale-strain-bij-hartfalen-myocardial-i/* This Myocardial-IRON subanalysis showed that IV ferric carboxymaltose improves left atrial strain in heart failure with iron deficiency, demonstrating atrial functional benefit from iron repletion. ## Personalized pulmonary vein isolation with very high-power short-duration lesions guided by left atrial wall thickness: the QDOT-by-LAWT randomized trial. *2024-03-30 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae087 · https://hartvaat.nl/2024/03/30/qdot-by-lawt-gepersonaliseerde-pvi-gestuurd-door-linkeratriale-wanddikte/* This randomized trial tested whether personalizing RF ablation energy delivery based on left atrial wall thickness improves pulmonary vein isolation outcomes for paroxysmal AF. ## Sacubitril/Valsartan in Patients Hospitalized With Decompensated Heart Failure. *2024-03-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.01.027 · https://hartvaat.nl/2024/03/26/sacubitril-valsartan-bij-gedecompenseerd-hartfalen-tijdens-opname/* This study confirmed the safety and efficacy of initiating sacubitril-valsartan during hospitalization for decompensated heart failure across the ejection fraction spectrum, supporting inpatient ARNI start. ## Cardiovascular Outcomes in GRADE (Glycemia Reduction Approaches in Type 2 Diabetes: A Comparative Effectiveness Study). *2024-03-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066604 · https://hartvaat.nl/2024/03/26/grade-cv-uitkomsten-van-glucoseverlagende-middelen-bij-type-2-diabetes/* The GRADE cardiovascular outcomes analysis showed that liraglutide offered the most favorable cardiovascular profile among the four glucose-lowering agents tested (glimepiride, sitagliptin, liraglutide, insulin glargine) when added to metformin in type 2 diabetes. ## Direct Oral Anticoagulants for Stroke Prevention in Patients With Device-Detected Atrial Fibrillation: A Study-Level Meta-Analysis of the NOAH-AFNET 6 and ARTESiA Trials. *2024-03-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067512 · https://hartvaat.nl/2024/03/26/doac-s-bij-device-gedetecteerd-af-meta-analyse-noah-afnet-6-en-artesia/* This meta-analysis of NOAH-AFNET 6 and ARTESIA showed that DOACs modestly reduce stroke in patients with device-detected subclinical AF but significantly increase bleeding. The pooled data suggest that anticoagulation may be warranted only in selected high-risk patients with subclinical AF. ## Intravitreal aflibercept 8 mg in diabetic macular oedema (PHOTON): 48-week results from a randomised, double-masked, non-inferiority, phase 2/3 trial. *2024-03-23 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)02577-1 · https://hartvaat.nl/2024/03/23/photon-aflibercept-8-mg-bij-diabetisch-macula-oedeem-verlengd-doseerinterval/* The PHOTON trial showed that high-dose aflibercept 8 mg with extended dosing intervals up to 16 weeks is noninferior to standard aflibercept for diabetic macular edema, reducing treatment burden for this chronic eye condition. ## Incidence, Predictors, and Impact of Hospital Readmission After Revascularization for Left Main Coronary Disease. *2024-03-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.01.012 · https://hartvaat.nl/2024/03/19/heropname-na-revascularisatie-voor-hoofdstamziekte-incidentie-en-impact/* This study documented the frequency and prognostic impact of hospital readmission after left main revascularization, showing that early readmission is common and associated with worse long-term survival. ## Kidney Injury After Minimal Radiographic Contrast Administration in Patients With Acute Coronary Syndromes. *2024-03-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.01.016 · https://hartvaat.nl/2024/03/19/nierschade-na-minimale-contrasttoediening-bij-acs/* This study showed that even minimal contrast administration during PCI for ACS can cause kidney injury, particularly in patients with pre-existing renal impairment, informing ultra-low contrast strategies. ## Efficacy and Safety of Non-Vitamin-K Antagonist Oral Anticoagulants Versus Warfarin Across the Spectrum of Body Mass Index and Body Weight: An Individual Patient Data Meta-Analysis of 4 Randomized Clinical Trials of Patients With Atrial Fibrillation. *2024-03-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066279 · https://hartvaat.nl/2024/03/19/combine-af-noac-s-versus-warfarine-over-bmi-spectrum-bij-af/* This COMBINE AF patient-level analysis confirmed that NOACs maintain superior efficacy and safety compared with warfarin across the full BMI spectrum in AF, providing reassurance for DOAC use in both normal-weight and obese patients. ## Sunitinib for metastatic progressive phaeochromocytomas and paragangliomas: results from FIRSTMAPPP, an academic, multicentre, international, randomised, placebo-controlled, double-blind, phase 2 trial. *2024-03-16 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)02554-0 · https://hartvaat.nl/2024/03/16/firstmappp-sunitinib-bij-metastatische-feochromocytomen-en-paragangliomen/* This Lancet trial of sunitinib for metastatic phaeochromocytomas/paragangliomas is relevant to cardiology due to the cardiovascular effects of catecholamine-secreting tumors and the cardiotoxicity profile of tyrosine kinase inhibitors. ## Very early invasive strategy in higher risk non-ST-elevation acute coronary syndrome: the RAPID NSTEMI trial. *2024-03-12 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2023-323513 · https://hartvaat.nl/2024/03/12/rapid-nstemi-zeer-vroege-invasieve-strategie-bij-hoger-risico-nstemi/* The RAPID NSTEMI trial tested a very early invasive strategy (within 2 hours) for higher-risk NSTEMI, finding that ultra-early intervention does not significantly improve outcomes over standard-timing invasive care. ## Mineralocorticoid receptor antagonists and atrial fibrillation: a meta-analysis of clinical trials. *2024-03-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehad811 · https://hartvaat.nl/2024/03/07/mra-s-verminderen-af-risico-meta-analyse-van-klinische-trials/* This meta-analysis of clinical trials showed that mineralocorticoid receptor antagonists reduce the risk of atrial fibrillation in heart failure patients, suggesting that the antifibrotic and anti-remodeling effects of MRAs extend to the atrial substrate. ## Angiotensin Receptor-Neprilysin Inhibition in Patients With STEMI vs NSTEMI. *2024-03-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2024.01.002 · https://hartvaat.nl/2024/03/05/paradise-mi-sacubitril-valsartan-bij-stemi-versus-nstemi/* This subanalysis compared the effects of sacubitril-valsartan in STEMI versus NSTEMI after acute MI, showing comparable neurohormonal effects regardless of the acute MI subtype. ## Patient-Level Pooled Analysis of Endovascular Ultrasound Renal Denervation or a Sham Procedure 6 Months After Medication Escalation: The RADIANCE Clinical Trial Program. *2024-03-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066941 · https://hartvaat.nl/2024/03/05/radiance-gepoolde-analyse-ultrageluid-renale-denervatie-na-medicatie-optitratie/* This pooled patient-level RADIANCE analysis confirmed that ultrasound renal denervation provides additive blood pressure reduction when initiated after medication optimization, demonstrating a consistent device effect on top of pharmacotherapy. ## Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve Replacement Among Patients With Atrial Fibrillation. *2024-03-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067312 · https://hartvaat.nl/2024/03/05/gelijktijdige-laa-occlusie-en-tavr-bij-af-haalbaarheid/* This study demonstrated the feasibility and safety of concurrent LAA occlusion during TAVR in AF patients, exploring a combined structural intervention that addresses both valve disease and stroke prevention in a single procedure. ## Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis. *2024-03-02 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)02454-6 · https://hartvaat.nl/2024/03/02/intravasculaire-beeldvorming-bij-des-implantatie-lancet-netwerk-meta-analyse/* This updated Lancet network meta-analysis confirmed that intravascular imaging-guided DES implantation (either IVUS or OCT) is superior to angiography-guided PCI for reducing cardiovascular death, MI, and stent thrombosis. The comprehensive analysis supported routine imaging guidance for coronary stenting. ## Role of electroanatomical mapping-guided superior vena cava isolation in paroxysmal atrial fibrillation patients without provoked superior vena cava triggers: a randomized controlled study. *2024-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae039 · https://hartvaat.nl/2024/03/01/svc-isolatie-bij-paroxysmaal-af-zonder-geinduceerde-svc-aritmieen/* This study found that empirical superior vena cava isolation during AF ablation does not improve outcomes in paroxysmal AF patients without demonstrated SVC triggers, arguing against routine SVC isolation. ## Dapagliflozin and Mode of Death in Heart Failure With Improved Ejection Fraction: A Post Hoc Analysis of the DELIVER Trial. *2024-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.5318 · https://hartvaat.nl/2024/03/01/deliver-dapagliflozine-vermindert-plotse-hartdood-bij-verbeterde-ef/* This DELIVER post-hoc analysis showed that dapagliflozin favorably affects the mode of death in patients with heart failure and improved ejection fraction, including a potential reduction in sudden cardiac death in this previously understudied population. ## Impact of Bempedoic Acid on Total Cardiovascular Events: A Prespecified Analysis of the CLEAR Outcomes Randomized Clinical Trial. *2024-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.5155 · https://hartvaat.nl/2024/03/01/clear-outcomes-bempedoinezuur-vermindert-totale-cv-events-bij-statine-intolerant/* This CLEAR Outcomes analysis of total cardiovascular events (including recurrent) showed that bempedoic acid significantly reduces the total burden of cardiovascular events in statin-intolerant patients, with greater absolute benefit than suggested by first-event analysis alone. ## Routine stress testing in diabetic patients after percutaneous coronary intervention: the POST-PCI trial. *2024-03-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad722 · https://hartvaat.nl/2024/03/01/post-pci-routine-stresstesten-bij-diabetespatienten-na-pci-niet-zinvol/* The POST-PCI trial confirmed that routine stress testing in diabetic patients after PCI does not improve clinical outcomes compared with a symptom-guided approach, arguing against surveillance testing even in this high-risk population. ## Self-Measured Blood Pressure-Guided Pharmacotherapy: A Systematic Review and Meta-Analysis of United States-Based Telemedicine Trials. *2024-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.22109 · https://hartvaat.nl/2024/03/01/thuisbloeddruk-geleide-farmacotherapie-via-telezorg-meta-analyse-van-vs-trials/* This meta-analysis of US-based telehealth trials confirmed that self-measured blood pressure-guided pharmacotherapy significantly improves blood pressure control compared with usual care, supporting the implementation of telemedicine hypertension management. ## Accuracy of visual estimation of ejection fraction in patients with heart failure using augmented reality glasses. *2024-02-23 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2023-323067 · https://hartvaat.nl/2024/02/23/ar-brillen-voor-ef-schatting-bij-hartfalen-haalbaarheidstudie/* This study evaluated augmented reality glasses for improving visual estimation of ejection fraction in heart failure, testing whether wearable display technology enhances bedside cardiac assessment. ## Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults. *2024-02-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.12.013 · https://hartvaat.nl/2024/02/20/zoutvervanger-voorkomt-hypertensie-bij-normotensieve-volwassenen/* This randomized trial showed that a potassium-enriched salt substitute significantly reduces the incidence of hypertension in normotensive adults, demonstrating that population-level dietary sodium-potassium modification can prevent blood pressure elevation before it starts. ## An Aspirin-Free Versus Dual Antiplatelet Strategy for Coronary Stenting: STOPDAPT-3 Randomized Trial. *2024-02-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066720 · https://hartvaat.nl/2024/02/20/stopdapt-3-aspirinevrij-versus-standaard-dapt-na-coronaire-stenting/* The STOPDAPT-3 trial tested an aspirin-free strategy (prasugrel monotherapy from day 1) versus standard DAPT after PCI. While the aspirin-free approach was noninferior for a net clinical benefit endpoint, the study raised questions about the bleeding-ischemia trade-off with immediate aspirin omission. ## Stopping Aspirin Within 1 Month After Stenting for Ticagrelor Monotherapy in Acute Coronary Syndrome: The T-PASS Randomized Noninferiority Trial. *2024-02-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066943 · https://hartvaat.nl/2024/02/20/t-pass-ticagrelor-monotherapie-binnen-1-maand-na-stenting-bij-acs/* The T-PASS trial showed that stopping aspirin within 1 month after DES implantation for ticagrelor monotherapy in ACS patients was noninferior to 12-month DAPT for ischemic events and reduced major bleeding. The results supported very early aspirin discontinuation specifically in the ACS population. ## Safety and Efficacy of Ticagrelor Monotherapy in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: An Individual Patient Data Meta-Analysis of TWILIGHT and TICO Randomized Trials. *2024-02-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067283 · https://hartvaat.nl/2024/02/20/ticagrelor-monotherapie-na-acs-ipd-meta-analyse-van-vroege-aspirinestop/* This individual patient data meta-analysis confirmed that early aspirin cessation with ticagrelor monotherapy after ACS and PCI is safe with significantly less bleeding, without increasing the risk of ischemic events. The pooled patient-level evidence provides the strongest support for this de-escalation strategy. ## Atrial fibrillation progression after cryoablation vs. radiofrequency ablation: the CIRCA-DOSE trial. *2024-02-16 · European heart journal · https://doi.org/10.1093/eurheartj/ehad572 · https://hartvaat.nl/2024/02/16/circa-dose-af-progressie-na-cryoablatie-versus-rf-ablatie/* The CIRCA-DOSE trial showed that AF progression from paroxysmal to persistent is comparable between cryoballoon and radiofrequency ablation, suggesting that the energy source does not significantly influence the natural history of AF. ## Implantable Hemodynamic Monitors Improve Survival in Patients With Heart Failure and Reduced Ejection Fraction. *2024-02-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.11.030 · https://hartvaat.nl/2024/02/13/implanteerbare-hemodynamische-monitoren-verbeteren-overleving-bij-hfref/* This analysis demonstrated that implantable pulmonary artery pressure monitors not only reduce heart failure hospitalization but also improve survival in patients with HFrEF. The mortality benefit adds a new dimension to the value proposition of hemodynamic-guided heart failure management. ## Randomized Trial of Effect of Bariatric Surgery on Blood Pressure After 5 Years. *2024-02-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.11.032 · https://hartvaat.nl/2024/02/13/bariatrische-chirurgie-en-bloeddruk-na-5-jaar-gerandomiseerde-trial/* This 5-year randomized trial confirmed that bariatric surgery provides superior long-term blood pressure reduction compared with lifestyle intervention alone in obese hypertensive patients, supporting surgical weight loss as an effective antihypertensive strategy. ## Cardiac Remodeling After Hypertensive Pregnancy Following Physician-Optimized Blood Pressure Self-Management: The POP-HT Randomized Clinical Trial Imaging Substudy. *2024-02-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067597 · https://hartvaat.nl/2024/02/13/pop-ht-bloeddrukzelfmanagement-verbetert-cardiale-remodelling-na-hypertensieve-z/* This POP-HT follow-up showed that physician-guided blood pressure self-management after hypertensive pregnancy reduces adverse cardiac remodeling, providing evidence that early postpartum blood pressure control can mitigate long-term cardiovascular structural changes. ## One-Year Outcomes After Amulet or Watchman Device for Percutaneous Left Atrial Appendage Closure: A Prespecified Analysis of the SWISS-APERO Randomized Clinical Trial. *2024-02-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067599 · https://hartvaat.nl/2024/02/06/swiss-apero-amulet-versus-watchman-na-1-jaar-voor-laa-sluiting/* One-year SWISS-APERO results showed comparable efficacy and safety between the Amulet and Watchman FLX devices for percutaneous LAA closure, informing device selection in clinical practice. ## Sequential hybrid ablation vs. surgical CryoMaze alone for treatment of atrial fibrillation: results of multicentre randomized controlled trial. *2024-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae040 · https://hartvaat.nl/2024/02/01/sequentiele-hybride-ablatie-versus-chirurgische-cryomaze-bij-af-met-structurele-/* This multicenter RCT showed that sequential hybrid ablation (combining surgical and catheter approaches) provides superior rhythm control compared with surgical CryoMaze alone in AF patients with structural heart disease. ## Pulmonary vein narrowing after pulsed field versus thermal ablation. *2024-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euae038 · https://hartvaat.nl/2024/02/01/pulmonaalvenenstenose-na-pfa-versus-thermale-ablatie-vergelijking/* This study showed that pulsed field ablation causes significantly less pulmonary vein narrowing than thermal ablation for AF, demonstrating a key safety advantage of the tissue-selective PFA technology. ## Dual Antiplatelet Therapy De-Escalation in Stabilized Myocardial Infarction With High Ischemic Risk: Post Hoc Analysis of the TALOS-AMI Randomized Clinical Trial. *2024-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.4587 · https://hartvaat.nl/2024/02/01/talos-ami-dapt-de-escalatie-veilig-bij-mi-met-hoog-ischemisch-risico/* This TALOS-AMI post-hoc analysis confirmed that de-escalation from ticagrelor to clopidogrel after 1 month is safe even in high-ischemic-risk MI patients, extending the de-escalation evidence to the population with the greatest concern about reducing antiplatelet potency. ## Multifaceted Strategy Based on Automated Text Messaging After a Recent Heart Failure Admission: The MESSAGE-HF Randomized Clinical Trial. *2024-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.4501 · https://hartvaat.nl/2024/02/01/message-hf-geautomatiseerde-sms-na-hartfalenopname-verbetert-uitkomsten-niet/* The MESSAGE-HF trial showed that automated text messaging after heart failure hospitalization does not significantly reduce readmissions or mortality, highlighting the limitations of simple digital interventions for complex disease management. ## Torsemide vs Furosemide Among Patients With New-Onset vs Worsening Chronic Heart Failure: A Substudy of the TRANSFORM-HF Randomized Clinical Trial. *2024-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.4776 · https://hartvaat.nl/2024/02/01/transform-hf-torsemide-versus-furosemide-bij-nieuw-vs-chronisch-hartfalen/* This TRANSFORM-HF substudy showed no difference between torsemide and furosemide in either new-onset or worsening chronic heart failure, confirming loop diuretic equivalence across HF presentations. ## Decline in Estimated Glomerular Filtration Rate After Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial. *2024-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.4664 · https://hartvaat.nl/2024/02/01/deliver-egfr-dip-na-dapagliflozine-bij-hfpef-is-veilig/* This DELIVER subanalysis confirmed that the initial eGFR decline after dapagliflozin initiation in HFpEF is hemodynamic rather than nephrotoxic and is not associated with worse outcomes, supporting continued therapy despite early creatinine changes. ## Acyl ghrelin increases cardiac output while preserving right ventricular-pulmonary arterial coupling in heart failure. *2024-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14580 · https://hartvaat.nl/2024/02/01/acyl-ghreline-verbetert-cardiac-output-met-behoud-van-rv-pa-koppeling-bij-hf/* This study confirmed that acyl ghrelin increases cardiac output in HFrEF while preserving right ventricular-pulmonary arterial coupling, supporting the safety of this metabolic hormone for hemodynamic augmentation. ## Meta-Analysis Global Group in Chronic Heart Failure score for the prediction of mortality in valvular heart disease. *2024-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14586 · https://hartvaat.nl/2024/02/01/maggic-score-voor-mortaliteitsvoorspelling-bij-klepziekte/* This study validated the MAGGIC risk score for mortality prediction in valvular heart disease patients with heart failure, showing acceptable discrimination for this important clinical subgroup. ## The efficacy and safety of new potassium binders on renin-angiotensin-aldosterone system inhibitor optimization in heart failure patients: a systematic review and meta-analysis. *2024-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14588 · https://hartvaat.nl/2024/02/01/nieuwe-kaliumbinders-verbeteren-raas-remmer-gebruik-bij-hartfalen-meta-analyse/* This meta-analysis confirmed that new potassium binders (patiromer, sodium zirconium cyclosilicate) safely enable optimization of RAAS inhibitor therapy in heart failure by preventing hyperkalemia, addressing a key barrier to reaching target doses. ## Ivabradine could not decrease mitral regurgitation triggered atrial fibrosis and fibrillation compared with carvedilol. *2024-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14577 · https://hartvaat.nl/2024/02/01/ivabradine-vermindert-mr-getriggerde-atriale-fibrose-niet-versus-carvedilol/* This study compared ivabradine with carvedilol in heart failure with mitral regurgitation, finding that carvedilol was more effective in reducing atrial fibrosis and fibrillation, suggesting that beta-blockade provides broader anti-remodeling benefit. ## Hydralazine combined with conventional therapy improved outcomes in severe systolic dysfunction and mitral regurgitation. *2024-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14564 · https://hartvaat.nl/2024/02/01/hydralazine-bij-ernstige-systolische-disfunctie-en-mitralisinsufficientie/* This study showed that adding hydralazine to conventional heart failure therapy improves outcomes in patients with severe systolic dysfunction and significant mitral regurgitation, supporting vasodilator therapy for afterload reduction in severe HF. ## Uric acid is a biomarker for heart failure, but not therapeutic target: result from a comprehensive meta-analysis. *2024-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14535 · https://hartvaat.nl/2024/02/01/urinezuur-als-biomarker-maar-niet-therapeutisch-doel-bij-hartfalen-meta-analyse/* This meta-analysis confirmed that uric acid is a strong prognostic biomarker in heart failure but that uric acid-lowering therapy does not improve clinical outcomes, distinguishing the biomarker role from the therapeutic target role. ## A Multicenter, Single-Blind, Randomized, Warfarin-Controlled Trial of Edoxaban in Patients With Chronic Thromboembolic Pulmonary Hypertension: KABUKI Trial. *2024-01-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067528 · https://hartvaat.nl/2024/01/30/edoxaban-versus-warfarine-bij-chronische-trombo-embolische-pulmonale-hypertensie/* This randomized trial showed that edoxaban is noninferior to warfarin for preventing thromboembolic events in patients with chronic thromboembolic pulmonary hypertension, providing a DOAC option for anticoagulation in this pulmonary vascular disease. ## Efficacy, Safety, and Tolerability of Inclisiran in Patients With Homozygous Familial Hypercholesterolemia: Results From the ORION-5 Randomized Clinical Trial. *2024-01-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.063460 · https://hartvaat.nl/2024/01/30/orion-5-inclisiran-bij-homozygote-fh/* The ORION-5 trial showed that inclisiran significantly lowers LDL cholesterol in patients with homozygous familial hypercholesterolemia, though the effect is smaller than in heterozygous FH due to reduced LDL receptor activity. The twice-yearly injection provides a new treatment option for the most severe genetic dyslipidemia. ## Safety of Switching From a Vitamin K Antagonist to a Non-Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients With Atrial Fibrillation: Results of the FRAIL-AF Randomized Controlled Trial. *2024-01-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066485 · https://hartvaat.nl/2024/01/23/switchen-van-vka-naar-noac-bij-fragiele-ouderen-met-af-veilig/* This study showed that switching from VKA to NOAC in frail elderly AF patients is safe and associated with fewer serious bleeding events, addressing the clinical uncertainty about anticoagulant transition in the most vulnerable population. ## Long-Term Outcomes of Resynchronization-Defibrillation for Heart Failure. *2024-01-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2304542 · https://hartvaat.nl/2024/01/18/raft-langetermijn-crt-d-bij-hartfalen-nejm-14-jaarsresultaten/* The RAFT trial 14-year follow-up showed that CRT-D provides sustained survival benefit over ICD alone in patients with HFrEF and wide QRS. These are among the longest-term randomized data supporting cardiac resynchronization therapy. ## Nurse and Social Worker Palliative Telecare Team and Quality of Life in Patients With COPD, Heart Failure, or Interstitial Lung Disease: The ADAPT Randomized Clinical Trial. *2024-01-16 · JAMA · https://doi.org/10.1001/jama.2023.24035 · https://hartvaat.nl/2024/01/16/connect-palliatieve-telezorg-verbetert-kwaliteit-van-leven-bij-hartfalen-jama/* The CONNECT trial demonstrated that palliative telecare delivered by nurses and social workers significantly improves quality of life in patients with COPD, heart failure, or interstitial lung disease, supporting scalable remote palliative care models. ## Lifestyle Walking Intervention for Patients With Heart Failure With Reduced Ejection Fraction: The WATCHFUL Trial. *2024-01-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.067395 · https://hartvaat.nl/2024/01/16/watchful-leefstijl-wandelinterventie-bij-hfref/* The WATCHFUL trial showed that a structured walking program improves daily physical activity and quality of life in HFrEF patients, demonstrating that low-intensity, lifestyle-integrated exercise provides meaningful functional benefit. ## Residual leaks following percutaneous left atrial appendage occlusion and outcomes: a meta-analysis. *2024-01-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad828 · https://hartvaat.nl/2024/01/14/residuele-lekkage-na-laa-occlusie-en-uitkomsten-meta-analyse/* This meta-analysis showed that residual leaks after LAA occlusion are associated with higher thromboembolic risk, particularly larger leaks, informing the importance of complete device sealing and post-procedural surveillance. ## Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation. *2024-01-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2310234 · https://hartvaat.nl/2024/01/11/artesia-apixaban-bij-subclinisch-af-nejm/* The ARTESIA trial showed that apixaban reduced the risk of stroke and systemic embolism by 37% compared with aspirin in patients with subclinical atrial fibrillation detected by implanted cardiac devices, but at the cost of increased major bleeding. The results support individualized anticoagulation decisions based on stroke risk factors in patients with device-detected AF. ## 2023 Atrial Fibrillation Guideline-at-a-Glance. *2024-01-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.10.021 · https://hartvaat.nl/2024/01/02/2023-af-richtlijn-op-een-blik-samenvatting/* This guideline-at-a-glance provided a concise visual summary of the 2023 ACC/AHA atrial fibrillation guidelines, distilling the key recommendations including the new staging system and early rhythm control approach into a practical quick-reference format. ## 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2024-01-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.08.017 · https://hartvaat.nl/2024/01/02/2023-acc-aha-af-richtlijn-jacc-editie/* The 2023 ACC/AHA/ACCP/HRS AF guideline (JACC edition) provides comprehensive updated recommendations for atrial fibrillation, including a new staging classification, early rhythm-control strategy, catheter ablation as first-line therapy in selected patients, and integrated management of AF risk factors including obesity. ## 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2024-01-02 · Circulation · https://doi.org/10.1161/CIR.0000000000001193 · https://hartvaat.nl/2024/01/02/2023-acc-aha-accp-hrs-af-richtlijn-nieuwe-classificatie-en-behandelaanpak/* The 2023 ACC/AHA/ACCP/HRS atrial fibrillation guideline introduced a new four-stage classification system (stages 1–4), emphasized early rhythm control, endorsed catheter ablation as a first-line option for selected patients, and highlighted weight management as a disease-modifying intervention. The guideline represents a fundamental shift toward proactive AF management. ## Clopidogrel vs Aspirin Monotherapy Beyond 1 Year After Percutaneous Coronary Intervention. *2024-01-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.10.013 · https://hartvaat.nl/2024/01/02/clopidogrel-versus-aspirine-als-langetermijnmonotherapie-na-pci-bevestiging/* This study confirmed that clopidogrel monotherapy remains superior to aspirin beyond 1 year after PCI, with sustained ischemic benefit and similar bleeding rates, reinforcing clopidogrel as the preferred long-term single antiplatelet agent. ## Abbreviated or Standard Dual Antiplatelet Therapy by Sex in Patients at High Bleeding Risk: A Prespecified Secondary Analysis of a Randomized Clinical Trial. *2024-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.4316 · https://hartvaat.nl/2024/01/01/verkorte-dapt-bij-hoog-bloedingsrisico-geen-sekseverschillen/* This subanalysis confirmed that abbreviated DAPT in high-bleeding-risk patients provides equal benefit in women and men, supporting sex-neutral antiplatelet de-escalation decisions. ## Effect of Tafamidis on Cardiac Function in Patients With Transthyretin Amyloid Cardiomyopathy: A Post Hoc Analysis of the ATTR-ACT Randomized Clinical Trial. *2024-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.4147 · https://hartvaat.nl/2024/01/01/tafamidis-en-cardiale-functie-bij-attr-cm-post-hoc-attr-act-analyse/* This ATTR-ACT post-hoc analysis demonstrated that tafamidis slows the progression of cardiac dysfunction in transthyretin amyloid cardiomyopathy, with echocardiographic evidence of preserved systolic and diastolic function over time. ## Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia. *2023-12-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2307983 · https://hartvaat.nl/2023/12/28/reality-restrictief-versus-liberaal-transfusiebeleid-bij-mi-en-anemie-nejm/* The REALITY trial demonstrated that a restrictive transfusion strategy (hemoglobin threshold <8 g/dL) was noninferior to a liberal strategy (<10 g/dL) for the composite of death, MI, stroke, or emergency revascularization in patients with acute MI and anemia. The results support conservative transfusion thresholds even in acute coronary syndromes. ## A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina. *2023-12-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2310610 · https://hartvaat.nl/2023/12/21/orbita-2-pci-versus-placebo-bij-stabiele-angina-pectoris-nejm/* ORBITA-2, a double-blind, placebo-controlled trial in patients with stable angina who were not receiving antianginal medications, showed that PCI significantly improved angina symptoms compared with a sham procedure. This resolved the debate from ORBITA-1 by confirming a true symptomatic benefit of PCI in appropriately selected patients with objectified ischemia. ## Efficacy of ferric carboxymaltose in heart failure with iron deficiency: an individual patient data meta-analysis. *2023-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad586 · https://hartvaat.nl/2023/12/21/iv-ferricarboxymaltose-bij-hartfalen-met-ijzerdeficientie-ipd-meta-analyse/* This individual patient data meta-analysis of all ferric carboxymaltose trials in heart failure confirmed that IV iron reduces heart failure hospitalization and cardiovascular death, with the most robust benefit in reducing recurrent hospitalizations. The analysis provided the pooled evidence that individual trials alone could not deliver. ## Effects of ticagrelor and prasugrel on coronary microcirculation in elective percutaneous coronary intervention. *2023-12-20 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321868 · https://hartvaat.nl/2023/12/20/ticagrelor-versus-prasugrel-en-coronaire-microcirculatie-bij-pci/* This study compared the effects of ticagrelor and prasugrel on coronary microcirculation during elective PCI, finding similar improvements in absolute coronary blood flow with both agents. ## Measuring the Impact of AI in the Diagnosis of Hospitalized Patients: A Randomized Clinical Vignette Survey Study. *2023-12-19 · JAMA · https://doi.org/10.1001/jama.2023.22295 · https://hartvaat.nl/2023/12/19/ai-diagnostiek-bij-gehospitaliseerde-patienten-jama-vignettenstudie/* This JAMA vignette study demonstrated that AI-assisted diagnosis improves clinical accuracy for hospitalized patients, while also showing that algorithmic bias can introduce systematic errors if not carefully monitored. ## Effects of Synchronizing Foot Strike and Cardiac Phase on Exercise Hemodynamics in Patients With Cardiac Resynchronization Therapy: A Within-Subjects Pilot Study to Fine-Tune Cardio-Locomotor Coupling for Heart Failure. *2023-12-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066170 · https://hartvaat.nl/2023/12/19/synchronisatie-van-voetstap-en-hartfase-bij-crt-patienten/* This innovative study tested whether synchronizing walking foot strike with the cardiac cycle improves exercise hemodynamics in CRT patients, exploring biomechanical-cardiac coupling as a novel exercise optimization strategy. ## Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. *2023-12-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2307563 · https://hartvaat.nl/2023/12/14/select-semaglutide-vermindert-cv-events-bij-obesitas-zonder-diabetes-nejm/* The SELECT trial demonstrated that semaglutide 2.4 mg reduced major adverse cardiovascular events by 20% in patients with overweight or obesity and established atherosclerotic disease but without diabetes. This landmark result established GLP-1 receptor agonists as a cardiovascular preventive therapy independent of glycemic control. ## Rivaroxaban Plus Aspirin Versus Aspirin Alone After Endovascular Revascularization for Symptomatic PAD: Insights From VOYAGER PAD. *2023-12-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.063806 · https://hartvaat.nl/2023/12/12/voyager-pad-rivaroxaban-plus-aspirine-na-endovasculaire-revascularisatie-voor-pa/* This VOYAGER PAD subanalysis confirmed that rivaroxaban plus aspirin after endovascular revascularization for symptomatic PAD reduces both cardiac and limb ischemic events, supporting dual-pathway inhibition specifically in the post-revascularization peripheral vascular population. ## Angioplasty Guidewire-Assisted vs. Conventional Transseptal Puncture for Left Atrial Appendage Occlusion: a multicentre randomized controlled trial. *2023-12-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad349 · https://hartvaat.nl/2023/12/06/gemodificeerde-transseptale-punctie-bij-laa-occlusie-rct/* This RCT showed that an angioplasty guidewire-assisted transseptal puncture technique for LAA occlusion improves procedural efficiency and precision compared with the conventional approach. ## Comparison of Intravascular Imaging, Functional, or Angiographically Guided Coronary Intervention. *2023-12-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.09.823 · https://hartvaat.nl/2023/12/05/intravasculaire-beeldvorming-versus-functionele-versus-angiografische-pci-begele/* This comprehensive meta-analysis compared intravascular imaging, functional testing (FFR/iFR), and angiography-guided PCI, finding that imaging guidance provides the best outcomes, followed by physiological guidance, with angiography alone yielding the worst results. ## Blood Pressure and Oxygen Targets on Kidney Injury After Cardiac Arrest. *2023-12-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066012 · https://hartvaat.nl/2023/12/05/bloeddruk-en-zuurstofstreefwaarden-en-nierschade-na-hartstilstand/* This analysis showed that higher MAP targets protect against acute kidney injury after cardiac arrest, informing hemodynamic management strategies for renal preservation in the post-resuscitation period. ## Potassium Magnesium Citrate Is Superior to Potassium Chloride in Reversing Metabolic Side Effects of Chlorthalidone. *2023-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21932 · https://hartvaat.nl/2023/12/01/kaliummagnesiumcitraat-versus-kaliumchloride-bij-thiazide-bijwerkingen/* This study showed that potassium magnesium citrate is superior to potassium chloride for correcting the metabolic side effects of chlorthalidone, providing a more comprehensive electrolyte replacement strategy during thiazide therapy. ## Influence of Baseline Diastolic Blood Pressure on the Effects of Intensive Blood Pressure Lowering: Results From the STEP Randomized Trial. *2023-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21892 · https://hartvaat.nl/2023/12/01/step-trial-diastolische-bloeddruk-beinvloedt-effect-van-intensieve-behandeling/* This STEP subanalysis showed that intensive blood pressure lowering is most effective in patients with higher baseline diastolic pressure, informing the identification of patients who derive the greatest absolute benefit from aggressive treatment. ## Hypoxaemic burden in heart failure patients receiving adaptive servo-ventilation. *2023-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14556 · https://hartvaat.nl/2023/12/01/adaptieve-servoventilatie-en-hypoxemische-belasting-bij-hartfalen/* This study showed that adaptive servo-ventilation effectively reduces the hypoxemic burden in heart failure patients with central sleep apnea, despite the safety concerns raised by the SERVE-HF trial. ## Incidence, mortality, and predictors of acute kidney injury in patients with heart failure: a systematic review. *2023-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14520 · https://hartvaat.nl/2023/12/01/acute-nierschade-bij-hartfalen-incidentie-mortaliteit-en-voorspellers-meta-analy/* This systematic review documented that acute kidney injury in heart failure occurs in 25-30% of patients and significantly worsens prognosis, highlighting the importance of renal monitoring during heart failure management. ## A comprehensive description of kidney disease progression after acute kidney injury from a prospective, parallel-group cohort study. *2023-12-01 · Kidney international · https://doi.org/10.1016/j.kint.2023.08.005 · https://hartvaat.nl/2023/12/01/nierziekteverloop-na-acute-nierschade-prospectieve-cohortstudie/* This prospective study documented the trajectory of kidney disease progression after AKI, showing significant CKD development risk particularly after severe episodes, informing post-AKI nephrological follow-up. ## Long-Term Blood Pressure Control After Hypertensive Pregnancy Following Physician-Optimized Self-Management: The POP-HT Randomized Clinical Trial. *2023-11-28 · JAMA · https://doi.org/10.1001/jama.2023.21523 · https://hartvaat.nl/2023/11/28/pop-ht-zelfmanagement-van-bloeddruk-na-hypertensieve-zwangerschap-jama-rct/* The POP-HT trial demonstrated that physician-guided blood pressure self-management after hypertensive pregnancy improves long-term blood pressure control, addressing the increased cardiovascular risk that follows pregnancy hypertension. ## Sleep-disordered breathing and cardiovascular disease: who and why to test and how to intervene? *2023-11-27 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-316375 · https://hartvaat.nl/2023/11/27/slaapgerelateerde-ademhalingsstoornissen-en-cv-ziekte-wie-testen-en-hoe-behandel/* This review summarized the relationship between sleep-disordered breathing and cardiovascular disease, addressing screening indications, diagnostic approaches, and treatment considerations for the common SDB-HF overlap. ## Zibotentan in combination with dapagliflozin compared with dapagliflozin in patients with chronic kidney disease (ZENITH-CKD): a multicentre, randomised, active-controlled, phase 2b, clinical trial. *2023-11-25 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)02230-4 · https://hartvaat.nl/2023/11/25/zenith-ckd-zibotentan-plus-dapagliflozine-bij-ckd-lancet/* The ZENITH-CKD trial showed that adding zibotentan (an endothelin A receptor antagonist) to dapagliflozin significantly reduced albuminuria in patients with CKD compared with dapagliflozin alone. The combination approach offers enhanced kidney protection through complementary mechanisms. ## Long-term outcomes with biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents in ST-segment elevation myocardial infarction: 5-year follow-up of the BIOSTEMI randomised superiority trial. *2023-11-25 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)02197-9 · https://hartvaat.nl/2023/11/25/biodegradeerbare-versus-duurzame-polymeer-des-bij-stemi-langetermijndata/* Long-term data confirmed that biodegradable polymer sirolimus-eluting stents provide comparable outcomes to durable polymer everolimus-eluting stents in STEMI patients, supporting either platform for primary PCI. ## Transcatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years. *2023-11-23 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2307447 · https://hartvaat.nl/2023/11/23/partner-3-vijfjaarsresultaten-tavr-vergelijkbaar-met-chirurgie-bij-laagrisico-ne/* The 5-year PARTNER 3 follow-up confirmed that outcomes after TAVR remained comparable to surgical aortic valve replacement in low-risk patients with severe aortic stenosis. Valve durability was maintained with no excess structural valve deterioration, supporting TAVR as a viable long-term option across risk categories. ## Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial. *2023-11-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066179 · https://hartvaat.nl/2023/11/14/early-unload-vroege-lv-ontlading-bij-va-ecmo-gerandomiseerde-trial/* The EARLY-UNLOAD trial showed that early left ventricular unloading during VA-ECMO support for cardiogenic shock improves LV recovery compared with conventional management, supporting proactive mechanical strategies to facilitate cardiac recovery. ## Rate control in atrial fibrillation, calcium channel blockers versus beta-blockers. *2023-11-10 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2023-322635 · https://hartvaat.nl/2023/11/10/rate-control-bij-af-calciumantagonisten-versus-betablokkers/* This study showed that non-dihydropyridine calcium channel blockers provide better rate control than beta-blockers in non-permanent AF, supporting calcium antagonists as an alternative first-line rate control strategy. ## Transcatheter closure of atrial septal defect in the elderly: a systematic review and meta-analysis. *2023-11-10 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2023-322529 · https://hartvaat.nl/2023/11/10/transcatheter-asd-sluiting-bij-ouderen-systematische-review-en-meta-analyse/* This meta-analysis confirmed that transcatheter ASD closure in elderly patients is safe and effective with significant hemodynamic improvement, supporting device closure even at advanced age. ## Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications. *2023-11-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.08.045 · https://hartvaat.nl/2023/11/07/renale-denervatie-veilig-en-effectief-bij-patienten-op-antihypertensiva/* This pooled analysis confirmed that renal denervation significantly reduces blood pressure in patients already taking antihypertensive medications, supporting the device-based approach as an add-on therapy for inadequately controlled hypertension. ## Effect of colchicine on perioperative atrial fibrillation and myocardial injury after non-cardiac surgery in patients undergoing major thoracic surgery (COP-AF): an international randomised trial. *2023-11-04 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)01689-6 · https://hartvaat.nl/2023/11/04/colchicine-vermindert-perioperatief-af-na-thoraxchirurgie-lancet-rct/* This Lancet trial showed that colchicine reduces perioperative atrial fibrillation and myocardial injury after major thoracic surgery in patients with preexisting cardiovascular disease, extending the anti-inflammatory benefit to the perioperative setting. ## Durability of pulmonary vein isolation for atrial fibrillation: a meta-analysis and systematic review. *2023-11-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad335 · https://hartvaat.nl/2023/11/02/duurzaamheid-van-pvi-bij-af-meta-analyse/* This meta-analysis documented that pulmonary vein reconnection after PVI is common (up to 60%) but that clinical outcomes are influenced more by durability of isolation than by initial procedure success, informing the follow-up strategy. ## Pulsed Field or Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation. *2023-11-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2307291 · https://hartvaat.nl/2023/11/02/advent-pulsed-field-ablatie-non-inferieur-aan-thermale-ablatie-bij-af-nejm/* The ADVENT trial demonstrated that pulsed field ablation was noninferior to conventional thermal ablation (radiofrequency or cryoablation) for the treatment of paroxysmal atrial fibrillation, with a comparable safety profile. This established PFA as a safe and effective tissue-selective alternative for pulmonary vein isolation. ## Effectiveness and Safety of Enteric-Coated vs Uncoated Aspirin in Patients With Cardiovascular Disease: A Secondary Analysis of the ADAPTABLE Randomized Clinical Trial. *2023-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.3364 · https://hartvaat.nl/2023/11/01/enterisch-gecoat-versus-ongecoat-aspirine-geen-verschil-in-gi-bloedingen-adaptab/* This ADAPTABLE secondary analysis found no difference in gastrointestinal bleeding between enteric-coated and uncoated aspirin in cardiovascular secondary prevention, challenging the widespread belief that enteric coating provides GI protection. ## The Role of Posterior Wall Isolation in Catheter Ablation for Persistent Atrial Fibrillation and Systolic Heart Failure: A Secondary Analysis of a Randomized Clinical Trial. *2023-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.3208 · https://hartvaat.nl/2023/11/01/posterior-wand-isolatie-bij-af-ablatie-en-systolisch-hartfalen-castle-af-subanal/* This CASTLE-AF subanalysis showed that adding posterior wall isolation to AF catheter ablation in HFrEF patients does not provide additional benefit over standard PVI, consistent with the neutral findings in the broader AF population. ## Repurposing the β3-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease: The Beta3-LVH Phase 2b Randomized Clinical Trial. *2023-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.3003 · https://hartvaat.nl/2023/11/01/beta3-lvh-mirabegron-bij-linkerventrikel-hypertrofie-fase-2b-rct/* This phase 2b trial of mirabegron (a beta-3 adrenergic agonist) in patients with LV hypertrophy did not significantly reduce LV mass, a negative result for this repurposed bladder medication as a cardiac therapy. ## Longer-Term Efficacy and Safety of Evinacumab in Patients With Refractory Hypercholesterolemia. *2023-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.2921 · https://hartvaat.nl/2023/11/01/evinacumab-bij-refractaire-hypercholesterolemie-langetermijn-effectiviteit-en-ve/* Longer-term data on evinacumab confirmed sustained LDL cholesterol reduction in patients with refractory hypercholesterolemia, providing reassurance about the durability and safety of ANGPTL3 inhibition over extended treatment periods. ## Instantaneous wave free ratio vs. fractional flow reserve and 5-year mortality: iFR SWEDEHEART and DEFINE FLAIR. *2023-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad582 · https://hartvaat.nl/2023/11/01/ifr-versus-ffr-en-vijfjaarsmortaliteit-swedeheart-en-define-flair/* Five-year pooled data from iFR-SWEDEHEART and DEFINE-FLAIR confirmed that iFR-guided revascularization has the same long-term mortality as FFR-guided treatment, providing the most robust evidence for the equivalence of these physiological assessment tools. ## Impact of the COVID-19 pandemic on delayed care of cardiovascular diseases in Europe: a systematic review. *2023-11-01 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)02117-7 · https://hartvaat.nl/2023/11/01/covid-19-en-vertraagde-cardiovasculaire-zorg-in-europa-lancet-systematische-revi/* This Lancet systematic review documented the impact of the COVID-19 pandemic on delayed cardiovascular care across Europe, quantifying reduced presentations, longer treatment delays, and excess cardiovascular mortality during pandemic waves. ## Prevalence of Pediatric Masked Hypertension and Risk of Subclinical Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. *2023-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.20967 · https://hartvaat.nl/2023/11/01/gemaskeerde-hypertensie-bij-kinderen-prevalentie-en-cv-risico-meta-analyse/* This meta-analysis showed that masked hypertension in children occurs in approximately 10% and is associated with subclinical cardiovascular damage, supporting ambulatory monitoring for pediatric blood pressure assessment. ## Systolic Blood Pressure Time in Target Range and Incident Atrial Fibrillation in Patients With Hypertension: Insights From the SPRINT Trial. *2023-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21651 · https://hartvaat.nl/2023/11/01/tijd-in-streefwaarde-van-bloeddruk-en-af-sprint-inzichten/* This SPRINT analysis showed that greater time with systolic blood pressure at target is associated with lower incident AF, supporting sustained blood pressure control as a strategy for atrial fibrillation prevention. ## Sex-Specific Effects of Blood Pressure Lowering Pharmacotherapy for the Prevention of Cardiovascular Disease: An Individual Participant-Level Data Meta-Analysis. *2023-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21496 · https://hartvaat.nl/2023/11/01/sekseverschillen-in-effect-van-bloeddrukverlaging-ipd-meta-analyse/* This individual patient data meta-analysis confirmed that the relative cardiovascular benefit of blood pressure lowering is similar in men and women, supporting equal treatment regardless of sex when blood pressure thresholds are met. ## Network Meta-Analysis of Initial Antithrombotic Regimens After Left Atrial Appendage Occlusion. *2023-10-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.08.010 · https://hartvaat.nl/2023/10/31/antitrombotische-therapie-na-laa-occlusie-netwerk-meta-analyse/* This network meta-analysis compared antithrombotic regimens after LAA occlusion, showing that DOAC monotherapy may offer a better safety-efficacy profile than traditional DAPT for post-LAAO management. ## Traditional Chinese Medicine Compound (Tongxinluo) and Clinical Outcomes of Patients With Acute Myocardial Infarction: The CTS-AMI Randomized Clinical Trial. *2023-10-24 · JAMA · https://doi.org/10.1001/jama.2023.19524 · https://hartvaat.nl/2023/10/24/cts-ami-tongxinluo-bij-acuut-mi-jama-mega-trial/* The CTS-AMI mega-trial demonstrated that Tongxinluo, a traditional Chinese medicine compound, significantly reduced cardiovascular events after STEMI when added to guideline-directed therapy. The large, rigorous trial provided the first high-quality randomized evidence for a TCM compound in acute coronary care. ## Oral Anticoagulation Use and Left Atrial Appendage Occlusion in LAAOS III. *2023-10-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.060315 · https://hartvaat.nl/2023/10/24/laaos-iii-laa-occlusie-en-anticoagulatiegebruik/* This LAAOS III subanalysis showed that surgical LAA occlusion reduces ischemic stroke independently of postoperative oral anticoagulation use, supporting the additive benefit of structural and pharmacological stroke prevention. ## Graft Failure After Coronary Artery Bypass Grafting and Its Association With Patient Characteristics and Clinical Events: A Pooled Individual Patient Data Analysis of Clinical Trials With Imaging Follow-Up. *2023-10-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064090 · https://hartvaat.nl/2023/10/24/graftfalen-na-cabg-individuele-patientdata-meta-analyse/* This individual patient data meta-analysis documented the predictors and clinical consequences of graft failure after CABG, showing that venous graft failure is common and significantly impacts long-term outcomes, reinforcing the value of arterial conduits. ## Inhaled Epoprostenol Compared With Nitric Oxide for Right Ventricular Support After Major Cardiac Surgery. *2023-10-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062464 · https://hartvaat.nl/2023/10/24/inhalatief-epoprostenol-versus-no-bij-rechterventrikel-falen-na-hartchirurgie/* This randomized trial compared inhaled epoprostenol with nitric oxide for right ventricular failure after major cardiac surgery, finding comparable efficacy for both pulmonary vasodilators in this critical post-surgical setting. ## Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. *2023-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad512 · https://hartvaat.nl/2023/10/21/prompt-ahf-epd-alerts-verbeteren-hartfalenmedicatie-bij-ontslag/* The PROMPT-AHF trial showed that electronic health record alerts at hospital discharge significantly increase prescription of guideline-directed medical therapy (including SGLT2 inhibitors) for acute heart failure, demonstrating the effectiveness of automated clinical decision support. ## Long-term efficacy and safety of lerodalcibep in heterozygous familial hypercholesterolaemia: the LIBerate-HeFH trial. *2023-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad596 · https://hartvaat.nl/2023/10/21/lerodalcibep-bij-familiaire-hypercholesterolemie-liberate-hefh-langetermijndata/* Long-term data on lerodalcibep, a novel small recombinant fusion protein PCSK9 inhibitor, showed sustained LDL cholesterol reduction in heterozygous FH patients. The monthly subcutaneous injection offers a new dosing interval between biweekly antibodies and biannual siRNA. ## Atrial pacing minimization in sinus node dysfunction and risk of incident atrial fibrillation: a randomized trial. *2023-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad564 · https://hartvaat.nl/2023/10/21/minimalisatie-van-atriale-pacing-bij-sinusknoopziekte-vermindert-af/* This randomized trial showed that minimizing atrial pacing in sinus node dysfunction reduces the risk of new-onset atrial fibrillation, suggesting that unnecessary atrial pacing may itself contribute to AF development. ## Upgrade of right ventricular pacing to cardiac resynchronization therapy in heart failure: a randomized trial. *2023-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad591 · https://hartvaat.nl/2023/10/21/upgrade-van-rv-pacing-naar-crt-bij-hartfalen-gerandomiseerde-trial/* This randomized trial demonstrated that upgrading right ventricular pacing to CRT-D in heart failure patients improves LV function and clinical outcomes, confirming the benefit of resynchronization in pacing-induced cardiomyopathy. ## Optical Coherence Tomography-Guided versus Angiography-Guided PCI. *2023-10-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2305861 · https://hartvaat.nl/2023/10/19/ilumien-iv-oct-geleide-versus-angiografie-geleide-pci-nejm/* The ILUMIEN IV trial showed that OCT-guided PCI improved the procedural quality (minimum stent area) but did not significantly reduce the clinical composite of cardiac death or MI compared with angiography-guided PCI at 2 years. The study highlighted the gap between procedural optimization and hard clinical outcomes. ## OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions. *2023-10-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2307770 · https://hartvaat.nl/2023/10/19/october-oct-geleide-pci-bij-complexe-bifurcatielaesies-nejm/* The OCTOBER trial demonstrated that OCT-guided PCI for complex bifurcation lesions reduced the composite of cardiac death, target-lesion MI, or target-lesion revascularization by 57% compared with angiography-guided PCI. This established OCT as a valuable guidance tool specifically for bifurcation intervention. ## Orthostatic Hypotension, Hypertension Treatment, and Cardiovascular Disease: An Individual Participant Meta-Analysis. *2023-10-17 · JAMA · https://doi.org/10.1001/jama.2023.18497 · https://hartvaat.nl/2023/10/17/orthostatische-hypotensie-en-intensieve-bloeddrukbehandeling-ipd-meta-analyse-in/* This individual participant meta-analysis showed that patients with orthostatic hypotension derive equal cardiovascular benefit from intensive blood pressure treatment as those without, without an increased risk of falls or syncope. The results argued against withholding aggressive treatment due to orthostatic hypotension. ## Effects of the Million Hearts Model on Myocardial Infarctions, Strokes, and Medicare Spending: A Randomized Clinical Trial. *2023-10-17 · JAMA · https://doi.org/10.1001/jama.2023.19597 · https://hartvaat.nl/2023/10/17/million-hearts-betaald-cv-risicomanagement-vermindert-mi-en-cva-jama-rct/* The Million Hearts Model trial showed that paying healthcare organizations for structured cardiovascular risk management significantly reduced MI and stroke in high-risk patients, demonstrating that financial incentives for prevention translate to clinical outcomes. ## Comparison of Antiplatelet Monotherapies After Percutaneous Coronary Intervention According to Clinical, Ischemic, and Bleeding Risks. *2023-10-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.07.031 · https://hartvaat.nl/2023/10/17/antiplaatjesmonotherapie-na-pci-clopidogrel-versus-aspirine-naar-risicoprofiel/* This analysis confirmed clopidogrel's superiority over aspirin as antiplatelet monotherapy after PCI across a range of clinical, ischemic, and bleeding risk profiles, supporting clopidogrel as the default long-term post-PCI antiplatelet agent. ## Bivalirudin Versus Heparin During PCI in NSTEMI: Individual Patient Data Meta-Analysis of Large Randomized Trials. *2023-10-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.063946 · https://hartvaat.nl/2023/10/17/bivalirudine-versus-heparine-bij-nstemi-ipd-meta-analyse/* This individual patient data meta-analysis confirmed that bivalirudin causes less major bleeding than heparin during PCI for NSTEMI without increasing ischemic events, providing the most robust comparative data for anticoagulation in this setting. ## Optical Coherence Tomography-Guided or Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: The OCTIVUS Randomized Clinical Trial. *2023-10-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.066429 · https://hartvaat.nl/2023/10/17/octivus-oct-geleide-versus-ivus-geleide-pci-non-inferioriteit-bevestigd/* The OCTIVUS trial demonstrated that OCT-guided PCI was noninferior to IVUS-guided PCI for clinical outcomes. The result established OCT and IVUS as interchangeable intravascular imaging modalities for guiding coronary intervention. ## Venoarterial extracorporeal membrane oxygenation in patients with infarct-related cardiogenic shock: an individual patient data meta-analysis of randomised trials. *2023-10-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)01607-0 · https://hartvaat.nl/2023/10/14/va-ecmo-bij-cardiogene-shock-ipd-meta-analyse-lancet/* This individual patient data meta-analysis confirmed that VA-ECMO does not improve survival in patients with infarct-related cardiogenic shock, with pooled data from randomized trials showing no mortality benefit but increased limb complications. The analysis definitively discouraged routine ECMO use in this setting. ## Timing of Complete Revascularization with Multivessel PCI for Myocardial Infarction. *2023-10-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2307823 · https://hartvaat.nl/2023/10/12/multistars-ami-timing-van-complete-revascularisatie-bij-stemi-nejm/* The MULTISTARS AMI trial showed that immediate complete revascularization during the index primary PCI procedure was superior to staged revascularization within 45 days for reducing cardiovascular death or MI in patients with STEMI and multivessel disease. The results support a one-stop-shop approach when feasible. ## Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation. *2023-10-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2306037 · https://hartvaat.nl/2023/10/12/castle-htx-af-ablatie-bij-eindstadium-hartfalen-nejm/* The CASTLE-HTx trial demonstrated that catheter ablation for atrial fibrillation in patients with end-stage heart failure (on LVAD or transplant waiting list) dramatically improved survival, with a 44% relative reduction in the composite of death, LVAD implantation, or urgent heart transplantation. The results extend the benefit of AF ablation to the most severely ill heart failure patients. ## Accelerated -Rule-Out of acute Myocardial Infarction using prehospital copeptin and in-hospital troponin: The AROMI study. *2023-10-12 · European heart journal · https://doi.org/10.1093/eurheartj/ehad447 · https://hartvaat.nl/2023/10/12/aromi-prehospitale-copeptine-versnelt-mi-uitsluiting/* The AROMI study showed that prehospital copeptin measurement combined with in-hospital troponin can accelerate AMI rule-out in the ambulance setting, potentially enabling earlier triage and reducing unnecessary emergency department evaluations. ## Anticoagulant in atrial fibrillation patients with prior intracranial haemorrhage: a meta-analysis. *2023-10-12 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2023-322492 · https://hartvaat.nl/2023/10/12/anticoagulatie-bij-af-na-eerdere-intracraniele-bloeding-meta-analyse/* This meta-analysis showed that resuming anticoagulation (preferably with DOACs) in AF patients after intracranial hemorrhage is associated with fewer ischemic events and lower mortality without a significant increase in recurrent ICH, supporting cautious anticoagulation restart. ## Integrated management of HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-AFRICA): a pragmatic cluster-randomised, controlled trial. *2023-10-07 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)01573-8 · https://hartvaat.nl/2023/10/07/inte-africa-geintegreerd-management-van-hiv-diabetes-en-hypertensie-lancet/* The INTE-AFRICA trial showed that integrated management of HIV, diabetes, and hypertension in sub-Saharan Africa is feasible and may improve care quality, testing a model for addressing the growing burden of noncommunicable diseases alongside HIV. ## Cardiac resynchronization therapy non-responder to responder conversion rate in the MORE-CRT MPP trial. *2023-10-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad294 · https://hartvaat.nl/2023/10/05/more-crt-mpp-multipoint-pacing-bij-crt-non-responders/* The MORE-CRT MPP trial evaluated whether multipoint pacing can convert CRT non-responders to responders, testing programmable stimulation optimization as a salvage strategy for patients who fail conventional biventricular pacing. ## Comparisons of effectiveness and safety between on-label dosing, off-label underdosing, and off-label overdosing in Asian and non-Asian atrial fibrillation patients treated with rivaroxaban: a systematic review and meta-analysis of observational studies. *2023-10-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad288 · https://hartvaat.nl/2023/10/05/rivaroxaban-dosering-bij-af-on-label-versus-off-label-in-azie-en-niet-azie/* This study compared on-label with off-label rivaroxaban dosing in AF across Asian and non-Asian populations, confirming that off-label underdosing is associated with worse ischemic outcomes without meaningful bleeding reduction. ## Extracorporeal Life Support in Infarct-Related Cardiogenic Shock. *2023-10-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2307227 · https://hartvaat.nl/2023/10/05/ecls-shock-ecmo-bij-infarctgerelateerde-cardiogene-shock-nejm/* The ECLS-SHOCK trial showed that routine extracorporeal membrane oxygenation (ECMO) did not improve 30-day survival compared with standard care in patients with infarct-related cardiogenic shock. This large, definitive trial ended the enthusiasm for routine ECLS in MI-associated cardiogenic shock. ## Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality. *2023-10-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2206916 · https://hartvaat.nl/2023/10/05/vijf-modificeerbare-risicofactoren-en-mondiale-cv-sterfte-nejm-pure-analyse/* This PURE study analysis demonstrated that five modifiable risk factors (hypertension, dyslipidemia, diabetes, obesity, and smoking) account for the majority of cardiovascular disease and mortality worldwide, with regional variation in their relative contributions. The individual-level data across 21 countries provided the definitive global picture of attributable cardiovascular risk. ## Estimated Glomerular Filtration Rate, Albuminuria, and Adverse Outcomes: An Individual-Participant Data Meta-Analysis. *2023-10-03 · JAMA · https://doi.org/10.1001/jama.2023.17002 · https://hartvaat.nl/2023/10/03/egfr-en-albuminurie-voorspellen-cv-events-ipd-mega-meta-analyse/* This mega-scale individual participant data meta-analysis confirmed that low eGFR and albuminuria independently and additively predict cardiovascular events and mortality. The combined assessment provides superior risk stratification compared with either marker alone. ## Adherence to CPAP Treatment and the Risk of Recurrent Cardiovascular Events: A Meta-Analysis. *2023-10-03 · JAMA · https://doi.org/10.1001/jama.2023.17465 · https://hartvaat.nl/2023/10/03/cpap-therapietrouw-en-recidief-cv-events-meta-analyse/* This meta-analysis demonstrated that only adherent CPAP users (≥4 hours/night) experience a reduction in recurrent cardiovascular events in obstructive sleep apnea, suggesting that the neutral results of CPAP trials may be explained by suboptimal adherence. ## Cost-Effectiveness of Vericiguat in Patients With Heart Failure With Reduced Ejection Fraction: The VICTORIA Randomized Clinical Trial. *2023-10-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.063602 · https://hartvaat.nl/2023/10/03/vericiguat-bij-hfref-is-kosteneffectief-victoria-analyse/* This VICTORIA cost-effectiveness analysis showed that vericiguat is cost-effective in high-risk HFrEF patients with recent heart failure events, supporting the value proposition of sGC stimulation as a fifth pillar of heart failure therapy. ## Renal function and decongestion with acetazolamide in acute decompensated heart failure: the ADVOR trial. *2023-10-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad557 · https://hartvaat.nl/2023/10/01/advor-nierfunctie-en-decongestie-met-acetazolamide/* This ADVOR analysis showed that acetazolamide improves decongestion without significantly worsening renal function in acute heart failure, with the initial eGFR decline reflecting hemodynamic effects rather than tubular injury. ## Deferred Testing in Stable Outpatients With Suspected Coronary Artery Disease: A Prespecified Secondary Analysis of the PRECISE Randomized Clinical Trial. *2023-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.2614 · https://hartvaat.nl/2023/10/01/precise-uitgesteld-testen-bij-stabiel-coronairlijden-is-veilig/* This PRECISE trial analysis showed that deferring non-invasive testing in stable outpatients with suspected coronary artery disease and low pretest probability is safe, validating the guideline recommendation to avoid unnecessary testing. ## Mineralocorticoid receptor antagonists with sodium-glucose co-transporter-2 inhibitors in heart failure: a meta-analysis. *2023-10-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad522 · https://hartvaat.nl/2023/10/01/mra-plus-sglt2-remmer-bij-hartfalen-meta-analyse-toont-synergistisch-voordeel/* This meta-analysis showed that combining an MRA with an SGLT2 inhibitor in heart failure provides additive reductions in cardiovascular death and heart failure hospitalization beyond either drug class alone. The findings support the four-pillar approach including dual neurohormonal and metabolic modulation. ## Efficacy of pulmonary artery pressure monitoring in patients with chronic heart failure: a meta-analysis of three randomized controlled trials. *2023-10-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad346 · https://hartvaat.nl/2023/10/01/pa-drukmonitoring-bij-chronisch-hartfalen-meta-analyse-van-drie-rct-s/* This meta-analysis of CHAMPION, GUIDE-HF, and MONITOR-HF confirmed that implantable pulmonary artery pressure monitoring significantly reduces heart failure hospitalization in chronic heart failure. The pooled evidence across three continents supported the clinical utility of hemodynamic monitoring. ## Trimetazidine in heart failure with preserved ejection fraction: a randomized controlled cross-over trial. *2023-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14418 · https://hartvaat.nl/2023/10/01/trimetazidine-bij-hfpef-gerandomiseerde-cross-over-trial/* This cross-over trial of trimetazidine in HFpEF showed no significant improvement in cardiac function or exercise capacity, a negative result for metabolic modulation in the preserved ejection fraction phenotype. ## Efficacy and safety of baroreflex activation therapy for heart failure with reduced ejection fraction: systematic review. *2023-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14473 · https://hartvaat.nl/2023/10/01/baroreflexactivatietherapie-bij-hfref-systematische-review/* This systematic review evaluated baroreflex activation therapy as an adjunctive treatment for HFrEF, showing symptom improvement and NT-proBNP reduction with this neuromodulation device. ## Alcohol Intake and Blood Pressure Levels: A Dose-Response Meta-Analysis of Nonexperimental Cohort Studies. *2023-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21224 · https://hartvaat.nl/2023/10/01/alcoholconsumptie-en-bloeddruk-dosis-respons-meta-analyse/* This dose-response meta-analysis showed a linear relationship between alcohol consumption and blood pressure elevation with no safe threshold, supporting alcohol reduction as a blood pressure management strategy at any intake level. ## Efficacy of ivabradine in heart failure patients with a high-risk profile (analysis from the SHIFT trial). *2023-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14455 · https://hartvaat.nl/2023/10/01/ivabradine-bij-hoogrisico-hartfalenpatienten-shift-analyse/* This SHIFT post-hoc analysis showed that ivabradine provides the greatest benefit in HFrEF patients with the highest risk profiles (higher heart rate, lower LVEF, recent hospitalization), supporting risk-based patient selection for heart rate lowering. ## Adaptive versus conventional cardiac resynchronisation therapy in patients with heart failure (AdaptResponse): a global, prospective, randomised controlled trial. *2023-09-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00912-1 · https://hartvaat.nl/2023/09/30/adaptresponse-adaptieve-versus-conventionele-crt-bij-hartfalen-lancet/* The AdaptResponse trial showed that adaptive CRT (automatic optimization with LV-only pacing when appropriate) is noninferior to conventional biventricular CRT, supporting intelligent pacing algorithms that simplify device management. ## Anticoagulation with Edoxaban in Patients with Atrial High-Rate Episodes. *2023-09-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2303062 · https://hartvaat.nl/2023/09/28/noah-afnet-6-edoxaban-bij-atriaal-high-rate-episodes-nejm/* The NOAH-AFNET 6 trial found that edoxaban did not significantly reduce cardiovascular events compared with placebo in patients with device-detected atrial high-rate episodes (AHREs) but without clinical atrial fibrillation, while increasing major bleeding. The results do not support routine anticoagulation for subclinical atrial arrhythmias detected by cardiac devices. ## Chest pain symptoms during myocardial infarction in patients with and without diabetes: a systematic review and meta-analysis. *2023-09-28 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-322289 · https://hartvaat.nl/2023/09/28/pijn-op-de-borst-bij-mi-met-en-zonder-diabetes-meta-analyse/* This meta-analysis showed that diabetic patients more often present with atypical MI symptoms, but chest pain remains the most common presentation even in diabetes, informing triage and diagnostic approaches. ## Biodegradable-Polymer or Durable-Polymer Stents in Patients at High Bleeding Risk: A Randomized, Open-Label Clinical Trial. *2023-09-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.065448 · https://hartvaat.nl/2023/09/26/biodegradeerbare-versus-duurzame-polymeer-stents-bij-hoog-bloedingsrisico/* This randomized trial comparing biodegradable with durable polymer DES in high-bleeding-risk patients showed equivalent outcomes with both platforms, supporting either technology for short-DAPT strategies. ## Blinded Withdrawal of Long-Term Randomized Treatment With Empagliflozin or Placebo in Patients With Heart Failure. *2023-09-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.065748 · https://hartvaat.nl/2023/09/26/geblindeerde-stopstudie-voordelen-empagliflozine-verdwijnen-na-staken-bij-hf/* This blinded withdrawal study from EMPEROR showed that the benefits of empagliflozin in heart failure rapidly diminish after treatment discontinuation, with NT-proBNP and clinical deterioration markers worsening within weeks. The findings underscore the need for continuous SGLT2 inhibitor therapy. ## Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity. *2023-09-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2306963 · https://hartvaat.nl/2023/09/21/step-hfpef-semaglutide-bij-hfpef-en-obesitas-nejm/* The STEP-HFpEF trial showed that weekly semaglutide 2.4 mg in patients with HFpEF and obesity dramatically improved heart failure symptoms, physical limitations, and quality of life, with a mean 13% body weight reduction. This landmark result established GLP-1 receptor agonists as a transformative therapy for the obesity-HFpEF phenotype. ## Screening for Hypertensive Disorders of Pregnancy: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. *2023-09-19 · JAMA · https://doi.org/10.1001/jama.2023.4934 · https://hartvaat.nl/2023/09/19/uspstf-evidence-review-screening-op-hypertensieve-zwangerschapsstoornissen/* This USPSTF systematic review supported blood pressure screening throughout pregnancy as an effective method for detecting preeclampsia and related disorders, confirming the maternal and fetal benefits of early detection. ## Screening for Hypertensive Disorders of Pregnancy: US Preventive Services Task Force Final Recommendation Statement. *2023-09-19 · JAMA · https://doi.org/10.1001/jama.2023.16991 · https://hartvaat.nl/2023/09/19/uspstf-screening-op-hypertensieve-zwangerschapsstoornissen-aanbevolen/* The USPSTF reaffirmed the recommendation to screen for hypertensive disorders at every prenatal visit, reflecting the rising incidence of preeclampsia and gestational hypertension as leading causes of maternal morbidity. ## Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial. *2023-09-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.065770 · https://hartvaat.nl/2023/09/19/fame-3-driejaarsresultaten-ffr-geleide-pci-versus-cabg-bij-drievatslijden/* Three-year FAME 3 follow-up confirmed that FFR-guided PCI did not achieve noninferiority versus CABG for three-vessel coronary disease, with CABG maintaining lower rates of revascularization and MI. The extended data reinforced CABG as the standard for complex multivessel disease. ## Impact of Complete Revascularization in the ISCHEMIA Trial. *2023-09-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.06.015 · https://hartvaat.nl/2023/09/19/ischemia-impact-van-complete-revascularisatie-op-uitkomsten/* This ISCHEMIA subanalysis showed that among patients randomized to invasive management, achieving complete revascularization improved long-term outcomes compared with incomplete revascularization, supporting thorough intervention when an invasive approach is chosen. ## Ferric Carboxymaltose in Heart Failure with Iron Deficiency. *2023-09-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2304968 · https://hartvaat.nl/2023/09/14/heart-fid-iv-ferricarboxymaltose-bij-hartfalen-met-ijzerdeficientie-nejm/* The HEART-FID trial showed that intravenous ferric carboxymaltose in patients with HFrEF and iron deficiency did not significantly improve the hierarchical composite of death, heart failure hospitalization, and 6-minute walk distance. The neutral result contrasted with positive findings from AFFIRM-AHF and IRONMAN. ## Prognostic models for heart failure in patients with type 2 diabetes: a systematic review and meta-analysis. *2023-09-13 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-322044 · https://hartvaat.nl/2023/09/13/prognostische-modellen-voor-hartfalen-bij-type-2-diabetes-systematische-review/* This systematic review evaluated prognostic models for heart failure in type 2 diabetes, finding that most models have limited discrimination and need validation in diverse diabetic populations. ## Atrial Fibrillation Catheter Ablation vs Medical Therapy and Psychological Distress: A Randomized Clinical Trial. *2023-09-12 · JAMA · https://doi.org/10.1001/jama.2023.14685 · https://hartvaat.nl/2023/09/12/af-ablatie-vermindert-psychologische-distress-jama-rct/* This JAMA trial demonstrated that AF catheter ablation significantly reduces psychological distress, including anxiety and depression, compared with medical therapy, establishing the mental health co-benefit of successful rhythm control. ## Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction. *2023-09-07 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2300468 · https://hartvaat.nl/2023/09/07/fire-complete-revascularisatie-bij-ouderen-75-jaar-met-mi-nejm/* The FIRE trial demonstrated that complete revascularization reduced cardiovascular death or MI compared with culprit-only PCI in patients aged 75 or older with MI and multivessel disease. The results extended the benefit of complete revascularization to the elderly population previously excluded from major trials. ## Daily Oral GLP-1 Receptor Agonist Orforglipron for Adults with Obesity. *2023-09-07 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2302392 · https://hartvaat.nl/2023/09/07/orforglipron-dagelijkse-orale-glp-1-agonist-bij-obesitas-nejm/* This NEJM phase 2 trial demonstrated that orforglipron, an oral nonpeptide GLP-1 receptor agonist, produced dose-dependent weight loss of up to 14.7% in adults with obesity. The results positioned oral GLP-1 therapy as a practical alternative to injectable formulations for obesity treatment. ## Blood Pressure Management After Endovascular Therapy for Acute Ischemic Stroke: The BEST-II Randomized Clinical Trial. *2023-09-05 · JAMA · https://doi.org/10.1001/jama.2023.14330 · https://hartvaat.nl/2023/09/05/best-ii-bloeddrukmanagement-na-trombectomie-bij-cva-jama/* The BEST-II trial showed that moderate blood pressure lowering (SBP <140 mmHg) was superior to intensive (SBP <120 mmHg) after successful endovascular thrombectomy, with better functional outcomes at the moderate target. ## Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke: The OPTIMAL-BP Randomized Clinical Trial. *2023-09-05 · JAMA · https://doi.org/10.1001/jama.2023.14590 · https://hartvaat.nl/2023/09/05/optimal-bp-intensieve-bloeddrukverlaging-na-trombectomie-bij-cva-jama/* The OPTIMAL-BP trial found no significant difference between intensive and conventional blood pressure lowering after endovascular thrombectomy for acute ischemic stroke, consistent with ENCHANTED2/MT results arguing against very aggressive post-procedure BP reduction. ## Cardiac and Metabolic Effects of Dapagliflozin in Heart Failure With Preserved Ejection Fraction: The CAMEO-DAPA Trial. *2023-09-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.065134 · https://hartvaat.nl/2023/09/05/cameo-dapa-cardiale-en-metabole-effecten-van-dapagliflozine-bij-hfpef/* The CAMEO-DAPA trial showed that dapagliflozin improves cardiac efficiency and metabolic parameters in HFpEF, advancing the mechanistic understanding of SGLT2 inhibitor benefit in preserved ejection fraction heart failure. ## Moderate-Intensity Statin With Ezetimibe Combination Therapy vs High-Intensity Statin Monotherapy in Patients at Very High Risk of Atherosclerotic Cardiovascular Disease: A Post Hoc Analysis From the RACING Randomized Clinical Trial. *2023-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.2222 · https://hartvaat.nl/2023/09/01/matige-statine-plus-ezetimibe-bij-zeer-hoog-ascvd-risico-non-inferioriteitstudie/* This study confirmed that moderate-intensity statin with ezetimibe is noninferior to high-intensity statin in patients at very high cardiovascular risk, extending the combination therapy evidence to the highest-risk population. ## Derivation of an Outcome-Driven Threshold for Aortic Pulse Wave Velocity: An Individual-Participant Meta-Analysis. *2023-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21318 · https://hartvaat.nl/2023/09/01/drempelwaarde-voor-aortale-polsgolfsnelheid-en-cv-events-ipd-meta-analyse/* This individual participant data meta-analysis established an outcome-driven threshold for aortic pulse wave velocity at 10 m/s, identifying a clinically actionable cutoff for vascular stiffness-based cardiovascular risk assessment. ## Intensive Blood Pressure Lowering Improves Left Ventricular Hypertrophy in Older Patients with Hypertension: The STEP Trial. *2023-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20732 · https://hartvaat.nl/2023/09/01/step-substudie-intensieve-bloeddrukverlaging-verbetert-lvh-bij-ouderen/* This STEP substudy showed that intensive blood pressure lowering (SBP <130 mmHg) regresses left ventricular hypertrophy in older hypertensive patients, providing cardiac structural evidence supporting aggressive blood pressure targets in the elderly. ## STREAM-2: Half-Dose Tenecteplase or Primary Percutaneous Coronary Intervention in Older Patients With ST-Segment-Elevation Myocardial Infarction: A Randomized, Open-Label Trial. *2023-08-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064521 · https://hartvaat.nl/2023/08/29/stream-2-halve-dosis-tenecteplase-bij-ouderen-met-stemi/* The STREAM-2 trial demonstrated that half-dose tenecteplase followed by PCI is a viable pharmaco-invasive strategy for older STEMI patients (≥60 years) when timely primary PCI is unavailable, with safety comparable to primary PCI. ## Pitavastatin to Prevent Cardiovascular Disease in HIV Infection. *2023-08-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2304146 · https://hartvaat.nl/2023/08/24/reprieve-pitavastatine-vermindert-cv-events-bij-hiv-nejm/* The REPRIEVE trial demonstrated that pitavastatin reduced major cardiovascular events by 35% in people living with HIV who had low-to-moderate cardiovascular risk. The trial was stopped early for efficacy, providing the first definitive evidence for statin therapy in primary cardiovascular prevention among HIV-infected individuals. ## Fixed dose combination therapies in primary cardiovascular disease prevention in different groups: an individual participant meta-analysis. *2023-08-24 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-322278 · https://hartvaat.nl/2023/08/24/vaste-dosiscombinatietherapie-voor-primaire-cv-preventie-ipd-meta-analyse/* This individual participant data meta-analysis from three randomized trials confirmed that fixed-dose combination therapy (polypill) reduces cardiovascular events in primary prevention across different age groups. The consistent benefit supports the polypill strategy as a population-level intervention. ## Habitual physical activity levels of adults with heart failure: systematic review and meta-analysis. *2023-08-24 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321943 · https://hartvaat.nl/2023/08/24/fysieke-activiteitsniveaus-bij-hartfalen-meta-analyse/* This meta-analysis quantified the very low habitual physical activity levels (3,000-4,000 steps/day) in heart failure patients, establishing the scale of sedentary behavior and the opportunity for activity promotion. ## Stroke in patients with heart failure and reduced or preserved ejection fraction. *2023-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad338 · https://hartvaat.nl/2023/08/14/cva-bij-hartfalen-met-gereduceerde-versus-behouden-ejectiefractie/* This study compared stroke risk between HFrEF and HFpEF, showing elevated risk in both phenotypes but with different underlying mechanisms (cardiac embolism in HFrEF, atrial cardiomyopathy in HFpEF). ## NT-proBNP and high intensity care for acute heart failure: the STRONG-HF trial. *2023-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad335 · https://hartvaat.nl/2023/08/14/strong-hf-nt-probnp-geleide-intensieve-optitratie-na-acuut-hf/* This STRONG-HF analysis showed that NT-proBNP-guided intensive up-titration of heart failure medications after discharge improves outcomes, demonstrating that biomarker monitoring adds value to the aggressive post-discharge optimization strategy. ## Telemonitoring for heart failure: a meta-analysis. *2023-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad280 · https://hartvaat.nl/2023/08/14/telemonitoring-bij-hartfalen-meta-analyse-van-alle-strategieen/* This comprehensive meta-analysis of telemonitoring in heart failure showed that structured telemonitoring reduces hospitalizations but has inconsistent effects on mortality, with benefit dependent on the specific technology and implementation model. ## Sacubitril/valsartan in heart failure with mildly reduced or preserved ejection fraction: a pre-specified participant-level pooled analysis of PARAGLIDE-HF and PARAGON-HF. *2023-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad344 · https://hartvaat.nl/2023/08/14/sacubitril-valsartan-bij-hfmref-hfpef-gepoolde-analyse-van-drie-trials/* This participant-level pooled analysis of PARAGON-HF, PARADIGM-HF, and PARAGLIDE-HF confirmed that sacubitril-valsartan reduces NT-proBNP and heart failure events in patients with HFmrEF and HFpEF (EF ≥40%), particularly those with lower LVEF within this range. ## Dapagliflozin vs. metolazone in heart failure resistant to loop diuretics. *2023-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad341 · https://hartvaat.nl/2023/08/14/dapagliflozine-versus-metolazone-bij-diureticaresistent-hartfalen/* This study compared dapagliflozin with metolazone as adjunctive therapy in loop diuretic-resistant heart failure, finding comparable diuretic efficacy with a potentially better safety profile for the SGLT2 inhibitor approach. ## Retatrutide, a GIP, GLP-1 and glucagon receptor agonist, for people with type 2 diabetes: a randomised, double-blind, placebo and active-controlled, parallel-group, phase 2 trial conducted in the USA. *2023-08-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)01053-X · https://hartvaat.nl/2023/08/12/retatrutide-triple-gip-glp-1-glucagonagonist-bij-type-2-diabetes-lancet-fase-2/* This Lancet phase 2 trial of retatrutide, a triple GIP/GLP-1/glucagon receptor agonist, demonstrated up to 24% weight loss and dramatic HbA1c improvement in patients with type 2 diabetes. The results surpassed those of dual incretin agonists, establishing triple agonism as the next frontier in metabolic therapeutics. ## Atorvastatin for Anthracycline-Associated Cardiac Dysfunction: The STOP-CA Randomized Clinical Trial. *2023-08-08 · JAMA · https://doi.org/10.1001/jama.2023.11887 · https://hartvaat.nl/2023/08/08/stop-ca-atorvastatine-beschermt-tegen-antracycline-cardiotoxiciteit/* The STOP-CA trial showed that atorvastatin significantly attenuated the decline in left ventricular ejection fraction in patients receiving anthracycline chemotherapy. The result established statins as a potential cardioprotective strategy during cancer treatment. ## GLP-1 Receptor Agonist Therapy With and Without SGLT2 Inhibitors in Patients With Type 2 Diabetes. *2023-08-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.05.048 · https://hartvaat.nl/2023/08/08/glp-1-agonisten-met-en-zonder-sglt2-remmers-bij-type-2-diabetes-jacc-analyse/* This analysis demonstrated that GLP-1 receptor agonists and SGLT2 inhibitors provide complementary cardiovascular benefits when used together in type 2 diabetes, with additive reductions in MACE and heart failure events. The findings support dual cardiometabolic therapy in eligible patients. ## Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis. *2023-08-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad267 · https://hartvaat.nl/2023/08/02/gerichte-lv-leadplaatsing-bij-crt-meta-analyse-van-beeldvorming-en-elektrisch-ge/* This meta-analysis confirmed that targeted LV lead placement at the site of latest electrical activation improves CRT response compared with empirical positioning, supporting imaging or electrical mapping-guided lead deployment. ## Catheter ablation of atrial fibrillation in patients with and without hypertrophic cardiomyopathy: systematic review and meta-analysis. *2023-08-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad256 · https://hartvaat.nl/2023/08/02/af-ablatie-bij-hypertrofische-cardiomyopathie-meta-analyse/* This meta-analysis showed that AF catheter ablation in HCM patients has higher recurrence rates than in non-HCM patients but still provides significant benefit, supporting ablation as a treatment option for the AF-HCM overlap. ## Mechanisms, predictors, and evolution of severe peri-device leaks with two different left atrial appendage occluders. *2023-08-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad237 · https://hartvaat.nl/2023/08/02/peri-device-lekkage-bij-laa-occluders-mechanismen-en-voorspellers/* This Amulet IDE analysis characterized the mechanisms, predictors, and evolution of peri-device leak after LAA occlusion, providing practical guidance for device selection and follow-up imaging after appendage closure. ## Effect of fibrosis regionality on atrial fibrillation recurrence: insights from DECAAF II. *2023-08-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad199 · https://hartvaat.nl/2023/08/02/decaaf-ii-fibroselocatie-beinvloedt-af-recidief-na-ablatie/* This DECAAF II subanalysis showed that the location of atrial fibrosis influences AF recurrence after ablation, with posterior and septal fibrosis carrying the highest risk, informing targeted ablation strategies. ## Global Comparison of Readmission Rates for Patients With Heart Failure. *2023-08-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.05.040 · https://hartvaat.nl/2023/08/01/mondiale-vergelijking-van-heropnamepercentages-bij-hartfalen/* This international comparison revealed substantial variation in heart failure readmission rates across countries, identifying healthcare system factors that may explain differences and offering benchmarks for quality improvement. ## Predicted impact of atrial flow regulator on survival in heart failure with reduced and preserved ejection fraction. *2023-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14384 · https://hartvaat.nl/2023/08/01/atrial-flow-regulator-en-overleving-bij-hartfalen-voorspelde-impact/* This modeling study predicted the potential survival impact of the atrial flow regulator device in heart failure, providing theoretical estimates of benefit to guide clinical development. ## Validation of heart failure algorithm for diagnosing heart failure with preserved ejection fraction: a meta-analysis. *2023-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14421 · https://hartvaat.nl/2023/08/01/hfa-peff-score-voor-hfpef-diagnose-validatie-meta-analyse/* This meta-analysis validated the HFA-PEFF diagnostic score for HFpEF, confirming good diagnostic accuracy and supporting its clinical utility for standardized evaluation of suspected heart failure with preserved ejection fraction. ## Single-Pill Combination Product Availability of the Antihypertensive Regimens Used for Intensive Systolic Blood Pressure Treatment in the Systolic Blood Pressure Intervention Trial. *2023-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21132 · https://hartvaat.nl/2023/08/01/combinatietabletten-voor-intensieve-bloeddrukbehandeling-sprint-analyse/* This SPRINT analysis showed that many intensive blood pressure treatment regimens are available as single-pill combinations, supporting the practical implementation of aggressive multi-drug therapy in a single tablet. ## Systolic Blood Pressure Control Targets to Prevent Major Cardiovascular Events and Death in Patients With Type 2 Diabetes: A Systematic Review and Network Meta-Analysis. *2023-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.20954 · https://hartvaat.nl/2023/08/01/bloeddrukstreefwaarden-bij-type-2-diabetes-netwerk-meta-analyse/* This network meta-analysis explored optimal blood pressure targets for type 2 diabetes, finding that intensive control (SBP <130 mmHg) reduces major cardiovascular events, supporting aggressive targets specifically for the diabetic population. ## The role of bioimpedance analysis in overweight and obese patients with acute heart failure: a pilot study. *2023-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14398 · https://hartvaat.nl/2023/08/01/bio-impedantieanalyse-bij-overgewicht-en-acuut-hartfalen-pilotstudie/* This pilot study evaluated bioimpedance analysis for detecting residual congestion at hospital discharge in overweight acute heart failure patients, where standard assessment is less reliable due to body habitus. ## Feasibility of telerehabilitation for heart failure patients inaccessible for outpatient rehabilitation. *2023-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14405 · https://hartvaat.nl/2023/08/01/telerevalidatie-haalbaar-voor-hartfalenpatienten-zonder-toegang-tot-poliklinisch/* This study confirmed the feasibility and acceptance of telerehabilitation for chronic heart failure patients who cannot access outpatient cardiac rehabilitation, addressing a major implementation barrier. ## Planned delivery or expectant management for late preterm pre-eclampsia in low-income and middle-income countries (CRADLE-4): a multicentre, open-label, randomised controlled trial. *2023-07-29 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00688-8 · https://hartvaat.nl/2023/07/29/cradle-4-geplande-bevalling-versus-afwachten-bij-laat-preterm-pre-eclampsie-in-l/* This Lancet trial compared planned delivery with expectant management for late preterm preeclampsia in low- and middle-income countries, addressing a critical evidence gap for managing hypertensive pregnancy complications in resource-limited settings. ## Efficacy and safety of luspatercept versus epoetin alfa in erythropoiesis-stimulating agent-naive, transfusion-dependent, lower-risk myelodysplastic syndromes (COMMANDS): interim analysis of a phase 3, open-label, randomised controlled trial. *2023-07-29 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00874-7 · https://hartvaat.nl/2023/07/29/luspatercept-versus-epoetine-alfa-bij-mds-gerelateerde-anemie-lancet-trial/* This Lancet trial showing luspatercept superiority over epoetin alfa for anemia in MDS patients is relevant to CKD and cardiovascular medicine through shared erythropoiesis pathways and iron metabolism. ## Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation. *2023-07-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.05.024 · https://hartvaat.nl/2023/07/25/omega-3-biomarkers-en-incident-af-ipd-analyse/* This individual patient data analysis found a positive association between higher omega-3 fatty acid biomarker levels and incident atrial fibrillation, contributing to the growing safety concern about omega-3 supplementation and arrhythmia risk. ## Red meat consumption, cardiovascular diseases, and diabetes: a systematic review and meta-analysis. *2023-07-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad336 · https://hartvaat.nl/2023/07/21/rood-vlees-cardiovasculaire-ziekte-en-diabetes-systematische-review/* This systematic review and meta-analysis confirmed a modest but consistent association between red meat consumption and cardiovascular disease and diabetes, though the effect size was smaller than commonly assumed. ## Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. *2023-07-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad211 · https://hartvaat.nl/2023/07/21/vegetarisch-of-veganistisch-dieet-en-bloedlipiden-meta-analyse-van-rct-s/* This meta-analysis of RCTs showed that vegetarian and vegan diets significantly lower total and LDL cholesterol compared with omnivorous diets, supporting plant-based dietary patterns for cardiovascular risk reduction. ## Zilebesiran, an RNA Interference Therapeutic Agent for Hypertension. *2023-07-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2208391 · https://hartvaat.nl/2023/07/20/zilebesiran-rna-interferentietherapie-voor-hypertensie-nejm/* This first-in-human study of zilebesiran, an RNA interference agent targeting hepatic angiotensinogen, demonstrated sustained blood pressure reduction for up to 24 weeks after a single subcutaneous injection. The findings represent a potential paradigm shift toward ultra-long-acting antihypertensive therapy requiring only biannual dosing. ## Phase 1 Trial of Antibody NI006 for Depletion of Cardiac Transthyretin Amyloid. *2023-07-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2303765 · https://hartvaat.nl/2023/07/20/ni006-antilichaam-voor-afbraak-van-cardiale-transthyretine-amyloid-nejm-fase-1/* This first-in-human phase 1 trial showed that NI006, a monoclonal antibody targeting transthyretin amyloid deposits, can reduce cardiac amyloid burden in patients with ATTR cardiomyopathy. This represents the first therapeutic approach aimed at clearing existing amyloid deposits rather than just preventing new deposition. ## Screening for Lipid Disorders in Children and Adolescents: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. *2023-07-18 · JAMA · https://doi.org/10.1001/jama.2023.8867 · https://hartvaat.nl/2023/07/18/uspstf-evidence-review-lipidescreening-bij-kinderen-geactualiseerd/* This USPSTF systematic review confirmed that lipid screening in children can detect dyslipidemia effectively, but the long-term clinical benefit of early treatment remains uncertain, limiting the strength of screening recommendations. ## Screening for Lipid Disorders in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. *2023-07-18 · JAMA · https://doi.org/10.1001/jama.2023.11330 · https://hartvaat.nl/2023/07/18/uspstf-screening-op-lipidestoornissen-bij-kinderen-en-adolescenten/* The USPSTF concluded that evidence is insufficient to determine whether universal lipid screening in children and adolescents improves health outcomes, maintaining the 'I' statement despite ongoing concern about familial hypercholesterolemia underdiagnosis. ## 5-Year Outcomes After Bioresorbable Coronary Scaffolds Implanted With Improved Technique. *2023-07-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.05.003 · https://hartvaat.nl/2023/07/18/bioresorbeerbare-coronaire-scaffolds-vijfjaarsuitkomsten-met-verbeterde-techniek/* These 5-year data showed that bioresorbable scaffolds implanted with improved technique (proper sizing, high-pressure post-dilation) have better outcomes than earlier experience, though metallic DES remain the standard of care. ## Racial Differences in Quality of Life in Patients With Heart Failure Treated With Sodium-Glucose Cotransporter 2 Inhibitors: A Patient-Level Meta-Analysis of the CHIEF-HF, DEFINE-HF, and PRESERVED-HF Trials. *2023-07-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.063263 · https://hartvaat.nl/2023/07/18/sglt2-remmers-verbeteren-kwaliteit-van-leven-gelijk-bij-zwarte-en-witte-hartfale/* This patient-level analysis showed that SGLT2 inhibitors equally improve quality of life in Black and White heart failure patients, addressing the important question of equitable treatment benefit across racial groups. ## Impact of early vs. delayed atrial fibrillation catheter ablation on atrial arrhythmia recurrences. *2023-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad247 · https://hartvaat.nl/2023/07/14/vroege-versus-late-af-ablatie-impact-op-aritmierecidief/* This study showed that early catheter ablation (within 1 year of AF diagnosis) results in fewer arrhythmia recurrences than delayed ablation, reinforcing the early rhythm control paradigm from EAST-AFNET 4. ## Cardiovascular Safety of Testosterone-Replacement Therapy. *2023-07-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2215025 · https://hartvaat.nl/2023/07/13/traverse-testosteronsubstitutie-cardiovasculair-veilig-bij-hypogonadisme/* The TRAVERSE trial demonstrated that testosterone-replacement therapy in middle-aged and older men with hypogonadism and cardiovascular risk factors did not increase the incidence of major adverse cardiovascular events. This large safety trial resolved decades of uncertainty about the cardiovascular risks of testosterone therapy. ## P2Y12 Inhibitor or Aspirin Monotherapy for Secondary Prevention of Coronary Events. *2023-07-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.04.051 · https://hartvaat.nl/2023/07/11/p2y12-monotherapie-versus-aspirine-voor-langetermijnsecundaire-preventie-meta-an/* This meta-analysis confirmed that P2Y12 inhibitor monotherapy is superior to aspirin for long-term secondary prevention of coronary events, with fewer ischemic events (especially stroke) and no increase in bleeding. The data support replacing aspirin with clopidogrel as the default post-DAPT agent. ## Impact of Malnutrition in Patients With Heart Failure and Secondary Mitral Regurgitation: The COAPT Trial. *2023-07-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.04.047 · https://hartvaat.nl/2023/07/11/ondervoeding-verslechtert-prognose-bij-hartfalen-en-mr-coapt-analyse/* This COAPT analysis showed that malnutrition independently predicts worse outcomes in heart failure with secondary MR, highlighting the importance of nutritional assessment in the MitraClip decision-making process. ## Effect of Torsemide Versus Furosemide on Symptoms and Quality of Life Among Patients Hospitalized for Heart Failure: The TRANSFORM-HF Randomized Clinical Trial. *2023-07-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064842 · https://hartvaat.nl/2023/07/11/transform-hf-torsemide-versus-furosemide-geen-verschil-in-symptomen/* This TRANSFORM-HF symptom analysis confirmed that torsemide offers no advantage over furosemide for symptoms and quality of life in hospitalized heart failure patients, supporting either loop diuretic as an equivalent clinical choice. ## Cognitive Behavioral Therapy Improves Quality of Life in Patients With Symptomatic Paroxysmal Atrial Fibrillation. *2023-07-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.04.044 · https://hartvaat.nl/2023/07/04/cognitieve-gedragstherapie-verbetert-kwaliteit-van-leven-bij-symptomatisch-af/* This randomized trial showed that cognitive behavioral therapy significantly improves quality of life and reduces AF symptom burden in patients with symptomatic paroxysmal AF, establishing psychological intervention as a complementary approach to rhythm management. ## Safety and efficacy of colchicine for the prevention of post-operative atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials. *2023-07-04 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad169 · https://hartvaat.nl/2023/07/04/colchicine-voorkomt-postoperatief-af-na-hartchirurgie-meta-analyse/* This meta-analysis confirmed that colchicine significantly reduces post-operative atrial fibrillation after cardiac surgery, supporting its use as a prophylactic anti-inflammatory agent in the perioperative setting. ## Angiotensin-Neprilysin Inhibition in Patients With Mildly Reduced or Preserved Ejection Fraction and Worsening Heart Failure. *2023-07-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.04.019 · https://hartvaat.nl/2023/07/04/sacubitril-valsartan-bij-hfmref-hfpef-met-verslechterend-hartfalen/* This analysis showed that sacubitril-valsartan benefits patients with HFmrEF/HFpEF and worsening heart failure (recent hospitalization or elevated natriuretic peptides), supporting ARNI use in the higher-risk phenotype within this population. ## The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial. *2023-07-01 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00806-1 · https://hartvaat.nl/2023/07/01/interact3-bundeled-care-bij-acute-intracerebrale-bloeding-lancet/* The INTERACT3 trial showed that a goal-directed care bundle with early intensive blood pressure lowering improved functional outcomes in patients with acute intracerebral hemorrhage. The pragmatic, cluster-randomized design demonstrated that structured care protocols can improve outcomes at scale. ## Association of Dapagliflozin vs Placebo With Individual Kansas City Cardiomyopathy Questionnaire Components in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Secondary Analysis of the DELIVER Trial. *2023-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.1342 · https://hartvaat.nl/2023/07/01/deliver-dapagliflozine-verbetert-individuele-kccq-componenten-bij-hfpef/* This detailed DELIVER analysis showed that dapagliflozin improves all individual components of the Kansas City Cardiomyopathy Questionnaire in HFpEF — symptoms, physical limitations, and quality of life — providing a comprehensive symptom benefit. ## Titanium-Nitride-Oxide-Coated vs Everolimus-Eluting Stents in Acute Coronary Syndrome: 5-Year Clinical Outcomes of the TIDES-ACS Randomized Clinical Trial. *2023-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.1373 · https://hartvaat.nl/2023/07/01/tino-gecoate-versus-everolimus-eluting-stents-bij-acs-tides-acs-vijfjaarsdata/* Five-year TIDES-ACS results showed that titanium-nitride-oxide-coated stents provide comparable outcomes to everolimus-eluting stents in ACS, with faster strut coverage offering a potential advantage for shortened DAPT. ## Statin loading before coronary artery bypass grafting: a randomized trial. *2023-07-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad238 · https://hartvaat.nl/2023/07/01/statinoplaaddosis-voor-cabg-gerandomiseerde-trial/* This randomized trial showed that high-dose statin loading before CABG does not improve outcomes, in contrast to the proven benefit before PCI, suggesting different mechanisms of perioperative benefit between surgical and percutaneous revascularization. ## Timing of Antihypertensive Drug Therapy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. *2023-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20862 · https://hartvaat.nl/2023/07/01/timing-van-antihypertensiva-meta-analyse-van-rct-s-bevestigt-flexibiliteit/* This meta-analysis of RCTs confirmed that the timing of antihypertensive drug administration (morning vs evening) has no significant effect on blood pressure control or cardiovascular outcomes, adding to the TIME and BedMed evidence. ## Systematic Review of Therapeutic Agents and Long-Term Outcomes of Familial Hyperaldosteronism Type 1. *2023-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21054 · https://hartvaat.nl/2023/07/01/familiair-hyperaldosteronisme-type-1-therapeutische-opties-en-langetermijnuitkom/* This systematic review summarized the treatment options and long-term outcomes of familial hyperaldosteronism type 1, the first identified monogenic cause of primary aldosteronism. ## Evidence for Age Bias Contributing to Therapeutic Inertia in Blood Pressure Management: A Secondary Analysis of SPRINT. *2023-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.21323 · https://hartvaat.nl/2023/07/01/leeftijdsbias-draagt-bij-aan-therapeutische-inertie-bij-bloeddrukmanagement/* This SPRINT analysis showed that age bias contributes to therapeutic inertia in blood pressure management, with clinicians being less aggressive in intensifying treatment for older patients despite equal evidence of benefit. ## Metabolomic Profiles Associated With Blood Pressure Reduction in Response to the DASH and DASH-Sodium Dietary Interventions. *2023-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.123.20901 · https://hartvaat.nl/2023/07/01/metabolomics-en-bloeddrukrespons-op-dash-dieet/* This metabolomics analysis from the DASH trials identified specific metabolic profiles associated with blood pressure response to the DASH diet, revealing biochemical pathways underlying dietary cardiovascular benefit. ## Early versus Later Anticoagulation for Stroke with Atrial Fibrillation. *2023-06-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2303048 · https://hartvaat.nl/2023/06/29/elan-vroege-versus-late-anticoagulatie-na-cva-bij-af-nejm/* The ELAN trial showed that early initiation of DOACs (within 48 hours for mild stroke, within 6–7 days for moderate stroke) after ischemic stroke in patients with atrial fibrillation was safe and associated with fewer recurrent strokes compared with later initiation. The results support a move toward earlier anticoagulation in this high-risk population. ## Effect of SGLT2 Inhibitors on Cardiovascular Outcomes Across Various Patient Populations. *2023-06-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.04.034 · https://hartvaat.nl/2023/06/27/sglt2-remmers-en-cv-uitkomsten-over-patientpopulaties-jacc-overzicht/* This comprehensive JACC review summarized the effects of SGLT2 inhibitors across all studied populations — HFrEF, HFpEF, CKD, and type 2 diabetes — providing a unified overview of their cardiovascular and renal benefits and positioning them as foundational cardiometabolic therapy. ## Effect of opioids for breathlessness in heart failure: a systematic review and meta-analysis. *2023-06-26 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-322074 · https://hartvaat.nl/2023/06/26/opioiden-bij-dyspneu-en-hartfalen-meta-analyse-toont-geen-voordeel/* This meta-analysis found that opioids do not significantly improve breathlessness in heart failure despite their widespread use, challenging the traditional practice of opioid administration for dyspnea in acute heart failure. ## Heart failure, peripheral artery disease, and dapagliflozin: a patient-level meta-analysis of DAPA-HF and DELIVER. *2023-06-25 · European heart journal · https://doi.org/10.1093/eurheartj/ehad276 · https://hartvaat.nl/2023/06/25/dapagliflozine-en-perifeer-arterieel-vaatlijden-bij-hartfalen-dapa-hf-deliver-me/* This patient-level meta-analysis of DAPA-HF and DELIVER confirmed that dapagliflozin does not increase the risk of amputation in heart failure patients, addressing the safety concern raised by the earlier canagliflozin CANVAS results. ## Importance of cystatin C in estimating glomerular filtration rate: the PARADIGM-HF trial. *2023-06-25 · European heart journal · https://doi.org/10.1093/eurheartj/ehad210 · https://hartvaat.nl/2023/06/25/cystatine-c-voor-gfr-schatting-bij-hartfalen-paradigm-hf-analyse/* This PARADIGM-HF analysis showed that the combined creatinine-cystatin C eGFR formula provides more accurate kidney function estimation in heart failure than creatinine alone, with implications for drug dosing and risk assessment. ## Remote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF): a randomised clinical trial. *2023-06-24 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00923-6 · https://hartvaat.nl/2023/06/24/monitor-hf-pa-drukmonitoring-bij-hartfalen-effectief-in-europa-lancet-rct/* The MONITOR-HF trial confirmed that remote pulmonary artery pressure monitoring (CardioMEMS) improved quality of life and reduced heart failure hospitalization in European patients with chronic heart failure treated with contemporary guideline-directed therapy. The results extended the evidence from the US-based CHAMPION trial. ## Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP Study. *2023-06-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064361 · https://hartvaat.nl/2023/06/13/loop-substudie-nt-probnp-verbetert-af-screeningsopbrengst/* This LOOP trial secondary analysis showed that NT-proBNP improves the yield of AF screening with implantable cardiac monitors, supporting a biomarker-enriched approach to identifying patients most likely to benefit from intensive arrhythmia monitoring. ## Pre-treatment bicarbonate levels and decongestion by acetazolamide: the ADVOR trial. *2023-06-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehad236 · https://hartvaat.nl/2023/06/09/advor-bicarbonaatwaarden-en-decongestie-effect-van-acetazolamide/* This ADVOR subanalysis showed that higher baseline bicarbonate levels predict better response to acetazolamide in acute heart failure, identifying a biomarker-guided approach to sequential nephron blockade. ## Acyl ghrelin improves cardiac function in heart failure and increases fractional shortening in cardiomyocytes without calcium mobilization. *2023-06-09 · European heart journal · https://doi.org/10.1093/eurheartj/ehad100 · https://hartvaat.nl/2023/06/09/acyl-ghreline-verbetert-hartfunctie-bij-hartfalen/* This translational study demonstrated that acylated ghrelin improves cardiac function in heart failure through a calcium-independent mechanism, exploring appetite hormone signaling as a novel HF therapeutic approach. ## Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy. *2023-06-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2214956 · https://hartvaat.nl/2023/06/08/behandeling-van-vroeg-gediagnosticeerde-zwangerschapsdiabetes-nejm-trial/* This NEJM trial demonstrated that treatment of gestational diabetes diagnosed before 20 weeks of pregnancy improved neonatal outcomes, with fewer macrosomic infants and less need for neonatal intensive care. The results extended the benefit of GDM treatment to earlier gestational ages. ## Uptitrating Treatment After Heart Failure Hospitalization Across the Spectrum of Left Ventricular Ejection Fraction. *2023-06-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.03.426 · https://hartvaat.nl/2023/06/06/strong-hf-optitratie-effectief-over-het-hele-ef-spectrum-na-hf-opname/* This STRONG-HF subanalysis showed that rapid up-titration of guideline-directed therapy after heart failure hospitalization was effective across the entire ejection fraction spectrum, including patients with HFpEF. The results expanded the aggressive post-discharge optimization approach beyond HFrEF. ## Direct Oral Anticoagulants Versus Warfarin Across the Spectrum of Kidney Function: Patient-Level Network Meta-Analyses From COMBINE AF. *2023-06-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062752 · https://hartvaat.nl/2023/06/06/combine-af-doac-s-versus-warfarine-over-het-nierfunctiespectrum-ipd-meta-analyse/* This COMBINE AF patient-level meta-analysis confirmed that DOACs are superior to warfarin for stroke prevention across the full spectrum of kidney function in AF patients, including those with moderate-to-severe CKD. The data address a key uncertainty in anticoagulation management. ## Association Between Intensive vs Standard Blood Pressure Control and Incident Left Ventricular Conduction Disease: A Post Hoc Analysis of the SPRINT Randomized Clinical Trial. *2023-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.0845 · https://hartvaat.nl/2023/06/01/intensieve-bloeddrukcontrole-en-geleidingsziekten-sprint-post-hoc-analyse/* This SPRINT post-hoc analysis showed that intensive blood pressure control is not associated with increased left ventricular conduction disease, addressing a safety concern about aggressive blood pressure management. ## Efficacy and Safety of Low-Dose Triple and Quadruple Combination Pills vs Monotherapy, Usual Care, or Placebo for the Initial Management of Hypertension: A Systematic Review and Meta-analysis. *2023-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.0720 · https://hartvaat.nl/2023/06/01/lage-dosis-drievoudige-viervoudige-combinatiepil-versus-monotherapie-bij-hyperte/* This meta-analysis confirmed that low-dose triple and quadruple combination antihypertensive pills are more effective than monotherapy for initial blood pressure treatment, with better control rates and comparable tolerability. The evidence supports multi-drug low-dose combinations as a first-line strategy. ## Dyslipidemia, inflammation, calcification, and adiposity in aortic stenosis: a genome-wide study. *2023-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehad142 · https://hartvaat.nl/2023/06/01/genetische-bijdrage-aan-aortastenose-dyslipidemie-inflammatie-en-verkalking/* This genome-wide association study identified novel genetic loci for aortic stenosis implicating pathways of dyslipidemia (including Lp(a)), inflammation, calcification, and adiposity, advancing the understanding of the genetic etiology of calcific aortic valve disease. ## Five-Year Follow-up after Transcatheter Repair of Secondary Mitral Regurgitation. *2023-06-01 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2300213 · https://hartvaat.nl/2023/06/01/coapt-vijfjaarsresultaten-mitraclip-duurzaam-effectief-bij-secundaire-mr/* The 5-year COAPT follow-up confirmed durable benefit of transcatheter mitral valve repair with MitraClip in patients with heart failure and severe secondary mitral regurgitation, with sustained reductions in mortality and heart failure hospitalization compared with medical therapy alone. ## IGFBP7 and left ventricular mass regression: a sub-analysis of the EMPA-HEART CardioLink-6 randomized clinical trial. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14335 · https://hartvaat.nl/2023/06/01/igfbp7-en-lv-massaregressie-met-empagliflozine-empa-heart-subanalyse/* This EMPA-HEART subanalysis showed that IGFBP7 levels may identify patients who derive greater cardiorenal benefit from empagliflozin, advancing biomarker-guided patient selection for SGLT2 inhibitor therapy. ## Baseline neutrophil-to-lymphocyte ratio and efficacy of SGLT2 inhibition with empagliflozin on cardiac remodelling. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14351 · https://hartvaat.nl/2023/06/01/nlr-en-cardiale-remodelling-met-empagliflozine-empa-heart-subanalyse/* This subanalysis showed that the neutrophil-to-lymphocyte ratio modifies the cardiac remodeling response to empagliflozin, suggesting that baseline inflammation status influences SGLT2 inhibitor benefit. ## Impact of diabetes duration on left ventricular mass regression with empagliflozin. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14357 · https://hartvaat.nl/2023/06/01/diabetesduur-beinvloedt-lv-massaregressie-met-empagliflozine/* This EMPA-HEART subanalysis showed that diabetes duration modifies the cardiac remodeling response to empagliflozin, with patients with shorter diabetes duration experiencing greater LV mass regression. ## Chronic Remote Ischemic Conditioning on Mild Hypertension in the Absence of Antihypertensive Medication: A Multicenter, Randomized, Double-Blind, Proof-of-Concept Clinical Trial. *2023-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20934 · https://hartvaat.nl/2023/06/01/remote-ischemische-conditionering-bij-milde-hypertensie-zonder-medicatie-rct/* This multicenter RCT showed that chronic remote ischemic conditioning does not significantly lower blood pressure in patients with mild hypertension without antihypertensive medication, limiting enthusiasm for this non-pharmacological approach. ## Beta-blocker use and mortality among patients with systolic heart failure and pacemaker rhythm. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14353 · https://hartvaat.nl/2023/06/01/betablokkers-bij-systolisch-hartfalen-en-pacemakerritme-mortaliteitseffect/* This study examined whether beta-blockers improve survival in HFrEF patients with permanent pacemaker rhythm, finding attenuated benefit in this population where heart rate control through pacing may reduce the therapeutic rationale. ## Systematic review of sodium-glucose cotransporter 2 inhibitors: a hopeful prospect in tackling heart failure-related events. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14355 · https://hartvaat.nl/2023/06/01/sglt2-remmers-bij-hartfalen-systematisch-overzicht-van-mechanismen-en-kliniek/* This systematic review summarized the current understanding of SGLT2 inhibitor mechanisms in heart failure, covering natriuresis, osmotic diuresis, ketone body metabolism, and cardiac energy substrate optimization. ## The impact of heart failure therapy in patients with mildly reduced ejection fraction: a network meta-analysis. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14284 · https://hartvaat.nl/2023/06/01/hartfalentherapie-bij-hfmref-netwerk-meta-analyse/* This network meta-analysis investigated the efficacy of heart failure therapies specifically in HFmrEF (LVEF 41-49%), finding that SGLT2 inhibitors, ARNI, and beta-blockers provide benefit in this intermediate ejection fraction group. ## Effectiveness and Cost-Effectiveness of Team-Based Care for Hypertension: A Meta-Analysis and Simulation Study. *2023-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20292 · https://hartvaat.nl/2023/06/01/team-based-care-bij-hypertensie-meta-analyse-bevestigt-effectiviteit-en-kostenef/* This meta-analysis and simulation study showed that team-based care for hypertension significantly improves blood pressure control and is cost-effective, supporting the implementation of pharmacist and nurse-led hypertension management models. ## Risk of Target Organ Damage in Children With Primary Ambulatory Hypertension: A Systematic Review and Meta-Analysis. *2023-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20190 · https://hartvaat.nl/2023/06/01/eindorgaanschade-bij-kinderen-met-primaire-hypertensie-meta-analyse/* This meta-analysis showed that target organ damage (LVH, increased vascular stiffness, elevated carotid IMT) is prevalent in children with primary ambulatory hypertension, supporting early cardiovascular assessment in pediatric blood pressure elevation. ## Diagnostic accuracy of natriuretic peptide screening for left ventricular systolic dysfunction in the community: systematic review and meta-analysis. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14314 · https://hartvaat.nl/2023/06/01/natriuretisch-peptide-screening-voor-lv-disfunctie-diagnostische-nauwkeurigheid/* This systematic review confirmed that natriuretic peptide screening in the community can effectively rule out left ventricular systolic dysfunction, supporting a biomarker-first strategy for early heart failure detection in primary care. ## Angiotensin pathways under therapy with empagliflozin in patients with chronic heart failure. *2023-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14313 · https://hartvaat.nl/2023/06/01/angiotensinepathways-onder-empagliflozine-bij-chronisch-hartfalen/* This study characterized the effects of empagliflozin on angiotensin pathway components in chronic heart failure, showing that SGLT2 inhibition modulates RAAS activation beyond its diuretic-natriuretic effects. ## Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation. *2023-05-30 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.03.418 · https://hartvaat.nl/2023/05/30/complicaties-van-af-ablatie-actueel-overzicht/* This comprehensive review of procedure-related complications of AF catheter ablation documented declining complication rates over time, providing current safety benchmarks and prevention strategies for the most common procedural risks. ## Assessment of Cardiac Energy Metabolism, Function, and Physiology in Patients With Heart Failure Taking Empagliflozin: The Randomized, Controlled EMPA-VISION Trial. *2023-05-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062021 · https://hartvaat.nl/2023/05/30/empagliflozine-en-cardiale-energiestofwisseling-bij-hartfalen-empa-vision/* The EMPA-VISION trial used cardiac MR spectroscopy to investigate whether empagliflozin changes myocardial energy metabolism in heart failure, exploring the metabolic mechanism hypothesis for SGLT2 inhibitor cardioprotection. ## Association Between Hemoglobin Levels and Efficacy of Intravenous Ferric Carboxymaltose in Patients With Acute Heart Failure and Iron Deficiency: An AFFIRM-AHF Subgroup Analysis. *2023-05-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.060757 · https://hartvaat.nl/2023/05/30/affirm-ahf-hemoglobine-beinvloedt-iv-ijzereffect-bij-acuut-hartfalen/* This AFFIRM-AHF subanalysis showed that intravenous ferric carboxymaltose is most effective in acute HF patients with iron deficiency and without severe anemia, informing patient selection for IV iron therapy. ## A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial. *2023-05-27 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00462-2 · https://hartvaat.nl/2023/05/27/best-cli-veneuze-bypass-versus-endovasculair-bij-chronische-kritieke-ischemie/* The BEST-CLI trial demonstrated that vein bypass surgery was superior to endovascular therapy as the initial revascularization strategy for patients with chronic limb-threatening ischemia when a good-quality great saphenous vein was available. The result re-established surgical bypass as the preferred option in suitable candidates. ## Outcomes of patients with atrial fibrillation and ischemic stroke while on oral anticoagulation. *2023-05-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad200 · https://hartvaat.nl/2023/05/21/prognose-van-ischemisch-cva-onder-orale-anticoagulatie-bij-af/* This study characterized the outcomes of AF patients who suffer ischemic stroke despite oral anticoagulation, showing poor prognosis and highlighting the residual stroke risk that persists even with guideline-directed anticoagulation. ## Multi-centre, prospective randomized comparison of three different substrate ablation strategies for persistent atrial fibrillation. *2023-05-19 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad090 · https://hartvaat.nl/2023/05/19/drie-substraatstrategieen-voor-persisterend-af-vergeleken-multicenter-rct/* This multicenter RCT compared three substrate ablation strategies for persistent AF, finding that no additional strategy (empirical linear lesions or voltage-guided ablation) significantly improved outcomes over PVI plus empirical lines. ## Role of oesophageal cooling in the prevention of oesophageal injury in atrial fibrillation catheter ablation: a systematic review and meta-analysis of randomized controlled trials. *2023-05-19 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad080 · https://hartvaat.nl/2023/05/19/slokdarmkoeling-voorkomt-oesofagale-schade-bij-af-ablatie-meta-analyse/* This meta-analysis showed that active esophageal cooling during AF catheter ablation significantly reduces the risk of thermal esophageal injury, supporting protective cooling as a safety adjunct during left atrial ablation procedures. ## Safety and efficacy of intracardiac echocardiography-guided zero-fluoroscopic cryoballoon ablation for atrial fibrillation: a prospective randomized controlled trial. *2023-05-19 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad086 · https://hartvaat.nl/2023/05/19/fluoroscopievrije-cryoballonablatie-met-ice-begeleiding-bij-af/* This prospective RCT confirmed that zero-fluoroscopy cryoballoon ablation guided by intracardiac echocardiography is safe and effective for AF, eliminating radiation exposure for both patients and operators. ## Cost-effectiveness of early rhythm control vs. usual care in atrial fibrillation care: an analysis based on data from the EAST-AFNET 4 trial. *2023-05-19 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad051 · https://hartvaat.nl/2023/05/19/east-afnet-4-vroege-ritmecontrole-bij-af-is-kosteneffectief/* This EAST-AFNET 4 economic analysis showed that early rhythm control for atrial fibrillation is cost-effective compared with usual care, with the clinical benefits translating to favorable health economic outcomes. ## Conduction system pacing, a European survey: insights from clinical practice. *2023-05-19 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euad019 · https://hartvaat.nl/2023/05/19/geleidingssysteempacing-in-europa-inzichten-uit-klinische-praktijk/* This European survey documented the current landscape of conduction system pacing practice, showing growing adoption of His bundle and left bundle branch area pacing with variability in technique and indications. ## Transcatheter Repair for Patients with Tricuspid Regurgitation. *2023-05-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2300525 · https://hartvaat.nl/2023/05/18/triluminate-transcatheter-tricuspidaliskleprepair-bij-ernstige-tr-nejm/* The TRILUMINATE trial demonstrated that transcatheter edge-to-edge repair (TriClip) for severe tricuspid regurgitation was safe and significantly reduced regurgitation severity, though it did not meet the primary composite endpoint of death or tricuspid-related surgery. The trial opened the door to transcatheter tricuspid valve intervention. ## Eliminating Medication Copayments for Low-Income Older Adults at High Cardiovascular Risk: A Randomized Controlled Trial. *2023-05-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064188 · https://hartvaat.nl/2023/05/16/afschaffen-eigen-bijdrage-medicatie-vermindert-cardiovasculair-risico-bij-oudere/* This randomized trial showed that eliminating medication copayments for low-income older adults at high cardiovascular risk significantly improves medication adherence and reduces cardiovascular events, demonstrating the clinical impact of financial barriers to care. ## Self-Management Support Using Advertising Principles for Older Adults With Low Income at High Cardiovascular Risk: A Randomized Controlled Trial. *2023-05-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064189 · https://hartvaat.nl/2023/05/16/zelfmanagement-via-reclameprincipes-bij-ouderen-met-hoog-cv-risico/* This RCT showed that a self-management support intervention using advertising-derived engagement principles improves cardiovascular risk factors in older low-income adults at high cardiovascular risk. ## Efficacy of implantable haemodynamic monitoring in heart failure across ranges of ejection fraction: a systematic review and meta-analysis. *2023-05-15 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321885 · https://hartvaat.nl/2023/05/15/implanteerbare-hemodynamische-monitoring-bij-hartfalen-meta-analyse-over-ef-spec/* This meta-analysis showed that implantable pulmonary artery pressure monitoring reduces heart failure hospitalization across the full ejection fraction spectrum, including HFpEF, supporting hemodynamic-guided management regardless of LVEF. ## Rule-out of non-ST-segment elevation acute coronary syndrome by a single, pre-hospital troponin measurement: a randomized trial. *2023-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehad056 · https://hartvaat.nl/2023/05/14/prehospitale-troponine-voor-uitsluiting-nste-acs-gerandomiseerde-trial/* This trial explored whether a single prehospital troponin measurement can safely rule out NSTE-ACS in the ambulance setting, potentially enabling faster triage and reducing unnecessary emergency department transfers. ## 2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. *2023-05-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.03.393 · https://hartvaat.nl/2023/05/09/2023-acc-expert-consensus-management-van-hfpef/* The 2023 ACC Expert Consensus provided a structured decision pathway for HFpEF management, positioning SGLT2 inhibitors as a cornerstone therapy alongside diuretics for volume management, GLP-1 receptor agonists for obesity, and targeted treatment of comorbidities. ## Intravascular Imaging-Guided or Angiography-Guided Complex PCI. *2023-05-04 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2216607 · https://hartvaat.nl/2023/05/04/renovate-complex-pci-intravasculaire-beeldvorming-versus-angiografie-bij-complex/* The RENOVATE-COMPLEX-PCI trial showed that intravascular imaging-guided PCI (using IVUS or OCT) significantly reduced the composite of cardiac death, MI, or revascularization compared with angiography-guided PCI in patients with complex coronary lesions. The results provided definitive evidence for routine imaging guidance in complex interventions. ## Comparison of 3- to 6-Month Versus 12-Month Dual Antiplatelet Therapy After Coronary Intervention Using the Contemporary Drug-Eluting Stents With Ultrathin Struts: The HOST-IDEA Randomized Clinical Trial. *2023-05-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064264 · https://hartvaat.nl/2023/05/02/korte-versus-standaard-dapt-na-pci-met-moderne-des-meta-analyse/* This meta-analysis of contemporary drug-eluting stents confirmed that 3-6 months of DAPT is as safe as 12 months for ischemic outcomes while reducing bleeding, supporting shortened antiplatelet duration with third-generation DES technology. ## Cluster Randomized Trial of a Personalized Clinical Decision Support Intervention to Improve Statin Prescribing in Patients With Atherosclerotic Cardiovascular Disease. *2023-05-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.123.064226 · https://hartvaat.nl/2023/05/02/gepersonaliseerde-beslisondersteuning-verhoogt-statinegebruik-bij-ascvd/* This cluster-randomized trial showed that personalized clinical decision support significantly increases statin prescribing in patients with established ASCVD, demonstrating the effectiveness of AI-assisted prescribing prompts. ## Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence: The AWARE Randomized Clinical Trial. *2023-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.0212 · https://hartvaat.nl/2023/05/01/aware-uitgebreide-ablatie-vermindert-af-recidief-niet-boven-standaard-pvi/* The AWARE trial showed that augmented ablation (PVI plus posterior wall and septum isolation) was not superior to standard PVI for reducing AF recurrence in paroxysmal AF, arguing against routine extensive ablation beyond pulmonary vein isolation. ## Association of Cardiac Biomarkers With Major Adverse Cardiovascular Events in High-risk Patients With Diabetes: A Secondary Analysis of the DECLARE-TIMI 58 Trial. *2023-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.0019 · https://hartvaat.nl/2023/05/01/cardiale-biomarkers-en-cv-events-bij-diabetes-declare-timi-58-subanalyse/* This analysis showed that NT-proBNP and troponin levels predict both cardiovascular risk and treatment response to dapagliflozin in high-risk diabetic patients, supporting biomarker-guided patient selection for SGLT2 inhibitor therapy. ## Dyslipidemia and Risk of Preeclampsia: A Multiancestry Mendelian Randomization Study. *2023-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20426 · https://hartvaat.nl/2023/05/01/dyslipidemie-en-pre-eclampsierisico-mendeliaanse-randomisatie/* This Mendelian randomization study suggested a causal link between genetically determined dyslipidemia (particularly elevated LDL) and preeclampsia risk, identifying lipid metabolism as a potential modifiable pathway in pregnancy hypertension. ## Phase 2b Randomized Trial of the Oral PCSK9 Inhibitor MK-0616. *2023-04-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.02.018 · https://hartvaat.nl/2023/04/25/mk-0616-eerste-orale-pcsk9-remmer-in-fase-2b/* This phase 2b trial of MK-0616, the first oral macrocyclic peptide PCSK9 inhibitor, demonstrated dose-dependent LDL cholesterol reductions of up to 60% with an acceptable safety profile. An oral PCSK9 inhibitor could dramatically expand access beyond injectable monoclonal antibodies and siRNA therapies. ## Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis. *2023-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac726 · https://hartvaat.nl/2023/04/21/cardiometabole-gezondheid-bij-kinderen-geboren-na-ivf/* This multi-cohort analysis showed that children born after assisted reproductive technology have a slightly less favorable cardiometabolic profile compared with naturally conceived children, warranting long-term cardiovascular follow-up. ## Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension. *2023-04-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2213558 · https://hartvaat.nl/2023/04/20/stellar-sotatercept-bij-pulmonale-arteriele-hypertensie-nejm-fase-3/* The STELLAR trial demonstrated that sotatercept, a first-in-class activin receptor fusion protein, dramatically improved exercise capacity, hemodynamics, and WHO functional class in patients with pulmonary arterial hypertension on background therapy. This represents the most significant therapeutic advance in PAH in over a decade, targeting the underlying proliferative pathophysiology. ## Supervised Exercise Training for Chronic Heart Failure With Preserved Ejection Fraction: A Scientific Statement From the American Heart Association and American College of Cardiology. *2023-04-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.02.012 · https://hartvaat.nl/2023/04/18/aha-scientific-statement-gestructureerde-inspanningstraining-bij-hfpef/* This AHA scientific statement reviewed the evidence for supervised exercise training in HFpEF, confirming it as the only proven intervention to improve exercise capacity in this population and providing practical implementation guidance. ## Coordinated Care to Optimize Cardiovascular Preventive Therapies in Type 2 Diabetes: A Randomized Clinical Trial. *2023-04-18 · JAMA · https://doi.org/10.1001/jama.2023.2854 · https://hartvaat.nl/2023/04/18/gecoordineerde-zorg-optimaliseert-cv-preventie-bij-type-2-diabetes-jama-rct/* This JAMA trial demonstrated that coordinated, multidisciplinary care significantly increases the use of evidence-based cardiovascular preventive therapies in patients with type 2 diabetes, translating guideline recommendations into clinical practice. ## Association Between Achieved Low-Density Lipoprotein Cholesterol Levels and Long-Term Cardiovascular and Safety Outcomes: An Analysis of FOURIER-OLE. *2023-04-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.063399 · https://hartvaat.nl/2023/04/18/optimaal-bereikt-ldl-cholesterol-en-langetermijn-cv-uitkomsten-fourier-analyse/* This long-term FOURIER analysis showed that very low achieved LDL cholesterol levels (below 20 mg/dL) with evolocumab were associated with the greatest cardiovascular risk reduction without excess safety concerns. The data supported pushing LDL targets as low as achievable. ## Dual antiplatelet therapy de-escalation in acute coronary syndrome: an individual patient meta-analysis. *2023-04-17 · European heart journal · https://doi.org/10.1093/eurheartj/ehac829 · https://hartvaat.nl/2023/04/17/dapt-de-escalatie-na-acs-ipd-meta-analyse/* This individual patient data meta-analysis confirmed that de-escalation from potent P2Y12 inhibitors to clopidogrel after the acute phase of ACS safely reduces bleeding without increasing ischemic events. The pooled patient-level evidence definitively supported the de-escalation approach. ## Coronary artery restenosis treatment with plain balloon, drug-coated balloon, or drug-eluting stent: 10-year outcomes of the ISAR-DESIRE 3 trial. *2023-04-17 · European heart journal · https://doi.org/10.1093/eurheartj/ehad026 · https://hartvaat.nl/2023/04/17/in-stent-restenose-tienjaarsuitkomsten-plain-balloon-vs-dcb-vs-des-isar-desire-3/* Ten-year ISAR-DESIRE 3 results showed that drug-eluting stents remain superior to drug-coated balloons and plain balloons for treating DES in-stent restenosis, providing the longest-term comparative data for this common PCI challenge. ## Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials. *2023-04-15 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00215-5 · https://hartvaat.nl/2023/04/15/inflammatie-en-cholesterol-als-cv-voorspellers-onder-statinetherapie-lancet-anal/* This collaborative analysis of three major statin trials demonstrated that residual inflammation (hsCRP) and residual cholesterol (LDL) independently predict cardiovascular events in statin-treated patients. Patients with dual residual risk derive the most benefit from additional interventions. ## Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients. *2023-04-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2215024 · https://hartvaat.nl/2023/04/13/clear-outcomes-bempedoinezuur-vermindert-cv-events-bij-statine-intolerantie/* The CLEAR Outcomes trial showed that bempedoic acid, an oral ACL inhibitor that does not act in skeletal muscle, reduced major cardiovascular events by 13% in statin-intolerant patients with elevated LDL cholesterol. This provided a new evidence-based treatment option for patients unable to tolerate statin therapy. ## Heterogeneity in Blood Pressure Response to 4 Antihypertensive Drugs: A Randomized Clinical Trial. *2023-04-11 · JAMA · https://doi.org/10.1001/jama.2023.3322 · https://hartvaat.nl/2023/04/11/heterogeniteit-in-bloeddrukrespons-op-antihypertensiva-jama-cross-over-rct/* This randomized crossover trial revealed substantial individual heterogeneity in blood pressure response to four different antihypertensive drug classes, with rotation of medications identifying the best-responding agent for each patient. The findings support personalized antihypertensive therapy through systematic drug rotation. ## Combination Moderate-Intensity Statin and Ezetimibe Therapy for Elderly Patients With Atherosclerosis. *2023-04-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.02.007 · https://hartvaat.nl/2023/04/11/matige-statine-plus-ezetimibe-bij-ouderen-met-atherosclerose-jacc-studie/* This study confirmed that moderate-intensity statin combined with ezetimibe provides comparable cardiovascular protection to high-intensity statin monotherapy in elderly patients with atherosclerosis, offering a better-tolerated alternative. ## Cluster-Randomized Trial Comparing Ambulatory Decision Support Tools to Improve Heart Failure Care. *2023-04-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.02.005 · https://hartvaat.nl/2023/04/11/ambulante-beslisondersteuning-verbetert-mra-voorschrijving-bij-hfref/* This cluster-randomized trial showed that ambulatory clinical decision support tools significantly increase MRA prescribing in HFrEF, demonstrating that automated prompts can overcome treatment inertia for underused heart failure medications. ## Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial. *2023-04-08 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(23)00351-3 · https://hartvaat.nl/2023/04/08/biovasc-directe-versus-gestageerde-complete-revascularisatie-bij-acs-met-meervat/* The BIOVASC trial showed that immediate complete revascularization during the index procedure was noninferior to staged complete PCI in patients with ACS and multivessel coronary disease, with similar rates of the composite primary endpoint at 1 year. ## Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease: A Randomized Clinical Trial. *2023-04-04 · JAMA · https://doi.org/10.1001/jama.2023.2487 · https://hartvaat.nl/2023/04/04/lodestar-treat-to-target-versus-hoge-dosis-statine-bij-coronairlijden/* The LODESTAR trial showed that a treat-to-target approach (targeting LDL <70 mg/dL with dose adjustment) was noninferior to fixed high-intensity statin therapy for cardiovascular outcomes in patients with coronary artery disease. The results supported either strategy as acceptable in clinical practice. ## Genetic Risk of Primary Aldosteronism and Its Contribution to Hypertension: A Cross-Ancestry Meta-Analysis of Genome-Wide Association Studies. *2023-04-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062349 · https://hartvaat.nl/2023/04/04/genetisch-risico-op-primair-aldosteronisme-en-bijdrage-aan-hypertensie-gwas-meta/* This cross-ancestry GWAS meta-analysis identified genetic loci for primary aldosteronism and quantified their contribution to hypertension, establishing the genetic architecture of this common form of secondary hypertension. ## Effect of Sacubitril/Valsartan vs Valsartan on Left Atrial Volume in Patients With Pre-Heart Failure With Preserved Ejection Fraction: The PARABLE Randomized Clinical Trial. *2023-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2023.0065 · https://hartvaat.nl/2023/04/01/parable-sacubitril-valsartan-vermindert-linkeratriumvolume-bij-pre-hfpef/* The PARABLE trial showed that sacubitril-valsartan reduces left atrial volume in patients with pre-HFpEF compared with valsartan, suggesting potential for early intervention to prevent the structural atrial changes that characterize established HFpEF. ## Association of Dapagliflozin Use With Clinical Outcomes and the Introduction of Uric Acid-Lowering Therapy and Colchicine in Patients With Heart Failure With and Without Gout: A Patient-Level Pooled Meta-analysis of DAPA-HF and DELIVER. *2023-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.5608 · https://hartvaat.nl/2023/04/01/dapagliflozine-verlaagt-urinezuur-en-vermindert-jichtaanvallen-bij-hartfalen/* This analysis showed that dapagliflozin reduces uric acid levels and decreases the need for uric acid-lowering therapy and colchicine in heart failure patients, demonstrating an anti-gout co-benefit of SGLT2 inhibition. ## Body Position and Orthostatic Hypotension in Hypertensive Adults: Results from the Syst-Eur Trial. *2023-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20602 · https://hartvaat.nl/2023/04/01/lichaamshouding-en-orthostatische-hypotensie-bij-hypertensie-syst-eur-analyse/* This Syst-Eur analysis showed that orthostatic hypotension measurement results depend on the starting position (seated vs supine), informing the standardization of OH assessment in hypertensive patients. ## Intravenous iron infusion in patients with heart failure: a systematic review and study-level meta-analysis. *2023-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14310 · https://hartvaat.nl/2023/04/01/intraveneus-ijzer-bij-hartfalen-meta-analyse-op-studieniveau/* This study-level meta-analysis confirmed that intravenous iron in heart failure with iron deficiency reduces the risk of heart failure hospitalization, with the strongest evidence from the largest trials (AFFIRM-AHF, IRONMAN). ## The cardiovascular effects of SGLT2 inhibitors, RAS inhibitors, and ARN inhibitors in heart failure. *2023-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14298 · https://hartvaat.nl/2023/04/01/sglt2-remmers-raas-remmers-en-arni-vergeleken-bij-hartfalen-meta-analyse/* This comprehensive meta-analysis compared the cardiovascular effects of SGLT2 inhibitors, RAAS inhibitors, and sacubitril-valsartan (ARNI) in heart failure, finding that all three drug classes contribute to the contemporary quadruple therapy framework. ## Indirect comparison of SGLT2 inhibitors in patients with established heart failure: evidence based on Bayesian methods. *2023-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14297 · https://hartvaat.nl/2023/04/01/indirecte-vergelijking-van-sglt2-remmers-bij-hartfalen-bayesiaanse-analyse/* This Bayesian network meta-analysis found no significant differences between individual SGLT2 inhibitors (empagliflozin, dapagliflozin, sotagliflozin) for heart failure outcomes, supporting a class effect without meaningful agent-level superiority. ## Danish phase II trial using adipose tissue derived mesenchymal stromal cells for patients with ischaemic heart failure. *2023-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14281 · https://hartvaat.nl/2023/04/01/mesenchymale-stamcellen-bij-ischemisch-hartfalen-deense-fase-ii-trial/* This Danish phase II trial of adipose tissue-derived mesenchymal stromal cells in ischemic HFrEF showed safety but no significant improvement in LV function, adding to the neutral stem cell therapy evidence. ## Aspirin in primary prevention and the risk of heart failure: a systematic review and meta-analysis of controlled trials. *2023-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14269 · https://hartvaat.nl/2023/04/01/aspirine-in-primaire-preventie-en-hartfalenrisico-meta-analyse/* This meta-analysis found that aspirin in primary prevention does not significantly increase or decrease the risk of heart failure, clarifying a neutral relationship between aspirin and HF development. ## Potassium reduction with sodium zirconium cyclosilicate in patients with heart failure. *2023-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14268 · https://hartvaat.nl/2023/04/01/natriumzirconiumcyclosilicaat-bij-hyperkaliemie-en-hartfalen/* This study showed that sodium zirconium cyclosilicate effectively lowers potassium in HFrEF patients, enabling higher RAAS inhibitor and MRA doses, addressing the hyperkalemia barrier to optimal heart failure pharmacotherapy. ## Multicomponent integrated care for patients with chronic heart failure: systematic review and meta-analysis. *2023-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14207 · https://hartvaat.nl/2023/04/01/multicomponent-geintegreerde-zorg-bij-chronisch-hartfalen-meta-analyse/* This meta-analysis confirmed that multicomponent integrated care programs improve clinical outcomes in chronic heart failure, supporting comprehensive disease management over isolated pharmacological or device interventions. ## Ablation versus anti-arrhythmic therapy for reducing all hospital episodes from recurrent atrial fibrillation: a prospective, randomized, multi-centre, open label trial. *2023-03-30 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac253 · https://hartvaat.nl/2023/03/30/ablatie-versus-antiaritmica-voor-vermindering-van-ziekenhuisbezoeken-bij-af/* This prospective randomized trial demonstrated that catheter ablation significantly reduces total AF-related hospital episodes compared with antiarrhythmic drug therapy, providing health economic data beyond traditional clinical endpoints. ## Revisiting the characteristics and ablation strategy of biatrial tachycardias: a case series and systematic review. *2023-03-30 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac231 · https://hartvaat.nl/2023/03/30/biatriale-tachycardieen-ablatiestrategie-en-linkeratriale-epicardiale-geleiding/* This study and systematic review described the role of left atrial epicardial conduction in biatrial tachycardias, providing ablation strategy guidance for this complex arrhythmia mechanism. ## Upgrading right ventricular pacemakers to biventricular pacing or conduction system pacing: a systematic review and meta-analysis. *2023-03-30 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac188 · https://hartvaat.nl/2023/03/30/upgrade-van-rv-pacemaker-naar-crt-of-geleidingssysteempacing-meta-analyse/* This meta-analysis showed that upgrading right ventricular pacemakers to biventricular or conduction system pacing improves left ventricular function and clinical outcomes, supporting upgrade consideration in pacemaker-dependent patients with reduced LV function. ## Does This Child With High Blood Pressure Have Secondary Hypertension?: The Rational Clinical Examination Systematic Review. *2023-03-28 · JAMA · https://doi.org/10.1001/jama.2023.3184 · https://hartvaat.nl/2023/03/28/secundaire-hypertensie-bij-kinderen-jama-klinische-diagnostiek/* This JAMA systematic review identified clinical factors that predict secondary hypertension in children, providing a rational evaluation framework for the workup of pediatric blood pressure elevation. ## Influence of Culprit Lesion Intervention on Outcomes in Infarct-Related Cardiogenic Shock With Cardiac Arrest. *2023-03-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2023.01.029 · https://hartvaat.nl/2023/03/28/culprit-interventie-bij-cardiogene-shock-met-hartstilstand/* This analysis examined the role of culprit lesion intervention in cardiogenic shock complicated by cardiac arrest, showing that primary PCI remains beneficial even in the most critically ill resuscitated patients. ## Exploring the Relationship Between Efpeglenatide Dose and Cardiovascular Outcomes in Type 2 Diabetes: Insights From the AMPLITUDE-O Trial. *2023-03-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.063716 · https://hartvaat.nl/2023/03/28/amplitude-o-dosisrespons-van-efpeglenatide-op-cv-uitkomsten-bij-diabetes/* This AMPLITUDE-O analysis explored the dose-response relationship between efpeglenatide and cardiovascular outcomes in type 2 diabetes, informing the optimal dosing of this GLP-1 receptor agonist for cardiovascular protection. ## Genetic variants associated with syncope implicate neural and autonomic processes. *2023-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehad016 · https://hartvaat.nl/2023/03/21/genetische-varianten-geassocieerd-met-syncope-neurale-en-autonome-processen/* This GWAS identified genetic loci associated with syncope that implicate neural and autonomic nervous system pathways, providing the first genomic insights into the pathophysiology of this common clinical condition. ## Coronary angiography after cardiac arrest without ST-elevation myocardial infarction: a network meta-analysis. *2023-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac611 · https://hartvaat.nl/2023/03/21/coronairangiografie-na-hartstilstand-zonder-stemi-netwerk-meta-analyse/* This network meta-analysis confirmed that early coronary angiography after cardiac arrest without STEMI provides no survival advantage over a selective, delayed approach, consistent with the COACT and TOMAHAWK trial results. ## Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trial. *2023-03-18 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)02603-4 · https://hartvaat.nl/2023/03/18/intensieve-bloeddrukinterventie-door-niet-artsen-in-lage-inkomenslanden-lancet-r/* This Lancet trial demonstrated that a community health worker-led intensive blood pressure intervention significantly reduced cardiovascular events compared with usual care in rural China. The scalable model addressed the critical shortage of physicians in low-resource settings. ## Predicting Malignant Ventricular Arrhythmias Using Real-Time Remote Monitoring. *2023-03-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.12.024 · https://hartvaat.nl/2023/03/14/real-time-remote-monitoring-voorspelt-maligne-ventriculaire-aritmieen/* This study showed that real-time remote monitoring of ICD patients can predict malignant ventricular arrhythmias based on changes in heart rate, activity, and impedance parameters, advancing proactive rhythm management. ## Moderate-intensity statin with ezetimibe vs. high-intensity statin in patients with diabetes and atherosclerotic cardiovascular disease in the RACING trial. *2023-03-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehac709 · https://hartvaat.nl/2023/03/14/matige-statine-plus-ezetimibe-versus-hoge-dosis-statine-bij-diabetes-en-ascvd/* This subanalysis in diabetic patients with ASCVD confirmed that moderate-intensity statin plus ezetimibe is noninferior to high-intensity statin monotherapy for cardiovascular outcomes, supporting combination therapy as an alternative in diabetes. ## Dual antiplatelet therapy duration after percutaneous coronary intervention in high bleeding risk: a meta-analysis of randomized trials. *2023-03-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehac706 · https://hartvaat.nl/2023/03/14/dapt-duur-na-pci-bij-hoog-bloedingsrisico-meta-analyse-van-rct-s/* This meta-analysis of RCTs confirmed that abbreviated DAPT (1-3 months) after PCI in high-bleeding-risk patients safely reduces bleeding without increasing ischemic events, consolidating the evidence for shortened antiplatelet therapy in vulnerable patients. ## Prevalence, outcomes and costs of a contemporary, multinational population with heart failure. *2023-03-10 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321702 · https://hartvaat.nl/2023/03/10/mondiale-prevalentie-uitkomsten-en-kosten-van-hartfalen-careme-studie/* The CaReMe study used digital healthcare data to estimate global heart failure prevalence, finding substantial disease burden with high hospitalization rates and healthcare costs, informing the scale of the heart failure epidemic. ## Randomized Trial of Targeted Transendocardial Mesenchymal Precursor Cell Therapy in Patients With Heart Failure. *2023-03-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.11.061 · https://hartvaat.nl/2023/03/07/mesenchymale-precursorcellen-bij-hfref-gerandomiseerde-trial/* This randomized trial of allogeneic mesenchymal precursor cells in HFrEF showed a trend toward fewer heart failure events without reaching statistical significance, providing preliminary data on cell-based immunomodulation for heart failure. ## Effect of Personalized Accelerated Pacing on Quality of Life, Physical Activity, and Atrial Fibrillation in Patients With Preclinical and Overt Heart Failure With Preserved Ejection Fraction: The myPACE Randomized Clinical Trial. *2023-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.5320 · https://hartvaat.nl/2023/03/01/gepersonaliseerde-versnelde-pacing-bij-hfpef-met-pacemaker/* This trial investigated whether a personalized higher pacemaker backup rate improves symptoms and physical activity in HFpEF patients with pacemakers, exploring chronotropic optimization as a therapeutic strategy in this population. ## Diastolic Blood Pressure and Intensive Blood Pressure Control on Cognitive Outcomes: Insights From the SPRINT MIND Trial. *2023-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20112 · https://hartvaat.nl/2023/03/01/diastolische-bloeddruk-en-cognitie-bij-intensieve-behandeling-sprint-mind/* This SPRINT MIND analysis showed that the cognitive benefit of intensive systolic blood pressure control is maintained even in patients with low diastolic blood pressure, addressing the concern that aggressive systolic lowering might compromise cerebral perfusion. ## Effects of Renal Denervation on Sympathetic Nerve Traffic and Correlates in Drug-Resistant and Uncontrolled Hypertension: A Systematic Review and Meta-Analysis. *2023-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20503 · https://hartvaat.nl/2023/03/01/renale-denervatie-en-sympathische-activiteit-systematische-review/* This systematic review examined whether renal denervation actually reduces sympathetic nerve activity, finding heterogeneous evidence for central sympathoinhibition as the mechanism of blood pressure lowering. ## Antihypertensive Medication Regimens Used in the Systolic Blood Pressure Intervention Trial. *2023-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20373 · https://hartvaat.nl/2023/03/01/antihypertensieve-regimes-in-sprint-gedetailleerd-beschreven/* This detailed description of antihypertensive regimens used in SPRINT showed that the intensive group required more RAAS inhibitors and diuretics, contextualizing the treatment strategy behind the landmark trial's results. ## Clinical Utility of Short-Term Blood Pressure Measures to Inform Long-Term Blood Pressure Management. *2023-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20458 · https://hartvaat.nl/2023/03/01/korttermijn-bloeddrukmetingen-voorspellen-langetermijneffect-van-behandeling/* This study showed that blood pressure measurements taken shortly after starting antihypertensive therapy reliably predict long-term effects, supporting early assessment to guide medication adjustments. ## Endovascular Ultrasound Renal Denervation to Treat Hypertension: The RADIANCE II Randomized Clinical Trial. *2023-02-28 · JAMA · https://doi.org/10.1001/jama.2023.0713 · https://hartvaat.nl/2023/02/28/radiance-ii-ultrageluid-renale-denervatie-bij-milde-tot-matige-hypertensie/* The RADIANCE II trial confirmed that ultrasound renal denervation significantly reduced blood pressure compared with a sham procedure in patients with mild-to-moderate hypertension, replicating the findings from RADIANCE-HTN SOLO with a refined study design. ## Incidental Coronary Artery Calcium: Opportunistic Screening of Previous Nongated Chest Computed Tomography Scans to Improve Statin Rates (NOTIFY-1 Project). *2023-02-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062746 · https://hartvaat.nl/2023/02/28/incidenteel-coronair-calcium-op-ct-thorax-ai-gestuurde-screening-verbetert-stati/* The NOTIFY study demonstrated that AI-detected coronary artery calcium on non-gated chest CT scans, when reported to clinicians and patients, significantly increased statin prescribing. The opportunistic screening approach leveraged existing imaging to improve cardiovascular prevention without additional testing. ## Coronary CT and timing of invasive coronary angiography in patients ≥75 years old with non-ST segment elevation acute coronary syndromes. *2023-02-23 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321640 · https://hartvaat.nl/2023/02/23/ct-coronairangiografie-bij-75-jarigen-met-nste-acs/* This study showed that coronary CT angiography can reliably rule out significant coronary disease in elderly NSTE-ACS patients, supporting a non-invasive-first approach for older adults with suspected acute coronary syndromes. ## Techniques improving electrical cardioversion success for patients with atrial fibrillation: a systematic review and meta-analysis. *2023-02-16 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac199 · https://hartvaat.nl/2023/02/16/technieken-om-cardioversiesucces-bij-af-te-verbeteren-meta-analyse/* This meta-analysis evaluated techniques for improving electrical cardioversion success in AF, finding that anteroposterior electrode position, higher initial energy, and pad-based delivery improve conversion rates. ## P-wave duration and atrial fibrillation recurrence after catheter ablation: a systematic review and meta-analysis. *2023-02-16 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac210 · https://hartvaat.nl/2023/02/16/p-golfduur-voorspelt-af-recidief-na-catheterablatie-meta-analyse/* This meta-analysis confirmed that prolonged P-wave duration on ECG independently predicts AF recurrence after catheter ablation, supporting this simple measure as a pre-ablation risk stratification tool. ## Higher power short duration vs. lower power longer duration posterior wall ablation for atrial fibrillation and oesophageal injury outcomes: a prospective multi-centre randomized controlled study (Hi-Lo HEAT trial). *2023-02-16 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac190 · https://hartvaat.nl/2023/02/16/hoog-vermogen-korte-duur-versus-laag-vermogen-langere-duur-posteriore-ablatie-bi/* This meta-analysis showed that high-power short-duration RF ablation of the posterior wall reduces esophageal thermal injury compared with conventional power settings, improving safety for this anatomically challenging ablation target. ## Catheter ablation improves cardiovascular outcomes in patients with atrial fibrillation and heart failure: a meta-analysis of randomized controlled trials. *2023-02-16 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac173 · https://hartvaat.nl/2023/02/16/catheterablatie-verbetert-cv-uitkomsten-bij-af-en-hartfalen-meta-analyse-van-rct/* This meta-analysis of randomized trials confirmed that catheter ablation for atrial fibrillation in heart failure patients significantly improves cardiovascular outcomes, including reductions in mortality and heart failure hospitalization. The pooled evidence strengthened the indication for AF ablation in the HF population. ## Sex Differences in 10-Year Outcomes After Percutaneous Coronary Intervention With Drug-Eluting Stents: Insights From the DECADE Cooperation. *2023-02-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062049 · https://hartvaat.nl/2023/02/14/sekseverschillen-in-tienjaarsuitkomsten-na-pci-decade-samenwerking/* This 10-year analysis showed that women have higher long-term mortality after PCI than men, primarily driven by older age and more comorbidities at presentation rather than the intervention itself. ## P2Y12 Inhibitor Monotherapy or Dual Antiplatelet Therapy After Complex Percutaneous Coronary Interventions. *2023-02-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.11.041 · https://hartvaat.nl/2023/02/14/p2y12-monotherapie-versus-dapt-na-complexe-pci/* This analysis showed that P2Y12 inhibitor monotherapy preserves ischemic protection while reducing bleeding risk compared with DAPT even after complex PCI, extending the de-escalation approach to the highest-complexity interventions. ## Cryoballoon Pulmonary Vein Isolation as First-Line Treatment for Typical Atrial Flutter. *2023-02-14 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321729 · https://hartvaat.nl/2023/02/14/cryoballon-pvi-als-eerstelijnsbehandeling-voor-typisch-atriumflutter/* This study compared cryoballoon pulmonary vein isolation with standard CTI ablation as first-line treatment for typical atrial flutter, finding that PVI provides additional AF prevention while treating the flutter, potentially offering a more comprehensive rhythm strategy. ## Randomized evaluation of redo ablation procedures of atrial fibrillation with focal impulse and rotor modulation-guided procedures: the REDO-FIRM study. *2023-02-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac122 · https://hartvaat.nl/2023/02/08/redo-firm-firm-geleide-ablatie-verbetert-uitkomst-niet-bij-recidief-af/* The REDO-FIRM trial showed that focal impulse and rotor modulation-guided redo ablation does not improve outcomes over conventional redo ablation for recurrent AF, a negative result for the rotor-mapping technology in repeat procedures. ## Predictors of recurrence after catheter ablation and electrical cardioversion of atrial fibrillation: an umbrella review of meta-analyses. *2023-02-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac143 · https://hartvaat.nl/2023/02/08/voorspellers-van-af-recidief-na-ablatie-en-cardioversie-umbrella-review/* This umbrella review of meta-analyses identified the strongest predictors of AF recurrence after catheter ablation and cardioversion — left atrial size, AF duration, age, and body mass index — providing a practical risk assessment framework. ## The association of coagulation and atrial fibrillation: a systematic review and meta-analysis. *2023-02-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac130 · https://hartvaat.nl/2023/02/08/stolling-en-atriumfibrilleren-systematische-review-en-meta-analyse/* This meta-analysis examined the bidirectional relationship between coagulation activation and AF, suggesting that coagulation may not only be a consequence but also a contributor to atrial fibrillation development. ## Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis. *2023-02-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehac747 · https://hartvaat.nl/2023/02/07/inspanningsgerichte-hartrevalidatie-bij-coronairlijden-geactualiseerde-meta-anal/* This updated meta-analysis confirmed that exercise-based cardiac rehabilitation for coronary heart disease reduces cardiovascular mortality and hospital readmission, with benefits extending to contemporary patient populations and interventions. ## Fractional flow reserve versus angiography-guided strategy in acute myocardial infarction with multivessel disease: a randomized trial. *2023-02-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehac763 · https://hartvaat.nl/2023/02/07/ffr-geleide-versus-angiografie-geleide-pci-bij-acuut-mi-met-meervatslijden/* This randomized trial comparing FFR-guided with angiography-guided PCI of nonculprit vessels in acute MI showed that FFR guidance results in fewer stent implantations but similar clinical outcomes, consistent with other FFR-in-MI trials. ## Extracorporeal Membrane Oxygenation in the Therapy of Cardiogenic Shock: Results of the ECMO-CS Randomized Clinical Trial. *2023-02-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062949 · https://hartvaat.nl/2023/02/07/ecmo-cs-ecmo-bij-cardiogene-shock-verbetert-overleving-niet/* The ECMO-CS trial showed that veno-arterial ECMO in cardiogenic shock was not associated with improved survival compared with standard medical therapy, consistent with the ECLS-SHOCK results. The negative finding discourages routine ECMO use in non-infarction cardiogenic shock. ## Phase 2 Trial of Baxdrostat for Treatment-Resistant Hypertension. *2023-02-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2213169 · https://hartvaat.nl/2023/02/02/baxdrostat-aldosteronsynthaseremmer-bij-resistente-hypertensie-nejm-fase-2/* This phase 2 NEJM trial of baxdrostat, the first selective aldosterone synthase inhibitor, demonstrated dose-dependent blood pressure reduction in patients with treatment-resistant hypertension. The results validated a new pharmacological target for the hardest-to-treat hypertension population. ## Frailty and Effects of a Multidomain Physical Rehabilitation Intervention Among Older Patients Hospitalized for Acute Heart Failure: A Secondary Analysis of a Randomized Clinical Trial. *2023-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.4903 · https://hartvaat.nl/2023/02/01/fysieke-revalidatie-bij-fragiele-ouderen-met-acuut-hartfalen/* This secondary analysis showed that multidomain physical rehabilitation improves quality of life and functional capacity in frail older patients hospitalized for acute heart failure, supporting rehabilitation even in the most vulnerable HF population. ## Performance of Cardiovascular Risk Prediction Models Among People Living With HIV: A Systematic Review and Meta-analysis. *2023-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.4873 · https://hartvaat.nl/2023/02/01/cv-risicomodellen-bij-hiv-patienten-systematische-review/* This meta-analysis showed that standard cardiovascular risk models underestimate risk in people living with HIV, supporting the development of HIV-specific risk calculators that account for the unique inflammatory and metabolic factors in this population. ## Associations Between New York Heart Association Classification, Objective Measures, and Long-term Prognosis in Mild Heart Failure: A Secondary Analysis of the PARADIGM-HF Trial. *2023-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.4427 · https://hartvaat.nl/2023/02/01/nyha-klasse-versus-objectieve-metingen-bij-mild-hartfalen-paradigm-hf-analyse/* This PARADIGM-HF analysis showed that NYHA functional classification correlates poorly with objective measures (BNP, exercise capacity) in HFrEF, questioning the reliability of NYHA class as a treatment decision tool. ## Combining loop with thiazide diuretics for decompensated heart failure: the CLOROTIC trial. *2023-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac689 · https://hartvaat.nl/2023/02/01/clorotic-thiazide-toevoegen-aan-lisdiureticum-bij-acuut-hartfalen/* The CLOROTIC trial showed that adding hydrochlorothiazide to furosemide in acute decompensated heart failure improved weight loss and urine output compared with furosemide alone, though it did not affect dyspnea or all-cause mortality. The results supported sequential nephron blockade as a diuretic strategy. ## Association Between Hypertensive Disorders of Pregnancy and Dementia: a Systematic Review and Meta-Analysis. *2023-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19399 · https://hartvaat.nl/2023/02/01/hypertensieve-zwangerschapscomplicaties-en-dementierisico-meta-analyse/* This meta-analysis showed that hypertensive disorders of pregnancy are associated with increased risk of later dementia, establishing gestational hypertension as a risk factor for long-term neurodegenerative disease. ## Effects of aspirin on cardiovascular outcomes in patients with chronic kidney disease. *2023-02-01 · Kidney international · https://doi.org/10.1016/j.kint.2022.09.023 · https://hartvaat.nl/2023/02/01/aspirine-en-cardiovasculaire-uitkomsten-bij-chronische-nierziekte/* This study evaluated aspirin for cardiovascular event prevention in CKD patients, showing modest ischemic benefit offset by increased bleeding risk, consistent with the general aspirin primary prevention evidence. ## Meta-analysed numbers needed to treat of novel antidiabetic drugs for cardiovascular outcomes. *2023-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14213 · https://hartvaat.nl/2023/02/01/nnt-van-nieuwe-antidiabetica-voor-cv-uitkomsten-meta-analyse/* This meta-analysis calculated the numbers needed to treat (NNT) for SGLT2 inhibitors and GLP-1 receptor agonists across cardiovascular outcomes, providing absolute treatment effect estimates useful for clinical decision-making and cost-effectiveness analysis. ## Performance of the heart failure risk scores in predicting 1 year mortality and short-term readmission of patients. *2023-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14208 · https://hartvaat.nl/2023/02/01/hartfalenrisicoscores-vergelijking-voor-mortaliteit-en-heropname/* This study compared the performance of multiple heart failure risk scores for predicting 1-year mortality and readmission, finding variable discrimination that depends on the population and outcome assessed. ## Trial of Intrapartum Extended-Release Nifedipine to Prevent Severe Hypertension Among Pregnant Individuals With Preeclampsia With Severe Features. *2023-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19751 · https://hartvaat.nl/2023/02/01/nifedipine-retard-intrapartum-bij-ernstige-pre-eclampsie-preventietrial/* This trial showed that intrapartum extended-release nifedipine reduces severe hypertension in women with preeclampsia, providing an evidence-based prophylactic strategy for the most dangerous intrapartum blood pressure elevations. ## Effects of multifaceted optimization management for chronic heart failure: a multicentre, randomized controlled study. *2023-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14170 · https://hartvaat.nl/2023/02/01/multifactoriele-optimalisatie-van-chronisch-hartfalen-gerandomiseerde-studie/* This multicenter RCT tested a multifaceted optimization program integrating traditional Chinese and Western medicine for chronic heart failure management, showing improved outcomes with the structured approach. ## Influence of diabetes on sacubitril/valsartan titration and clinical outcomes in patients hospitalized for heart failure. *2023-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14166 · https://hartvaat.nl/2023/02/01/diabetes-en-sacubitril-valsartan-titratie-bij-hartfalen-na-opname/* This study showed that diabetes complicates sacubitril-valsartan up-titration during heart failure hospitalization but that the clinical benefit is maintained, supporting ARNI initiation efforts even in diabetic HF patients. ## Thromboprophylaxis in Patients With Fontan Circulation. *2023-01-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.10.037 · https://hartvaat.nl/2023/01/31/tromboseprofylaxe-bij-fontan-circulatie-aspirine-warfarine-of-noac/* This randomized study compared aspirin, warfarin, and a NOAC as thromboprophylaxis in patients with Fontan circulation, providing the first randomized data to guide antithrombotic strategy in this unique congenital heart disease population. ## Challenging the Hemodynamic Hypothesis in Heart Failure With Preserved Ejection Fraction: Is Exercise Capacity Limited by Elevated Pulmonary Capillary Wedge Pressure? *2023-01-31 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.061828 · https://hartvaat.nl/2023/01/31/hfpef-inspanningsbeperking-niet-alleen-door-hemodynamiek/* This study challenged the hemodynamic hypothesis in HFpEF by showing that exercise intolerance is not fully explained by elevated wedge pressures, suggesting peripheral and skeletal muscle limitations contribute significantly to functional impairment. ## PCSK9 Inhibition During the Inflammatory Stage of SARS-CoV-2 Infection. *2023-01-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.10.030 · https://hartvaat.nl/2023/01/24/pcsk9-remming-bij-covid-19-anti-inflammatoir-potentieel-onderzocht/* This study tested PCSK9 inhibition as an anti-inflammatory intervention during COVID-19 infection, based on the hypothesis that PCSK9 modulates the inflammatory response through lipid-immune pathway interactions. ## A Randomized Controlled Trial Comparing Apixaban With the Vitamin K Antagonist Phenprocoumon in Patients on Chronic Hemodialysis: The AXADIA-AFNET 8 Study. *2023-01-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062779 · https://hartvaat.nl/2023/01/24/axadia-afnet-8-apixaban-versus-vka-bij-af-op-hemodialyse/* The AXADIA trial comparing apixaban with phenprocoumon in AF patients on hemodialysis was underpowered for clinical outcomes, illustrating the ongoing challenge of generating definitive anticoagulation evidence in end-stage kidney disease. ## Empagliflozin and Left Ventricular Remodeling in People Without Diabetes: Primary Results of the EMPA-HEART 2 CardioLink-7 Randomized Clinical Trial. *2023-01-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062769 · https://hartvaat.nl/2023/01/24/empa-heart-2-empagliflozine-vermindert-lv-massa-niet-bij-patienten-zonder-diabet/* The EMPA-HEART 2 trial showed that empagliflozin did not significantly reduce left ventricular mass in patients with coronary artery disease without diabetes or heart failure, suggesting that SGLT2 inhibitor cardiac remodeling benefits may be specific to diabetic or heart failure populations. ## Growth differentiation factor 15 and cardiovascular risk: individual patient meta-analysis. *2023-01-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac577 · https://hartvaat.nl/2023/01/21/gdf-15-en-cardiovasculair-risico-ipd-meta-analyse/* This individual patient data meta-analysis confirmed that GDF-15 is a strong, independent predictor of diverse cardiovascular outcomes, establishing this stress-responsive cytokine as a powerful risk biomarker. ## Effect of Torsemide vs Furosemide After Discharge on All-Cause Mortality in Patients Hospitalized With Heart Failure: The TRANSFORM-HF Randomized Clinical Trial. *2023-01-17 · JAMA · https://doi.org/10.1001/jama.2022.23924 · https://hartvaat.nl/2023/01/17/transform-hf-torsemide-biedt-geen-overlevingsvoordeel-boven-furosemide/* The TRANSFORM-HF trial found no difference in all-cause mortality between torsemide and furosemide in patients hospitalized for heart failure. This definitive pragmatic trial ended the long-standing hypothesis that torsemide's anti-aldosterone properties might confer a survival advantage over furosemide. ## Indobufen or Aspirin on Top of Clopidogrel After Coronary Drug-Eluting Stent Implantation (OPTION): A Randomized, Open-Label, End Point-Blinded, Noninferiority Trial. *2023-01-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062762 · https://hartvaat.nl/2023/01/17/option-indobufen-als-aspirine-alternatief-in-dapt-na-pci/* The OPTION trial showed that indobufen, a reversible COX inhibitor, is noninferior to aspirin when combined with clopidogrel after coronary DES implantation, providing an alternative antiplatelet backbone with potentially fewer GI side effects. ## Decongestion With Acetazolamide in Acute Decompensated Heart Failure Across the Spectrum of Left Ventricular Ejection Fraction: A Prespecified Analysis From the ADVOR Trial. *2023-01-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062486 · https://hartvaat.nl/2023/01/17/advor-acetazolamide-effectief-over-het-hele-ef-spectrum-bij-acuut-hartfalen/* This ADVOR subanalysis confirmed that adjunctive acetazolamide improves decongestion in acute heart failure regardless of left ventricular ejection fraction, supporting sequential nephron blockade across the heart failure spectrum. ## Cost-effectiveness of population screening for atrial fibrillation: the STROKESTOP study. *2023-01-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehac547 · https://hartvaat.nl/2023/01/14/strokestop-af-screening-is-kosteneffectief-bij-75-76-jarigen/* The STROKESTOP cost-effectiveness analysis showed that population-level screening for atrial fibrillation in 75-76-year-olds using intermittent ECG recordings is cost-effective, with favorable incremental cost per QALY gained. The economic evaluation complemented the clinical benefit demonstrated in the main trial. ## Progression of Atrial Fibrillation after Cryoablation or Drug Therapy. *2023-01-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2212540 · https://hartvaat.nl/2023/01/12/early-af-2-jaar-cryoablatie-vertraagt-af-progressie-beter-dan-antiaritmica/* The 2-year EARLY-AF results showed that initial cryoablation therapy not only maintained better rhythm control but also significantly reduced progression from paroxysmal to persistent atrial fibrillation compared with antiarrhythmic drugs. This disease-modifying effect strengthened the case for early ablation intervention. ## Empagliflozin in Patients with Chronic Kidney Disease. *2023-01-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2204233 · https://hartvaat.nl/2023/01/12/empa-kidney-empagliflozine-beschermt-nieren-bij-brede-ckd-populatie/* The EMPA-KIDNEY trial demonstrated that empagliflozin reduced kidney disease progression and cardiovascular death in a broad population of patients with chronic kidney disease, including those without diabetes and those with only mildly reduced eGFR. The trial was stopped early for efficacy and extended the renal protection of SGLT2 inhibitors to virtually all CKD patients. ## Methamphetamine-associated heart failure: a systematic review of observational studies. *2023-01-11 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321610 · https://hartvaat.nl/2023/01/11/metamfetamine-geassocieerd-hartfalen-systematische-review/* This systematic review characterized methamphetamine-associated heart failure as a distinct clinical entity affecting younger patients with unique pathophysiology, raising awareness of this emerging cause of cardiomyopathy. ## Outcomes and drivers of inappropriate dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a systematic review and meta-analysis. *2023-01-11 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321114 · https://hartvaat.nl/2023/01/11/inadequate-noac-dosering-bij-af-uitkomsten-en-oorzaken-meta-analyse/* This systematic review documented that inappropriate NOAC dosing (particularly underdosing) in AF is prevalent and associated with worse outcomes, highlighting the importance of adherence to recommended dose criteria for stroke prevention. ## Effect of Catheter Ablation Using Pulmonary Vein Isolation With vs Without Posterior Left Atrial Wall Isolation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation: The CAPLA Randomized Clinical Trial. *2023-01-10 · JAMA · https://doi.org/10.1001/jama.2022.23722 · https://hartvaat.nl/2023/01/10/capla-posterior-wand-isolatie-verbetert-uitkomst-niet-bij-persisterend-af/* The CAPLA trial showed that adding posterior left atrial wall isolation to standard pulmonary vein isolation did not significantly reduce AF recurrence in patients with persistent atrial fibrillation. The result argued against routine posterior wall ablation as an adjunctive strategy. ## Prospective Association of Daily Steps With Cardiovascular Disease: A Harmonized Meta-Analysis. *2023-01-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.061288 · https://hartvaat.nl/2023/01/10/dagelijkse-stappen-en-cardiovasculaire-ziekte-geharmoniseerde-meta-analyse/* This harmonized meta-analysis demonstrated a dose-response relationship between daily step count and cardiovascular disease risk, with as few as 2,000-3,000 steps per day providing measurable benefit. The findings established a practical, evidence-based physical activity target for cardiovascular prevention. ## Aspirin Versus Clopidogrel for Long-Term Maintenance Monotherapy After Percutaneous Coronary Intervention: The HOST-EXAM Extended Study. *2023-01-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062770 · https://hartvaat.nl/2023/01/10/host-exam-extended-clopidogrel-superieur-aan-aspirine-als-monotherapie-na-pci/* The HOST-EXAM Extended study confirmed the sustained superiority of clopidogrel over aspirin for long-term maintenance antiplatelet monotherapy after PCI, with fewer cardiovascular events and similar bleeding rates over extended follow-up. ## Trial of an Intervention to Improve Acute Heart Failure Outcomes. *2023-01-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2211680 · https://hartvaat.nl/2023/01/05/nejm-interventie-voor-snelle-ambulante-follow-up-na-acuut-hartfalen/* This NEJM trial tested whether an intervention combining rapid clinical assessment, structured decision support, and early post-discharge follow-up improves outcomes in acute heart failure, addressing the persistent challenge of high readmission rates. ## Phase 2 Study of Aficamten in Patients With Obstructive Hypertrophic Cardiomyopathy. *2023-01-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.10.020 · https://hartvaat.nl/2023/01/03/aficamten-bij-obstructieve-hypertrofische-cardiomyopathie-fase-2-resultaten/* This phase 2 study of aficamten, a next-generation cardiac myosin inhibitor, showed dose-dependent reduction of the LVOT gradient and symptom improvement in patients with obstructive hypertrophic cardiomyopathy. The results advanced aficamten toward phase 3 development as an alternative to mavacamten. ## Comparative Effects of Low-Dose Rosuvastatin, Placebo, and Dietary Supplements on Lipids and Inflammatory Biomarkers. *2023-01-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.10.013 · https://hartvaat.nl/2023/01/03/rosuvastatine-versus-voedingssupplementen-voor-lipidenmanagement/* This JACC study compared low-dose rosuvastatin with six popular dietary supplements (fish oil, cinnamon, garlic, turmeric, plant sterols, red yeast rice) for lipid and inflammatory biomarker effects. Only rosuvastatin significantly lowered LDL cholesterol, definitively demonstrating the inefficacy of supplements for cholesterol management. ## Survival After Invasive or Conservative Management of Stable Coronary Disease. *2023-01-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062714 · https://hartvaat.nl/2023/01/03/ischemia-langetermijn-geen-overlevingsverschil-invasief-versus-conservatief-bij-/* Extended ISCHEMIA follow-up confirmed that an initial invasive strategy provided no survival benefit over conservative management in patients with stable coronary disease and moderate-to-severe ischemia. The durable finding reinforced medical therapy as a safe initial approach in this population. ## Effect of Nudges to Clinicians, Patients, or Both to Increase Statin Prescribing: A Cluster Randomized Clinical Trial. *2023-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.4373 · https://hartvaat.nl/2023/01/01/nudging-verhoogt-statinevoorschrijving-bij-zowel-arts-als-patient/* This cluster-randomized trial showed that behavioral nudges targeting clinicians, patients, or both significantly increase statin prescribing for eligible individuals, demonstrating the effectiveness of decision architecture for cardiovascular prevention. ## Statin-Associated Muscle Symptoms Among New Statin Users Randomly Assigned to Vitamin D or Placebo. *2023-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.4250 · https://hartvaat.nl/2023/01/01/vitamine-d-voorkomt-statine-gerelateerde-spierklachten-niet/* This randomized study showed that vitamin D supplementation does not reduce the incidence of statin-associated muscle symptoms in new statin users, arguing against routine vitamin D for preventing statin intolerance. ## Dapagliflozin and Kidney Outcomes in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Analysis of the DELIVER Randomized Clinical Trial. *2023-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.4210 · https://hartvaat.nl/2023/01/01/deliver-dapagliflozine-beschermt-ook-de-nieren-bij-hfpef/* This DELIVER analysis showed that dapagliflozin slows kidney function decline in patients with HFpEF, demonstrating renoprotective effects of SGLT2 inhibition that extend to the preserved ejection fraction heart failure population. ## Impact of empagliflozin on decongestion in acute heart failure: the EMPULSE trial. *2023-01-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac530 · https://hartvaat.nl/2023/01/01/empulse-empagliflozine-verbetert-decongestie-bij-acuut-hartfalen/* This EMPULSE subanalysis showed that empagliflozin started during acute heart failure hospitalization significantly improved decongestion markers, including weight loss and hemoconcentration, supporting SGLT2 inhibitors as an adjunctive decongestion strategy. ## Independent Associations of Education, Intelligence, and Cognition With Hypertension and the Mediating Effects of Cardiometabolic Risk Factors: A Mendelian Randomization Study. *2023-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.20286 · https://hartvaat.nl/2023/01/01/opleiding-intelligentie-en-cognitie-onafhankelijke-verbanden-met-hypertensie/* This Mendelian randomization study showed that lower educational attainment is independently associated with hypertension risk, partially mediated by cognitive factors and cardiovascular risk behaviors. ## Chlorthalidone vs. Hydrochlorothiazide for Hypertension-Cardiovascular Events. *2022-12-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2212270 · https://hartvaat.nl/2022/12/29/chloortalidon-versus-hydrochloorthiazide-geen-verschil-in-cv-events/* This large pragmatic NEJM trial in 13,000 hypertensive veterans demonstrated that chlorthalidone was not superior to hydrochlorothiazide for preventing major cardiovascular events. The results challenged the assumption of chlorthalidone's superiority and supported continued use of either thiazide diuretic. ## Relationship between orthostatic blood pressure changes and intensive blood pressure management in patients with hypertension. *2022-12-22 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321276 · https://hartvaat.nl/2022/12/22/orthostatische-bloeddruk-en-intensieve-behandeling-sprint-inzichten/* This SPRINT analysis showed that intensive blood pressure treatment does not significantly increase the risk of orthostatic hypotension, providing reassurance for aggressive blood pressure management in the elderly. ## Effect of inclisiran on lipids in primary prevention: the ORION-11 trial. *2022-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac615 · https://hartvaat.nl/2022/12/21/orion-11-inclisiran-verlaagt-ldl-effectief-bij-primaire-preventie/* This ORION-11 subanalysis showed that inclisiran effectively lowers LDL cholesterol in primary prevention patients on statins, demonstrating the twice-yearly injection's utility beyond the secondary prevention population. ## Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis. *2022-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac584 · https://hartvaat.nl/2022/12/21/bloeddrukverlaging-en-dementiepreventie-ipd-meta-analyse/* This individual patient data meta-analysis demonstrated that blood pressure lowering reduces the risk of incident dementia, with no evidence of a U-shaped relationship at lower blood pressure levels. The analysis provided the strongest evidence yet for blood pressure control as a dementia prevention strategy. ## Effect of empagliflozin on circulating proteomics in heart failure: mechanistic insights into the EMPEROR programme. *2022-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac495 · https://hartvaat.nl/2022/12/21/empagliflozine-en-het-circulerend-proteoom-bij-hartfalen-emperor-mechanismen/* This proteomics analysis of EMPEROR program data revealed that empagliflozin significantly alters circulating protein profiles in heart failure, identifying molecular pathways that may explain SGLT2 inhibitor cardioprotection beyond diuresis. ## Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial. *2022-12-17 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)02083-9 · https://hartvaat.nl/2022/12/17/ironman-intraveneus-ijzer-bij-hartfalen-met-ijzerdeficientie-lancet-rct/* The IRONMAN trial showed a trend toward reduced heart failure hospitalization and cardiovascular death with intravenous ferric derisomaltose in patients with heart failure and iron deficiency, though the primary endpoint did not reach statistical significance. COVID-19 pandemic disruptions affected enrollment and follow-up. ## Micronutrient Supplementation to Reduce Cardiovascular Risk. *2022-12-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.09.048 · https://hartvaat.nl/2022/12/13/micronutrientensuppletie-en-cardiovasculair-risico-jacc-systematische-review/* This systematic review of micronutrient supplementation and cardiovascular risk found that only folate and omega-3 fatty acids (specifically in REDUCE-IT) show evidence of CV benefit, while other supplements lack convincing efficacy data. ## The impact of urbanisation on the cardiometabolic health of Indigenous Brazilian peoples: a systematic review and meta-analysis, and data from the Brazilian Health registry. *2022-12-10 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00625-0 · https://hartvaat.nl/2022/12/10/urbanisatie-en-cardiometabool-risico-bij-inheemse-braziliaanse-volkeren/* This Lancet study documented the cardiometabolic impact of urbanization on Indigenous Brazilian peoples, showing rapid increases in hypertension, diabetes, and dyslipidemia following nutritional transition from traditional to modern diets. ## Evidence-based insights on ideal blanking period duration following atrial fibrillation catheter ablation. *2022-12-09 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac098 · https://hartvaat.nl/2022/12/09/ideale-blankingperiode-na-af-ablatie-bewijs-voor-herziening/* This review examined the evidence for the standard 3-month blanking period after AF ablation, showing that early recurrences within the blanking period are associated with late outcomes and may warrant earlier therapeutic consideration. ## Apixaban for Patients With Atrial Fibrillation on Hemodialysis: A Multicenter Randomized Controlled Trial. *2022-12-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.054990 · https://hartvaat.nl/2022/12/06/apixaban-bij-af-op-hemodialyse-eerste-gerandomiseerde-trial/* This first randomized trial of apixaban in AF patients on hemodialysis showed no significant improvement over usual care (mostly warfarin) for stroke prevention, with similar rates of bleeding and thrombotic events. The result highlighted the persistent evidence gap in anticoagulation for dialysis patients with AF. ## The Effects of Angiotensin Receptor-Neprilysin Inhibition on Major Coronary Events in Patients With Acute Myocardial Infarction: Insights From the PARADISE-MI Trial. *2022-12-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.060841 · https://hartvaat.nl/2022/12/06/paradise-mi-sacubitril-valsartan-vermindert-coronaire-events-niet-na-mi/* This PARADISE-MI analysis confirmed that sacubitril-valsartan does not reduce major coronary events compared with ramipril after acute MI, consistent with the neutral primary endpoint and limiting ARNI use to established heart failure. ## Dual endothelin antagonist aprocitentan for resistant hypertension (PRECISION): a multicentre, blinded, randomised, parallel-group, phase 3 trial. *2022-12-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)02034-7 · https://hartvaat.nl/2022/12/03/precision-aprocitentan-bij-resistente-hypertensie-eerste-endothelineantagonist/* The PRECISION trial showed that aprocitentan, a dual endothelin receptor antagonist, significantly reduced blood pressure in patients with resistant hypertension on triple therapy. This was the first positive phase 3 trial of an endothelin antagonist for systemic hypertension, opening a new mechanism of action for treatment-resistant blood pressure. ## Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial. *2022-12-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)02076-1 · https://hartvaat.nl/2022/12/03/strong-hf-snelle-optitratie-van-hartfalenmedicatie-na-ziekenhuis-is-veilig-en-ef/* The STRONG-HF trial demonstrated that rapid, intensive up-titration of guideline-directed medical therapy (beta-blocker, RAAS inhibitor, MRA) within two weeks of hospital discharge for acute heart failure was safe and significantly reduced heart failure readmission and death compared with usual care. The study established early, aggressive optimization as the standard post-discharge approach. ## Effects of Renal Denervation vs Sham in Resistant Hypertension After Medication Escalation: Prespecified Analysis at 6 Months of the RADIANCE-HTN TRIO Randomized Clinical Trial. *2022-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.3904 · https://hartvaat.nl/2022/12/01/radiance-htn-trio-renale-denervatie-effectief-na-medicatie-optitratie/* This RADIANCE-HTN TRIO prespecified analysis confirmed that ultrasound renal denervation significantly reduces blood pressure in patients with confirmed resistant hypertension even after medication escalation, supporting device-based therapy as an adjunct to optimized pharmacotherapy. ## Association of Serial High-Sensitivity Cardiac Troponin T With Subsequent Cardiovascular Events in Patients Stabilized After Acute Coronary Syndrome: A Secondary Analysis From IMPROVE-IT. *2022-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.3627 · https://hartvaat.nl/2022/12/01/serieel-hoog-sensitief-troponine-t-voorspelt-cv-events-na-acs-odyssey-analyse/* This ODYSSEY OUTCOMES analysis showed that serial high-sensitivity troponin T measurements after ACS improve cardiovascular event prediction beyond baseline values, supporting dynamic biomarker monitoring for post-ACS risk assessment. ## Time to Clinical Benefit of Dapagliflozin in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial. *2022-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.3750 · https://hartvaat.nl/2022/12/01/deliver-snel-voordeel-van-dapagliflozine-bij-hfpef-binnen-weken-merkbaar/* This DELIVER analysis demonstrated that dapagliflozin achieves clinical benefit within 13 days of initiation in HFpEF, establishing SGLT2 inhibitors as one of the fastest-acting therapies for heart failure across the ejection fraction spectrum. ## Comparing Pharmacist-Led Telehealth Care and Clinic-Based Care for Uncontrolled High Blood Pressure: The Hyperlink 3 Pragmatic Cluster-Randomized Trial. *2022-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19816 · https://hartvaat.nl/2022/12/01/apotheker-geleide-telezorg-versus-poliklinische-zorg-bij-ongecontroleerde-hypert/* The Hyperlink 3 trial showed that pharmacist-led telehealth care achieves comparable blood pressure control to clinic-based care in uncontrolled hypertension, validating remote team-based management models. ## Causality of Opportunistic Pathogen Klebsiella pneumoniae to Hypertension Development. *2022-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.18878 · https://hartvaat.nl/2022/12/01/klebsiella-pneumoniae-als-mogelijke-oorzaak-van-hypertensie/* This translational study suggested a causal relationship between the gut pathogen Klebsiella pneumoniae and hypertension development, advancing the microbiome-hypertension hypothesis with species-level specificity. ## Blood Pressure and Cardiorenal Outcomes With Finerenone in Chronic Kidney Disease in Type 2 Diabetes. *2022-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19744 · https://hartvaat.nl/2022/12/01/finerenon-bloeddrukeffecten-en-cardiorenale-uitkomsten-bij-ckd-en-diabetes/* This analysis showed that finerenone modestly lowers blood pressure in patients with CKD and type 2 diabetes, but the cardiorenal benefit is independent of blood pressure reduction, operating through direct mineralocorticoid receptor-mediated organ protection. ## Heart failure during the COVID-19 pandemic: clinical, diagnostic, management, and organizational dilemmas. *2022-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14118 · https://hartvaat.nl/2022/12/01/hartfalen-tijdens-de-covid-19-pandemie-klinische-en-organisatorische-dilemma-s/* This review described the multifaceted impact of COVID-19 on heart failure care, covering delayed presentations, disrupted diagnostic pathways, telemedicine adoption, and the long-term cardiovascular consequences of SARS-CoV-2 infection. ## Association of immune cell subsets with incident heart failure in two population-based cohorts. *2022-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14140 · https://hartvaat.nl/2022/12/01/immuuncelsubsets-voorspellen-incident-hartfalen-in-populatiestudies/* This population-based study showed that specific immune cell subsets (monocytes, neutrophils) predict incident heart failure, establishing immune profiling as a novel approach to HF risk assessment. ## Efficacy and safety of digital therapeutics-based cardiac rehabilitation in heart failure patients: a systematic review. *2022-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14145 · https://hartvaat.nl/2022/12/01/digitale-hartrevalidatie-bij-hartfalen-systematische-review/* This systematic review confirmed that digital therapeutics-based cardiac rehabilitation improves functional capacity and quality of life in heart failure, supporting virtual programs as a viable alternative during and after the COVID-19 pandemic. ## Long-term mortality in heart failure with mid-range ejection fraction: systematic review and meta-analysis. *2022-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14125 · https://hartvaat.nl/2022/12/01/langetermijnmortaliteit-bij-hfmref-systematische-review-en-meta-analyse/* This meta-analysis confirmed that long-term mortality in HFmrEF is intermediate between HFrEF and HFpEF, supporting the classification of mid-range ejection fraction as a distinct prognostic category. ## Daprodustat for anaemia in patients with heart failure and chronic kidney disease: A randomized controlled study. *2022-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14109 · https://hartvaat.nl/2022/12/01/daprodustat-bij-anemie-en-hartfalen-met-ckd-gerandomiseerde-studie/* This randomized study of daprodustat in patients with heart failure, CKD, and anemia showed that the HIF-PH inhibitor improves hemoglobin with an acceptable safety profile, exploring oral anemia therapy in the cardio-renal population. ## Vericiguat and NT-proBNP in patients with heart failure with reduced ejection fraction: analyses from the VICTORIA trial. *2022-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14050 · https://hartvaat.nl/2022/12/01/vericiguat-en-nt-probnp-bij-hfref-victoria-subanalyse/* This VICTORIA subanalysis showed that vericiguat's benefit in HFrEF is consistent across NT-proBNP levels, with patients at the highest natriuretic peptide levels having the greatest absolute benefit from sGC stimulation. ## 2-Year Outcomes of Angiographic Quantitative Flow Ratio-Guided Coronary Interventions. *2022-11-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.09.007 · https://hartvaat.nl/2022/11/29/favor-iii-qfr-geleide-pci-verbetert-tweejaarsuitkomsten/* Two-year FAVOR III results confirmed that angiographic QFR-guided PCI maintains superior outcomes compared with conventional angiography guidance, supporting the durability of wire-free physiological assessment for coronary intervention decisions. ## LY3437943, a novel triple GIP, GLP-1, and glucagon receptor agonist in people with type 2 diabetes: a phase 1b, multicentre, double-blind, placebo-controlled, randomised, multiple-ascending dose trial. *2022-11-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)02033-5 · https://hartvaat.nl/2022/11/26/triple-gip-glp-1-glucagonreceptoragonist-bij-type-2-diabetes-fase-1b/* This phase 1b trial of a triple GIP/GLP-1/glucagon receptor agonist (retatrutide) demonstrated dramatic HbA1c reduction and weight loss in patients with type 2 diabetes. The triple agonism concept showed additive metabolic benefit beyond dual GIP/GLP-1 agonists. ## Bivalirudin plus a high-dose infusion versus heparin monotherapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: a randomised trial. *2022-11-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)01999-7 · https://hartvaat.nl/2022/11/26/bivalirudine-versus-heparine-bij-primaire-pci-voor-stemi-lancet-trial/* This Lancet trial compared bivalirudin with high-dose infusion versus heparin monotherapy in STEMI patients undergoing primary PCI, providing updated safety and efficacy data for anticoagulation during primary percutaneous coronary intervention. ## Triglyceride Lowering with Pemafibrate to Reduce Cardiovascular Risk. *2022-11-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2210645 · https://hartvaat.nl/2022/11/24/prominent-pemafibrate-verlaagt-triglyceriden-maar-vermindert-cv-events-niet/* The PROMINENT trial showed that pemafibrate, a selective PPARα agonist, effectively lowered triglycerides but did not reduce cardiovascular events in patients with type 2 diabetes and elevated triglycerides despite statin therapy. This definitive negative result, together with earlier fibrate failures, largely closed the door on triglyceride lowering as a cardiovascular prevention strategy. ## Prospective RandOmised Trial of Emergency Cardiac Computerised Tomography (PROTECCT). *2022-11-24 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-320990 · https://hartvaat.nl/2022/11/24/protecct-ct-bij-verdenking-acs-met-intermediaire-troponinewaarden/* The PROTECCT trial evaluated whether coronary CT angiography can improve the diagnostic pathway for patients with suspected ACS and intermediate troponin levels, exploring the role of CCTA in the diagnostic gray zone. ## Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Artery Disease: Extended Follow-Up Outcomes of Multicenter Randomized Controlled BEST Trial. *2022-11-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.062188 · https://hartvaat.nl/2022/11/22/ees-versus-cabg-bij-meervatslijden-langetermijn-follow-up-van-rct-s/* This extended follow-up of multiple randomized trials comparing PCI with everolimus-eluting stents versus CABG for multivessel disease confirmed that CABG provides superior long-term outcomes, particularly for complex coronary anatomy. The results reinforced CABG as the preferred strategy for extensive multivessel disease. ## Comprehensive comparison of stroke risk score performance: a systematic review and meta-analysis among 6 267 728 patients with atrial fibrillation. *2022-11-22 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac096 · https://hartvaat.nl/2022/11/22/cva-risicoscores-bij-af-vergeleken-cha2ds2-vasc-blijft-de-beste/* This comprehensive meta-analysis of 6.3 million AF patients compared multiple stroke risk prediction scores, confirming that CHA₂DS₂-VASc remains the best-validated and most practical tool for thromboembolic risk stratification in clinical practice. ## Efficacy and safety of dronedarone across age and sex subgroups: a post hoc analysis of the ATHENA study among patients with non-permanent atrial fibrillation/flutter. *2022-11-22 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab208 · https://hartvaat.nl/2022/11/22/athena-subanalyse-dronedaron-effectief-ongeacht-leeftijd-en-geslacht-bij-af/* This ATHENA post-hoc analysis confirmed that dronedarone maintains consistent efficacy and safety across age and sex subgroups in AF, supporting its use as a rhythm control agent regardless of patient demographics. ## Impact of diabetes on the effects of sodium glucose co-transporter-2 inhibitors on kidney outcomes: collaborative meta-analysis of large placebo-controlled trials. *2022-11-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)02074-8 · https://hartvaat.nl/2022/11/19/sglt2-remmers-en-nieruitkomsten-diabetes-maakt-niet-uit-lancet-meta-analyse/* This collaborative meta-analysis of major SGLT2 inhibitor trials demonstrated that the kidney-protective effects of SGLT2 inhibition are independent of diabetes status and baseline kidney function. The findings support SGLT2 inhibitors as a universal renoprotective therapy across diverse CKD populations. ## Small Interfering RNA to Reduce Lipoprotein(a) in Cardiovascular Disease. *2022-11-17 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2211023 · https://hartvaat.nl/2022/11/17/olpasiran-sirna-verlaagt-lipoproteine-a-spectaculair-in-fase-2-trial/* The OCEAN(a)-DOSE trial demonstrated that olpasiran, a small interfering RNA targeting hepatic apolipoprotein(a) synthesis, reduced lipoprotein(a) levels by more than 95% in patients with established atherosclerotic cardiovascular disease. This represented the first pharmacological agent capable of near-complete Lp(a) elimination, opening a new therapeutic frontier. ## Hospitalizations and Mortality in Patients With Secondary Mitral Regurgitation and Heart Failure: The COAPT Trial. *2022-11-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.08.803 · https://hartvaat.nl/2022/11/15/coapt-mitraclip-vermindert-hospitalisaties-bij-secundaire-mr-en-hartfalen/* Long-term COAPT analysis confirmed that transcatheter edge-to-edge repair (MitraClip) durably reduces hospitalizations and mortality in patients with heart failure and severe secondary mitral regurgitation, with sustained benefit beyond the initial follow-up period. ## FGF21-Sirtuin 3 Axis Confers the Protective Effects of Exercise Against Diabetic Cardiomyopathy by Governing Mitochondrial Integrity. *2022-11-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059631 · https://hartvaat.nl/2022/11/15/fgf21-sirtuin-3-hoe-inspanning-beschermt-tegen-diabetische-cardiomyopathie/* This translational study revealed that exercise protects against diabetic cardiomyopathy through the FGF21-Sirtuin 3 axis, which governs mitochondrial dynamics and cardiac metabolic homeostasis. ## Mammalian Target of Rapamycin Inhibition in Patients With ST-Segment Elevation Myocardial Infarction. *2022-11-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.08.747 · https://hartvaat.nl/2022/11/08/mtor-remming-bij-stemi-sirolimus-vermindert-infarctgrootte-niet/* This randomized trial tested whether mTOR inhibition with sirolimus reduces infarct size after STEMI through anti-inflammatory mechanisms, exploring immunomodulation as an adjunct to primary PCI reperfusion. ## Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2/MT): a multicentre, open-label, blinded-endpoint, randomised controlled trial. *2022-11-05 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)01882-7 · https://hartvaat.nl/2022/11/05/enchanted2-mt-intensieve-bloeddrukverlaging-na-trombectomie-bij-cva-is-schadelij/* The ENCHANTED2/MT trial demonstrated that intensive blood pressure lowering to <120 mmHg after endovascular thrombectomy for acute ischemic stroke worsened functional outcomes compared with a higher target. The trial was stopped early for futility and potential harm. ## Complete Revascularization vs Culprit Lesion-Only Percutaneous Coronary Intervention for Angina-Related Quality of Life in Patients With ST-Segment Elevation Myocardial Infarction: Results From the COMPLETE Randomized Clinical Trial. *2022-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.3032 · https://hartvaat.nl/2022/11/01/complete-revascularisatie-bij-stemi-verbetert-angina-gerelateerde-kwaliteit-van-/* This substudy demonstrated that complete revascularization improves angina-related quality of life compared with culprit-only PCI in STEMI patients with multivessel disease, adding patient-centered outcomes to the clinical event reduction. ## Association of Empagliflozin Treatment With Albuminuria Levels in Patients With Heart Failure: A Secondary Analysis of EMPEROR-Pooled. *2022-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.2924 · https://hartvaat.nl/2022/11/01/empagliflozine-vermindert-albuminurie-bij-hartfalen-emperor-pooled-analyse/* This pooled EMPEROR analysis showed that empagliflozin significantly reduces albuminuria across the heart failure spectrum (both HFrEF and HFpEF), providing evidence of kidney-protective effects of SGLT2 inhibition in heart failure beyond eGFR preservation. ## Atrial Fibrillation and Dapagliflozin Efficacy in Patients With Preserved or Mildly Reduced Ejection Fraction. *2022-11-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.08.718 · https://hartvaat.nl/2022/11/01/deliver-dapagliflozine-effectief-bij-hfpef-ongeacht-atriumfibrilleren/* This DELIVER subanalysis confirmed that dapagliflozin reduces heart failure events in HFpEF patients regardless of whether they have concurrent atrial fibrillation, an important finding given the high prevalence of AF in this population. ## Empagliflozin in acute myocardial infarction: the EMMY trial. *2022-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac494 · https://hartvaat.nl/2022/11/01/emmy-empagliflozine-na-acuut-myocardinfarct-verbetert-nt-probnp-en-remodelling/* The EMMY trial showed that empagliflozin started after acute MI significantly reduced NT-proBNP levels and attenuated left ventricular remodeling compared with placebo. The results provided early evidence of SGLT2 inhibitor cardioprotection in the acute post-MI setting. ## Influenza vaccination strategy in acute coronary syndromes: the VIP-ACS trial. *2022-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac472 · https://hartvaat.nl/2022/11/01/vip-acs-dubbele-dosis-griepvaccinatie-na-acs-verbetert-uitkomsten-niet/* The VIP-ACS trial showed that double-dose influenza vaccination during ACS hospitalization was not superior to standard-dose outpatient vaccination for preventing cardiovascular events, testing whether enhanced immunogenicity provides clinical benefit in the acute setting. ## Patiromer for the management of hyperkalemia in heart failure with reduced ejection fraction: the DIAMOND trial. *2022-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac401 · https://hartvaat.nl/2022/11/01/diamond-patiromer-maakt-raas-remmer-optitratie-bij-hfref-met-hyperkaliemie-mogel/* The DIAMOND trial showed that patiromer effectively reduced serum potassium in patients with HFrEF, enabling more patients to reach target doses of RAAS inhibitors without hyperkalemia-related dose reductions. The results addressed a key barrier to optimal heart failure pharmacotherapy. ## Immune Checkpoint Inhibitors Do Not Increase Short-Term Risk of Hypertension in Cancer Patients: a Systematic Literature Review and Meta-Analysis. *2022-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19865 · https://hartvaat.nl/2022/11/01/checkpoint-remmers-verhogen-korttermijnrisico-op-hypertensie-niet-meta-analyse/* This meta-analysis showed that immune checkpoint inhibitors do not increase the short-term risk of hypertension in cancer patients, providing reassurance on this specific cardiovascular safety concern during immunotherapy. ## Effect of 3, 2-Drug Combinations of Antihypertensive Therapies on Blood Pressure Variability in Black African Patients: Secondary Analyses of the CREOLE Trial. *2022-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18333 · https://hartvaat.nl/2022/11/01/antihypertensieve-combinaties-bij-afrikaanse-patienten-creole-secundaire-analyse/* This CREOLE secondary analysis compared blood pressure variability among three antihypertensive combinations in Black African patients, showing that the calcium channel blocker-containing combinations provide more stable blood pressure control. ## Effects on Mortality and Major Bleeding of Radial Versus Femoral Artery Access for Coronary Angiography or Percutaneous Coronary Intervention: Meta-Analysis of Individual Patient Data From 7 Multicenter Randomized Clinical Trials. *2022-11-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.061527 · https://hartvaat.nl/2022/11/01/radiale-versus-femorale-toegang-bij-coronairangiografie-meta-analyse-toont-morta/* This comprehensive meta-analysis confirmed that radial artery access for coronary angiography and PCI is associated with lower mortality and fewer major bleeding events compared with femoral access. The pooled evidence supported transradial access as the default approach for coronary procedures. ## Arterial stiffness, endothelial dysfunction and impaired fibrinolysis are pathogenic mechanisms contributing to cardiovascular risk in ANCA-associated vasculitis. *2022-11-01 · Kidney international · https://doi.org/10.1016/j.kint.2022.07.026 · https://hartvaat.nl/2022/11/01/arteriele-stijfheid-en-endotheeldysfunctie-bij-anca-geassocieerde-vasculitis/* This study showed that patients with ANCA-associated vasculitis have increased arterial stiffness and endothelial dysfunction, identifying vascular pathogenic mechanisms that contribute to their elevated cardiovascular risk. ## Mortality after multivessel revascularisation involving the proximal left anterior descending artery. *2022-10-28 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-320934 · https://hartvaat.nl/2022/10/28/pci-versus-cabg-bij-drievatslijden-met-proximale-lad-betrokkenheid/* This study confirmed that CABG provides superior long-term survival compared with PCI in patients with three-vessel disease involving the proximal LAD, reinforcing the importance of surgical revascularization when this critical territory is involved. ## 2022 ACC/AHA Key Data Elements and Definitions for Chest Pain and Acute Myocardial Infarction: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Data Standards. *2022-10-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.05.012 · https://hartvaat.nl/2022/10/25/2022-acc-aha-datadefinities-voor-pijn-op-de-borst-en-acuut-myocardinfarct/* This ACC/AHA document standardized data elements and definitions for chest pain and acute MI research and quality improvement, enabling consistent data collection across registries and clinical trials. ## Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial. *2022-10-22 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)01786-X · https://hartvaat.nl/2022/10/22/time-avonddosering-antihypertensiva-biedt-geen-voordeel-boven-ochtenddosering/* The TIME trial showed that evening dosing of antihypertensive medications offered no cardiovascular benefit over morning dosing in hypertensive adults, definitively refuting the chronotherapy hypothesis. The pragmatic result simplified clinical practice by confirming that dosing time does not matter. ## Long-term outcomes after catheter-based renal artery denervation for resistant hypertension: final follow-up of the randomised SYMPLICITY HTN-3 Trial. *2022-10-22 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)01787-1 · https://hartvaat.nl/2022/10/22/symplicity-htn-3-langetermijn-follow-up-renale-denervatie-bij-resistente-hyperte/* Long-term SYMPLICITY HTN-3 follow-up confirmed the safety but not the efficacy of the first-generation renal denervation system, with the negative result attributed to procedural limitations that were subsequently addressed by newer-generation devices. ## Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest. *2022-10-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2208687 · https://hartvaat.nl/2022/10/20/box-bloeddrukdoelen-bij-comateuze-overlevenden-van-hartstilstand/* The BOX trial found no difference between a high (77 mmHg) versus low (63 mmHg) mean arterial pressure target in comatose survivors of out-of-hospital cardiac arrest. The result indicated that there is a broad acceptable blood pressure range in post-cardiac arrest intensive care. ## Dose-Response to Sacubitril/Valsartan in Patients With Heart Failure and Reduced Ejection Fraction. *2022-10-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.08.737 · https://hartvaat.nl/2022/10/18/dosisrespons-van-sacubitril-valsartan-bij-hfref/* This study showed that even lower-than-target doses of sacubitril-valsartan provide meaningful clinical benefit in HFrEF, with a dose-response relationship where any dose is better than no exposure. The finding supports initiating ARNI therapy even when target dose cannot be achieved. ## Intensive Blood Pressure Lowering in Patients With Malignant Left Ventricular Hypertrophy. *2022-10-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.08.735 · https://hartvaat.nl/2022/10/18/intensieve-bloeddrukverlaging-bij-maligne-linkerventrikel-hypertrofie/* This analysis showed that patients with malignant left ventricular hypertrophy (elevated troponin and BNP) have the highest cardiovascular risk but also derive the greatest absolute benefit from intensive blood pressure lowering, supporting targeted aggressive treatment. ## A Multicenter, Phase 2, Randomized, Placebo-Controlled, Double-Blind, Parallel-Group, Dose-Finding Trial of the Oral Factor XIa Inhibitor Asundexian to Prevent Adverse Cardiovascular Outcomes After Acute Myocardial Infarction. *2022-10-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.061612 · https://hartvaat.nl/2022/10/18/asundexian-factor-xia-remmer-na-acs-fase-2-dosisfindingsstudie/* This phase 2 trial of the oral factor XIa inhibitor asundexian after ACS showed dose-dependent suppression of thrombin generation with minimal bleeding increase, providing early safety and pharmacodynamic data that preceded the larger AF trial. ## Efficacy and Safety of Dapagliflozin According to Frailty in Patients With Heart Failure: A Prespecified Analysis of the DELIVER Trial. *2022-10-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.061754 · https://hartvaat.nl/2022/10/18/deliver-dapagliflozine-effectief-ongeacht-frailteit-bij-hfpef/* This DELIVER subanalysis demonstrated that dapagliflozin provides similar relative benefit in frail and non-frail patients with HFpEF, with even greater absolute benefit in frail patients due to their higher baseline risk. The results supported SGLT2 inhibitor use regardless of frailty status. ## Pharmacogenetics-guided dalcetrapib therapy after an acute coronary syndrome: the dal-GenE trial. *2022-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehac374 · https://hartvaat.nl/2022/10/14/dal-gene-farmacogenetica-geleide-dalcetrapib-na-acs/* The dal-GenE trial tested a pharmacogenetics-guided approach with dalcetrapib after ACS, targeting patients with a specific ADCY9 genotype predicted to respond to CETP inhibition. The trial explored precision medicine in the lipid-lowering space. ## Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction. *2022-10-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2206606 · https://hartvaat.nl/2022/10/13/revived-bcis2-pci-verbetert-overleving-niet-bij-ischemische-lv-disfunctie/* The REVIVED-BCIS2 trial showed that PCI did not improve survival or left ventricular function compared with optimal medical therapy in patients with severe ischemic cardiomyopathy and viable myocardium. The result challenged the long-held assumption that revascularization improves outcomes in ischemic left ventricular dysfunction and supports a medical-therapy-first approach. ## Low-voltage area substrate modification for atrial fibrillation ablation: a systematic review and meta-analysis of clinical trials. *2022-10-13 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac089 · https://hartvaat.nl/2022/10/13/low-voltage-substraatmodificatie-bij-af-ablatie-meta-analyse/* This meta-analysis evaluated the additional value of low-voltage area substrate modification beyond pulmonary vein isolation for AF ablation, finding mixed results for this targeted approach to substrate-based ablation. ## Pre-treatment with antiarrhythmic drugs for elective electrical cardioversion of atrial fibrillation: a systematic review and network meta-analysis. *2022-10-13 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac063 · https://hartvaat.nl/2022/10/13/voorbehandeling-met-antiaritmica-voor-cardioversie-bij-af-netwerk-meta-analyse/* This network meta-analysis compared different antiarrhythmic drugs as pretreatment before electrical cardioversion of AF, identifying vernakalant and flecainide as the most effective agents for enhancing cardioversion success. ## Combined epicardial and endocardial approach for redo radiofrequency catheter ablation in patients with persistent atrial fibrillation: a randomized clinical trial. *2022-10-13 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac058 · https://hartvaat.nl/2022/10/13/gecombineerde-epicardiale-en-endocardiale-redo-ablatie-bij-persisterend-af/* This randomized trial tested whether adding an epicardial approach to endocardial redo ablation for persistent AF improves outcomes, evaluating the value of hybrid surgical-catheter strategies for recurrent arrhythmia. ## Effects of intensive blood pressure control on cardiovascular and cognitive outcomes in patients with atrial fibrillation: insights from the SPRINT trial. *2022-10-13 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac059 · https://hartvaat.nl/2022/10/13/intensieve-bloeddrukcontrole-bij-af-inzichten-uit-sprint/* This SPRINT substudy in patients with atrial fibrillation showed that intensive blood pressure control reduces cardiovascular events even in the AF population, while also potentially reducing cognitive decline. ## Efficacy and safety of same-day discharge after atrial fibrillation ablation compared with post-procedural overnight stay: a systematic review and meta-analysis. *2022-10-13 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac068 · https://hartvaat.nl/2022/10/13/dagopname-na-af-ablatie-even-veilig-als-overnachting-meta-analyse/* This meta-analysis confirmed that same-day discharge after AF catheter ablation is as safe as overnight observation, supporting the cost-effective approach of outpatient ablation procedures. ## Fractional flow reserve versus angiography alone in guiding myocardial revascularisation: a systematic review and meta-analysis of randomised trials. *2022-10-13 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320768 · https://hartvaat.nl/2022/10/13/ffr-geleide-versus-angiografie-geleide-revascularisatie-meta-analyse-van-rct-s/* This meta-analysis confirmed that FFR-guided revascularization results in fewer stent implantations than angiography-guided treatment without compromising clinical outcomes, supporting the value of physiological assessment for treatment selection. ## Epidemiology of cerebral microbleeds and risk of adverse outcomes in atrial fibrillation: a systematic review and meta-analysis. *2022-10-13 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac028 · https://hartvaat.nl/2022/10/13/cerebrale-microbloedingen-en-risico-bij-af-systematische-review/* This meta-analysis documented the prevalence of cerebral microbleeds in AF patients and their association with increased intracranial hemorrhage risk, informing the bleeding risk assessment for anticoagulation decisions. ## Long-Term Evolocumab in Patients With Established Atherosclerotic Cardiovascular Disease. *2022-10-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.061620 · https://hartvaat.nl/2022/10/11/langetermijn-evolocumab-bij-atherosclerotisch-vaatlijden-open-label-extensie-fou/* The open-label FOURIER extension showed that long-term evolocumab use (up to 5 years) maintains sustained LDL cholesterol reduction with a favorable safety profile, providing the longest-term safety data for PCSK9 monoclonal antibody therapy. ## Allopurinol versus usual care in UK patients with ischaemic heart disease (ALL-HEART): a multicentre, prospective, randomised, open-label, blinded-endpoint trial. *2022-10-08 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)01657-9 · https://hartvaat.nl/2022/10/08/all-heart-allopurinol-verbetert-cv-uitkomsten-niet-bij-ischemische-hartziekte/* The ALL-HEART trial showed that allopurinol did not improve cardiovascular outcomes in patients with ischemic heart disease without gout, despite its theoretical benefits on endothelial function and oxidative stress. The large, pragmatic negative result argued against using allopurinol for cardiovascular prevention. ## Effects of Empagliflozin in Women and Men With Heart Failure and Preserved Ejection Fraction. *2022-10-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059755 · https://hartvaat.nl/2022/10/04/empagliflozine-bij-hfpef-gelijk-effect-bij-vrouwen-en-mannen/* This EMPEROR-Preserved sex-stratified analysis confirmed that empagliflozin reduces heart failure events equally in women and men with HFpEF, a reassuring finding given the female predominance in the HFpEF population. ## Impact of Sacubitril/Valsartan Compared With Ramipril on Cardiac Structure and Function After Acute Myocardial Infarction: The PARADISE-MI Echocardiographic Substudy. *2022-10-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059210 · https://hartvaat.nl/2022/10/04/paradise-mi-sacubitril-valsartan-versus-ramipril-na-acuut-mi-echocardiografie/* This PARADISE-MI echocardiographic substudy showed that sacubitril-valsartan did not significantly improve left ventricular remodeling compared with ramipril after acute MI, consistent with the neutral clinical primary endpoint. ## Early Versus Delayed Non-Vitamin K Antagonist Oral Anticoagulant Therapy After Acute Ischemic Stroke in Atrial Fibrillation (TIMING): A Registry-Based Randomized Controlled Noninferiority Study. *2022-10-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.060666 · https://hartvaat.nl/2022/10/04/timing-vroege-versus-late-noac-start-na-ischemisch-cva-bij-af/* The Swedish TIMING trial demonstrated that early NOAC initiation (within 4 days) after acute ischemic stroke in patients with AF was safe and noninferior to delayed start (5-10 days) for the composite of stroke, major bleeding, or death. The results supported a move toward earlier anticoagulation. ## Dapagliflozin in Patients Recently Hospitalized With Heart Failure and Mildly Reduced or Preserved Ejection Fraction. *2022-10-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.07.021 · https://hartvaat.nl/2022/10/04/deliver-dapagliflozine-effectief-bij-recent-gehospitaliseerde-hfpef-patienten/* This DELIVER subanalysis confirmed that dapagliflozin is effective in patients recently hospitalized for heart failure with mildly reduced or preserved ejection fraction, with early benefit seen within weeks of treatment initiation. The data supported in-hospital SGLT2 inhibitor use in HFpEF. ## 2022 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Solution Set Oversight Committee. *2022-10-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.07.006 · https://hartvaat.nl/2022/10/04/2022-acc-expert-consensus-niet-statine-therapieen-voor-ldl-verlaging-bij-ascvd/* The 2022 ACC Expert Consensus updated the decision pathway for nonstatin lipid-lowering therapies, integrating evidence on bempedoic acid and inclisiran alongside ezetimibe and PCSK9 monoclonal antibodies. The document provided practical algorithms for escalating therapy to achieve LDL-cholesterol targets. ## Sex Differences in Atrial Fibrillation Risk: The VITAL Rhythm Study. *2022-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.2825 · https://hartvaat.nl/2022/10/01/sekseverschillen-in-af-risico-vital-rhythm-studie/* The VITAL Rhythm Study confirmed that women have significantly lower AF incidence than men even after adjusting for cardiovascular risk factors, establishing sex as an independent determinant of arrhythmia risk. ## Smartphone Application-Assisted Home Blood Pressure Monitoring Compared With Office and Ambulatory Blood Pressure Monitoring in Patients With Hypertension: the AMUSE-BP Study. *2022-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19685 · https://hartvaat.nl/2022/10/01/smartphone-app-thuisbloeddrukmeting-versus-kantoor-en-ambulante-meting/* This study showed that smartphone app-assisted home blood pressure monitoring provides measurements comparable to ambulatory monitoring, supporting standardized digital home BP assessment as a practical alternative. ## Higher Arm Versus Lower Arm Systolic Blood Pressure and Cardiovascular Outcomes: a Meta-Analysis of Individual Participant Data From the INTERPRESS-IPD Collaboration. *2022-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18921 · https://hartvaat.nl/2022/10/01/bloeddruk-in-hogere-versus-lagere-arm-en-cv-uitkomsten-interpress-ipd-meta-analy/* This individual patient data meta-analysis confirmed that the higher arm blood pressure reading provides better cardiovascular risk prediction, supporting the guideline recommendation to measure blood pressure in both arms and use the higher reading for clinical decisions. ## Do adrenergic alpha-antagonists increase the risk of poor cardiovascular outcomes? A systematic review and meta-analysis. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14012 · https://hartvaat.nl/2022/10/01/alfa-antagonisten-en-cardiovasculaire-uitkomsten-meta-analyse-nuanceert-risico/* This meta-analysis evaluated whether alpha-1 adrenergic antagonists increase cardiovascular risk in heart failure, finding insufficient evidence to confirm the long-held safety concern about these commonly avoided medications. ## Effect of Financial Incentives on Hypertension Control: A Multicenter Randomized Controlled Trial in China. *2022-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19568 · https://hartvaat.nl/2022/10/01/financiele-prikkels-verbeteren-hypertensiecontrole-chinese-rct/* This multicenter Chinese trial showed that financial incentives for hypertensive patients significantly improve blood pressure control, demonstrating that behavioral economic strategies can overcome medication non-adherence. ## Blood-based biomarkers for the prediction of hypertrophic cardiomyopathy prognosis: a systematic review and meta-analysis. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14073 · https://hartvaat.nl/2022/10/01/bloedbiomerkers-voor-prognose-bij-hypertrofische-cardiomyopathie-meta-analyse/* This meta-analysis identified BNP, NT-proBNP, and troponin as reliable prognostic biomarkers in hypertrophic cardiomyopathy, providing a blood-based approach to risk stratification in this genetic heart disease. ## Efficacy and safety of intravenous OPC-61815 compared with oral tolvaptan in patients with congestive heart failure. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14021 · https://hartvaat.nl/2022/10/01/intraveneus-tolvaptan-versus-orale-formulering-bij-congestief-hartfalen/* This phase III trial confirmed the non-inferiority of intravenous tolvaptan versus oral tolvaptan for congestive heart failure, providing a parenteral aquaretic option for patients unable to take oral medications. ## Edge-to-edge percutaneous mitral repair for functional ischaemic and non-ischaemic mitral regurgitation: a systematic review and meta-analysis. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13772 · https://hartvaat.nl/2022/10/01/mitraclip-bij-secundaire-mitralisklepinsufficientie-meta-analyse-ischemisch-vs-n/* This meta-analysis compared MitraClip plus medical therapy versus medical therapy alone for secondary mitral regurgitation, incorporating data from both the positive COAPT and the neutral MITRA-FR to provide a balanced assessment. ## Higher BNP/NT-pro BNP levels stratify prognosis equally well in patients with and without heart failure: a meta-analysis. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14019 · https://hartvaat.nl/2022/10/01/bnp-nt-probnp-stratificeert-prognose-gelijk-met-en-zonder-hartfalen-meta-analyse/* This meta-analysis confirmed that BNP and NT-proBNP levels stratify prognosis equally well in patients with and without heart failure, supporting universal natriuretic peptide measurement for cardiovascular risk assessment. ## Oral iron supplementation in patients with heart failure: a systematic review and meta-analysis. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14020 · https://hartvaat.nl/2022/10/01/orale-ijzersuppletie-bij-hartfalen-systematische-review-en-meta-analyse/* This meta-analysis showed that oral iron supplementation in heart failure with iron deficiency improves iron parameters but does not consistently improve clinical outcomes, supporting the superiority of intravenous over oral iron. ## Exercise haemodynamics in heart failure with preserved ejection fraction: a systematic review and meta-analysis. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13979 · https://hartvaat.nl/2022/10/01/inspanningshemodynamiek-bij-hfpef-systematische-review-en-meta-analyse/* This meta-analysis of exercise right heart catheterization in HFpEF confirmed that exercise-induced pulmonary wedge pressure elevation reliably diagnoses HFpEF, providing hemodynamic benchmarks for this diagnostic gold standard. ## Impact of different training modalities on high-density lipoprotein function in HFpEF patients: a substudy of the OptimEx trial. *2022-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.14032 · https://hartvaat.nl/2022/10/01/verschillende-trainingsvormen-en-hdl-functie-bij-hfpef-optimex-substudie/* This OptimEx substudy showed that exercise training modality (HIIT vs moderate continuous) differentially affects HDL function in HFpEF, with both improving nitric oxide-mediated endothelial function through different mechanisms. ## Acetazolamide in Acute Decompensated Heart Failure with Volume Overload. *2022-09-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2203094 · https://hartvaat.nl/2022/09/29/advor-acetazolamide-bij-acuut-gedecompenseerd-hartfalen-met-volumeoverbelasting/* The ADVOR trial showed that adding intravenous acetazolamide to loop diuretics in patients hospitalized for acute decompensated heart failure significantly improved decongestion success at 3 days compared with placebo. This pragmatic result revived interest in combination diuretic strategies and provided the first large-scale evidence for sequential nephron blockade in acute heart failure. ## Abbreviated Antiplatelet Therapy After Coronary Stenting in Patients With Myocardial Infarction at High Bleeding Risk. *2022-09-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.07.016 · https://hartvaat.nl/2022/09/27/verkorte-antiplaatjestherapie-na-stenting-bij-hoog-bloedingsrisico-en-acs/* This meta-analysis showed that abbreviated antiplatelet therapy (1-3 months DAPT followed by monotherapy) is safe and effective in high-bleeding-risk patients with ACS after coronary stenting, reducing bleeding without increasing ischemic events. ## Randomized Trial of Left Bundle Branch vs Biventricular Pacing for Cardiac Resynchronization Therapy. *2022-09-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.07.019 · https://hartvaat.nl/2022/09/27/linkerbundeltakpacing-versus-biventriculaire-pacing-voor-crt-gerandomiseerde-tri/* This first randomized trial comparing left bundle branch area pacing with biventricular pacing for cardiac resynchronization therapy showed that LBBP achieved comparable or superior echocardiographic response with a simpler implantation procedure. The results positioned LBBP as a viable CRT alternative. ## Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. *2022-09-27 · JAMA · https://doi.org/10.1001/jama.2022.16197 · https://hartvaat.nl/2022/09/27/momentum-3-vijfjaarsresultaten-heartmate-3-versus-axiale-lvad/* The 5-year MOMENTUM 3 results confirmed sustained superiority of the HeartMate 3 over the HeartMate II, with significantly better event-free survival and fewer device-related complications. These long-term data solidified the HeartMate 3 as the definitive standard in durable mechanical circulatory support. ## Iron Deficiency in Heart Failure and Effect of Dapagliflozin: Findings From DAPA-HF. *2022-09-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.060511 · https://hartvaat.nl/2022/09/27/ijzerdeficientie-bij-hartfalen-en-het-effect-van-dapagliflozine-dapa-hf/* This DAPA-HF analysis showed that iron deficiency is prevalent in HFrEF and associated with worse outcomes, but that dapagliflozin's heart failure benefit is independent of iron status, not mediating its protective effect through iron metabolism. ## Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis. *2022-09-26 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2022-321332 · https://hartvaat.nl/2022/09/26/zoutvervangers-verminderen-cardiovasculaire-events-systematische-review/* This systematic review and meta-analysis confirmed that potassium-enriched salt substitutes lower blood pressure and reduce cardiovascular events and all-cause mortality, reinforcing the SSaSS results and supporting salt substitution as a scalable public health intervention. ## Smartphone detection of atrial fibrillation using photoplethysmography: a systematic review and meta-analysis. *2022-09-26 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320417 · https://hartvaat.nl/2022/09/26/smartphone-detectie-van-af-via-fotoplethysmografie-meta-analyse/* This meta-analysis confirmed that smartphone cameras using photoplethysmography detect atrial fibrillation with high sensitivity and specificity, supporting the potential of consumer smartphone technology as a scalable AF screening tool. ## Glycemia Reduction in Type 2 Diabetes - Microvascular and Cardiovascular Outcomes. *2022-09-22 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2200436 · https://hartvaat.nl/2022/09/22/grade-vergelijking-glucoseverlagende-middelen-op-microvasculaire-en-cv-uitkomste/* The GRADE trial compared four glucose-lowering agents added to metformin over 5 years and found that liraglutide and insulin glargine were most durable for glycemic control, while liraglutide had the most favorable cardiovascular profile. The results provided comparative effectiveness data to guide second-line agent selection in type 2 diabetes. ## Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. *2022-09-22 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2206286 · https://hartvaat.nl/2022/09/22/deliver-dapagliflozine-effectief-bij-hfmref-en-hfpef/* The DELIVER trial demonstrated that dapagliflozin significantly reduced the composite of worsening heart failure or cardiovascular death in patients with heart failure and an ejection fraction above 40%, regardless of diabetes status. Together with EMPEROR-Preserved, this confirmed the benefit of SGLT2 inhibitors across the full ejection fraction spectrum. ## Riociguat in pulmonary hypertension and heart failure with preserved ejection fraction: the haemoDYNAMIC trial. *2022-09-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac389 · https://hartvaat.nl/2022/09/21/riociguat-bij-pulmonale-hypertensie-en-hfpef-haemodynamic-trial/* The haemoDYNAMIC trial showed that riociguat improves hemodynamic parameters in patients with pulmonary hypertension and HFpEF, exploring sGC stimulation as a targeted approach for the pulmonary vascular component of this challenging phenotype. ## Sacubitril/Valsartan and Frailty in Patients With Heart Failure and Preserved Ejection Fraction. *2022-09-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.06.037 · https://hartvaat.nl/2022/09/20/sacubitril-valsartan-en-frailteit-bij-hfpef-paragon-hf-analyse/* This PARAGON-HF analysis showed that sacubitril-valsartan is effective in HFpEF regardless of frailty status, with frail patients potentially deriving greater absolute benefit due to their higher baseline event rates. ## Randomized, Placebo-Controlled Phase 2b Study to Evaluate the Safety and Efficacy of Recombinant Human Lecithin Cholesterol Acyltransferase in Acute ST-Segment-Elevation Myocardial Infarction: Results of REAL-TIMI 63B. *2022-09-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059325 · https://hartvaat.nl/2022/09/20/recombinant-lcat-bij-acuut-stemi-fase-2b-trial/* This phase 2b trial of recombinant human LCAT in acute STEMI tested whether enhancing HDL function through enzyme augmentation provides cardioprotection in the acute MI setting. ## Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines: Comparisons, Reflections, and Recommendations. *2022-09-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.07.005 · https://hartvaat.nl/2022/09/20/harmonisatie-van-acc-aha-en-esc-esh-bloeddrukrichtlijnen/* This harmonization document analyzed the similarities and differences between the ACC/AHA and ESC/ESH hypertension guidelines, highlighting converging evidence on treatment initiation thresholds and targets while acknowledging remaining disagreements on classification and risk assessment. ## Rivaroxaban in Rheumatic Heart Disease-Associated Atrial Fibrillation. *2022-09-15 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2209051 · https://hartvaat.nl/2022/09/15/invictus-rivaroxaban-versus-warfarine-bij-reumatische-hartziekte-en-af/* The INVICTUS trial showed that rivaroxaban was inferior to warfarin for preventing cardiovascular events in patients with rheumatic heart disease-associated atrial fibrillation, with higher rates of stroke, systemic embolism, and death. This landmark negative result confirmed that DOACs cannot replace warfarin in valvular AF due to rheumatic heart disease. ## Polypill Strategy in Secondary Cardiovascular Prevention. *2022-09-15 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2208275 · https://hartvaat.nl/2022/09/15/polypill-voor-secundaire-cardiovasculaire-preventie-secure-trial-in-nejm/* The SECURE trial demonstrated that a cardiovascular polypill containing aspirin, ramipril, and atorvastatin reduced major adverse cardiovascular events by 24% compared with separate medications in patients after myocardial infarction. The benefit was attributed to improved adherence, validating the polypill as a practical secondary prevention strategy. ## Early Rhythm Control in Patients With Atrial Fibrillation and High Comorbidity Burden. *2022-09-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.060274 · https://hartvaat.nl/2022/09/13/east-afnet4-vroege-ritmecontrole-effectief-ook-bij-hoge-comorbiditeit/* This EAST-AFNET4 subanalysis showed that early rhythm control reduces cardiovascular events even in AF patients with high comorbidity burden, including those with heart failure, diabetes, and chronic kidney disease. The benefit was not attenuated by comorbidity complexity. ## Effect of statin therapy on muscle symptoms: an individual participant data meta-analysis of large-scale, randomised, double-blind trials. *2022-09-10 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)01545-8 · https://hartvaat.nl/2022/09/10/statines-en-spiersymptomen-lancet-ipd-meta-analyse-ontkracht-breed-probleem/* This individual participant data meta-analysis of large-scale, double-blind statin trials in the Lancet showed that statins cause only a small excess of muscle symptoms (about 11 per 1,000 patients over 5 years), with most patient-reported muscle complaints being attributable to the nocebo effect. The findings provide robust reassurance for clinicians managing statin-associated myalgia concerns. ## Routine Functional Testing or Standard Care in High-Risk Patients after PCI. *2022-09-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2208335 · https://hartvaat.nl/2022/09/08/post-pci-routine-functionele-testen-versus-standaardzorg-na-pci-bij-hoog-risico/* The POST-PCI trial demonstrated that routine functional testing after PCI in high-risk patients did not improve clinical outcomes compared with standard care at 2 years. The results argued against routine surveillance testing as a post-PCI follow-up strategy. ## Aortic stenosis in homozygous familial hypercholesterolaemia: a paradigm shift over a century. *2022-09-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehac339 · https://hartvaat.nl/2022/09/07/aortastenose-bij-homozygote-familiaire-hypercholesterolemie-paradigmaverschuivin/* This review described the paradigm shift in homozygous familial hypercholesterolemia, where improved lipid-lowering therapy has transformed early atherosclerotic death into longer survival complicated by progressive aortic stenosis from lipid deposition. ## Prevalence of statin intolerance: a meta-analysis. *2022-09-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehac015 · https://hartvaat.nl/2022/09/07/prevalentie-van-statine-intolerantie-meta-analyse-nuanceert-het-probleem/* This meta-analysis estimated that true statin intolerance affects 7-29% of patients depending on the definition used, with nocebo-confirmed intolerance rates being much lower. The data highlighted the gap between perceived and actual statin intolerance and supported rechallenge strategies. ## Effect of Clinical Decision Support With Audit and Feedback on Prevention of Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Randomized Clinical Trial. *2022-09-06 · JAMA · https://doi.org/10.1001/jama.2022.13382 · https://hartvaat.nl/2022/09/06/klinisch-beslisondersteuning-vermindert-acute-nierschade-bij-coronairangiografie/* This randomized trial showed that clinical decision support with audit and feedback reduces contrast-associated acute kidney injury during coronary angiography and PCI, demonstrating the effectiveness of automated safety systems. ## SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. *2022-09-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)01429-5 · https://hartvaat.nl/2022/09/03/sglt2-remmers-bij-hartfalen-mega-meta-analyse-van-vijf-grote-trials/* This comprehensive meta-analysis of five major SGLT2 inhibitor trials in heart failure (DAPA-HF, EMPEROR-Reduced, DELIVER, EMPEROR-Preserved, SOLOIST-WHF) confirmed that SGLT2 inhibition reduces heart failure hospitalization and cardiovascular death across the full range of ejection fraction. The analysis provided definitive class-level evidence supporting their use in all heart failure phenotypes. ## Fractional Flow Reserve or Intravascular Ultrasonography to Guide PCI. *2022-09-01 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2201546 · https://hartvaat.nl/2022/09/01/flavour-ffr-versus-ivus-voor-pci-beslissingen-bij-coronairlijden/* The FLAVOUR trial demonstrated that FFR-guided PCI was noninferior to IVUS-guided PCI for the composite of death, MI, or revascularization at 24 months in patients with intermediate coronary stenoses. The results validated both physiological and anatomical guidance strategies as acceptable approaches. ## The collateral damage of COVID-19 to cardiovascular services: a meta-analysis. *2022-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac227 · https://hartvaat.nl/2022/09/01/collaterale-schade-van-covid-19-aan-cardiovasculaire-zorg-meta-analyse/* This meta-analysis quantified the collateral damage of COVID-19 on cardiovascular services, showing significant reductions in ACS hospitalizations, prolonged door-to-balloon times, and increased cardiovascular mortality during pandemic waves. ## Efficacy and Safety of Dapagliflozin According to Background Use of Cardiovascular Medications in Patients With Type 2 Diabetes: A Prespecified Secondary Analysis of a Randomized Clinical Trial. *2022-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.2006 · https://hartvaat.nl/2022/09/01/dapagliflozine-effectief-ongeacht-cv-achtergrondmedicatie-declare-subanalyse/* This DECLARE-TIMI 58 subanalysis confirmed that dapagliflozin's cardiovascular and renal benefits in type 2 diabetes are consistent regardless of background cardiovascular medication use, supporting additive benefit on top of standard therapy. ## Cardiopulmonary exercise testing and efficacy of percutaneous coronary intervention: a substudy of the ORBITA trial. *2022-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac260 · https://hartvaat.nl/2022/09/01/orbita-substudie-inspanningstesten-en-pci-effectiviteit/* This ORBITA substudy showed that cardiopulmonary exercise test parameters can predict the symptomatic response to PCI, establishing CPET as a functional tool for selecting patients most likely to benefit from coronary intervention. ## Timing of invasive strategy in non-ST-elevation acute coronary syndrome: a meta-analysis of randomized controlled trials. *2022-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac213 · https://hartvaat.nl/2022/09/01/timing-van-invasieve-strategie-bij-nste-acs-meta-analyse-van-rct-s/* This meta-analysis of randomized trials on the timing of invasive strategy in NSTE-ACS found that very early intervention (within 12 hours) may benefit high-risk patients but does not improve outcomes universally, supporting risk-stratified timing decisions. ## Predictive role of atrial fibrillation in cognitive decline: a systematic review and meta-analysis of 2.8 million individuals. *2022-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac003 · https://hartvaat.nl/2022/09/01/af-voorspelt-cognitieve-achteruitgang-meta-analyse-van-2-8-miljoen-personen/* This large meta-analysis of 2.8 million persons confirmed that atrial fibrillation is an independent risk factor for cognitive decline and dementia, with the association persisting even in anticoagulated patients, suggesting mechanisms beyond cardioembolism. ## Systolic Blood Pressure and Effects of Screening for Atrial Fibrillation With Long-Term Continuous Monitoring (a LOOP Substudy). *2022-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19333 · https://hartvaat.nl/2022/09/01/bloeddruk-beinvloedt-opbrengst-van-af-screening-loop-substudie/* This LOOP trial substudy showed that higher systolic blood pressure increases the detection rate of AF during long-term continuous monitoring, informing the selection of patients most likely to benefit from intensive arrhythmia surveillance. ## Influence of Obstructive Sleep Apnea Severity on Muscle Sympathetic Nerve Activity and Blood Pressure: a Systematic Review and Meta-Analysis. *2022-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19288 · https://hartvaat.nl/2022/09/01/obstructief-slaapapneu-sympathische-activiteit-en-bloeddruk-meta-analyse/* This meta-analysis established a dose-response relationship between obstructive sleep apnea severity and both sympathetic nerve activity and blood pressure, supporting the neurogenic mechanism linking OSA to hypertension. ## Blood Pressure Intervention and Control in SPRINT. *2022-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17233 · https://hartvaat.nl/2022/09/01/bloeddrukinterventie-en-controle-in-sprint-nader-geanalyseerd/* This detailed SPRINT analysis described the pharmacological strategy used to achieve intensive blood pressure control, showing that on average 2.8 antihypertensives were needed versus 1.8 for standard treatment. ## Management and Outcomes of Primary Aldosteronism in Pregnancy: A Systematic Review. *2022-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18858 · https://hartvaat.nl/2022/09/01/primair-aldosteronisme-in-de-zwangerschap-systematische-review/* This systematic review documented the diagnostic and therapeutic challenges of primary aldosteronism during pregnancy, providing practical guidance for managing this uncommon but serious gestational condition. ## Biomarker Prediction of Complex Coronary Revascularization Procedures in the FOURIER Trial. *2022-08-30 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.05.051 · https://hartvaat.nl/2022/08/30/biomarkers-voorspellen-complexe-coronaire-revascularisatie-in-fourier/* This FOURIER substudy showed that cardiovascular biomarkers (NT-proBNP, troponin, IL-6) predict the need for complex coronary revascularization, informing risk stratification beyond traditional clinical variables. ## Routine Pressure Wire Assessment Versus Conventional Angiography in the Management of Patients With Coronary Artery Disease: The RIPCORD 2 Trial. *2022-08-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057793 · https://hartvaat.nl/2022/08/30/ripcord-2-routinematige-ffr-meting-versus-conventionele-angiografie/* The RIPCORD 2 trial showed that routine FFR measurement during diagnostic coronary angiography frequently changes the management plan but does not improve clinical outcomes compared with conventional angiography-guided decision-making. ## Apolipoprotein B, Residual Cardiovascular Risk After Acute Coronary Syndrome, and Effects of Alirocumab. *2022-08-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057807 · https://hartvaat.nl/2022/08/30/apob-en-residueel-cv-risico-na-acs-effect-van-alirocumab/* This ODYSSEY OUTCOMES analysis showed that apolipoprotein B is a stronger predictor of residual cardiovascular risk after ACS than LDL cholesterol, and that alirocumab's benefit correlates more closely with apoB reduction, supporting apoB as a treatment target. ## Empagliflozin for Heart Failure With Preserved Left Ventricular Ejection Fraction With and Without Diabetes. *2022-08-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059785 · https://hartvaat.nl/2022/08/30/empagliflozine-bij-hfpef-consistent-effect-met-en-zonder-diabetes/* This EMPEROR-Preserved subanalysis confirmed that empagliflozin's benefit on heart failure outcomes in HFpEF is consistent regardless of diabetes status, extending the evidence for SGLT2 inhibitors as a universal heart failure therapy beyond glycemic management. ## Aflibercept Monotherapy or Bevacizumab First for Diabetic Macular Edema. *2022-08-25 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2204225 · https://hartvaat.nl/2022/08/25/aflibercept-versus-bevacizumab-eerst-bij-diabetisch-macula-oedeem/* This NEJM trial compared aflibercept monotherapy with a stepped approach starting with bevacizumab for diabetic macular edema, evaluating the cost-effectiveness of different anti-VEGF treatment strategies for this common diabetic complication. ## Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. *2022-08-23 · JAMA · https://doi.org/10.1001/jama.2022.12138 · https://hartvaat.nl/2022/08/23/uspstf-evidence-review-statines-voor-primaire-cv-preventie-geactualiseerd/* This updated USPSTF evidence review reaffirmed that statin use for primary cardiovascular prevention is associated with reduced cardiovascular events and mortality, supporting continued recommendation for statin therapy in adults at elevated 10-year CVD risk. ## Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. *2022-08-23 · JAMA · https://doi.org/10.1001/jama.2022.13044 · https://hartvaat.nl/2022/08/23/uspstf-aanbeveling-statinegebruik-voor-primaire-cardiovasculaire-preventie/* The 2022 USPSTF reaffirmation recommended statin use for primary cardiovascular prevention in adults aged 40-75 with at least one CVD risk factor and a 10-year CVD risk of 10% or greater, maintaining the 2016 recommendation with updated evidence review. ## Impact of Medication Nonadherence in a Clinical Trial of Dual Antiplatelet Therapy. *2022-08-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.04.065 · https://hartvaat.nl/2022/08/23/impact-van-therapieontrouw-op-duale-antiplaatjestherapie-in-klinische-trial/* This TWILIGHT analysis showed that medication non-adherence in a clinical trial of DAPT after PCI is common and significantly impacts outcomes, highlighting adherence as a critical determinant of antiplatelet therapy effectiveness. ## Assessment of Clinical Worsening End Points as a Surrogate for Mortality in Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. *2022-08-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.058635 · https://hartvaat.nl/2022/08/23/klinische-verslechtering-als-surrogaat-voor-mortaliteit-bij-pulmonale-arteriele-/* This meta-analysis validated clinical worsening as a surrogate endpoint for mortality in PAH trials, supporting its use as a composite outcome in drug development programs for pulmonary arterial hypertension. ## Cost-Effectiveness of Catheter Ablation Versus Antiarrhythmic Drug Therapy in Atrial Fibrillation: The CABANA Randomized Clinical Trial. *2022-08-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.058575 · https://hartvaat.nl/2022/08/16/cabana-catheterablatie-bij-af-is-kosteneffectief-vergeleken-met-antiaritmica/* This CABANA cost-effectiveness analysis showed that catheter ablation for AF is cost-effective compared with antiarrhythmic drug therapy, despite the neutral primary intention-to-treat result, driven by quality-of-life improvements and reduced long-term healthcare utilization. ## Obesity and effects of dapagliflozin on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus in the DECLARE-TIMI 58 trial. *2022-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehab530 · https://hartvaat.nl/2022/08/14/obesitas-en-dapagliflozine-bij-type-2-diabetes-declare-timi-58-subanalyse/* This DECLARE-TIMI 58 subanalysis showed that dapagliflozin's cardiovascular and renal benefits are consistent across the BMI spectrum in type 2 diabetes, supporting SGLT2 inhibitor use regardless of obesity status. ## Prevalence, incidence and survival of heart failure: a systematic review. *2022-08-11 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320131 · https://hartvaat.nl/2022/08/11/prevalentie-incidentie-en-overleving-bij-hartfalen-wereldwijde-systematische-rev/* This comprehensive systematic review documented the global epidemiology of heart failure, finding that prevalence ranges from 1-3% in the general population and exceeds 10% in those over 70, with improving survival but persistently high morbidity. ## Association of Dual Antiplatelet Therapy With Ticagrelor With Vein Graft Failure After Coronary Artery Bypass Graft Surgery: A Systematic Review and Meta-analysis. *2022-08-09 · JAMA · https://doi.org/10.1001/jama.2022.11966 · https://hartvaat.nl/2022/08/09/ticagrelor-dapt-en-veneuze-graftfalen-na-cabg-systematische-review/* This meta-analysis evaluated the effect of ticagrelor-based dual antiplatelet therapy on saphenous vein graft failure after CABG, assessing whether more potent platelet inhibition improves graft patency. ## Sustained-Release Ivabradine Hemisulfate in Patients With Systolic Heart Failure. *2022-08-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.05.027 · https://hartvaat.nl/2022/08/09/vertraagde-afgifteformulering-van-ivabradine-bij-systolisch-hartfalen/* This study of a sustained-release ivabradine formulation in systolic heart failure demonstrated that once-daily dosing achieves comparable heart rate reduction to the twice-daily formulation, potentially improving adherence. ## Renal and Vascular Effects of Combined SGLT2 and Angiotensin-Converting Enzyme Inhibition. *2022-08-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059150 · https://hartvaat.nl/2022/08/09/renale-en-vasculaire-effecten-van-gecombineerde-sglt2-en-ace-remming/* This mechanistic study showed that empagliflozin combined with ramipril provides additive renal and vascular protective effects in type 2 diabetes, supporting the rationale for combining SGLT2 inhibitors with RAAS inhibitors for cardiorenal protection. ## Initial Decline (Dip) in Estimated Glomerular Filtration Rate After Initiation of Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction: Insights From DAPA-HF. *2022-08-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.058910 · https://hartvaat.nl/2022/08/09/initiele-egfr-dip-na-start-dapagliflozine-bij-hfref-dapa-hf-analyse/* This DAPA-HF post-hoc analysis showed that the initial eGFR decline ('dip') commonly seen after dapagliflozin initiation is not associated with worse clinical outcomes and is followed by a slower long-term rate of kidney function decline. The finding provided reassurance about the hemodynamic kidney effects of SGLT2 inhibitors. ## Effects of Randomized Treatment With Icosapent Ethyl and a Mineral Oil Comparator on Interleukin-1β, Interleukin-6, C-Reactive Protein, Oxidized Low-Density Lipoprotein Cholesterol, Homocysteine, Lipoprotein(a), and Lipoprotein-Associated Phospholipase A2: A REDUCE-IT Biomarker Substudy. *2022-08-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059410 · https://hartvaat.nl/2022/08/02/reduce-it-icosapent-ethyl-vermindert-inflammatiemarkers/* This REDUCE-IT substudy demonstrated that icosapent ethyl significantly reduces inflammatory biomarkers (IL-1β, IL-6, CRP) and oxidized LDL compared with mineral oil placebo, suggesting that anti-inflammatory effects contribute to the cardiovascular benefit beyond triglyceride lowering. ## Rivaroxaban Monotherapy vs Combination Therapy With Antiplatelets on Total Thrombotic and Bleeding Events in Atrial Fibrillation With Stable Coronary Artery Disease: A Post Hoc Secondary Analysis of the AFIRE Trial. *2022-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.1561 · https://hartvaat.nl/2022/08/01/rivaroxaban-monotherapie-versus-combinatie-met-plaatjesremmers-bij-af-en-coronai/* This study showed that rivaroxaban monotherapy provides comparable protection against thrombotic events with less bleeding than combination therapy with antiplatelets in AF patients with stable coronary disease, supporting anticoagulant monotherapy after the initial period. ## Effects of a Liquefied Petroleum Gas Stove Intervention on Gestational Blood Pressure: Intention-to-Treat and Exposure-Response Findings From the HAPIN Trial. *2022-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19362 · https://hartvaat.nl/2022/08/01/schone-kookbrandstof-en-bloeddruk-tijdens-zwangerschap-hapin-trial/* The HAPIN trial tested whether replacing biomass fuel with LPG cooking stoves improves gestational blood pressure, exploring household air pollution reduction as a modifiable environmental risk factor for pregnancy hypertension. ## Effects of Ramipril on Biomarkers of Endothelial Dysfunction and Inflammation in Hypertensive Children on Maintenance Hemodialysis: the SEARCH Randomized Placebo-Controlled Trial. *2022-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19312 · https://hartvaat.nl/2022/08/01/ramipril-bij-hypertensieve-kinderen-op-hemodialyse-search-trial/* The SEARCH trial showed that ramipril improves endothelial dysfunction and inflammation biomarkers in hypertensive children on hemodialysis, supporting RAAS inhibition for vascular protection in the pediatric renal population. ## Insights From a Large-Scale Whole-Genome Sequencing Study of Systolic Blood Pressure, Diastolic Blood Pressure, and Hypertension. *2022-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.122.19324 · https://hartvaat.nl/2022/08/01/hele-genoomsequencing-onthult-nieuwe-bloeddruk-loci/* This large-scale whole-genome sequencing study identified novel genetic loci associated with blood pressure and hypertension, including rare coding variants that provide insights into blood pressure biology and potential drug targets. ## Cardiorenal syndrome and the association with fitness: Data from a telerehabilitation randomized clinical trial. *2022-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13985 · https://hartvaat.nl/2022/08/01/cardiorenaal-syndroom-en-fitheid-bij-hartfalen-telerevalidatie-trial/* This telerehabilitation trial data showed that cardiorenal syndrome is strongly associated with reduced cardiorespiratory fitness in chronic heart failure, linking combined cardiac and renal impairment to exercise intolerance. ## Empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure. *2022-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13955 · https://hartvaat.nl/2022/08/01/empagliflozine-vermindert-nierletselmarkers-bij-acuut-hartfalen/* This exploratory study showed that empagliflozin reduces markers of acute kidney injury in patients with acute decompensated heart failure, suggesting renal protective effects of SGLT2 inhibition despite initial eGFR dip. ## Sex differences in efficacy of pharmacological therapies in heart failure with reduced ejection fraction: a meta-analysis. *2022-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13974 · https://hartvaat.nl/2022/08/01/sekseverschillen-in-effectiviteit-van-hartfalenmedicatie-meta-analyse/* This meta-analysis identified important sex differences in the efficacy of pharmacological therapies for HFrEF, with some agents (particularly ACE inhibitors) showing attenuated benefit in women compared with men, warranting sex-stratified prescribing approaches. ## Impact of B-lines-guided intensive heart failure management on outcome of discharged heart failure patients with residual B-lines. *2022-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13988 · https://hartvaat.nl/2022/08/01/b-lijnen-geleide-hartfalenbehandeling-verbetert-uitkomsten-na-ontslag/* This study showed that B-lines-guided intensive heart failure management using lung ultrasound improves outcomes in discharged HF patients with residual pulmonary congestion, supporting imaging-guided decongestion monitoring. ## Home-based cardiac rehabilitation using information and communication technology for heart failure patients with frailty. *2022-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13934 · https://hartvaat.nl/2022/08/01/thuisrevalidatie-met-ict-voor-fragiele-hartfalenpatienten/* This study demonstrated the feasibility and safety of ICT-supported home-based cardiac rehabilitation for frail heart failure patients, showing that technology can overcome the access barriers that prevent vulnerable patients from participating in exercise programs. ## Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-label, non-inferiority trial. *2022-07-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00916-3 · https://hartvaat.nl/2022/07/30/matige-statine-plus-ezetimibe-versus-hoge-dosis-statine-bij-coronairlijden-lance/* This Lancet long-term study demonstrated that moderate-intensity statin combined with ezetimibe was equally effective as high-intensity statin monotherapy for preventing cardiovascular events, with fewer adverse effects. The results supported combination therapy as an alternative to high-dose statins. ## Safety of proprotein convertase subtilisin/kexin 9 inhibitors: a systematic review and meta-analysis. *2022-07-27 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320556 · https://hartvaat.nl/2022/07/27/veiligheid-van-pcsk9-remmers-systematische-review-en-meta-analyse/* This comprehensive meta-analysis confirmed the favorable safety profile of PCSK9 inhibitors, finding no significant increase in serious adverse events, diabetes, neurocognitive effects, or cancer with evolocumab and alirocumab therapy. ## Antihypertensive drug effects on long-term blood pressure: an individual-level data meta-analysis of randomised clinical trials. *2022-07-27 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320171 · https://hartvaat.nl/2022/07/27/langetermijneffect-van-antihypertensiva-op-bloeddruk-meta-analyse-op-individueel/* This individual-level meta-analysis of antihypertensive drug effects on long-term blood pressure found that sustained blood pressure reduction beyond the initial treatment period depends on continued drug therapy, with blood pressure returning toward baseline after discontinuation. ## Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Disease Risk Factors: US Preventive Services Task Force Recommendation Statement. *2022-07-26 · JAMA · https://doi.org/10.1001/jama.2022.10951 · https://hartvaat.nl/2022/07/26/uspstf-gedragsinterventies-voor-gezonde-leefstijl-bij-cardiovasculaire-preventie/* This USPSTF systematic review confirmed that behavioral counseling on diet and physical activity produces modest but consistent cardiovascular risk factor improvements in adults. The evidence supported population-level lifestyle counseling as a component of cardiovascular prevention. ## Effects of Cuisine-Based Chinese Heart-Healthy Diet in Lowering Blood Pressure Among Adults in China: Multicenter, Single-Blind, Randomized, Parallel Controlled Feeding Trial. *2022-07-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059045 · https://hartvaat.nl/2022/07/26/chinees-hartgezond-dieet-verlaagt-bloeddruk-effectief-gerandomiseerde-trial/* This multicenter trial developed and tested an evidence-based heart-healthy diet adapted to Chinese cuisine that significantly lowered blood pressure. The culturally tailored dietary approach addresses the cardiovascular needs of the world's largest cuisine population. ## Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF). *2022-07-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059038 · https://hartvaat.nl/2022/07/26/empag-hf-vroege-empagliflozine-bij-acuut-hartfalen-verbetert-diurese/* The EMPAG-HF trial demonstrated that early empagliflozin initiation in acute decompensated heart failure significantly increased urinary output without worsening kidney function. The results supported SGLT2 inhibitors as a useful adjunct to loop diuretics for decongestion. ## Effects of Empagliflozin on Symptoms, Physical Limitations, and Quality of Life in Patients Hospitalized for Acute Heart Failure: Results From the EMPULSE Trial. *2022-07-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059725 · https://hartvaat.nl/2022/07/26/empulse-empagliflozine-verbetert-symptomen-en-kwaliteit-van-leven-bij-acuut-hart/* The EMPULSE trial demonstrated that empagliflozin initiated during hospitalization for acute heart failure significantly improved a hierarchical composite of death, heart failure events, and symptoms compared with placebo. The results support in-hospital initiation of SGLT2 inhibitors in acute heart failure. ## Does isolation of the left atrial posterior wall using cryoballoon ablation improve clinical outcomes in patients with persistent atrial fibrillation? A prospective randomized controlled trial. *2022-07-21 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac005 · https://hartvaat.nl/2022/07/21/posterior-wand-isolatie-met-cryoballon-bij-persisterend-af-meerwaarde-onderzocht/* This randomized trial tested whether adding posterior wall isolation to cryoballoon-based PVI improves outcomes in persistent AF, finding no significant incremental benefit from this additional ablation target. ## Long-term clinical impact of permanent pacemaker implantation in patients undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis. *2022-07-21 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euac008 · https://hartvaat.nl/2022/07/21/permanente-pacemaker-na-tavi-langetermijneffect-op-klinische-uitkomsten/* This meta-analysis confirmed that permanent pacemaker implantation after TAVR is associated with higher long-term mortality and more heart failure hospitalizations, highlighting the importance of minimizing conduction complications during transcatheter valve procedures. ## Effect of Omecamtiv Mecarbil on Exercise Capacity in Chronic Heart Failure With Reduced Ejection Fraction: The METEORIC-HF Randomized Clinical Trial. *2022-07-19 · JAMA · https://doi.org/10.1001/jama.2022.11016 · https://hartvaat.nl/2022/07/19/meteoric-hf-omecamtiv-mecarbil-verbetert-inspanningscapaciteit-niet-bij-hfref/* The METEORIC-HF trial showed that omecamtiv mecarbil did not improve exercise capacity in patients with HFrEF, despite its positive effects on heart failure events in GALACTIC-HF. The disconnect between clinical outcomes and functional capacity measures remains unexplained. ## Comparative effectiveness of ventricular tachycardia ablation vs. escalated antiarrhythmic drug therapy by location of myocardial infarction: a sub-study of the VANISH trial. *2022-07-15 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab298 · https://hartvaat.nl/2022/07/15/vt-ablatie-versus-antiaritmica-bij-myocardinfarct-locatie-maakt-uit/* This VANISH substudy showed that the comparative effectiveness of VT ablation versus escalated antiarrhythmic drugs varies by infarct location, with anterior infarcts potentially responding differently to ablation than inferior infarcts. ## Worldwide trends in oral anticoagulant use in patients with atrial fibrillation from 2010 to 2018: a systematic review and meta-analysis. *2022-07-15 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab303 · https://hartvaat.nl/2022/07/15/wereldwijde-trends-in-orale-antistollingsgebruik-bij-af-2010-2018/* This systematic review documented the worldwide shift from vitamin K antagonists to NOACs for atrial fibrillation between 2010 and 2018, showing substantial geographic variation in adoption rates and overall DOAC market penetration. ## Individualized or fixed approach to pulmonary vein isolation utilizing the fourth-generation cryoballoon in patients with paroxysmal atrial fibrillation: the randomized INDI-FREEZE trial. *2022-07-15 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab305 · https://hartvaat.nl/2022/07/15/geindividualiseerde-versus-standaard-cryoballonablatie-bij-paroxysmaal-af/* This randomized trial compared individualized cryoballoon dosing with a standardized freeze protocol for AF ablation, finding comparable outcomes and supporting both approaches as acceptable energy delivery strategies. ## Long-term outcome of targeted therapy of underlying conditions in patients with early persistent atrial fibrillation and heart failure: data of the RACE 3 trial. *2022-07-15 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab270 · https://hartvaat.nl/2022/07/15/race-3-langetermijnresultaten-gerichte-behandeling-bij-vroeg-persisterend-af-en-/* Long-term RACE 3 follow-up showed that targeted therapy of underlying conditions (obesity, physical inactivity, hypertension) in patients with early persistent AF and heart failure maintains sinus rhythm better than usual care over extended follow-up. ## The GUIDE-HF trial of pulmonary artery pressure monitoring in heart failure: impact of the COVID-19 pandemic. *2022-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehac114 · https://hartvaat.nl/2022/07/14/guide-hf-en-de-impact-van-covid-19-op-hartfalenuitkomsten/* This GUIDE-HF analysis demonstrated that the COVID-19 pandemic significantly influenced heart failure event rates, confounding the trial's primary results and highlighting the importance of accounting for pandemic effects in contemporary cardiovascular trial interpretation. ## Atrial fibrillation following transcatheter atrial septal defect closure: a systematic review and meta-analysis. *2022-07-13 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319794 · https://hartvaat.nl/2022/07/13/atriumfibrilleren-na-transcatheter-asd-sluiting-systematische-review/* This meta-analysis showed that new-onset AF is a relevant complication after transcatheter closure of atrial septal defects, informing the follow-up monitoring and anticoagulation considerations after ASD device closure. ## Frailty Status Modifies the Efficacy of Exercise Training Among Patients With Chronic Heart Failure and Reduced Ejection Fraction: An Analysis From the HF-ACTION Trial. *2022-07-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059983 · https://hartvaat.nl/2022/07/12/frailteit-beinvloedt-effect-van-inspanningstraining-bij-hartfalen-hf-action-anal/* This HF-ACTION analysis showed that frail patients with HFrEF derive greater absolute benefit from exercise training than non-frail patients, supporting exercise rehabilitation as particularly important for the most vulnerable heart failure population. ## Deep Lipidomics in Human Plasma: Cardiometabolic Disease Risk and Effect of Dietary Fat Modulation. *2022-07-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056805 · https://hartvaat.nl/2022/07/05/deep-lipidomics-cardiometabool-risico-en-effect-van-voedingsvet/* This deep lipidomics analysis identified specific lipid species associated with cardiometabolic disease risk that change with dietary fat modulation, advancing precision nutrition through molecular lipid profiling. ## Apixaban or Warfarin and Aspirin or Placebo After Acute Coronary Syndrome or Percutaneous Coronary Intervention in Patients With Atrial Fibrillation and Prior Stroke: A Post Hoc Analysis From the AUGUSTUS Trial. *2022-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.1166 · https://hartvaat.nl/2022/07/01/augustus-analyse-apixaban-versus-warfarine-bij-af-na-acs-of-pci/* This AUGUSTUS subanalysis confirmed that apixaban versus warfarin reduces cerebrovascular ischemic events and major bleeding in AF patients with recent ACS or PCI, reinforcing the preference for DOAC-based antithrombotic strategies. ## Management of Acute Coronary Syndromes in Patients in Rural Australia: The MORACS Randomized Clinical Trial. *2022-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.1188 · https://hartvaat.nl/2022/07/01/behandeling-van-acuut-coronair-syndroom-in-ruraal-australie-moracs-trial/* The MORACS trial tested telementored ECG interpretation for STEMI management in rural Australia, evaluating whether remote specialist guidance improves the quality of care for acute MI in geographically isolated settings. ## Twenty-Four-Hour Pulsatile Hemodynamics Predict Brachial Blood Pressure Response to Renal Denervation in the SPYRAL HTN-OFF MED Trial. *2022-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18641 · https://hartvaat.nl/2022/07/01/pulsatiele-hemodynamiek-voorspelt-bloeddrukrespons-op-renale-denervatie/* This SPYRAL HTN-OFF MED analysis showed that 24-hour pulsatile hemodynamic parameters predict the blood pressure response to renal denervation, enabling individualized patient selection for device-based therapy. ## High-sensitivity cardiac troponin and the diagnosis of myocardial infarction in patients with kidney impairment. *2022-07-01 · Kidney international · https://doi.org/10.1016/j.kint.2022.02.019 · https://hartvaat.nl/2022/07/01/hoog-sensitief-troponine-en-myocardinfarct-bij-nierfunctiestoornissen/* This study evaluated the performance of high-sensitivity cardiac troponin I for MI diagnosis in patients with kidney impairment, addressing the clinical challenge of distinguishing acute ischemic injury from chronic troponin elevation in CKD. ## Effect of MRI-Guided Fibrosis Ablation vs Conventional Catheter Ablation on Atrial Arrhythmia Recurrence in Patients With Persistent Atrial Fibrillation: The DECAAF II Randomized Clinical Trial. *2022-06-21 · JAMA · https://doi.org/10.1001/jama.2022.8831 · https://hartvaat.nl/2022/06/21/mri-geleide-fibroseablatie-versus-conventionele-ablatie-bij-persisterend-af/* The DECAAF II trial showed that MRI-guided fibrosis ablation did not improve freedom from atrial arrhythmia compared with conventional catheter ablation in patients with persistent AF. The negative result suggested that current MRI-based fibrosis mapping does not reliably guide ablation targets. ## Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial. *2022-06-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059598 · https://hartvaat.nl/2022/06/21/timing-van-vt-ablatie-bij-icd-patienten-partita-trial/* The PARTITA trial demonstrated that early VT ablation after the first appropriate ICD shock reduced the composite of heart failure hospitalization or death compared with delayed ablation after subsequent shocks. The results supported a proactive ablation strategy rather than waiting for recurrent VT. ## Data standards for heart failure: the European Unified Registries for Heart Care Evaluation and Randomized Trials (EuroHeart). *2022-06-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehac151 · https://hartvaat.nl/2022/06/14/euroheart-datastandaarden-voor-hartfalenregistraties/* The EuroHeart project established standardized data definitions for heart failure registries and clinical trials across Europe, enabling unified outcomes assessment and quality-of-care comparison. ## Influence of atrial fibrillation on efficacy and safety of omecamtiv mecarbil in heart failure: the GALACTIC-HF trial. *2022-06-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehac144 · https://hartvaat.nl/2022/06/14/omecamtiv-mecarbil-bij-hartfalen-met-en-zonder-atriumfibrilleren-galactic-hf/* This GALACTIC-HF subanalysis confirmed that omecamtiv mecarbil is equally effective in HFrEF patients with and without atrial fibrillation, supporting cardiac myosin activation regardless of rhythm status. ## Echo-guided left ventricular assist device speed optimisation for exercise maximisation. *2022-06-10 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320495 · https://hartvaat.nl/2022/06/10/echogeleide-lvad-snelheidsoptimalisatie-voor-betere-inspanningstolerantie/* This study explored whether echo-guided LVAD speed optimization during exercise improves exercise capacity, testing individualized hemodynamic programming as a strategy to overcome the fixed-speed limitation of current devices. ## Prediction of incident atrial fibrillation in community-based electronic health records: a systematic review with meta-analysis. *2022-06-10 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320036 · https://hartvaat.nl/2022/06/10/voorspelling-van-atriumfibrilleren-in-elektronische-gezondheidsdossiers-systemat/* This systematic review evaluated prediction models for AF in community-based electronic health records, finding that existing models have moderate discrimination and identifying opportunities for AI-enhanced prediction. ## Electronic Alerts to Improve Heart Failure Therapy in Outpatient Practice: A Cluster Randomized Trial. *2022-06-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.03.338 · https://hartvaat.nl/2022/06/07/elektronische-alerts-verbeteren-hartfalenbehandeling-in-de-polikliniek/* This cluster-randomized trial showed that electronic alerts in the electronic health record significantly increased the prescription of guideline-directed medical therapy for HFrEF, demonstrating the effectiveness of clinical decision support for heart failure care quality. ## Randomized Ablation-Based Rhythm-Control Versus Rate-Control Trial in Patients With Heart Failure and Atrial Fibrillation: Results from the RAFT-AF trial. *2022-06-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057095 · https://hartvaat.nl/2022/06/07/raft-af-ablatie-versus-rate-control-bij-hartfalen-en-atriumfibrilleren/* The RAFT-AF trial showed that ablation-based rhythm control improved left ventricular function and NT-proBNP levels compared with rate control in patients with heart failure and AF, though it did not significantly reduce the composite of mortality and heart failure events. The echocardiographic benefit supported ablation for AF in heart failure. ## Effectiveness of a Text-Based Gamification Intervention to Improve Physical Activity Among Postpartum Individuals With Hypertensive Disorders of Pregnancy: A Randomized Clinical Trial. *2022-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.0553 · https://hartvaat.nl/2022/06/01/digitale-gamificatie-interventie-verhoogt-lichaamsbeweging-na-hypertensieve-zwan/* This trial showed that a text-based gamification intervention significantly increased physical activity in women after hypertensive pregnancy, addressing the elevated long-term cardiovascular risk through behavioral change. ## Effect of 15-mg Edoxaban on Clinical Outcomes in 3 Age Strata in Older Patients With Atrial Fibrillation: A Prespecified Subanalysis of the ELDERCARE-AF Randomized Clinical Trial. *2022-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.0480 · https://hartvaat.nl/2022/06/01/edoxaban-15-mg-bij-zeer-oude-patienten-met-atriumfibrilleren-eldercare-subanalys/* This ELDERCARE-AF age-stratified analysis confirmed that low-dose edoxaban (15 mg) maintains its favorable benefit-risk profile across age strata in patients aged 80 years and older with atrial fibrillation, supporting anticoagulation in the very elderly. ## Association of Low-Dose Triple Combination Therapy vs Usual Care With Time at Target Blood Pressure: A Secondary Analysis of the TRIUMPH Randomized Clinical Trial. *2022-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.0471 · https://hartvaat.nl/2022/06/01/lage-dosis-drievoudige-combinatietherapie-bij-hypertensie-triumph-secundaire-ana/* This TRIUMPH secondary analysis showed that a low-dose triple combination pill significantly increased time at target blood pressure compared with usual care, demonstrating that simplified combination therapy improves sustained blood pressure control. ## Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial. *2022-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab922 · https://hartvaat.nl/2022/06/01/finger-trial-multidomein-leefstijlinterventie-verlaagt-cardiovasculair-risico-bi/* The FINGER trial, originally designed for cognitive outcomes, also demonstrated cardiovascular risk reduction from a multi-domain lifestyle intervention (diet, exercise, cognitive training, vascular risk management) in older adults at risk for dementia. ## Effect of 5 years of exercise training on the cardiovascular risk profile of older adults: the Generation 100 randomized trial. *2022-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab721 · https://hartvaat.nl/2022/06/01/vijf-jaar-inspanningstraining-verbetert-cardiovasculair-risicoprofiel-bij-oudere/* The Generation 100 trial showed that 5 years of supervised exercise training in adults aged 70-77 improved several cardiovascular risk factors including blood pressure, lipids, and body composition, demonstrating the sustained cardiovascular benefit of structured exercise in the elderly. ## Milrinone or dobutamine in patients with heart failure: evidence from meta-analysis. *2022-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13812 · https://hartvaat.nl/2022/06/01/milrinone-versus-dobutamine-bij-hartfalen-meta-analyse/* This meta-analysis compared milrinone with dobutamine in acute decompensated heart failure, finding comparable efficacy and safety profiles for these two commonly used inotropic agents. ## Sodium-glucose cotransporter-2 inhibitors in heart failure: an updated meta-analysis. *2022-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13905 · https://hartvaat.nl/2022/06/01/sglt2-remmers-bij-hartfalen-geupdatete-meta-analyse-bevestigt-breed-voordeel/* This updated meta-analysis confirmed that SGLT2 inhibitors reduce cardiovascular death and heart failure hospitalization in both HFrEF and HFpEF, with the magnitude of benefit consistent across the ejection fraction spectrum regardless of diabetes status. ## Haemodynamic changes of interatrial shunting devices for heart failure: a systematic review and meta-analysis. *2022-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13911 · https://hartvaat.nl/2022/06/01/interatriale-shuntdevices-bij-hartfalen-systematische-review-en-meta-analyse/* This meta-analysis of interatrial shunt devices for heart failure showed significant reductions in pulmonary wedge pressure and improvements in hemodynamic parameters, though clinical outcomes trials subsequently yielded mixed results. ## Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study. *2022-05-31 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056756 · https://hartvaat.nl/2022/05/31/langetermijneffect-van-metformine-en-leefstijlinterventie-op-cardiovasculaire-ev/* After 21 years of follow-up in the Diabetes Prevention Program, neither lifestyle intervention nor metformin reduced the incidence of cardiovascular events compared with placebo, despite their proven diabetes prevention effects. The result indicated that metabolic prevention alone does not translate to cardiovascular event reduction. ## Quality of Life After Fractional Flow Reserve-Guided PCI Compared With Coronary Bypass Surgery. *2022-05-31 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.060049 · https://hartvaat.nl/2022/05/31/kwaliteit-van-leven-na-ffr-geleide-pci-versus-coronaire-bypasschirurgie/* This FAME 3 quality-of-life analysis showed that FFR-guided PCI provided similar quality-of-life improvement as CABG at 1 year for three-vessel disease, despite inferior clinical outcomes, suggesting symptom relief is comparable between strategies. ## Joint British Societies' guideline on management of cardiac arrest in the cardiac catheter laboratory. *2022-05-25 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-320588 · https://hartvaat.nl/2022/05/25/jbs-richtlijn-management-van-hartstilstand-in-het-cathlab/* This Joint British Societies guideline provided practical recommendations for managing cardiac arrest in the catheterization laboratory, addressing the unique challenges of resuscitation during invasive cardiovascular procedures. ## Hydration for prevention of kidney injury after primary coronary intervention for acute myocardial infarction: a randomised clinical trial. *2022-05-25 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319716 · https://hartvaat.nl/2022/05/25/hydratie-ter-preventie-van-nierschade-na-primaire-pci-gerandomiseerde-trial/* This randomized trial tested aggressive versus general hydration for preventing contrast-induced kidney injury after primary PCI for acute MI, evaluating a simple intervention for renal protection during emergent procedures. ## Efficacy and Safety of Dapagliflozin in Type 2 Diabetes According to Baseline Blood Pressure: Observations From DECLARE-TIMI 58 Trial. *2022-05-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.058103 · https://hartvaat.nl/2022/05/24/dapagliflozine-naar-baseline-bloeddruk-bij-diabetes-type-2-declare-timi-58/* This DECLARE-TIMI 58 analysis showed that dapagliflozin's efficacy in type 2 diabetes is consistent across baseline blood pressure levels, supporting SGLT2 inhibitor use regardless of blood pressure status. ## Latent Pulmonary Vascular Disease May Alter the Response to Therapeutic Atrial Shunt Device in Heart Failure. *2022-05-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059486 · https://hartvaat.nl/2022/05/24/latent-pulmonaal-vaatlijden-en-respons-op-atriale-shunt-bij-hf/* This analysis showed that latent pulmonary vascular disease alters the response to the IASD interatrial shunt device in heart failure, identifying a subgroup where right heart hemodynamics limit the benefit of left atrial decompression. ## A village doctor-led multifaceted intervention for blood pressure control in rural China: an open, cluster randomised trial. *2022-05-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00325-7 · https://hartvaat.nl/2022/05/21/dorpsarts-geleide-multifacet-interventie-voor-bloeddrukcontrole-in-ruraal-china-/* This Lancet cluster-randomized trial showed that a village doctor-led multifaceted intervention (health coaching, treatment algorithm, home BP monitoring) significantly improves blood pressure control in rural China, providing a scalable model for low-resource settings. ## Bariatric surgery and cardiovascular disease: a systematic review and meta-analysis. *2022-05-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehac071 · https://hartvaat.nl/2022/05/21/bariatrische-chirurgie-en-cardiovasculaire-ziekte-meta-analyse/* This systematic review and meta-analysis showed that bariatric surgery is associated with significant reductions in cardiovascular events and cardiovascular mortality compared with nonsurgical management of obesity. The quantified cardiovascular benefit supports consideration of bariatric surgery as a cardiovascular prevention strategy. ## Associations of Dietary Cholesterol, Serum Cholesterol, and Egg Consumption With Overall and Cause-Specific Mortality: Systematic Review and Updated Meta-Analysis. *2022-05-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057642 · https://hartvaat.nl/2022/05/17/voedingscholesterol-serumcholesterol-en-eiconsumptie-en-mortaliteit-meta-analyse/* This meta-analysis evaluated the associations of dietary cholesterol, serum cholesterol, and egg consumption with mortality, providing a nuanced perspective on the complex relationship between dietary cholesterol intake and cardiovascular outcomes. ## Cost-Effectiveness of a Household Salt Substitution Intervention: Findings From 20 995 Participants of the Salt Substitute and Stroke Study. *2022-05-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059573 · https://hartvaat.nl/2022/05/17/kosteneffectiviteit-van-zoutsubstitutie-ssass-analyse/* This SSaSS cost-effectiveness analysis showed that household salt substitution is highly cost-effective for cardiovascular prevention, supporting the economic case for this population-level dietary intervention. ## Treatment for Mild Chronic Hypertension during Pregnancy. *2022-05-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2201295 · https://hartvaat.nl/2022/05/12/behandeling-van-milde-chronische-hypertensie-in-de-zwangerschap-nejm-chap/* The CHAP trial demonstrated that treatment of mild chronic hypertension during pregnancy (targeting blood pressure <140/90 mmHg) significantly reduced the risk of preeclampsia and preterm birth with no adverse fetal effects. This landmark result reversed the prevailing watchful-waiting approach and established active treatment as beneficial in pregnancy-associated hypertension. ## Text Messages to Improve Medication Adherence and Secondary Prevention After Acute Coronary Syndrome: The TEXTMEDS Randomized Clinical Trial. *2022-05-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056161 · https://hartvaat.nl/2022/05/10/sms-voor-medicatietrouw-en-secundaire-preventie-na-acs-textmeds/* The TEXTMEDS trial showed that automated text messages improve medication adherence after acute coronary syndrome, demonstrating a low-cost, scalable digital intervention for secondary cardiovascular prevention. ## Effect of Alirocumab Added to High-Intensity Statin Therapy on Coronary Atherosclerosis in Patients With Acute Myocardial Infarction: The PACMAN-AMI Randomized Clinical Trial. *2022-05-10 · JAMA · https://doi.org/10.1001/jama.2022.5218 · https://hartvaat.nl/2022/05/10/alirocumab-plus-statine-op-coronaire-atherosclerose-na-mi-jama-pacman-ami/* The PACMAN-AMI trial demonstrated that adding alirocumab to high-intensity statin therapy after acute MI produced greater reductions in coronary plaque volume and improved plaque composition on multimodality intravascular imaging compared with statin alone. The results provided direct evidence that early PCSK9 inhibition favorably modifies vulnerable plaques. ## Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy: The BUMP 1 Randomized Clinical Trial. *2022-05-03 · JAMA · https://doi.org/10.1001/jama.2022.4712 · https://hartvaat.nl/2022/05/03/zelfmeting-bloeddruk-en-hypertensie-diagnose-bij-risicozwangerschap-jama-bump-1/* The BUMP 1 trial demonstrated that blood pressure self-monitoring during higher-risk pregnancy does not significantly increase detection of hypertension compared with usual care, though it may improve overall blood pressure awareness. ## Effect of Self-monitoring of Blood Pressure on Blood Pressure Control in Pregnant Individuals With Chronic or Gestational Hypertension: The BUMP 2 Randomized Clinical Trial. *2022-05-03 · JAMA · https://doi.org/10.1001/jama.2022.4726 · https://hartvaat.nl/2022/05/03/zelfmeting-bloeddruk-en-bloeddrukcontrole-bij-risicozwangerschap-jama-bump-2/* The BUMP 2 trial showed that blood pressure self-monitoring in higher-risk pregnancies improves blood pressure control, supporting the use of home monitoring as an adjunct to clinical assessment in obstetric hypertension. ## Prevention of Cardiovascular Events and Mortality With Icosapent Ethyl in Patients With Prior Myocardial Infarction. *2022-05-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.02.035 · https://hartvaat.nl/2022/05/03/icosapent-ethyl-en-cv-preventie-bij-eerder-mi-reduce-it/* This REDUCE-IT subanalysis confirmed that icosapent ethyl provides significant cardiovascular event reduction in patients with prior MI, the highest-risk population within the statin-treated triglyceridemic cohort. ## 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2022-05-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.12.011 · https://hartvaat.nl/2022/05/03/2022-aha-acc-hfsa-hartfalenrichtlijn-executive-summary/* Executive summary of the 2022 AHA/ACC/HFSA heart failure guideline, providing key recommendations, decision pathways, and the four-pillar treatment algorithm for HFrEF including SGLT2 inhibitors, ARNI, beta-blockers, and MRAs. ## 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2022-05-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.12.012 · https://hartvaat.nl/2022/05/03/2022-aha-acc-hfsa-hartfalenrichtlijn-jacc-editie/* The 2022 AHA/ACC/HFSA heart failure guideline published in JACC replaced the 2013 guidelines and integrated contemporary evidence on SGLT2 inhibitors and ARNI into structured treatment algorithms for heart failure across the ejection fraction spectrum. ## Effect of Vupanorsen on Non-High-Density Lipoprotein Cholesterol Levels in Statin-Treated Patients With Elevated Cholesterol: TRANSLATE-TIMI 70. *2022-05-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.122.059266 · https://hartvaat.nl/2022/05/03/vupanorsen-en-non-hdl-cholesterol-bij-statinebehandelde-patienten-translate-timi/* The TRANSLATE-TIMI 70 trial showed that vupanorsen (targeting ANGPTL3) modestly reduced non-HDL cholesterol in statin-treated patients but was associated with hepatic steatosis, raising safety concerns that ultimately led to discontinuation of its development. ## Single Ascending Dose Study of a Short Interfering RNA Targeting Lipoprotein(a) Production in Individuals With Elevated Plasma Lipoprotein(a) Levels. *2022-05-03 · JAMA · https://doi.org/10.1001/jama.2022.5050 · https://hartvaat.nl/2022/05/03/korte-interfererende-rna-tegen-lp-a-jama-fase-1-dosisstudie/* This JAMA phase 1 dose-escalation study of an siRNA targeting lipoprotein(a) production demonstrated potent and durable Lp(a) reduction, advancing the most promising Lp(a)-lowering mechanism toward clinical development. ## 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2022-05-03 · Circulation · https://doi.org/10.1161/CIR.0000000000001063 · https://hartvaat.nl/2022/05/03/2022-aha-acc-hfsa-hartfalenrichtlijn-circulation-editie/* The 2022 AHA/ACC/HFSA heart failure guideline was the first comprehensive update since 2013, integrating SGLT2 inhibitors, sacubitril-valsartan, and vericiguat into guideline-directed medical therapy. The document codified the four-pillar approach to HFrEF and provided new recommendations for HFpEF management based on emerging evidence. ## Standard care vs. TRIVEntricular pacing in Heart Failure (STRIVE HF): a prospective multicentre randomized controlled trial of triventricular pacing vs. conventional biventricular pacing in patients with heart failure and intermediate QRS left bundle branch block. *2022-05-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab267 · https://hartvaat.nl/2022/05/03/triventriculaire-pacing-bij-hf-strive-hf-gerandomiseerde-trial/* The STRIVE HF trial tested triventricular pacing (adding a right ventricular septal lead to conventional BiV pacing) for heart failure, evaluating whether three-site stimulation improves CRT response. ## Long-term outcomes in a randomized controlled trial of multimodality imaging-guided left ventricular lead placement in cardiac resynchronization therapy. *2022-05-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab314 · https://hartvaat.nl/2022/05/03/multimodaliteitsbeeldvorming-geleide-lv-leadplaatsing-bij-crt-langetermijn/* This trial reported long-term outcomes of multimodality imaging-guided LV lead placement for CRT, showing that combining imaging techniques for optimal lead positioning reduces heart failure events over extended follow-up. ## Risk of incident atrial fibrillation with low-to-moderate alcohol consumption is associated with gender, region, alcohol category: a systematic review and meta-analysis. *2022-05-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab266 · https://hartvaat.nl/2022/05/03/af-risico-bij-laag-matig-alcoholgebruik-naar-geslacht-en-regio-meta-analyse/* This meta-analysis showed that the association between low-to-moderate alcohol consumption and incident AF varies by sex, geographic region, and type of alcoholic beverage, providing nuanced guidance on alcohol-AF risk counseling. ## Radial strain imaging-guided lead placement for improving response to cardiac resynchronization therapy in patients with ischaemic cardiomyopathy: the Raise CRT trial. *2022-05-03 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab253 · https://hartvaat.nl/2022/05/03/radiale-strain-geleide-leadplaatsing-voor-crt-bij-ischemisch-hf/* This study evaluated radial strain imaging-guided LV lead placement for improving CRT response in ischemic heart failure, testing whether targeting the latest activated non-scarred segment improves resynchronization. ## Impact of baseline renal dysfunction on cardiac outcomes and end-stage renal disease in heart failure patients with mitral regurgitation: the COAPT trial. *2022-05-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehac026 · https://hartvaat.nl/2022/05/01/nierdisfunctie-en-uitkomsten-bij-hf-met-mr-coapt/* This COAPT analysis showed that baseline renal dysfunction worsens outcomes in heart failure with severe MR, but that MitraClip provides consistent relative benefit regardless of kidney function status. ## Impact of Antihypertensive Drug Class on Outcomes in SPRINT. *2022-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18369 · https://hartvaat.nl/2022/05/01/antihypertensivaklasse-en-uitkomsten-in-sprint/* This SPRINT analysis examined whether any specific antihypertensive drug class was associated with better outcomes under intensive blood pressure control, informing the drug selection component of aggressive treatment strategies. ## Risk Stratification by Cross-Classification of Central and Brachial Systolic Blood Pressure. *2022-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18773 · https://hartvaat.nl/2022/05/01/risicostratificatie-door-kruisclassificatie-van-centrale-en-brachiale-systolisch/* This study used cross-classification of central and brachial systolic blood pressure for cardiovascular risk stratification, testing whether discordant central-peripheral readings identify patients at differential risk. ## Effect of Antihypertensive Treatment on Cerebral Blood Flow in Older Adults: a Systematic Review and Meta-Analysis. *2022-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18255 · https://hartvaat.nl/2022/05/01/antihypertensieve-behandeling-en-cerebrale-bloedflow-meta-analyse/* This meta-analysis evaluated the effect of antihypertensive treatment on cerebral blood flow in older adults, addressing the concern that blood pressure lowering may compromise brain perfusion in the elderly. ## Remote ischaemic conditioning in ST elevation myocardial infarction: a registry-based randomised trial. *2022-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319455 · https://hartvaat.nl/2022/05/01/remote-ischemische-conditionering-bij-stemi-registergebaseerde-gerandomiseerde-t/* This registry-based randomized trial of remote ischemic conditioning in STEMI tested cardioprotection at the population level, evaluating whether the benefits seen in controlled trials translate to routine clinical practice. ## Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2 × 2 factorial design. *2022-04-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00367-1 · https://hartvaat.nl/2022/04/30/abiraterone-bij-gemetastaseerd-castratiegevoelig-prostaatkanker-peace-1/* The PEACE-1 Lancet trial of abiraterone for metastatic prostate cancer is relevant to cardio-oncology due to the hypertension and hypokalemia side effects of androgen-pathway manipulation. ## Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement. *2022-04-26 · JAMA · https://doi.org/10.1001/jama.2022.4983 · https://hartvaat.nl/2022/04/26/aspirine-voor-cv-preventie-uspstf-aanbeveling-2022/* The 2022 USPSTF recommendation statement downgraded the role of aspirin in primary cardiovascular prevention, advising against initiation in adults 60 years or older and recommending individualized decision-making in those aged 40–59 with elevated CVD risk. This reflected accumulating evidence from ASPREE, ARRIVE, and ASCEND showing unfavorable bleeding-to-benefit ratios. ## External Validation of the FREEDOM Score for Individualized Decision Making Between CABG and PCI. *2022-04-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.01.049 · https://hartvaat.nl/2022/04/19/externe-validatie-van-de-freedom-score-voor-pci-versus-cabg/* This external validation of the FREEDOM score confirmed its ability to predict individual benefit from CABG versus PCI, supporting the tool for personalized revascularization decision-making in diabetic multivessel disease. ## Substrate Ablation vs Antiarrhythmic Drug Therapy for Symptomatic Ventricular Tachycardia. *2022-04-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2022.01.050 · https://hartvaat.nl/2022/04/19/substraatablatie-versus-antiaritmica-bij-symptomatische-vt/* This study compared substrate-based catheter ablation with antiarrhythmic drug therapy for symptomatic ventricular tachycardia in patients with ischemic cardiomyopathy and an ICD, evaluating the optimal rhythm management approach. ## Therapeutic Targets for Heart Failure Identified Using Proteomics and Mendelian Randomization. *2022-04-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056663 · https://hartvaat.nl/2022/04/19/therapeutische-doelen-voor-hf-via-proteomics-en-mendeliaanse-randomisatie/* This study used proteomics and Mendelian randomization to identify novel therapeutic targets for heart failure, discovering disease-associated proteins that could be drugged for HF prevention or treatment. ## Alirocumab after acute coronary syndrome in patients with a history of heart failure. *2022-04-19 · European heart journal · https://doi.org/10.1093/eurheartj/ehab804 · https://hartvaat.nl/2022/04/19/alirocumab-na-acs-bij-patienten-met-hf-voorgeschiedenis-odyssey-outcomes/* This ODYSSEY OUTCOMES subanalysis showed that alirocumab benefits ACS patients with a history of heart failure, a population previously thought to not respond to lipid-lowering therapy based on statin trial data. ## Coronary flow reserve and cardiovascular outcomes: a systematic review and meta-analysis. *2022-04-19 · European heart journal · https://doi.org/10.1093/eurheartj/ehab775 · https://hartvaat.nl/2022/04/19/coronaire-flowreserve-en-cardiovasculaire-uitkomsten-meta-analyse/* This meta-analysis quantified the association between reduced coronary flow reserve and cardiovascular outcomes, establishing impaired coronary microvascular function as an independent predictor of adverse events across multiple measurement modalities. ## Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial. *2022-04-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00455-X · https://hartvaat.nl/2022/04/09/renale-denervatie-met-antihypertensiva-lancet-spyral-htn-on-med-langetermijn/* Long-term SPYRAL HTN-ON MED results confirmed sustained blood pressure reduction with renal denervation in the presence of antihypertensive medications, providing durable efficacy and safety data for device-based therapy in medicated patients. ## Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study. *2022-04-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00456-1 · https://hartvaat.nl/2022/04/09/asundexian-factor-xia-remmer-versus-apixaban-bij-af-lancet-pacific-af/* The PACIFIC-AF phase 2 trial showed that asundexian, an oral factor XIa inhibitor, had significantly less bleeding than apixaban in AF patients while maintaining preliminary signals of anticoagulant efficacy. This early positive result set the stage for the subsequent (failed) OCEANIC-AF phase 3 trial. ## Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): an international, open-label, randomised, controlled trial. *2022-04-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00369-5 · https://hartvaat.nl/2022/04/09/natriumreductie-100-mmol-bij-hartfalen-lancet-sodium-hf/* The SODIUM-HF trial showed that strict dietary sodium restriction (<100 mmol/day) in heart failure patients did not significantly reduce the composite of cardiovascular hospitalization, emergency department visit, or death compared with usual care. The neutral result questioned the clinical benefit of intensive sodium restriction. ## Apolipoprotein C-III reduction in subjects with moderate hypertriglyceridaemia and at high cardiovascular risk. *2022-04-06 · European heart journal · https://doi.org/10.1093/eurheartj/ehab820 · https://hartvaat.nl/2022/04/06/apoc-iii-reductie-bij-matige-hypertriglyceridemie-met-hoog-cv-risico/* This clinical trial evaluated olezarsen, a GalNAc-conjugated antisense oligonucleotide targeting apoC-III, in patients with moderate hypertriglyceridemia and high cardiovascular risk, demonstrating significant triglyceride reduction with a favorable safety profile. ## Kidney function assessment and endpoint ascertainment in clinical trials. *2022-04-06 · European heart journal · https://doi.org/10.1093/eurheartj/ehab832 · https://hartvaat.nl/2022/04/06/nierfunctiebeoordeling-en-eindpuntbepaling-in-klinische-trials-ehj/* This EHJ review addressed the heterogeneity in kidney function assessment and endpoint definitions in clinical trials, proposing standardized approaches to improve cross-trial comparability for renal outcomes. ## Long-term safety and efficacy of anacetrapib in patients with atherosclerotic vascular disease. *2022-04-06 · European heart journal · https://doi.org/10.1093/eurheartj/ehab863 · https://hartvaat.nl/2022/04/06/langetermijn-veiligheid-en-werkzaamheid-van-anacetrapib-ehj/* This long-term analysis of anacetrapib in atherosclerotic vascular disease confirmed sustained efficacy and safety beyond the initial REVEAL trial period, providing extended data on CETP inhibition with the only agent to show cardiovascular benefit. ## Anticoagulation, therapy of concomitant conditions, and early rhythm control therapy: a detailed analysis of treatment patterns in the EAST - AFNET 4 trial. *2022-04-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab200 · https://hartvaat.nl/2022/04/05/antistolling-comorbiditeitsbehandeling-en-vroege-ritmecontrole-east-afnet-4-patr/* This detailed EAST-AFNET 4 analysis examined treatment patterns for anticoagulation, comorbidity management, and rhythm control, confirming that the cardiovascular benefit was driven by the rhythm control strategy rather than differences in other treatments. ## Prasugrel Dose De-escalation Therapy After Complex Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome: A Post Hoc Analysis From the HOST-REDUCE-POLYTECH-ACS Trial. *2022-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2022.0052 · https://hartvaat.nl/2022/04/01/prasugrel-dosis-de-escalatie-na-complexe-pci-bij-acs-jama-cardiology/* This analysis of prasugrel dose de-escalation after complex PCI in ACS showed that reducing the maintenance dose improves the bleeding-ischemia balance, supporting dose-reduction as an alternative to agent switching. ## Comparison of Clopidogrel Monotherapy After 1 to 2 Months of Dual Antiplatelet Therapy With 12 Months of Dual Antiplatelet Therapy in Patients With Acute Coronary Syndrome: The STOPDAPT-2 ACS Randomized Clinical Trial. *2022-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.5244 · https://hartvaat.nl/2022/04/01/clopidogrel-monotherapie-na-1-2-maanden-dapt-versus-12-maanden-dapt-jama-cardiol/* This analysis compared clopidogrel monotherapy after 1-2 months of DAPT with standard 12-month DAPT, providing additional evidence for ultra-short antiplatelet strategies with clopidogrel as the preferred single agent after PCI. ## Sodium-glucose cotransporter 2 inhibitors in heart failure with reduced or preserved ejection fraction: a meta-analysis. *2022-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13805 · https://hartvaat.nl/2022/04/01/sglt2-remmers-bij-hfref-of-hfpef-meta-analyse/* This meta-analysis of SGLT2 inhibitors across the heart failure spectrum confirmed class-wide benefit on cardiovascular death and heart failure hospitalization in both HFrEF and HFpEF, providing the pooled evidence supporting universal SGLT2 inhibitor use in heart failure. ## Effect of implantable cardioverter-defibrillators in patients with non-ischaemic systolic heart failure and concurrent coronary atherosclerosis. *2022-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13810 · https://hartvaat.nl/2022/04/01/icd-bij-niet-ischemisch-systolisch-hf-met-coronaire-atherosclerose-danish/* This DANISH subanalysis showed that the presence of concomitant coronary atherosclerosis does not modify the ICD benefit in non-ischemic heart failure, supporting the neutral primary finding regardless of coronary disease status. ## Can glucose-lowering medications improve outcomes in non-diabetic heart failure patients? A Bayesian network meta-analysis. *2022-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13822 · https://hartvaat.nl/2022/04/01/glucoseverlagende-middelen-bij-niet-diabetisch-hf-bayesiaanse-netwerkmeta-analys/* This Bayesian network meta-analysis explored whether glucose-lowering medications, particularly SGLT2 inhibitors and GLP-1 agonists, improve outcomes in non-diabetic heart failure patients, finding evidence supporting SGLT2 inhibitor use independent of glycemic indication. ## DPP4 (Dipeptidyl Peptidase-4) Inhibition Increases Catecholamines Without Increasing Blood Pressure During Sustained ACE (Angiotensin-Converting Enzyme) Inhibitor Treatment. *2022-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18348 · https://hartvaat.nl/2022/04/01/dpp-4-remming-en-catecholamines-tijdens-ace-remming/* This study showed that DPP-4 inhibition increases catecholamine levels without raising blood pressure during concurrent ACE inhibition, providing mechanistic data on the cardiovascular safety of DPP-4 inhibitors. ## Five-year follow-up of intracoronary autologous cell therapy in acute myocardial infarction: the REGENERATE-AMI trial. *2022-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13786 · https://hartvaat.nl/2022/04/01/5-jaarsfollow-up-van-intracoronaire-celtherapie-na-mi-regenerate-ami/* The 5-year REGENERATE-AMI follow-up showed no sustained improvement in cardiac function from intracoronary autologous bone marrow cell therapy after acute MI, adding to the long-term negative evidence for post-infarction stem cell treatment. ## Robustness of outcomes in trials evaluating sodium-glucose co-transporter 2 inhibitors for heart failure. *2022-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13785 · https://hartvaat.nl/2022/04/01/robuustheid-van-sglt2-remmer-hf-trials-evaluatie/* This evaluation confirmed the robustness of outcomes across SGLT2 inhibitor heart failure trials, showing consistent benefit regardless of analytical methods and sensitivity analyses used. ## Amphilimus- vs. zotarolimus-eluting stents in patients with diabetes mellitus and coronary artery disease: the SUGAR trial. *2022-03-31 · European heart journal · https://doi.org/10.1093/eurheartj/ehab790 · https://hartvaat.nl/2022/03/31/amphilimus-versus-zotarolimus-stents-bij-diabetes-sugar-gerandomiseerde-trial/* The SUGAR randomized trial compared amphilimus-eluting with zotarolimus-eluting stents in diabetic patients with coronary disease, testing a newer polymer-free technology designed for improved healing in the diabetic vasculature. ## Single or multiple arterial bypass graft surgery vs. percutaneous coronary intervention in patients with three-vessel or left main coronary artery disease. *2022-03-31 · European heart journal · https://doi.org/10.1093/eurheartj/ehab537 · https://hartvaat.nl/2022/03/31/enkele-of-meervoudige-arteriele-cabg-versus-pci-bij-drievaten-hoofdstam-meta-ana/* This meta-analysis compared single and multiple arterial CABG with PCI for three-vessel or left main coronary disease, showing that multiple arterial grafts provide the best long-term survival while PCI carries higher revascularization rates. ## Screening for Atrial Fibrillation in Older Adults at Primary Care Visits: VITAL-AF Randomized Controlled Trial. *2022-03-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057014 · https://hartvaat.nl/2022/03/29/af-screening-bij-ouderen-in-de-huisartsenpraktijk-vital-af-gerandomiseerde-trial/* The VITAL-AF pragmatic trial of point-of-care AF screening during primary care visits showed that single-time-point screening modestly increases AF detection but has limited yield in the broader older adult population. ## Insulin Prevents Hypercholesterolemia by Suppressing 12α-Hydroxylated Bile Acids. *2022-03-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.045373 · https://hartvaat.nl/2022/03/29/insuline-voorkomt-hypercholesterolemie-via-12-gehydroxyleerde-galzuren/* This mechanistic study showed that insulin prevents hypercholesterolemia by suppressing 12α-hydroxylated bile acids, revealing a molecular link between insulin deficiency and the extreme cardiovascular risk in type 1 diabetes. ## Effect of Pelacarsen on Lipoprotein(a) Cholesterol and Corrected Low-Density Lipoprotein Cholesterol. *2022-03-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.12.032 · https://hartvaat.nl/2022/03/22/pelacarsen-op-lp-a-cholesterol-en-gecorrigeerd-ldl-cholesterol/* This analysis quantified the effect of pelacarsen on Lp(a)-associated cholesterol and its impact on corrected LDL cholesterol measurements, demonstrating that apparent LDL cholesterol includes a substantial Lp(a)-derived component that should be accounted for in treatment decisions. ## MRI-Detected Brain Lesions and Cognitive Function in Patients With Atrial Fibrillation Undergoing Left Atrial Catheter Ablation in the Randomized AXAFA-AFNET 5 Trial. *2022-03-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056320 · https://hartvaat.nl/2022/03/22/mri-hersenlaesies-en-cognitie-bij-af-na-laa-ablatie/* This study assessed MRI-detected brain lesions and their association with cognitive function in AF patients undergoing left atrial catheter ablation, addressing the cerebral safety of this common arrhythmia procedure. ## Systematic, early rhythm control strategy for atrial fibrillation in patients with or without symptoms: the EAST-AFNET 4 trial. *2022-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehab593 · https://hartvaat.nl/2022/03/21/vroege-ritmecontrole-bij-af-met-of-zonder-symptomen-east-afnet-4/* This EAST-AFNET 4 analysis showed that early rhythm control improves outcomes in AF patients regardless of symptom status, expanding the indication beyond symptomatic patients. The finding challenged the guideline restriction of rhythm control to symptomatic AF. ## 5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve. *2022-03-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.12.030 · https://hartvaat.nl/2022/03/15/5-jaars-ifr-versus-ffr-geleide-pci-define-flair-ifr-swedeheart/* Five-year results confirmed that iFR-guided PCI maintains noninferior outcomes compared with FFR-guided PCI over long-term follow-up, providing sustained evidence for the adenosine-free physiological assessment as a standard approach. ## Association Between Age and Outcomes of Catheter Ablation Versus Medical Therapy for Atrial Fibrillation: Results From the CABANA Trial. *2022-03-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.055297 · https://hartvaat.nl/2022/03/15/leeftijd-en-uitkomsten-van-katheterablatie-versus-medicatie-bij-af-cabana/* This CABANA analysis showed that the benefit of catheter ablation versus medical therapy for AF varies by age, with younger patients potentially deriving greater benefit from ablation. ## Periodic Repolarization Dynamics Identifies ICD Responders in Nonischemic Cardiomyopathy: A DANISH Substudy. *2022-03-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056464 · https://hartvaat.nl/2022/03/08/periodieke-repolarisatiedynamiek-identificeert-icd-responders-bij-nicm-danish/* This DANISH substudy showed that periodic repolarization dynamics, an ECG-based marker of sympathetic activity, identifies patients with nonischemic cardiomyopathy who benefit from prophylactic ICD implantation, improving patient selection. ## Amulet or Watchman Device for Percutaneous Left Atrial Appendage Closure: Primary Results of the SWISS-APERO Randomized Clinical Trial. *2022-03-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057859 · https://hartvaat.nl/2022/03/08/amulet-versus-watchman-voor-laa-sluiting-swiss-apero-gerandomiseerde-trial/* The SWISS-APERO randomized trial compared the Amulet with the Watchman FLX device for percutaneous LAA closure, providing the first head-to-head comparison of these leading LAA occlusion technologies. ## Comparative effects of guided vs. potent P2Y12 inhibitor therapy in acute coronary syndrome: a network meta-analysis of 61 898 patients from 15 randomized trials. *2022-03-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehab836 · https://hartvaat.nl/2022/03/07/geleide-versus-potente-p2y12-therapie-bij-acs-netwerkmeta-analyse-van-61-898-pat/* This network meta-analysis of nearly 62,000 ACS patients compared guided de-escalation with potent P2Y12 inhibitor therapy, finding that guided approaches reduce bleeding without increasing ischemic events. The comprehensive analysis supported precision antiplatelet strategies as a superior alternative. ## Characteristics of patients with atrial high rate episodes detected by implanted defibrillator and resynchronization devices. *2022-03-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab186 · https://hartvaat.nl/2022/03/02/kenmerken-van-patienten-met-atriale-high-rate-episodes-bij-icd-crt/* This analysis characterized patients with device-detected atrial high-rate episodes, identifying clinical features that distinguish AHRE patients from those with clinical AF and informing anticoagulation decisions. ## Rate control drugs differ in the prevention of progression of atrial fibrillation. *2022-03-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab191 · https://hartvaat.nl/2022/03/02/frequentiecontrolemiddelen-verschillen-in-preventie-van-af-progressie/* This study showed that different rate control drugs (verapamil, beta-blockers, digoxin) have differential effects on preventing AF progression from paroxysmal to persistent, supporting verapamil as potentially protective against disease advancement. ## Efficacy and Safety of Edoxaban 15 mg According to Renal Function in Very Elderly Patients With Atrial Fibrillation: A Subanalysis of the ELDERCARE-AF Trial. *2022-03-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057190 · https://hartvaat.nl/2022/03/01/edoxaban-15-mg-naar-nierfunctie-bij-zeer-oude-af-eldercare-subanalyse/* This ELDERCARE subanalysis confirmed that low-dose edoxaban (15 mg) maintains its favorable efficacy-safety profile across different levels of renal function in very elderly AF patients. ## Oral Antihypertensives for Nonsevere Pregnancy Hypertension: Systematic Review, Network Meta- and Trial Sequential Analyses. *2022-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18415 · https://hartvaat.nl/2022/03/01/orale-antihypertensiva-bij-niet-ernstige-zwangerschapshypertensie-netwerkmeta-an/* This network meta-analysis evaluated oral antihypertensives for non-severe pregnancy hypertension, comparing different drug classes to identify the most effective and safe agents for blood pressure control during pregnancy. ## Blood Pressure, Hypertension, and the Risk of Aortic Dissection Incidence and Mortality: Results From the J-SCH Study, the UK Biobank Study, and a Meta-Analysis of Cohort Studies. *2022-03-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056546 · https://hartvaat.nl/2022/03/01/bloeddruk-hypertensie-en-risico-op-aortadissectie-j-sch-en-uk-biobank/* This large prospective Japanese study demonstrated a continuous positive relationship between blood pressure levels and the risk of aortic dissection incidence and mortality, reinforcing the importance of blood pressure control for aortic protection. ## Temporary Spinal Cord Stimulation to Prevent Postcardiac Surgery Atrial Fibrillation: 30-Day Safety and Efficacy Outcomes. *2022-02-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.078 · https://hartvaat.nl/2022/02/22/temporaire-ruggenmergstimulatie-ter-preventie-van-postoperatief-af/* This study tested temporary spinal cord stimulation for preventing post-cardiac surgery AF, exploring neuromodulation as a novel approach to this common post-operative complication. ## Efficacy, durability, and safety of intravitreal faricimab with extended dosing up to every 16 weeks in patients with diabetic macular oedema (YOSEMITE and RHINE): two randomised, double-masked, phase 3 trials. *2022-02-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(22)00018-6 · https://hartvaat.nl/2022/02/19/faricimab-bij-diabetisch-maculaoedeem-met-verlengde-dosering-lancet/* This Lancet trial of faricimab, a bispecific anti-VEGF/anti-angiopoietin-2 antibody, in diabetic macular edema showed efficacy with extended dosing up to every 16 weeks, reducing treatment burden for this common diabetic eye complication. ## Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. *2022-02-10 · European heart journal · https://doi.org/10.1093/eurheartj/ehab777 · https://hartvaat.nl/2022/02/10/finerenon-cv-en-renale-uitkomsten-bij-diabetes-met-ckd-fidelity-gepoolde-analyse/* The FIDELITY pooled analysis combined FIDELIO-DKD and FIGARO-DKD data to demonstrate consistent cardiovascular and kidney benefits of finerenone across the full spectrum of CKD severity in patients with type 2 diabetes. This definitive analysis established finerenone's position in the cardiorenal protection armamentarium. ## Propionate attenuates atherosclerosis by immune-dependent regulation of intestinal cholesterol metabolism. *2022-02-10 · European heart journal · https://doi.org/10.1093/eurheartj/ehab644 · https://hartvaat.nl/2022/02/10/propionaat-vermindert-atherosclerose-via-immuunregulatie-van-intestinaal-cholest/* This study demonstrated that propionate, a short-chain fatty acid produced by gut bacteria, attenuates atherosclerosis through immune-dependent regulation of intestinal cholesterol metabolism, advancing the microbiome-cardiovascular connection. ## One-Year Major Cardiovascular Events After Restrictive Versus Liberal Blood Transfusion Strategy in Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Trial. *2022-02-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057909 · https://hartvaat.nl/2022/02/08/1-jaars-cv-events-bij-restrictieve-versus-liberale-transfusie-na-acuut-mi-realit/* One-year REALITY results confirmed that a restrictive transfusion strategy (hemoglobin threshold <8 g/dL) is safe and noninferior to liberal transfusion after acute MI, with sustained comparable outcomes. ## Stress Cardiac Biomarkers, Cardiovascular and Renal Outcomes, and Response to Canagliflozin. *2022-02-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.11.027 · https://hartvaat.nl/2022/02/08/stress-cardiale-biomarkers-en-cv-renale-uitkomsten-bij-canagliflozine/* This analysis showed that stress cardiac biomarkers (NT-proBNP, troponin) predict both cardiovascular-renal outcomes and response to canagliflozin in diabetes, supporting biomarker-guided SGLT2 inhibitor therapy. ## Antithrombotic Therapy in Patients With Atrial Fibrillation After Acute Coronary Syndromes or Percutaneous Intervention. *2022-02-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.11.035 · https://hartvaat.nl/2022/02/08/antitrombotische-therapie-bij-af-na-acs-of-pci-jacc-overzicht/* This JACC overview of antithrombotic therapy in AF patients after ACS or PCI synthesized the evidence from AUGUSTUS, RE-DUAL PCI, and ENTRUST-AF PCI, confirming dual therapy with a DOAC and P2Y12 inhibitor as the preferred approach. ## Finerenone Reduces Risk of Incident Heart Failure in Patients With Chronic Kidney Disease and Type 2 Diabetes: Analyses From the FIGARO-DKD Trial. *2022-02-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057983 · https://hartvaat.nl/2022/02/08/finerenon-vermindert-incident-hf-bij-ckd-met-diabetes-fidelity/* This FIDELITY pooled analysis demonstrated that finerenone reduces the risk of new-onset heart failure in patients with CKD and type 2 diabetes, adding heart failure prevention to the established renal and cardiovascular benefits of nonsteroidal mineralocorticoid receptor antagonism. ## Cryoballoon vs. radiofrequency catheter ablation: insights from NOrwegian randomized study of PERSistent Atrial Fibrillation (NO-PERSAF study). *2022-02-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab281 · https://hartvaat.nl/2022/02/02/cryoballon-versus-rf-bij-persisterend-af-noorse-no-pers-af-gerandomiseerde-trial/* The NO-PERS AF Norwegian randomized study compared cryoballoon with radiofrequency ablation specifically for persistent AF, providing head-to-head data in this more challenging arrhythmia phenotype. ## Effect of remote monitoring on clinical outcomes in European heart failure patients with an implantable cardioverter-defibrillator: secondary results of the REMOTE-CIED randomized trial. *2022-02-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab221 · https://hartvaat.nl/2022/02/02/remote-monitoring-en-klinische-uitkomsten-bij-europese-hf-met-icd-langetermijn/* This long-term analysis of remote monitoring in European heart failure patients with ICDs evaluated whether sustained RPM reduces clinical events and healthcare utilization over extended follow-up. ## Combining home monitoring temporal trends from implanted defibrillators and baseline patient risk profile to predict heart failure hospitalizations: results from the SELENE HF study. *2022-02-02 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab170 · https://hartvaat.nl/2022/02/02/thuismonitoring-temporele-trends-en-baseline-risico-voor-hf-voorspelling-bij-icd/* This study developed and validated an algorithm combining remote monitoring temporal trends from implanted defibrillators with baseline patient risk profiles to predict heart failure hospitalizations. ## Effect of Moderate Hypothermia vs Normothermia on 30-Day Mortality in Patients With Cardiogenic Shock Receiving Venoarterial Extracorporeal Membrane Oxygenation: A Randomized Clinical Trial. *2022-02-01 · JAMA · https://doi.org/10.1001/jama.2021.24776 · https://hartvaat.nl/2022/02/01/matige-hypothermie-versus-normothermie-bij-cardiogene-shock-met-va-ecmo-jama-hyp/* The HYPERION2 trial showed that moderate hypothermia did not improve 30-day mortality compared with normothermia in patients with cardiogenic shock receiving VA-ECMO, a negative result for temperature management in this setting. ## Economic Outcomes of Rehabilitation Therapy in Older Patients With Acute Heart Failure in the REHAB-HF Trial: A Secondary Analysis of a Randomized Clinical Trial. *2022-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.4836 · https://hartvaat.nl/2022/02/01/economische-uitkomsten-van-revalidatie-bij-ouderen-met-acuut-hf-rehab-hf/* This REHAB-HF economic analysis showed that rehabilitation therapy in older acute heart failure patients is cost-effective, with the functional improvement translating to acceptable healthcare economic value. ## Optimizing Training Response for Women in Cardiac Rehabilitation: A Randomized Clinical Trial. *2022-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.4822 · https://hartvaat.nl/2022/02/01/optimalisatie-van-trainingsrespons-voor-vrouwen-in-hartrevalidatie-jama-cardiolo/* This randomized trial showed that optimizing training intensity and modality specifically for women in cardiac rehabilitation significantly improves peak aerobic capacity, addressing the sex-based response gap in standard rehabilitation programs. ## Individualized Studies of Triggers of Paroxysmal Atrial Fibrillation: The I-STOP-AFib Randomized Clinical Trial. *2022-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.5010 · https://hartvaat.nl/2022/02/01/geindividualiseerde-triggerstudies-bij-paroxysmaal-af-jama-i-stop-afib/* The I-STOP-AFib trial investigated whether individualized identification and avoidance of patient-reported AF triggers (alcohol, caffeine, exercise, sleep deprivation) reduces AF episode frequency, exploring a personalized behavioral approach to rhythm management. ## Effects of luseogliflozin on estimated plasma volume in patients with heart failure with preserved ejection fraction. *2022-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13683 · https://hartvaat.nl/2022/02/01/luseogliflozine-en-geschat-plasmavolume-bij-hfpef/* This study showed that luseogliflozin reduces estimated plasma volume in HFpEF patients, demonstrating the diuretic-natriuretic mechanism of SGLT2 inhibition in the preserved ejection fraction phenotype. ## Myocardial Mechanics in Hypertensive Disorders of Pregnancy: a Systematic Review and Meta-Analysis. *2022-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18123 · https://hartvaat.nl/2022/02/01/myocardiale-mechanica-bij-hypertensieve-zwangerschapsaandoeningen-meta-analyse/* This meta-analysis evaluated myocardial mechanics (global longitudinal strain) in hypertensive disorders of pregnancy, showing that GLS detects subclinical cardiac dysfunction even when ejection fraction appears preserved. ## Integrating sex and gender in studies of cardiac resynchronization therapy: a systematic review. *2022-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13733 · https://hartvaat.nl/2022/02/01/sekse-en-gender-in-crt-studies-systematische-review/* This systematic review documented the underrepresentation and inconsistent reporting of sex and gender in cardiac resynchronization therapy studies, highlighting the need for sex-specific CRT evidence. ## Prognostic value of coronary computed tomography angiographic derived fractional flow reserve: a systematic review and meta-analysis. *2022-02-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319773 · https://hartvaat.nl/2022/02/01/ccta-afgeleide-ffr-prognostische-waarde-meta-analyse/* This meta-analysis evaluated the prognostic value of CT-derived fractional flow reserve (FFR-CT), showing that non-invasive physiological assessment of coronary stenoses predicts future cardiovascular events beyond anatomical assessment alone. ## Screening for Atrial Fibrillation: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. *2022-01-25 · JAMA · https://doi.org/10.1001/jama.2021.21811 · https://hartvaat.nl/2022/01/25/screening-op-af-uspstf-geactualiseerde-evidence-report-2022/* This updated USPSTF evidence review evaluated current screening strategies for atrial fibrillation in asymptomatic adults, including wearable devices and single-lead ECG, assessing the evidence for population-level AF screening programs. ## Screening for Atrial Fibrillation: US Preventive Services Task Force Recommendation Statement. *2022-01-25 · JAMA · https://doi.org/10.1001/jama.2021.23732 · https://hartvaat.nl/2022/01/25/screening-op-af-uspstf-aanbeveling-2022/* The 2022 USPSTF reaffirmed the insufficient evidence ('I' statement) for ECG screening for atrial fibrillation in asymptomatic older adults, despite advancing wearable technology, due to the lack of randomized trials demonstrating that screening-detected AF treatment improves outcomes. ## Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation: Patient-Level Network Meta-Analyses of Randomized Clinical Trials With Interaction Testing by Age and Sex. *2022-01-25 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056355 · https://hartvaat.nl/2022/01/25/doac-s-versus-warfarine-bij-af-patient-niveau-netwerkmeta-analyse-van-gerandomis/* This patient-level network meta-analysis of all four DOACs versus warfarin in atrial fibrillation confirmed the class-wide superiority of DOACs for stroke prevention with less intracranial hemorrhage. The analysis also provided the first robust head-to-head indirect comparisons between individual DOACs. ## 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. *2022-01-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.09.005 · https://hartvaat.nl/2022/01/18/2021-acc-aha-scai-richtlijn-voor-coronaire-revascularisatie-executive-summary/* The 2021 ACC/AHA/SCAI coronary revascularization guideline executive summary integrated evidence from ISCHEMIA, EXCEL, NOBLE, and contemporary trials to update recommendations for PCI versus CABG decision-making. The document emphasized heart team consultation, functional ischemia testing, and patient-centered shared decision-making for complex coronary disease. ## Magnetically Controlled Capsule Endoscopy for Assessment of Antiplatelet Therapy-Induced Gastrointestinal Injury. *2022-01-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.10.028 · https://hartvaat.nl/2022/01/18/magnetisch-gecontroleerde-capsule-endoscopie-voor-antiplaatjestherapie-gi-schade/* This study used magnetically controlled capsule endoscopy to non-invasively assess antiplatelet therapy-induced gastrointestinal injury, providing a patient-friendly method for detecting subclinical GI damage. ## Fractional Flow Reserve-Guided PCI as Compared with Coronary Bypass Surgery. *2022-01-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2112299 · https://hartvaat.nl/2022/01/13/ffr-geleide-pci-versus-cabg-nejm-fame-3/* The FAME 3 trial showed that FFR-guided PCI was not noninferior to CABG for the composite of death, MI, stroke, or repeat revascularization at 1 year in patients with three-vessel coronary artery disease. The result reinforced CABG as the preferred strategy for extensive multivessel disease. ## Risk factors for type 1 and type 2 myocardial infarction. *2022-01-13 · European heart journal · https://doi.org/10.1093/eurheartj/ehab581 · https://hartvaat.nl/2022/01/13/risicofactoren-voor-type-1-en-type-2-mi/* This study identified distinct risk factor profiles for type 1 versus type 2 myocardial infarction, showing that while type 1 MI is driven by traditional atherosclerotic risk factors, type 2 MI is associated with non-cardiac comorbidities. ## 4-Year Outcomes After Left Atrial Appendage Closure Versus Nonwarfarin Oral Anticoagulation for Atrial Fibrillation. *2022-01-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.10.023 · https://hartvaat.nl/2022/01/04/4-jaars-laa-sluiting-versus-niet-warfarine-oac-bij-af/* Four-year PRAGUE-17 results confirmed that left atrial appendage closure is noninferior to DOAC therapy for AF-related stroke prevention, providing the longest-term randomized comparison of structural versus pharmacological stroke prevention using contemporary anticoagulants. ## Association between sodium-glucose cotransporter-2 inhibitors and risk of sudden cardiac death or ventricular arrhythmias: a meta-analysis of randomized controlled trials. *2022-01-04 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab177 · https://hartvaat.nl/2022/01/04/sglt2-remmers-en-plotse-hartdood-ventriculaire-aritmie-meta-analyse/* This meta-analysis found that SGLT2 inhibitors may reduce the risk of sudden cardiac death and ventricular arrhythmias in patients with type 2 diabetes and heart failure, suggesting an antiarrhythmic component to the cardiovascular benefit of SGLT2 inhibition. ## Effectiveness and safety of a single freeze strategy of cryoballoon ablation of atrial fibrillation: an EHRA systematic review and meta-analysis. *2022-01-04 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab133 · https://hartvaat.nl/2022/01/04/enkele-freeze-cryoballonablatie-bij-af-ehra-systematische-review/* This EHRA systematic review confirmed that a single cryoballoon freeze application per vein achieves comparable efficacy and safety to the standard double-freeze protocol, supporting procedural simplification for AF ablation. ## Effect of Treatment With Sacubitril/Valsartan in Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. *2022-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.4567 · https://hartvaat.nl/2022/01/01/sacubitril-valsartan-bij-gevorderd-hfref-jama-cardiology-life-gerandomiseerde-tr/* The LIFE trial showed that sacubitril-valsartan in patients with advanced (NYHA class IV) HFrEF is safe but does not provide significant clinical benefit beyond standard RAAS inhibition, defining the limits of ARNI therapy in end-stage heart failure. ## Assessment of Omecamtiv Mecarbil for the Treatment of Patients With Severe Heart Failure: A Post Hoc Analysis of Data From the GALACTIC-HF Randomized Clinical Trial. *2022-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.4027 · https://hartvaat.nl/2022/01/01/omecamtiv-mecarbil-bij-ernstig-hf-galactic-hf-post-hoc-analyse/* This GALACTIC-HF post-hoc analysis showed that omecamtiv mecarbil provides the greatest absolute benefit in patients with the most severe heart failure (lowest EF, highest NT-proBNP), identifying the target population for cardiac myosin activation. ## Hypertension Pharmacological Treatment in Adults: A World Health Organization Guideline Executive Summary. *2022-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18192 · https://hartvaat.nl/2022/01/01/farmacologische-hypertensiebehandeling-bij-volwassenen-who-richtlijn-samenvattin/* The WHO executive summary on pharmacological hypertension treatment provided practical, globally applicable recommendations including treatment initiation thresholds, drug class selection, and follow-up strategies for resource-limited settings where the burden of uncontrolled hypertension is greatest. ## Benefits of sodium glucose cotransporter 2 inhibitors across the spectrum of cardiovascular diseases. *2022-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319185 · https://hartvaat.nl/2022/01/01/sglt2-remmers-over-het-cv-ziektespectrum-overzicht/* This review summarized the cardiovascular benefits of SGLT2 inhibitors across the full spectrum of diseases — type 2 diabetes, heart failure (HFrEF and HFpEF), and CKD — providing a unified perspective on their therapeutic versatility. ## Telomere length is independently associated with all-cause mortality in chronic heart failure. *2022-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-318654 · https://hartvaat.nl/2022/01/01/telomeerlengte-en-mortaliteit-bij-chronisch-hartfalen/* This study showed that leucocyte telomere length, a marker of biological aging, is independently associated with all-cause mortality in chronic heart failure, adding a measure of cellular senescence to HF risk stratification. ## Dolutegravir as First- or Second-Line Treatment for HIV-1 Infection in Children. *2021-12-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2108793 · https://hartvaat.nl/2021/12/30/dolutegravir-als-eerste-of-tweedelijnbehandeling-voor-hiv-1-bij-kinderen-nejm/* This NEJM trial of dolutegravir in children with HIV is relevant to cardiology through the cardiovascular-metabolic interactions of antiretroviral therapy, including effects on lipids and glucose metabolism in the pediatric population. ## Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease. *2021-12-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2110730 · https://hartvaat.nl/2021/12/30/chlorthalidon-bij-hypertensie-met-gevorderde-ckd-nejm-click/* The CLICK trial demonstrated that chlorthalidone effectively lowered blood pressure in patients with advanced CKD (eGFR 15-30 mL/min), a population traditionally thought unresponsive to thiazide diuretics. This evidence-changing result supported the use of thiazide-like diuretics even in severe kidney disease. ## Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. *2021-12-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2101909 · https://hartvaat.nl/2021/12/30/angiografie-na-buitenziekenhuis-hartstilstand-zonder-st-elevatie-nejm-tomahawk/* The TOMAHAWK trial confirmed that immediate coronary angiography did not improve 30-day survival compared with a delayed approach in patients resuscitated from out-of-hospital cardiac arrest without ST-segment elevation. Together with COACT, this definitively argued against routine emergent catheterization in this setting. ## Ten-year all-cause death after percutaneous or surgical revascularization in diabetic patients with complex coronary artery disease. *2021-12-28 · European heart journal · https://doi.org/10.1093/eurheartj/ehab441 · https://hartvaat.nl/2021/12/28/10-jaars-mortaliteit-na-pci-of-cabg-bij-diabetes-met-complex-coronairlijden/* This 10-year comparison of PCI versus CABG in diabetic patients with complex coronary disease confirmed the long-term survival advantage of surgical revascularization, consistent with FREEDOM and reinforcing CABG as the preferred strategy in this population. ## Sex differences in outcomes after coronary artery bypass grafting: a pooled analysis of individual patient data. *2021-12-28 · European heart journal · https://doi.org/10.1093/eurheartj/ehab504 · https://hartvaat.nl/2021/12/28/sekseverschillen-na-cabg-gepoolde-ipd-analyse/* This pooled individual patient data analysis of sex differences after CABG found that women have higher perioperative complication rates but similar long-term survival compared with men, informing the ongoing discussion about sex-specific outcomes in cardiac surgery. ## Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. *2021-12-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.055654 · https://hartvaat.nl/2021/12/21/langdurige-omega-3-suppletie-en-af-risico-meta-analyse-van-cv-trials/* This meta-analysis of randomized controlled trials confirmed that long-term marine omega-3 fatty acid supplementation is associated with a significantly increased risk of atrial fibrillation. The definitive safety signal raised concerns about the cardiovascular use of fish oil supplements. ## The effect of intravenous ferric carboxymaltose on cardiac reverse remodelling following cardiac resynchronization therapy-the IRON-CRT trial. *2021-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehab411 · https://hartvaat.nl/2021/12/21/iv-ijzercarboxymaltose-en-cardiale-reverse-remodellering-na-crt-iron-crt/* The IRON-CRT trial demonstrated that intravenous ferric carboxymaltose enhances cardiac reverse remodeling after CRT implantation in iron-deficient heart failure patients, suggesting that iron repletion and resynchronization have synergistic cardiac benefits. ## Percutaneous coronary intervention with drug-eluting stents versus coronary artery bypass grafting in left main coronary artery disease: an individual patient data meta-analysis. *2021-12-18 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)02334-5 · https://hartvaat.nl/2021/12/18/pci-met-des-versus-cabg-bij-hoofdstamlijden-lancet-precombat-10-jaars/* The PRECOMBAT 10-year follow-up showed no significant difference in the composite of death, MI, stroke, or revascularization between PCI with DES and CABG for left main coronary disease, though individual event rates favored CABG numerically. The long-term Korean data added to the revascularization debate. ## Daprodustat for the Treatment of Anemia in Patients Not Undergoing Dialysis. *2021-12-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2113380 · https://hartvaat.nl/2021/12/16/daprodustat-bij-anemie-bij-niet-dialysepatienten-nejm/* This NEJM trial showed that daprodustat effectively treats anemia in CKD patients not on dialysis, with cardiovascular safety comparable to darbepoetin alfa, expanding the oral HIF inhibitor option to the non-dialysis CKD population. ## Daprodustat for the Treatment of Anemia in Patients Undergoing Dialysis. *2021-12-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2113379 · https://hartvaat.nl/2021/12/16/daprodustat-bij-anemie-bij-dialysepatienten-nejm/* This NEJM trial demonstrated that daprodustat, an oral HIF prolyl hydroxylase inhibitor, is noninferior to darbepoetin alfa for treating anemia in dialysis patients, with a favorable cardiovascular safety profile and the convenience of oral dosing. ## Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): a multicentre, randomised, sham-controlled trial. *2021-12-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)02248-0 · https://hartvaat.nl/2021/12/11/qfr-geleide-coronaire-interventie-lancet-favor-iii-china-sham-gecontroleerd/* The FAVOR III China trial demonstrated that angiographic quantitative flow ratio (QFR)-guided PCI significantly improved 1-year outcomes compared with angiography-guided PCI. The wire-free virtual physiological assessment offered a practical alternative to pressure wire-based FFR measurement. ## Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes. *2021-12-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2110956 · https://hartvaat.nl/2021/12/09/finerenon-bij-nierziekte-met-diabetes-type-2-nejm-figaro-dkd/* The FIGARO-DKD trial demonstrated that finerenone reduced cardiovascular events in patients with type 2 diabetes and a broader range of CKD severity than FIDELIO, including those with earlier-stage kidney disease and less severely elevated albuminuria. Together with FIDELIO, the FIDELITY program established finerenone's cardiorenal benefit across the full CKD spectrum in diabetes. ## AV junction ablation and cardiac resynchronization for patients with permanent atrial fibrillation and narrow QRS: the APAF-CRT mortality trial. *2021-12-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehab569 · https://hartvaat.nl/2021/12/07/av-junctieablatie-plus-crt-bij-permanent-af-met-smal-qrs-apaf-crt-mortaliteitsan/* The APAF-CRT mortality analysis confirmed that AV junction ablation combined with cardiac resynchronization therapy significantly reduced all-cause mortality in patients with permanent atrial fibrillation, narrow QRS, and heart failure. The result established this strategy as a life-saving intervention in drug-refractory AF with HF. ## Meta-analysis of controlled studies on minimally interrupted vs. continuous use of non-vitamin K antagonist oral anticoagulants in catheter ablation for atrial fibrillation. *2021-12-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab175 · https://hartvaat.nl/2021/12/07/minimaal-onderbroken-versus-continue-doac-bij-af-ablatie-meta-analyse/* This meta-analysis compared minimally interrupted with continuous DOAC use during AF catheter ablation, showing similar safety and efficacy for both periprocedural anticoagulation strategies. ## Efficacy and safety of the GOLD FORCE multicentre randomized clinical trial: multielectrode phased radiofrequency vs. irrigated radiofrequency single-tip catheter with contact force ablation for treatment of symptomatic paroxysmal atrial fibrillation. *2021-12-07 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab168 · https://hartvaat.nl/2021/12/07/gold-force-multi-elektrode-rf-versus-irrigated-rf-bij-af-gerandomiseerde-trial/* The GOLD FORCE trial compared multielectrode phased RF ablation with irrigated RF ablation for AF, evaluating a balloon-based multielectrode technology against the conventional single-tip approach. ## Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-centre, single-blind, randomised, controlled trial. *2021-12-04 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)02490-9 · https://hartvaat.nl/2021/12/04/posterieure-pericardiotomie-ter-preventie-van-af-na-hartchirurgie-lancet-palacs/* The PALACS trial demonstrated that posterior left pericardiotomy, a simple 30-second surgical addition during cardiac surgery, significantly reduced the incidence of postoperative atrial fibrillation. The low-cost, low-risk intervention offered an elegant preventive strategy. ## Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR. *2021-12-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2111016 · https://hartvaat.nl/2021/12/02/edoxaban-versus-vka-bij-af-na-tavr-nejm-envisage-tavi-af/* The ENVISAGE-TAVI AF trial showed that edoxaban was noninferior to vitamin K antagonists for the composite of net adverse clinical events in patients with AF after TAVR, but was associated with more gastrointestinal bleeding. The results informed DOAC use in the growing post-TAVR AF population. ## Ticagrelor monotherapy in patients at high bleeding risk undergoing percutaneous coronary intervention: TWILIGHT-HBR. *2021-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab702 · https://hartvaat.nl/2021/12/01/ticagrelor-monotherapie-bij-hoog-bloedingsrisico-na-pci-twilight-hbr/* This TWILIGHT-HBR subanalysis confirmed that ticagrelor monotherapy after short DAPT significantly reduces bleeding in high-bleeding-risk patients undergoing PCI, with no increase in ischemic events, supporting the de-escalation approach in this vulnerable population. ## Potential Implications of Expanded US Food and Drug Administration Labeling for Sacubitril/Valsartan in the US. *2021-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.3651 · https://hartvaat.nl/2021/12/01/sacubitril-valsartan-uitgebreide-fda-labeling-jama-cardiology-implicaties/* This analysis estimated the potential impact of expanded FDA labeling for sacubitril-valsartan (including HF with LVEF above 40%) on the eligible US patient population, quantifying the implementation opportunity. ## Associations of High-Sensitivity Troponin and Natriuretic Peptide Levels With Outcomes After Intensive Blood Pressure Lowering: Findings From the SPRINT Randomized Clinical Trial. *2021-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.3187 · https://hartvaat.nl/2021/12/01/hs-troponine-en-natriuretische-peptiden-na-intensieve-bp-verlaging-sprint-biomar/* This SPRINT biomarker analysis showed that elevated troponin and natriuretic peptide levels modify the benefit of intensive blood pressure treatment, with the highest-biomarker patients deriving the greatest cardiovascular risk reduction. ## Ticagrelor monotherapy in patients with chronic kidney disease undergoing percutaneous coronary intervention: TWILIGHT-CKD. *2021-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab533 · https://hartvaat.nl/2021/12/01/ticagrelor-monotherapie-bij-ckd-na-pci-twilight-ckd/* This TWILIGHT-CKD subanalysis confirmed that ticagrelor monotherapy after PCI is safe and effective in patients with chronic kidney disease, extending the de-escalation strategy to the renally impaired population. ## Thin-cap fibroatheroma predicts clinical events in diabetic patients with normal fractional flow reserve: the COMBINE OCT-FFR trial. *2021-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab433 · https://hartvaat.nl/2021/12/01/thin-cap-fibroatheroom-voorspelt-events-bij-diabetes-met-normale-ffr-combine-oct/* The COMBINE OCT-FFR trial demonstrated that thin-cap fibroatheroma detected by OCT in diabetic patients with normal FFR predicts future cardiovascular events, supporting imaging-based vulnerable plaque identification for risk stratification beyond physiological assessment. ## Post-stenting fractional flow reserve vs coronary angiography for optimization of percutaneous coronary intervention (TARGET-FFR). *2021-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab449 · https://hartvaat.nl/2021/12/01/post-stenting-ffr-versus-angiografie-voor-pci-optimalisatie-target-ffr/* The TARGET-FFR trial showed that post-stenting FFR-guided optimization did not significantly improve clinical outcomes compared with angiographic assessment alone, questioning the routine use of FFR to guide stent optimization. ## Cardiac mortality in patients randomised to elective coronary revascularisation plus medical therapy or medical therapy alone: a systematic review and meta-analysis. *2021-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab246 · https://hartvaat.nl/2021/12/01/cardiale-mortaliteit-bij-electieve-revascularisatie-plus-medicamenteus-versus-me/* This meta-analysis showed that elective coronary revascularization plus medical therapy reduces cardiac mortality compared with medical therapy alone in stable coronary disease patients, a finding driven primarily by CABG rather than PCI trials. ## Acute Aerobic Exercise Induces Short-Term Reductions in Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta-Analysis. *2021-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.18099 · https://hartvaat.nl/2021/12/01/acute-aerobe-training-en-kortdurende-ambulante-bloeddrukreductie-bij-hypertensie/* This meta-analysis showed that acute aerobic exercise produces short-term reductions in ambulatory blood pressure in hypertensive patients, providing evidence for the immediate cardiovascular effects of physical activity. ## Efficacy and safety of intermittent repeated levosimendan infusions in advanced heart failure patients: the LAICA study. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13670 · https://hartvaat.nl/2021/12/01/intermitterend-levosimendan-bij-gevorderd-hf-laica-studie/* The LAICA study of intermittent levosimendan infusions in advanced heart failure evaluated whether repeated inotropic support reduces hospitalization and improves quality of life in patients with refractory disease. ## The benefits of sacubitril-valsartan in patients with acute myocardial infarction: a systematic review and meta-analysis. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13677 · https://hartvaat.nl/2021/12/01/sacubitril-valsartan-na-acuut-mi-meta-analyse/* This meta-analysis of sacubitril-valsartan after acute MI showed favorable effects on cardiac function and remodeling, though the clinical benefit beyond standard RAAS inhibition requires further study. ## SGLT2 inhibitors and cardiac remodelling: a systematic review and meta-analysis of randomized cardiac magnetic resonance imaging trials. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13645 · https://hartvaat.nl/2021/12/01/sglt2-remmers-en-cardiale-remodellering-meta-analyse-van-mri-trials/* This meta-analysis of randomized cardiac MRI studies confirmed that SGLT2 inhibitors reduce left ventricular mass and improve cardiac remodeling parameters, providing imaging evidence for the structural cardiac benefits of this drug class. ## Variability in estimated glomerular filtration rate and patients' outcomes in a real-world heart failure population. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13557 · https://hartvaat.nl/2021/12/01/egfr-variabiliteit-en-uitkomsten-bij-real-world-hf/* This study showed that variability in eGFR predicts outcomes in a real-world heart failure population, establishing kidney function instability as a prognostic marker beyond baseline renal impairment. ## Left ventricular dimensions and cardiovascular outcomes in systolic heart failure: the WARCEF trial. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13560 · https://hartvaat.nl/2021/12/01/lv-dimensies-en-cv-uitkomsten-bij-systolisch-hf-warcef/* This WARCEF analysis showed that LV dimensions are independently associated with cardiovascular outcomes in systolic heart failure, supporting echocardiographic size parameters for risk stratification beyond ejection fraction. ## Effects of the sodium-glucose cotransporter 2 inhibitor empagliflozin on vascular function in patients with chronic heart failure. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13622 · https://hartvaat.nl/2021/12/01/empagliflozine-en-vaatfunctie-bij-chronisch-hf/* This study showed that empagliflozin improves vascular function in chronic heart failure patients, providing mechanistic evidence that SGLT2 inhibitors reduce afterload through direct vascular effects. ## Design of a multifaceted strategy based on automated text messaging in patients with recent heart failure admission. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13516 · https://hartvaat.nl/2021/12/01/sms-strategie-bij-patienten-na-recente-hf-opname-studieontwerp/* The MESSAGE-HF study describes the design of a multicentre Brazilian trial evaluating an automated text messaging and telephone support telemonitoring strategy for patients recently hospitalised for heart failure with reduced ejection fraction. ## Heart failure and atrial flutter: a systematic review of current knowledge and practices. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13526 · https://hartvaat.nl/2021/12/01/hartfalen-en-atriumflutter-systematische-review/* This systematic review addressed the under-studied relationship between heart failure and atrial flutter (as distinct from AF), identifying knowledge gaps in the management of this specific arrhythmia-HF combination. ## Influence of baseline parameters on one-year physical, mental, and health-related quality of life in patients with heart failure and preserved ejection fraction. *2021-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13593 · https://hartvaat.nl/2021/12/01/baseline-parameters-en-1-jaars-qol-bij-hf-na-crt-d-esc-hf/* Post-hoc analysis of the Aldo-DHF trial identified baseline parameters that longitudinally influence one-year physical function, mental health, and overall quality of life in patients with HFpEF. ## A randomized multicenter trial on a lung ultrasound-guided treatment strategy in patients on chronic hemodialysis with high cardiovascular risk. *2021-12-01 · Kidney international · https://doi.org/10.1016/j.kint.2021.07.024 · https://hartvaat.nl/2021/12/01/longechogeleide-behandeling-bij-hemodialysepatienten-met-hoog-cv-risico-gerandom/* This randomized multicenter trial showed that lung ultrasound-guided treatment in chronic hemodialysis patients with high cardiovascular risk reduces pulmonary congestion, testing a practical imaging strategy for fluid management. ## Predictive models for cardiovascular and kidney outcomes in patients with type 2 diabetes: systematic review and meta-analyses. *2021-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319243 · https://hartvaat.nl/2021/12/01/predictieve-modellen-voor-cv-en-renale-uitkomsten-bij-diabetes-type-2-meta-analy/* This systematic review evaluated predictive models for cardiovascular and kidney outcomes in type 2 diabetes, informing the BMJ Rapid Recommendations on SGLT2 inhibitor and GLP-1 agonist treatment decisions. ## Predictors of Atrial Fibrillation Development in Patients With Embolic Stroke of Undetermined Source: An Analysis of the RE-SPECT ESUS Trial. *2021-11-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.055176 · https://hartvaat.nl/2021/11/30/voorspellers-van-af-ontwikkeling-bij-embolic-stroke-of-undetermined-source-re-sp/* This RE-SPECT ESUS analysis identified predictors of AF development in patients with embolic stroke of undetermined source, informing which ESUS patients should receive prolonged cardiac monitoring for occult AF detection. ## Effect of β-Blocker Withdrawal on Functional Capacity in Heart Failure and Preserved Ejection Fraction. *2021-11-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.073 · https://hartvaat.nl/2021/11/23/betablokkerstaken-en-functionele-capaciteit-bij-hfpef/* This study showed that beta-blocker withdrawal in HFpEF patients improves chronotropic response and functional capacity, providing evidence that beta-blockers may be counterproductive in preserved ejection fraction heart failure. ## Effect of Sacubitril/Valsartan vs Standard Medical Therapies on Plasma NT-proBNP Concentration and Submaximal Exercise Capacity in Patients With Heart Failure and Preserved Ejection Fraction: The PARALLAX Randomized Clinical Trial. *2021-11-16 · JAMA · https://doi.org/10.1001/jama.2021.18463 · https://hartvaat.nl/2021/11/16/sacubitril-valsartan-versus-standaardtherapie-op-nt-probnp-en-inspanningscapacit/* The PARALLAX trial demonstrated that sacubitril-valsartan reduces NT-proBNP levels compared with standard medical therapy in patients with heart failure and EF ≥40%, but did not significantly improve submaximal exercise capacity. ## Regional and ethnic influences on the response to empagliflozin in patients with heart failure and a reduced ejection fraction: the EMPEROR-Reduced trial. *2021-11-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehab360 · https://hartvaat.nl/2021/11/14/regionale-en-etnische-invloeden-op-empagliflozine-bij-hfref-emperor-reduced/* This EMPEROR-Reduced analysis showed that empagliflozin's benefit in HFrEF is consistent across geographic regions and racial/ethnic groups, supporting universal SGLT2 inhibitor use regardless of population background. ## Blood pressure lowering and risk of new-onset type 2 diabetes: an individual participant data meta-analysis. *2021-11-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01920-6 · https://hartvaat.nl/2021/11/13/bloeddrukverlaging-en-risico-op-diabetes-type-2-lancet-bplttc-ipd-meta-analyse/* This BPLTTC meta-analysis revealed that pharmacological blood pressure lowering reduces the risk of new-onset type 2 diabetes, with an estimated 11% relative risk reduction per 5 mmHg systolic blood pressure decrease. The unexpected metabolic benefit adds a new dimension to the argument for aggressive blood pressure management. ## Tirzepatide versus insulin glargine in type 2 diabetes and increased cardiovascular risk (SURPASS-4): a randomised, open-label, parallel-group, multicentre, phase 3 trial. *2021-11-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)02188-7 · https://hartvaat.nl/2021/11/13/tirzepatide-versus-insuline-glargine-bij-diabetes-type-2-met-hoog-cv-risico-lanc/* The SURPASS-4 trial showed that tirzepatide was superior to insulin glargine for HbA1c reduction and weight loss in patients with type 2 diabetes and increased cardiovascular risk, while demonstrating cardiovascular safety in this high-risk population. ## Angiotensin Receptor-Neprilysin Inhibition in Acute Myocardial Infarction. *2021-11-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2104508 · https://hartvaat.nl/2021/11/11/sacubitril-valsartan-bij-acuut-mi-nejm-paradise-mi/* The PARADISE-MI trial found that sacubitril-valsartan did not significantly reduce the composite of cardiovascular death or heart failure events compared with ramipril in patients with acute MI and reduced left ventricular function. The result indicated that ARNI therapy does not provide additional benefit over ACE inhibition in the post-MI setting. ## Colchicine in Patients With Acute Coronary Syndrome: Two-Year Follow-Up of the Australian COPS Randomized Clinical Trial. *2021-11-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.054610 · https://hartvaat.nl/2021/11/09/colchicine-na-acs-2-jaars-cops-follow-up/* The 2-year COPS follow-up of colchicine after ACS showed attenuation of the early mortality signal and a trend toward ischemic benefit, providing longer-term context for the initial concerning safety finding. ## Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease. *2021-11-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.061 · https://hartvaat.nl/2021/11/09/ffr-voor-behandeling-van-multivatencoronairlijden-jacc/* This analysis evaluated the role of FFR in guiding treatment strategy for multivessel coronary disease, assessing whether physiological assessment improves revascularization decisions in complex coronary anatomy. ## Role of pre-operative transthoracic echocardiography in predicting post-operative atrial fibrillation after cardiac surgery: a systematic review of the literature and meta-analysis. *2021-11-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab095 · https://hartvaat.nl/2021/11/08/preoperatieve-tte-voor-voorspelling-van-postoperatief-af-meta-analyse/* This meta-analysis evaluated preoperative echocardiographic predictors of postoperative AF after cardiac surgery, identifying LA size, LV diastolic dysfunction, and atrial remodeling markers as the strongest predictors. ## Impact of closed loop stimulation on prognostic cardiopulmonary variables in patients with chronic heart failure and severe chronotropic incompetence: a pilot, randomized, crossover study. *2021-11-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab110 · https://hartvaat.nl/2021/11/08/closed-loop-stimulatie-en-cardiopulmonale-variabelen-bij-chronisch-hf-met-chrono/* This study evaluated the impact of closed-loop stimulation on cardiopulmonary exercise variables in heart failure patients with chronotropic incompetence undergoing CRT, testing physiological rate adaptation for functional optimization. ## Targeting Higher Intraoperative Blood Pressures Does Not Reduce Adverse Cardiovascular Events Following Noncardiac Surgery. *2021-11-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.048 · https://hartvaat.nl/2021/11/02/hogere-intraoperatieve-bloeddrukstreefwaarden-en-cv-events-bij-niet-cardiale-chi/* This study showed that targeting higher intraoperative blood pressures during non-cardiac surgery does not reduce postoperative cardiovascular events, challenging the strategy of aggressive intraoperative hemodynamic augmentation. ## Influenza Vaccination After Myocardial Infarction: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. *2021-11-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.057042 · https://hartvaat.nl/2021/11/02/griepvaccinatie-na-mi-iami-dubbelblinde-gerandomiseerde-multicenter-trial/* The IAMI trial showed that influenza vaccination administered within 72 hours of myocardial infarction or high-risk coronary intervention reduced the composite of all-cause death, MI, or stent thrombosis at 12 months. This is the first large, placebo-controlled trial demonstrating the cardiovascular protective effect of influenza vaccination after acute coronary events. ## Association of Atrial Fibrillation Burden With Health-Related Quality of Life After Atrial Fibrillation Ablation: Substudy of the Cryoballoon vs Contact-Force Atrial Fibrillation Ablation (CIRCA-DOSE) Randomized Clinical Trial. *2021-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.3063 · https://hartvaat.nl/2021/11/01/af-last-en-qol-na-af-ablatie-cabana-substudie/* This CABANA substudy showed that AF burden reduction after ablation correlates with quality-of-life improvement, supporting AF burden as a meaningful outcome measure for rhythm control interventions. ## Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension: A Randomized Clinical Trial. *2021-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.2735 · https://hartvaat.nl/2021/11/01/inspanningstraining-en-ambulante-bloeddruk-bij-resistente-hypertensie-jama-cardi/* This randomized trial showed that structured aerobic exercise training significantly reduces ambulatory blood pressure in patients with resistant hypertension, supporting exercise as an important adjunctive strategy even when blood pressure is difficult to control pharmacologically. ## Extrapolating Long-term Event-Free and Overall Survival With Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction: An Exploratory Analysis of a Phase 3 Randomized Clinical Trial. *2021-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.2632 · https://hartvaat.nl/2021/11/01/langetermijn-event-vrije-en-totale-overleving-met-dapagliflozine-bij-hfref-jama-/* This DAPA-HF analysis extrapolated long-term survival benefits of dapagliflozin in HFrEF, estimating that SGLT2 inhibitor therapy translates to meaningful gains in event-free and overall survival over the patient's remaining lifetime. ## Effects of Different Rest Period Durations Prior to Blood Pressure Measurement: The Best Rest Trial. *2021-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17496 · https://hartvaat.nl/2021/11/01/rustduur-voor-bloeddrukmeting-best-rest-trial/* The Best Rest Trial evaluated different rest period durations before blood pressure measurement, providing evidence for optimizing the pre-measurement protocol to improve clinical accuracy. ## Association Between Blood Pressure Variability With Dementia and Cognitive Impairment: A Systematic Review and Meta-Analysis. *2021-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17797 · https://hartvaat.nl/2021/11/01/bloeddrukvariabiliteit-en-dementie-cognitieve-stoornis-meta-analyse/* This systematic review and meta-analysis found that blood pressure variability, both short-term and long-term, is independently associated with increased risk of dementia and cognitive impairment, adding to the growing evidence linking hemodynamic instability to neurodegeneration. ## Aspirin versus P2Y12 inhibitors with anticoagulation therapy for atrial fibrillation. *2021-11-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319321 · https://hartvaat.nl/2021/11/01/aspirine-versus-p2y12-remmer-met-antistolling-bij-af/* This analysis compared aspirin with P2Y12 inhibitors as the antiplatelet component of combined antithrombotic therapy in AF patients, evaluating which antiplatelet offers the best ischemia-bleeding balance alongside anticoagulation. ## Antiplatelet therapy in patients with myocardial infarction without obstructive coronary artery disease. *2021-11-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-318045 · https://hartvaat.nl/2021/11/01/antiplaatjestherapie-bij-mi-zonder-obstructief-coronairlijden-minoca/* This study evaluated antiplatelet therapy in patients with myocardial infarction without obstructive coronary artery disease (MINOCA), addressing the uncertain role of intensified antithrombotic treatment in this distinct MI phenotype. ## Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk. *2021-10-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2108749 · https://hartvaat.nl/2021/10/28/dapt-na-pci-bij-hoog-bloedingsrisico-nejm-master-dapt/* The MASTER DAPT trial showed that abbreviated 1-month dual antiplatelet therapy followed by single antiplatelet therapy was noninferior to standard DAPT for net adverse clinical events in high-bleeding-risk patients after drug-eluting stent implantation. The results support a shortened DAPT duration in this vulnerable population. ## Early Impedance-Guided Intervention Improves Long-Term Outcome in Patients With Heart Failure. *2021-10-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.036 · https://hartvaat.nl/2021/10/26/vroege-impedantie-geleide-interventie-verbetert-langetermijn-hf-uitkomsten/* This study demonstrated that early intervention guided by thoracic impedance monitoring improves long-term outcomes in heart failure patients, supporting proactive congestion management through implanted device monitoring. ## Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP): a multicentre, parallel group, unmasked, randomised controlled trial. *2021-10-23 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01637-8 · https://hartvaat.nl/2021/10/23/systematische-af-screening-en-klinische-uitkomsten-lancet-strokestop/* The STROKESTOP trial demonstrated that systematic screening for atrial fibrillation in 75-76-year-olds using intermittent ECG recordings, followed by anticoagulation when AF was detected, reduced the composite of ischemic stroke, systemic embolism, bleeding, and death compared with no screening. This is the first randomized trial showing clinical benefit from population-level AF screening. ## Efficacy of a digital therapeutics system in the management of essential hypertension: the HERB-DH1 pivotal trial. *2021-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehab559 · https://hartvaat.nl/2021/10/21/digitale-therapeutica-bij-essentiele-hypertensie-herb-dh1-pivottrial/* The HERB-DH1 pivotal trial demonstrated that a smartphone-based digital therapeutics system for lifestyle modification significantly reduces blood pressure in patients with essential hypertension, validating the concept of software-as-treatment for chronic disease management. ## Prevalence and Prognostic Implications of Diabetes With Cardiomyopathy in Community-Dwelling Adults. *2021-10-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.020 · https://hartvaat.nl/2021/10/19/diabetes-met-cardiomyopathie-in-de-community-prevalentie-en-prognose/* This study characterized the prevalence and prognostic significance of diabetes with cardiomyopathy in community-dwelling adults, showing that diabetic cardiomyopathy is common and predicts subsequent heart failure development. ## Effect of Empagliflozin on Worsening Heart Failure Events in Patients With Heart Failure and Preserved Ejection Fraction: EMPEROR-Preserved Trial. *2021-10-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.056824 · https://hartvaat.nl/2021/10/19/empagliflozine-en-verslechterende-hf-events-bij-hfpef-emperor-preserved-analyse/* This EMPEROR-Preserved analysis detailed that empagliflozin reduced worsening heart failure events across the ejection fraction spectrum in HFpEF, with consistent benefit regardless of baseline LVEF, diabetes status, or renal function. ## Redefining β-blocker response in heart failure patients with sinus rhythm and atrial fibrillation: a machine learning cluster analysis. *2021-10-16 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01638-X · https://hartvaat.nl/2021/10/16/betablokker-respons-bij-hf-met-sinusritme-en-af-machine-learning-clusteranalyse/* This Lancet machine learning analysis redefined beta-blocker response in heart failure, showing that the mortality benefit of beta-blockers is driven by heart rate reduction and is absent in patients with atrial fibrillation, challenging the assumption of universal beta-blocker benefit in HFrEF. ## Empagliflozin in Heart Failure with a Preserved Ejection Fraction. *2021-10-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2107038 · https://hartvaat.nl/2021/10/14/empagliflozine-bij-hfpef-nejm-emperor-preserved/* The EMPEROR-Preserved trial was the first to demonstrate that an SGLT2 inhibitor (empagliflozin) reduces heart failure hospitalization in patients with HFpEF. This landmark result extended the benefit of SGLT2 inhibition across the full ejection fraction spectrum, addressing an area with previously no proven pharmacological therapy. ## Empagliflozin and Major Renal Outcomes in Heart Failure. *2021-10-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMc2112411 · https://hartvaat.nl/2021/10/14/empagliflozine-en-renale-uitkomsten-bij-hartfalen-nejm-emperor-reduced-renal/* This EMPEROR-Reduced renal analysis showed that empagliflozin slowed the decline in eGFR and reduced the risk of serious kidney outcomes in patients with heart failure, demonstrating renoprotective effects of SGLT2 inhibition in the heart failure population. ## Effects of lignocaine vs. opioids on antiplatelet activity of ticagrelor: the LOCAL trial. *2021-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehab557 · https://hartvaat.nl/2021/10/14/lignocaine-versus-opioiden-op-antiplaatjeseffect-van-ticagrelor-local-trial/* The LOCAL trial showed that intravenous lignocaine avoids the antiplatelet-delaying effect of opioids on ticagrelor in ACS patients, providing an alternative analgesic strategy that preserves rapid P2Y12 inhibition. ## Bridging Antiplatelet Therapy After Percutaneous Coronary Intervention: JACC Review Topic of the Week. *2021-10-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.013 · https://hartvaat.nl/2021/10/12/overbrugging-van-antiplaatjestherapie-na-pci-jacc-review/* This JACC review addressed the practical challenge of bridging antiplatelet therapy when patients with coronary stents require non-cardiac surgery, providing guidance on risk assessment and perioperative management. ## Comparative Reductions in Investigator-Reported and Adjudicated Ischemic Events in REDUCE-IT. *2021-10-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.009 · https://hartvaat.nl/2021/10/12/reductie-in-ischemische-events-door-onderzoekers-en-adjudicatiecommissie-reduce-/* This REDUCE-IT analysis compared investigator-reported with centrally adjudicated ischemic events, showing consistent treatment effects regardless of event ascertainment method, strengthening the trial's internal validity. ## Baseline Low-Density Lipoprotein Cholesterol and Clinical Outcomes of Combining Ezetimibe With Statin Therapy in IMPROVE-IT. *2021-10-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.08.011 · https://hartvaat.nl/2021/10/12/baseline-ldl-en-klinische-uitkomsten-van-ezetimibe-plus-statine-improve-it/* This IMPROVE-IT analysis showed that patients with higher baseline LDL cholesterol derive greater absolute benefit from adding ezetimibe to statin therapy, supporting the treat-to-target approach based on baseline lipid levels. ## Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial. *2021-10-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.055329 · https://hartvaat.nl/2021/10/12/leefstijlmodificatie-bij-resistente-hypertensie-triumph-gerandomiseerde-trial/* The TRIUMPH randomized trial showed that lifestyle modifications (dietary counseling, exercise, weight loss) significantly reduce blood pressure in patients with resistant hypertension already on pharmacotherapy, demonstrating that non-pharmacological approaches retain benefit even in treatment-resistant disease. ## Unguided de-escalation from ticagrelor to clopidogrel in stabilised patients with acute myocardial infarction undergoing percutaneous coronary intervention (TALOS-AMI): an investigator-initiated, open-label, multicentre, non-inferiority, randomised trial. *2021-10-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01445-8 · https://hartvaat.nl/2021/10/09/ongeleide-de-escalatie-van-ticagrelor-naar-clopidogrel-na-mi-met-pci-lancet-talo/* The TALOS-AMI trial demonstrated that unguided de-escalation from ticagrelor to clopidogrel one month after MI reduced bleeding without increasing ischemic events. The pragmatic approach, requiring no platelet function testing, offered a simpler de-escalation strategy than guided protocols. ## A meta-analysis of clinical risk factors for stroke in anticoagulant-naïve patients with atrial fibrillation. *2021-10-09 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab087 · https://hartvaat.nl/2021/10/09/klinische-risicofactoren-voor-cva-bij-anticoagulantie-naieve-af-meta-analyse/* This meta-analysis of clinical risk factors for stroke in anticoagulant-naive AF patients identified the strongest predictors of thromboembolism, informing risk stratification for anticoagulation initiation decisions. ## Predictors of sinus rhythm 6 weeks after cardioversion of atrial fibrillation: a pre-planned post hoc analysis of the X-VeRT trial. *2021-10-09 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab084 · https://hartvaat.nl/2021/10/09/voorspellers-van-sinusritme-6-weken-na-af-cardioversie-x-vert/* This X-VeRT post-hoc analysis identified predictors of sinus rhythm maintenance 6 weeks after cardioversion of AF, informing which patients are likely to benefit from electrical rhythm restoration. ## Supervised Obesity Reduction Trial for AF ablation patients: results from the SORT-AF trial. *2021-10-09 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab122 · https://hartvaat.nl/2021/10/09/gewichtsverlies-voor-af-ablatie-sort-af-gerandomiseerde-trial/* The SORT-AF trial investigated whether structured weight reduction before AF catheter ablation improves ablation outcomes in obese patients, testing the hypothesis that upstream risk factor modification enhances procedural success. ## Association of Circulating Ketone Bodies With Functional Outcomes After ST-Segment Elevation Myocardial Infarction. *2021-10-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.07.054 · https://hartvaat.nl/2021/10/05/ketonlichamen-en-functionele-uitkomsten-na-stemi/* This study showed that circulating ketone body levels are associated with functional outcomes after STEMI, supporting the metabolic shift toward ketone utilization as a compensatory mechanism in cardiac injury. ## Effect of Paroxetine-Mediated G-Protein Receptor Kinase 2 Inhibition vs Placebo in Patients With Anterior Myocardial Infarction: A Randomized Clinical Trial. *2021-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.2247 · https://hartvaat.nl/2021/10/01/paroxetine-grk2-remming-versus-placebo-bij-anterieur-mi-jama-cardiology/* This trial tested paroxetine as a GRK2 inhibitor (repurposed from antidepressant) for preventing LV remodeling after anterior MI, exploring kinase inhibition for post-infarction cardioprotection. ## Ticagrelor or Prasugrel for Patients With Acute Coronary Syndrome Treated With Percutaneous Coronary Intervention: A Prespecified Subgroup Analysis of a Randomized Clinical Trial. *2021-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.2228 · https://hartvaat.nl/2021/10/01/ticagrelor-of-prasugrel-na-pci-voor-acs-isar-react-5-pre-gespecificeerde-analyse/* This ISAR-REACT 5 prespecified subanalysis of ACS patients treated with PCI confirmed the superiority of prasugrel over ticagrelor for the composite of death, MI, or stroke in the interventionally managed population. ## The European bifurcation club Left Main Coronary Stent study: a randomized comparison of stepwise provisional vs. systematic dual stenting strategies (EBC MAIN). *2021-10-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab283 · https://hartvaat.nl/2021/10/01/ebc-hoofdstam-stentstudie-provisional-versus-systematisch-dubbel-stenten/* This European Bifurcation Club randomized study compared stepwise provisional stenting with systematic double stenting for left main coronary bifurcation lesions, providing data on the optimal bifurcation strategy for this critical anatomy. ## Acute pleiotropic effects of dapagliflozin in type 2 diabetic patients with heart failure with reduced ejection fraction: a crossover trial. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13553 · https://hartvaat.nl/2021/10/01/acute-pleiotrope-effecten-van-dapagliflozine-bij-diabetes-type-2-met-hfref-cross/* This crossover study characterized the acute pleiotropic effects of dapagliflozin in diabetic patients with HFrEF, showing rapid hemodynamic and metabolic changes within hours of administration. ## Cross-sectional study of aortic valve calcification and cardiovascular risk factors in older Danish men. *2021-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319023 · https://hartvaat.nl/2021/10/01/aortaklepcalcificatie-en-cv-risicofactoren-bij-oudere-deense-mannen/* This cross-sectional study examined the relationship between aortic valve calcification and cardiovascular risk factors in older Danish men, exploring shared pathways between valvular calcification and atherosclerotic disease. ## Effect of a strategy of comprehensive vasodilation versus usual care on health-related quality of life among patients with acute heart failure. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13543 · https://hartvaat.nl/2021/10/01/uitgebreide-vasodilatatie-en-qol-bij-acuut-hf-substudie/* This quality-of-life substudy showed that a comprehensive vasodilation strategy versus usual care in acute heart failure does not improve long-term health-related quality of life, consistent with the neutral primary endpoint. ## Sacubitril/valsartan in real-life European patients with heart failure and reduced ejection fraction: a systematic review and meta-analysis. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13547 · https://hartvaat.nl/2021/10/01/sacubitril-valsartan-in-real-life-europese-hfref-meta-analyse/* This systematic review of European real-world evidence for sacubitril-valsartan in HFrEF showed consistent clinical benefits outside the controlled trial setting, supporting broader ARNI implementation. ## Use of novel non-invasive techniques and biomarkers to guide outpatient management of fluid overload and reduce hospital readmission: systematic review and meta-analysis. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13510 · https://hartvaat.nl/2021/10/01/niet-invasieve-technieken-en-biomarkers-voor-poliklinisch-vochtmanagement-bij-hf/* This review evaluated novel non-invasive techniques (bioimpedance, lung ultrasound) and biomarkers for outpatient fluid management in heart failure, supporting technology-assisted congestion monitoring to reduce readmissions. ## Effects of intravenous furosemide plus small-volume hypertonic saline solutions on markers of heart failure. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13511 · https://hartvaat.nl/2021/10/01/iv-furosemide-plus-hypertone-zoutoplossing-en-hf-markers/* This study compared the effects of intravenous furosemide combined with small-volume hypertonic saline solution versus furosemide alone on heart failure biomarkers in acute decompensated HFrEF. The combination approach may enhance diuretic efficacy. ## Catheter ablation as first-line treatment for paroxysmal atrial fibrillation: a systematic review and meta-analysis. *2021-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2021-319496 · https://hartvaat.nl/2021/10/01/katheterablatie-als-eerstelijns-paf-therapie-meta-analyse/* This meta-analysis of catheter ablation as first-line treatment for paroxysmal AF confirmed superior efficacy over antiarrhythmic drugs for maintaining sinus rhythm, with a favorable safety profile supporting the ablation-first approach. ## The evidence for pharmacist care in outpatients with heart failure: a systematic review and meta-analysis. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13508 · https://hartvaat.nl/2021/10/01/apothekerzorg-bij-poliklinisch-hf-meta-analyse/* This meta-analysis provided evidence that pharmacist-led care for outpatients with heart failure improves medication adherence, quality of life, and clinical outcomes, supporting interprofessional HF management models. ## A systematic review of rehabilitation in chronic heart failure: evaluating the reporting of exercise interventions. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13498 · https://hartvaat.nl/2021/10/01/revalidatie-bij-chronisch-hf-systematische-review-van-inspanningsinterventies/* This systematic review evaluated the quality of exercise intervention reporting in chronic heart failure rehabilitation trials, finding inconsistencies that hinder reproducibility and implementation of evidence-based programs. ## Empagliflozin confers reno-protection in acute myocardial infarction and type 2 diabetes mellitus. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13509 · https://hartvaat.nl/2021/10/01/empagliflozine-en-nierprotectie-bij-acuut-mi-met-diabetes-pilot/* This study demonstrated renoprotective effects of empagliflozin in patients with acute MI and type 2 diabetes, extending the kidney-protective benefits of SGLT2 inhibitors to the acute coronary care setting. ## Sodium-glucose cotransporter 2 inhibitor effects on heart failure hospitalization and cardiac function: systematic review. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13483 · https://hartvaat.nl/2021/10/01/sglt2-remmers-en-hf-hospitalisatie-en-hartfunctie-systematische-review/* This systematic review evaluated the effects of SGLT2 inhibitors on heart failure hospitalization and cardiac function parameters, consolidating the mechanistic and clinical evidence for SGLT2 inhibitor cardioprotection. ## Effects of inspiratory muscle training combined with aerobic exercise training on neurovascular control in chronic heart failure patients. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13478 · https://hartvaat.nl/2021/10/01/inspiratoire-spiertraining-plus-aerobe-training-en-neurovasculaire-controle-bij-/* This study tested whether combining inspiratory muscle training with aerobic exercise improves neurovascular control in chronic heart failure, showing synergistic effects on sympathetic nerve activity and baroreflex sensitivity. ## Non-invasive home telemonitoring in patients with decompensated heart failure: a systematic review and meta-analysis. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13475 · https://hartvaat.nl/2021/10/01/niet-invasieve-thuistelemonitoring-bij-gedecompenseerd-hf-meta-analyse/* This meta-analysis of non-invasive home telemonitoring in decompensated heart failure showed that remote monitoring reduces mortality and readmission, supporting technology-enabled post-discharge surveillance. ## Sacubitril/valsartan improves cardiac function in Chinese patients with heart failure: a real-world study. *2021-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13491 · https://hartvaat.nl/2021/10/01/sacubitril-valsartan-verbetert-hartfunctie-bij-chinese-hf-patienten-real-world/* A real-world study from a Chinese tertiary hospital demonstrated that sacubitril/valsartan improves cardiac function in Chinese patients with HFrEF, adding to the evidence base beyond the original PARADIGM-HF trial population. ## Ozanimod as Induction and Maintenance Therapy for Ulcerative Colitis. *2021-09-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2033617 · https://hartvaat.nl/2021/09/30/ozanimod-bij-colitis-ulcerosa-nejm/* This NEJM trial of ozanimod for ulcerative colitis is relevant to cardiology due to the S1P receptor modulator's effects on heart rate (transient bradycardia) and the need for cardiac monitoring during treatment initiation. ## Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension. *2021-09-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2111437 · https://hartvaat.nl/2021/09/30/intensieve-bloeddrukcontrole-bij-oudere-patienten-met-hypertensie-nejm-step/* The STEP trial demonstrated that intensive blood pressure control (target 110–130 mmHg) significantly reduced cardiovascular events compared with standard treatment (130–150 mmHg) in Chinese patients aged 60–80 with hypertension. The results confirmed the benefits of intensive blood pressure targets in older adults, extending the findings of SPRINT to an Asian population. ## Empagliflozin Improves Cardiovascular and Renal Outcomes in Heart Failure Irrespective of Systolic Blood Pressure. *2021-09-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.07.049 · https://hartvaat.nl/2021/09/28/empagliflozine-verbetert-cv-en-renale-uitkomsten-ongeacht-systolische-bloeddruk-/* This EMPEROR-Reduced analysis confirmed that empagliflozin improves cardiovascular and renal outcomes regardless of baseline systolic blood pressure, supporting SGLT2 inhibitor use even in patients with lower blood pressures. ## Prognostic Importance of NT-proBNP and Effect of Empagliflozin in the EMPEROR-Reduced Trial. *2021-09-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.07.046 · https://hartvaat.nl/2021/09/28/nt-probnp-prognose-en-empagliflozine-effect-bij-emperor-reduced/* This EMPEROR-Reduced analysis showed that baseline NT-proBNP levels have prognostic value and that empagliflozin reduces heart failure events consistently across the natriuretic peptide spectrum. ## One-Year Committed Exercise Training Reverses Abnormal Left Ventricular Myocardial Stiffness in Patients With Stage B Heart Failure With Preserved Ejection Fraction. *2021-09-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.054117 · https://hartvaat.nl/2021/09/21/1-jaar-inspanningstraining-keert-lv-stijfheid-om-bij-stadium-b-hf/* This study demonstrated that one year of committed high-intensity exercise training can reverse abnormal left ventricular myocardial stiffness in patients with stage B heart failure (hypertrophy with elevated biomarkers), supporting exercise as a disease-modifying intervention before clinical HF develops. ## PCSK9 Inhibition and Oxidized Phospholipids. *2021-09-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.07.031 · https://hartvaat.nl/2021/09/21/pcsk9-remming-en-geoxideerde-fosfolipiden/* This study examined the effect of PCSK9 inhibition on oxidized phospholipids, exploring whether evolocumab reduces these atherogenic mediators as an additional mechanism of cardiovascular protection beyond LDL lowering. ## Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment. *2021-09-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.07.022 · https://hartvaat.nl/2021/09/21/bijwerkingspatronen-in-crossover-trial-statine-placebo-geen-behandeling-statinwi/* This StatinWISE detailed analysis of daily symptom scores showed that statin-attributed side effects are largely not reproducible under blinded conditions, with patients experiencing similar symptom levels during statin, placebo, and no-treatment periods. ## Effect of dapagliflozin on ventricular arrhythmias, resuscitated cardiac arrest, or sudden death in DAPA-HF. *2021-09-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehab560 · https://hartvaat.nl/2021/09/21/dapagliflozine-en-ventriculaire-aritmieen-en-plotse-dood-bij-hf-dapa-hf/* This DAPA-HF analysis showed that dapagliflozin does not significantly reduce the incidence of ventricular arrhythmias, resuscitated cardiac arrest, or sudden death in HFrEF, suggesting that the mortality benefit operates primarily through heart failure-related mechanisms. ## Sacubitril-valsartan as a treatment for apparent resistant hypertension in patients with heart failure and preserved ejection fraction. *2021-09-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehab499 · https://hartvaat.nl/2021/09/21/sacubitril-valsartan-bij-schijnbaar-resistente-hypertensie-met-hfpef/* This study showed that sacubitril-valsartan effectively lowers blood pressure in HFpEF patients with apparent resistant hypertension, identifying a potential additional indication for ARNI therapy in the hypertension-HFpEF overlap. ## Initial treatment with a single pill containing quadruple combination of quarter doses of blood pressure medicines versus standard dose monotherapy in patients with hypertension (QUARTET): a phase 3, randomised, double-blind, active-controlled trial. *2021-09-18 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01922-X · https://hartvaat.nl/2021/09/18/kwartdosis-viervoudige-combinatiepil-versus-standaardzorg-bij-hypertensie-lancet/* The QUARTET trial showed that initial treatment with a quarter-dose quadruple combination blood pressure pill achieved superior blood pressure control compared with standard care monotherapy at 12 weeks. The results support ultra-low-dose combination therapy as an effective strategy to overcome treatment inertia in hypertension. ## Effect of Salt Substitution on Cardiovascular Events and Death. *2021-09-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2105675 · https://hartvaat.nl/2021/09/16/zoutsubstitutie-en-cv-events-en-sterfte-nejm-ssass/* The SSaSS trial showed that replacing regular salt with a potassium-enriched salt substitute in 20,995 participants significantly reduced stroke, cardiovascular events, and all-cause mortality without increasing hyperkalemia. This is the largest dietary intervention trial in cardiovascular prevention and demonstrates a scalable public health strategy. ## Prevalence, management and impact of chronic obstructive pulmonary disease in atrial fibrillation: a systematic review and meta-analysis of 4,200,000 patients. *2021-09-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehab453 · https://hartvaat.nl/2021/09/14/copd-bij-af-prevalentie-management-en-impact-meta-analyse/* This meta-analysis quantified the prevalence and adverse impact of COPD in AF patients, showing that respiratory comorbidity significantly worsens cardiovascular outcomes in the atrial fibrillation population. ## Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial. *2021-09-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01754-2 · https://hartvaat.nl/2021/09/11/hemodynamisch-geleid-hf-management-lancet-guide-hf/* The GUIDE-HF trial of hemodynamic-guided heart failure management with implantable PA pressure sensors showed no significant overall benefit, though a pre-COVID subanalysis suggested reduced heart failure events. The results highlighted the confounding impact of the pandemic on heart failure trials. ## Antiarrhythmic drugs in patients with early persistent atrial fibrillation and heart failure: results of the RACE 3 study. *2021-09-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab062 · https://hartvaat.nl/2021/09/08/antiaritmica-bij-vroeg-persisterend-af-met-hf-race-3/* This RACE 3 analysis evaluated antiarrhythmic drug use in patients with early persistent AF and heart failure, showing that rhythm control drugs have limited additional benefit when combined with upstream therapy targeting risk factors. ## Effect of Heart Rate on the Outcome of Renal Denervation in Patients With Uncontrolled Hypertension. *2021-09-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.06.044 · https://hartvaat.nl/2021/09/07/hartfrequentie-en-uitkomsten-van-renale-denervatie-bij-ongecontroleerde-hyperten/* This analysis showed that baseline heart rate influences the blood pressure-lowering response to renal denervation, identifying heart rate as a predictor of RDN efficacy in uncontrolled hypertension. ## Cardiovascular and Renal Outcomes with Efpeglenatide in Type 2 Diabetes. *2021-09-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2108269 · https://hartvaat.nl/2021/09/02/efpeglenatide-en-cv-en-renale-uitkomsten-bij-diabetes-type-2-nejm-amplitude-o/* The AMPLITUDE-O trial demonstrated that efpeglenatide, an exendin-based GLP-1 receptor agonist, reduced cardiovascular events and kidney outcomes in patients with type 2 diabetes at high cardiovascular risk. This was the sixth positive GLP-1 RA cardiovascular outcomes trial, extending the class benefit to a structurally distinct agent. ## Effect of the Million Hearts Cardiovascular Disease Risk Reduction Model on Initiating and Intensifying Medications: A Prespecified Secondary Analysis of a Randomized Clinical Trial. *2021-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.1565 · https://hartvaat.nl/2021/09/01/million-hearts-cv-risicoreductiemodel-en-medicatie-initiatie-jama-cardiology/* This analysis showed that the Million Hearts cardiovascular risk reduction model successfully increases initiation and intensification of preventive medications, translating the pay-for-performance approach into measurable prescribing changes. ## Sex Differences Among Patients With High Risk Receiving Ticagrelor With or Without Aspirin After Percutaneous Coronary Intervention: A Subgroup Analysis of the TWILIGHT Randomized Clinical Trial. *2021-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.1720 · https://hartvaat.nl/2021/09/01/sekseverschillen-bij-ticagrelor-aspirine-na-pci-bij-hoog-risico-twilight/* This TWILIGHT sex-stratified analysis showed that ticagrelor monotherapy after short DAPT reduces bleeding similarly in women and men undergoing PCI, confirming sex-equal benefit of the de-escalation strategy. ## SPARTE Study: Normalization of Arterial Stiffness and Cardiovascular Events in Patients With Hypertension at Medium to Very High Risk. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17579 · https://hartvaat.nl/2021/09/01/normalisatie-van-arteriele-stijfheid-en-cv-events-sparte-studie/* The SPARTE study investigated whether targeting normalization of arterial stiffness (pulse wave velocity) reduces cardiovascular events in hypertensive patients at moderate-to-high risk, testing a biomarker-guided treatment strategy. ## Cardiovascular Benefits of Combination Angiotensin-Converting Enzyme Inhibition Plus Calcium Channel Blockade in Black Hypertensive Patients. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17990 · https://hartvaat.nl/2021/09/01/ace-remmer-plus-calciumantagonist-bij-zwarte-hypertensieve-patienten/* This analysis showed that combination ACE inhibitor plus calcium channel blocker therapy provides superior cardiovascular benefit in Black hypertensive patients, informing drug class selection in populations with different pharmacogenomic responses. ## Effect of a Physician/Pharmacist Collaborative Care Model on Time in Target Range for Systolic Blood Pressure: Post Hoc Analysis of the CAPTION Trial. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17873 · https://hartvaat.nl/2021/09/01/arts-apotheker-samenwerkingsmodel-en-time-in-target-bloeddruk-post-hoc-analyse/* This post-hoc analysis showed that a physician-pharmacist collaborative care model improves blood pressure time-in-target range, demonstrating that team-based management achieves more sustained blood pressure control than usual care. ## Health Care Delivery Interventions for Hypertension Management in Underserved Populations in the United States: A Systematic Review. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15946 · https://hartvaat.nl/2021/09/01/zorginterventies-voor-hypertensie-bij-achtergestelde-populaties-in-de-vs-meta-an/* This systematic review evaluated healthcare delivery interventions for hypertension in underserved US populations, identifying team-based care, community health workers, and digital health as the most effective approaches for closing treatment disparities. ## Long-Term Blood Pressure Variability Increases Risks of Dementia and Cognitive Decline: A Meta-Analysis of Longitudinal Studies. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17788 · https://hartvaat.nl/2021/09/01/langetermijn-bloeddrukvariabiliteit-en-dementierisico-meta-analyse/* This meta-analysis of longitudinal studies demonstrated that long-term blood pressure variability (visit-to-visit fluctuations) is independently associated with increased risk of dementia and cognitive decline, beyond mean blood pressure levels. ## Albuminuria Testing in Hypertension and Diabetes: An Individual-Participant Data Meta-Analysis in a Global Consortium. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17323 · https://hartvaat.nl/2021/09/01/albuminurietesting-bij-hypertensie-en-diabetes-ipd-meta-analyse/* This individual participant data meta-analysis from a global consortium showed that albuminuria testing provides important prognostic information in patients with hypertension and diabetes, supporting routine albuminuria screening for cardiovascular and renal risk stratification. ## Effects of Experimental Sleep Restriction on Ambulatory and Sleep Blood Pressure in Healthy Young Adults: A Randomized Crossover Study. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17622 · https://hartvaat.nl/2021/09/01/slaaprestrictie-en-ambulante-en-slaap-bloeddruk-gerandomiseerde-crossover/* This randomized crossover trial demonstrated that experimental sleep restriction increases both ambulatory and nocturnal blood pressure in healthy young adults, establishing a causal link between insufficient sleep and blood pressure elevation. ## Blood-Brain Barrier Crossing Renin-Angiotensin Drugs and Cognition in the Elderly: A Meta-Analysis. *2021-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17049 · https://hartvaat.nl/2021/09/01/bloed-hersenbarriere-kruisende-raas-middelen-en-cognitie-bij-ouderen-meta-analys/* This meta-analysis showed that blood-brain-barrier-crossing RAAS inhibitors may have superior cognitive benefits compared with non-crossing agents in elderly hypertensive patients, informing antihypertensive drug selection for neuroprotection. ## Effect of blood pressure lowering drugs and antibiotics on abdominal aortic aneurysm growth: a systematic review and meta-analysis. *2021-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-318192 · https://hartvaat.nl/2021/09/01/bloeddrukverlagende-middelen-en-antibiotica-en-aaa-groei-meta-analyse/* This meta-analysis evaluated the effect of blood pressure-lowering drugs and antibiotics on abdominal aortic aneurysm growth, finding limited evidence for pharmacological slowing of aneurysm progression. ## Colchicine in Patients With Chronic Coronary Disease in Relation to Prior Acute Coronary Syndrome. *2021-08-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.06.037 · https://hartvaat.nl/2021/08/31/colchicine-bij-chronisch-coronairlijden-met-versus-zonder-eerder-acs/* This analysis of colchicine in chronic coronary disease stratified by prior ACS showed that the anti-inflammatory benefit is consistent regardless of ACS history, supporting colchicine use across the stable coronary disease population. ## 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee. *2021-08-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.06.011 · https://hartvaat.nl/2021/08/31/2021-acc-consensus-ascvd-risicoreductie-bij-persistente-hypertriglyceridemie/* The 2021 ACC Expert Consensus addressed ASCVD risk reduction in patients with persistent hypertriglyceridemia, providing decision algorithms integrating icosapent ethyl, fibrates, and lifestyle modification based on the REDUCE-IT and STRENGTH evidence. ## De-Escalation of Dual Antiplatelet Therapy in Patients With Acute Coronary Syndromes. *2021-08-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.06.012 · https://hartvaat.nl/2021/08/24/de-escalatie-van-dapt-bij-acs-jacc-review/* This JACC review comprehensively summarized all available evidence on DAPT de-escalation strategies after ACS, including guided (pharmacogenomic/pharmacodynamic), unguided, dose-reduction, and early aspirin discontinuation approaches. ## The effect of intravenous ferric carboxymaltose on health-related quality of life in iron-deficient patients with acute heart failure: the results of the AFFIRM-AHF study. *2021-08-17 · European heart journal · https://doi.org/10.1093/eurheartj/ehab234 · https://hartvaat.nl/2021/08/17/iv-ijzercarboxymaltose-en-qol-bij-ijzerdeficient-acuut-hf-affirm-ahf/* This AFFIRM-AHF quality-of-life analysis showed that intravenous ferric carboxymaltose significantly improves health-related quality of life in iron-deficient patients with acute heart failure, complementing the clinical event data. ## Lowering cholesterol, blood pressure, or both to prevent cardiovascular events: results of 8.7 years of follow-up of Heart Outcomes Evaluation Prevention (HOPE)-3 study participants. *2021-08-17 · European heart journal · https://doi.org/10.1093/eurheartj/ehab225 · https://hartvaat.nl/2021/08/17/cholesterol-en-bloeddrukverlaging-na-hope-3-8-7-jaars-follow-up/* The HOPE-3 extended 8.7-year follow-up showed that the cardiovascular benefits of rosuvastatin observed during the active treatment period persisted after trial completion, suggesting a legacy effect of intermediate-risk lipid lowering on long-term cardiovascular protection. ## Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3): a randomised, open-label, parallel-group, phase 3 trial. *2021-08-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01443-4 · https://hartvaat.nl/2021/08/14/tirzepatide-versus-insuline-degludec-bij-diabetes-type-2-lancet-surpass-3/* The SURPASS-3 trial demonstrated that tirzepatide was superior to insulin degludec for glycemic control and weight loss when added to metformin with or without an SGLT2 inhibitor in type 2 diabetes. The results positioned tirzepatide as a potent alternative to basal insulin. ## Single-dose oral anti-arrhythmic drugs for cardioversion of recent-onset atrial fibrillation: a systematic review and network meta-analysis of randomized controlled trials. *2021-08-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab014 · https://hartvaat.nl/2021/08/06/orale-antiaritmica-voor-cardioversie-van-recent-onset-af-netwerkmeta-analyse/* This network meta-analysis of single-dose oral antiarrhythmic drugs for recent-onset AF cardioversion identified the most effective agents and their relative efficacy, informing the pill-in-the-pocket approach to acute rhythm management. ## Risk of ventricular arrhythmia in cardiac resynchronization therapy responders and super-responders: a systematic review and meta-analysis. *2021-08-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa414 · https://hartvaat.nl/2021/08/06/ventriculaire-aritmie-bij-crt-responders-en-super-responders-meta-analyse/* This meta-analysis showed that CRT responders and super-responders have reduced risk of ventricular arrhythmias compared with non-responders, supporting the antiarrhythmic effect of successful resynchronization. ## Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock. *2021-08-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2026845 · https://hartvaat.nl/2021/08/05/milrinone-versus-dobutamine-bij-cardiogene-shock-nejm-doremi/* The DOREMI trial found no significant difference between milrinone and dobutamine for the primary outcome in patients with cardiogenic shock. As the first large head-to-head comparison of inotropes in shock, it established that neither agent is clearly superior. ## Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol. *2021-08-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.102 · https://hartvaat.nl/2021/08/03/lp-a-en-pcsk9-remmingsvoordeel-bij-nominaal-gecontroleerd-ldl/* This analysis showed that elevated Lp(a) identifies patients who benefit from PCSK9 inhibition even when LDL cholesterol appears adequately controlled, supporting Lp(a) measurement to guide treatment escalation decisions. ## Randomized Controlled Trial Comparing Automated Office Blood Pressure Readings After Zero or Five Minutes of Rest. *2021-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17319 · https://hartvaat.nl/2021/08/01/aobp-na-nul-versus-vijf-minuten-rust-gerandomiseerde-trial/* This randomized trial showed that automated office blood pressure readings obtained after zero minutes of rest are comparable to those after five minutes, simplifying the measurement protocol for clinical practice. ## Clinical Phenotype of Resistant Hypertension Responders to Continuous Positive Airway Pressure Treatment: Results From the HIPARCO Randomized Clinical Trial. *2021-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17364 · https://hartvaat.nl/2021/08/01/fenotype-van-cpap-responders-bij-resistente-hypertensie-hiparco/* This HIPARCO analysis characterized the clinical phenotype of resistant hypertension patients who respond to CPAP therapy, identifying which obstructive sleep apnea patients benefit most from positive airway pressure for blood pressure control. ## Effectiveness of motivational interviewing on health-service use and mortality: a secondary outcome analysis of the MOTIVATE-HF trial. *2021-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13373 · https://hartvaat.nl/2021/08/01/motivational-interviewing-en-zorggebruik-en-mortaliteit-bij-hf-motivate-hf/* This MOTIVATE-HF secondary analysis showed that motivational interviewing reduces healthcare service use and may improve mortality in heart failure patients, demonstrating both clinical and economic benefits of behavioral intervention. ## Growth differentiation factor-15, treatment with liraglutide, and clinical outcomes among patients with heart failure. *2021-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13348 · https://hartvaat.nl/2021/08/01/gdf-15-en-liraglutide-behandeling-bij-hf-patienten/* This analysis evaluated GDF-15 as a biomarker in heart failure patients treated with liraglutide, assessing whether this stress-responsive cytokine predicts treatment response and cardiovascular outcomes. ## Eligibility of outpatients with chronic heart failure for sodium-glucose co-transporter-2 inhibitors. *2021-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13380 · https://hartvaat.nl/2021/08/01/geschiktheid-van-poliklinische-chronische-hf-patienten-voor-sglt2-remmers/* This analysis estimated the proportion of outpatient chronic heart failure patients eligible for SGLT2 inhibitors based on trial criteria, identifying the implementation opportunity and potential treatment gap. ## Pulse Wave Calibration and Implications for Blood Pressure Measurement: Systematic Review and Meta-Analysis. *2021-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16817 · https://hartvaat.nl/2021/08/01/polsgolfcalibratie-en-implicaties-voor-bloeddrukmeting-meta-analyse/* This meta-analysis evaluated pulse wave calibration methods and their implications for blood pressure measurement accuracy, addressing a fundamental technical issue that affects all non-invasive BP devices. ## Effects of echo-optimization of left ventricular assist devices on functional capacity, a randomized controlled trial. *2021-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13359 · https://hartvaat.nl/2021/08/01/echo-optimalisatie-van-lvad-en-functionele-capaciteit-gerandomiseerde-trial/* This randomized trial tested whether echo-guided optimization of LVAD pump parameters improves exercise capacity, evaluating individualized device programming for functional benefit in mechanically supported patients. ## Clinical phenogroups are more effective than left ventricular ejection fraction categories in stratifying heart failure outcomes. *2021-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13344 · https://hartvaat.nl/2021/08/01/klinische-fenotypen-zijn-effectiever-dan-ef-categorieen-voor-hf-uitkomsten/* This study showed that data-driven clinical phenotype clusters stratify heart failure risk more effectively than traditional LVEF categories, supporting the move toward phenotype-based rather than EF-based classification. ## Effect of a Hospital and Postdischarge Quality Improvement Intervention on Clinical Outcomes and Quality of Care for Patients With Heart Failure With Reduced Ejection Fraction: The CONNECT-HF Randomized Clinical Trial. *2021-07-27 · JAMA · https://doi.org/10.1001/jama.2021.8844 · https://hartvaat.nl/2021/07/27/ziekenhuis-en-post-ontslagkwaliteitsinterventie-bij-hf-jama-connect-hf/* The CONNECT-HF trial showed that a hospital and post-discharge quality improvement intervention did not significantly reduce mortality or heart failure rehospitalization, highlighting the challenges of translating guideline adherence into outcome improvement. ## Does This Adult Patient Have Hypertension?: The Rational Clinical Examination Systematic Review. *2021-07-27 · JAMA · https://doi.org/10.1001/jama.2021.4533 · https://hartvaat.nl/2021/07/27/heeft-deze-volwassene-hypertensie-jama-rational-clinical-examination/* This JAMA Rational Clinical Examination review addressed how to diagnose hypertension in adults, comparing office, home, and ambulatory blood pressure measurement methods and their diagnostic accuracy. ## Multivessel PCI Guided by FFR or Angiography for Myocardial Infarction. *2021-07-22 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2104650 · https://hartvaat.nl/2021/07/22/multivaten-pci-geleid-door-ffr-of-angiografie-bij-mi-nejm-flower-mi/* The FLOWER-MI trial showed that FFR-guided complete revascularization of nonculprit lesions did not reduce the composite of death, MI, or urgent revascularization compared with angiography-guided PCI in patients with STEMI and multivessel disease. The surprising negative result questioned the added value of FFR guidance in the acute MI setting. ## Efficacy and safety of low-dose colchicine in patients with coronary disease: a systematic review and meta-analysis of randomized trials. *2021-07-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehab115 · https://hartvaat.nl/2021/07/21/laaggedoseerd-colchicine-bij-coronairlijden-meta-analyse-van-gerandomiseerde-tri/* This meta-analysis of colchicine trials in coronary disease confirmed that low-dose colchicine reduces cardiovascular events with an acceptable safety profile, integrating COLCOT, LoDoCo2, and COPS data. The pooled evidence supported colchicine as a cost-effective anti-inflammatory strategy. ## Smartphone electrocardiogram for detecting atrial fibrillation after a cerebral ischaemic event: a multicentre randomized controlled trial. *2021-07-18 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab036 · https://hartvaat.nl/2021/07/18/smartphone-ecg-voor-af-detectie-na-cerebrovasculair-event-multicenter-rct/* This multicenter randomized trial evaluated smartphone-based ECG for AF detection after cerebral ischemic events, exploring consumer technology as a scalable post-stroke monitoring strategy. ## Cryoballoon ablation vs. antiarrhythmic drugs: first-line therapy for patients with paroxysmal atrial fibrillation. *2021-07-18 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab029 · https://hartvaat.nl/2021/07/18/cryoballonablatie-versus-antiaritmica-als-eerstelijns-paf-therapie/* This study compared cryoballoon ablation with antiarrhythmic drugs as first-line therapy for paroxysmal AF, providing additional evidence for the ablation-first approach as the initial treatment strategy. ## Likelihood of injury due to vasovagal syncope: a systematic review and meta-analysis. *2021-07-18 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euab041 · https://hartvaat.nl/2021/07/18/letselrisico-bij-vasovagale-syncope-systematische-review-en-meta-analyse/* This meta-analysis quantified the likelihood of injury due to vasovagal syncope, showing that physical injuries are more common than previously recognized, challenging the perception of VVS as uniformly benign. ## Relationship between procedural volume and complication rates for catheter ablation of atrial fibrillation: a systematic review and meta-analysis. *2021-07-18 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa415 · https://hartvaat.nl/2021/07/18/procedurevolume-en-complicaties-bij-af-ablatie-meta-analyse/* This meta-analysis showed that higher procedural volume for AF catheter ablation is associated with lower complication rates, supporting centralization of complex electrophysiology procedures in experienced centers. ## Long-term follow-up after ultrathin vs. conventional 2nd-generation drug-eluting stents: a systematic review and meta-analysis of randomized controlled trials. *2021-07-15 · European heart journal · https://doi.org/10.1093/eurheartj/ehab280 · https://hartvaat.nl/2021/07/15/ultradunne-versus-conventionele-2e-generatie-des-langetermijn-meta-analyse/* This meta-analysis of long-term follow-up data confirmed that ultrathin-strut DES provide improved safety outcomes compared with conventional second-generation stents, supporting the continued evolution toward thinner coronary device platforms. ## Physical Rehabilitation for Older Patients Hospitalized for Heart Failure. *2021-07-15 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2026141 · https://hartvaat.nl/2021/07/15/fysieke-revalidatie-bij-oudere-gehospitaliseerde-hf-patienten-nejm-rehab-hf/* The REHAB-HF trial showed that a tailored physical rehabilitation intervention improved physical function and frailty in older patients hospitalized for acute heart failure, though it did not significantly reduce rehospitalization or death. The functional benefit supports rehabilitation in elderly heart failure patients. ## Ablation Versus Drug Therapy for Atrial Fibrillation in Racial and Ethnic Minorities. *2021-07-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.092 · https://hartvaat.nl/2021/07/13/ablatie-versus-medicatie-bij-af-naar-ras-en-etniciteit/* This study showed that racial and ethnic minorities with AF have similar outcomes from catheter ablation as White patients, supporting equitable access to rhythm control procedures across diverse populations. ## Finerenone Reduces New-Onset Atrial Fibrillation in Patients With Chronic Kidney Disease and Type 2 Diabetes. *2021-07-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.079 · https://hartvaat.nl/2021/07/13/finerenon-vermindert-nieuw-onset-af-bij-ckd-met-diabetes-fidelio-dkd/* This FIDELIO-DKD analysis showed that finerenone reduces new-onset atrial fibrillation in patients with CKD and type 2 diabetes, revealing an unexpected antiarrhythmic benefit of nonsteroidal mineralocorticoid receptor antagonism. ## Effect of Ejection Fraction on Clinical Outcomes in Patients Treated With Omecamtiv Mecarbil in GALACTIC-HF. *2021-07-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.065 · https://hartvaat.nl/2021/07/13/ef-en-uitkomsten-bij-omecamtiv-mecarbil-galactic-hf/* This GALACTIC-HF analysis showed that omecamtiv mecarbil provides greater benefit in patients with lower ejection fractions, suggesting that the cardiac myosin activator is most effective in those with the most severely impaired contractility. ## Ten-Year All-Cause Death According to Completeness of Revascularization in Patients With Three-Vessel Disease or Left Main Coronary Artery Disease: Insights From the SYNTAX Extended Survival Study. *2021-07-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046289 · https://hartvaat.nl/2021/07/13/10-jaars-mortaliteit-naar-compleetheid-van-revascularisatie-bij-drievaten-hoofds/* This 10-year analysis of all-cause mortality according to completeness of revascularization in three-vessel or left main disease showed that complete revascularization is associated with better long-term survival regardless of whether PCI or CABG was used. ## Late Outcomes of the RAPID-TnT Randomized Controlled Trial: 0/1-Hour High-Sensitivity Troponin T Protocol in Suspected ACS. *2021-07-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.121.055009 · https://hartvaat.nl/2021/07/13/late-rapid-tnt-uitkomsten-0-1-uur-hs-troponine-t-bij-verdenking-acs/* Late outcomes of the RAPID-TnT trial confirmed that a 0/1-hour high-sensitivity troponin protocol for suspected ACS safely reduces emergency department evaluation time without missing clinically significant MI. ## Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. *2021-07-10 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01324-6 · https://hartvaat.nl/2021/07/10/tirzepatide-bij-diabetes-type-2-lancet-surpass-1-fase-3/* The SURPASS-1 trial demonstrated that tirzepatide, a novel dual GIP/GLP-1 receptor agonist, produced superior HbA1c reduction and weight loss compared with placebo as monotherapy in type 2 diabetes. These first phase 3 results foreshadowed the transformative potential of dual incretin agonism. ## Similar cardiovascular outcomes in patients with diabetes and established or high risk for coronary vascular disease treated with dulaglutide with and without baseline metformin. *2021-07-08 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa777 · https://hartvaat.nl/2021/07/08/cv-uitkomsten-bij-diabetes-met-vastgesteld-of-hoog-risico-coronairlijden-dulaglu/* This analysis showed that dulaglutide provides similar cardiovascular protection in diabetic patients with established versus high-risk-for coronary disease, supporting GLP-1 receptor agonist use for primary prevention in high-risk diabetes. ## Performance of the GRACE 2.0 score in patients with type 1 and type 2 myocardial infarction. *2021-07-08 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa375 · https://hartvaat.nl/2021/07/08/grace-2-0-score-bij-type-1-en-type-2-mi/* This analysis showed that the GRACE 2.0 risk score performs well for type 1 MI but has limited accuracy for type 2 MI, suggesting the need for separate risk models for demand-type myocardial infarction. ## Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary Revascularization. *2021-07-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.087 · https://hartvaat.nl/2021/07/06/optimale-medicamenteuze-therapie-en-10-jaarsmortaliteit-na-revascularisatie/* This analysis showed that optimal medical therapy significantly impacts 10-year mortality after coronary revascularization regardless of whether PCI or CABG was performed, reinforcing that pharmacotherapy is the foundation of long-term post-revascularization care. ## Mortality Benefit of Rivaroxaban Plus Aspirin in Patients With Chronic Coronary or Peripheral Artery Disease. *2021-07-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.083 · https://hartvaat.nl/2021/07/06/mortaliteitsvoordeel-van-rivaroxaban-plus-aspirine-bij-chronisch-vaatlijden-comp/* This COMPASS analysis quantified the mortality benefit of rivaroxaban plus aspirin in patients with chronic coronary or peripheral artery disease, showing that the dual-pathway strategy reduces both cardiovascular and all-cause death. ## Calcium/Calmodulin-Dependent Protein Kinase II Delta Inhibition and Ventricular Remodeling After Myocardial Infarction: A Randomized Clinical Trial. *2021-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.0676 · https://hartvaat.nl/2021/07/01/camkii-delta-remming-en-ventriculaire-remodellering-na-mi-jama-cardiology/* This randomized trial tested a CaMKII delta inhibitor for preventing ventricular remodeling after anterior STEMI, exploring targeted kinase inhibition as a post-MI cardioprotective strategy. ## Effect of Dapagliflozin on Cardiovascular Outcomes According to Baseline Kidney Function and Albuminuria Status in Patients With Type 2 Diabetes: A Prespecified Secondary Analysis of a Randomized Clinical Trial. *2021-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.0660 · https://hartvaat.nl/2021/07/01/dapagliflozine-naar-nierfunctie-en-albuminurie-bij-diabetes-declare/* This DECLARE analysis showed that dapagliflozin's cardiovascular benefit is consistent across baseline kidney function and albuminuria categories, supporting SGLT2 inhibitor use regardless of renal status in type 2 diabetes. ## Efficacy and Safety of Revacept, a Novel Lesion-Directed Competitive Antagonist to Platelet Glycoprotein VI, in Patients Undergoing Elective Percutaneous Coronary Intervention for Stable Ischemic Heart Disease: The Randomized, Double-blind, Placebo-Controlled ISAR-PLASTER Phase 2 Trial. *2021-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.0475 · https://hartvaat.nl/2021/07/01/revacept-gpvi-antagonist-bij-pci-jama-cardiology/* This trial of revacept, a novel competitive antagonist of platelet glycoprotein VI, during PCI tested a new antithrombotic mechanism that targets the collagen-platelet interaction at the site of vascular injury. ## Transforming clinical research by involving and empowering patients- the RATE-AF randomized trial. *2021-07-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab098 · https://hartvaat.nl/2021/07/01/transformatie-van-klinisch-onderzoek-door-patientbetrokkenheid-rate-af/* This EHJ article highlighted the RATE-AF trial as a model for patient involvement and empowerment in cardiovascular clinical research, demonstrating how patient-centered trial design improves research quality and relevance. ## Associations of Empagliflozin With Left Ventricular Volumes, Mass, and Function in Patients With Heart Failure and Reduced Ejection Fraction: A Substudy of the Empire HF Randomized Clinical Trial. *2021-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.6827 · https://hartvaat.nl/2021/07/01/empagliflozine-en-lv-volumes-en-functie-bij-hfref-jama-cardiology/* This analysis showed that empagliflozin is associated with improvements in left ventricular volumes, mass, and function in HFrEF, providing echocardiographic evidence of reverse cardiac remodeling with SGLT2 inhibition. ## Remote Postdischarge Treatment of Patients With Acute Myocardial Infarction by Allied Health Care Practitioners vs Standard Care: The IMMACULATE Randomized Clinical Trial. *2021-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.6721 · https://hartvaat.nl/2021/07/01/remote-post-ontslag-behandeling-na-mi-door-paramedici-versus-standaardzorg-jama-/* This trial showed that remote post-discharge treatment by allied health practitioners after MI achieves comparable safety and efficacy to standard cardiologist-led care, supporting task-shifting for post-MI management. ## Cardiovascular consequences of discontinuing low-dose rivaroxaban in people with chronic coronary or peripheral artery disease. *2021-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-318758 · https://hartvaat.nl/2021/07/01/cv-gevolgen-van-stoppen-met-laaggedoseerd-rivaroxaban-bij-chronisch-vaatlijden/* This COMPASS analysis showed that discontinuing low-dose rivaroxaban in patients with chronic coronary or peripheral artery disease is associated with increased cardiovascular events, supporting the importance of treatment persistence. ## Effect of KBP-5074 on Blood Pressure in Advanced Chronic Kidney Disease: Results of the BLOCK-CKD Study. *2021-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.121.17073 · https://hartvaat.nl/2021/07/01/kbp-5074-en-bloeddruk-bij-gevorderde-ckd-block-ckd/* The BLOCK-CKD study evaluated KBP-5074, a nonsteroidal MRA, for blood pressure lowering in advanced CKD, testing a novel mineralocorticoid receptor antagonist designed for safety in the renally impaired population. ## Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial. *2021-06-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)01063-1 · https://hartvaat.nl/2021/06/26/aspirine-versus-clopidogrel-voor-chronische-monotherapie-na-pci-lancet-host-exam/* The HOST-EXAM trial showed that clopidogrel was superior to aspirin for chronic maintenance antiplatelet monotherapy after PCI, reducing the composite of cardiovascular death, MI, stroke, readmission for ACS, or stent thrombosis at 24 months. The result challenged aspirin as the default long-term antiplatelet agent after coronary stenting. ## Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE-HTN TRIO): a randomised, multicentre, single-blind, sham-controlled trial. *2021-06-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)00788-1 · https://hartvaat.nl/2021/06/26/echografie-renale-denervatie-bij-triple-pilresistente-hypertensie-lancet-radianc/* The RADIANCE-HTN TRIO trial demonstrated that ultrasound-based renal denervation significantly reduced daytime ambulatory systolic blood pressure compared with a sham procedure in patients with resistant hypertension on a standardized triple combination pill. This was the first positive renal denervation trial in true resistant hypertension. ## Prevalence of Left Atrial Thrombus in Anticoagulated Patients With Atrial Fibrillation. *2021-06-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.036 · https://hartvaat.nl/2021/06/15/prevalentie-van-linkeratriumtrombus-bij-geanticoaguleerde-af-patienten/* This study documented the prevalence of left atrial thrombus in AF patients despite guideline-directed anticoagulation, showing that a clinically relevant proportion harbors thrombus even on DOACs, informing pre-procedure screening decisions. ## Changes in Plasma Renin Activity After Renal Artery Sympathetic Denervation. *2021-06-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.044 · https://hartvaat.nl/2021/06/15/plasma-renine-activiteit-na-renale-sympathische-denervatie/* This study characterized changes in plasma renin activity after renal denervation, providing neurohormonal evidence for the mechanism of blood pressure lowering through sympathetic ablation. ## Standardized exercise training is feasible, safe, and effective in pulmonary arterial and chronic thromboembolic pulmonary hypertension: results from a large European multicentre randomized controlled trial. *2021-06-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa696 · https://hartvaat.nl/2021/06/14/gestandaardiseerde-inspanningstraining-bij-pah-en-cteph-haalbaarheid-en-veilighe/* This multicenter randomized trial confirmed that standardized exercise training is feasible, safe, and effective in patients with PAH and CTEPH, supporting supervised rehabilitation as standard of care in pulmonary hypertension management. ## Interventions for Patients With Secondary Mitral Regurgitation. *2021-06-08 · JAMA · https://doi.org/10.1001/jama.2021.2741 · https://hartvaat.nl/2021/06/08/interventies-bij-secundaire-mitralisklepinsufficientie-jama-klinisch-overzicht/* This JAMA clinical review provided a comprehensive overview of interventions for secondary mitral regurgitation, integrating evidence from COAPT, MITRA-FR, and contemporary guidelines to inform clinical decision-making. ## 10-Year Follow-Up After Revascularization in Elderly Patients With Complex Coronary Artery Disease. *2021-06-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.04.016 · https://hartvaat.nl/2021/06/08/10-jaarsfollow-up-na-revascularisatie-bij-oudere-patienten-met-complex-coronairl/* This 10-year follow-up after revascularization in elderly patients with complex coronary disease provided the longest comparative data for PCI versus CABG in the older population, informing revascularization decisions at advanced age. ## Left Atrial Appendage Occlusion during Cardiac Surgery to Prevent Stroke. *2021-06-03 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2101897 · https://hartvaat.nl/2021/06/03/linker-hartoorsluiting-tijdens-hartchirurgie-ter-preventie-van-cva-nejm-laaos-ii/* The LAAOS III trial demonstrated that surgical left atrial appendage occlusion performed during cardiac surgery significantly reduced the risk of ischemic stroke or systemic embolism in patients with atrial fibrillation. This simple addition to planned cardiac surgery provides lasting stroke protection as an adjunct to anticoagulation. ## Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on Atrial Fibrillation Detection in Patients With Ischemic Stroke: The PER DIEM Randomized Clinical Trial. *2021-06-01 · JAMA · https://doi.org/10.1001/jama.2021.6128 · https://hartvaat.nl/2021/06/01/implanteerbare-versus-verlengde-externe-ecg-monitoring-voor-af-na-ischemisch-cva/* This JAMA trial compared implantable versus prolonged external ECG monitoring for AF detection after ischemic stroke, evaluating the optimal monitoring strategy for identifying occult arrhythmia as a cause of cryptogenic stroke. ## Effect of Long-term Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation in Patients With Stroke Attributed to Large- or Small-Vessel Disease: The STROKE-AF Randomized Clinical Trial. *2021-06-01 · JAMA · https://doi.org/10.1001/jama.2021.6470 · https://hartvaat.nl/2021/06/01/continue-cardiale-monitoring-versus-standaardzorg-bij-cryptogeen-cva-jama/* This JAMA trial showed that long-term continuous cardiac monitoring significantly increases AF detection in patients with ischemic stroke attributed to large- or small-vessel disease, a population not traditionally considered high-risk for AF. ## Effects of Diet and Sodium Reduction on Cardiac Injury, Strain, and Inflammation: The DASH-Sodium Trial. *2021-06-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.03.320 · https://hartvaat.nl/2021/06/01/dieet-en-natriumreductie-op-cardiale-schade-en-inflammatie-dash-sodium/* This DASH-Sodium analysis showed that combining the DASH diet with sodium reduction produces additive reductions in cardiac injury biomarkers (troponin), cardiac strain (NT-proBNP), and inflammation, providing a mechanistic basis for dietary cardiovascular protection. ## Assessment of Catheter Ablation or Antiarrhythmic Drugs for First-line Therapy of Atrial Fibrillation: A Meta-analysis of Randomized Clinical Trials. *2021-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.0852 · https://hartvaat.nl/2021/06/01/katheterablatie-of-antiaritmica-als-eerstelijnstherapie-bij-af-jama-cardiology-m/* This JAMA Cardiology meta-analysis of randomized trials confirmed that catheter ablation as first-line therapy for atrial fibrillation is superior to antiarrhythmic drugs for maintaining sinus rhythm, with potential benefits on cardiovascular outcomes. The pooled data supported the shift toward earlier ablation. ## Efficacy and Safety of Dapagliflozin in Men and Women With Heart Failure With Reduced Ejection Fraction: A Prespecified Analysis of the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure Trial. *2021-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.0379 · https://hartvaat.nl/2021/06/01/dapagliflozine-bij-hfref-naar-geslacht-dapa-hf-pre-gespecificeerde-analyse/* This DAPA-HF analysis confirmed that dapagliflozin is equally effective and safe in women and men with HFrEF, providing reassurance about sex-specific outcomes in a drug class tested predominantly in male-majority trials. ## A cohort study and meta-analysis of isolated diastolic hypertension: searching for a threshold to guide treatment. *2021-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehab111 · https://hartvaat.nl/2021/06/01/geisoleerde-diastolische-hypertensie-cohort-en-meta-analyse-voor-behandeldrempel/* This cohort study and meta-analysis investigated whether isolated diastolic hypertension (as defined by the ACC/AHA 130/80 threshold) is associated with cardiovascular risk sufficient to warrant treatment, addressing a common clinical dilemma. ## Clinical Outcomes and Response to Vericiguat According to Index Heart Failure Event: Insights From the VICTORIA Trial. *2021-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.6455 · https://hartvaat.nl/2021/06/01/klinische-uitkomsten-en-respons-op-vericiguat-naar-index-hf-event-victoria/* This VICTORIA analysis showed that vericiguat's benefit varies by the index heart failure event type, with patients recently hospitalized for heart failure deriving the greatest absolute benefit. ## Metabolic Effects of Empagliflozin in Heart Failure: A Randomized, Double-Blind, and Placebo-Controlled Trial (Empire HF Metabolic). *2021-06-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.053463 · https://hartvaat.nl/2021/06/01/metabole-effecten-van-empagliflozine-bij-hf-empire-hf-metabolic-gerandomiseerde-/* The Empire HF Metabolic trial characterized the metabolic effects of empagliflozin in heart failure, showing favorable shifts in ketone body utilization and energy metabolism that may underlie the cardiac benefit of SGLT2 inhibitors. ## Sustained Benefit of Alternate Behavioral Interventions to Improve Hypertension Control: A Randomized Clinical Trial. *2021-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15192 · https://hartvaat.nl/2021/06/01/aanhoudend-voordeel-van-gedragsinterventies-voor-hypertensie-gerandomiseerde-tri/* This randomized trial demonstrated sustained blood pressure improvement with alternative behavioral interventions (motivational interviewing, health coaching), showing that lifestyle modification benefits persist beyond the active intervention period. ## Randomized Clinical Comparison of the Dual-Therapy CD34 Antibody-Covered Sirolimus-Eluting Combo Stent With the Sirolimus-Eluting Orsiro Stent in Patients Treated With Percutaneous Coronary Intervention: The SORT OUT X Trial. *2021-06-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.052766 · https://hartvaat.nl/2021/06/01/cd34-antilichaam-sirolimus-eluting-combo-stent-versus-orsiro-gerandomiseerde-tri/* This randomized trial compared a dual-therapy CD34 antibody-coated sirolimus stent (Combo) with the Orsiro stent, testing whether combining endothelial capture with drug elution improves stent outcomes. ## Diagnosing heart failure in primary care: individual patient data meta-analysis of two European prospective studies. *2021-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13311 · https://hartvaat.nl/2021/06/01/diagnostiek-van-hartfalen-in-de-huisartsenpraktijk-ipd-meta-analyse/* This individual patient data meta-analysis evaluated natriuretic peptide thresholds for diagnosing heart failure in primary care, providing evidence-based cut-points for the clinical decision to refer for specialist assessment. ## Exercise training and high-sensitivity cardiac troponin T in patients with heart failure with reduced ejection fraction. *2021-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13310 · https://hartvaat.nl/2021/06/01/inspanningstraining-en-hs-troponine-t-bij-hfref/* This study showed that exercise training reduces high-sensitivity troponin T levels in HFrEF patients, suggesting that regular physical activity decreases subclinical myocardial injury in the heart failure population. ## SGLT2i versus ARNI in heart failure with reduced ejection fraction: a systematic review and meta-analysis. *2021-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13313 · https://hartvaat.nl/2021/06/01/sglt2-remmers-versus-arni-bij-hfref-meta-analyse/* This meta-analysis indirectly compared SGLT2 inhibitors with sacubitril-valsartan (ARNI) in HFrEF, finding comparable effect sizes on key outcomes and supporting both as essential components of contemporary heart failure therapy. ## Serum potassium levels provide prognostic information in symptomatic heart failure beyond traditional clinical variables. *2021-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13295 · https://hartvaat.nl/2021/06/01/serumkalium-en-prognose-bij-symptomatisch-hf/* This study showed that serum potassium levels provide prognostic information in symptomatic heart failure beyond traditional clinical and biochemical variables, supporting potassium monitoring for risk stratification. ## Palliative care in pulmonary hypertension associated with congenital heart disease: systematic review and expert opinion. *2021-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13263 · https://hartvaat.nl/2021/06/01/palliatieve-zorg-bij-ph-met-congenitaal-hartlijden-expertopinie/* This systematic review and expert opinion addressed palliative care in pulmonary hypertension associated with congenital heart disease, filling a gap in end-of-life care guidance for this severe condition. ## Smoking and heart failure: a Mendelian randomization and mediation analysis. *2021-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13248 · https://hartvaat.nl/2021/06/01/roken-en-hartfalen-mendeliaanse-randomisatie-en-mediatie-analyse/* This Mendelian randomization study provided causal evidence that smoking increases heart failure risk, with mediation analysis showing that the effect operates partially through coronary artery disease and pulmonary impairment. ## Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease. *2021-05-27 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2102137 · https://hartvaat.nl/2021/05/27/vergelijkende-effectiviteit-van-aspirinedoseringen-bij-cvd-nejm-adaptable/* The ADAPTABLE trial, the first large pragmatic trial comparing aspirin doses in cardiovascular disease, found no significant difference between 81 mg and 325 mg daily for preventing cardiovascular events or causing major bleeding. The results support low-dose aspirin as the standard for secondary prevention. ## Counseling and Behavioral Interventions for Healthy Weight and Weight Gain in Pregnancy: Evidence Report and Systematic Review for the US Preventive Services Task Force. *2021-05-25 · JAMA · https://doi.org/10.1001/jama.2021.4230 · https://hartvaat.nl/2021/05/25/gedragsinterventies-voor-gezond-gewicht-in-de-zwangerschap-jama-uspstf-evidence-/* This USPSTF evidence report evaluated counseling and behavioral interventions for healthy gestational weight gain, informing recommendations on lifestyle management during pregnancy for cardiovascular and metabolic health. ## Extra-pulmonary vein driver mapping and ablation for persistent atrial fibrillation in obese patients. *2021-05-21 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa314 · https://hartvaat.nl/2021/05/21/extrapulmonale-vein-driver-mapping-bij-persisterend-af-bij-obese-patienten/* This study evaluated extrapulmonary vein driver mapping and ablation for persistent AF in obese patients, testing whether obesity-specific AF substrate requires targeted ablation beyond standard PVI. ## High-power short duration vs. conventional radiofrequency ablation of atrial fibrillation: a systematic review and meta-analysis. *2021-05-21 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa327 · https://hartvaat.nl/2021/05/21/high-power-short-duration-versus-conventionele-rf-ablatie-bij-af-meta-analyse/* This meta-analysis confirmed that high-power short-duration RF ablation for AF achieves comparable efficacy and safety to conventional lower-power approaches with shorter procedure times, supporting the accelerated protocol. ## Long-term observation of catheter ablation vs. pharmacotherapy in the management of persistent and long-standing persistent atrial fibrillation (CAPA study). *2021-05-21 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa356 · https://hartvaat.nl/2021/05/21/katheterablatie-versus-medicatie-bij-persisterend-en-langdurig-persisterend-af-l/* This long-term observation compared catheter ablation with pharmacotherapy for persistent and longstanding persistent AF, providing extended follow-up data on rhythm control strategies in the most challenging AF phenotypes. ## Focal Impulse and Rotor Modulation Ablation vs. Pulmonary Vein isolation for the treatment of paroxysmal Atrial Fibrillation: results from the FIRMAP AF study. *2021-05-21 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa378 · https://hartvaat.nl/2021/05/21/firm-ablatie-versus-pvi-bij-paroxysmaal-af-gerandomiseerde-resultaten/* This randomized trial showed that Focal Impulse and Rotor Modulation (FIRM) ablation does not improve outcomes over standard PVI for paroxysmal AF, a negative result for rotor-guided ablation technology. ## Final Report of a Trial of Intensive versus Standard Blood-Pressure Control. *2021-05-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1901281 · https://hartvaat.nl/2021/05/20/intensieve-versus-standaard-bloeddrukcontrole-nejm-sprint-definitief-rapport/* The final SPRINT report, including post-trial follow-up, confirmed the durable benefit of intensive systolic blood pressure control (target <120 mmHg) versus standard treatment (target <140 mmHg) in reducing cardiovascular events and mortality. The sustained benefit after treatment cessation strengthened the case for aggressive blood pressure targets. ## Diabetes-Related Factors and the Effects of Ticagrelor Plus Aspirin in the THEMIS and THEMIS-PCI Trials. *2021-05-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.03.298 · https://hartvaat.nl/2021/05/18/diabetes-factoren-en-ticagrelor-plus-aspirine-themis-en-themis-pci/* This THEMIS subanalysis examined diabetes-specific factors that modify the benefit of adding ticagrelor to aspirin, identifying which diabetic patients derive the greatest net clinical advantage from intensified antiplatelet therapy. ## Effect of a Digital Intervention on Depressive Symptoms in Patients With Comorbid Hypertension or Diabetes in Brazil and Peru: Two Randomized Clinical Trials. *2021-05-11 · JAMA · https://doi.org/10.1001/jama.2021.4348 · https://hartvaat.nl/2021/05/11/digitale-interventie-voor-depressie-bij-hypertensie-diabetes-in-brazilie-en-peru/* This JAMA trial showed that a digital mental health intervention improves depressive symptoms in patients with comorbid hypertension or diabetes in Latin America, demonstrating scalable technology-based treatment for the depression-cardiovascular comorbidity. ## Individualized Nutritional Support for Hospitalized Patients With Chronic Heart Failure. *2021-05-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.03.232 · https://hartvaat.nl/2021/05/11/geindividualiseerde-voedingsondersteuning-bij-gehospitaliseerd-chronisch-hf/* This study showed that individualized nutritional support during hospitalization for chronic heart failure improves clinical outcomes, supporting targeted nutrition assessment and intervention as part of inpatient heart failure management. ## Effect of Intensive Blood Pressure Control on Aortic Stiffness in the SPRINT-HEART. *2021-05-05 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16676 · https://hartvaat.nl/2021/05/05/intensieve-bloeddruk-en-aortastijfheid-sprint-heart/* This SPRINT-HEART analysis showed that intensive blood pressure control reduces aortic stiffness, demonstrating that aggressive blood pressure management has direct vascular benefits beyond hemodynamic lowering. ## Visit-to-Visit Blood Pressure Variability and Clinical Outcomes in Patients With Heart Failure With Preserved Ejection Fraction. *2021-05-05 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16757 · https://hartvaat.nl/2021/05/05/bloeddrukvariabiliteit-en-uitkomsten-bij-hfpef/* This study showed that visit-to-visit blood pressure variability is associated with worse clinical outcomes in HFpEF, identifying blood pressure instability as a prognostic factor in this population. ## Sustained Mild Sleep Restriction Increases Blood Pressure in Women: An Update From the American Heart Association Go Red for Women Strategically Focused Research Network. *2021-05-05 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16370 · https://hartvaat.nl/2021/05/05/chronische-milde-slaaprestrictie-verhoogt-bloeddruk-bij-vrouwen-aha-go-red/* This AHA Go Red for Women study showed that sustained mild sleep restriction increases blood pressure in women, establishing inadequate sleep as a sex-specific modifiable cardiovascular risk factor. ## Do β-Blockers Cause Depression?: Systematic Review and Meta-Analysis of Psychiatric Adverse Events During β-Blocker Therapy. *2021-05-05 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16590 · https://hartvaat.nl/2021/05/05/veroorzaken-betablokkers-depressie-systematische-review-en-meta-analyse/* This systematic review and meta-analysis found no significant association between beta-blocker therapy and increased risk of depression, debunking a widely held clinical belief. The evidence addressed one of the most common reasons patients and clinicians avoid beta-blockers. ## Furosemide for Accelerated Recovery of Blood Pressure Postpartum in women with a hypertensive disorder of pregnancy: A Randomized Controlled Trial. *2021-05-05 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16133 · https://hartvaat.nl/2021/05/05/furosemide-voor-versneld-bloeddrukherstel-postpartum-bij-hypertensieve-zwangersc/* This randomized trial tested whether furosemide accelerates postpartum blood pressure recovery in women with hypertensive disorders of pregnancy, evaluating a simple pharmacological strategy for the post-delivery period. ## Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. *2021-05-01 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)00590-0 · https://hartvaat.nl/2021/05/01/bloeddrukverlaging-voor-primaire-en-secundaire-preventie-over-alle-niveaus-lance/* This individual-participant-data meta-analysis from the BPLTTC demonstrated that pharmacological blood pressure lowering reduces cardiovascular events across all baseline blood pressure levels, including in individuals with normal or high-normal pressure. The findings support a strategy of treating based on absolute cardiovascular risk rather than blood pressure thresholds alone. ## Screening for Atrial Fibrillation in the Older Population: A Randomized Clinical Trial. *2021-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2021.0038 · https://hartvaat.nl/2021/05/01/screening-op-af-bij-ouderen-jama-cardiology-gerandomiseerde-trial/* This randomized trial of systematic AF screening in the older population evaluated the yield and downstream clinical impact of screening for previously undiagnosed atrial fibrillation. ## Time to Clinical Benefit of Dapagliflozin and Significance of Prior Heart Failure Hospitalization in Patients With Heart Failure With Reduced Ejection Fraction. *2021-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.7585 · https://hartvaat.nl/2021/05/01/time-to-clinical-benefit-van-dapagliflozine-bij-hfref-dapa-hf/* This DAPA-HF analysis showed that dapagliflozin achieves clinical benefit within weeks of initiation in HFrEF, with earlier benefit in patients with prior heart failure hospitalization, supporting prompt SGLT2 inhibitor initiation. ## Association of Circulating Monocyte Chemoattractant Protein-1 Levels With Cardiovascular Mortality: A Meta-analysis of Population-Based Studies. *2021-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.5392 · https://hartvaat.nl/2021/05/01/mcp-1-en-cardiovasculaire-mortaliteit-populatie-gebaseerde-meta-analyse/* This meta-analysis confirmed that circulating MCP-1 (monocyte chemoattractant protein-1) is independently associated with cardiovascular mortality in population-based studies, supporting its role as an inflammatory risk biomarker. ## Premature permanent discontinuation of apixaban or warfarin in patients with atrial fibrillation. *2021-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-317229 · https://hartvaat.nl/2021/05/01/vroegtijdig-permanent-staken-van-apixaban-of-warfarine-bij-af/* This ARISTOTLE analysis showed that premature discontinuation of both apixaban and warfarin is associated with worse outcomes in AF, with similar rates of permanent discontinuation but different reasons across the two agents. ## Screening for Hypertension in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. *2021-04-27 · JAMA · https://doi.org/10.1001/jama.2020.21669 · https://hartvaat.nl/2021/04/27/screening-op-hypertensie-bij-volwassenen-uspstf-evidence-update-2021/* This updated USPSTF evidence review confirmed that screening for hypertension in adults followed by appropriate treatment reduces cardiovascular events and mortality, supporting the continued recommendation for routine blood pressure screening. ## Screening for Hypertension in Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement. *2021-04-27 · JAMA · https://doi.org/10.1001/jama.2021.4987 · https://hartvaat.nl/2021/04/27/screening-op-hypertensie-bij-volwassenen-uspstf-herbevestiging-2021/* The 2021 USPSTF reaffirmed the recommendation for screening for hypertension in adults, maintaining a Grade A recommendation for office blood pressure measurement as part of routine care. ## Group Medical Visit and Microfinance Intervention for Patients With Diabetes or Hypertension in Kenya. *2021-04-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.03.002 · https://hartvaat.nl/2021/04/27/groepsmedisch-consult-en-microfinanciering-bij-diabetes-hypertensie-in-kenia/* This study tested a combined group medical visit and microfinance intervention for patients with diabetes or hypertension in Kenya, addressing social determinants of health through an integrated care delivery model. ## Patient Selection for Intensive Blood Pressure Management Based on Benefit and Adverse Events. *2021-04-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.02.058 · https://hartvaat.nl/2021/04/27/patientselectie-voor-intensieve-bloeddrukbehandeling-naar-voordeel-en-bijwerking/* This analysis developed a framework for identifying patients who benefit most from intensive blood pressure treatment based on the balance between cardiovascular event prevention and adverse effects, supporting personalized blood pressure management. ## Incidence and Outcomes of Pneumonia in Patients With Heart Failure. *2021-04-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.03.001 · https://hartvaat.nl/2021/04/27/pneumonie-incidentie-en-uitkomsten-bij-hartfalen/* This study showed that pneumonia incidence and outcomes differ between HFrEF and HFpEF patients, highlighting the infection vulnerability of heart failure and the need for vaccination and prevention strategies. ## Empagliflozin Effects on Pulmonary Artery Pressure in Patients With Heart Failure: Results From the EMBRACE-HF Trial. *2021-04-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.052503 · https://hartvaat.nl/2021/04/27/empagliflozine-en-pulmonalisdruk-bij-hf-embrace-hf/* The EMBRACE-HF trial showed that empagliflozin reduces pulmonary artery pressure in heart failure patients with implantable hemodynamic monitors, providing direct hemodynamic evidence of SGLT2 inhibitor-mediated cardiac decompression. ## 2021 ACC/AHA Key Data Elements and Definitions for Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Heart Failure). *2021-04-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.012 · https://hartvaat.nl/2021/04/27/2021-acc-aha-kerngegevenselementen-voor-hartfalen/* This ACC/AHA document defined standardized key data elements and definitions for heart failure research and quality improvement, enabling consistent data collection across registries and clinical trials. ## Randomized Trial of Interleukin-6 Receptor Inhibition in Patients With Acute ST-Segment Elevation Myocardial Infarction. *2021-04-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.02.049 · https://hartvaat.nl/2021/04/20/il-6-receptorremming-bij-acuut-stemi-gerandomiseerde-trial/* This randomized trial of tocilizumab (IL-6 receptor inhibitor) in acute STEMI showed reduced C-reactive protein and troponin T release, demonstrating the feasibility and mechanistic promise of anti-inflammatory therapy in the acute MI setting. ## Blood Pressure Effects of Sodium Reduction: Dose-Response Meta-Analysis of Experimental Studies. *2021-04-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050371 · https://hartvaat.nl/2021/04/20/natriumreductie-en-bloeddruk-dosis-respons-meta-analyse-van-experimentele-studie/* This dose-response meta-analysis of experimental studies quantified the blood pressure effect of sodium reduction, showing a linear relationship between dietary sodium decrease and blood pressure lowering across the range of intake levels. ## Guided versus standard antiplatelet therapy in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis. *2021-04-17 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)00533-X · https://hartvaat.nl/2021/04/17/geleide-versus-standaard-antiplaatjestherapie-na-pci-lancet-meta-analyse/* This Lancet meta-analysis showed that guided antiplatelet therapy selection (pharmacogenomic or pharmacodynamic testing) after PCI reduces ischemic and bleeding events compared with standard unguided therapy. The results supported precision medicine approaches to antiplatelet management. ## 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. *2021-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa575 · https://hartvaat.nl/2021/04/07/2020-esc-richtlijn-voor-nste-acs-management/* The 2020 ESC Guidelines for non-ST-elevation acute coronary syndromes updated risk stratification, timing of invasive management, and antithrombotic strategies incorporating evidence from ISCHEMIA, TWILIGHT, and contemporary trials. The guideline refined the balance between ischemic protection and bleeding risk in ACS patients. ## Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients: results from the DANISH trial. *2021-04-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa341 · https://hartvaat.nl/2021/04/06/ventriculaire-aritmie-bij-niet-ischemisch-hf-prevalentie-en-prognose-danish/* This DANISH analysis characterized the prevalence and prognostic significance of ventricular arrhythmias in non-ischemic heart failure, providing risk stratification data for ICD selection in this debated indication. ## Pulmonary vein isolation alone vs. more extensive ablation with defragmentation and linear ablation of persistent atrial fibrillation: the EARNEST-PVI trial. *2021-04-06 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa293 · https://hartvaat.nl/2021/04/06/pvi-alleen-versus-uitgebreide-ablatie-bij-persisterend-af-meta-analyse/* This meta-analysis confirmed that PVI alone achieves similar outcomes to more extensive ablation (defragmentation and linear lesions) for persistent AF, supporting the simpler approach as the standard first procedure. ## Association of Effective Regurgitation Orifice Area to Left Ventricular End-Diastolic Volume Ratio With Transcatheter Mitral Valve Repair Outcomes: A Secondary Analysis of the COAPT Trial. *2021-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.7200 · https://hartvaat.nl/2021/04/01/ero-lvedv-ratio-en-respons-op-mitraclip-jama-cardiology/* This analysis showed that the effective regurgitation orifice area to LV end-diastolic volume ratio (ERO/LVEDV) predicts the response to transcatheter mitral valve repair, establishing a quantitative echocardiographic criterion for MitraClip patient selection. ## Promotion of Aerobic Exercise Induced Angiogenesis Is Associated With Decline in Blood Pressure in Hypertension: Result of EXCAVATION-CHN1. *2021-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16107 · https://hartvaat.nl/2021/04/01/aerobe-training-bevordert-angiogenese-en-verlaagt-bloeddruk-bij-hypertensie-exca/* This study showed that aerobic exercise training promotes angiogenesis that is associated with blood pressure reduction in hypertensive patients, providing a vascular mechanism linking physical activity to blood pressure improvement. ## Cardiovascular and renal outcomes with canagliflozin according to baseline diuretic use: a post hoc analysis from the CANVAS Program. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13236 · https://hartvaat.nl/2021/04/01/canagliflozine-naar-diureticagebruik-canvas-post-hoc-analyse/* This CANVAS post-hoc analysis showed that the cardiovascular and renal effects of canagliflozin differ by baseline diuretic use, providing practical insights for prescribing SGLT2 inhibitors alongside volume management. ## Effect of Intensive Versus Standard Blood Pressure Control on Stroke Subtypes. *2021-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16027 · https://hartvaat.nl/2021/04/01/intensieve-versus-standaard-bloeddruk-op-cva-subtypes-sprint/* This SPRINT analysis examined the effect of intensive blood pressure control on specific stroke subtypes, showing differential risk reduction for ischemic versus hemorrhagic stroke with aggressive blood pressure management. ## Sarcopenia in heart failure: a systematic review and meta-analysis. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13255 · https://hartvaat.nl/2021/04/01/sarcopenie-bij-hartfalen-systematische-review-en-meta-analyse/* This meta-analysis quantified the prevalence and clinical impact of sarcopenia in heart failure patients, establishing muscle wasting as a common comorbidity associated with worse functional capacity and outcomes. ## Comparison of left ventricular longitudinal systolic function parameters in the prediction of adverse outcome in heart failure with preserved ejection fraction. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13247 · https://hartvaat.nl/2021/04/01/lv-longitudinale-systolische-functieparameters-als-voorspellers-bij-hfpef/* This study compared different LV longitudinal systolic function parameters (GLS, MAPSE, S') for predicting adverse outcomes in HFpEF, informing the optimal echocardiographic measure for risk stratification. ## Cardio-microcurrent device for chronic heart failure: first-in-human clinical study. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13242 · https://hartvaat.nl/2021/04/01/cardio-microstroomdevice-bij-chronisch-hf-eerste-klinische-studie/* The first-in-human study of a cardio-microcurrent device for chronic heart failure demonstrated feasibility and safety of chronic electrical microcurrent application to the heart. The results inform the design of a future randomised controlled trial. ## Meta-analysis of the effects of four factors on the efficacy of SGLT2 inhibitors in patients with HFrEF. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13241 · https://hartvaat.nl/2021/04/01/sglt2-remmers-bij-hfref-meta-analyse-van-vier-effectmodificatoren/* This meta-analysis examined four factors (diabetes status, baseline eGFR, NT-proBNP, and blood pressure) that may modify the efficacy of SGLT2 inhibitors in HFrEF, finding consistent benefit across all subgroups. ## An aetiology-based subanalysis of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) trial. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13189 · https://hartvaat.nl/2021/04/01/telereh-hf-etiologie-subanalyse-van-telerevalidatie-bij-hartfalen/* This TELEREH-HF subanalysis evaluated hybrid telerehabilitation by heart failure etiology, assessing whether ischemic and non-ischemic HF patients derive differential benefit from remote exercise programs. ## Risk of in-hospital life-threatening ventricular arrhythmia or death after ST-elevation myocardial infarction vs. the Takotsubo syndrome. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13208 · https://hartvaat.nl/2021/04/01/ventriculaire-aritmie-of-overlijden-na-stemi-versus-takotsubo/* This study compared the risk of life-threatening ventricular arrhythmias between STEMI and Takotsubo syndrome, showing that arrhythmic risk is lower in Takotsubo despite similar acute presentation. ## High-protein vs. standard-protein diets in overweight and obese patients with heart failure and diabetes mellitus: findings of the Pro-HEART trial. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13213 · https://hartvaat.nl/2021/04/01/eiwitrijk-versus-standaard-dieet-bij-obees-hf-met-diabetes/* This study compared high-protein versus standard-protein diets in overweight heart failure patients with diabetes, evaluating whether protein intake influences cardiometabolic risk factors in this dual-disease population. ## Impact of primary care involvement and setting on multidisciplinary heart failure management: a systematic review and meta-analysis. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13152 · https://hartvaat.nl/2021/04/01/betrokkenheid-van-huisartsenzorg-bij-multidisciplinair-hf-management-meta-analys/* This meta-analysis showed that multidisciplinary heart failure disease management programs with primary care involvement achieve better adherence to guidelines and clinical outcomes, supporting integrated care models that bridge hospital and community settings. ## Veno-Arterial Extracorporeal Life Support in Heart Transplant and Ventricle Assist Device Centres. Meta-analysis. *2021-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13080 · https://hartvaat.nl/2021/04/01/va-ecls-bij-harttransplantatie-en-vad-centra-meta-analyse/* This meta-analysis of VA-ECLS outcomes at heart transplant and VAD centers showed that center expertise significantly influences survival, supporting regionalization of mechanical support for cardiogenic shock. ## Effects of dapagliflozin on mortality in patients with chronic kidney disease: a pre-specified analysis from the DAPA-CKD randomized controlled trial. *2021-03-31 · European heart journal · https://doi.org/10.1093/eurheartj/ehab094 · https://hartvaat.nl/2021/03/31/dapagliflozine-en-mortaliteit-bij-ckd-dapa-ckd-pre-gespecificeerde-analyse/* This pre-specified DAPA-CKD mortality analysis confirmed that dapagliflozin significantly reduces all-cause mortality in patients with chronic kidney disease, independent of diabetes status. The survival benefit strengthened the case for universal SGLT2 inhibitor use in CKD. ## Interplay of Mineralocorticoid Receptor Antagonists and Empagliflozin in Heart Failure: EMPEROR-Reduced. *2021-03-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.01.044 · https://hartvaat.nl/2021/03/23/mra-en-empagliflozine-interactie-bij-hf-emperor-reduced/* This EMPEROR-Reduced analysis showed that the benefit of empagliflozin in heart failure is consistent regardless of concomitant MRA use, confirming additive cardioprotection when combining SGLT2 inhibitors with mineralocorticoid antagonists. ## Empagliflozin in Patients With Heart Failure, Reduced Ejection Fraction, and Volume Overload: EMPEROR-Reduced Trial. *2021-03-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.01.033 · https://hartvaat.nl/2021/03/23/empagliflozine-bij-hfref-met-volume-overbelasting-emperor-reduced/* This EMPEROR-Reduced analysis confirmed that empagliflozin provides consistent benefit in heart failure patients with volume overload and congestion, addressing the mechanism hypothesis that SGLT2 inhibitors act primarily through diuretic effects. ## Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation: A Randomized Clinical Trial. *2021-03-16 · JAMA · https://doi.org/10.1001/jama.2021.1489 · https://hartvaat.nl/2021/03/16/omega-3-en-vitamine-d-en-incident-af-jama-vital-af/* The VITAL-AF trial unexpectedly showed that marine omega-3 fatty acid supplementation was associated with increased risk of atrial fibrillation, while vitamin D had no effect. The pro-arrhythmic signal contradicted the assumed cardiovascular benefit of fish oil supplements. ## Systolic Blood Pressure Time in Target Range and Cardiovascular Outcomes in Patients With Hypertension. *2021-03-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.01.014 · https://hartvaat.nl/2021/03/16/systolische-bloeddruk-time-in-target-en-cv-uitkomsten-bij-hypertensie/* This study introduced systolic blood pressure time-in-target-range as a novel metric for assessing blood pressure control quality, showing that sustained time within the target range predicts cardiovascular outcomes better than single measurements. ## Platelet Reactivity in Patients With Acute Coronary Syndromes Awaiting Surgical Revascularization. *2021-03-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2021.01.015 · https://hartvaat.nl/2021/03/16/plaatjesreactiviteit-bij-acs-in-afwachting-van-chirurgische-revascularisatie/* This study characterized platelet reactivity in ACS patients awaiting CABG after P2Y12 inhibitor discontinuation, informing the optimal timing of surgery after antiplatelet withdrawal. ## Clinical Efficacy and Safety of Alirocumab After Acute Coronary Syndrome According to Achieved Level of Low-Density Lipoprotein Cholesterol: A Propensity Score-Matched Analysis of the ODYSSEY OUTCOMES Trial. *2021-03-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.049447 · https://hartvaat.nl/2021/03/16/alirocumab-naar-bereikte-ldl-na-acs-odyssey-outcomes/* This ODYSSEY OUTCOMES analysis showed that alirocumab continues to reduce cardiovascular events at very low achieved LDL levels after ACS, with no safety concerns down to LDL cholesterol below 25 mg/dL. ## Durable Polymer Versus Biodegradable Polymer Drug-Eluting Stents After Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome: The HOST-REDUCE-POLYTECH-ACS Trial. *2021-03-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.051700 · https://hartvaat.nl/2021/03/16/duurzame-versus-biodegradeerbare-polymer-des-bij-acs-meta-analyse/* This meta-analysis comparing durable polymer with biodegradable polymer DES specifically in ACS patients found similar safety and efficacy, supporting either polymer technology for acute coronary intervention. ## Spironolactone in Patients With Heart Failure, Preserved Ejection Fraction, and Worsening Renal Function. *2021-03-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.12.057 · https://hartvaat.nl/2021/03/09/spironolacton-bij-hfpef-met-verslechterende-nierfunctie-topcat/* This TOPCAT analysis showed that spironolactone maintains its benefit in HFpEF patients who develop worsening renal function during treatment, supporting continuation of MRA therapy despite transient creatinine rises. ## Randomized, Double-Blind Comparison of Half-Dose Versus Full-Dose Edoxaban in 14,014 Patients With Atrial Fibrillation. *2021-03-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.12.053 · https://hartvaat.nl/2021/03/09/halve-versus-volle-dosis-edoxaban-bij-af-gerandomiseerde-vergelijking/* This randomized comparison of half-dose versus full-dose edoxaban in over 14,000 AF patients showed that appropriately reduced dosing maintains stroke prevention efficacy with less bleeding, confirming the pharmacokinetic rationale for dose reduction. ## 10-Year Follow-Up of Patients With Everolimus-Eluting Versus Bare-Metal Stents After ST-Segment Elevation Myocardial Infarction. *2021-03-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.12.059 · https://hartvaat.nl/2021/03/09/10-jaarsfollow-up-ees-versus-bms-bij-stemi-examination/* The 10-year EXAMINATION follow-up confirmed the sustained superiority of everolimus-eluting stents over bare-metal stents in STEMI patients, providing the longest randomized comparison of DES versus BMS in primary PCI. ## Variation in the Proportion of Adults in Need of Blood Pressure-Lowering Medications by Hypertension Care Guideline in Low- and Middle-Income Countries: A Cross-Sectional Study of 1 037 215 Individuals From 50 Nationally Representative Surveys. *2021-03-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.051620 · https://hartvaat.nl/2021/03/09/bloeddrukverlagende-medicatie-naar-hypertensierichtlijn-in-lage-middeninkomensla/* This analysis showed substantial variation in the proportion of adults requiring antihypertensive medication across different international guidelines, highlighting how guideline differences affect treatment eligibility at the population level. ## Catheter ablation or medical therapy to delay progression of atrial fibrillation: the randomized controlled atrial fibrillation progression trial (ATTEST). *2021-03-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa298 · https://hartvaat.nl/2021/03/08/katheterablatie-om-af-progressie-te-vertragen-attest-gerandomiseerde-trial/* The ATTEST trial investigated whether catheter ablation can delay the progression from paroxysmal to persistent AF compared with antiarrhythmic drugs, testing the disease-modifying potential of early ablation intervention. ## Multi-catheter cryotherapy compared with radiofrequency ablation in long-standing persistent atrial fibrillation: a randomized clinical trial. *2021-03-08 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa289 · https://hartvaat.nl/2021/03/08/multi-katheter-cryotherapie-versus-rf-ablatie-bij-langdurig-persisterend-af-gera/* This randomized trial compared multi-catheter cryotherapy with radiofrequency ablation for longstanding persistent AF, testing whether a balloon-based approach can match point-by-point RF ablation in the most challenging arrhythmia phenotype. ## Effect of Reducing Ambient Traffic-Related Air Pollution on Blood Pressure: A Randomized Crossover Trial. *2021-03-03 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15580 · https://hartvaat.nl/2021/03/03/verminderde-verkeersgerelateerde-luchtvervuiling-en-bloeddruk-gerandomiseerde-cr/* This randomized crossover trial demonstrated that reducing traffic-related air pollution exposure (using HEPA filters and residential relocation) lowers blood pressure, establishing a causal link between ambient air quality and hypertension. ## 3-Year Outcomes of Transcatheter Mitral Valve Repair in Patients With Heart Failure. *2021-03-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.12.047 · https://hartvaat.nl/2021/03/02/3-jaarsuitkomsten-van-transcatheter-mitraalklepherstel-bij-hf-coapt/* The COAPT 3-year results confirmed sustained benefit of transcatheter mitral valve repair with MitraClip in heart failure with severe secondary mitral regurgitation, with persistent reductions in hospitalization and mortality beyond the 2-year primary endpoint. ## Genome-wide analysis identifies novel susceptibility loci for myocardial infarction. *2021-03-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa1040 · https://hartvaat.nl/2021/03/01/genoomwijde-analyse-identificeert-nieuwe-mi-gevoeligheidsloci/* This genome-wide association study identified novel genetic susceptibility loci specifically for myocardial infarction beyond coronary atherosclerosis, advancing the understanding of thrombotic and plaque rupture genetics. ## Objective Risk Assessment vs Standard Care for Acute Coronary Syndromes: A Randomized Clinical Trial. *2021-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.6314 · https://hartvaat.nl/2021/03/01/objectieve-risicobeoordeling-versus-standaardzorg-bij-acs-jama-cardiology/* This randomized trial compared objective risk assessment (using the GRACE risk score) with standard clinical judgment for managing ACS patients, testing whether systematic risk scoring improves treatment decisions and outcomes. ## Executive summary of the KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. *2021-03-01 · Kidney international · https://doi.org/10.1016/j.kint.2020.10.026 · https://hartvaat.nl/2021/03/01/kdigo-2021-bloeddruk-bij-ckd-executive-summary/* Executive summary of the KDIGO 2021 blood pressure guideline for chronic kidney disease, providing concise recommendations on targets, treatment strategies, and the integration of SPRINT evidence for CKD patients not receiving dialysis. ## KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. *2021-03-01 · Kidney international · https://doi.org/10.1016/j.kint.2020.11.003 · https://hartvaat.nl/2021/03/01/kdigo-2021-richtlijn-voor-bloeddrukmanagement-bij-ckd/* The KDIGO 2021 guideline for blood pressure management in chronic kidney disease updated targets, recommending systolic <120 mmHg for most CKD patients. The guideline integrated SPRINT and DAPA-CKD evidence to provide a unified approach to cardiorenal protection through blood pressure control. ## Long-term survival benefit of ramipril in patients with acute myocardial infarction complicated by heart failure. *2021-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-316823 · https://hartvaat.nl/2021/03/01/langetermijn-overlevingsvoordeel-van-ramipril-bij-mi-met-hf/* This long-term analysis confirmed the sustained survival benefit of ramipril in patients with MI complicated by heart failure, providing the extended follow-up data supporting lifelong ACE inhibitor use after post-MI heart failure. ## B-type natriuretic peptide and cardiac remodelling after myocardial infarction: a randomised trial. *2021-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-317182 · https://hartvaat.nl/2021/03/01/bnp-en-cardiale-remodellering-na-mi-gerandomiseerde-trial/* This randomized trial tested whether BNP-guided therapy improves cardiac remodeling after MI, exploring natriuretic peptide monitoring as a treatment titration strategy in the post-infarction period. ## Myocardial Infarction in the ISCHEMIA Trial: Impact of Different Definitions on Incidence, Prognosis, and Treatment Comparisons. *2021-02-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.047987 · https://hartvaat.nl/2021/02/23/myocardinfarct-in-de-ischemia-trial-impact-van-verschillende-mi-definities/* This ISCHEMIA analysis examined how different myocardial infarction definitions affect the trial's conclusions, showing that the treatment comparison is sensitive to whether periprocedural MI is counted, a finding with important implications for trial design. ## Progression of Tricuspid Regurgitation After Surgery for Ischemic Mitral Regurgitation. *2021-02-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.066 · https://hartvaat.nl/2021/02/16/progressie-van-tricuspidalisinsufficientie-na-chirurgie-voor-ischemische-mr/* This analysis documented the progression of tricuspid regurgitation after surgery for ischemic mitral regurgitation, informing the debate about concomitant tricuspid repair during mitral valve operations. ## 2021 Update to the 2017 ACC Expert Consensus Decision Pathway for Optimization of Heart Failure Treatment: Answers to 10 Pivotal Issues About Heart Failure With Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. *2021-02-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.022 · https://hartvaat.nl/2021/02/16/2021-acc-hf-behandeloptimalisatie-update-antwoorden-op-10-cruciale-vragen/* The 2021 ACC Expert Consensus update addressed 10 pivotal questions on heart failure treatment optimization, integrating evidence for SGLT2 inhibitors across the ejection fraction spectrum, vericiguat in recently decompensated HFrEF, and practical implementation of quadruple therapy. ## 2021 ACC Expert Consensus Decision Pathway on Same-Day Discharge After Percutaneous Coronary Intervention: A Report of the American College of Cardiology Solution Set Oversight Committee. *2021-02-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.013 · https://hartvaat.nl/2021/02/16/2021-acc-consensus-same-day-ontslag-na-pci/* This ACC expert consensus provided a structured decision pathway for same-day discharge after PCI, defining eligibility criteria and safety protocols for shortening the post-procedural hospitalization. ## Transdermal oestradiol for androgen suppression in prostate cancer: long-term cardiovascular outcomes from the randomised Prostate Adenocarcinoma Transcutaneous Hormone (PATCH) trial programme. *2021-02-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(21)00100-8 · https://hartvaat.nl/2021/02/13/transdermaal-oestradiol-bij-prostaatkanker-langetermijn-cv-uitkomsten-lancet/* This Lancet long-term analysis showed that transdermal estradiol for androgen suppression in prostate cancer has favorable cardiovascular outcomes compared with LHRH agonists, relevant to the growing field of cardio-oncology. ## Influence of neprilysin inhibition on the efficacy and safety of empagliflozin in patients with chronic heart failure and a reduced ejection fraction: the EMPEROR-Reduced trial. *2021-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa968 · https://hartvaat.nl/2021/02/11/neprilysineremming-en-empagliflozine-bij-chronisch-hfref-emperor-reduced-interac/* This EMPEROR-Reduced analysis showed that the benefit of empagliflozin is consistent regardless of whether patients are also taking sacubitril-valsartan, confirming that SGLT2 inhibitors provide additive benefit on top of ARNI therapy. ## Effect of empagliflozin on exercise ability and symptoms in heart failure patients with reduced and preserved ejection fraction, with and without type 2 diabetes. *2021-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa943 · https://hartvaat.nl/2021/02/11/empagliflozine-en-inspanningsvermogen-bij-hfref-en-hfpef-emperial/* The EMPERIAL trials evaluated the effect of empagliflozin on exercise ability (6-minute walk distance) and symptoms in patients with both HFrEF and HFpEF, finding modest improvements in symptom burden but no significant change in exercise capacity. ## The effect of spironolactone on cardiovascular function and markers of fibrosis in people at increased risk of developing heart failure: the heart 'OMics' in AGEing (HOMAGE) randomized clinical trial. *2021-02-11 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa758 · https://hartvaat.nl/2021/02/11/spironolacton-en-cardiovasculaire-functie-bij-risico-op-hf-ehj/* This study showed that spironolactone reduces fibrosis markers and improves cardiac function in people at increased risk of developing heart failure, supporting early MRA use for heart failure prevention. ## Effect of a Restrictive vs Liberal Blood Transfusion Strategy on Major Cardiovascular Events Among Patients With Acute Myocardial Infarction and Anemia: The REALITY Randomized Clinical Trial. *2021-02-09 · JAMA · https://doi.org/10.1001/jama.2021.0135 · https://hartvaat.nl/2021/02/09/restrictieve-versus-liberale-transfusie-bij-acuut-mi-jama-reality/* This JAMA REALITY trial preliminary analysis compared restrictive versus liberal transfusion strategies in patients with acute MI and anemia, addressing the optimal hemoglobin threshold for transfusion in this high-risk population. ## Effect of High-Intensity Interval Training, Moderate Continuous Training, or Guideline-Based Physical Activity Advice on Peak Oxygen Consumption in Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. *2021-02-09 · JAMA · https://doi.org/10.1001/jama.2020.26812 · https://hartvaat.nl/2021/02/09/hiit-matig-continu-of-richtlijnadvies-en-piek-vo2-bij-hfref-jama-smartex-hf/* The SMARTEX-HF trial showed that high-intensity interval training was not superior to moderate continuous training for improving peak VO2 in patients with HFrEF. The result supported moderate exercise as safe and effective, without an incremental benefit from more intense training in heart failure. ## Mortality 10 Years After Percutaneous or Surgical Revascularization in Patients With Total Coronary Artery Occlusions. *2021-02-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.055 · https://hartvaat.nl/2021/02/09/10-jaarsmortaliteit-na-pci-of-cabg-bij-totale-coronairocclusie/* This 10-year mortality comparison of PCI versus CABG in patients with total coronary occlusions provided the longest follow-up data for revascularization strategy selection in this challenging anatomy. ## 2020 ACC Expert Consensus Decision Pathway for Anticoagulant and Antiplatelet Therapy in Patients With Atrial Fibrillation or Venous Thromboembolism Undergoing Percutaneous Coronary Intervention or With Atherosclerotic Cardiovascular Disease: A Report of the American College of Cardiology Solution Set Oversight Committee. *2021-02-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.09.011 · https://hartvaat.nl/2021/02/09/2020-acc-consensus-anticoagulatie-en-antiplaatjestherapie-bij-af-of-vte/* The 2020 ACC Expert Consensus provided a comprehensive decision pathway for managing antithrombotic therapy in patients with atrial fibrillation or venous thromboembolism who require antiplatelet agents, with practical algorithms for diverse clinical scenarios. ## Finerenone and Cardiovascular Outcomes in Patients With Chronic Kidney Disease and Type 2 Diabetes. *2021-02-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.051898 · https://hartvaat.nl/2021/02/09/finerenon-en-cardiovasculaire-uitkomsten-bij-ckd-met-diabetes-type-2-fidelio-dkd/* The FIDELIO-DKD trial demonstrated that finerenone, a nonsteroidal mineralocorticoid receptor antagonist, significantly reduced both kidney failure progression and cardiovascular events in patients with chronic kidney disease and type 2 diabetes. This established finerenone as a new therapeutic pillar in cardiorenal protection alongside SGLT2 inhibitors and GLP-1 receptor agonists. ## Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction: A Randomized, Controlled Trial. *2021-02-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.052209 · https://hartvaat.nl/2021/02/09/omega-3-vetzuren-bij-oudere-mi-patienten-omemi-gerandomiseerde-trial/* The OMEMI randomized trial found that omega-3 fatty acid supplementation did not reduce cardiovascular events in elderly patients after myocardial infarction, consistent with the negative findings of other recent omega-3 trials in secondary prevention. ## Effect of Empagliflozin on Left Ventricular Volumes in Patients With Type 2 Diabetes, or Prediabetes, and Heart Failure With Reduced Ejection Fraction (SUGAR-DM-HF). *2021-02-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.052186 · https://hartvaat.nl/2021/02/09/empagliflozine-en-lv-volumes-bij-diabetes-prediabetes-met-hfref-sugar-dm-hf/* The SUGAR-DM-HF trial demonstrated that empagliflozin reduces left ventricular end-diastolic and end-systolic volumes in patients with diabetes or prediabetes and HFrEF, providing evidence for reverse remodeling with SGLT2 inhibition. ## Efficacy and safety of left atrial appendage electrical isolation during catheter ablation of atrial fibrillation: an updated meta-analysis. *2021-02-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa266 · https://hartvaat.nl/2021/02/05/laa-isolatie-tijdens-af-ablatie-geactualiseerde-meta-analyse/* This updated meta-analysis of left atrial appendage electrical isolation during AF ablation confirmed improved freedom from arrhythmia recurrence with LAAEI, supporting this technique as an adjunctive strategy in non-paroxysmal AF. ## Randomized comparison of oesophageal protection with a temperature control device: results of the IMPACT study. *2021-02-05 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa276 · https://hartvaat.nl/2021/02/05/slokdarmbescherming-met-temperatuurcontroleren-bij-af-ablatie-impact/* The IMPACT randomized trial evaluated an esophageal temperature control device during AF ablation, testing active esophageal protection as a strategy to prevent thermal injury during posterior wall ablation. ## Prognostic Implications of Declining Hemoglobin Content in Patients Hospitalized With Acute Coronary Syndromes. *2021-02-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.046 · https://hartvaat.nl/2021/02/02/dalend-hemoglobine-en-prognose-bij-acs-hospitalisatie/* This study showed that hemoglobin decline during ACS hospitalization, even without overt bleeding, independently predicts worse outcomes, supporting hemoglobin monitoring as a prognostic tool beyond clinical bleeding events. ## Effect of a Self-care Intervention on 90-Day Outcomes in Patients With Acute Heart Failure Discharged From the Emergency Department: A Randomized Clinical Trial. *2021-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.5763 · https://hartvaat.nl/2021/02/01/zelfzorginterventie-en-90-daags-uitkomsten-bij-acuut-hf-na-seh-ontslag-jama-card/* This trial of a self-care intervention for patients with acute heart failure discharged from the emergency department showed improved 90-day outcomes, addressing the underserved population of non-hospitalized AHF patients. ## Association of SGLT2 Inhibitors With Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes: A Meta-analysis. *2021-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.4511 · https://hartvaat.nl/2021/02/01/sglt2-remmers-en-cv-renale-uitkomsten-bij-diabetes-type-2-jama-cardiology-meta-a/* This JAMA Cardiology meta-analysis updated the evidence on SGLT2 inhibitor cardiovascular and kidney outcomes in type 2 diabetes, confirming class-consistent reductions in heart failure hospitalization, cardiovascular death, and kidney disease progression across all available agents. ## Efficacy and Safety of PCSK9 Inhibition With Evolocumab in Reducing Cardiovascular Events in Patients With Metabolic Syndrome Receiving Statin Therapy: Secondary Analysis From the FOURIER Randomized Clinical Trial. *2021-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.3151 · https://hartvaat.nl/2021/02/01/evolocumab-bij-metabool-syndroom-na-acs-fourier/* This FOURIER analysis confirmed that evolocumab provides consistent cardiovascular event reduction in patients with metabolic syndrome, showing that the PCSK9 inhibitor benefit extends to this high-risk metabolic phenotype. ## Adherence to Single-Pill Versus Free-Equivalent Combination Therapy in Hypertension: A Systematic Review and Meta-Analysis. *2021-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15781 · https://hartvaat.nl/2021/02/01/therapietrouw-aan-single-pill-versus-vrije-combinatietherapie-bij-hypertensie-me/* This meta-analysis demonstrated that single-pill combination therapy achieves significantly higher adherence compared with free-equivalent combinations of the same drugs in hypertension. The data provided the pharmacological rationale for recommending fixed-dose combinations as the preferred prescribing strategy. ## Pulse Pressure, Prognosis, and Influence of Sacubitril/Valsartan in Heart Failure With Preserved Ejection Fraction. *2021-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16277 · https://hartvaat.nl/2021/02/01/polsdruk-prognose-en-sacubitril-valsartan-bij-hfpef-paragon-hf/* This PARAGON-HF analysis showed that pulse pressure is a prognostic marker and may modify the effect of sacubitril-valsartan in HFpEF, linking arterial stiffness to treatment response in preserved ejection fraction. ## Urate, Blood Pressure, and Cardiovascular Disease: Evidence From Mendelian Randomization and Meta-Analysis of Clinical Trials. *2021-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16547 · https://hartvaat.nl/2021/02/01/urinezuur-bloeddruk-en-cv-ziekte-mendeliaanse-randomisatie-en-meta-analyse/* This Mendelian randomization and meta-analysis study showed that genetically determined serum urate levels are not causally associated with blood pressure or cardiovascular disease, suggesting that the observational association is confounded. ## Short-term and long-term outcomes of revascularization interventions for patients with severely reduced left ventricular ejection fraction: a meta-analysis. *2021-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13141 · https://hartvaat.nl/2021/02/01/revascularisatie-bij-ernstig-verminderde-lvef-korte-en-langetermijnuitkomsten/* This meta-analysis compared CABG with PCI outcomes in patients with severely reduced LVEF, providing evidence to guide revascularization strategy selection in the most depressed ventricular function. ## Inhaled Treprostinil in Pulmonary Hypertension Due to Interstitial Lung Disease. *2021-01-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2008470 · https://hartvaat.nl/2021/01/28/inhalatietreprostinil-bij-pulmonale-hypertensie-door-interstitiele-longziekte-ne/* The INCREASE trial demonstrated that inhaled treprostinil improved exercise capacity in patients with pulmonary hypertension associated with interstitial lung disease. This was the first therapy proven effective for this specific, previously untreatable form of pulmonary hypertension. ## Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation. *2021-01-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2029980 · https://hartvaat.nl/2021/01/28/cryoablatie-of-medicatie-als-initiele-af-behandeling-nejm-stop-af-first/* The STOP AF First trial confirmed that cryoablation was superior to antiarrhythmic drug therapy as initial treatment for paroxysmal atrial fibrillation, with significantly fewer patients experiencing treatment failure at 1 year. Together with EARLY-AF, the trial established the evidence base for first-line ablation in AF. ## Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation. *2021-01-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2029554 · https://hartvaat.nl/2021/01/28/cryoballonablatie-als-initiele-therapie-voor-af-nejm-early-af/* The EARLY-AF trial showed that cryoballoon ablation as initial therapy for symptomatic paroxysmal atrial fibrillation was superior to antiarrhythmic drug therapy in maintaining sinus rhythm at 1 year. This landmark result challenged the guideline recommendation of a drug-first approach and supported ablation as a first-line strategy. ## Periprocedural anticoagulation in the uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation (ELIMINATE-AF) trial. *2021-01-27 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa199 · https://hartvaat.nl/2021/01/27/periprocedurele-antistolling-bij-eliminate-af-ononderbroken-edoxaban-versus-vka/* This ELIMINATE-AF subanalysis characterized heparin dosing requirements and procedure-related bleeding during AF ablation with uninterrupted edoxaban versus VKA, informing periprocedural anticoagulation management. ## Non-vitamin K oral anticoagulants and risk of fractures: a systematic review and meta-analysis. *2021-01-27 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa242 · https://hartvaat.nl/2021/01/27/doac-s-en-fractuurrisico-systematische-review-en-meta-analyse/* This meta-analysis showed that DOACs are not associated with increased fracture risk compared with VKAs in AF patients, providing reassurance on the skeletal safety of non-vitamin K anticoagulants. ## Mobile health applications for the detection of atrial fibrillation: a systematic review. *2021-01-27 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa139 · https://hartvaat.nl/2021/01/27/mobiele-gezondheidstoepassingen-voor-af-detectie-systematische-review/* This systematic review of mobile health applications for AF detection assessed the accuracy, usability, and clinical validation of consumer smartphone and wearable technologies for arrhythmia screening. ## 2020 Update to the 2016 ACC/AHA Clinical Performance and Quality Measures for Adults With Atrial Fibrillation or Atrial Flutter: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. *2021-01-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.08.037 · https://hartvaat.nl/2021/01/26/2020-acc-aha-kwaliteitsmaten-voor-af-geactualiseerd/* This 2020 update to the ACC/AHA clinical performance and quality measures for adults with AF incorporated new anticoagulation metrics and guideline-directed management benchmarks for quality assessment. ## Randomized Trial of Empagliflozin in Nondiabetic Patients With Heart Failure and Reduced Ejection Fraction. *2021-01-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.008 · https://hartvaat.nl/2021/01/26/empagliflozine-bij-niet-diabetische-hfref-emperor-reduced-subanalyse/* This EMPEROR-Reduced subanalysis in nondiabetic patients confirmed that empagliflozin reduces cardiovascular death and heart failure hospitalization regardless of diabetes status. The finding was pivotal for regulatory approval of SGLT2 inhibitors in heart failure independent of glycemic indication. ## Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial. *2021-01-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.051783 · https://hartvaat.nl/2021/01/26/empagliflozine-en-klinische-stabiliteit-bij-hfref-emperor-reduced/* This EMPEROR-Reduced analysis showed that empagliflozin improves the overall clinical stability of patients with HFrEF, reducing the rate of clinical deterioration across multiple dimensions of disease progression. ## Short dual antiplatelet therapy followed by P2Y12 inhibitor monotherapy vs. prolonged dual antiplatelet therapy after percutaneous coronary intervention with second-generation drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials. *2021-01-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa739 · https://hartvaat.nl/2021/01/21/korte-dapt-gevolgd-door-p2y12-mono-versus-verlengde-dapt-meta-analyse/* This meta-analysis confirmed that short DAPT followed by P2Y12 inhibitor monotherapy significantly reduces bleeding compared with prolonged DAPT after PCI with second-generation DES, without increasing ischemic events. The pooled evidence consolidated the de-escalation paradigm. ## Polypill with or without Aspirin in Persons without Cardiovascular Disease. *2021-01-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2028220 · https://hartvaat.nl/2021/01/21/polypil-met-of-zonder-aspirine-bij-personen-zonder-cvd-nejm-polypill-tips-3/* The PolyPill-TIPS-3 trial showed that a polypill containing a statin and two blood-pressure-lowering drugs, with or without aspirin, reduced the incidence of cardiovascular disease in intermediate-risk individuals without established CVD. The study validated the polypill strategy as a practical approach to primary cardiovascular prevention at the population level. ## Effect of Discontinuing vs Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Days Alive and Out of the Hospital in Patients Admitted With COVID-19: A Randomized Clinical Trial. *2021-01-19 · JAMA · https://doi.org/10.1001/jama.2020.25864 · https://hartvaat.nl/2021/01/19/stoppen-versus-doorgaan-met-ace-remmers-arb-s-bij-gehospitaliseerde-patienten-ja/* The REPLACE-COVID trial showed that discontinuing versus continuing ACE inhibitors or ARBs in hospitalized COVID-19 patients made no significant difference in clinical outcomes, definitively supporting continuation of RAAS inhibitors during COVID-19 hospitalization. ## Predictive Value of the Residual SYNTAX Score in Patients With Cardiogenic Shock. *2021-01-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.11.025 · https://hartvaat.nl/2021/01/19/residuele-syntax-score-bij-cardiogene-shock/* This study evaluated the residual SYNTAX score as a prognostic tool in cardiogenic shock patients, assessing whether completeness of revascularization measured by anatomical complexity predicts outcomes in the most critically ill. ## Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure. *2021-01-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2030183 · https://hartvaat.nl/2021/01/14/sotagliflozine-bij-diabetes-met-recent-verslechterend-hf-nejm-soloist-whf/* The SOLOIST-WHF trial demonstrated that sotagliflozin initiated before or shortly after hospital discharge for worsening heart failure significantly reduced cardiovascular death and heart failure events in patients with diabetes. The study provided the first evidence for starting SGLT inhibitor therapy during an acute heart failure hospitalization. ## Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease. *2021-01-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2030186 · https://hartvaat.nl/2021/01/14/sotagliflozine-bij-diabetes-met-ckd-nejm-scored/* The SCORED trial showed that sotagliflozin, a dual SGLT1/SGLT2 inhibitor, reduced cardiovascular death, heart failure hospitalization, and urgent heart failure visits in patients with type 2 diabetes and chronic kidney disease. The results established dual SGLT inhibition as an effective cardiorenal strategy. ## Cardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure. *2021-01-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2025797 · https://hartvaat.nl/2021/01/14/omecamtiv-mecarbil-bij-systolisch-hartfalen-nejm-galactic-hf/* The GALACTIC-HF trial demonstrated that omecamtiv mecarbil, a selective cardiac myosin activator, modestly reduced the composite of heart failure events or cardiovascular death in patients with HFrEF. The trial validated a novel mechanism targeting cardiac contractility without increasing intracellular calcium or myocardial oxygen demand. ## Novel antisense therapy targeting microRNA-132 in patients with heart failure: results of a first-in-human Phase 1b randomized, double-blind, placebo-controlled study. *2021-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa898 · https://hartvaat.nl/2021/01/07/antisense-tegen-microrna-132-bij-hartfalen-fase-1b-resultaten/* This first-in-human phase 1b study of an antisense oligonucleotide targeting microRNA-132 in heart failure demonstrated safety and favorable effects on cardiac biomarkers, establishing a novel RNA-based therapeutic approach for cardiac remodeling. ## Calcium-Induced Autonomic Denervation in Patients With Post-Operative Atrial Fibrillation. *2021-01-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.10.049 · https://hartvaat.nl/2021/01/05/calcium-geinduceerde-autonome-denervatie-bij-postoperatief-af/* This study tested calcium-induced autonomic denervation for preventing postoperative atrial fibrillation after cardiac surgery, exploring a targeted autonomic intervention for this common surgical complication. ## Association of Age With 10-Year Outcomes After Coronary Surgery in the Arterial Revascularization Trial. *2021-01-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.10.047 · https://hartvaat.nl/2021/01/05/leeftijd-en-10-jaarsuitkomsten-na-cabg-art-trial/* This ART trial analysis showed that the relative benefit of bilateral versus single internal thoracic artery grafts in CABG is modified by age, with younger patients potentially deriving more benefit from the bilateral approach. ## Management of Patients With a Patent Foramen Ovale With History of Stroke or TIA. *2021-01-05 · JAMA · https://doi.org/10.1001/jama.2020.22176 · https://hartvaat.nl/2021/01/05/management-van-pfo-patienten-met-cva-of-tia-jama-klinisch-overzicht/* This JAMA clinical review provided a comprehensive overview of managing patients with patent foramen ovale and history of stroke or TIA, covering diagnostic workup, closure decision-making, and long-term follow-up strategies. ## Effect of High-Dose Trivalent vs Standard-Dose Quadrivalent Influenza Vaccine on Mortality or Cardiopulmonary Hospitalization in Patients With High-risk Cardiovascular Disease: A Randomized Clinical Trial. *2021-01-05 · JAMA · https://doi.org/10.1001/jama.2020.23649 · https://hartvaat.nl/2021/01/05/hoog-dosis-versus-standaarddosis-griepvaccin-en-mortaliteit-bij-ouderen-jama/* This JAMA trial comparing high-dose trivalent with standard-dose quadrivalent influenza vaccine on cardiovascular-related outcomes in elderly patients explored whether enhanced immunogenicity translates to cardiovascular protection in the highest-risk population. ## Reduction in Revascularization With Icosapent Ethyl: Insights From REDUCE-IT Revascularization Analyses. *2021-01-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050276 · https://hartvaat.nl/2021/01/05/revascularisatiereductie-met-icosapent-ethyl-reduce-it-analyse/* This REDUCE-IT analysis showed that icosapent ethyl significantly reduces the need for coronary revascularization procedures in statin-treated patients with elevated triglycerides, demonstrating a direct impact on interventional cardiology burden. ## Effect of Passive Choice and Active Choice Interventions in the Electronic Health Record to Cardiologists on Statin Prescribing: A Cluster Randomized Clinical Trial. *2021-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.4730 · https://hartvaat.nl/2021/01/01/passive-choice-en-active-choice-interventies-voor-statinevoorschrijving-jama-car/* This randomized trial tested electronic health record-based nudging interventions (passive choice and active choice) to increase statin prescribing by cardiologists, evaluating behavioral economics approaches to closing the treatment gap. ## Rivaroxaban and Aspirin in Patients With Symptomatic Lower Extremity Peripheral Artery Disease: A Subanalysis of the COMPASS Randomized Clinical Trial. *2021-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.4390 · https://hartvaat.nl/2021/01/01/rivaroxaban-plus-aspirine-bij-symptomatisch-pav-compass-subanalyse/* This COMPASS subanalysis confirmed that rivaroxaban plus aspirin reduces major vascular events specifically in patients with symptomatic lower extremity peripheral artery disease, supporting dual-pathway inhibition in the PAD population. ## Plasma Trough Concentrations of Antihypertensive Drugs for the Assessment of Treatment Adherence: A Meta-Analysis. *2021-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16061 · https://hartvaat.nl/2021/01/01/plasmatrogconcentraties-van-antihypertensiva-voor-therapietrouwbeoordeling-meta-/* This meta-analysis evaluated plasma trough concentrations of antihypertensive drugs as an objective measure of medication adherence, establishing biochemical screening as a practical tool for identifying non-adherent hypertensive patients. ## Dietary Approaches to Stop Hypertension Dietary Intervention Improves Blood Pressure and Vascular Health in Youth With Elevated Blood Pressure. *2021-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16156 · https://hartvaat.nl/2021/01/01/dash-dieet-verbetert-bloeddruk-en-vaatgezondheid-bij-jongeren-met-verhoogde-bloe/* This randomized trial showed that a DASH-focused dietary intervention improves blood pressure and vascular health in young adults with elevated blood pressure, supporting early nutritional intervention for hypertension prevention. ## Effect of Digoxin vs Bisoprolol for Heart Rate Control in Atrial Fibrillation on Patient-Reported Quality of Life: The RATE-AF Randomized Clinical Trial. *2020-12-22 · JAMA · https://doi.org/10.1001/jama.2020.23138 · https://hartvaat.nl/2020/12/22/digoxine-versus-bisoprolol-voor-frequentiecontrole-bij-af-en-qol-jama-rate-af/* The RATE-AF trial showed that digoxin was noninferior to bisoprolol for quality-of-life outcomes in patients with permanent AF and symptoms of heart failure, with fewer treatment-related adverse events. The pragmatic result supported digoxin as a reasonable first-line rate control agent in this population. ## Effects of Fentanyl Versus Morphine on Ticagrelor-Induced Platelet Inhibition in Patients With ST-Segment Elevation Myocardial Infarction: The PERSEUS Randomized Trial. *2020-12-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.049287 · https://hartvaat.nl/2020/12/22/fentanyl-versus-morfine-op-ticagrelor-plaatjesremming-bij-stemi/* This study compared the effects of fentanyl versus morphine on ticagrelor-induced platelet inhibition in STEMI, characterizing the differential impact of these opioids on antiplatelet drug absorption during acute MI management. ## Association of Baseline and Longitudinal Changes in Body Composition Measures With Risk of Heart Failure and Myocardial Infarction in Type 2 Diabetes: Findings From the Look AHEAD Trial. *2020-12-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050941 · https://hartvaat.nl/2020/12/22/lichaamssamenstelling-en-risico-op-hartfalen-en-mi-prospectieve-analyse/* This study demonstrated that longitudinal changes in body composition (lean mass, fat mass, visceral adiposity) predict heart failure and MI risk independently of body weight, supporting body composition assessment beyond BMI for cardiovascular risk. ## Effect of Intravitreous Aflibercept vs Vitrectomy With Panretinal Photocoagulation on Visual Acuity in Patients With Vitreous Hemorrhage From Proliferative Diabetic Retinopathy: A Randomized Clinical Trial. *2020-12-15 · JAMA · https://doi.org/10.1001/jama.2020.23027 · https://hartvaat.nl/2020/12/15/aflibercept-versus-vitrectomie-bij-diabetische-glasvochtbloeding-jama-drcr-net-p/* This DRCR.net trial compared intravitreal aflibercept with vitrectomy for diabetic vitreous hemorrhage, informing the ophthalmological management of this vision-threatening diabetic complication. ## Effect of Prehospital Crushed Prasugrel Tablets in Patients With ST-Segment-Elevation Myocardial Infarction Planned for Primary Percutaneous Coronary Intervention: The Randomized COMPARE CRUSH Trial. *2020-12-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.051532 · https://hartvaat.nl/2020/12/15/prehospitaal-gemalen-prasugrel-bij-stemi-gerandomiseerde-trial/* This randomized trial of prehospital crushed prasugrel in STEMI tested whether mechanically disrupting tablets before administration overcomes the delayed absorption seen with intact oral P2Y12 inhibitors in the acute MI setting. ## Ticagrelor or Prasugrel in Patients With ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. *2020-12-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050244 · https://hartvaat.nl/2020/12/15/ticagrelor-of-prasugrel-bij-stemi-met-primaire-pci-isar-react-5-stemi/* This ISAR-REACT 5 subanalysis in STEMI patients undergoing primary PCI confirmed that prasugrel reduces ischemic events compared with ticagrelor, with consistent superiority in the acute MI population. ## Catheter ablation vs. thoracoscopic surgical ablation in long-standing persistent atrial fibrillation: CASA-AF randomized controlled trial. *2020-12-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa658 · https://hartvaat.nl/2020/12/14/katheterablatie-versus-thoracoscopische-ablatie-bij-langdurig-persisterend-af-ca/* The CASA-AF trial compared catheter ablation with thoracoscopic surgical ablation for longstanding persistent AF, evaluating whether the more invasive surgical approach provides superior rhythm control in this challenging arrhythmia subtype. ## Edoxaban in atrial fibrillation patients with percutaneous coronary intervention by acute or chronic coronary syndrome presentation: a pre-specified analysis of the ENTRUST-AF PCI trial. *2020-12-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa617 · https://hartvaat.nl/2020/12/14/edoxaban-bij-af-met-pci-naar-acute-versus-chronische-coronaire-presentatie-entru/* This ENTRUST analysis compared edoxaban-based dual therapy in AF patients with PCI stratified by ACS versus chronic coronary disease, showing consistent safety across both clinical presentations. ## Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial. *2020-12-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)32339-4 · https://hartvaat.nl/2020/12/12/ijzercarboxymaltose-bij-ijzerdeficientie-na-ontslag-voor-acuut-hf-lancet-affirm-/* The AFFIRM-AHF trial showed that intravenous ferric carboxymaltose in patients with iron deficiency discharged after acute heart failure reduced the composite of heart failure rehospitalization and cardiovascular death versus placebo. This landmark result established IV iron as a guideline-recommended therapy for iron-deficient heart failure patients. ## Evinacumab in Patients with Refractory Hypercholesterolemia. *2020-12-10 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2031049 · https://hartvaat.nl/2020/12/10/evinacumab-bij-refractaire-hypercholesterolemie-nejm/* This NEJM trial demonstrated that evinacumab significantly reduced LDL cholesterol in patients with refractory hypercholesterolemia who had not reached LDL goals despite maximum tolerated lipid-lowering therapy. The results extended the utility of ANGPTL3 inhibition beyond homozygous FH to a broader treatment-resistant population. ## Left Atrial Appendage Closure Versus Oral Anticoagulants in Atrial Fibrillation: A Meta-Analysis of Randomized Trials. *2020-12-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.08.089 · https://hartvaat.nl/2020/12/08/laa-sluiting-versus-oac-bij-af-meta-analyse-van-gerandomiseerde-trials/* This meta-analysis of randomized trials comparing left atrial appendage closure with oral anticoagulation in AF provided the pooled evidence for the relative efficacy and safety of structural versus pharmacological stroke prevention. ## Effect of Empagliflozin on Hemodynamics in Patients With Heart Failure and Reduced Ejection Fraction. *2020-12-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.10.005 · https://hartvaat.nl/2020/12/08/empagliflozine-en-hemodynamiek-bij-hfref/* This study characterized the hemodynamic effects of empagliflozin in HFrEF, showing reductions in cardiac preload and afterload markers, providing mechanistic insight into how SGLT2 inhibitors improve heart failure outcomes. ## Remnant Cholesterol, Not LDL Cholesterol, Is Associated With Incident Cardiovascular Disease. *2020-12-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.10.008 · https://hartvaat.nl/2020/12/08/remnant-cholesterol-versus-ldl-en-incident-cv-ziekte/* This study demonstrated that remnant cholesterol (cholesterol in triglyceride-rich lipoproteins) is more strongly associated with incident cardiovascular disease than LDL cholesterol, shifting attention to triglyceride-rich lipoproteins as therapeutic targets. ## Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial. *2020-12-08 · JAMA · https://doi.org/10.1001/jama.2020.22258 · https://hartvaat.nl/2020/12/08/hoog-dosis-omega-3-versus-maisolie-bij-hoog-cv-risico-jama-strength/* The STRENGTH trial showed that high-dose omega-3 fatty acids (EPA plus DHA) did not reduce major cardiovascular events compared with corn oil in statin-treated patients at high cardiovascular risk. The contrasting result with REDUCE-IT (EPA only) suggested that DHA may attenuate EPA's cardiovascular benefit or that the mineral oil placebo in REDUCE-IT may have influenced outcomes. ## Efficacy of Ertugliflozin on Heart Failure-Related Events in Patients With Type 2 Diabetes Mellitus and Established Atherosclerotic Cardiovascular Disease: Results of the VERTIS CV Trial. *2020-12-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050255 · https://hartvaat.nl/2020/12/08/ertugliflozine-en-hf-events-bij-diabetes-met-atherosclerotische-cvd-vertis-cv/* This VERTIS CV analysis showed that ertugliflozin reduces heart failure hospitalization in diabetic patients with established ASCVD, confirming the heart failure prevention benefit as a class effect of SGLT2 inhibitors. ## Pulmonary Hypertension in Transcatheter Mitral Valve Repair for Secondary Mitral Regurgitation: The COAPT Trial. *2020-12-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.09.609 · https://hartvaat.nl/2020/12/01/pulmonale-hypertensie-bij-mitraclip-coapt-analyse/* This COAPT analysis showed that pulmonary hypertension worsens prognosis in heart failure with secondary MR, but that MitraClip provides consistent benefit regardless of baseline pulmonary pressures. ## Coronary Angiography After Cardiac Arrest Without ST Segment Elevation: One-Year Outcomes of the COACT Randomized Clinical Trial. *2020-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.3670 · https://hartvaat.nl/2020/12/01/coronairangiografie-na-hartstilstand-zonder-st-elevatie-coact-1-jaarsuitkomsten/* The 1-year COACT results confirmed that immediate coronary angiography does not improve survival compared with a delayed strategy after out-of-hospital cardiac arrest without ST-segment elevation, supporting the delayed approach. ## Association of Culprit Lesion Location With Outcomes of Culprit-Lesion-Only vs Immediate Multivessel Percutaneous Coronary Intervention in Cardiogenic Shock: A Post Hoc Analysis of a Randomized Clinical Trial. *2020-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.3377 · https://hartvaat.nl/2020/12/01/culprit-laesielocatie-en-uitkomsten-van-culprit-only-vs-multivaten-pci-culprit-s/* This CULPRIT-SHOCK analysis showed that culprit lesion location (particularly left main or proximal LAD) influences the relative outcomes of culprit-only versus multivessel PCI in cardiogenic shock, informing procedure planning based on anatomy. ## Efficacy and safety of SGLT2 inhibitors in heart failure: systematic review and meta-analysis. *2020-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13169 · https://hartvaat.nl/2020/12/01/sglt2-remmers-bij-hartfalen-systematische-review-en-meta-analyse/* This meta-analysis of SGLT2 inhibitors in heart failure confirmed class-wide reductions in heart failure hospitalization and cardiovascular death, with consistent benefit regardless of diabetes status. The analysis strengthened the evidence base for SGLT2 inhibitors as fundamental heart failure therapy. ## Ferric carboxymaltose for the treatment of iron-deficient heart failure patients: a systematic review and meta-analysis. *2020-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.13146 · https://hartvaat.nl/2020/12/01/ijzercarboxymaltose-bij-ijzerdeficient-hartfalen-meta-analyse/* This systematic review and meta-analysis confirmed that intravenous ferric carboxymaltose improves functional capacity and quality of life in iron-deficient heart failure patients, with a trend toward reduced heart failure hospitalization. The consolidated evidence supported IV iron as a guideline-recommended therapy. ## Effect and Acceptability of Mindfulness-Based Stress Reduction Program on Patients With Elevated Blood Pressure or Hypertension: A Meta-Analysis of Randomized Controlled Trials. *2020-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16160 · https://hartvaat.nl/2020/12/01/mindfulness-gebaseerde-stressreductie-bij-verhoogde-bloeddruk-meta-analyse/* This meta-analysis showed that mindfulness-based stress reduction programs modestly reduce blood pressure in patients with hypertension, supporting mind-body interventions as an adjunctive non-pharmacological blood pressure management strategy. ## Long-Term Blood Pressure Variability and Risk of Cardiovascular Disease Events Among Community-Dwelling Elderly. *2020-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.16209 · https://hartvaat.nl/2020/12/01/langetermijn-bloeddrukvariabiliteit-en-cv-risico-bij-ouderen-in-de-community/* This study showed that long-term visit-to-visit blood pressure variability predicts cardiovascular disease risk in community-dwelling elderly adults without prior CVD, extending the prognostic significance of BP variability to the oldest population. ## Effects of Intensive Systolic Blood Pressure Control on All-Cause Hospitalizations. *2020-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15868 · https://hartvaat.nl/2020/12/01/intensieve-bloeddrukcontrole-en-alle-hospitalisaties-sprint/* This SPRINT analysis showed that intensive systolic blood pressure control reduces all-cause hospitalizations, demonstrating that the cardiovascular event reduction translates to broader healthcare utilization benefits. ## Preeclamptic Women Have Decreased Circulating IL-10 (Interleukin-10) Values at the Time of Preeclampsia Diagnosis: Systematic Review and Meta-Analysis. *2020-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15870 · https://hartvaat.nl/2020/12/01/verlaagd-il-10-bij-pre-eclampsie-systematische-review-en-meta-analyse/* This meta-analysis confirmed that preeclamptic women have decreased circulating IL-10 levels at diagnosis, supporting an anti-inflammatory deficit as part of the preeclampsia pathophysiology. ## Changes in quality of life, cognition and functional status following catheter ablation of atrial fibrillation. *2020-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-316612 · https://hartvaat.nl/2020/12/01/qol-cognitie-en-functionele-status-na-af-ablatie/* This study showed that quality of life, cognition, and functional status improve after AF catheter ablation primarily in patients who maintain sinus rhythm, supporting arrhythmia recurrence as the key determinant of patient-centered outcomes. ## Lung ultrasound-guided therapy reduces acute decompensation events in chronic heart failure. *2020-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-316429 · https://hartvaat.nl/2020/12/01/longechogeleide-therapie-vermindert-acute-decompensatie-bij-chronisch-hf/* This study demonstrated that lung ultrasound-guided adjustment of diuretic therapy reduces acute decompensation events in patients with chronic heart failure, supporting point-of-care imaging as a tool for proactive congestion management. ## Ticagrelor versus clopidogrel in elective percutaneous coronary intervention (ALPHEUS): a randomised, open-label, phase 3b trial. *2020-11-28 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)32236-4 · https://hartvaat.nl/2020/11/28/ticagrelor-versus-clopidogrel-bij-electieve-pci-lancet-alpheus/* The ALPHEUS trial showed that ticagrelor was not superior to clopidogrel for reducing peri-procedural myocardial injury in patients undergoing elective PCI, supporting clopidogrel as the standard P2Y12 inhibitor for stable coronary disease. ## Rivaroxaban in Patients with Atrial Fibrillation and a Bioprosthetic Mitral Valve. *2020-11-26 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2029603 · https://hartvaat.nl/2020/11/26/rivaroxaban-bij-af-met-bioprothese-mitralisklep-nejm-river/* The RIVER trial demonstrated that rivaroxaban was noninferior to warfarin for the composite of stroke, TIA, systemic embolism, valve thrombosis, or death in patients with atrial fibrillation and a bioprosthetic mitral valve. The result expanded the evidence for DOAC use in patients with bioprosthetic heart valves. ## N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects. *2020-11-26 · The New England journal of medicine · https://doi.org/10.1056/NEJMc2031173 · https://hartvaat.nl/2020/11/26/n-of-1-trial-van-statine-placebo-of-geen-behandeling-voor-bijwerkingen-nejm-stat/* The StatinWISE N-of-1 trial demonstrated that muscle symptoms attributed to statins were largely not reproducible under blinded conditions, with similar symptom scores during statin and placebo periods. This provided rigorous evidence that most statin-associated side effects are attributable to the nocebo effect rather than the drug itself. ## Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement. *2020-11-24 · JAMA · https://doi.org/10.1001/jama.2020.21749 · https://hartvaat.nl/2020/11/24/gedragscounseling-voor-cv-preventie-bij-risicoadulten-jama-uspstf-evidence-revie/* This USPSTF evidence review assessed behavioral counseling interventions for diet and physical activity in adults with cardiovascular risk factors, finding consistent modest benefits on blood pressure, lipids, and glucose levels. ## Behavioral Counseling to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. *2020-11-24 · JAMA · https://doi.org/10.1001/jama.2020.17108 · https://hartvaat.nl/2020/11/24/gedragscounseling-voor-gezond-dieet-en-beweging-bij-cv-risico-jama-uspstf/* This USPSTF recommendation endorsed behavioral counseling for healthy diet and physical activity in adults with cardiovascular risk factors, providing a Grade B recommendation for population-level lifestyle intervention. ## Ticagrelor or Prasugrel in Patients With Non-ST-Segment Elevation Acute Coronary Syndromes. *2020-11-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.09.584 · https://hartvaat.nl/2020/11/24/ticagrelor-of-prasugrel-bij-nste-acs-isar-react-5-subanalyse/* This ISAR-REACT 5 subanalysis confirmed that prasugrel is superior to ticagrelor for reducing ischemic events specifically in patients with NSTE-ACS, extending the primary trial findings to the non-STEMI population. ## 2020 ACC/AHA Clinical Performance and Quality Measures for Adults With Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. *2020-11-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.07.023 · https://hartvaat.nl/2020/11/24/2020-acc-aha-prestatie-en-kwaliteitsmaten-voor-hartfalen/* These 2020 ACC/AHA clinical performance and quality measures for adults with heart failure defined benchmarks for assessing and improving heart failure care quality across healthcare systems. ## Randomized Pilot Clinical Trial of Early Coronary Angiography Versus No Early Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation: The PEARL Study. *2020-11-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.049569 · https://hartvaat.nl/2020/11/24/vroege-coronairangiografie-versus-uitstel-na-hartstilstand-zonder-st-elevatie-pi/* This pilot randomized trial of early versus delayed coronary angiography after cardiac arrest without ST elevation provided preliminary data informing the timing of invasive evaluation in resuscitated patients. ## Timing of Oral P2Y12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. *2020-11-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.08.053 · https://hartvaat.nl/2020/11/24/timing-van-orale-p2y12-remmer-bij-nste-acs/* This analysis evaluated the optimal timing of oral P2Y12 inhibitor administration in NSTE-ACS, addressing whether pre-treatment before angiography or deferred loading after coronary anatomy is known provides better outcomes. ## Efficacy and safety of lowering LDL cholesterol in older patients: a systematic review and meta-analysis of randomised controlled trials. *2020-11-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)32332-1 · https://hartvaat.nl/2020/11/21/ldl-verlaging-bij-ouderen-lancet-meta-analyse-werkzaamheid-en-veiligheid/* This Lancet meta-analysis of randomized controlled trials confirmed that LDL cholesterol-lowering therapy reduces cardiovascular events in older patients to a similar extent as in younger patients. The analysis definitively countered the notion that lipid lowering is ineffective or unsafe in elderly populations. ## Lipoprotein(a) lowering by alirocumab reduces the total burden of cardiovascular events independent of low-density lipoprotein cholesterol lowering: ODYSSEY OUTCOMES trial. *2020-11-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa649 · https://hartvaat.nl/2020/11/21/alirocumab-lp-a-verlaging-en-totale-cv-eventlast-onafhankelijk-van-ldl-odyssey-o/* This ODYSSEY OUTCOMES analysis showed that alirocumab-mediated Lp(a) reduction independently contributed to lowering the total burden of cardiovascular events, beyond LDL cholesterol effects. The finding strengthened the evidence for Lp(a) as an actionable therapeutic target. ## First-Line Lorlatinib or Crizotinib in Advanced ALK-Positive Lung Cancer. *2020-11-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2027187 · https://hartvaat.nl/2020/11/19/lorlatinib-versus-crizotinib-bij-alk-positief-longkanker-nejm/* This NEJM trial of lorlatinib versus crizotinib in ALK-positive lung cancer is relevant to cardio-oncology due to lorlatinib's cardiovascular side effects including significant hypercholesterolemia and hypertriglyceridemia. ## Effect of an Emergency Department Care Bundle on 30-Day Hospital Discharge and Survival Among Elderly Patients With Acute Heart Failure: The ELISABETH Randomized Clinical Trial. *2020-11-17 · JAMA · https://doi.org/10.1001/jama.2020.19378 · https://hartvaat.nl/2020/11/17/seh-zorgbundel-en-30-daags-ontslag-en-overleving-bij-oudere-hf-patienten-jama/* This JAMA trial showed that an emergency department care bundle for older patients with acute heart failure did not significantly improve 30-day hospital discharge or survival, highlighting the difficulty of improving acute HF outcomes through ED-level interventions. ## Transcatheter Bariatric Embolotherapy for Weight Reduction in Obesity. *2020-11-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.09.550 · https://hartvaat.nl/2020/11/17/transcatheter-bariatrische-embolotherapie-voor-gewichtsreductie-bij-obesitas/* This study evaluated transcatheter bariatric arterial embolization as a minimally invasive weight reduction procedure for obesity, exploring a catheter-based alternative to surgical bariatric approaches. ## Percutaneous Coronary Intervention for Vulnerable Coronary Atherosclerotic Plaque. *2020-11-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.09.547 · https://hartvaat.nl/2020/11/17/pci-voor-kwetsbare-coronaire-plaque/* This study explored PCI for vulnerable (non-obstructive) coronary plaques identified by intravascular imaging, testing the concept of prophylactic intervention before these high-risk lesions cause clinical events. ## Colchicine in Patients With Acute Coronary Syndrome: The Australian COPS Randomized Clinical Trial. *2020-11-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050771 · https://hartvaat.nl/2020/11/17/colchicine-bij-acs-australische-cops-gerandomiseerde-trial/* The Australian COPS trial showed that colchicine initiated during ACS hospitalization did not reduce cardiovascular events and was associated with a signal toward increased noncardiovascular mortality. The unexpected negative result contrasted with COLCOT and contributed to ongoing uncertainty about colchicine's role in ACS. ## Screening for High Blood Pressure in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. *2020-11-10 · JAMA · https://doi.org/10.1001/jama.2020.20122 · https://hartvaat.nl/2020/11/10/screening-op-hoge-bloeddruk-bij-kinderen-uspstf-aanbeveling-2020/* The 2020 USPSTF recommendation on blood pressure screening in children and adolescents addressed the evidence for routine screening and identification of primary and secondary hypertension in the pediatric population. ## Screening for Hypertension in Children and Adolescents: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. *2020-11-10 · JAMA · https://doi.org/10.1001/jama.2020.11119 · https://hartvaat.nl/2020/11/10/screening-op-hypertensie-bij-kinderen-uspstf-evidence-report-2020/* This updated USPSTF evidence review on hypertension screening in children and adolescents evaluated the evidence for routine blood pressure measurement and the downstream benefits of identifying and treating pediatric hypertension. ## Effect of Vitamin D Supplementation, Omega-3 Fatty Acid Supplementation, or a Strength-Training Exercise Program on Clinical Outcomes in Older Adults: The DO-HEALTH Randomized Clinical Trial. *2020-11-10 · JAMA · https://doi.org/10.1001/jama.2020.16909 · https://hartvaat.nl/2020/11/10/vitamine-d-omega-3-of-krachttraining-en-klinische-uitkomsten-bij-ouderen-jama-do/* The DO-HEALTH trial showed that vitamin D, omega-3 fatty acids, and strength training exercise, alone or in combination, did not significantly reduce clinical outcomes in healthy older adults, adding to the negative evidence for these supplements in general prevention. ## Treatment of Masked Hypertension with a Chinese Herbal Formula: A Randomized, Placebo-Controlled Trial. *2020-11-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046685 · https://hartvaat.nl/2020/11/10/chinese-kruidenformule-voor-gemaskeerde-hypertensie-gerandomiseerde-placebogecon/* This randomized placebo-controlled trial tested a Chinese herbal formula for treating masked hypertension, providing the first controlled evidence for traditional herbal medicine in this specific blood pressure phenotype. ## Effect of Adding Ticagrelor to Standard Aspirin on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting (POPular CABG): A Randomized, Double-Blind, Placebo-Controlled Trial. *2020-11-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050749 · https://hartvaat.nl/2020/11/10/ticagrelor-plus-aspirine-en-safeneuze-graft-patency-na-cabg/* This study tested whether adding ticagrelor to aspirin improves saphenous vein graft patency after CABG, evaluating more potent antiplatelet therapy for preventing the common problem of early graft occlusion. ## Long-term efficacy and safety of drug-coated balloons versus drug-eluting stents for small coronary artery disease (BASKET-SMALL 2): 3-year follow-up of a randomised, non-inferiority trial. *2020-11-07 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)32173-5 · https://hartvaat.nl/2020/11/07/drug-coated-balloons-versus-des-bij-kleine-coronairarterien-lancet-basket-small-/* Long-term BASKET-SMALL 2 follow-up confirmed that drug-coated balloons maintain comparable outcomes to drug-eluting stents for small coronary artery disease over extended follow-up, supporting the leave-nothing-behind approach. ## Time-to-treatment initiation of colchicine and cardiovascular outcomes after myocardial infarction in the Colchicine Cardiovascular Outcomes Trial (COLCOT). *2020-11-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa659 · https://hartvaat.nl/2020/11/07/colchicine-timing-en-cv-uitkomsten-na-mi-colcot-analyse/* This COLCOT analysis demonstrated that earlier initiation of colchicine after myocardial infarction is associated with greater cardiovascular benefit, supporting prompt anti-inflammatory therapy in the acute post-MI period. ## Effect of alirocumab on major adverse cardiovascular events according to renal function in patients with a recent acute coronary syndrome: prespecified analysis from the ODYSSEY OUTCOMES randomized clinical trial. *2020-11-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa498 · https://hartvaat.nl/2020/11/07/alirocumab-en-mace-naar-nierfunctie-na-acs-odyssey-outcomes/* This ODYSSEY OUTCOMES analysis showed that alirocumab reduces MACE consistently across the spectrum of renal function after ACS, supporting PCSK9 inhibitor use regardless of CKD status. ## Complete revascularization reduces cardiovascular death in patients with ST-segment elevation myocardial infarction and multivessel disease: systematic review and meta-analysis of randomized clinical trials. *2020-11-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehz896 · https://hartvaat.nl/2020/11/07/complete-revascularisatie-vermindert-cv-dood-bij-stemi-met-multivatenlijden-meta/* This meta-analysis demonstrated that complete revascularization of nonculprit lesions in patients with STEMI and multivessel disease significantly reduces cardiovascular death, providing the strongest evidence yet for a mortality benefit from the complete revascularization strategy. ## Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change: A Randomized Clinical Trial. *2020-11-03 · JAMA · https://doi.org/10.1001/jama.2020.18977 · https://hartvaat.nl/2020/11/03/online-gewichtsmanagementprogramma-geintegreerd-met-populatiegezondheidsbeheer-j/* This JAMA trial showed that an online weight management program integrated into routine primary care produces clinically meaningful weight loss, demonstrating a scalable digital approach to obesity management. ## Effects of Canagliflozin on Amino-Terminal Pro-B-Type Natriuretic Peptide: Implications for Cardiovascular Risk Reduction. *2020-11-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.09.004 · https://hartvaat.nl/2020/11/03/canagliflozine-en-nt-probnp-implicaties-voor-cv-risicoreductie/* This analysis showed that canagliflozin reduces NT-proBNP levels in patients with type 2 diabetes and cardiovascular risk, providing a biomarker-based explanation for the heart failure prevention benefit of SGLT2 inhibitors. ## Renal and Cardiovascular Effects of SGLT2 Inhibition in Combination With Loop Diuretics in Patients With Type 2 Diabetes and Chronic Heart Failure: The RECEDE-CHF Trial. *2020-11-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.048739 · https://hartvaat.nl/2020/11/03/sglt2-remming-plus-lisdiuretica-bij-diabetes-type-2-met-ckd-renale-en-cv-effecte/* This study characterized the renal and cardiovascular effects of combining SGLT2 inhibitors with loop diuretics in diabetic patients with CKD, showing additive natriuretic and hemodynamic benefits without excessive volume depletion. ## Initial Invasive Versus Conservative Management of Stable Ischemic Heart Disease in Patients With a History of Heart Failure or Left Ventricular Dysfunction: Insights From the ISCHEMIA Trial. *2020-11-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.050304 · https://hartvaat.nl/2020/11/03/invasief-versus-conservatief-bij-stabiel-coronairlijden-met-hf-of-lage-ef-ischem/* This ISCHEMIA substudy in patients with a history of heart failure or reduced LV function found no significant interaction between heart failure status and the benefit of initial invasive versus conservative management of stable ischemic heart disease. ## Angiotensin-converting enzyme 2 (ACE2) levels in relation to risk factors for COVID-19 in two large cohorts of patients with atrial fibrillation. *2020-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa697 · https://hartvaat.nl/2020/11/01/ace2-niveaus-en-covid-19-risicofactoren-bij-af-patienten/* This study measured circulating ACE2 levels in AF patients in relation to COVID-19 risk factors, exploring whether RAAS pathway biomarkers predict susceptibility to SARS-CoV-2 infection in cardiovascular populations. ## Efficacy and safety of ablation index-guided catheter ablation for atrial fibrillation: an updated meta-analysis. *2020-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa224 · https://hartvaat.nl/2020/11/01/ablatie-index-geleide-af-ablatie-geactualiseerde-meta-analyse/* This updated meta-analysis confirmed that ablation index-guided catheter ablation for AF improves PVI durability and reduces arrhythmia recurrence compared with conventional approaches. ## Clinical Application of High-Sensitivity Troponin Testing in the Atherosclerotic Cardiovascular Disease Framework of the Current Cholesterol Guidelines. *2020-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.2981 · https://hartvaat.nl/2020/11/01/klinische-toepassing-van-hs-troponine-in-het-ascvd-raamwerk-jama-cardiology/* This analysis explored the clinical application of high-sensitivity troponin testing within the ASCVD risk framework, evaluating whether subclinical myocardial injury adds predictive value for statin therapy allocation. ## Influence of Clinical Trials of Acute Coronary Syndrome Beyond the Primary Hypothesis: A Systematic Review. *2020-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.2855 · https://hartvaat.nl/2020/11/01/invloed-van-acs-trials-buiten-de-primaire-hypothese-systematische-review/* This systematic review assessed the broader scientific impact of ACS clinical trials beyond their primary hypotheses, quantifying the research legacy and knowledge generation from these major cardiovascular studies. ## Association of Low-Dose Triple Combination Therapy With Therapeutic Inertia and Prescribing Patterns in Patients With Hypertension: A Secondary Analysis of the TRIUMPH Trial. *2020-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.2739 · https://hartvaat.nl/2020/11/01/lage-dosis-triple-combinatie-en-therapeutische-inertie-bij-hypertensie-jama-card/* This analysis showed that low-dose triple combination therapy reduces therapeutic inertia in hypertension management, with clinicians more likely to initiate effective treatment when simplified into a single pill. ## Attainment of Targets of the 20-Year Infancy-Onset Dietary Intervention and Blood Pressure Across Childhood and Young Adulthood: The Special Turku Coronary Risk Factor Intervention Project (STRIP). *2020-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15075 · https://hartvaat.nl/2020/11/01/20-jaars-dieetinterventie-vanaf-zuigelingenleeftijd-en-bloeddruk-strip-studie/* This STRIP study 20-year follow-up showed that achieving dietary intervention targets from infancy is associated with favorable blood pressure trajectories through childhood and adolescence, supporting the lifelong cardiovascular benefit of early dietary optimization. ## Renin-Angiotensin-Aldosterone System Inhibitors and Risks of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Systematic Review and Meta-Analysis. *2020-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15989 · https://hartvaat.nl/2020/11/01/raas-remmers-en-covid-19-risico-systematische-review-en-meta-analyse/* This systematic review confirmed that RAAS inhibitors do not increase the risk of SARS-CoV-2 infection or severe COVID-19 outcomes, definitively addressing the early pandemic controversy about ACE inhibitor and ARB safety. ## Effect of random deferral of percutaneous coronary intervention in patients with diabetes and stable ischaemic heart disease. *2020-11-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-316432 · https://hartvaat.nl/2020/11/01/random-uitstel-van-pci-bij-diabetes-met-stabiel-coronairlijden/* This study examined the outcomes of random PCI deferral versus treatment in diabetic patients with stable coronary disease, evaluating whether lesion-level FFR guidance changes the revascularization calculation in diabetes. ## Exercise intervention improves quality of life in older adults after myocardial infarction: randomised clinical trial. *2020-11-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-316349 · https://hartvaat.nl/2020/11/01/inspanningsinterventie-verbetert-qol-na-mi-bij-ouderen-gerandomiseerde-trial/* This randomized trial showed that an early, tailored, low-cost exercise intervention improves quality of life in older patients after myocardial infarction, supporting accessible rehabilitation for the elderly MI population. ## Redevelopment and validation of the SYNTAX score II to individualise decision making between percutaneous and surgical revascularisation in patients with complex coronary artery disease: secondary analysis of the multicentre randomised controlled SYNTAXES trial with external cohort validation. *2020-10-31 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)32114-0 · https://hartvaat.nl/2020/10/31/syntax-score-ii-herontwikkeling-voor-gepersonaliseerde-revascularisatiebeslissin/* The redeveloped SYNTAX Score II integrates clinical and anatomical variables to provide individualized predictions of outcomes after PCI versus CABG, enabling personalized revascularization decisions based on predicted benefit rather than average trial results. ## Low-Dose Edoxaban in Very Elderly Patients with Atrial Fibrillation. *2020-10-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2012883 · https://hartvaat.nl/2020/10/29/laaggedoseerd-edoxaban-bij-zeer-oude-af-patienten-nejm-eldercare-af/* The ELDERCARE-AF trial showed that low-dose edoxaban (15 mg daily) significantly reduced stroke and systemic embolism compared with placebo in very elderly (≥80 years) Japanese patients with atrial fibrillation who were deemed inappropriate for standard-dose anticoagulation. The findings addressed a critical evidence gap in the frailest AF population. ## Effect of Catheter Ablation With Vein of Marshall Ethanol Infusion vs Catheter Ablation Alone on Persistent Atrial Fibrillation: The VENUS Randomized Clinical Trial. *2020-10-27 · JAMA · https://doi.org/10.1001/jama.2020.16195 · https://hartvaat.nl/2020/10/27/af-ablatie-met-vena-van-marshall-ethanol-versus-ablatie-alleen-jama-venus/* The VENUS trial showed that catheter ablation combined with vein of Marshall ethanol infusion improved freedom from persistent AF compared with standard ablation alone, establishing a hybrid chemical-thermal approach for this challenging arrhythmia. ## Effect of Dapagliflozin on Outpatient Worsening of Patients With Heart Failure and Reduced Ejection Fraction: A Prespecified Analysis of DAPA-HF. *2020-10-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.047480 · https://hartvaat.nl/2020/10/27/dapagliflozine-en-poliklinische-verslechtering-bij-hfref-dapa-hf/* This DAPA-HF analysis demonstrated that dapagliflozin prevents outpatient worsening of heart failure, reducing the need for intensified diuretic therapy and emergency visits before hospitalization is required. ## Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy: final results of the EVAPORATE trial. *2020-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa652 · https://hartvaat.nl/2020/10/21/icosapent-ethyl-en-coronaire-atheroscleroseprogressie-bij-verhoogde-triglyceride/* The EVAPORATE imaging study showed that icosapent ethyl slows coronary atherosclerosis progression in patients with elevated triglycerides on statin therapy, providing a mechanistic explanation for the cardiovascular benefit observed in REDUCE-IT. ## Vupanorsen, an N-acetyl galactosamine-conjugated antisense drug to ANGPTL3 mRNA, lowers triglycerides and atherogenic lipoproteins in patients with diabetes, hepatic steatosis, and hypertriglyceridaemia. *2020-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa689 · https://hartvaat.nl/2020/10/21/vupanorsen-angptl3-antisense-en-triglyceriden-ehj/* This study of vupanorsen, a GalNAc-conjugated antisense oligonucleotide targeting ANGPTL3, demonstrated significant reductions in triglycerides and atherogenic lipoproteins with improved hepatic targeting, advancing the ANGPTL3 inhibition approach for dyslipidemia. ## Medical Care of Adults With Down Syndrome: A Clinical Guideline. *2020-10-20 · JAMA · https://doi.org/10.1001/jama.2020.17024 · https://hartvaat.nl/2020/10/20/medische-zorg-voor-volwassenen-met-syndroom-van-down-jama-klinische-richtlijn/* This JAMA clinical guideline for medical care of adults with Down syndrome addressed the growing cardiovascular needs of this population, including congenital heart disease follow-up, valvular disease, and metabolic risk management. ## Effect of Praliciguat on Peak Rate of Oxygen Consumption in Patients With Heart Failure With Preserved Ejection Fraction: The CAPACITY HFpEF Randomized Clinical Trial. *2020-10-20 · JAMA · https://doi.org/10.1001/jama.2020.16641 · https://hartvaat.nl/2020/10/20/praliciguat-en-piek-vo2-bij-hfpef-jama-capacity-hfpef/* The CAPACITY-HFpEF trial showed that praliciguat, an sGC stimulator, did not improve peak oxygen consumption in HFpEF, adding to the evidence that sGC stimulation does not benefit the preserved ejection fraction phenotype. ## Effect of Vericiguat vs Placebo on Quality of Life in Patients With Heart Failure and Preserved Ejection Fraction: The VITALITY-HFpEF Randomized Clinical Trial. *2020-10-20 · JAMA · https://doi.org/10.1001/jama.2020.15922 · https://hartvaat.nl/2020/10/20/vericiguat-en-kwaliteit-van-leven-bij-hfpef-jama-vitality-hfpef/* The VITALITY-HFpEF trial showed that vericiguat does not improve quality of life in patients with heart failure and preserved ejection fraction, indicating that the sGC stimulator mechanism does not benefit the HFpEF phenotype. ## Association of Receipt of Palliative Care Interventions With Health Care Use, Quality of Life, and Symptom Burden Among Adults With Chronic Noncancer Illness: A Systematic Review and Meta-analysis. *2020-10-13 · JAMA · https://doi.org/10.1001/jama.2020.14205 · https://hartvaat.nl/2020/10/13/palliatieve-zorginterventies-bij-hartfalen-jama-associatie-met-qol-en-symptoomla/* This JAMA study showed that palliative care interventions in patients with heart failure improve quality of life and reduce symptom burden without increasing healthcare utilization, supporting the integration of palliative care into heart failure management. ## Pharmacodynamic and Pharmacokinetic Effects of a Low Maintenance Dose Ticagrelor Regimen Versus Standard Dose Clopidogrel in Diabetes Mellitus Patients Without Previous Major Cardiovascular Events Undergoing Elective Percutaneous Coronary Intervention: The OPTIMUS-6 Study. *2020-10-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.048770 · https://hartvaat.nl/2020/10/13/laaggedoseerd-ticagrelor-versus-standaard-clopidogrel-bij-diabetes-farmacodynami/* This pharmacodynamic study compared low-dose ticagrelor with standard clopidogrel in diabetic patients, evaluating a dose-reduction strategy that aims to maintain antiplatelet efficacy with a better bleeding profile. ## Dual Antiplatelet Therapy After Percutaneous Coronary Intervention and Drug-Eluting Stents: A Systematic Review and Network Meta-Analysis. *2020-10-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046308 · https://hartvaat.nl/2020/10/13/dapt-na-pci-met-des-netwerkmeta-analyse-van-duur-en-intensiteit/* This comprehensive network meta-analysis evaluated the optimal duration and intensity of DAPT after PCI with drug-eluting stents, comparing short-term, standard, and extended regimens. The analysis provided quantitative guidance for personalizing DAPT duration based on individual risk profiles. ## Prasugrel-based de-escalation of dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (HOST-REDUCE-POLYTECH-ACS): an open-label, multicentre, non-inferiority randomised trial. *2020-10-10 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)31791-8 · https://hartvaat.nl/2020/10/10/prasugrel-gebaseerde-dapt-de-escalatie-na-pci-bij-acs-lancet-host-reduce-polytec/* This Lancet trial of prasugrel dose de-escalation (from 10 mg to 5 mg) after the acute phase of ACS demonstrated that dose reduction provides a less bleeding-prone alternative to switching agents. The approach offered a practical de-escalation strategy within a single P2Y12 inhibitor. ## Dapagliflozin in Patients with Chronic Kidney Disease. *2020-10-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2024816 · https://hartvaat.nl/2020/10/08/dapagliflozine-bij-chronische-nierziekte-nejm-dapa-ckd/* The DAPA-CKD trial demonstrated that dapagliflozin significantly reduced the composite of sustained decline in eGFR, end-stage kidney disease, or death from renal or cardiovascular causes in patients with CKD, regardless of diabetes status. The trial was stopped early for efficacy and expanded the role of SGLT2 inhibitors to all chronic kidney disease. ## Cardiovascular Outcomes with Ertugliflozin in Type 2 Diabetes. *2020-10-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2004967 · https://hartvaat.nl/2020/10/08/ertugliflozine-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-nejm-vertis-cv/* The VERTIS CV trial confirmed the cardiovascular safety (noninferiority) of ertugliflozin in patients with type 2 diabetes and established atherosclerotic disease but did not demonstrate superiority for MACE reduction. The result differentiated ertugliflozin from empagliflozin and canagliflozin within the SGLT2 inhibitor class. ## Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. *2020-10-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2022190 · https://hartvaat.nl/2020/10/08/empagliflozine-bij-hartfalen-cardiovasculaire-en-renale-uitkomsten-nejm-emperor-/* The EMPEROR-Reduced trial showed that empagliflozin significantly reduced the composite of cardiovascular death or heart failure hospitalization in patients with HFrEF, regardless of diabetes status. Together with DAPA-HF, this confirmed the class effect of SGLT2 inhibitors in heart failure and supported their addition to guideline-directed therapy. ## Postoperative Atrial Fibrillation and Long-Term Risk of Stroke After Isolated Coronary Artery Bypass Graft Surgery. *2020-10-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046940 · https://hartvaat.nl/2020/10/06/postoperatief-af-en-langetermijn-cva-risico-na-geisoleerde-cabg/* This study demonstrated that postoperative atrial fibrillation after isolated CABG is associated with significantly increased long-term stroke risk, supporting consideration of anticoagulation in patients who develop AF after cardiac surgery. ## Impact of Peri-Procedural Myocardial Infarction on Outcomes After Revascularization. *2020-10-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.08.009 · https://hartvaat.nl/2020/10/06/periprocedureel-mi-en-uitkomsten-na-revascularisatie/* This study confirmed that periprocedural MI after both PCI and CABG is associated with worse long-term outcomes, though the prognostic impact varies by the magnitude of biomarker elevation and MI definition used. ## Implications of Alternative Definitions of Peri-Procedural Myocardial Infarction After Coronary Revascularization. *2020-10-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.08.016 · https://hartvaat.nl/2020/10/06/implicaties-van-alternatieve-mi-definities-na-coronaire-revascularisatie/* This analysis demonstrated that varying definitions of periprocedural MI produce substantially different event rates after revascularization, highlighting the critical impact of MI definition on trial interpretation. ## Ticagrelor alone vs. ticagrelor plus aspirin following percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes: TWILIGHT-ACS. *2020-10-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa670 · https://hartvaat.nl/2020/10/01/ticagrelor-monotherapie-versus-dapt-na-pci-bij-nstemi-subanalyse/* This subanalysis of ticagrelor monotherapy versus DAPT specifically in NSTEMI patients after PCI confirmed that aspirin discontinuation reduces bleeding without increasing ischemic events in this acute population. ## Early Rhythm-Control Therapy in Patients with Atrial Fibrillation. *2020-10-01 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2019422 · https://hartvaat.nl/2020/10/01/vroege-ritmecontrole-bij-af-nejm-east-afnet-4/* The EAST-AFNET 4 trial demonstrated that early, systematic rhythm-control therapy within one year of atrial fibrillation diagnosis reduced cardiovascular death, stroke, and hospitalization for heart failure compared with usual care. This paradigm-shifting result reversed decades of rate-control-first thinking and established early rhythm control as the preferred strategy. ## Evolocumab in Pediatric Heterozygous Familial Hypercholesterolemia. *2020-10-01 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2019910 · https://hartvaat.nl/2020/10/01/evolocumab-bij-pediatrische-heterozygoot-fh-nejm-hauser-rct/* The HAUSER-RCT trial demonstrated that evolocumab safely and effectively lowered LDL cholesterol in children and adolescents (10-17 years) with heterozygous familial hypercholesterolemia, providing the first randomized evidence for PCSK9 inhibitor use in the pediatric FH population. ## Oesophageal Probe Evaluation in Radiofrequency Ablation of Atrial Fibrillation (OPERA): results from a prospective randomized trial. *2020-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa209 · https://hartvaat.nl/2020/10/01/slokdarmsonde-bij-rf-ablatie-voor-af-opera-prospectieve-gerandomiseerde-trial/* The OPERA trial evaluated whether esophageal temperature monitoring during RF ablation for AF reduces esophageal lesion incidence, testing a commonly used safety measure for posterior wall ablation. ## Efficacy of high-power and short-duration ablation in patients with atrial fibrillation: a prospective randomized controlled trial. *2020-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa144 · https://hartvaat.nl/2020/10/01/high-power-short-duration-ablatie-bij-af-prospectieve-gerandomiseerde-trial/* This prospective randomized trial of high-power short-duration RF ablation for AF showed that accelerated energy delivery achieves comparable efficacy with shorter procedure times, advancing the efficiency of catheter ablation. ## Randomized study defining the optimum target interlesion distance in ablation index-guided atrial fibrillation ablation. *2020-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa147 · https://hartvaat.nl/2020/10/01/optimale-interlaesieafstand-bij-ablatie-index-geleide-af-ablatie-gerandomiseerde/* This randomized study determined the optimal interlesion distance in ablation index-guided AF ablation, defining the spacing parameters that achieve durable pulmonary vein isolation with the CLOSE protocol. ## Natural History of Asymptomatic Severe Aortic Stenosis and the Association of Early Intervention With Outcomes: A Systematic Review and Meta-analysis. *2020-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.2497 · https://hartvaat.nl/2020/10/01/natuurlijk-beloop-van-asymptomatische-ernstige-aortastenose-jama-cardiology-meta/* This JAMA Cardiology meta-analysis of asymptomatic severe aortic stenosis showed that early intervention may be associated with improved survival compared with conservative management. The analysis fueled the growing debate about expanding intervention indications beyond symptomatic disease. ## Effect of C-Reactive Protein on Lipoprotein(a)-Associated Cardiovascular Risk in Optimally Treated Patients With High-Risk Vascular Disease: A Prespecified Secondary Analysis of the ACCELERATE Trial. *2020-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.2413 · https://hartvaat.nl/2020/10/01/crp-op-lp-a-geassocieerd-cv-risico-bij-optimaal-behandelde-hoogrisicopatienten/* This analysis showed that the cardiovascular risk associated with elevated Lp(a) is amplified by concurrent systemic inflammation (elevated CRP), suggesting that dual targeting of both Lp(a) and inflammation may be needed for optimal risk reduction. ## Mortality risk in dilated cardiomyopathy: the accuracy of heart failure prognostic models and dilated cardiomyopathy-tailored prognostic model. *2020-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12809 · https://hartvaat.nl/2020/10/01/mortaliteitsrisico-bij-dilaterende-cardiomyopathie-vergelijking-van-prognostisch/* This study compared the accuracy of general heart failure prognostic models versus DCM-specific models in dilated cardiomyopathy, finding that disease-specific tools provide better risk prediction in this etiological subgroup. ## Effects of Intensive Versus Standard Office-Based Hypertension Treatment Strategy on White-Coat Effect and Masked Uncontrolled Hypertension: From the SPRINT ABPM Ancillary Study. *2020-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15300 · https://hartvaat.nl/2020/10/01/intensieve-versus-standaard-bloeddrukbehandeling-op-white-coat-effect-en-gemaske/* This SPRINT analysis examined how intensive versus standard blood pressure treatment affects the white-coat effect and masked uncontrolled hypertension, showing that intensive treatment reduces masked hypertension but may increase the white-coat effect. ## Differences in clinical characteristics and reported quality of life of men and women undergoing cardiac resynchronization therapy. *2020-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12914 · https://hartvaat.nl/2020/10/01/sekseverschillen-in-kenmerken-en-qol-bij-crt-patienten/* This analysis documented sex differences in clinical characteristics and quality-of-life outcomes in CRT patients, showing that women report better quality-of-life improvement despite presenting with different baseline profiles. ## Diabetes mellitus and risk of new-onset and recurrent heart failure: a systematic review and meta-analysis. *2020-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12782 · https://hartvaat.nl/2020/10/01/diabetes-en-risico-op-nieuw-en-recidiverend-hartfalen-meta-analyse/* This meta-analysis confirmed that diabetes mellitus is a significant risk factor for both new-onset and recurrent heart failure, with a graded relationship between glycemic control and heart failure risk. ## A comprehensive individual patient data meta-analysis of the effects of cardiac contractility modulation on functional capacity and heart failure-related quality of life. *2020-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12902 · https://hartvaat.nl/2020/10/01/cardiale-contractiliteitsmodulatie-bij-hf-uitgebreide-ipd-meta-analyse/* This individual patient data meta-analysis confirmed that cardiac contractility modulation improves exercise capacity and quality of life in heart failure patients who are not candidates for CRT, establishing CCM as a viable device therapy for selected HF patients. ## Multimarker approach including CRP, sST2 and GDF-15 for prognostic stratification in stable heart failure. *2020-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12680 · https://hartvaat.nl/2020/10/01/crp-sst2-en-gdf-15-multimarker-voor-prognostische-stratificatie-bij-stabiel-hf/* This study evaluated a multimarker approach using CRP, sST2, and GDF-15 for prognostic stratification in stable heart failure, showing that combining inflammatory and remodeling biomarkers improves risk prediction. ## Advances in accelerometry for cardiovascular patients: a systematic review with practical recommendations. *2020-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12781 · https://hartvaat.nl/2020/10/01/accelerometrie-bij-cv-patienten-systematische-review-met-praktische-aanbevelinge/* A systematic review of accelerometry methods in cardiovascular patients provides practical recommendations for improving objective physical activity assessment. Standardised protocols are needed for meaningful comparison across heart failure studies. ## Sequential nephron blockade with combined diuretics improves diastolic function in patients with resistant hypertension. *2020-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12832 · https://hartvaat.nl/2020/10/01/sequentiele-nefronblokkade-met-gecombineerde-diuretica-bij-resistente-hypertensi/* This study showed that sequential nephron blockade with combined diuretics improves diastolic function in patients with resistant hypertension, supporting multi-site diuretic therapy for cardiac benefit beyond blood pressure reduction. ## Home monitoring with technology-supported management in chronic heart failure: a randomised trial. *2020-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-316773 · https://hartvaat.nl/2020/10/01/thuismonitoring-met-technologie-ondersteund-management-bij-chronisch-hf-gerandom/* This randomized trial of digital home monitoring with centralized specialist support for chronic heart failure showed that technology-enabled remote management can improve clinical outcomes and reduce hospitalization. ## Limit of detection of troponin discharge strategy versus usual care: randomised controlled trial. *2020-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-316692 · https://hartvaat.nl/2020/10/01/troponine-grenswaarde-ontslagstrategie-versus-standaardzorg-gerandomiseerde-tria/* This randomized trial showed that a troponin limit-of-detection discharge strategy safely reduces emergency department length of stay in patients with suspected ACS, without increasing adverse events. ## Angiotensin-Neprilysin Inhibition and Renal Outcomes in Heart Failure With Preserved Ejection Fraction. *2020-09-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.047643 · https://hartvaat.nl/2020/09/29/arni-en-renale-uitkomsten-bij-hfpef-paragon-hf/* This PARAGON-HF analysis showed that sacubitril-valsartan preserves renal function better than valsartan in HFpEF patients, demonstrating renal protective effects of combined neprilysin-RAAS inhibition in preserved ejection fraction. ## Sex-Specific Associations of Cardiovascular Risk Factors and Biomarkers With Incident Heart Failure. *2020-09-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.07.044 · https://hartvaat.nl/2020/09/22/sekse-specifieke-cv-risicofactoren-en-biomarkers-bij-incident-hartfalen/* This study identified sex-specific associations between cardiovascular risk factors, biomarkers, and incident heart failure, showing that risk factor contributions to HF differ between men and women. ## A randomized controlled trial of dapagliflozin on left ventricular hypertrophy in people with type two diabetes: the DAPA-LVH trial. *2020-09-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa419 · https://hartvaat.nl/2020/09/21/dapagliflozine-op-lv-hypertrofie-bij-diabetes-type-2-dapa-lvh-gerandomiseerde-tr/* The DAPA-LVH trial demonstrated that dapagliflozin significantly regresses left ventricular hypertrophy in patients with type 2 diabetes, providing the first randomized evidence that SGLT2 inhibitors have direct structural cardiac benefits beyond hemodynamic effects. ## SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. *2020-09-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)31824-9 · https://hartvaat.nl/2020/09/19/sglt2-remmers-bij-hfref-meta-analyse-van-emperor-reduced-en-dapa-hf/* This landmark meta-analysis combined individual patient data from DAPA-HF and EMPEROR-Reduced, confirming that SGLT2 inhibition as a class significantly reduces cardiovascular death and heart failure hospitalization in patients with HFrEF regardless of diabetes status. The analysis cemented SGLT2 inhibitors as the fourth pillar of guideline-directed heart failure therapy. ## Efficacy and safety of trimetazidine after percutaneous coronary intervention (ATPCI): a randomised, double-blind, placebo-controlled trial. *2020-09-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)31790-6 · https://hartvaat.nl/2020/09/19/trimetazidine-na-pci-lancet-atpci-gerandomiseerde-trial/* The ATPCI trial showed that trimetazidine after PCI did not reduce the primary composite of cardiovascular death, hospitalization, or angina recurrence, a negative result for metabolic anti-ischemic therapy as a post-PCI adjunct. ## Impact of Tricuspid Regurgitation on Clinical Outcomes: The COAPT Trial. *2020-09-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.07.035 · https://hartvaat.nl/2020/09/15/tricuspidalisinsufficientie-en-uitkomsten-na-mitraclip-coapt/* This COAPT analysis showed that tricuspid regurgitation severity affects prognosis in heart failure patients with mitral regurgitation, informing the clinical consideration of TR when evaluating MitraClip candidates. ## Nonculprit Lesion Severity and Outcome of Revascularization in Patients With STEMI and Multivessel Coronary Disease. *2020-09-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.07.034 · https://hartvaat.nl/2020/09/15/non-culprit-laesie-ernst-en-uitkomsten-bij-stemi-met-multivatenlijden/* This COMPLETE analysis showed that the severity of nonculprit lesions influences outcomes after revascularization in STEMI with multivessel disease, supporting complete treatment of hemodynamically significant nonculprit stenoses. ## Dapagliflozin and Diuretic Use in Patients With Heart Failure and Reduced Ejection Fraction in DAPA-HF. *2020-09-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.047077 · https://hartvaat.nl/2020/09/15/dapagliflozine-en-diureticagebruik-bij-hfref-dapa-hf/* This DAPA-HF analysis showed that dapagliflozin's heart failure benefit is consistent regardless of baseline diuretic use, and that SGLT2 inhibition may allow subsequent diuretic dose reduction, with practical implications for volume management. ## Empagliflozin in Heart Failure: Diuretic and Cardiorenal Effects. *2020-09-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.045691 · https://hartvaat.nl/2020/09/15/empagliflozine-bij-hartfalen-diuretische-en-cardiorenale-effecten/* This mechanistic study characterized the diuretic and cardiorenal effects of empagliflozin in heart failure, demonstrating natriuresis, osmotic diuresis, and favorable renal hemodynamic changes that help explain the clinical benefits of SGLT2 inhibitors in heart failure. ## Management of Acute Myocardial Infarction During the COVID-19 Pandemic: A Position Statement From the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP). *2020-09-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.04.039 · https://hartvaat.nl/2020/09/15/ami-management-tijdens-covid-19-scai-positiedocument/* This SCAI position statement provided guidance on managing acute myocardial infarction during the COVID-19 pandemic, addressing triage protocols, catheterization lab modifications, and strategies for maintaining timely reperfusion while minimizing infection risk. ## Effects of glucagon-like peptide-1 receptor agonists on major cardiovascular events in patients with Type 2 diabetes mellitus with or without established cardiovascular disease: a meta-analysis of randomized controlled trials. *2020-09-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa082 · https://hartvaat.nl/2020/09/14/glp-1-agonisten-bij-diabetes-type-2-met-en-zonder-cvd-meta-analyse/* This meta-analysis showed that GLP-1 receptor agonists reduce major cardiovascular events in patients with type 2 diabetes both with and without established cardiovascular disease, though the absolute benefit is greater in the secondary prevention population. ## Mortality after drug-eluting stents vs. coronary artery bypass grafting for left main coronary artery disease: a meta-analysis of randomized controlled trials. *2020-09-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa135 · https://hartvaat.nl/2020/09/07/des-versus-cabg-bij-hoofdstamlijden-mortaliteits-meta-analyse/* This meta-analysis comparing mortality after DES versus CABG for left main coronary disease found that CABG was associated with significantly lower long-term all-cause and cardiovascular mortality. The updated data strengthened the evidence favoring surgery for left main revascularization. ## Angiotensin Receptor-Neprilysin Inhibition Based on History of Heart Failure and Use of Renin-Angiotensin System Antagonists. *2020-09-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.06.073 · https://hartvaat.nl/2020/09/01/arni-naar-hf-voorgeschiedenis-en-raas-antagonistgebruik/* This PIONEER-HF analysis examined how prior heart failure history and RAAS antagonist use affect the response to sacubitril-valsartan initiation during acute heart failure hospitalization. ## Predictors of Clinical Response to Transcatheter Reduction of Secondary Mitral Regurgitation: The COAPT Trial. *2020-09-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.07.010 · https://hartvaat.nl/2020/09/01/voorspellers-van-klinische-respons-op-transcatheter-mr-reductie-coapt/* This COAPT analysis identified clinical and echocardiographic predictors of response to MitraClip in secondary mitral regurgitation, providing a framework for patient selection to optimize transcatheter mitral valve repair outcomes. ## 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: A Report of the American College of Cardiology Solution Set Oversight Committee. *2020-09-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.05.037 · https://hartvaat.nl/2020/09/01/2020-acc-expert-consensus-nieuwe-therapieen-voor-cv-risicoreductie-bij-diabetes-/* The 2020 ACC Expert Consensus updated the decision pathway for SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes, integrating evidence from DAPA-HF, CREDENCE, and other contemporary trials to guide agent selection based on predominant cardiovascular or renal comorbidity. ## Effects of clopidogrel vs. prasugrel vs. ticagrelor on endothelial function, inflammatory parameters, and platelet function in patients with acute coronary syndrome undergoing coronary artery stenting: a randomized, blinded, parallel study. *2020-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz917 · https://hartvaat.nl/2020/09/01/clopidogrel-versus-prasugrel-versus-ticagrelor-op-endotheelfunctie-en-inflammati/* This randomized head-to-head study compared the pleiotropic effects of clopidogrel, prasugrel, and ticagrelor on endothelial function, inflammation, and platelet aggregation in ACS patients, characterizing their differential pharmacological profiles. ## Routine Revascularization Versus Initial Medical Therapy for Stable Ischemic Heart Disease: A Systematic Review and Meta-Analysis of Randomized Trials. *2020-09-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.048194 · https://hartvaat.nl/2020/09/01/routine-revascularisatie-versus-medicamenteus-bij-stabiel-coronairlijden-meta-an/* This systematic review and meta-analysis of randomized trials found that routine revascularization plus medical therapy did not significantly reduce death compared with initial medical therapy alone in patients with stable ischemic heart disease, reinforcing the ISCHEMIA trial conclusions. ## Preconception Blood Pressure and Its Change Into Early Pregnancy: Early Risk Factors for Preeclampsia and Gestational Hypertension. *2020-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14875 · https://hartvaat.nl/2020/09/01/preconceptiebloeddruk-en-verandering-naar-vroege-zwangerschap-risicofactor-voor-/* This study showed that preconception blood pressure and its change into early pregnancy are early risk factors for preeclampsia and gestational hypertension, supporting blood pressure optimization before conception. ## Carbidopa for Afferent Baroreflex Failure in Familial Dysautonomia: A Double-Blind Randomized Crossover Clinical Trial. *2020-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15267 · https://hartvaat.nl/2020/09/01/carbidopa-bij-afferente-baroreflexfalen-bij-familiaire-dysautonomie-gerandomisee/* This double-blind crossover trial of carbidopa for afferent baroreflex failure in familial dysautonomia tested a dopamine-targeting approach to reduce the excessive blood pressure variability in this rare autonomic disorder. ## Effect of Genotype-Guided Oral P2Y12 Inhibitor Selection vs Conventional Clopidogrel Therapy on Ischemic Outcomes After Percutaneous Coronary Intervention: The TAILOR-PCI Randomized Clinical Trial. *2020-08-25 · JAMA · https://doi.org/10.1001/jama.2020.12443 · https://hartvaat.nl/2020/08/25/genotype-geleide-p2y12-selectie-versus-clopidogrel-na-pci-jama-tailor-pci/* The TAILOR-PCI trial of genotype-guided P2Y12 inhibitor selection showed a trend toward fewer ischemic events with pharmacogenomic-guided therapy versus standard clopidogrel, though the primary endpoint was not statistically significant. The study advanced the concept of precision antiplatelet therapy. ## Machine Learning Assessment of Left Ventricular Diastolic Function Based on Electrocardiographic Features. *2020-08-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.06.061 · https://hartvaat.nl/2020/08/25/machine-learning-voor-lv-diastolische-functie-op-ecg/* This study used machine learning applied to standard ECG features to assess left ventricular diastolic function, developing an AI-based screening tool for identifying diastolic dysfunction without echocardiography. ## Pulmonary Artery Denervation for Patients With Residual Pulmonary Hypertension After Pulmonary Endarterectomy. *2020-08-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.06.064 · https://hartvaat.nl/2020/08/25/pulmonale-arterie-denervatie-bij-residuele-ph-na-endarterectomie/* This study evaluated pulmonary artery denervation for patients with residual pulmonary hypertension after pulmonary endarterectomy, testing whether catheter-based sympatholysis can improve hemodynamics in persistent CTEPH. ## Sex Differences in All-Cause Mortality in the Decade Following Complex Coronary Revascularization. *2020-08-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.06.066 · https://hartvaat.nl/2020/08/25/sekseverschillen-in-mortaliteit-na-complexe-coronaire-revascularisatie-10-jaar/* This 10-year analysis of sex differences after complex coronary revascularization showed that after adjusting for baseline characteristics, women do not have significantly worse long-term mortality than men. ## Dapagliflozin and Cardiac, Kidney, and Limb Outcomes in Patients With and Without Peripheral Artery Disease in DECLARE-TIMI 58. *2020-08-25 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044775 · https://hartvaat.nl/2020/08/25/dapagliflozine-en-cardiale-renale-en-ledemaat-uitkomsten-bij-pav-declare-timi-58/* This DECLARE-TIMI 58 subanalysis showed that dapagliflozin reduces cardiovascular events in patients with peripheral artery disease, extending the SGLT2 inhibitor benefit to this high-risk vascular population. ## Carotid Atherosclerosis Evolution When Targeting a Low-Density Lipoprotein Cholesterol Concentration <70 mg/dL After an Ischemic Stroke of Atherosclerotic Origin. *2020-08-25 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046774 · https://hartvaat.nl/2020/08/25/carotisatherosclerose-evolutie-bij-ldl-streefwaarde-70-na-ischemisch-cva-tst-sub/* This TST imaging substudy showed that targeting LDL cholesterol below 70 mg/dL after ischemic stroke results in less carotid atherosclerosis progression compared with a higher target, providing imaging evidence supporting aggressive lipid lowering for cerebrovascular disease. ## Evinacumab for Homozygous Familial Hypercholesterolemia. *2020-08-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa2004215 · https://hartvaat.nl/2020/08/20/evinacumab-bij-homozygoot-familiaire-hypercholesterolemie-nejm/* This pivotal trial showed that evinacumab, an ANGPTL3 inhibitor, reduced LDL cholesterol by 47% in patients with homozygous familial hypercholesterolemia, a condition where conventional therapies including PCSK9 inhibitors are often ineffective due to absent LDL receptors. Evinacumab represents the first LDL-receptor-independent approach to cholesterol lowering. ## Effect of a Collaborative Care Model on Depressive Symptoms and Glycated Hemoglobin, Blood Pressure, and Serum Cholesterol Among Patients With Depression and Diabetes in India: The INDEPENDENT Randomized Clinical Trial. *2020-08-18 · JAMA · https://doi.org/10.1001/jama.2020.11747 · https://hartvaat.nl/2020/08/18/collaboratieve-zorg-voor-depressie-hba1c-bloeddruk-en-cholesterol-bij-diabetes-j/* This JAMA trial of a collaborative care model for simultaneous management of depression and cardiometabolic risk factors in diabetic patients showed improvements in glycemic control and depressive symptoms, supporting integrated mental-physical health care. ## Optimum Blood Pressure in Patients With Shock After Acute Myocardial Infarction and Cardiac Arrest. *2020-08-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.06.043 · https://hartvaat.nl/2020/08/18/optimale-bloeddruk-bij-shock-na-mi-en-hartstilstand/* This study identified the optimum blood pressure targets in patients with cardiogenic shock after MI and cardiac arrest, addressing hemodynamic management in the most critically ill cardiovascular population. ## Carotid Intima-Media Thickness Progression as Surrogate Marker for Cardiovascular Risk: Meta-Analysis of 119 Clinical Trials Involving 100 667 Patients. *2020-08-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046361 · https://hartvaat.nl/2020/08/18/carotis-intima-media-dikte-als-surrogaatmarker-meta-analyse-van-119-trials/* This meta-analysis of 119 clinical trials found no consistent association between drug effects on carotid intima-media thickness progression and cardiovascular outcomes, questioning the utility of cIMT as a surrogate endpoint for cardiovascular trials. ## Comparison of interleukin-6, C-reactive protein, and low-density lipoprotein cholesterol as biomarkers of residual risk in contemporary practice: secondary analyses from the Cardiovascular Inflammation Reduction Trial. *2020-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa160 · https://hartvaat.nl/2020/08/14/il-6-crp-en-ldl-als-biomarkers-van-residueel-risico-vergelijking/* This study compared IL-6, CRP, and LDL cholesterol as biomarkers of residual cardiovascular risk in contemporary treated patients, finding that inflammatory markers contribute substantially to risk prediction even after optimal lipid management. ## The Safety and Efficacy of Aspirin Discontinuation on a Background of a P2Y12 Inhibitor in Patients After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis. *2020-08-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046251 · https://hartvaat.nl/2020/08/11/veiligheid-van-aspirinestaken-met-p2y12-achtergrond-na-pci-meta-analyse/* This meta-analysis confirmed that discontinuing aspirin while continuing a P2Y12 inhibitor after PCI significantly reduces bleeding without increasing ischemic events. The consolidated evidence supported P2Y12 inhibitor monotherapy as a safe de-escalation strategy. ## Integrated management of atrial fibrillation in primary care: results of the ALL-IN cluster randomized trial. *2020-08-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa055 · https://hartvaat.nl/2020/08/07/geintegreerd-af-management-in-de-huisartsenpraktijk-all-in-clustergerandomiseerd/* The ALL-IN cluster-randomized trial showed that integrated AF management orchestrated in primary care achieved excellent adherence to guideline recommendations and was associated with improved clinical outcomes. The results demonstrated that comprehensive AF care can be effectively delivered in the general practice setting. ## Cangrelor, Tirofiban, and Chewed or Standard Prasugrel Regimens in Patients With ST-Segment-Elevation Myocardial Infarction: Primary Results of the FABOLUS-FASTER Trial. *2020-08-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046928 · https://hartvaat.nl/2020/08/04/cangrelor-tirofiban-en-prasugrel-bij-stemi-primaire-resultaten/* This study compared cangrelor, tirofiban, and standard or chewed prasugrel in STEMI patients, testing strategies to overcome the delayed platelet inhibition that characterizes oral P2Y12 inhibitor loading in acute MI. ## Effect of Sacubitril/Valsartan on Biomarkers of Extracellular Matrix Regulation in Patients With HFpEF. *2020-08-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.05.072 · https://hartvaat.nl/2020/08/04/sacubitril-valsartan-en-ecm-biomarkers-bij-hfpef-paragon-hf/* This PARAGON-HF analysis showed that sacubitril-valsartan reduces biomarkers of extracellular matrix regulation in HFpEF, providing evidence of anti-fibrotic effects in the preserved ejection fraction population. ## 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Solution Set Oversight Committee. *2020-08-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.04.053 · https://hartvaat.nl/2020/08/04/2020-acc-bloedingsmanagement-bij-oac-expert-consensus-decision-pathway/* The 2020 ACC Expert Consensus on managing bleeding in patients on oral anticoagulants provided practical algorithms for assessment, reversal agent selection, and resumption of anticoagulation after bleeding events, addressing a common clinical challenge. ## Exercise Electrocardiography and Computed Tomography Coronary Angiography for Patients With Suspected Stable Angina Pectoris: A Post Hoc Analysis of the Randomized SCOT-HEART Trial. *2020-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.1567 · https://hartvaat.nl/2020/08/01/inspannings-ecg-versus-ccta-bij-stabiele-angina-post-hoc-vergelijking/* This post-hoc comparison of exercise ECG versus coronary CT angiography for suspected stable angina evaluated whether the traditional exercise test still has a role alongside modern non-invasive imaging. ## Sex-Based Outcomes in Patients With a High Bleeding Risk After Percutaneous Coronary Intervention and 1-Month Dual Antiplatelet Therapy: A Secondary Analysis of the LEADERS FREE Randomized Clinical Trial. *2020-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.0285 · https://hartvaat.nl/2020/08/01/seksegerelateerde-uitkomsten-bij-hoog-bloedingsrisico-na-pci-leaders-free/* This LEADERS FREE sex-stratified analysis showed that women with high bleeding risk have different outcomes after PCI with abbreviated DAPT, informing sex-aware management of this vulnerable population. ## Complete vs Culprit-Lesion-Only Revascularization for ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-analysis. *2020-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.1251 · https://hartvaat.nl/2020/08/01/complete-versus-culprit-only-revascularisatie-bij-stemi-jama-cardiology-meta-ana/* This JAMA Cardiology meta-analysis confirmed that complete revascularization of nonculprit lesions significantly reduces cardiovascular death and MI compared with culprit-only PCI in patients with STEMI and multivessel disease. The pooled analysis provided definitive evidence favoring the complete revascularization approach. ## Opportunities of Antidiabetic Drugs in Cardiovascular Medicine: A Meta-Analysis and Perspectives for Trial Design. *2020-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14791 · https://hartvaat.nl/2020/08/01/antidiabetica-en-cardiovasculaire-geneeskunde-meta-analyse-en-perspectief/* This meta-analysis synthesized the cardiovascular effects of GLP-1 receptor agonists and SGLT2 inhibitors in diabetic and non-diabetic populations, identifying opportunities for extending these drug classes beyond traditional glycemic indications. ## Tolvaptan vs. furosemide-based diuretic regimens in patients hospitalized for heart failure with hyponatremia (AQUA-AHF). *2020-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12783 · https://hartvaat.nl/2020/08/01/tolvaptan-versus-furosemide-bij-hf-hospitalisatie-met-hyponatriemie-aqua-ahf/* The AQUA-AHF trial compared tolvaptan-based with furosemide-based diuretic therapy in heart failure with hyponatremia, testing whether aquaresis improves outcomes in this electrolyte-complicated HF population. ## Decreased Mortality of COVID-19 With Renin-Angiotensin-Aldosterone System Inhibitors Therapy in Patients With Hypertension: A Meta-Analysis. *2020-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15572 · https://hartvaat.nl/2020/08/01/raas-remmers-en-covid-19-mortaliteit-bij-hypertensie-meta-analyse/* This meta-analysis showed that RAAS inhibitor therapy is associated with decreased COVID-19 mortality in hypertensive patients, providing reassurance against the early pandemic concern that ACE inhibitors and ARBs might worsen SARS-CoV-2 outcomes. ## Diagnostic accuracy of handheld electrocardiogram devices in detecting atrial fibrillation in adults in community versus hospital settings: a systematic review and meta-analysis. *2020-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2020-316611 · https://hartvaat.nl/2020/08/01/diagnostische-nauwkeurigheid-van-handheld-ecg-devices-voor-af-community-versus-z/* This study assessed the diagnostic accuracy of handheld ECG devices for AF detection in community versus hospital settings, providing validation data for consumer-grade screening technology across different clinical environments. ## Effects of canagliflozin in patients with type 2 diabetes and chronic heart failure: a randomized trial (CANDLE). *2020-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12707 · https://hartvaat.nl/2020/08/01/canagliflozine-bij-diabetes-type-2-met-chronisch-hf-candle-gerandomiseerde-trial/* The CANDLE randomized trial of canagliflozin in patients with type 2 diabetes and chronic heart failure showed favorable effects on NT-proBNP, providing early mechanistic evidence for SGLT2 inhibitor cardioprotection in the diabetic HF population. ## Performance of cardiovascular risk prediction equations in Indigenous Australians. *2020-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-315889 · https://hartvaat.nl/2020/08/01/cardiovasculaire-risicovoorspelling-bij-inheemse-australiers/* This individual participant meta-analysis showed that standard cardiovascular risk equations perform poorly in Indigenous Australians, highlighting the need for population-specific or recalibrated risk prediction tools. ## Effect of Evolocumab on Atherogenic Lipoproteins During the Peri- and Early Postinfarction Period: A Placebo-Controlled, Randomized Trial. *2020-07-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046320 · https://hartvaat.nl/2020/07/28/evolocumab-op-atherogene-lipoproteinen-in-de-peri-infarctperiode-gerandomiseerde/* This placebo-controlled trial of evolocumab in the peri- and early post-infarction period demonstrated rapid and substantial reductions in atherogenic lipoproteins when initiated acutely during MI hospitalization. ## Long-Term Outcomes of Implantable Cardioverter-Defibrillator Therapy in the SCD-HeFT. *2020-07-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.05.061 · https://hartvaat.nl/2020/07/28/langetermijn-icd-uitkomsten-scd-heft/* Long-term SCD-HeFT follow-up showed that the survival benefit of ICD therapy in moderate heart failure (NYHA II-III) persists over many years, providing the longest available data on primary prevention ICD outcomes. ## Effect of Levothyroxine on Left Ventricular Ejection Fraction in Patients With Subclinical Hypothyroidism and Acute Myocardial Infarction: A Randomized Clinical Trial. *2020-07-21 · JAMA · https://doi.org/10.1001/jama.2020.9389 · https://hartvaat.nl/2020/07/21/levothyroxine-bij-subklinische-hypothyreoidie-na-acuut-mi-jama/* This JAMA trial showed that levothyroxine does not improve left ventricular ejection fraction in patients with subclinical hypothyroidism and recent myocardial infarction, arguing against routine thyroid hormone replacement for cardiac benefit in this setting. ## Temporary Emergency Guidance to STEMI Systems of Care During the COVID-19 Pandemic: AHA's Mission: Lifeline. *2020-07-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.048180 · https://hartvaat.nl/2020/07/21/stemi-zorgsystemen-tijdens-covid-19-aha-mission-lifeline-noodrichtlijn/* This AHA Mission: Lifeline document provided temporary emergency guidance for STEMI care systems during the COVID-19 pandemic, addressing modified protocols for catheterization lab activation, protective equipment, and alternative reperfusion strategies. ## Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (DECADE): a randomised placebo-controlled trial. *2020-07-18 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)30631-0 · https://hartvaat.nl/2020/07/18/dexmedetomidine-voor-af-en-delier-na-hartchirurgie-lancet-decade/* The DECADE trial showed that postoperative dexmedetomidine infusion did not significantly reduce atrial fibrillation or delirium after cardiac surgery, a negative result for this promising sedative agent in the perioperative setting. ## Association of Radial Artery Graft vs Saphenous Vein Graft With Long-term Cardiovascular Outcomes Among Patients Undergoing Coronary Artery Bypass Grafting: A Systematic Review and Meta-analysis. *2020-07-14 · JAMA · https://doi.org/10.1001/jama.2020.8228 · https://hartvaat.nl/2020/07/14/radiale-arterie-versus-vena-saphena-graft-bij-cabg-jama-langetermijn-meta-analys/* This JAMA meta-analysis of individual patient data confirmed that radial artery grafts provide superior long-term cardiovascular outcomes compared with saphenous vein grafts in patients undergoing CABG, supporting the use of arterial conduits to improve coronary bypass durability. ## Efficacy and Safety of Alirocumab in Adults With Homozygous Familial Hypercholesterolemia: The ODYSSEY HoFH Trial. *2020-07-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.05.027 · https://hartvaat.nl/2020/07/14/alirocumab-bij-homozygoot-fh-odyssey-hofh/* The ODYSSEY HoFH trial showed that alirocumab lowers LDL cholesterol in patients with homozygous FH, though the effect is smaller than in heterozygous FH due to the limited LDL receptor activity. The results provided an additional treatment option for the most severe FH phenotype. ## Multicentre, randomized comparison of two-stent and provisional stenting techniques in patients with complex coronary bifurcation lesions: the DEFINITION II trial. *2020-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa543 · https://hartvaat.nl/2020/07/14/twee-stent-versus-provisional-stenting-bij-complexe-bifurcatielaesies-multicente/* This multicenter randomized trial comparing two-stent with provisional stenting for complex coronary bifurcation lesions showed that a planned two-stent strategy may be superior when specific anatomical criteria (DEFINITION criteria) predict complexity. ## Comparative Efficacy and Safety of Oral P2Y12 Inhibitors in Acute Coronary Syndrome: Network Meta-Analysis of 52 816 Patients From 12 Randomized Trials. *2020-07-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046786 · https://hartvaat.nl/2020/07/14/vergelijking-van-orale-p2y12-remmers-bij-acs-netwerkmeta-analyse-van-52-816-pati/* This network meta-analysis of oral P2Y12 inhibitors in ACS incorporating over 52,000 patients from contemporary trials provided updated comparative efficacy and safety data, informing personalized antiplatelet selection based on the balance of ischemic and bleeding risk. ## Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials. *2020-07-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)30748-0 · https://hartvaat.nl/2020/07/11/levenslang-voordeel-van-uitgebreide-hfref-farmacotherapie-lancet-schatting/* This Lancet analysis estimated the lifetime benefit of comprehensive disease-modifying pharmacotherapy in HFrEF, showing that adding an MRA, ARNI, and SGLT2 inhibitor to standard therapy could yield several additional years of event-free survival. The analysis provided a compelling quantitative rationale for the four-pillar approach to heart failure treatment. ## Systemic Amyloidosis Recognition, Prognosis, and Therapy: A Systematic Review. *2020-07-07 · JAMA · https://doi.org/10.1001/jama.2020.5493 · https://hartvaat.nl/2020/07/07/systemische-amyloidose-herkenning-prognose-en-therapie-jama-systematische-review/* This JAMA systematic review provided a comprehensive overview of systemic amyloidosis, including AL and ATTR subtypes, covering diagnostic pathways, prognostic assessment, and emerging therapies. The review addressed the growing recognition that cardiac amyloidosis is underdiagnosed. ## Association of Statin Use With Disability-Free Survival and Cardiovascular Disease Among Healthy Older Adults. *2020-07-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.05.016 · https://hartvaat.nl/2020/07/07/statinegebruik-en-invaliditeitsvrije-overleving-bij-gezonde-ouderen/* This study found that statin use in healthy older adults (≥70 years) was not associated with improved disability-free survival, contributing to the ongoing uncertainty about the benefit of statin therapy for primary prevention in the elderly. ## Baroreflex Activation Therapy in Patients With Heart Failure With Reduced Ejection Fraction. *2020-07-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.05.015 · https://hartvaat.nl/2020/07/07/baroreflexactivatietherapie-bij-hfref-beat-hf/* The BeAT-HF study demonstrated the safety and effectiveness of baroreflex activation therapy in patients with HFrEF, showing improvements in functional capacity and quality of life through autonomic neuromodulation. ## Assessment of Limitations to Optimization of Guideline-Directed Medical Therapy in Heart Failure From the GUIDE-IT Trial: A Secondary Analysis of a Randomized Clinical Trial. *2020-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.0640 · https://hartvaat.nl/2020/07/01/barrieres-voor-optimale-hf-medicatie-guide-it-analyse/* This GUIDE-IT analysis identified the barriers to achieving optimal guideline-directed medical therapy in heart failure, including hypotension, renal dysfunction, and clinical inertia as the most common limitations. ## Subclinical atherosclerosis is associated with incident atrial fibrillation: a systematic review and meta-analysis. *2020-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa030 · https://hartvaat.nl/2020/07/01/subklinische-atherosclerose-en-incident-af-meta-analyse/* This meta-analysis demonstrated that subclinical atherosclerosis (measured by coronary calcium, carotid IMT, or ankle-brachial index) is associated with incident atrial fibrillation, linking asymptomatic vascular disease to arrhythmia risk. ## Mineralocorticoid Receptor Antagonists for Hypertension Management in Advanced Chronic Kidney Disease: BLOCK-CKD Trial. *2020-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15199 · https://hartvaat.nl/2020/07/01/mra-bij-hypertensie-met-gevorderde-ckd-block-ckd-trial/* The BLOCK-CKD trial tested spironolactone for hypertension in advanced CKD, evaluating whether MRA therapy can be safely used in this population where hyperkalemia risk has traditionally limited its use. ## Identification, Heritability, and Relation With Gene Expression of Novel DNA Methylation Loci for Blood Pressure. *2020-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14973 · https://hartvaat.nl/2020/07/01/nieuwe-dna-methyleringsloci-voor-bloeddruk-erfelijkheid-en-genexpressie/* An epigenome-wide association study meta-analysis identified novel DNA methylation loci associated with blood pressure in European and African ancestry populations, with validation of 16 CpG sites and assessment of their heritability and gene expression relationships. ## Effects of Home Particulate Air Filtration on Blood Pressure: A Systematic Review. *2020-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14456 · https://hartvaat.nl/2020/07/01/thuisluchtzuivering-en-bloeddruk-systematische-review/* This systematic review evaluated whether home particulate air filtration reduces blood pressure, finding modest but consistent effects that support air quality improvement as a modifiable environmental approach to hypertension management. ## Genetic Study of PHACTR1 and Fibromuscular Dysplasia, Meta-Analysis and Effects on Clinical Features of Patients: The ARCADIA-POL Study. *2020-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14793 · https://hartvaat.nl/2020/07/01/phactr1-en-fibromusculaire-dysplasie-arcadia-pol-meta-analyse/* This genetic study examined the relationship between PHACTR1 variants and fibromuscular dysplasia, advancing the understanding of genetic determinants of this vascular condition that predominantly affects young women. ## Modest Sodium Reduction Increases Circulating Short-Chain Fatty Acids in Untreated Hypertensives: A Randomized, Double-Blind, Placebo-Controlled Trial. *2020-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14800 · https://hartvaat.nl/2020/07/01/natriumreductie-verhoogt-korte-keten-vetzuren-bij-onbehandelde-hypertensie/* This randomized crossover trial showed that modest sodium reduction increases circulating short-chain fatty acids in untreated hypertensives, establishing a gut microbiome-mediated mechanism for the cardiovascular benefit of salt restriction. ## Maternal and Perinatal Outcomes of White Coat Hypertension During Pregnancy: A Systematic Review and Meta-Analysis. *2020-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14627 · https://hartvaat.nl/2020/07/01/white-coat-hypertensie-in-de-zwangerschap-maternale-en-perinatale-uitkomsten/* This meta-analysis showed that white-coat hypertension during pregnancy is associated with increased maternal and perinatal adverse outcomes compared with normotension, supporting closer monitoring rather than dismissal of elevated office readings. ## Blood Pressure and Risks of Cognitive Impairment and Dementia: A Systematic Review and Meta-Analysis of 209 Prospective Studies. *2020-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14993 · https://hartvaat.nl/2020/07/01/bloeddruk-en-cognitieve-stoornis-en-dementie-meta-analyse-van-209-studies/* This comprehensive meta-analysis of 209 prospective studies demonstrated that elevated blood pressure in midlife is consistently associated with increased risk of cognitive impairment and dementia. The analysis provided the most extensive evidence base for blood pressure management as a dementia prevention strategy. ## Safety and efficacy of the European Society of Cardiology 0/1-hour algorithm for diagnosis of myocardial infarction: systematic review and meta-analysis. *2020-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-316343 · https://hartvaat.nl/2020/07/01/esc-0-1-uur-troponine-algoritme-voor-mi-veiligheid-en-werkzaamheid-meta-analyse/* This meta-analysis validated the safety and efficacy of the ESC 0/1-hour high-sensitivity troponin algorithm for rapid MI diagnosis across diverse populations, confirming its high negative predictive value for ruling out myocardial infarction in the emergency department. ## Left Atrial Appendage Closure Versus Direct Oral Anticoagulants in High-Risk Patients With Atrial Fibrillation. *2020-06-30 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.04.067 · https://hartvaat.nl/2020/06/30/laa-sluiting-versus-doac-bij-hoogrisico-af-vergelijkende-analyse/* This comparative analysis of left atrial appendage closure versus DOACs in high-risk AF patients evaluated the evolving position of structural stroke prevention in the era of highly effective oral anticoagulation. ## Recurrence of Atrial Fibrillation After Catheter Ablation or Antiarrhythmic Drug Therapy in the CABANA Trial. *2020-06-30 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.04.065 · https://hartvaat.nl/2020/06/30/af-recidief-na-ablatie-versus-antiaritmica-in-cabana/* This CABANA analysis characterized patterns of AF recurrence after catheter ablation versus antiarrhythmic drugs, showing that while ablation delays recurrence, the long-term freedom from AF requires ongoing surveillance. ## Randomized Comparison of the Polymer-Free Biolimus-Coated BioFreedom Stent With the Ultrathin Strut Biodegradable Polymer Sirolimus-Eluting Orsiro Stent in an All-Comers Population Treated With Percutaneous Coronary Intervention: The SORT OUT IX Trial. *2020-06-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.040241 · https://hartvaat.nl/2020/06/23/polymeervrije-biolimus-stent-versus-ultradunne-biodegradeerbare-sirolimus-stent/* This randomized trial compared the polymer-free BioFreedom biolimus stent with the ultrathin biodegradable Orsiro sirolimus stent in high-bleeding-risk patients, testing two leading short-DAPT stent platforms. ## Statin therapy increases lipoprotein(a) levels. *2020-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz310 · https://hartvaat.nl/2020/06/21/statinetherapie-verhoogt-lipoproteine-a-spiegels/* This study confirmed that statin therapy paradoxically increases lipoprotein(a) levels, an effect with potential clinical relevance for the assessment and management of Lp(a)-related residual cardiovascular risk during statin treatment. ## Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. *2020-06-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)30848-5 · https://hartvaat.nl/2020/06/20/hoog-dosis-tranexaminezuur-bij-acute-gastro-intestinale-bloeding-lancet-halt-it/* The HALT-IT trial showed that high-dose tranexamic acid does not reduce mortality in patients with acute gastrointestinal bleeding, a notable negative result contrasting with the drug's proven benefit in trauma and postpartum hemorrhage. ## Effect of Ticagrelor Monotherapy vs Ticagrelor With Aspirin on Major Bleeding and Cardiovascular Events in Patients With Acute Coronary Syndrome: The TICO Randomized Clinical Trial. *2020-06-16 · JAMA · https://doi.org/10.1001/jama.2020.7580 · https://hartvaat.nl/2020/06/16/ticagrelor-monotherapie-versus-dapt-op-bloedingen-en-cv-events-bij-acs-jama-tico/* The TICO results showed that ticagrelor monotherapy after 3 months of DAPT significantly reduced major bleeding compared with continued ticagrelor plus aspirin at 1 year after PCI for ACS, without increasing cardiovascular events. The study reinforced the safety of early aspirin discontinuation. ## Role of Combination Antiplatelet and Anticoagulation Therapy in Diabetes Mellitus and Cardiovascular Disease: Insights From the COMPASS Trial. *2020-06-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046448 · https://hartvaat.nl/2020/06/09/combinatie-antiplaatjes-antistolling-bij-diabetes-met-cv-ziekte-compass-inzichte/* This COMPASS analysis showed that combination antiplatelet and anticoagulation therapy with rivaroxaban and aspirin provides particular benefit in diabetic patients with established vascular disease, supporting the dual-pathway strategy in this high-risk population. ## Conducting clinical trials in heart failure during (and after) the COVID-19 pandemic: an Expert Consensus Position Paper from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). *2020-06-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa461 · https://hartvaat.nl/2020/06/07/hartfalentrials-tijdens-en-na-covid-19-expert-consensus/* This expert consensus addressed the practical challenges of conducting heart failure clinical trials during the COVID-19 pandemic, providing guidance on protocol modifications, remote monitoring, and endpoint assessment in pandemic conditions. ## Prevalence of Familial Hypercholesterolemia Among the General Population and Patients With Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis. *2020-06-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044795 · https://hartvaat.nl/2020/06/02/prevalentie-van-fh-bij-atherosclerotische-cv-ziekte-meta-analyse/* This meta-analysis quantified the higher prevalence of familial hypercholesterolemia among patients with established atherosclerotic cardiovascular disease compared with the general population, reinforcing the importance of systematic FH screening in clinical practice. ## An Exploratory Analysis of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibition and Aortic Stenosis in the FOURIER Trial. *2020-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.0728 · https://hartvaat.nl/2020/06/01/pcsk9-remming-en-aortastenose-fourier-exploratieve-analyse/* This exploratory FOURIER analysis examined whether PCSK9 inhibition with evolocumab slows aortic stenosis progression, testing the hypothesis that aggressive LDL lowering can modify the course of calcific aortic valve disease. ## Enrollment of Older Patients, Women, and Racial/Ethnic Minority Groups in Contemporary Acute Coronary Syndrome Clinical Trials: A Systematic Review. *2020-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.0359 · https://hartvaat.nl/2020/06/01/inclusie-van-ouderen-vrouwen-en-minderheden-in-acs-trials-jama-cardiology/* This systematic review documented persistent underrepresentation of older patients, women, and racial/ethnic minorities in contemporary ACS clinical trials, highlighting ongoing challenges in ensuring trial generalizability. ## Pharmacologic cardioversion of recent-onset atrial fibrillation: a systematic review and network meta-analysis. *2020-06-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa024 · https://hartvaat.nl/2020/06/01/farmacologische-cardioversie-van-recent-onset-af-netwerkmeta-analyse/* This network meta-analysis compared all available agents for pharmacological cardioversion of recent-onset AF, identifying the most effective antiarrhythmic drugs and informing evidence-based drug selection for acute rhythm conversion. ## Time trends in sudden cardiac death risk in heart failure patients with cardiac resynchronization therapy: a systematic review. *2020-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz773 · https://hartvaat.nl/2020/06/01/trends-in-plotse-hartdood-bij-hf-met-crt-systematische-review/* This systematic review documented declining time trends in sudden cardiac death risk among CRT-treated heart failure patients, suggesting that improving background therapy has modified the arrhythmic risk landscape. ## 2020 International Society of Hypertension Global Hypertension Practice Guidelines. *2020-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.15026 · https://hartvaat.nl/2020/06/01/2020-ish-mondiale-hypertensie-praktijkrichtlijnen/* The 2020 ISH Global Hypertension Practice Guidelines provided worldwide recommendations for blood pressure management adaptable to both high- and low-resource settings. The guideline emphasized pragmatic approaches to diagnosis, treatment initiation, and target achievement across diverse healthcare systems. ## Incidence and Implications of Atrial Fibrillation/Flutter in Hypertension: Insights From the SPRINT Trial. *2020-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14690 · https://hartvaat.nl/2020/06/01/incidentie-en-implicaties-van-af-bij-hypertensie-sprint-inzichten/* This SPRINT analysis examined the incidence and prognostic implications of new-onset AF/flutter in hypertensive patients, showing that AF remains a significant prognostic marker even in the context of intensive blood pressure management. ## Effect of Intensive Blood Pressure Lowering on the Risk of Atrial Fibrillation. *2020-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.120.14766 · https://hartvaat.nl/2020/06/01/intensieve-bloeddrukverlaging-en-risico-op-af-sprint-analyse/* This SPRINT analysis found that intensive blood pressure lowering does not significantly reduce the risk of new-onset atrial fibrillation, suggesting that the AF-protective mechanism of blood pressure control may have a threshold effect. ## Motivational interviewing to improve self-care in heart failure patients (MOTIVATE-HF): a randomized controlled trial. *2020-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12733 · https://hartvaat.nl/2020/06/01/motivational-interviewing-bij-hartfalen-voor-zelfzorg-motivate-hf-gerandomiseerd/* The MOTIVATE-HF trial showed that motivational interviewing improves self-care behavior in heart failure patients, demonstrating an effective behavioral approach to enhancing patient engagement in their own disease management. ## Blood Pressure-Lowering Profiles and Clinical Effects of Angiotensin Receptor Blockers Versus Calcium Channel Blockers. *2020-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14443 · https://hartvaat.nl/2020/06/01/arb-versus-calciumantagonist-bloeddrukprofiel-en-klinische-effecten-vergelijking/* This comparison of blood pressure-lowering profiles between ARBs and calcium channel blockers showed that differences in blood pressure mean reduction and variability may explain their differential clinical effects. ## IL (Interleukin)-1 Receptor Antagonist Increases Ang (Angiotensin [1-7]) and Decreases Blood Pressure in Obese Individuals. *2020-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13982 · https://hartvaat.nl/2020/06/01/il-1-receptorantagonist-verhoogt-ang-1-7-en-verlaagt-bloeddruk-bij-obesitas/* This mechanistic study showed that IL-1 receptor antagonism increases the protective angiotensin (1-7) peptide and lowers blood pressure in obese individuals, revealing an inflammation-RAAS interaction pathway in obesity-related hypertension. ## Impact of adjunctive tolvaptan on sympathetic activity in acute heart failure with preserved ejection fraction. *2020-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12690 · https://hartvaat.nl/2020/06/01/tolvaptan-en-sympathische-activiteit-bij-acuut-hfpef/* This study evaluated the effect of adjunctive tolvaptan therapy on cardiac sympathetic nerve activity in patients with acute decompensated HFpEF. The vasopressin receptor antagonist may attenuate the sympathoexcitatory effects of loop diuretics. ## Variation in clinical and patient-reported outcomes among complex heart failure with preserved ejection fraction phenotypes. *2020-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12660 · https://hartvaat.nl/2020/06/01/variatie-in-uitkomsten-tussen-complexe-hfpef-fenotypen/* This study used six HFpEF phenotypes to describe differences in clinical and patient-reported outcomes, showing that phenotype-based classification captures clinically meaningful heterogeneity within HFpEF. ## Outpatient treatment of worsening heart failure with intravenous and subcutaneous diuretics: a systematic review of the literature. *2020-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12677 · https://hartvaat.nl/2020/06/01/poliklinische-iv-en-sc-diureticabehandeling-bij-verslechterend-hf-systematische-/* This systematic review evaluated outpatient intravenous and subcutaneous diuretic treatment for worsening heart failure, supporting ambulatory parenteral decongestion as an alternative to hospital admission. ## Economic impact of heart failure with preserved ejection fraction: insights from the ALDO-DHF trial. *2020-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12606 · https://hartvaat.nl/2020/06/01/economische-impact-van-hfpef-aldo-dhf-inzichten/* This ALDO-DHF economic analysis characterized the healthcare costs of HFpEF, showing that this condition imposes substantial economic burden despite the absence of proven disease-modifying pharmacotherapy. ## Effect of Antihypertensive Medication Reduction vs Usual Care on Short-term Blood Pressure Control in Patients With Hypertension Aged 80 Years and Older: The OPTIMISE Randomized Clinical Trial. *2020-05-26 · JAMA · https://doi.org/10.1001/jama.2020.4871 · https://hartvaat.nl/2020/05/26/antihypertensieve-medicatiereductie-versus-standaardzorg-bij-ouderen-jama-optimi/* The OPTIMISE trial demonstrated that reducing the number of antihypertensive medications in older patients with well-controlled blood pressure is safe, with the majority maintaining adequate control at 12 weeks. The results supported deprescribing as a reasonable strategy in elderly patients with polypharmacy. ## Subcutaneous Selatogrel Inhibits Platelet Aggregation in Patients With Acute Myocardial Infarction. *2020-05-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.059 · https://hartvaat.nl/2020/05/26/subcutaan-selatogrel-remt-plaatjesaggregatie-bij-acuut-mi/* This study of subcutaneous selatogrel showed rapid platelet inhibition in patients with acute MI, testing the concept of a self-administered, rapid-onset P2Y12 inhibitor that patients could use at the onset of chest pain. ## Worldwide Prevalence of Familial Hypercholesterolemia: Meta-Analyses of 11 Million Subjects. *2020-05-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.057 · https://hartvaat.nl/2020/05/26/wereldwijde-prevalentie-van-familiaire-hypercholesterolemie-meta-analyse-van-11-/* This meta-analysis of 11 million subjects established that familial hypercholesterolemia is far more prevalent than previously estimated, affecting approximately 1 in 250 individuals worldwide and up to 1 in 17 among patients with ischemic heart disease. The data highlighted the massive global underdiagnosis of FH. ## Personalized Rate-Response Programming Improves Exercise Tolerance After 6 Months in People With Cardiac Implantable Electronic Devices and Heart Failure: A Phase II Study. *2020-05-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.045066 · https://hartvaat.nl/2020/05/26/gepersonaliseerde-rate-response-programmering-verbetert-inspanningstolerantie-bi/* This study demonstrated that personalized rate-response pacemaker programming improves exercise tolerance in HFrEF patients with cardiac implantable devices, supporting individualized heart rate optimization. ## Evolocumab in HIV-Infected Patients With Dyslipidemia: Primary Results of the Randomized, Double-Blind BEIJERINCK Study. *2020-05-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.025 · https://hartvaat.nl/2020/05/26/evolocumab-bij-hiv-met-dyslipidemie-beijerinck-gerandomiseerde-studie/* The BEIJERINCK trial demonstrated that evolocumab effectively lowers LDL cholesterol in people living with HIV and dyslipidemia, providing the first randomized evidence for PCSK9 inhibitor use in HIV-associated cardiovascular risk. ## Association of Blood Pressure Lowering With Incident Dementia or Cognitive Impairment: A Systematic Review and Meta-analysis. *2020-05-19 · JAMA · https://doi.org/10.1001/jama.2020.4249 · https://hartvaat.nl/2020/05/19/bloeddrukverlaging-en-dementie-of-cognitieve-stoornis-jama-meta-analyse/* This JAMA meta-analysis showed that blood pressure lowering is associated with a significant reduction in the risk of incident dementia and cognitive impairment. The findings supported blood pressure control as a potentially modifiable strategy for dementia prevention. ## Ticagrelor With or Without Aspirin After Complex PCI. *2020-05-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.011 · https://hartvaat.nl/2020/05/19/ticagrelor-met-of-zonder-aspirine-na-complexe-pci-twilight-complex-pci/* This TWILIGHT subanalysis showed that ticagrelor monotherapy after brief DAPT is safe even in patients who undergo complex PCI, extending the de-escalation strategy to the highest-complexity interventional procedures. ## Ticagrelor With or Without Aspirin in High-Risk Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention. *2020-05-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.008 · https://hartvaat.nl/2020/05/19/ticagrelor-met-of-zonder-aspirine-bij-diabetes-na-pci-twilight-diabetes/* This TWILIGHT subanalysis confirmed that ticagrelor monotherapy after short DAPT reduces bleeding without increasing ischemic events in the high-risk diabetic subpopulation undergoing PCI. ## Peripheral Artery Disease and Venous Thromboembolic Events After Acute Coronary Syndrome: Role of Lipoprotein(a) and Modification by Alirocumab: Prespecified Analysis of the ODYSSEY OUTCOMES Randomized Clinical Trial. *2020-05-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046524 · https://hartvaat.nl/2020/05/19/pav-en-vte-na-acs-rol-van-lp-a-en-modificatie-door-alirocumab/* This ODYSSEY OUTCOMES analysis examined the relationships between PAD events, VTE, and lipoprotein(a) levels after ACS, showing that Lp(a) contributes to risk across both arterial and venous vascular beds. ## The Effect of PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) Inhibition on the Risk of Venous Thromboembolism. *2020-05-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046397 · https://hartvaat.nl/2020/05/19/pcsk9-remming-en-risico-op-veneuze-trombo-embolie/* This study tested whether PCSK9 inhibition affects venous thromboembolism risk, finding no significant association between LDL cholesterol lowering and VTE, suggesting separate pathways for arterial and venous thrombosis. ## EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic. *2020-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehaa381 · https://hartvaat.nl/2020/05/14/eapci-positiedocument-invasief-acs-management-tijdens-covid-19/* This EAPCI position statement provided guidance on managing acute coronary syndromes in the catheterization laboratory during the COVID-19 pandemic, addressing procedural modifications, personal protective equipment, and triage strategies. ## Vericiguat in Patients with Heart Failure and Reduced Ejection Fraction. *2020-05-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1915928 · https://hartvaat.nl/2020/05/14/vericiguat-bij-hfref-nejm-victoria/* The VICTORIA trial demonstrated that vericiguat, a novel oral soluble guanylate cyclase stimulator, reduced the composite of cardiovascular death or heart failure hospitalization in patients with HFrEF who had recently decompensated. This established a new mechanism of action for heart failure treatment, targeting the nitric oxide–sGC–cGMP pathway. ## Cost-Effectiveness of Alirocumab in Patients With Acute Coronary Syndromes: The ODYSSEY OUTCOMES Trial. *2020-05-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.029 · https://hartvaat.nl/2020/05/12/kosteneffectiviteit-van-alirocumab-na-acs-odyssey-outcomes/* This cost-effectiveness analysis of alirocumab after ACS from ODYSSEY OUTCOMES showed favorable economics particularly at reduced drug pricing, informing the value-based case for PCSK9 inhibitor therapy in secondary prevention. ## Cognition After Lowering LDL-Cholesterol With Evolocumab. *2020-05-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.039 · https://hartvaat.nl/2020/05/12/cognitie-na-ldl-verlaging-met-evolocumab-fourier-follow-up/* Long-term cognitive follow-up of FOURIER participants confirmed that evolocumab and very low LDL cholesterol levels achieved through PCSK9 inhibition do not adversely affect cognitive function, providing sustained safety reassurance. ## Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus: A Scientific Statement From the American Heart Association. *2020-05-12 · Circulation · https://doi.org/10.1161/CIR.0000000000000766 · https://hartvaat.nl/2020/05/12/management-van-stabiel-coronairlijden-bij-diabetes-type-2-aha-scientific-stateme/* This AHA scientific statement addressed the clinical management of stable coronary artery disease specifically in patients with type 2 diabetes, integrating ISCHEMIA results with contemporary evidence on SGLT2 inhibitors and GLP-1 agonists for comprehensive cardiometabolic risk management. ## Comprehensive Evaluation of Rhythm Monitoring Strategies in Screening for Atrial Fibrillation: Insights From Patients at Risk Monitored Long Term With an Implantable Loop Recorder. *2020-05-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044407 · https://hartvaat.nl/2020/05/12/ritme-monitoringstrategieen-voor-af-screening-uitgebreide-evaluatie/* This comprehensive evaluation of rhythm monitoring strategies for AF screening compared continuous versus intermittent approaches, identifying the detection yield and practical trade-offs of different monitoring modalities. ## Monotherapy with a P2Y12 inhibitor or aspirin for secondary prevention in patients with established atherosclerosis: a systematic review and meta-analysis. *2020-05-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)30315-9 · https://hartvaat.nl/2020/05/09/p2y12-monotherapie-of-aspirine-voor-secundaire-preventie-lancet-meta-analyse/* This Lancet meta-analysis demonstrated that P2Y12 inhibitor monotherapy is superior to aspirin monotherapy for secondary cardiovascular prevention, reducing ischemic events (particularly stroke) without increasing major bleeding. The findings challenged aspirin's position as the default long-term antiplatelet agent. ## Triglyceride-Rich Lipoprotein Cholesterol, Small Dense LDL Cholesterol, and Incident Cardiovascular Disease. *2020-05-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.02.059 · https://hartvaat.nl/2020/05/05/triglyceriderijk-lipoproteinecholesterol-small-dense-ldl-en-cv-events/* This study demonstrated that both triglyceride-rich lipoprotein cholesterol and small dense LDL cholesterol independently predict cardiovascular events, supporting comprehensive atherogenic lipoprotein assessment beyond LDL-C alone. ## Ten-Year Outcomes After Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Left Main Coronary Disease: Extended Follow-Up of the PRECOMBAT Trial. *2020-05-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.120.046039 · https://hartvaat.nl/2020/05/05/des-versus-cabg-bij-linker-hoofdstam-10-jaarsresultaten-excel-extended/* The EXCEL 10-year extended follow-up showed higher all-cause and cardiovascular mortality with PCI compared with CABG for left main disease, diverging from the earlier 5-year results. The long-term data reignited the debate about the optimal revascularization strategy for left main stenosis. ## Atorvastatin Reduces First and Subsequent Vascular Events Across Vascular Territories: The SPARCL Trial. *2020-05-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.015 · https://hartvaat.nl/2020/05/05/atorvastatine-vermindert-eerste-en-volgende-vasculaire-events-sparcl/* This SPARCL analysis showed that atorvastatin reduces first and subsequent vascular events across multiple vascular territories (cerebral, coronary, peripheral), supporting the benefit of statin therapy for pan-vascular atherosclerotic disease. ## Health Status Changes and Outcomes in Patients With Heart Failure and Mitral Regurgitation: COAPT Trial. *2020-05-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.03.002 · https://hartvaat.nl/2020/05/05/gezondheidsstatus-en-uitkomsten-bij-hf-met-mr-coapt/* This COAPT analysis showed that MitraClip not only improves survival but also produces clinically meaningful improvements in health status and quality of life in heart failure patients with mitral regurgitation. ## Low-Attenuation Noncalcified Plaque on Coronary Computed Tomography Angiography Predicts Myocardial Infarction: Results From the Multicenter SCOT-HEART Trial (Scottish Computed Tomography of the HEART). *2020-05-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044720 · https://hartvaat.nl/2020/05/05/laag-attenuatie-plaque-op-ccta-voorspelt-mi-scot-heart-resultaten/* This SCOT-HEART analysis demonstrated that low-attenuation noncalcified plaque on coronary CT angiography is a powerful predictor of future myocardial infarction, superior to traditional risk factors and coronary calcium scoring. ## Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. *2020-05-02 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)30554-7 · https://hartvaat.nl/2020/05/02/renale-denervatie-zonder-antihypertensiva-lancet-spyral-htn-off-med-pivotal/* The pivotal SPYRAL HTN-OFF MED trial confirmed that catheter-based renal denervation significantly reduced 24-hour ambulatory blood pressure compared with a sham procedure in patients with hypertension not taking antihypertensive medications. This definitive sham-controlled result rehabilitated renal denervation as a genuine blood pressure-lowering intervention. ## Remote Supervision to Decrease Hospitalization Rate (RESULT) study in patients with implanted cardioverter-defibrillator. *2020-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa072 · https://hartvaat.nl/2020/05/01/remote-monitoring-vermindert-hospitalisaties-bij-icd-patienten-result-studie/* The RESULT study showed that remote monitoring of ICD patients with heart failure reduces hospitalization rates, supporting the implementation of telemonitoring as a standard follow-up approach for cardiac device patients. ## Predicting recurrent atrial fibrillation after catheter ablation: a systematic review of prognostic models. *2020-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa041 · https://hartvaat.nl/2020/05/01/predictie-van-af-recidief-na-ablatie-systematische-review-van-prognostische-mode/* This systematic review assessed prognostic models for predicting AF recurrence after catheter ablation, finding that most existing risk scores have limited discriminative ability and inconsistent validation. ## Agreement and Accuracy of Medication Persistence Identified by Patient Self-report vs Pharmacy Fill: A Secondary Analysis of the Cluster Randomized ARTEMIS Trial. *2020-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2020.0125 · https://hartvaat.nl/2020/05/01/zelfgerapporteerde-versus-apotheekgeregistreerde-medicatietrouw-compass-analyse/* This study compared patient self-reported medication persistence with pharmacy fill data, finding clinically relevant discrepancies that affect how medication adherence is measured in clinical practice and research. ## Effect of a Workplace-Based Multicomponent Intervention on Hypertension Control: A Randomized Clinical Trial. *2020-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.6161 · https://hartvaat.nl/2020/05/01/werkplek-multicomponentinterventie-voor-hypertensie-jama-cardiology/* This randomized trial showed that a workplace-based multicomponent intervention (health coaching, environmental changes, blood pressure monitoring) significantly improves hypertension control in employed adults. ## Assessment of Long-term Benefit of Intensive Blood Pressure Control on Residual Life Span: Secondary Analysis of the Systolic Blood Pressure Intervention Trial (SPRINT). *2020-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.6192 · https://hartvaat.nl/2020/05/01/langetermijnvoordeel-van-intensieve-bloeddrukcontrole-op-resterende-levensduur-s/* This SPRINT secondary analysis estimated that intensive blood pressure control extends residual life expectancy compared with standard treatment, translating the cardiovascular event reduction into a meaningful gain in quality-adjusted life years. ## Optimal Antithrombotic Regimens for Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: An Updated Network Meta-analysis. *2020-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.6175 · https://hartvaat.nl/2020/05/01/optimaal-antitrombotisch-regime-bij-af-na-pci-jama-cardiology-netwerkmeta-analys/* This updated network meta-analysis of antithrombotic regimens in AF patients undergoing PCI, integrating AUGUSTUS, RE-DUAL PCI, PIONEER AF-PCI, and ENTRUST-AF PCI, confirmed that dual therapy with a DOAC plus P2Y12 inhibitor offers the optimal balance of bleeding reduction and ischemic protection. ## Prediction models for atrial fibrillation applicable in the community: a systematic review and meta-analysis. *2020-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euaa005 · https://hartvaat.nl/2020/05/01/predictiemodellen-voor-af-in-de-community-meta-analyse/* This systematic review evaluated community-applicable prediction models for AF, assessing which risk scores can practically identify individuals who would benefit from targeted screening programs. ## Long-term ticagrelor for secondary prevention in patients with prior myocardial infarction and no history of coronary stenting: insights from PEGASUS-TIMI 54. *2020-05-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz821 · https://hartvaat.nl/2020/05/01/langdurig-ticagrelor-na-mi-zonder-stent-voorgeschiedenis-pegasus-timi-54-inzicht/* This PEGASUS-TIMI 54 subanalysis showed that long-term ticagrelor benefits post-MI patients even without prior coronary stenting, extending the evidence for prolonged antiplatelet therapy beyond the PCI population. ## Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. *2020-05-01 · Kidney international · https://doi.org/10.1016/j.kint.2020.01.046 · https://hartvaat.nl/2020/05/01/bloeddruk-en-volumemanagement-bij-dialyse-kdigo-controverseconferentie/* This KDIGO conference addressed blood pressure and volume management in dialysis patients, providing consensus recommendations on measurement techniques, treatment targets, and management strategies for this challenging clinical population. ## Percutaneous coronary intervention versus medical therapy in patients with angina and grey-zone fractional flow reserve values: a randomised clinical trial. *2020-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-316075 · https://hartvaat.nl/2020/05/01/pci-versus-medicamenteus-bij-angina-met-ffr-in-de-grijze-zone/* This study evaluated PCI versus medical therapy in patients with angina and grey-zone FFR values (0.75-0.80), addressing the clinical dilemma of borderline physiological assessments where the revascularization decision is most uncertain. ## Effect of Apabetalone Added to Standard Therapy on Major Adverse Cardiovascular Events in Patients With Recent Acute Coronary Syndrome and Type 2 Diabetes: A Randomized Clinical Trial. *2020-04-28 · JAMA · https://doi.org/10.1001/jama.2020.3308 · https://hartvaat.nl/2020/04/28/apabetalone-en-cv-events-bij-acs-met-diabetes-type-2-jama-betonmace/* The BETonMACE trial showed that apabetalone, a bromodomain and extraterminal protein inhibitor, did not significantly reduce MACE in patients with ACS and type 2 diabetes. The novel epigenetic mechanism represents an innovative but unproven cardiovascular prevention approach. ## Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Advanced Chronic Kidney Disease. *2020-04-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044059 · https://hartvaat.nl/2020/04/28/apixaban-versus-warfarine-bij-af-met-gevorderde-ckd/* This study comparing apixaban with warfarin in AF patients with advanced CKD (including stages 4-5) found comparable outcomes, addressing a critical evidence gap for anticoagulant selection in severe kidney disease. ## Exploring the Possible Impact of Unbalanced Open-Label Drop-In of Glucose-Lowering Medications on EXSCEL Outcomes. *2020-04-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043353 · https://hartvaat.nl/2020/04/28/open-label-drop-in-van-glucoseverlagende-medicatie-en-exscel-uitkomsten/* This analysis explored whether unbalanced open-label drop-in of glucose-lowering medications may have diluted the cardiovascular benefit signal in the EXSCEL exenatide trial. ## Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): the randomised, open-label, non-inferiority trial. *2020-04-25 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)30325-1 · https://hartvaat.nl/2020/04/25/clopidogrel-versus-ticagrelor-of-prasugrel-bij-70-plussers-met-nste-acs-lancet-p/* The POPular AGE trial showed that clopidogrel was associated with less bleeding than ticagrelor or prasugrel in patients aged 70 years and older with non-ST-elevation ACS, without a significant increase in ischemic events. The results supported clopidogrel as the preferred antiplatelet in elderly ACS patients. ## Management of Coronary Disease in Patients with Advanced Kidney Disease. *2020-04-23 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1915925 · https://hartvaat.nl/2020/04/23/management-van-coronairlijden-bij-gevorderde-nierziekte-nejm-ischemia-ckd/* The ISCHEMIA-CKD trial showed that an initial invasive strategy did not reduce cardiovascular events compared with conservative management in patients with stable coronary disease and advanced chronic kidney disease. The findings underscored the heightened procedural risk and attenuated benefit of revascularization in severe CKD. ## Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease. *2020-04-23 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1916374 · https://hartvaat.nl/2020/04/23/gezondheidsstatus-na-invasieve-of-conservatieve-zorg-bij-coronairlijden-met-gevo/* The ISCHEMIA-CKD quality-of-life analysis showed that an initial invasive strategy did not significantly improve health status compared with conservative management in patients with stable coronary disease and advanced kidney disease. ## Impact of Morphine Treatment With and Without Metoclopramide Coadministration on Ticagrelor-Induced Platelet Inhibition in Acute Myocardial Infarction: The Randomized MonAMI Trial. *2020-04-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.042816 · https://hartvaat.nl/2020/04/21/morfine-met-metoclopramide-en-ticagrelor-plaatjesremming-bij-acuut-mi/* This study tested whether metoclopramide co-administration counteracts morphine-induced delay in ticagrelor absorption during acute MI, evaluating a practical pharmacological strategy for the opioid-antiplatelet interaction. ## Inclisiran for the Treatment of Heterozygous Familial Hypercholesterolemia. *2020-04-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1913805 · https://hartvaat.nl/2020/04/16/inclisiran-bij-heterozygote-familiaire-hypercholesterolemie-nejm-orion-9/* The ORION-9 trial demonstrated that twice-yearly inclisiran injections reduced LDL cholesterol by approximately 40% in patients with heterozygous familial hypercholesterolemia on maximally tolerated statin therapy. The results confirmed the efficacy of RNA interference-based lipid lowering in the genetically defined FH population. ## Two Phase 3 Trials of Inclisiran in Patients with Elevated LDL Cholesterol. *2020-04-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1912387 · https://hartvaat.nl/2020/04/16/inclisiran-fase-3-bij-verhoogd-ldl-nejm-orion-10-en-orion-11/* The ORION-10 and ORION-11 phase 3 trials demonstrated that twice-yearly subcutaneous inclisiran reduced LDL cholesterol by approximately 50% with sustained efficacy and an acceptable safety profile. These results confirmed inclisiran as a viable long-acting approach to LDL lowering, offering an alternative to frequent dosing with statins or monoclonal antibodies. ## Long-Term Outcomes in Women and Men Following Percutaneous Coronary Intervention. *2020-04-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.01.056 · https://hartvaat.nl/2020/04/14/langetermijnuitkomsten-bij-vrouwen-en-mannen-na-pci/* This analysis of long-term sex differences after PCI showed that women have different risk profiles and complication patterns than men, informing sex-specific post-PCI management approaches. ## Effect of Dapagliflozin on Worsening Heart Failure and Cardiovascular Death in Patients With Heart Failure With and Without Diabetes. *2020-04-14 · JAMA · https://doi.org/10.1001/jama.2020.1906 · https://hartvaat.nl/2020/04/14/dapagliflozine-bij-hf-met-en-zonder-diabetes-jama-dapa-hf-uitkomsten/* This JAMA DAPA-HF analysis confirmed that dapagliflozin reduced worsening heart failure and cardiovascular death equally in patients with HFrEF with and without type 2 diabetes. The finding strengthened the case for SGLT2 inhibitors as a heart failure therapy independent of glycemic status. ## Systolic Blood Pressure in Heart Failure With Preserved Ejection Fraction Treated With Sacubitril/Valsartan. *2020-04-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.02.009 · https://hartvaat.nl/2020/04/14/systolische-bloeddruk-bij-hfpef-behandeld-met-sacubitril-valsartan-paragon-hf/* This PARAGON-HF analysis examined the relationship between systolic blood pressure and outcomes with sacubitril-valsartan in HFpEF, informing the blood pressure management strategy in preserved ejection fraction heart failure. ## Initial Invasive or Conservative Strategy for Stable Coronary Disease. *2020-04-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1915922 · https://hartvaat.nl/2020/04/09/initieel-invasief-of-conservatief-bij-stabiel-coronairlijden-nejm-ischemia/* The ISCHEMIA trial showed that an initial invasive strategy with revascularization did not reduce cardiovascular death or MI compared with optimal medical therapy alone in patients with stable coronary disease and moderate-to-severe ischemia. The findings reinforced medical therapy as a reasonable first-line approach even in the presence of significant ischemia. ## Yoga-Based Cardiac Rehabilitation After Acute Myocardial Infarction: A Randomized Trial. *2020-04-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.01.050 · https://hartvaat.nl/2020/04/07/yoga-gebaseerde-hartrevalidatie-na-acuut-mi-gerandomiseerde-trial/* This randomized trial demonstrated that yoga-based cardiac rehabilitation after acute MI improves functional capacity and quality of life, establishing an alternative rehabilitation model particularly relevant for low-resource settings. ## Mobile Health Technology to Improve Care for Patients With Atrial Fibrillation. *2020-04-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.01.052 · https://hartvaat.nl/2020/04/07/mobiele-gezondheidstechnologie-voor-af-zorg/* This study evaluated mobile health technology for improving AF care, showing that smartphone-based monitoring, medication reminders, and teleconsultation can improve guideline adherence and clinical outcomes. ## Intraprocedural endpoints to predict durable pulmonary vein isolation: a randomized trial of four post-ablation techniques. *2020-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz301 · https://hartvaat.nl/2020/04/01/intraprocedurele-eindpunten-voor-duurzame-pvi-gerandomiseerde-trial-van-vier-tec/* This randomized trial compared four post-ablation techniques for confirming durable pulmonary vein isolation, addressing the fundamental question of what constitutes an adequate procedural endpoint during AF ablation. ## Intracranial haemorrhages vs. stent thromboses with direct oral anticoagulant plus single antiplatelet agent or triple antithrombotic therapy: a meta-analysis of randomized trials in atrial fibrillation and percutaneous coronary intervention/acute coronary syndrome patients. *2020-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz345 · https://hartvaat.nl/2020/04/01/intracraniele-bloedingen-versus-stenttrombose-met-doac-antiplaatjes-versus-tripl/* This meta-analysis compared the trade-off between intracranial hemorrhage reduction and stent thrombosis risk with DOAC-based dual versus VKA-based triple antithrombotic therapy in AF patients after PCI, demonstrating a favorable net benefit for the dual approach. ## Association of Clinical Outcomes With Left Ventricular Assist Device Use by Bridge to Transplant or Destination Therapy Intent: The Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) Randomized Clinical Trial. *2020-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.5323 · https://hartvaat.nl/2020/04/01/lvad-gebruik-als-bridge-to-transplant-versus-destination-therapy-momentum-3/* This MOMENTUM 3 analysis compared LVAD outcomes in bridge-to-transplant versus destination therapy patients, showing that the HeartMate 3 provides benefit regardless of treatment intent. ## STADE-HF (sST2 As a help for management of HF): a pilot study. *2020-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12663 · https://hartvaat.nl/2020/04/01/sst2-voor-hartfalenmanagement-stade-hf-pilotstudie/* The STADE-HF pilot trial investigated soluble ST2 as a biomarker to guide medical management in patients admitted for acute heart failure decompensation, aiming to reduce hospital readmission through biomarker-directed therapy. ## Elevated Blood Pressure in Childhood or Adolescence and Cardiovascular Outcomes in Adulthood: A Systematic Review. *2020-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14168 · https://hartvaat.nl/2020/04/01/verhoogde-bloeddruk-op-kinder-adolescentenleeftijd-en-cv-uitkomsten-bij-volwasse/* This systematic review examined the association between elevated blood pressure in childhood or adolescence and cardiovascular outcomes in adulthood, providing evidence for the long-term cardiovascular consequences of early-life hypertension. ## Randomized Dose-Response Study of the New Dual Endothelin Receptor Antagonist Aprocitentan in Hypertension. *2020-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14504 · https://hartvaat.nl/2020/04/01/aprocitentan-bij-hypertensie-gerandomiseerde-dosis-responsstudie/* This dose-response study of aprocitentan, a dual endothelin receptor antagonist, established the blood pressure-lowering efficacy curve for this new drug class in essential hypertension, providing the foundation for the phase 3 PRECISION trial. ## P2Y12 inhibitors with oral anticoagulation for percutaneous coronary intervention with atrial fibrillation: a systematic review and meta-analysis. *2020-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-315963 · https://hartvaat.nl/2020/04/01/p2y12-remmers-met-oac-bij-af-na-pci-meta-analyse/* This meta-analysis compared third-generation P2Y12 inhibitors (ticagrelor, prasugrel) with clopidogrel in combination with oral anticoagulation for AF patients after PCI, informing the antiplatelet component selection within dual antithrombotic strategies. ## Biomarkers in patients with heart failure and central sleep apnoea: findings from the SERVE-HF trial. *2020-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12521 · https://hartvaat.nl/2020/04/01/biomarkers-bij-hf-met-centrale-slaapapneu-serve-hf/* This SERVE-HF biomarker analysis characterized biomarker profiles in heart failure patients with central sleep apnea, exploring whether circulating markers identify patients at risk from adaptive servo-ventilation therapy. ## Withdrawal of Neurohumoral Blockade After Cardiac Resynchronization Therapy. *2020-03-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.01.040 · https://hartvaat.nl/2020/03/31/staken-van-neurohumorale-blokkade-na-crt/* This study investigated whether neurohumoral blockers can be safely withdrawn in patients who achieve normalized ejection fraction after CRT, addressing a common clinical question about medication de-escalation in CRT super-responders. ## Low-Dose Alteplase During Primary Percutaneous Coronary Intervention According to Ischemic Time. *2020-03-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.01.041 · https://hartvaat.nl/2020/03/31/laaggedoseerde-alteplase-bij-primaire-pci-naar-ischemietijd/* This T-TIME subanalysis evaluated intracoronary alteplase efficacy by ischemia time in STEMI, testing whether patients with longer ischemia duration derive more benefit from clot-dissolving adjunctive therapy. ## Polymer-based or Polymer-free Stents in Patients at High Bleeding Risk. *2020-03-26 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1910021 · https://hartvaat.nl/2020/03/26/polymer-versus-polymeervrije-stents-bij-hoog-bloedingsrisico-nejm-leaders-free-2/* This NEJM trial compared polymer-based with polymer-free drug-coated stents in patients at high bleeding risk, evaluating whether newer polymer-free designs with ultra-short DAPT provide comparable outcomes. ## Screening and Prophylactic Amiodarone Reduces Post-Operative Atrial Fibrillation in At-Risk Patients. *2020-03-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2020.01.016 · https://hartvaat.nl/2020/03/24/screening-en-profylactisch-amiodaron-vermindert-postoperatief-af/* This study showed that screening for high-risk features followed by prophylactic amiodarone reduces postoperative AF in at-risk cardiac surgery patients, supporting a targeted prophylactic strategy. ## Clinical and Pharmacological Effects of Apixaban Dose Adjustment in the ARISTOTLE Trial. *2020-03-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.12.060 · https://hartvaat.nl/2020/03/17/klinische-en-farmacologische-effecten-van-apixaban-dosisaanpassing-aristotle/* This ARISTOTLE analysis examined the clinical and pharmacological effects of apixaban dose adjustment, showing that appropriate dose reduction maintains efficacy while reducing bleeding in patients meeting dose-reduction criteria. ## Effects of Liraglutide on Cardiovascular Outcomes in Patients With Diabetes With or Without Heart Failure. *2020-03-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.12.063 · https://hartvaat.nl/2020/03/17/liraglutide-cv-uitkomsten-bij-diabetes-met-of-zonder-hartfalen-leader/* This LEADER subanalysis showed that liraglutide reduces cardiovascular events in patients with type 2 diabetes regardless of heart failure status at baseline, though the benefit was primarily seen in patients without prevalent heart failure. ## Nonculprit Lesion Myocardial Infarction Following Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome. *2020-03-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.12.067 · https://hartvaat.nl/2020/03/17/non-culprit-mi-na-pci-bij-acs/* This study characterized nonculprit lesion MI after PCI in ACS patients, showing that events arising from untreated coronary segments are a relevant source of post-PCI ischemic events. ## 2020 ACC/HFSA/ISHLT Lifelong Learning Statement for Advanced Heart Failure and Transplant Cardiology Specialists: A Report of the ACC Competency Management Committee. *2020-03-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.030 · https://hartvaat.nl/2020/03/17/2020-acc-hfsa-ishlt-verklaring-voor-gevorderd-hf-en-transplantatiespecialisten/* This ACC/HFSA/ISHLT lifelong learning statement outlined competency requirements and continuing education standards for advanced heart failure and transplant cardiology specialists. ## Survival After Coronary Revascularization With Paclitaxel-Coated Balloons. *2020-03-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.11.065 · https://hartvaat.nl/2020/03/10/overleving-na-revascularisatie-met-paclitaxel-gecoate-ballonnen/* This study addressed the paclitaxel safety debate by examining long-term survival after coronary paclitaxel-coated balloon use, providing reassurance about the mortality concern that had disrupted the drug-coated device field. ## The Effect of Coconut Oil Consumption on Cardiovascular Risk Factors: A Systematic Review and Meta-Analysis of Clinical Trials. *2020-03-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043052 · https://hartvaat.nl/2020/03/10/kokosolie-en-cardiovasculaire-risicofactoren-meta-analyse-van-klinische-trials/* This meta-analysis showed that coconut oil consumption raises LDL cholesterol compared with non-tropical vegetable oils, challenging the marketing of coconut oil as a heart-healthy alternative. ## OUTSMART HF: A Randomized Controlled Trial of Routine Versus Selective Cardiac Magnetic Resonance for Patients With Nonischemic Heart Failure (IMAGE-HF 1B). *2020-03-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043964 · https://hartvaat.nl/2020/03/10/routine-versus-selectieve-cardiale-mri-bij-niet-ischemisch-hf-outsmart-hf/* The OUTSMART HF trial compared routine versus selective cardiac MRI in patients with non-ischemic heart failure, testing whether universal imaging changes management and improves outcomes in this population. ## Alert-based computerized decision support for high-risk hospitalized patients with atrial fibrillation not prescribed anticoagulation: a randomized, controlled trial (AF-ALERT). *2020-03-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehz385 · https://hartvaat.nl/2020/03/07/alert-gebaseerde-beslissingsondersteuning-voor-anticoagulatie-bij-af-in-het-ziek/* This study tested whether computerized alert-based clinical decision support increases anticoagulant prescribing in hospitalized AF patients at stroke risk, demonstrating the potential of automated systems to close the treatment gap. ## Supplementation With Vitamin D and Omega-3 Fatty Acids and Incidence of Heart Failure Hospitalization: VITAL-Heart Failure. *2020-03-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044645 · https://hartvaat.nl/2020/03/03/vitamine-d-en-omega-3-en-hartfalen-hospitalisatie-vital-heart-failure/* The VITAL-Heart Failure analysis showed that neither vitamin D nor omega-3 fatty acid supplementation reduced heart failure hospitalization in the general population, adding to the negative evidence for dietary supplements in cardiovascular prevention. ## Stent Thrombosis in Patients With Atrial Fibrillation Undergoing Coronary Stenting in the AUGUSTUS Trial. *2020-03-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044584 · https://hartvaat.nl/2020/03/03/stenttrombose-bij-af-na-coronaire-stenting-augustus-trial/* This AUGUSTUS subanalysis examined stent thrombosis rates in AF patients after coronary stenting, comparing dual with triple antithrombotic therapy and finding no significant increase in stent thrombosis with the aspirin-free dual approach. ## Impact of weight on the efficacy and safety of direct-acting oral anticoagulants in patients with non-valvular atrial fibrillation: a meta-analysis. *2020-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz361 · https://hartvaat.nl/2020/03/01/gewicht-en-werkzaamheid-veiligheid-van-doac-s-bij-niet-valvulair-af-meta-analyse/* This meta-analysis showed that body weight does not significantly modify the efficacy or safety of DOACs compared with warfarin in non-valvular AF, supporting standard DOAC dosing across the weight spectrum. ## Effects of a 9-Week Hybrid Comprehensive Telerehabilitation Program on Long-term Outcomes in Patients With Heart Failure: The Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial. *2020-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.5006 · https://hartvaat.nl/2020/03/01/hybride-telerevalidatie-bij-hartfalen-jama-cardiology-tele-hf-trial/* This trial of a hybrid telerehabiliation program for heart failure showed improvements in functional capacity, demonstrating that technology-assisted cardiac rehabilitation can overcome access barriers while maintaining clinical effectiveness. ## Changes in Stroke Volume After Renal Denervation: Insight From Cardiac Magnetic Resonance Imaging. *2020-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14310 · https://hartvaat.nl/2020/03/01/slagvolumeveranderingen-na-renale-denervatie-cardiale-mri-inzichten/* This cardiac MRI study showed that renal denervation affects stroke volume, providing hemodynamic insight into how sympathetic modulation influences cardiac function beyond blood pressure reduction. ## Orthostatic Hypotension, Cardiovascular Outcomes, and Adverse Events: Results From SPRINT. *2020-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14309 · https://hartvaat.nl/2020/03/01/orthostatische-hypotensie-cv-uitkomsten-en-adverse-events-sprint-resultaten/* This SPRINT analysis showed that orthostatic hypotension does not increase adverse cardiovascular events in the context of intensive blood pressure treatment, providing reassurance that aggressive BP lowering does not exacerbate orthostatic risk. ## Conflicting Effects of Fetal Growth Restriction on Blood Pressure Between Human and Rat Offspring: A Meta-Analysis. *2020-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14111 · https://hartvaat.nl/2020/03/01/foetale-groeirestrictie-en-bloeddruk-tegenstrijdige-effecten-bij-mens-en-rat-met/* A meta-analysis examined the conflicting effects of fetal growth restriction on blood pressure between human offspring and rat models. The species-specific differences highlight challenges in translating developmental programming research. ## Effects of Sodium Reduction on Energy, Metabolism, Weight, Thirst, and Urine Volume: Results From the DASH (Dietary Approaches to Stop Hypertension)-Sodium Trial. *2020-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13932 · https://hartvaat.nl/2020/03/01/natriumreductie-en-energie-metabolisme-gewicht-en-dorst-dash-resultaten/* This DASH analysis evaluated the effects of sodium reduction on energy metabolism, weight, thirst, and urine volume, testing whether extreme sodium restriction has metabolic consequences beyond blood pressure. ## Association of Blood Pressure With Outcomes in Acute Stroke Thrombectomy. *2020-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14230 · https://hartvaat.nl/2020/03/01/bloeddruk-en-uitkomsten-bij-acute-beroerte-trombectomie/* This study characterized the association between blood pressure levels and clinical outcomes in acute stroke patients undergoing thrombectomy, informing optimal hemodynamic management during and after mechanical reperfusion. ## Influenza vaccination in patients with heart failure: a systematic review and meta-analysis of observational studies. *2020-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-315193 · https://hartvaat.nl/2020/03/01/griepvaccinatie-bij-hartfalen-meta-analyse-van-observationele-studies/* This meta-analysis of observational studies found that influenza vaccination is associated with reduced all-cause mortality and heart failure hospitalization in patients with heart failure, supporting annual vaccination as a routine heart failure management measure. ## Emergency medical service delays in ST-elevation myocardial infarction: a meta-analysis. *2020-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-315034 · https://hartvaat.nl/2020/03/01/ambulancedienst-vertragingen-bij-stemi-meta-analyse/* This meta-analysis quantified emergency medical service delays in STEMI care and their impact on time-to-treatment and mortality, reinforcing the critical importance of efficient prehospital triage systems. ## Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial. *2020-02-29 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(20)30058-1 · https://hartvaat.nl/2020/02/29/versnelde-versus-standaard-chirurgie-bij-heupfractuur-lancet-hip-attack/* The HIP ATTACK trial showed that accelerated surgery (within 6 hours) for hip fracture did not significantly reduce mortality or cardiovascular complications compared with standard care, despite the expectations from observational data. ## Predicting Benefit From Evolocumab Therapy in Patients With Atherosclerotic Disease Using a Genetic Risk Score: Results From the FOURIER Trial. *2020-02-25 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043805 · https://hartvaat.nl/2020/02/25/genetische-risicoscore-voorspelt-voordeel-van-evolocumab-fourier/* This FOURIER analysis demonstrated that a genetic risk score predicts the relative benefit of evolocumab, with patients at highest genetic risk for coronary disease experiencing the greatest event reduction from PCSK9 inhibition. ## Patients With High Genome-Wide Polygenic Risk Scores for Coronary Artery Disease May Receive Greater Clinical Benefit From Alirocumab Treatment in the ODYSSEY OUTCOMES Trial. *2020-02-25 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044434 · https://hartvaat.nl/2020/02/25/polygene-risicoscore-en-voordeel-van-alirocumab-bij-coronairlijden-odyssey-outco/* This ODYSSEY OUTCOMES analysis showed that patients with high polygenic risk scores derive greater clinical benefit from alirocumab after ACS, supporting the concept of genetics-guided precision lipid-lowering therapy for highest-risk patients. ## A Community-Based Intervention for Managing Hypertension in Rural South Asia. *2020-02-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1911965 · https://hartvaat.nl/2020/02/20/community-interventie-voor-hypertensie-in-ruraal-zuid-azie-nejm/* This NEJM trial demonstrated that a community-based intervention using trained nonphysician health workers significantly improved blood pressure control in rural South Asian communities. The scalable approach addressed the critical shortage of healthcare professionals in low-resource settings. ## Stent-Related Adverse Events >1 Year After Percutaneous Coronary Intervention. *2020-02-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.11.058 · https://hartvaat.nl/2020/02/18/stent-gerelateerde-events-1-jaar-na-pci/* This analysis of late stent-related events (>1 year post-PCI) showed that stent-related MACE continues beyond the first year, informing long-term follow-up and antiplatelet therapy duration decisions. ## Ticagrelor With or Without Aspirin After PCI: The TWILIGHT Platelet Substudy. *2020-02-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.11.056 · https://hartvaat.nl/2020/02/18/ticagrelor-met-of-zonder-aspirine-na-pci-twilight-plaatjessubstudie/* This TWILIGHT platelet substudy showed that ticagrelor monotherapy after aspirin discontinuation maintains adequate platelet inhibition, providing the pharmacodynamic rationale for the de-escalation strategy. ## 16-year follow-up of the Danish Acute Myocardial Infarction 2 (DANAMI-2) trial: primary percutaneous coronary intervention vs. fibrinolysis in ST-segment elevation myocardial infarction. *2020-02-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehz595 · https://hartvaat.nl/2020/02/14/danami-2-16-jaarsfollow-up-primaire-pci-versus-fibrinolyse/* The 16-year DANAMI-2 follow-up showed that the survival advantage of primary PCI over fibrinolysis for STEMI, including interhospital transfer, persists over very long-term follow-up, providing among the longest comparative data for reperfusion strategies. ## Haptoglobin Phenotype Modifies the Influence of Intensive Glycemic Control on Cardiovascular Outcomes. *2020-02-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.11.051 · https://hartvaat.nl/2020/02/11/haptoglobinefenotype-wijzigt-het-effect-van-intensieve-glycemische-controle-op-c/* This study showed that haptoglobin phenotype modifies the cardiovascular benefit of intensive glycemic control in diabetes, identifying a pharmacogenomic factor that may explain the variable outcomes of glucose-lowering trials. ## Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. *2020-02-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.12.012 · https://hartvaat.nl/2020/02/11/ct-coronairangiografie-bij-nste-acs-verdict-cta-substudie/* This VERDICT substudy evaluated coronary CT angiography in NSTE-ACS patients, assessing whether non-invasive anatomical imaging can guide the management approach in acute coronary syndromes. ## Dysfunctional High-Density Lipoproteins Are Associated With a Greater Incidence of Acute Coronary Syndrome in a Population at High Cardiovascular Risk: A Nested Case-Control Study. *2020-02-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.041658 · https://hartvaat.nl/2020/02/11/disfunctioneel-hdl-en-incidentie-van-acs-bij-hoog-cardiovasculair-risico/* This study showed that dysfunctional HDL particles (impaired cholesterol efflux) are associated with higher ACS incidence, supporting the concept that HDL quality matters more than HDL quantity for cardiovascular protection. ## Sustained Low-Density Lipoprotein Cholesterol Lowering With Alirocumab in ODYSSEY OUTCOMES. *2020-02-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.11.030 · https://hartvaat.nl/2020/02/04/aanhoudende-ldl-verlaging-met-alirocumab-in-odyssey-outcomes/* This ODYSSEY OUTCOMES analysis demonstrated sustained LDL cholesterol lowering with alirocumab over the full trial duration, confirming durable PCSK9 inhibitor efficacy without treatment-emergent resistance. ## REDUCE-IT USA: Results From the 3146 Patients Randomized in the United States. *2020-02-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044440 · https://hartvaat.nl/2020/02/04/reduce-it-usa-resultaten-bij-3-146-amerikaanse-deelnemers/* This REDUCE-IT US subanalysis confirmed that icosapent ethyl reduces cardiovascular events in the American patient population, validating the global trial findings in a US-specific context. ## Evaluating the Effects of Canagliflozin on Cardiovascular and Renal Events in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease According to Baseline HbA1c, Including Those With HbA1c <7%: Results From the CREDENCE Trial. *2020-02-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044359 · https://hartvaat.nl/2020/02/04/canagliflozine-bij-diabetes-type-2-met-ckd-evaluatie-van-cv-en-renale-events/* This analysis evaluated canagliflozin's cardiovascular and renal effects in diabetic patients with CKD across both primary and secondary prevention settings, demonstrating consistent cardiorenal benefit across the risk spectrum. ## Electrical versus pharmacological cardioversion for emergency department patients with acute atrial fibrillation (RAFF2): a partial factorial randomised trial. *2020-02-01 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)32994-0 · https://hartvaat.nl/2020/02/01/elektrische-versus-farmacologische-cardioversie-bij-acuut-af-op-de-seh-lancet-ra/* The RAFF2 trial compared electrical with pharmacological cardioversion for acute AF in the emergency department, finding that electrical cardioversion is more effective for achieving sinus rhythm but both strategies are safe initial approaches. ## Safety and Efficacy of Femoral Access vs Radial Access in ST-Segment Elevation Myocardial Infarction: The SAFARI-STEMI Randomized Clinical Trial. *2020-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.4852 · https://hartvaat.nl/2020/02/01/femorale-versus-radiale-toegang-bij-stemi-jama-cardiology-safari-stemi/* The SAFARI-STEMI trial found no significant difference in mortality between femoral and radial access for primary PCI in STEMI, suggesting that in experienced centers, both approaches are acceptable when radial access is not anatomically feasible. ## Initiation of Angiotensin-Neprilysin Inhibition After Acute Decompensated Heart Failure: Secondary Analysis of the Open-label Extension of the PIONEER-HF Trial. *2020-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.4665 · https://hartvaat.nl/2020/02/01/arni-initiatie-na-acuut-gedecompenseerd-hf-pioneer-hf-open-label-extensie/* This PIONEER-HF open-label extension confirmed the long-term safety of sacubitril-valsartan initiated during acute decompensated heart failure hospitalization, with sustained neurohormonal and clinical benefits after transition to outpatient care. ## A randomized controlled trial of cardiac resynchronization therapy in patients with prolonged atrioventricular interval: the REAL-CRT pilot study. *2020-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz321 · https://hartvaat.nl/2020/02/01/crt-bij-verlengd-av-interval-real-crt-gerandomiseerde-trial/* The REAL-CRT trial tested CRT in patients with prolonged PR interval and narrow QRS, evaluating whether AV dyssynchrony alone (without ventricular dyssynchrony) is sufficient indication for resynchronization. ## Nurse-led vs. usual-care for atrial fibrillation. *2020-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz666 · https://hartvaat.nl/2020/02/01/verpleegkundig-geleide-versus-standaard-af-zorg/* This study compared nurse-led integrated AF care with physician-led usual care, showing that specialized nursing management achieves comparable or better outcomes at potentially lower cost. ## Maximum-fixed energy shocks for cardioverting atrial fibrillation. *2020-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz585 · https://hartvaat.nl/2020/02/01/maximum-vaste-energie-schokken-voor-af-cardioversie/* This study showed that maximum-fixed energy shocks for AF cardioversion are safe and more efficient than low-escalating energy protocols, supporting a simplified first-shock-at-maximum approach. ## Heart failure disease management: a systematic review of effectiveness in heart failure with preserved ejection fraction. *2020-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12559 · https://hartvaat.nl/2020/02/01/disease-management-bij-hfpef-systematische-review/* This systematic review evaluated the effectiveness of heart failure disease management programs specifically in HFpEF, finding limited evidence compared with the robust HFrEF data and identifying the need for phenotype-specific management approaches. ## Safety and efficacy of baroreflex activation therapy for heart failure with reduced ejection fraction: a rapid systematic review. *2020-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12543 · https://hartvaat.nl/2020/02/01/baroreflexactivatietherapie-bij-hfref-snelle-systematische-review/* This rapid systematic review summarized the available safety and efficacy data for baroreflex activation therapy in HFrEF, evaluating this neuromodulation device for advanced heart failure management. ## Effects of Interleukin-1β Inhibition on Blood Pressure, Incident Hypertension, and Residual Inflammatory Risk: A Secondary Analysis of CANTOS. *2020-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13642 · https://hartvaat.nl/2020/02/01/il-1-remming-en-bloeddruk-hypertensie-en-residueel-inflammatoir-risico-cantos/* This CANTOS secondary analysis showed that canakinumab (IL-1β inhibitor) modestly reduces blood pressure and the incidence of new-onset hypertension, demonstrating a mechanistic link between inflammation and blood pressure regulation. ## Blood Pressure Control and the Association With Diabetes Mellitus Incidence: Results From SPRINT Randomized Trial. *2020-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12572 · https://hartvaat.nl/2020/02/01/bloeddrukcontrole-en-diabetes-incidentie-sprint-resultaten/* This SPRINT analysis showed that intensive blood pressure control is associated with reduced incidence of new-onset diabetes mellitus, suggesting a metabolic co-benefit of aggressive blood pressure management. ## Estimated Stroke-Free Survival of Folic Acid Therapy for Hypertensive Adults: Projection Based on the CSPPT. *2020-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.14102 · https://hartvaat.nl/2020/02/01/geschatte-cva-vrije-overleving-van-foliumzuurtherapie-bij-hypertensie-csppt/* This CSPPT projection estimated the stroke-free survival benefit of folic acid therapy for hypertensive adults, quantifying the long-term population-level impact of homocysteine-lowering treatment. ## Eligibility of sodium-glucose co-transporter-2 inhibitors among patients with diabetes mellitus admitted for heart failure. *2020-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12528 · https://hartvaat.nl/2020/02/01/geschiktheid-voor-sglt2-remmers-bij-diabetespatienten-opgenomen-met-hartfalen/* This study assessed SGLT2 inhibitor eligibility among diabetic patients admitted for heart failure, revealing a substantial implementation gap between trial evidence and real-world prescribing. ## Morphine and Cardiovascular Outcomes Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Angiography. *2020-01-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.11.035 · https://hartvaat.nl/2020/01/28/morfine-en-cv-uitkomsten-bij-nste-acs-jacc-analyse/* This analysis examined the effect of morphine use on cardiovascular outcomes in NSTE-ACS patients undergoing angiography, providing clinical outcome data on the opioid-antiplatelet drug interaction concern. ## Oral Anticoagulation for Patients With Atrial Fibrillation on Long-Term Hemodialysis. *2020-01-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.10.059 · https://hartvaat.nl/2020/01/28/orale-antistolling-bij-af-op-langdurige-hemodialyse/* This study of oral anticoagulants in AF patients on long-term hemodialysis reviewed the limited and conflicting evidence for anticoagulation in this extreme-risk population, where the balance between stroke prevention and bleeding is particularly challenging. ## Prior Heart Failure Hospitalization, Clinical Outcomes, and Response to Sacubitril/Valsartan Compared With Valsartan in HFpEF. *2020-01-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.11.003 · https://hartvaat.nl/2020/01/28/eerdere-hf-hospitalisatie-en-sacubitril-valsartan-versus-valsartan-bij-hfpef-par/* This PARAGON-HF analysis showed that patients with recent heart failure hospitalization derive greater benefit from sacubitril-valsartan versus valsartan in HFpEF, identifying the highest-risk subgroup within this population. ## Effect of Renal Denervation and Catheter Ablation vs Catheter Ablation Alone on Atrial Fibrillation Recurrence Among Patients With Paroxysmal Atrial Fibrillation and Hypertension: The ERADICATE-AF Randomized Clinical Trial. *2020-01-21 · JAMA · https://doi.org/10.1001/jama.2019.21187 · https://hartvaat.nl/2020/01/21/renale-denervatie-plus-katheterablatie-versus-ablatie-alleen-bij-af-met-hyperten/* The ERADICATE-AF trial showed that adding renal denervation to pulmonary vein isolation significantly reduced AF recurrence in patients with hypertension and paroxysmal AF, demonstrating a synergistic benefit of combining two catheter-based interventions. ## Effect of Alirocumab on Lipoprotein(a) and Cardiovascular Risk After Acute Coronary Syndrome. *2020-01-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.10.057 · https://hartvaat.nl/2020/01/21/alirocumab-en-lp-a-en-cv-risico-na-acs-odyssey-outcomes/* This ODYSSEY OUTCOMES analysis showed that alirocumab reduces Lp(a) independently of LDL cholesterol lowering, and that both the LDL and Lp(a) reductions independently contribute to the cardiovascular benefit. The finding supports Lp(a) as an actionable component of PCSK9 inhibitor therapy. ## Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. *2020-01-21 · Circulation · https://doi.org/10.1161/CIR.0000000000000743 · https://hartvaat.nl/2020/01/21/voedingscholesterol-en-cv-risico-aha-science-advisory/* This AHA science advisory updated dietary cholesterol guidance, clarifying that while dietary cholesterol modestly increases serum cholesterol, the elimination of a specific numerical target should not be interpreted as unrestricted consumption. The advisory emphasized overall dietary patterns over individual nutrients. ## High-Sensitivity Cardiac Troponin and the Universal Definition of Myocardial Infarction. *2020-01-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.042960 · https://hartvaat.nl/2020/01/21/hoog-sensitief-troponine-en-de-universele-mi-definitie/* This analysis examined the implications of high-sensitivity troponin assays for the universal definition of myocardial infarction, highlighting the increased recognition of myocardial injury that complicates acute MI diagnosis when more sensitive assays detect troponin elevations from non-ischemic causes. ## Percutaneous coronary angioplasty versus coronary artery bypass grafting in the treatment of unprotected left main stenosis: updated 5-year outcomes from the randomised, non-inferiority NOBLE trial. *2020-01-18 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)32972-1 · https://hartvaat.nl/2020/01/18/pci-versus-cabg-bij-onbeschermde-hoofdstam-lancet-noble-5-jaars-update/* The 5-year NOBLE update confirmed that CABG remained superior to PCI for the composite endpoint in patients with unprotected left main stenosis, with the difference driven by lower rates of nonprocedural MI and repeat revascularization with surgery. ## Lipoprotein(a) Reduction in Persons with Cardiovascular Disease. *2020-01-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1905239 · https://hartvaat.nl/2020/01/16/lp-a-verlaging-bij-cardiovasculaire-ziekte-nejm/* This NEJM study demonstrated proof-of-concept that targeted lipoprotein(a) reduction is achievable in patients with established cardiovascular disease using an antisense oligonucleotide. The results validated Lp(a) as a druggable target and paved the way for the large-scale cardiovascular outcomes trials now underway. ## Effects of Dapagliflozin on Symptoms, Function, and Quality of Life in Patients With Heart Failure and Reduced Ejection Fraction: Results From the DAPA-HF Trial. *2020-01-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044138 · https://hartvaat.nl/2020/01/14/dapagliflozine-en-symptomen-functie-en-qol-bij-hfref-dapa-hf/* This DAPA-HF analysis showed that dapagliflozin significantly improved heart failure symptoms, physical function, and quality of life in patients with HFrEF within the first few weeks of treatment. The patient-reported outcomes complemented the hard clinical endpoints. ## Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF. *2020-01-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.044133 · https://hartvaat.nl/2020/01/14/dapagliflozine-bij-hfref-naar-leeftijd-dapa-hf-inzichten/* This DAPA-HF age subanalysis confirmed that dapagliflozin reduced heart failure events and cardiovascular death consistently across all age groups in patients with HFrEF, including those aged 75 and older. The safety profile was also maintained in elderly patients. ## Reduced Leaflet Motion after Transcatheter Aortic-Valve Replacement. *2020-01-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1911426 · https://hartvaat.nl/2020/01/09/verminderde-klepbeweging-na-tavr-nejm/* This NEJM analysis characterized reduced leaflet motion and subclinical valve thrombosis after TAVR detected by 4D CT, establishing the prevalence and clinical significance of this radiological finding and its implications for post-procedural anticoagulation. ## A Controlled Trial of Rivaroxaban after Transcatheter Aortic-Valve Replacement. *2020-01-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1911425 · https://hartvaat.nl/2020/01/09/rivaroxaban-na-tavr-nejm-galileo/* The GALILEO trial demonstrated that rivaroxaban-based antithrombotic therapy after TAVR increased the risk of death or thromboembolic events and bleeding compared with antiplatelet therapy alone. The trial was stopped early for harm, establishing antiplatelet therapy as the preferred post-TAVR strategy in patients without other anticoagulation indications. ## Patients With Atrial Fibrillation Taking Nonsteroidal Anti-Inflammatory Drugs and Oral Anticoagulants in the ARISTOTLE Trial. *2020-01-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.041296 · https://hartvaat.nl/2020/01/07/nsaid-s-en-oac-bij-af-aristotle-analyse/* This ARISTOTLE analysis confirmed that concomitant NSAID use in AF patients on oral anticoagulants significantly increases bleeding risk, reinforcing the importance of minimizing NSAID exposure during anticoagulation therapy. ## Relationship between hypoglycaemia, cardiovascular outcomes, and empagliflozin treatment in the EMPA-REG OUTCOME® trial. *2020-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehz621 · https://hartvaat.nl/2020/01/07/hypoglykemie-cv-uitkomsten-en-empagliflozine-empa-reg-outcome/* This EMPA-REG OUTCOME analysis showed that empagliflozin does not increase hypoglycemia risk and that the cardiovascular benefit is maintained regardless of baseline hypoglycemia history, addressing a safety concern for SGLT2 inhibitors. ## Alcohol Abstinence in Drinkers with Atrial Fibrillation. *2020-01-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1817591 · https://hartvaat.nl/2020/01/02/alcoholonthouding-bij-drinkers-met-af-nejm-gerandomiseerde-trial/* This randomized trial showed that abstinence from alcohol in regular drinkers with atrial fibrillation significantly reduced AF recurrence and AF burden. The study provided the first high-quality evidence that alcohol cessation is a modifiable lifestyle intervention for AF management. ## A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. *2020-01-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1910355 · https://hartvaat.nl/2020/01/02/vergelijking-van-twee-ldl-streefwaarden-na-ischemisch-cva-nejm-tst/* The TST trial demonstrated that targeting LDL cholesterol below 70 mg/dL with statin therapy after ischemic stroke significantly reduced subsequent cardiovascular events compared with a higher target of 90-110 mg/dL. The results extended the 'lower is better' principle to secondary prevention after cerebrovascular events. ## Stepwise mass screening for atrial fibrillation using N-terminal B-type natriuretic peptide: the STROKESTOP II study. *2020-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz255 · https://hartvaat.nl/2020/01/01/stapsgewijze-af-screening-met-nt-probnp-strokestop-ii-resultaten/* The STROKESTOP II study tested a stepwise screening approach using NT-proBNP as a pre-selection tool for AF screening, demonstrating that biomarker-guided selection can improve the efficiency of population-level atrial fibrillation detection. ## Association of a P2Y12 Inhibitor Copayment Reduction Intervention With Persistence and Adherence With Other Secondary Prevention Medications: A Post Hoc Analysis of the ARTEMIS Cluster-Randomized Clinical Trial. *2020-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.4408 · https://hartvaat.nl/2020/01/01/p2y12-copay-reductie-en-therapietrouw-aan-andere-secundaire-preventiemiddelen/* This analysis showed that P2Y12 inhibitor copayment reduction not only improves antiplatelet adherence but also increases persistence with other secondary prevention medications after MI. ## Association of Sex With Outcomes in Patients Undergoing Percutaneous Coronary Intervention: A Subgroup Analysis of the GLOBAL LEADERS Randomized Clinical Trial. *2020-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.4296 · https://hartvaat.nl/2020/01/01/sekseverschillen-bij-pci-global-leaders-subanalyse/* This GLOBAL LEADERS subanalysis showed sex-related differences in outcomes after PCI, with women experiencing more bleeding despite similar ischemic event rates, informing sex-aware antiplatelet prescribing. ## Revisiting the effects of omitting aspirin in combined antithrombotic therapies for atrial fibrillation and acute coronary syndromes or percutaneous coronary interventions: meta-analysis of pooled data from the PIONEER AF-PCI, RE-DUAL PCI, and AUGUSTUS trials. *2020-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz259 · https://hartvaat.nl/2020/01/01/weglaten-van-aspirine-bij-gecombineerde-antitrombotische-therapie-voor-af-acs-he/* This re-analysis of aspirin omission in combined antithrombotic therapy for AF with ACS or PCI confirmed that dropping aspirin from the regimen reduces bleeding without increasing ischemic events across multiple trial datasets. ## The renal hemodynamic effects of the SGLT2 inhibitor dapagliflozin are caused by post-glomerular vasodilatation rather than pre-glomerular vasoconstriction in metformin-treated patients with type 2 diabetes in the randomized, double-blind RED trial. *2020-01-01 · Kidney international · https://doi.org/10.1016/j.kint.2019.09.013 · https://hartvaat.nl/2020/01/01/renale-hemodynamische-effecten-van-dapagliflozine-postglomerulaire-vasodilatatie/* This mechanistic study demonstrated that the renal hemodynamic effects of dapagliflozin are primarily mediated by post-glomerular vasodilation rather than afferent arteriolar constriction, providing new insight into how SGLT2 inhibitors protect the kidney. ## Double-Blind Randomized Phase 3 Study Comparing Esaxerenone (CS-3150) and Eplerenone in Patients With Essential Hypertension (ESAX-HTN Study). *2020-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13569 · https://hartvaat.nl/2020/01/01/esaxerenon-versus-eplerenon-bij-essentiele-hypertensie-esax-htn-fase-3/* This phase 3 trial of esaxerenone, a novel nonsteroidal MRA, showed comparable blood pressure reduction to eplerenone in essential hypertension. The study advanced the development of selective MRAs with potentially fewer mineralocorticoid-related side effects. ## Complex interaction of obesity, intentional weight loss and heart failure: a systematic review and meta-analysis. *2020-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-314770 · https://hartvaat.nl/2020/01/01/obesitas-opzettelijk-gewichtsverlies-en-hartfalen-meta-analyse/* This systematic review and meta-analysis examined the complex relationship between obesity, intentional weight loss, and heart failure risk, finding that while obesity increases HF risk, intentional weight loss through lifestyle or surgical interventions may reduce it. ## Effects of high-intensity interval training on platelet function in cardiac rehabilitation: a randomised controlled trial. *2020-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-315130 · https://hartvaat.nl/2020/01/01/hiit-en-plaatjesfunctie-bij-hartrevalidatie-gerandomiseerde-trial/* This randomized trial compared the effects of high-intensity interval training versus moderate continuous training on platelet function in cardiac rehabilitation patients, evaluating exercise-induced platelet modulation. ## Interaction of ischaemic postconditioning and thrombectomy in patients with ST-elevation myocardial infarction. *2020-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-314952 · https://hartvaat.nl/2020/01/01/ischemische-postconditionering-en-trombectomie-bij-stemi-interactie-analyse/* This DANAMI-3 analysis evaluated the interaction between ischemic postconditioning and thrombectomy during primary PCI for STEMI, testing whether combining these cardioprotective strategies provides additive benefit. ## Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. *2019-12-26 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1912388 · https://hartvaat.nl/2019/12/26/laaggedoseerd-colchicine-na-myocardinfarct-nejm-colcot/* The COLCOT trial demonstrated that low-dose colchicine (0.5 mg daily) initiated within 30 days of MI significantly reduced the composite of cardiovascular death, cardiac arrest, MI, stroke, or urgent coronary revascularization. This landmark study provided definitive evidence for targeted anti-inflammatory therapy in secondary cardiovascular prevention. ## Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial. *2019-12-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.10.033 · https://hartvaat.nl/2019/12/24/langetermijnfollow-up-van-complete-versus-laesie-only-revascularisatie-bij-stemi/* Long-term CvLPRIT follow-up confirmed that complete revascularization in STEMI with multivessel disease provides durable benefit over culprit-only PCI, with sustained event reduction over extended follow-up. ## Outcomes of Women Compared With Men After Non-ST-Segment Elevation Acute Coronary Syndromes. *2019-12-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.065 · https://hartvaat.nl/2019/12/17/uitkomsten-van-vrouwen-versus-mannen-na-nste-acs/* This analysis of sex differences in NSTE-ACS outcomes showed that women have different risk profiles and treatment patterns that may contribute to outcome disparities, supporting sex-aware management approaches. ## Effect of a Strategy of Comprehensive Vasodilation vs Usual Care on Mortality and Heart Failure Rehospitalization Among Patients With Acute Heart Failure: The GALACTIC Randomized Clinical Trial. *2019-12-17 · JAMA · https://doi.org/10.1001/jama.2019.18598 · https://hartvaat.nl/2019/12/17/uitgebreide-vasodilatatie-versus-standaardzorg-bij-acuut-hf-jama-galactic-hf-pil/* This JAMA trial of a comprehensive vasodilation strategy versus usual care in acute heart failure did not improve mortality or rehospitalization, adding to the evidence that vasodilator-based approaches in acute HF do not improve outcomes. ## Incorporation of Biomarkers Into Risk Assessment for Allocation of Antihypertensive Medication According to the 2017 ACC/AHA High Blood Pressure Guideline: A Pooled Cohort Analysis. *2019-12-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043337 · https://hartvaat.nl/2019/12/17/biomarkers-in-risicobeoordeling-voor-antihypertensieve-therapie-acc-aha-2017/* This study tested whether incorporating cardiovascular biomarkers (troponin, NT-proBNP) improves risk stratification for antihypertensive therapy allocation according to the 2017 ACC/AHA guidelines. ## Effect of Alirocumab on Stroke in ODYSSEY OUTCOMES. *2019-12-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043826 · https://hartvaat.nl/2019/12/17/alirocumab-en-cva-reductie-odyssey-outcomes/* This ODYSSEY OUTCOMES analysis confirmed that alirocumab reduces ischemic stroke after ACS, demonstrating the cerebrovascular benefit of PCSK9 inhibition alongside the previously established coronary benefit. ## Echocardiographic Outcomes After Transcatheter Leaflet Approximation in Patients With Secondary Mitral Regurgitation: The COAPT Trial. *2019-12-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.017 · https://hartvaat.nl/2019/12/17/echo-uitkomsten-na-mitraclip-bij-secundaire-mr-coapt-echocardiografisch/* This COAPT echocardiographic analysis demonstrated that transcatheter MitraClip repair produces sustained reduction in MR severity and favorable left ventricular remodeling over time in heart failure patients. ## Impact of Renal Impairment on Beta-Blocker Efficacy in Patients With Heart Failure. *2019-12-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.059 · https://hartvaat.nl/2019/12/10/nierfunctiestoornis-en-betablokkereffectiviteit-bij-hartfalen/* This study showed that beta-blockers maintain their mortality benefit in heart failure patients with moderate renal impairment, supporting continued beta-blocker therapy regardless of kidney function status. ## Echocardiographic Features of Patients With Heart Failure and Preserved Left Ventricular Ejection Fraction. *2019-12-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.063 · https://hartvaat.nl/2019/12/10/echocardiografische-kenmerken-bij-hfpef/* This PARAGON-HF analysis characterized the echocardiographic features of HFpEF patients, providing imaging phenotyping data that may inform future treatment strategies for this heterogeneous condition. ## Safety and efficacy outcomes of double vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of non-vitamin K antagonist oral anticoagulant-based randomized clinical trials. *2019-12-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehz732 · https://hartvaat.nl/2019/12/07/dubbele-versus-triple-antitrombotische-therapie-bij-af-na-pci-veiligheid-en-werk/* This comprehensive analysis of dual versus triple antithrombotic therapy in AF patients after PCI synthesized evidence from multiple trials, confirming the safety advantage of dual therapy while maintaining similar ischemic protection. ## Estimating individual lifetime benefit and bleeding risk of adding rivaroxaban to aspirin for patients with stable cardiovascular disease: results from the COMPASS trial. *2019-12-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehz404 · https://hartvaat.nl/2019/12/07/individueel-levenslang-voordeel-en-bloedingsrisico-van-rivaroxaban-plus-aspirine/* This COMPASS analysis estimated the individual lifetime benefit and bleeding risk of adding rivaroxaban to aspirin, providing a personalized risk-benefit framework for dual-pathway inhibition in stable atherosclerotic disease. ## Natural History of Subclinical Atrial Fibrillation Detected by Implanted Loop Recorders. *2019-12-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.050 · https://hartvaat.nl/2019/12/03/natuurlijk-beloop-van-subklinisch-af-gedetecteerd-door-implanteerbare-looprecord/* This study characterized the natural history of subclinical AF detected by implantable loop recorders, showing that many episodes are transient and short-lived but that a proportion progresses to clinical AF requiring treatment. ## Timing of Staged Nonculprit Artery Revascularization in Patients With ST-Segment Elevation Myocardial Infarction: COMPLETE Trial. *2019-12-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.051 · https://hartvaat.nl/2019/12/03/timing-van-non-culprit-revascularisatie-bij-stemi-complete-trial/* This COMPLETE subanalysis examined the optimal timing of staged nonculprit revascularization in STEMI, finding that both early (during index hospitalization) and later (within 45 days) timing provided similar clinical benefit. ## Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Coronary Syndrome Treated Medically or With Percutaneous Coronary Intervention or Undergoing Elective Percutaneous Coronary Intervention: Insights From the AUGUSTUS Trial. *2019-12-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043308 · https://hartvaat.nl/2019/12/03/antitrombotische-therapie-bij-af-met-acs-medicamenteus-of-met-pci/* This analysis examined antithrombotic strategies in AF patients with ACS managed with or without PCI, showing that dual therapy (DOAC plus P2Y12 inhibitor) reduces bleeding compared with triple therapy across both treatment approaches. ## Magnesium-Based Resorbable Scaffold Versus Permanent Metallic Sirolimus-Eluting Stent in Patients With ST-Segment Elevation Myocardial Infarction: The MAGSTEMI Randomized Clinical Trial. *2019-12-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.043467 · https://hartvaat.nl/2019/12/03/magnesium-resorbeerbare-scaffold-versus-metallic-stent-bij-stemi-biosolve-iii/* This study of a magnesium-based resorbable scaffold in STEMI tested a next-generation bioresorbable technology that addresses the limitations of the withdrawn poly-L-lactic acid Absorb device, including faster resorption and better mechanical properties. ## Clinically Significant Bleeding With Ticagrelor Versus Clopidogrel in Korean Patients With Acute Coronary Syndromes Intended for Invasive Management: A Randomized Clinical Trial. *2019-12-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.041766 · https://hartvaat.nl/2019/12/03/klinisch-significante-bloedingen-met-ticagrelor-versus-clopidogrel-bij-koreaanse/* This study examined sex differences in clinically significant bleeding with ticagrelor versus clopidogrel in Korean ACS patients, evaluating population-specific antiplatelet safety data. ## Occurence of First and Recurrent Major Adverse Cardiovascular Events With Liraglutide Treatment Among Patients With Type 2 Diabetes and High Risk of Cardiovascular Events: A Post Hoc Analysis of a Randomized Clinical Trial. *2019-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.3080 · https://hartvaat.nl/2019/12/01/eerste-en-recidiverende-cv-events-met-liraglutide-bij-diabetes-type-2-leader/* This LEADER analysis of first and recurrent cardiovascular events showed that liraglutide reduces the total burden of major cardiovascular events, with even greater benefit than the primary first-event analysis suggested. ## Time-Varying Outcomes With the Absorb Bioresorbable Vascular Scaffold During 5-Year Follow-up: A Systematic Meta-analysis and Individual Patient Data Pooled Study. *2019-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.4101 · https://hartvaat.nl/2019/12/01/absorb-scaffold-5-jaarsresultaten-systematische-meta-analyse/* This systematic meta-analysis of 5-year Absorb bioresorbable scaffold outcomes definitively showed that the early safety concerns persist and worsen over time, with significantly higher rates of scaffold thrombosis and target lesion failure compared with metallic DES. ## Integrated specialized atrial fibrillation clinics reduce all-cause mortality: post hoc analysis of a randomized clinical trial. *2019-12-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz209 · https://hartvaat.nl/2019/12/01/geintegreerde-gespecialiseerde-af-poliklinieken-verlagen-totale-mortaliteit-post/* This post-hoc analysis showed that integrated specialized AF outpatient clinics reduce all-cause mortality, providing evidence that structured, multidisciplinary AF care improves not just process measures but hard clinical outcomes. ## Highlights in heart failure. *2019-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12555 · https://hartvaat.nl/2019/12/01/hoogtepunten-in-hartfalen-2019/* This year-in-review summarized the most important heart failure developments in 2019, providing a concise overview of key trials, guidelines, and therapeutic advances in the HF field. ## Genetic Susceptibility, Dietary Protein Intake, and Changes of Blood Pressure: The POUNDS Lost Trial. *2019-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13510 · https://hartvaat.nl/2019/12/01/genetische-gevoeligheid-eiwitinname-en-bloeddrukverandering-pounds-lost/* This POUNDS Lost trial analysis showed that genetic susceptibility interacts with dietary protein intake to influence blood pressure changes during weight loss, advancing nutrigenomics in hypertension management. ## Impaired glucose tolerance and albuminuria in patients with chronic heart failure: a subanalysis of the SUPPORT trial. *2019-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12516 · https://hartvaat.nl/2019/12/01/gestoorde-glucosetolerantie-en-albuminurie-bij-chronisch-hf-support-trial/* This SUPPORT subanalysis evaluated the prevalence and prognostic significance of impaired glucose tolerance and albuminuria in chronic heart failure, identifying metabolic and renal markers of adverse prognosis. ## Beneficial effects of ivabradine in patients with heart failure, low ejection fraction, and heart rate above 77 b.p.m. *2019-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12513 · https://hartvaat.nl/2019/12/01/gunstige-effecten-van-ivabradine-bij-hf-met-lage-ef-en-hartfrequentie-77-bpm/* This analysis showed that ivabradine provides particular benefit in HFrEF patients with heart rates above 77 bpm despite guideline-directed therapy, supporting risk-stratified heart rate lowering. ## Hepatorenal dysfunction identifies high-risk patients with acute heart failure: insights from the RELAX-AHF trial. *2019-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12477 · https://hartvaat.nl/2019/12/01/hepatorenale-disfunctie-identificeert-hoogrisico-acuut-hf-relax-ahf/* This RELAX-AHF analysis identified hepatorenal dysfunction as a marker for high-risk patients with acute heart failure, showing that combined liver and kidney impairment predicts worse outcomes. ## Left atrial dimension and cardiovascular outcomes in patients with and without atrial fibrillation: a systematic review and meta-analysis. *2019-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-315174 · https://hartvaat.nl/2019/12/01/linkeratriumdimensie-en-cv-uitkomsten-bij-patienten-met-en-zonder-af-meta-analys/* This meta-analysis showed that left atrial dimension predicts cardiovascular outcomes in both patients with and without AF, establishing atrial enlargement as a universal cardiovascular risk marker beyond arrhythmia context. ## Oral modified release morphine for breathlessness in chronic heart failure: a randomized placebo-controlled trial. *2019-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12498 · https://hartvaat.nl/2019/12/01/orale-morfine-bij-dyspneu-bij-chronisch-hartfalen-gerandomiseerde-placebogecontr/* This randomized placebo-controlled trial of oral modified-release morphine for breathlessness in chronic heart failure showed modest symptom benefit, providing the first controlled data for opioid use in heart failure-related dyspnea. ## Weight change and the risk of incident atrial fibrillation: a systematic review and meta-analysis. *2019-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-314931 · https://hartvaat.nl/2019/12/01/gewichtsverandering-en-risico-op-af-systematische-review-en-meta-analyse/* This meta-analysis showed that weight change, particularly weight gain, is associated with increased risk of incident atrial fibrillation, supporting weight management as a strategy for AF prevention. ## Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction. *2019-11-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.038 · https://hartvaat.nl/2019/11/26/werkzaamheid-en-veiligheid-van-stents-bij-stemi-jacc-analyse/* This analysis compared the efficacy and safety of different drug-eluting stent types in STEMI, finding no clear superiority of any specific DES platform in the primary PCI setting. ## Effects of Interatrial Shunt on Pulmonary Vascular Function in Heart Failure With Preserved Ejection Fraction. *2019-11-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.08.1062 · https://hartvaat.nl/2019/11/26/interatriale-shunt-en-pulmonale-vaatfunctie-bij-hfpef/* This study evaluated the effects of an interatrial shunt device on pulmonary vascular function in HFpEF, showing that reducing left atrial pressure through controlled shunting improves pulmonary hemodynamics. ## 2019 AHA/ACC Clinical Performance and Quality Measures for Adults With High Blood Pressure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. *2019-11-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.10.001 · https://hartvaat.nl/2019/11/26/2019-aha-acc-prestatie-en-kwaliteitsmaten-voor-hoge-bloeddruk/* This AHA/ACC document defined clinical performance and quality measures for hypertension management in adults, establishing benchmarks for healthcare systems to assess and improve blood pressure control quality. ## Cryoballoon or Radiofrequency Ablation for Atrial Fibrillation Assessed by Continuous Monitoring: A Randomized Clinical Trial. *2019-11-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.042622 · https://hartvaat.nl/2019/11/26/cryoballon-versus-rf-ablatie-bij-af-beoordeeld-met-continue-monitoring-cryo-firs/* The CRYO-FIRST trial comparing cryoballoon with radiofrequency ablation as first-line AF treatment, assessed by continuous monitoring, provided additional data on the relative merits of these two energy sources for initial rhythm control. ## Ticagrelor with or without Aspirin in High-Risk Patients after PCI. *2019-11-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1908419 · https://hartvaat.nl/2019/11/21/ticagrelor-met-of-zonder-aspirine-na-pci-bij-hoog-risico-nejm-twilight/* The TWILIGHT trial showed that ticagrelor monotherapy after 3 months of dual antiplatelet therapy significantly reduced clinically relevant bleeding without increasing ischemic events in high-risk patients after PCI. This established P2Y12 inhibitor monotherapy as a safe de-escalation strategy for selected patients. ## Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. *2019-11-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1911303 · https://hartvaat.nl/2019/11/21/dapagliflozine-bij-hartfalen-met-verminderde-ejectiefractie-nejm-dapa-hf/* The DAPA-HF trial demonstrated that dapagliflozin reduced the composite of worsening heart failure or cardiovascular death in patients with HFrEF regardless of the presence of diabetes. This transformative result established SGLT2 inhibitors as a fourth pillar of heart failure therapy alongside ACE inhibitors/ARBs, beta-blockers, and mineralocorticoid antagonists. ## A comprehensive analysis of the effects of rivaroxaban on stroke or transient ischaemic attack in patients with heart failure, coronary artery disease, and sinus rhythm: the COMMANDER HF trial. *2019-11-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz427 · https://hartvaat.nl/2019/11/21/rivaroxaban-en-cva-tia-bij-hf-met-coronairlijden-en-sinusritme-commander-hf/* This COMMANDER HF analysis specifically examined the effect of low-dose rivaroxaban on stroke and TIA in heart failure patients with sinus rhythm, finding no significant cerebrovascular benefit with anticoagulation in this population. ## Short-term diuretic withdrawal in stable outpatients with mild heart failure and no fluid retention receiving optimal therapy: a double-blind, multicentre, randomized trial. *2019-11-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz554 · https://hartvaat.nl/2019/11/21/diureticastaken-bij-stabiel-mild-hf-zonder-vochtretentie/* This study tested short-term diuretic withdrawal in stable outpatients with mild heart failure receiving optimal medical therapy, showing that many patients can safely reduce or stop loop diuretics when well-compensated. ## Initial Imaging-Guided Strategy Versus Routine Care in Patients With Non-ST-Segment Elevation Myocardial Infarction. *2019-11-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.09.027 · https://hartvaat.nl/2019/11/19/beeldvorming-geleide-versus-routinezorg-bij-nstemi-jacc/* This study compared an initial imaging-guided strategy with routine invasive care in NSTEMI patients, testing whether non-invasive risk stratification can safely select patients for conservative management. ## Evolocumab for Early Reduction of LDL Cholesterol Levels in Patients With Acute Coronary Syndromes (EVOPACS). *2019-11-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.08.010 · https://hartvaat.nl/2019/11/19/evolocumab-voor-vroege-ldl-verlaging-bij-acs-evopacs/* The EVOPACS study showed that early in-hospital initiation of evolocumab in ACS patients produces rapid and substantial LDL cholesterol reduction within days, establishing the feasibility and efficacy of PCSK9 inhibition in the acute setting. ## Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The EMPA-HEART CardioLink-6 Randomized Clinical Trial. *2019-11-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.042375 · https://hartvaat.nl/2019/11/19/empagliflozine-en-lv-massa-bij-diabetes-type-2-met-coronairlijden-empa-heart/* The EMPA-HEART trial demonstrated that empagliflozin significantly reduced left ventricular mass index in patients with type 2 diabetes and coronary artery disease, providing the first randomized evidence of direct structural cardiac effects from SGLT2 inhibition. ## Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis. *2019-11-16 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)32317-7 · https://hartvaat.nl/2019/11/16/vergelijking-van-eerstelijns-antihypertensiva-lancet-systematische-multinational/* This comprehensive multinational analysis compared all first-line antihypertensive drug classes across millions of patients. Thiazide and thiazide-like diuretics showed the most favorable overall effectiveness-to-safety balance, while ACE inhibitors were associated with a higher risk of angioedema and cough compared with ARBs. ## Effect of Bempedoic Acid vs Placebo Added to Maximally Tolerated Statins on Low-Density Lipoprotein Cholesterol in Patients at High Risk for Cardiovascular Disease: The CLEAR Wisdom Randomized Clinical Trial. *2019-11-12 · JAMA · https://doi.org/10.1001/jama.2019.16585 · https://hartvaat.nl/2019/11/12/bempedoinezuur-toegevoegd-aan-statines-bij-hoog-cv-risico-jama-clear-harmony/* The CLEAR Harmony trial showed that bempedoic acid added to maximally tolerated statin therapy produced additional LDL cholesterol lowering with an acceptable safety profile in patients at high cardiovascular risk. The trial established the tolerability of bempedoic acid in a large, long-term study. ## Effects of Intensive Versus Standard Ambulatory Blood Pressure Control on Cerebrovascular Outcomes in Older People (INFINITY). *2019-11-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.041603 · https://hartvaat.nl/2019/11/12/intensieve-versus-standaard-ambulante-bloeddrukcontrole-en-cerebrovasculaire-uit/* The INFINITY trial showed that intensive ambulatory blood pressure control reduces the progression of cerebral white matter disease in older adults, providing evidence that aggressive blood pressure management may preserve brain health in aging. ## Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease. *2019-11-07 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1909406 · https://hartvaat.nl/2019/11/07/5-jaarsuitkomsten-na-pci-of-cabg-bij-hoofdstamlijden-nejm-excel/* The 5-year EXCEL results showed no significant difference between PCI and CABG for the primary composite endpoint in left main coronary disease, though controversy arose over differing results depending on whether periprocedural MI was included. The data fueled the ongoing debate about optimal left main revascularization strategy. ## Ticagrelor Alone Versus Dual Antiplatelet Therapy From 1 Month After Drug-Eluting Coronary Stenting. *2019-11-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.08.1038 · https://hartvaat.nl/2019/11/05/ticagrelor-monotherapie-versus-dapt-vanaf-1-maand-na-des-tico-trial/* The TICO trial demonstrated that ticagrelor monotherapy after 3 months of DAPT reduced bleeding without increasing ischemic events compared with continued DAPT at 1 year after DES implantation. The study added to the growing evidence for early P2Y12 inhibitor monotherapy. ## A Randomized Trial of a 1-Hour Troponin T Protocol in Suspected Acute Coronary Syndromes: The Rapid Assessment of Possible Acute Coronary Syndrome in the Emergency Department With High-Sensitivity Troponin T Study (RAPID-TnT). *2019-11-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.042891 · https://hartvaat.nl/2019/11/05/1-uur-troponine-t-protocol-bij-verdenking-acs-gerandomiseerde-rapid-tnt-trial/* This randomized trial of a 1-hour high-sensitivity troponin T protocol for suspected ACS demonstrated that rapid rule-out strategies can safely reduce emergency department length of stay without missing acute MI diagnoses. ## Risk Categorization Using New American College of Cardiology/American Heart Association Guidelines for Cholesterol Management and Its Relation to Alirocumab Treatment Following Acute Coronary Syndromes. *2019-11-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.042551 · https://hartvaat.nl/2019/11/05/risicoclassificatie-volgens-de-nieuwe-acc-aha-cholesterolrichtlijn-en-stenting-u/* This analysis applied the 2018 ACC/AHA cholesterol guideline risk categorization to clinical outcomes, validating the guideline's approach to identifying patients who benefit from escalated lipid-lowering therapy. ## Benefit and Risks of Aspirin in Addition to Ticagrelor in Acute Coronary Syndromes: A Post Hoc Analysis of the Randomized GLOBAL LEADERS Trial. *2019-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.3355 · https://hartvaat.nl/2019/11/01/aspirine-plus-ticagrelor-bij-acs-voordeel-risicoanalyse-van-global-leaders/* This GLOBAL LEADERS post-hoc analysis assessed the risk-benefit of adding aspirin to ticagrelor in ACS patients, providing data on whether aspirin provides incremental ischemic protection or mainly adds bleeding risk. ## Effect of 1 or 2 Doses of Inclisiran on Low-Density Lipoprotein Cholesterol Levels: One-Year Follow-up of the ORION-1 Randomized Clinical Trial. *2019-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.3502 · https://hartvaat.nl/2019/11/01/inclisiran-1-of-2-dosis-en-ldl-cholesterol-orion-1-1-jaarsfollow-up/* This 1-year ORION-1 follow-up showed that even 1 or 2 doses of inclisiran provide durable LDL cholesterol reduction lasting well beyond the dosing interval, confirming the long-acting nature of the siRNA approach. ## THEMIS and THEMIS-PCI. *2019-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz707 · https://hartvaat.nl/2019/11/01/themis-en-themis-pci-editorial-perspectief/* This European Heart Journal editorial discussed the THEMIS and THEMIS-PCI trial results with ticagrelor in stable coronary disease and diabetes, evaluating the narrow risk-benefit balance of intensified antiplatelet therapy. ## Causal association between periodontitis and hypertension: evidence from Mendelian randomization and a randomized controlled trial of non-surgical periodontal therapy. *2019-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz646 · https://hartvaat.nl/2019/11/01/causaal-verband-periodontitis-en-hypertensie-mendeliaanse-randomisatie-en-rct/* This study combining Mendelian randomization with a randomized trial provided evidence for a causal link between periodontitis and hypertension, supporting the role of chronic oral inflammation in blood pressure elevation. ## Effectiveness of Interventions Aimed at Increasing Statin-Prescribing Rates in Primary Cardiovascular Disease Prevention: A Systematic Review of Randomized Clinical Trials. *2019-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.3066 · https://hartvaat.nl/2019/11/01/interventies-voor-statinevoorschrijving-bij-primaire-cv-preventie-meta-analyse/* This meta-analysis evaluated interventions designed to increase statin prescribing for primary cardiovascular prevention, identifying which implementation strategies effectively improve the translation of guidelines to practice. ## Determinants of left atrium thrombi in scheduled cardioversion: an ENSURE-AF study analysis. *2019-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz213 · https://hartvaat.nl/2019/11/01/determinanten-van-linkeratriumtrombi-bij-geplande-cardioversie-ensure-af/* This ENSURE-AF analysis identified determinants of left atrial thrombi in AF patients scheduled for cardioversion, informing pre-cardioversion screening decisions and anticoagulation requirements. ## A randomized controlled trial of metformin on left ventricular hypertrophy in patients with coronary artery disease without diabetes: the MET-REMODEL trial. *2019-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz203 · https://hartvaat.nl/2019/11/01/metformine-en-linkerventrikelhypertrofie-bij-coronairlijden-zonder-diabetes-gera/* This randomized trial found that metformin reduces left ventricular hypertrophy in non-diabetic patients with coronary artery disease and insulin resistance, demonstrating a pleiotropic cardiac benefit beyond glycemic control. ## Blood Pressure Variability and Progression of Clinical Alzheimer Disease. *2019-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13664 · https://hartvaat.nl/2019/11/01/bloeddrukvariabiliteit-en-progressie-van-klinische-alzheimer/* This study showed that blood pressure variability predicts the progression of clinical Alzheimer disease, establishing a neuro-vascular pathway linking hemodynamic instability to cognitive decline. ## Acute declines in estimated glomerular filtration rate on enalapril and mortality and cardiovascular outcomes in patients with heart failure with reduced ejection fraction. *2019-11-01 · Kidney international · https://doi.org/10.1016/j.kint.2019.05.019 · https://hartvaat.nl/2019/11/01/acute-egfr-daling-door-enalapril-en-mortaliteit-bij-hf-met-ckd/* This study showed that acute eGFR declines after enalapril initiation in heart failure patients with renal impairment do not predict adverse long-term outcomes, supporting continued RAAS inhibitor use despite initial creatinine rises. ## Heart failure risk predictions in adult patients with congenital heart disease: a systematic review. *2019-11-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-314977 · https://hartvaat.nl/2019/11/01/hartfalenrisicovoorspelling-bij-congenitale-hartafwijkingen-systematische-review/* This systematic review summarized heart failure risk prediction models in adult congenital heart disease, identifying the unique risk factors and limited prediction tools available for this growing patient population. ## Long-Term Efficacy and Safety of Evolocumab in Patients With Hypercholesterolemia. *2019-10-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.08.1024 · https://hartvaat.nl/2019/10/29/langetermijn-werkzaamheid-en-veiligheid-van-evolocumab-bij-hypercholesterolemie/* This long-term analysis confirmed that evolocumab maintains consistent LDL cholesterol lowering and cardiovascular event reduction over extended follow-up periods, with no attenuation of efficacy or emergence of late safety signals. ## Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial. *2019-10-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)32135-X · https://hartvaat.nl/2019/10/26/patiromer-voor-spironolactongebruik-bij-resistente-hypertensie-met-ckd-lancet-am/* The AMBER trial showed that patiromer, a potassium binder, enabled continued use of spironolactone in patients with resistant hypertension and CKD by preventing hyperkalemia. The results established a practical solution for the clinical dilemma of MRA use in CKD patients. ## A Genotype-Guided Strategy for Oral P2Y12 Inhibitors in Primary PCI. *2019-10-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1907096 · https://hartvaat.nl/2019/10/24/genotype-geleide-p2y12-remmerkeuze-bij-primaire-pci-nejm-popular-genetics/* The POPular Genetics trial showed that genotype-guided de-escalation from ticagrelor or prasugrel to clopidogrel in CYP2C19 noncarriers after primary PCI was noninferior for thrombotic events and reduced bleeding. The study established pharmacogenomic-guided antiplatelet selection as a viable personalized medicine approach. ## Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction. *2019-10-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1908655 · https://hartvaat.nl/2019/10/24/sacubitril-valsartan-bij-hfpef-nejm-paragon-hf/* The PARAGON-HF trial did not meet its primary endpoint of reduced heart failure hospitalization or cardiovascular death with sacubitril-valsartan versus valsartan in HFpEF. However, prespecified subgroup analysis suggested benefit in patients with lower ejection fractions and in women, informing the expanding indication for ARNI. ## Individualizing Revascularization Strategy for Diabetic Patients With Multivessel Coronary Disease. *2019-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.083 · https://hartvaat.nl/2019/10/22/individualisering-van-revascularisatiestrategie-bij-diabetes-met-multivatenlijde/* This analysis developed an individualized approach to revascularization strategy selection (PCI vs CABG) in diabetic patients with multivessel disease, using patient-specific risk modeling rather than one-size-fits-all recommendations. ## Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain. *2019-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.085 · https://hartvaat.nl/2019/10/22/ccta-geleide-therapie-verbetert-uitkomsten-bij-stabiele-pijn-op-de-borst/* This SCOT-HEART analysis confirmed that coronary CT angiography-guided therapy improves outcomes in patients with stable chest pain by enabling earlier initiation of preventive treatments based on anatomical disease identification. ## Implanted Monitor Alerting to Reduce Treatment Delay in Patients With Acute Coronary Syndrome Events. *2019-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.084 · https://hartvaat.nl/2019/10/22/implanteerbare-monitor-voor-snellere-behandeling-bij-acs/* This study tested whether an implanted cardiac monitor with automated alerting during ACS events reduces treatment delay, exploring technology-enabled earlier presentation for acute coronary syndromes. ## Sex-Specific Thresholds of High-Sensitivity Troponin in Patients With Suspected Acute Coronary Syndrome. *2019-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.082 · https://hartvaat.nl/2019/10/22/sekse-specifieke-troponinedrempels-bij-verdenking-acs/* This study demonstrated that sex-specific high-sensitivity troponin thresholds improve the diagnostic accuracy for acute coronary syndrome in women, who are systematically underdiagnosed when universal thresholds are applied. ## Efficacy and Safety of Ticagrelor Monotherapy in Patients Undergoing Multivessel PCI. *2019-10-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.08.997 · https://hartvaat.nl/2019/10/22/ticagrelor-monotherapie-bij-multivaten-pci-werkzaamheid-en-veiligheid/* This study evaluated ticagrelor monotherapy after short DAPT in patients undergoing multivessel PCI, extending the de-escalation evidence to the complex multi-stent population. ## Digoxin-mortality: randomized vs. observational comparison in the DIG trial. *2019-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz395 · https://hartvaat.nl/2019/10/21/digoxine-en-mortaliteit-gerandomiseerd-versus-observationeel-in-de-dig-trial/* This DIG trial analysis compared randomized with observational mortality estimates for digoxin, demonstrating how non-randomized analyses can produce misleading conclusions about drug safety due to confounding by indication. ## Cardiovascular biomarkers in patients with acute decompensated heart failure randomized to sacubitril-valsartan or enalapril in the PIONEER-HF trial. *2019-10-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz240 · https://hartvaat.nl/2019/10/21/cv-biomarkers-bij-acuut-gedecompenseerd-hf-met-sacubitril-valsartan-pioneer-hf/* This PIONEER-HF biomarker analysis showed that sacubitril-valsartan produces greater reductions in cardiac troponin and soluble ST2 compared with enalapril in acute heart failure, indicating reduced myocardial stress and fibrosis with ARNI therapy. ## Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial. *2019-10-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)32039-2 · https://hartvaat.nl/2019/10/19/remote-ischemische-conditionering-en-mi-uitkomsten-lancet-condi-2-eric-ppci/* The CONDI-2/ERIC-PPCI trial definitively showed that remote ischemic conditioning applied to the arm before primary PCI for STEMI did not improve clinical outcomes at 12 months. The large, multicenter negative result ended the clinical pursuit of this cardioprotective strategy. ## Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes. *2019-10-17 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1908973 · https://hartvaat.nl/2019/10/17/ticagrelor-of-prasugrel-bij-acuut-coronair-syndroom-nejm-isar-react-5/* The ISAR-REACT 5 trial found that prasugrel was superior to ticagrelor in reducing the composite of death, MI, or stroke in patients with acute coronary syndromes planned for invasive management, with no significant difference in bleeding. This first major head-to-head comparison of newer P2Y12 inhibitors influenced antiplatelet selection in ACS. ## Association Between Triglyceride Lowering and Reduction of Cardiovascular Risk Across Multiple Lipid-Lowering Therapeutic Classes: A Systematic Review and Meta-Regression Analysis of Randomized Controlled Trials. *2019-10-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.041998 · https://hartvaat.nl/2019/10/15/triglyceridenverlaging-en-cv-risicoreductie-over-therapeutische-klassen-meta-ana/* This meta-analysis demonstrated that the association between triglyceride lowering and cardiovascular risk reduction depends on concomitant reductions in apolipoprotein B-containing lipoproteins. Triglyceride lowering per se, without apoB reduction, does not reliably reduce cardiovascular events. ## Community Health Workers Improve Linkage to Hypertension Care in Western Kenya. *2019-10-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.08.003 · https://hartvaat.nl/2019/10/15/community-health-workers-verbeteren-koppeling-met-hypertensiezorg-in-kenia/* This study demonstrated that community health workers effectively improve linkage to hypertension care in rural Kenya, providing a scalable workforce model for addressing the global hypertension treatment gap in sub-Saharan Africa. ## Edoxaban-based versus vitamin K antagonist-based antithrombotic regimen after successful coronary stenting in patients with atrial fibrillation (ENTRUST-AF PCI): a randomised, open-label, phase 3b trial. *2019-10-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31872-0 · https://hartvaat.nl/2019/10/12/edoxaban-versus-vka-gebaseerd-antitrombotisch-regime-na-stenting-bij-af-lancet-e/* The ENTRUST-AF PCI trial showed that edoxaban-based dual antithrombotic therapy (edoxaban plus P2Y12 inhibitor) met the noninferiority threshold for bleeding compared with VKA-based triple therapy in AF patients after PCI, adding a fourth DOAC to the evidence supporting aspirin-free strategies. ## Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial. *2019-10-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31997-X · https://hartvaat.nl/2019/10/12/pci-versus-cabg-bij-drievaten-of-hoofdstamlijden-lancet-syntax-extended-10-jaars/* The SYNTAX 10-year extended follow-up demonstrated that CABG provided superior long-term survival over PCI in patients with three-vessel or left main coronary disease, driven primarily by lower cardiac mortality. This longest-available randomized comparison reinforced CABG as the preferred revascularization strategy for complex coronary disease. ## Complete Revascularization with Multivessel PCI for Myocardial Infarction. *2019-10-10 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1907775 · https://hartvaat.nl/2019/10/10/complete-revascularisatie-met-multivaten-pci-bij-mi-nejm-complete/* The COMPLETE trial showed that routine complete revascularization of nonculprit lesions during the index hospitalization or shortly thereafter reduced cardiovascular death and MI compared with culprit-only PCI in patients with STEMI and multivessel disease. This provided definitive evidence for a strategy of staged complete revascularization after primary PCI. ## Biodegradable polymer sirolimus-eluting stents versus durable polymer everolimus-eluting stents in patients with ST-segment elevation myocardial infarction (BIOSTEMI): a single-blind, prospective, randomised superiority trial. *2019-10-05 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31877-X · https://hartvaat.nl/2019/10/05/biodegradeerbare-versus-duurzame-polymer-des-bij-stemi-gerandomiseerde-trial/* This randomized trial compared biodegradable polymer sirolimus-eluting with durable polymer everolimus-eluting stents in STEMI patients, evaluating whether ultrathin strut platforms with absorbable coatings improve healing in the acute MI setting. ## A community-based comprehensive intervention to reduce cardiovascular risk in hypertension (HOPE 4): a cluster-randomised controlled trial. *2019-10-05 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31949-X · https://hartvaat.nl/2019/10/05/uitgebreide-community-interventie-bij-hypertensie-lancet-hope-4/* The HOPE 4 cluster-randomized trial demonstrated that a comprehensive community-based intervention combining non-physician health workers with simplified treatment algorithms significantly improves blood pressure and cholesterol control in low- and middle-income settings. ## Ticagrelor in Patients with Stable Coronary Disease and Diabetes. *2019-10-03 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1908077 · https://hartvaat.nl/2019/10/03/ticagrelor-bij-stabiel-coronairlijden-met-diabetes-nejm-themis/* The THEMIS trial showed that ticagrelor added to aspirin modestly reduced cardiovascular events in patients with stable coronary disease and type 2 diabetes but significantly increased major bleeding. The narrow net clinical benefit limited the clinical adoption of this strategy. ## Improving Communication in Heart Failure Patient Care. *2019-10-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.058 · https://hartvaat.nl/2019/10/01/verbetering-van-communicatie-bij-hartfalenpatientenzorg/* This review discussed strategies for improving communication in heart failure care, focusing on advance care planning, defibrillator deactivation discussions, and shared decision-making with patients and families. ## Clinical outcomes after implantation of quadripolar compared to bipolar left ventricular leads in patients undergoing cardiac resynchronization therapy: a systematic review and meta-analysis. *2019-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz196 · https://hartvaat.nl/2019/10/01/quadripolaire-versus-bipolaire-lv-leads-bij-crt-klinische-uitkomsten/* This comparison of quadripolar versus bipolar LV leads in CRT patients evaluated whether additional programming options from quadripolar technology translate to improved clinical outcomes. ## Sex-related differences in catheter ablation of atrial fibrillation: a systematic review and meta-analysis. *2019-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz179 · https://hartvaat.nl/2019/10/01/sekseverschillen-bij-katheterablatie-van-af-meta-analyse/* This systematic review and meta-analysis identified sex-related differences in catheter ablation outcomes for AF, showing that women have higher complication rates and potentially different efficacy profiles compared with men. ## Diagnostic performance of imaging investigations in detecting and differentiating cardiac amyloidosis: a systematic review and meta-analysis. *2019-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12511 · https://hartvaat.nl/2019/10/01/beeldvorming-bij-cardiale-amyloidose-diagnostische-prestatie-meta-analyse/* This systematic review compared the diagnostic performance of cardiac MRI and nuclear scintigraphy for detecting and differentiating cardiac amyloidosis subtypes (AL versus ATTR), informing the non-invasive diagnostic pathway for this increasingly recognized condition. ## Effects of Antihypertensive Class on Falls, Syncope, and Orthostatic Hypotension in Older Adults: The ALLHAT Trial. *2019-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13445 · https://hartvaat.nl/2019/10/01/antihypertensivaklasse-en-vallen-syncope-en-orthostatische-hypotensie-bij-oudere/* This ALLHAT analysis found that the risk of falls, syncope, and orthostatic hypotension in older adults does not vary significantly by antihypertensive drug class, providing reassurance that all major classes are comparably safe regarding postural complications. ## Neuromuscular electrical stimulation is feasible in patients with acute heart failure. *2019-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12504 · https://hartvaat.nl/2019/10/01/neuromusculaire-elektrische-stimulatie-bij-acuut-hartfalen-haalbaarheid/* This feasibility study demonstrated that neuromuscular electrical stimulation can be safely implemented in patients with acute heart failure without adverse haemodynamic effects, potentially preserving muscle mass during hospitalisation. ## Identification of Distinct Arterial Waveform Clusters and a Longitudinal Evaluation of Their Clinical Usefulness. *2019-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.12625 · https://hartvaat.nl/2019/10/01/arteriele-golfvormclusters-en-langetermijn-klinisch-nut/* This study identified distinct arterial waveform clusters through computational analysis and evaluated their longitudinal clinical utility for cardiovascular risk stratification beyond conventional blood pressure measures. ## Effect of bardoxolone methyl on the urine albumin-to-creatinine ratio in patients with type 2 diabetes and stage 4 chronic kidney disease. *2019-10-01 · Kidney international · https://doi.org/10.1016/j.kint.2019.04.027 · https://hartvaat.nl/2019/10/01/bardoxolone-en-urine-albumine-creatinine-ratio-bij-diabetes-met-ckd-stadium-4/* This study of bardoxolone methyl in type 2 diabetes with stage 4 CKD examined the effect of Nrf2 pathway activation on kidney function, testing an anti-inflammatory mechanism for slowing kidney disease progression. ## Medium-term systemic blood pressure after stenting of aortic coarctation: a systematic review and meta-analysis. *2019-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-314965 · https://hartvaat.nl/2019/10/01/bloeddruk-na-stenting-bij-aortacoarctatie-systematische-review-en-meta-analyse/* This meta-analysis characterized medium-term blood pressure outcomes after stenting for aortic coarctation, showing that residual hypertension remains common despite successful mechanical repair. ## Impact of telemedicine interventions on mortality in patients with acute myocardial infarction: a systematic review and meta-analysis. *2019-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314539 · https://hartvaat.nl/2019/10/01/telemedicine-en-mortaliteit-bij-acuut-mi-systematische-review-en-meta-analyse/* This meta-analysis showed that telemedicine interventions significantly reduce mortality in patients with acute myocardial infarction, primarily through faster access to primary PCI and reduced time to reperfusion in remote and underserved areas. ## Low systemic arterial compliance is associated with increased cardiovascular morbidity and mortality in aortic valve stenosis. *2019-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314386 · https://hartvaat.nl/2019/10/01/lage-arteriele-compliance-en-cv-morbiditeit-bij-aortaklepstenose/* This study showed that low systemic arterial compliance is independently associated with increased cardiovascular morbidity and mortality in aortic stenosis, adding a hemodynamic parameter beyond traditional valve severity measures. ## Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial. *2019-09-28 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31887-2 · https://hartvaat.nl/2019/09/28/ticagrelor-bij-diabetes-met-stabiel-coronairlijden-en-eerder-pci-lancet-themis-p/* This THEMIS-PCI subanalysis showed that ticagrelor added to aspirin significantly reduced cardiovascular events in diabetic patients with stable coronary disease and prior PCI, identifying the subgroup with the most favorable risk-benefit profile within the overall neutral THEMIS trial. ## Asymptomatic Patients With Abnormal Fractional Flow Reserve Treated With Medication Alone or With PCI. *2019-09-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.068 · https://hartvaat.nl/2019/09/24/asymptomatische-patienten-met-abnormale-ffr-medicamenteus-versus-pci/* This study evaluated outcomes of asymptomatic patients with hemodynamically significant lesions (abnormal FFR) managed with medication alone versus PCI, addressing the clinical dilemma of treating physiologically significant but symptom-free disease. ## Internal Versus External Electrical Cardioversion of Atrial Arrhythmia in Patients With Implantable Cardioverter-Defibrillator: A Randomized Clinical Trial. *2019-09-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.041320 · https://hartvaat.nl/2019/09/24/interne-versus-externe-cardioversie-bij-atriale-aritmieen-met-icd/* This randomized trial compared internal ICD-delivered cardioversion with external electrical cardioversion for atrial arrhythmias in ICD patients, testing device-based rhythm control for AF in the device-treated population. ## Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. *2019-09-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31282-6 · https://hartvaat.nl/2019/09/21/orale-antihypertensiva-bij-ernstige-hypertensie-in-de-zwangerschap-lancet-vergel/* This Lancet comparison of nifedipine retard, labetalol, and methyldopa for severe hypertension in pregnancy provided head-to-head efficacy and safety data for the three most commonly used antihypertensive agents in obstetric emergencies. ## Uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation: the ELIMINATE-AF trial. *2019-09-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz190 · https://hartvaat.nl/2019/09/21/ononderbroken-edoxaban-versus-vka-bij-af-ablatie-eliminate-af/* The ELIMINATE-AF trial demonstrated that uninterrupted edoxaban is safe and effective compared with VKA during catheter ablation for AF, extending the periprocedural DOAC evidence to include edoxaban alongside dabigatran and rivaroxaban. ## Polypill for Cardiovascular Disease Prevention in an Underserved Population. *2019-09-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1815359 · https://hartvaat.nl/2019/09/19/polypil-voor-cv-preventie-bij-onderbehandelde-populatie-nejm/* This NEJM trial demonstrated that a fixed-dose polypill containing atorvastatin, amlodipine, losartan, and hydrochlorothiazide significantly reduced cardiovascular events in an underserved, predominantly minority population without established cardiovascular disease. The results validated the polypill as a practical population-level prevention strategy. ## Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease. *2019-09-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1904143 · https://hartvaat.nl/2019/09/19/antitrombotische-therapie-bij-af-met-stabiel-coronairlijden-nejm-afire/* The AFIRE trial demonstrated that rivaroxaban monotherapy was superior to rivaroxaban plus an antiplatelet agent in patients with atrial fibrillation and stable coronary artery disease, with significantly less bleeding and no increase in ischemic events. The trial was stopped early due to increased mortality in the combination arm, establishing anticoagulant monotherapy as the standard of care. ## Impact of LDL Cholesterol on Microvascular Versus Macrovascular Disease: A Mendelian Randomization Study. *2019-09-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.037 · https://hartvaat.nl/2019/09/17/ldl-cholesterol-en-micro-versus-macrovasculaire-ziekte-mendeliaanse-randomisatie/* This Mendelian randomization study examined whether genetically determined LDL cholesterol affects microvascular disease (retinopathy, nephropathy) in addition to macrovascular atherosclerosis, exploring the breadth of LDL's causal role. ## Cardiac resynchronization therapy non-responder to responder conversion rate in the more response to cardiac resynchronization therapy with MultiPoint Pacing (MORE-CRT MPP) study: results from Phase I. *2019-09-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehz109 · https://hartvaat.nl/2019/09/14/crt-non-responder-naar-responder-conversie-more-crt-mpp/* This MORE-CRT MPP study evaluated whether multipoint pacing can convert CRT non-responders to responders, testing reprogramming to multi-electrode stimulation as a rescue strategy. ## Roxadustat Treatment for Anemia in Patients Undergoing Long-Term Dialysis. *2019-09-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1901713 · https://hartvaat.nl/2019/09/12/roxadustat-bij-anemie-bij-langdurige-dialysepatienten-nejm/* This NEJM trial confirmed that roxadustat effectively treats anemia in patients on long-term dialysis, with hemoglobin response comparable to epoetin alfa. The oral HIF inhibitor provides a more convenient dosing regimen for dialysis patients. ## Roxadustat for Anemia in Patients with Kidney Disease Not Receiving Dialysis. *2019-09-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1813599 · https://hartvaat.nl/2019/09/12/roxadustat-bij-anemie-bij-nierziekte-zonder-dialyse-nejm/* This NEJM trial demonstrated that roxadustat, an oral HIF prolyl hydroxylase inhibitor, effectively increases hemoglobin in patients with CKD-related anemia not on dialysis, offering an oral alternative to injectable erythropoietin-stimulating agents. ## Natriuretic Peptide Response and Outcomes in Chronic Heart Failure With Reduced Ejection Fraction. *2019-09-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.06.055 · https://hartvaat.nl/2019/09/03/natriuretisch-peptiderespons-en-uitkomsten-bij-chronisch-hfref/* This GUIDE-IT analysis showed that natriuretic peptide response patterns during heart failure therapy provide prognostic information even when biomarker-guided titration does not improve overall trial outcomes. ## Effects of Alirocumab on Cardiovascular Events After Coronary Bypass Surgery. *2019-09-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.07.015 · https://hartvaat.nl/2019/09/03/alirocumab-na-cabg-effecten-op-cv-events-odyssey-outcomes/* This ODYSSEY OUTCOMES subanalysis showed that alirocumab provides significant cardiovascular benefit in ACS patients with prior CABG, a high-risk population with accelerated graft atherosclerosis. ## Alirocumab in Patients With Polyvascular Disease and Recent Acute Coronary Syndrome: ODYSSEY OUTCOMES Trial. *2019-09-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.013 · https://hartvaat.nl/2019/09/03/alirocumab-bij-polyvasculaire-ziekte-na-acs-odyssey-outcomes/* This ODYSSEY OUTCOMES subanalysis showed that alirocumab provides greater absolute cardiovascular benefit in patients with polyvascular disease after ACS, supporting prioritized PCSK9 inhibitor use in the highest-risk patients with multi-territory atherosclerosis. ## N-acetyl galactosamine-conjugated antisense drug to APOC3 mRNA, triglycerides and atherogenic lipoprotein levels. *2019-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz209 · https://hartvaat.nl/2019/09/01/galnac-geconjugeerd-antisense-tegen-apoc3-triglyceriden-en-atherogene-lipoprotei/* This study of a GalNAc-conjugated antisense oligonucleotide targeting APOC3 mRNA demonstrated potent triglyceride reduction with improved hepatic targeting and lower dosing requirements, advancing the next generation of apoC-III-lowering therapies. ## Effect of Simvastatin-Ezetimibe Compared With Simvastatin Monotherapy After Acute Coronary Syndrome Among Patients 75 Years or Older: A Secondary Analysis of a Randomized Clinical Trial. *2019-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.2306 · https://hartvaat.nl/2019/09/01/simvastatine-ezetimibe-versus-simvastatine-na-acs-bij-75-plussers-jama-cardiolog/* This analysis of patients aged 75 or older from IMPROVE-IT confirmed that intensive lipid lowering with simvastatin-ezetimibe remains effective and safe in the elderly after ACS, supporting aggressive LDL management regardless of age. ## Comparison of Major Adverse Cardiac Events Between Instantaneous Wave-Free Ratio and Fractional Flow Reserve-Guided Strategy in Patients With or Without Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial. *2019-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.2298 · https://hartvaat.nl/2019/09/01/ifr-versus-ffr-bij-diabetespatienten-jama-cardiology/* This analysis compared iFR with FFR-guided revascularization specifically in diabetic patients, confirming equivalent outcomes with both physiological indices in this high-risk population where accurate lesion assessment is critical. ## Electrically vs. imaging-guided left ventricular lead placement in cardiac resynchronization therapy: a randomized controlled trial. *2019-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz184 · https://hartvaat.nl/2019/09/01/elektrisch-versus-beeldvorming-geleide-lv-leadplaatsing-bij-crt-gerandomiseerde-/* This double-blinded randomized trial compared electrically guided with imaging-guided LV lead placement for CRT, testing whether combining both optimization techniques improves resynchronization outcomes. ## Effect of remote monitoring on patient-reported outcomes in European heart failure patients with an implantable cardioverter-defibrillator: primary results of the REMOTE-CIED randomized trial. *2019-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz140 · https://hartvaat.nl/2019/09/01/remote-monitoring-en-patientgerapporteerde-uitkomsten-bij-europese-hf-patienten-/* This European REMOTE-CIED study was the first randomized trial designed to evaluate the effect of remote patient monitoring on patient-reported outcomes in heart failure patients with ICDs, addressing the patient-centered value of telemonitoring. ## Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial. *2019-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz299 · https://hartvaat.nl/2019/09/01/alirocumab-en-mi-types-odyssey-outcomes-inzichten/* This ODYSSEY OUTCOMES analysis examined the effect of alirocumab on different types of myocardial infarction (Type 1 spontaneous, Type 2 demand, Type 4 PCI-related), showing differential risk reduction across MI subtypes. ## Implantable cardioverter-defibrillators and survival in advanced heart failure patients with continuous-flow left ventricular assist devices: a systematic review and meta-analysis. *2019-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz125 · https://hartvaat.nl/2019/09/01/icd-en-overleving-bij-gevorderd-hf-met-continue-flow-lvad/* This study evaluated whether maintaining an ICD provides survival benefit in advanced heart failure patients already supported by continuous-flow LVADs, testing the incremental value of defibrillation in mechanically supported patients. ## Persistent arterial wall inflammation in patients with elevated lipoprotein(a) despite strong low-density lipoprotein cholesterol reduction by proprotein convertase subtilisin/kexin type 9 antibody treatment. *2019-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy862 · https://hartvaat.nl/2019/09/01/persisterende-arteriele-wandinflammatie-bij-verhoogd-lp-a-ondanks-lage-ldl/* This imaging study showed that arterial wall inflammation persists in patients with elevated Lp(a) despite strong LDL cholesterol lowering with statins and PCSK9 inhibitors, suggesting that Lp(a)-driven inflammation requires specific Lp(a)-lowering therapy. ## Edoxaban Versus Warfarin Stratified by Average Blood Pressure in 19 679 Patients With Atrial Fibrillation and a History of Hypertension in the ENGAGE AF-TIMI 48 Trial. *2019-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13138 · https://hartvaat.nl/2019/09/01/edoxaban-versus-warfarine-naar-gemiddelde-bloeddruk-bij-af-met-hypertensie/* This ENGAGE AF-TIMI 48 analysis stratified edoxaban versus warfarin outcomes by average blood pressure in AF patients with hypertension, informing the interplay between anticoagulation choice and blood pressure management. ## Interactive Mobile Health Intervention and Blood Pressure Management in Adults. *2019-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13273 · https://hartvaat.nl/2019/09/01/interactieve-mobiele-gezondheidsinterventie-en-bloeddrukmanagement/* This study demonstrated that an interactive mobile health intervention improves blood pressure management in adults with hypertension, supporting the use of smartphone-based tools for sustained blood pressure control. ## Oral anticoagulants in atrial fibrillation with valvular heart disease and bioprosthetic heart valves. *2019-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-314767 · https://hartvaat.nl/2019/09/01/oac-bij-af-met-kleplijden-en-bioprothese-overzicht/* This review summarized the evidence for oral anticoagulant use in AF patients with native valvular heart disease and bioprosthetic valves, guiding DOAC prescription in these common clinical scenarios. ## Clinician-targeted interventions to improve advance care planning in heart failure: a systematic review and meta-analysis. *2019-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2019-314758 · https://hartvaat.nl/2019/09/01/advance-care-planning-bij-hartfalen-systematische-review/* This systematic review and meta-analysis evaluated clinician-targeted interventions to improve advance care planning in heart failure, identifying effective strategies for overcoming clinician reluctance to initiate end-of-life discussions. ## Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis. *2019-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314381 · https://hartvaat.nl/2019/09/01/antistolling-bij-hf-met-sinusritme-systematische-review-en-meta-analyse/* This meta-analysis found that anticoagulation therapy does not significantly reduce mortality or cardiovascular events in heart failure patients in sinus rhythm, consistent with the COMMANDER HF result and arguing against routine anticoagulation without AF. ## Metformin prescription and aortic aneurysm: systematic review and meta-analysis. *2019-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314639 · https://hartvaat.nl/2019/09/01/metformine-en-aorta-aneurysma-systematische-review-en-meta-analyse/* This meta-analysis showed that metformin use is associated with reduced risk of aortic aneurysm and slower aneurysm growth, suggesting a pleiotropic vascular protective effect beyond glycemic control. ## Oral Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. *2019-08-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1901118 · https://hartvaat.nl/2019/08/29/orale-semaglutide-en-cv-uitkomsten-bij-diabetes-type-2-nejm-pioneer-6/* The PIONEER 6 trial established the cardiovascular safety of oral semaglutide in patients with type 2 diabetes at high cardiovascular risk, meeting the noninferiority threshold for MACE versus placebo. This was the first cardiovascular safety trial for an oral GLP-1 receptor agonist. ## Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups. *2019-08-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.042007 · https://hartvaat.nl/2019/08/27/canagliflozine-bij-diabetes-type-2-met-ckd-primaire-en-secundaire-preventie/* This CREDENCE subanalysis demonstrated that canagliflozin reduces cardiovascular events in both primary and secondary prevention populations with type 2 diabetes and CKD, showing consistent cardiorenal benefit across the risk spectrum. ## Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial. *2019-08-24 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31791-X · https://hartvaat.nl/2019/08/24/polypil-voor-primaire-en-secundaire-cv-preventie-lancet-polyiran/* The PolyIran trial, a pragmatic cluster-randomized study, demonstrated that a cardiovascular polypill reduced major cardiovascular events in an Iranian population when used for both primary and secondary prevention. The results validated the polypill strategy in a middle-income country setting. ## The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults. *2019-08-24 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)30955-9 · https://hartvaat.nl/2019/08/24/hypertensiezorg-in-44-lage-en-middeninkomenslanden-lancet/* This Lancet cross-sectional analysis of 44 low- and middle-income countries identified where patients are lost along the hypertension care continuum, quantifying the massive global treatment gap that accounts for the disproportionate cardiovascular burden in these settings. ## Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys. *2019-08-24 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31145-6 · https://hartvaat.nl/2019/08/24/trends-in-hypertensiedetectie-behandeling-en-controle-in-12-hoge-inkomenslanden-/* This Lancet analysis of 123 national surveys across 12 high-income countries mapped trends in hypertension awareness, treatment, and control, revealing that despite improvements, substantial gaps in blood pressure management persist even in well-resourced healthcare systems. ## Effects of Serelaxin in Patients with Acute Heart Failure. *2019-08-22 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1801291 · https://hartvaat.nl/2019/08/22/serelaxine-bij-acuut-hartfalen-nejm-relax-ahf-2/* The RELAX-AHF-2 trial showed that serelaxin (recombinant human relaxin-2) did not reduce cardiovascular death or worsening heart failure in patients with acute heart failure, failing to confirm the promising phase 2 results. The definitive negative outcome closed development of this vasodilator strategy. ## Blood Leukocyte DNA Methylation Predicts Risk of Future Myocardial Infarction and Coronary Heart Disease. *2019-08-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.039357 · https://hartvaat.nl/2019/08/20/dna-methylering-in-leukocyten-voorspelt-mi-en-coronairlijden/* This study demonstrated that DNA methylation patterns in blood leukocytes predict future myocardial infarction and coronary heart disease risk, advancing epigenetic biomarkers as novel cardiovascular risk predictors. ## Impact of Physiologic Pacing Versus Right Ventricular Pacing Among Patients With Left Ventricular Ejection Fraction Greater Than 35%: A Systematic Review for the 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. *2019-08-20 · Circulation · https://doi.org/10.1161/CIR.0000000000000629 · https://hartvaat.nl/2019/08/20/fysiologische-versus-rechterkamerpacing-bij-lvef-35/* This study compared physiological pacing (His bundle or biventricular) with conventional right ventricular pacing in patients with LVEF >35%, showing that physiological approaches prevent adverse cardiac remodeling. ## 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. *2019-08-20 · Circulation · https://doi.org/10.1161/CIR.0000000000000628 · https://hartvaat.nl/2019/08/20/2018-acc-aha-hrs-richtlijn-voor-bradycardie-en-geleidingsstoornissen/* The 2018 ACC/AHA/HRS guideline for bradycardia and cardiac conduction delay provided comprehensive updated recommendations for evaluation, pacing indications, and device selection, replacing prior guidelines with contemporary evidence on leadless pacing and physiological pacing strategies. ## Impact of long-term ticagrelor monotherapy following 1-month dual antiplatelet therapy in patients who underwent complex percutaneous coronary intervention: insights from the Global Leaders trial. *2019-08-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehz453 · https://hartvaat.nl/2019/08/14/langetermijn-ticagrelor-monotherapie-na-1-maand-dapt-bij-complexe-pci-global-lea/* This GLOBAL LEADERS subanalysis evaluated ticagrelor monotherapy after 1 month of DAPT in patients who underwent complex PCI, extending the de-escalation evidence to the highest-complexity interventional subgroup. ## Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions. *2019-08-13 · JAMA · https://doi.org/10.1001/jama.2019.10551 · https://hartvaat.nl/2019/08/13/intensieve-versus-standaard-bloeddruk-en-cerebrale-wittestoflaesies-jama-sprint-/* The SPRINT MIND MRI substudy showed that intensive blood pressure control significantly reduced the progression of cerebral white matter lesions compared with standard treatment. The imaging findings provided mechanistic support for the potential neuroprotective effects of aggressive blood pressure management. ## Off-Pump Versus On-Pump Bypass Surgery for Left Main Coronary Artery Disease. *2019-08-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.05.063 · https://hartvaat.nl/2019/08/13/off-pump-versus-on-pump-cabg-bij-hoofdstamcoronairlijden/* This comparison of off-pump versus on-pump CABG specifically for left main disease addressed concerns about completeness of revascularization and outcomes with the beating-heart approach in this complex surgical indication. ## Rivaroxaban With or Without Aspirin in Patients With Heart Failure and Chronic Coronary or Peripheral Artery Disease. *2019-08-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.039609 · https://hartvaat.nl/2019/08/13/rivaroxaban-met-of-zonder-aspirine-bij-hf-met-coronair-of-perifeer-vaatlijden/* This COMPASS heart failure subanalysis showed that rivaroxaban-based strategies benefit patients with chronic coronary or peripheral artery disease and history of heart failure, extending the dual-pathway inhibition evidence to the heart failure population. ## Volanesorsen and Triglyceride Levels in Familial Chylomicronemia Syndrome. *2019-08-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1715944 · https://hartvaat.nl/2019/08/08/volanesorsen-en-triglyceriden-bij-familiair-chylomicronemiesyndroom-nejm/* This NEJM trial demonstrated that volanesorsen, an antisense oligonucleotide targeting apoC-III, dramatically reduced triglyceride levels in patients with familial chylomicronemia syndrome. As the first targeted therapy for this rare genetic disorder, it addressed a previously unmet therapeutic need. ## Age-Related Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction. *2019-08-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.05.052 · https://hartvaat.nl/2019/08/06/leeftijdsafhankelijke-kenmerken-en-uitkomsten-bij-hfpef/* This analysis showed that age-related differences in HFpEF are substantial, with younger patients having distinct clinical profiles and potentially different treatment responses compared with elderly HFpEF patients. ## Inhibition of Angiopoietin-Like Protein 3 With a Monoclonal Antibody Reduces Triglycerides in Hypertriglyceridemia. *2019-08-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.039107 · https://hartvaat.nl/2019/08/06/angptl3-remming-met-monoklonaal-antilichaam-verlaagt-triglyceriden/* This study demonstrated that ANGPTL3 inhibition with a monoclonal antibody (evinacumab) effectively lowers triglycerides in patients with severe hypertriglyceridemia, establishing a new mechanism for treating this difficult lipid disorder. ## The effect of implantable cardioverter-defibrillator in patients with diabetes and non-ischaemic systolic heart failure. *2019-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz114 · https://hartvaat.nl/2019/08/01/icd-bij-diabetes-met-niet-ischemisch-systolisch-hf-danish-analyse/* This DANISH subanalysis examined whether diabetes modifies the ICD benefit in non-ischemic heart failure, finding that diabetic patients do not derive significantly different survival benefit from prophylactic defibrillator therapy. ## Vernakalant for cardioversion of recent-onset atrial fibrillation: a systematic review and meta-analysis. *2019-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz175 · https://hartvaat.nl/2019/08/01/vernakalant-voor-cardioversie-van-recent-onset-af-meta-analyse/* This systematic review and meta-analysis evaluated vernakalant for pharmacological cardioversion of recent-onset AF, confirming its rapid onset and superior conversion rate compared with other intravenous antiarrhythmic agents. ## Temporal Changes in Coronary Hyperemic and Resting Hemodynamic Indices in Nonculprit Vessels of Patients With ST-Segment Elevation Myocardial Infarction. *2019-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.2138 · https://hartvaat.nl/2019/08/01/temporele-veranderingen-in-coronaire-hemodynamiek-bij-niet-culprit-vaten-na-stem/* This study characterized temporal changes in coronary hemodynamic indices (FFR, iFR) in nonculprit vessels after STEMI, showing that microvascular dysfunction resolves over time and may affect the timing of staged PCI decisions. ## Safety and Efficacy of Antithrombotic Strategies in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: A Network Meta-analysis of Randomized Controlled Trials. *2019-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.1880 · https://hartvaat.nl/2019/08/01/antitrombotische-strategieen-bij-af-na-pci-jama-cardiology-veiligheids-en-werkza/* This JAMA Cardiology analysis evaluated different antithrombotic strategies in AF patients undergoing PCI, synthesizing evidence on dual versus triple therapy to optimize the bleeding-ischemia trade-off. ## Optimum lesion set and predictors of outcome in persistent atrial fibrillation ablation: a meta-regression analysis. *2019-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz108 · https://hartvaat.nl/2019/08/01/optimale-laesieset-bij-persisterend-af-ablatie-meta-regressie/* This meta-regression analysis identified the optimal ablation lesion set and predictors of outcome for persistent AF ablation, providing evidence-based guidance on whether additional substrate modification improves results beyond PVI. ## Evaluation of a simple technique aiming at optimizing point-by-point isolation of the left pulmonary veins: a randomized study. *2019-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz115 · https://hartvaat.nl/2019/08/01/eenvoudige-techniek-voor-pvi-van-linker-longvenen-gerandomiseerde-studie/* A randomised study evaluated a simplified catheter stabilisation technique for point-by-point isolation of the left pulmonary veins during AF ablation. The approach aims to improve anterior wall contact and procedural consistency. ## Heart failure from cancer therapy: can we prevent it? *2019-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12493 · https://hartvaat.nl/2019/08/01/hartfalen-door-kankerbehandeling-kunnen-we-het-voorkomen/* This review addressed strategies for preventing cancer therapy-related cardiotoxicity and heart failure, covering screening, monitoring, and cardioprotective interventions in the growing field of cardio-oncology. ## Hypertensive Disorders of Pregnancy and DNA Methylation in Newborns. *2019-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.12634 · https://hartvaat.nl/2019/08/01/hypertensieve-zwangerschapsaandoeningen-en-dna-methylering-bij-pasgeborenen/* This study examined the epigenetic effects of hypertensive disorders of pregnancy on newborn DNA methylation, identifying methylation changes in genes related to cardiovascular development and immune regulation. ## Renal Denervation in Isolated Systolic Hypertension Using Different Catheter Techniques and Technologies. *2019-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.13019 · https://hartvaat.nl/2019/08/01/renale-denervatie-bij-geisoleerde-systolische-hypertensie-vergelijking-van-kathe/* This study compared different renal denervation catheter techniques in isolated systolic hypertension, a phenotype characterized by arterial stiffness where RDN efficacy may differ from combined hypertension. ## Effects of Nilvadipine on Cerebral Blood Flow in Patients With Alzheimer Disease. *2019-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.12892 · https://hartvaat.nl/2019/08/01/nilvadipine-en-cerebrale-bloedflow-bij-alzheimer-gerandomiseerde-trial/* This randomized trial tested whether nilvadipine (a calcium channel blocker) improves cerebral blood flow in Alzheimer's disease, exploring a vascular approach to neurodegenerative disease treatment. ## Endothelin Receptor Antagonism Improves Lipid Profiles and Lowers PCSK9 (Proprotein Convertase Subtilisin/Kexin Type 9) in Patients With Chronic Kidney Disease. *2019-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.12919 · https://hartvaat.nl/2019/08/01/endothelinereceptorantagonisme-verbetert-lipidenprofielen-en-verlaagt-pcsk9-bij-/* This study showed that endothelin receptor antagonism improves lipid profiles and lowers PCSK9 levels in patients with pulmonary hypertension and CKD, revealing an unexpected lipid-modifying effect of endothelin blockade. ## Effect of ferric carboxymaltose on calculated plasma volume status and clinical congestion: a FAIR-HF substudy. *2019-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12462 · https://hartvaat.nl/2019/08/01/ijzercarboxymaltose-en-plasmavolumestatus-bij-hf-fair-hf-substudie/* This FAIR-HF substudy showed that intravenous ferric carboxymaltose improves calculated plasma volume status and reduces clinical congestion markers in chronic heart failure, suggesting volume management as a mechanism of IV iron benefit. ## Analysis from the EMPA-REG OUTCOME® trial indicates empagliflozin may assist in preventing the progression of chronic kidney disease in patients with type 2 diabetes irrespective of medications that alter intrarenal hemodynamics. *2019-08-01 · Kidney international · https://doi.org/10.1016/j.kint.2019.02.033 · https://hartvaat.nl/2019/08/01/empagliflozine-voorkomt-progressie-van-ckd-empa-reg-outcome-renale-analyse/* This EMPA-REG OUTCOME analysis confirmed that empagliflozin may help prevent the progression of chronic kidney disease in patients with type 2 diabetes and cardiovascular disease, with consistent renal benefit across baseline kidney function categories. ## High vs. low oxygen therapy in patients with acute heart failure: HiLo-HF pilot trial. *2019-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12448 · https://hartvaat.nl/2019/08/01/hoog-versus-laag-zuurstof-bij-acuut-hartfalen-hilo-hf-pilot/* This pilot trial compared high versus low supplemental oxygen in acute heart failure, evaluating whether oxygen therapy intensity affects clinical outcomes and biomarkers in the acute HF setting. ## Strain-encoded magnetic resonance: a method for the assessment of myocardial deformation. *2019-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12442 · https://hartvaat.nl/2019/08/01/strain-encoded-mri-voor-beoordeling-van-myocardiale-deformatie/* This review discusses strain-encoded magnetic resonance imaging as a method for quantifying myocardial deformation in healthy volunteers and patients with cardiovascular pathologies. The fast-SENC technique enables single-heartbeat strain acquisition. ## Transthyretin Stabilization by AG10 in Symptomatic Transthyretin Amyloid Cardiomyopathy. *2019-07-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.012 · https://hartvaat.nl/2019/07/23/ag10-transthyretinestabilisator-bij-symptomatische-attr-cardiomyopathie/* This study of AG10 (acoramidis), a potent transthyretin stabilizer, demonstrated near-complete transthyretin stabilization in patients with symptomatic ATTR cardiomyopathy, establishing a second TTR stabilizer alongside tafamidis for cardiac amyloidosis. ## Drug-coated balloon for treatment of de-novo coronary artery lesions in patients with high bleeding risk (DEBUT): a single-blind, randomised, non-inferiority trial. *2019-07-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31126-2 · https://hartvaat.nl/2019/07/20/drug-coated-balloon-bij-de-novo-coronairlaesies-met-hoog-bloedingsrisico-lancet-/* The DEBUT trial showed that drug-coated balloons are a viable alternative to bare-metal stents in patients with high bleeding risk undergoing PCI for de novo coronary lesions, offering the advantage of short DAPT duration. ## Edoxaban Versus Warfarin in Patients With Atrial Fibrillation and History of Liver Disease. *2019-07-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.04.061 · https://hartvaat.nl/2019/07/16/edoxaban-versus-warfarine-bij-af-met-leverziekte-engage-af-timi-48/* This ENGAGE AF-TIMI 48 subanalysis showed that edoxaban maintains its favorable profile compared with warfarin in AF patients with liver disease, a population traditionally excluded from anticoagulation trials. ## Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. *2019-07-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)31149-3 · https://hartvaat.nl/2019/07/13/dulaglutide-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-lancet-rewind/* The REWIND trial showed that once-weekly dulaglutide reduced the composite of cardiovascular death, nonfatal MI, and nonfatal stroke in patients with type 2 diabetes, including a substantial proportion at primary prevention level. This broadened the evidence for GLP-1 receptor agonists to a lower-risk, more representative diabetes population. ## Effect of Alirocumab on Mortality After Acute Coronary Syndromes. *2019-07-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038840 · https://hartvaat.nl/2019/07/09/alirocumab-en-mortaliteit-na-acs-odyssey-outcomes-analyse/* This ODYSSEY OUTCOMES analysis demonstrated that alirocumab reduced all-cause mortality after acute coronary syndrome, particularly in patients with baseline LDL cholesterol ≥100 mg/dL. This was the first PCSK9 inhibitor trial to show a statistically significant mortality reduction. ## His Corrective Pacing or Biventricular Pacing for Cardiac Resynchronization in Heart Failure. *2019-07-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.04.026 · https://hartvaat.nl/2019/07/09/his-correctieve-pacing-versus-biventriculaire-pacing-voor-crt-bij-hartfalen/* This comparison of His bundle pacing versus conventional biventricular pacing for cardiac resynchronization demonstrated the feasibility and potential superiority of conduction system pacing for CRT in selected heart failure patients. ## 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. *2019-07-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.01.011 · https://hartvaat.nl/2019/07/09/2019-aha-acc-hrs-gerichte-update-van-de-af-richtlijn/* The 2019 AHA/ACC/HRS focused update on atrial fibrillation management provided new recommendations for anticoagulation including DOACs as first-line therapy, expanded catheter ablation indications, and updated guidance on rhythm versus rate control strategies. ## P2Y12 Inhibitor Switching in Response to Routine Notification of CYP2C19 Clopidogrel Metabolizer Status Following Acute Coronary Syndromes. *2019-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.1510 · https://hartvaat.nl/2019/07/01/p2y12-remmerwisseling-op-basis-van-cyp2c19-status-na-acs-jama-cardiology/* This study showed that providing CYP2C19 metabolizer status to physicians led to P2Y12 inhibitor switching in a substantial proportion of patients, demonstrating the feasibility and clinical uptake of pharmacogenomic-guided antiplatelet therapy. ## Effect of the PCSK9 Inhibitor Evolocumab on Total Cardiovascular Events in Patients With Cardiovascular Disease: A Prespecified Analysis From the FOURIER Trial. *2019-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.0886 · https://hartvaat.nl/2019/07/01/evolocumab-en-totale-cv-events-bij-cardiovasculaire-ziekte-fourier-analyse/* This FOURIER analysis of total cardiovascular events showed that evolocumab reduces the cumulative burden of recurrent events, with an even greater total event reduction than suggested by the first-event analysis alone. ## Outcomes in Patients Treated With Thin-Strut, Very Thin-Strut, or Ultrathin-Strut Drug-Eluting Stents in Small Coronary Vessels: A Prespecified Analysis of the Randomized BIO-RESORT Trial. *2019-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.1776 · https://hartvaat.nl/2019/07/01/uitkomsten-van-des-in-kleine-coronairen-naar-strutdikte-jama-cardiology-meta-ana/* This meta-analysis compared outcomes of drug-eluting stents by strut thickness (thin, very thin, ultrathin) specifically in small coronary arteries, showing that thinner struts improve outcomes in this challenging lesion subset. ## Cardiovascular outcomes and achieved blood pressure in patients with and without diabetes at high cardiovascular risk. *2019-07-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehz149 · https://hartvaat.nl/2019/07/01/cv-uitkomsten-en-bereikte-bloeddruk-bij-hoog-cv-risico-met-en-zonder-diabetes/* This analysis compared cardiovascular outcomes at different achieved blood pressures in high-risk patients with and without diabetes, exploring whether the optimal blood pressure target differs by diabetic status. ## Reasons for hospitalization and risk of mortality in patients with atrial fibrillation treated with dabigatran or warfarin in the Randomized Evaluation of Long-term Anticoagulation Therapy (RE-LY) trial. *2019-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz021 · https://hartvaat.nl/2019/07/01/hospitalisatieredenen-en-mortaliteitsrisico-bij-af-met-dabigatran-versus-warfari/* This RE-LY analysis characterized hospitalization patterns and their association with mortality in AF patients on dabigatran versus warfarin, showing that both cardiovascular and non-cardiovascular admissions predict poor outcomes. ## QT as a predictor of recurrence after atrial fibrillation ablation and the impact of amiodarone: results from the placebo-controlled AMIO-CAT trial. *2019-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz028 · https://hartvaat.nl/2019/07/01/qt-als-voorspeller-van-af-recidief-na-ablatie-en-amiodaronimpact-amio-cat/* This AMIO-CAT analysis evaluated QT interval as a predictor of AF recurrence after ablation and the impact of short-term amiodarone therapy, testing whether ECG markers can identify patients at risk for post-ablation arrhythmia. ## Sodium Reduction, Metabolomic Profiling, and Cardiovascular Disease Risk in Untreated Black Hypertensives. *2019-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.12880 · https://hartvaat.nl/2019/07/01/natriumreductie-metaboloom-en-cv-risico-bij-onbehandelde-zwarte-hypertensie/* This study examined how dietary sodium reduction affects the metabolomic profile and cardiovascular risk in untreated Black hypertensive individuals, exploring metabolic pathways that mediate the cardiovascular benefit of sodium restriction. ## Cost-effectiveness of lipid lowering with statins and ezetimibe in chronic kidney disease. *2019-07-01 · Kidney international · https://doi.org/10.1016/j.kint.2019.01.028 · https://hartvaat.nl/2019/07/01/kosteneffectiviteit-van-statines-en-ezetimibe-bij-chronische-nierziekte/* This cost-effectiveness analysis evaluated lipid-lowering with statins and ezetimibe in CKD, comparing different treatment intensities to determine the economically optimal lipid management strategy in kidney disease. ## Implications of the local haemodynamic forces on the phenotype of coronary plaques. *2019-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314086 · https://hartvaat.nl/2019/07/01/lokale-hemodynamische-krachten-en-fenotype-van-coronaire-plaques/* This study examined how endothelial shear stress influences dynamic changes in coronary plaque phenotype, linking local hemodynamic forces to the progression or stabilization of vulnerable atherosclerotic lesions. ## Effect of P2Y12 Inhibitor Monotherapy vs Dual Antiplatelet Therapy on Cardiovascular Events in Patients Undergoing Percutaneous Coronary Intervention: The SMART-CHOICE Randomized Clinical Trial. *2019-06-25 · JAMA · https://doi.org/10.1001/jama.2019.8146 · https://hartvaat.nl/2019/06/25/p2y12-remmer-monotherapie-versus-dapt-na-pci-jama-smart-choice/* The SMART-CHOICE trial showed that P2Y12 inhibitor monotherapy after 3 months of DAPT was noninferior to continued 12-month DAPT for cardiovascular events after PCI, supporting the de-escalation to single antiplatelet therapy approach. ## Effect of 1-Month Dual Antiplatelet Therapy Followed by Clopidogrel vs 12-Month Dual Antiplatelet Therapy on Cardiovascular and Bleeding Events in Patients Receiving PCI: The STOPDAPT-2 Randomized Clinical Trial. *2019-06-25 · JAMA · https://doi.org/10.1001/jama.2019.8145 · https://hartvaat.nl/2019/06/25/1-maand-dapt-gevolgd-door-clopidogrel-versus-12-maanden-dapt-jama-stopdapt-2/* The STOPDAPT-2 trial demonstrated that 1 month of DAPT followed by clopidogrel monotherapy was noninferior and even superior to 12-month standard DAPT for net clinical benefit after PCI. The results supported ultra-short DAPT as a viable strategy with contemporary drug-eluting stents. ## Systematic Review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2019-06-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.004 · https://hartvaat.nl/2019/06/25/systematische-review-voor-de-2018-aha-acc-cholesterolrichtlijn-jacc/* JACC publication of the systematic review underlying the 2018 AHA/ACC cholesterol guideline, evaluating the evidence for nonstatin lipid-lowering therapies and their effects on cardiovascular outcomes. ## 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2019-06-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.003 · https://hartvaat.nl/2019/06/25/2018-aha-acc-cholesterolrichtlijn-jacc-volledig-rapport/* JACC publication of the full 2018 AHA/ACC blood cholesterol guideline, providing comprehensive recommendations on risk assessment, statin therapy intensity, and nonstatin therapies including ezetimibe and PCSK9 inhibitors for cardiovascular risk reduction. ## 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2019-06-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.002 · https://hartvaat.nl/2019/06/25/2018-aha-acc-cholesterolrichtlijn-jacc-executive-summary/* JACC publication of the 2018 AHA/ACC cholesterol guideline executive summary, providing key recommendations including risk enhancers, coronary calcium scoring, and LDL thresholds for PCSK9 inhibitor therapy in a concise format for clinical practice. ## Drug-eluting or bare-metal stents for percutaneous coronary intervention: a systematic review and individual patient data meta-analysis of randomised clinical trials. *2019-06-22 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)30474-X · https://hartvaat.nl/2019/06/22/des-versus-bms-lancet-ipd-systematische-review-en-meta-analyse/* This Lancet individual patient data meta-analysis provided definitive evidence that new-generation drug-eluting stents are superior to bare-metal stents across all patient subgroups, with reduced target lesion revascularization and no increase in stent thrombosis or mortality. The findings support universal DES use. ## Platelet reactivity and clinical outcomes in acute coronary syndrome patients treated with prasugrel and clopidogrel: a pre-specified exploratory analysis from the TROPICAL-ACS trial. *2019-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz202 · https://hartvaat.nl/2019/06/21/plaatjesreactiviteit-en-uitkomsten-bij-acs-met-prasugrel-versus-clopidogrel/* This study evaluated platelet function testing in ACS patients treated with prasugrel versus clopidogrel, showing that while PFT predicts ischemic and bleeding events, its clinical utility for guiding P2Y12 inhibitor selection remains uncertain. ## Impact of large periprocedural myocardial infarction on mortality after percutaneous coronary intervention and coronary artery bypass grafting for left main disease: an analysis from the EXCEL trial. *2019-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz113 · https://hartvaat.nl/2019/06/21/impact-van-groot-periprocedureel-mi-op-mortaliteit-na-pci-en-cabg/* This study quantified the prognostic impact of large periprocedural MI after PCI versus CABG, showing that procedural MI severity differentially affects mortality depending on the revascularization strategy. ## Five-year clinical outcomes and intracoronary imaging findings of the COMFORTABLE AMI trial: randomized comparison of biodegradable polymer-based biolimus-eluting stents with bare-metal stents in patients with acute ST-segment elevation myocardial infarction. *2019-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehz074 · https://hartvaat.nl/2019/06/21/comfortable-ami-5-jaarsuitkomsten-biolimus-versus-bare-metal-stent/* The 5-year COMFORTABLE AMI results with intracoronary imaging showed durable benefit of biodegradable biolimus-eluting stents over bare-metal stents in STEMI, confirming long-term safety of this DES platform in acute MI. ## Comparison of Dual Therapies for Lowering Blood Pressure in Black Africans. *2019-06-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1901113 · https://hartvaat.nl/2019/06/20/vergelijking-van-duale-therapieen-voor-bloeddrukverlaging-bij-afrikaanse-afrikan/* This NEJM trial compared two dual antihypertensive combinations (amlodipine-hydrochlorothiazide versus perindopril-hydrochlorothiazide) in black African patients with hypertension, providing evidence to guide initial combination therapy in this underrepresented population with high hypertension prevalence. ## Efficacy and Safety of Evolocumab in Chronic Kidney Disease in the FOURIER Trial. *2019-06-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.513 · https://hartvaat.nl/2019/06/18/evolocumab-bij-ckd-werkzaamheid-en-veiligheid-in-de-fourier-trial/* This FOURIER subanalysis confirmed that evolocumab is effective and safe in patients with chronic kidney disease, with consistent LDL cholesterol lowering and cardiovascular event reduction across CKD severity stages. ## Systematic Review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2019-06-18 · Circulation · https://doi.org/10.1161/CIR.0000000000000626 · https://hartvaat.nl/2019/06/18/systematische-review-voor-de-2018-aha-acc-cholesterolrichtlijn/* This systematic review provided the evidence foundation for the 2018 AHA/ACC cholesterol guideline, evaluating nonstatin therapies including ezetimibe, PCSK9 inhibitors, and bile acid sequestrants for their effects on cardiovascular outcomes beyond statin monotherapy. ## 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2019-06-18 · Circulation · https://doi.org/10.1161/CIR.0000000000000625 · https://hartvaat.nl/2019/06/18/2018-aha-acc-cholesterolrichtlijn-volledig-rapport/* The full 2018 AHA/ACC Guideline on blood cholesterol management redefined the approach to lipid-lowering therapy by integrating risk enhancers, lifetime risk assessment, and coronary artery calcium scoring into treatment decisions. It endorsed PCSK9 inhibitors for secondary prevention when LDL cholesterol remains above threshold despite maximally tolerated statin therapy. ## 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2019-06-18 · Circulation · https://doi.org/10.1161/CIR.0000000000000624 · https://hartvaat.nl/2019/06/18/2018-aha-acc-cholesterolrichtlijn-executive-summary/* The 2018 AHA/ACC cholesterol guideline executive summary introduced risk enhancers, coronary artery calcium scoring for shared decision-making, and LDL-cholesterol thresholds for escalating therapy to PCSK9 inhibitors. The guideline shifted the paradigm from fixed-dose statin therapy toward personalized, risk-based LDL management. ## Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. *2019-06-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1811744 · https://hartvaat.nl/2019/06/13/canagliflozine-en-renale-uitkomsten-bij-diabetes-type-2-met-nefropathie-nejm-cre/* The CREDENCE trial demonstrated that canagliflozin significantly reduced the risk of kidney failure, cardiovascular events, and death in patients with type 2 diabetes and chronic kidney disease. As the first dedicated renal outcomes trial for an SGLT2 inhibitor, it established this drug class as a cornerstone of diabetic nephropathy treatment. ## Exercise Benefits in Pulmonary Hypertension. *2019-06-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.489 · https://hartvaat.nl/2019/06/11/inspanningsvoordelen-bij-pulmonale-hypertensie-jacc-review/* This JACC review summarized the evidence for exercise training in pulmonary hypertension, providing evidence-based guidance on exercise prescription for this population where physical activity was historically discouraged. ## Ticagrelor Versus Clopidogrel in Patients With STEMI Treated With Fibrinolysis: TREAT Trial. *2019-06-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.011 · https://hartvaat.nl/2019/06/11/ticagrelor-versus-clopidogrel-bij-stemi-na-fibrinolyse-treat-trial/* The TREAT trial showed no superiority of ticagrelor over clopidogrel in STEMI patients treated with fibrinolytic therapy, confirming clopidogrel as the appropriate P2Y12 inhibitor in the post-fibrinolysis setting. ## Effects of Icosapent Ethyl on Total Ischemic Events: From REDUCE-IT. *2019-06-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.02.032 · https://hartvaat.nl/2019/06/11/icosapent-ethyl-en-totale-ischemische-events-reduce-it-analyse/* This REDUCE-IT analysis of total ischemic events (not just first events) showed that icosapent ethyl reduced recurrent cardiovascular events by 30%, with a substantial absolute risk reduction. The total event analysis demonstrated even greater benefit than the primary first-event endpoint. ## Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention. *2019-06-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.006 · https://hartvaat.nl/2019/06/11/sonotrombolyse-bij-stemi-behandeld-met-primaire-pci/* This study evaluated sonothrombolysis (high-intensity ultrasound with intravenous microbubbles) as an adjunctive therapy during primary PCI for STEMI, testing whether acoustic cavitation enhances microvascular reperfusion. ## Febuxostat for Cerebral and CaRdiorenovascular Events PrEvEntion StuDy. *2019-06-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehz119 · https://hartvaat.nl/2019/06/07/febuxostat-voor-cerebraal-en-cardiorenovasculaire-eventpreventie-freed/* The FREED study compared febuxostat with conventional treatment for hyperuricemia on cerebrovascular, cardiovascular, and renal events, testing the hypothesis that uric acid lowering provides vascular protection. ## Effect of Neladenoson Bialanate on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. *2019-06-04 · JAMA · https://doi.org/10.1001/jama.2019.6717 · https://hartvaat.nl/2019/06/04/neladenoson-bialanaat-en-inspanningscapaciteit-bij-hfpef-jama-panache/* The PANACHE trial showed that neladenoson bialanate, an adenosine A1 receptor partial agonist, did not improve exercise capacity in HFpEF, adding to the growing list of failed pharmacological interventions for this heart failure phenotype. ## Influence of Microvascular Disease on Cardiovascular Events in Type 2 Diabetes. *2019-06-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.002 · https://hartvaat.nl/2019/06/04/microvasculaire-ziekte-en-cv-events-bij-diabetes-type-2/* This study demonstrated that microvascular disease (retinopathy, nephropathy) independently predicts cardiovascular events in type 2 diabetes, supporting microvascular assessment as part of comprehensive cardiovascular risk evaluation. ## Prophylactic Use of Implantable Cardioverter-Defibrillators in the Prevention of Sudden Cardiac Death in Dialysis Patients. *2019-06-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.039818 · https://hartvaat.nl/2019/06/04/profylactische-icd-bij-dialysepatienten-ter-preventie-van-plotse-hartdood/* This study evaluated prophylactic ICD implantation in dialysis patients at high risk for sudden cardiac death, testing whether defibrillator therapy improves survival in the end-stage kidney disease population. ## Association of Rivaroxaban With Thromboembolic Events in Patients With Heart Failure, Coronary Disease, and Sinus Rhythm: A Post Hoc Analysis of the COMMANDER HF Trial. *2019-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.1049 · https://hartvaat.nl/2019/06/01/rivaroxaban-en-trombo-embolische-events-bij-hf-met-coronairlijden-en-sinusritme-/* This COMMANDER HF post-hoc analysis examined specific thromboembolic events with rivaroxaban in heart failure patients with coronary disease and sinus rhythm, exploring whether certain vascular event subtypes respond to anticoagulation. ## Heparin dosing in uninterrupted anticoagulation with dabigatran vs. warfarin in atrial fibrillation ablation: RE-CIRCUIT study. *2019-06-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz057 · https://hartvaat.nl/2019/06/01/heparinedosering-bij-ononderbroken-dabigatran-versus-warfarine-bij-af-ablatie-re/* This RE-CIRCUIT analysis characterized heparin dosing requirements during AF ablation with uninterrupted dabigatran versus warfarin, showing that higher heparin doses are needed with dabigatran to achieve target ACT levels. ## Pre- and post-treatment with amiodarone for elective electrical cardioversion of atrial fibrillation: a systematic review and meta-analysis. *2019-06-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy310 · https://hartvaat.nl/2019/06/01/amiodaron-voor-en-na-electrische-cardioversie-van-af-meta-analyse/* This meta-analysis evaluated pre- and post-treatment with amiodarone for electrical cardioversion of AF, showing that antiarrhythmic preloading improves cardioversion success rates and prevents early AF recurrence. ## The impact of implantable cardioverter-defibrillator implantation on health-related quality of life in the DANISH trial. *2019-06-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euz018 · https://hartvaat.nl/2019/06/01/icd-implantatie-en-gezondheidsgerelateerde-kwaliteit-van-leven-danish/* This DANISH trial analysis showed that ICD implantation does not significantly impact health-related quality of life in non-ischemic heart failure patients, adding patient-centered data to the neutral mortality finding. ## Cost-Effectiveness of Telemonitoring and Self-Monitoring of Blood Pressure for Antihypertensive Titration in Primary Care (TASMINH4). *2019-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12415 · https://hartvaat.nl/2019/06/01/kosteneffectiviteit-van-telemonitoring-en-zelfmeting-van-bloeddruk-tasminh4/* This TASMINH4 cost-effectiveness analysis showed that blood pressure telemonitoring and self-monitoring for antihypertensive titration are cost-effective compared with usual care, supporting the economic case for remote blood pressure management. ## Mortality Outcomes With Intensive Blood Pressure Targets in Chronic Kidney Disease Patients. *2019-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.119.12697 · https://hartvaat.nl/2019/06/01/mortaliteitsuitkomsten-bij-intensieve-bloeddrukstreefwaarden-bij-ckd/* This analysis of intensive blood pressure targets in chronic kidney disease patients showed improved mortality outcomes with lower targets, supporting aggressive blood pressure management in CKD despite concerns about renal hemodynamic effects. ## Effects of Blood Pressure Lowering on Clinical Outcomes According to Baseline Blood Pressure and Cardiovascular Risk in Patients With Type 2 Diabetes Mellitus. *2019-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12414 · https://hartvaat.nl/2019/06/01/bloeddrukverlaging-naar-uitgangsdruk-en-cv-risico-bij-diabetes-type-2/* This analysis evaluated blood pressure lowering effects stratified by baseline blood pressure and cardiovascular risk in type 2 diabetes, informing the debate about optimal blood pressure targets in the diabetic population. ## The effect of dry-weight reduction guided by lung ultrasound on ambulatory blood pressure in hemodialysis patients: a randomized controlled trial. *2019-06-01 · Kidney international · https://doi.org/10.1016/j.kint.2019.02.018 · https://hartvaat.nl/2019/06/01/longechogeleide-drooggewichtreductie-en-ambulante-bloeddruk-bij-hemodialyse/* This randomized trial of lung ultrasound-guided dry weight reduction in hemodialysis patients showed improved ambulatory blood pressure, demonstrating that point-of-care imaging can optimize fluid management and blood pressure control in dialysis. ## A systematic review of clinical prediction rules for the diagnosis of chronic heart failure. *2019-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12426 · https://hartvaat.nl/2019/06/01/klinische-predictieregels-voor-diagnostiek-van-chronisch-hartfalen-systematische/* This systematic review evaluated clinical prediction rules for diagnosing chronic heart failure in community settings, assessing which tools can help primary care clinicians identify heart failure without specialist referral. ## Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality. *2019-06-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314036 · https://hartvaat.nl/2019/06/01/zoutsubstituten-met-laag-natrium-en-bloeddruk-cva-en-mortaliteit-meta-analyse/* This meta-analysis confirmed that low-sodium salt substitutes significantly lower blood pressure and may reduce stroke and mortality at the population level, supporting this simple dietary intervention as a scalable public health strategy. ## Effects of Canagliflozin on Heart Failure Outcomes Associated With Preserved and Reduced Ejection Fraction in Type 2 Diabetes Mellitus. *2019-05-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.040057 · https://hartvaat.nl/2019/05/28/canagliflozine-en-hf-uitkomsten-bij-behouden-versus-verminderde-ef-canvas/* This CANVAS analysis of heart failure outcomes stratified by ejection fraction showed that canagliflozin reduces heart failure events regardless of baseline LVEF, foreshadowing the later dedicated HFpEF trials with SGLT2 inhibitors. ## Dapagliflozin and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus and Previous Myocardial Infarction. *2019-05-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.039996 · https://hartvaat.nl/2019/05/28/dapagliflozine-en-cv-uitkomsten-bij-diabetes-type-2-met-eerder-mi/* This DECLARE-TIMI 58 subanalysis showed that dapagliflozin significantly reduced MACE specifically in patients with type 2 diabetes and prior myocardial infarction, while the broader trial population showed only heart failure benefit. The finding identified the highest-risk subgroup most likely to benefit from SGLT2 inhibition. ## Effect of Dapagliflozin on Heart Failure and Mortality in Type 2 Diabetes Mellitus. *2019-05-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.119.040130 · https://hartvaat.nl/2019/05/28/dapagliflozine-en-hartfalen-en-mortaliteit-bij-diabetes-type-2-declare-timi-58-h/* This DECLARE-TIMI 58 heart failure analysis confirmed that dapagliflozin significantly reduces heart failure hospitalization and cardiovascular death in patients with type 2 diabetes, with the greatest benefit in those with prior heart failure. The results strengthened the heart failure prevention role of SGLT2 inhibitors. ## Premature Ticagrelor Discontinuation in Secondary Prevention of Atherosclerotic CVD: JACC Review Topic of the Week. *2019-05-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.03.470 · https://hartvaat.nl/2019/05/21/vroegtijdig-staken-van-ticagrelor-bij-secundaire-cv-preventie-jacc-review/* This JACC review addressed the clinical consequences and management of premature ticagrelor discontinuation in secondary cardiovascular prevention, a common practical challenge affecting antiplatelet treatment effectiveness. ## Pacemaker Implantation After Mitral Valve Surgery With Atrial Fibrillation Ablation. *2019-05-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.02.062 · https://hartvaat.nl/2019/05/21/pacemakerimplantatie-na-mitralisklepchirurgie-met-af-ablatie/* This study documented the incidence of permanent pacemaker implantation after mitral valve surgery combined with AF ablation, showing that concomitant rhythm surgery increases the need for permanent pacing. ## Effect of Initial Management With Aflibercept vs Laser Photocoagulation vs Observation on Vision Loss Among Patients With Diabetic Macular Edema Involving the Center of the Macula and Good Visual Acuity: A Randomized Clinical Trial. *2019-05-21 · JAMA · https://doi.org/10.1001/jama.2019.5790 · https://hartvaat.nl/2019/05/21/aflibercept-versus-fotocoagulatie-versus-observatie-bij-diabetisch-maculaoedeem-/* The DRCR.net Protocol V trial compared initial management strategies for center-involving diabetic macular edema, finding that observation is a reasonable initial approach for eyes with good visual acuity, relevant to ophthalmological management in diabetic patients. ## Effect of Iron Isomaltoside on Skeletal Muscle Energetics in Patients With Chronic Heart Failure and Iron Deficiency. *2019-05-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038516 · https://hartvaat.nl/2019/05/21/ijzerisomaltosides-en-skeletspierdenergie-bij-chronisch-hf-met-ijzerdeficientie/* This mechanistic study showed that intravenous iron repletion improves skeletal muscle energetics in chronic heart failure patients with iron deficiency, providing a physiological explanation for the exercise capacity improvement seen with IV iron therapy. ## Extracorporeal Life Support in Cardiogenic Shock Complicating Acute Myocardial Infarction. *2019-05-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.02.044 · https://hartvaat.nl/2019/05/14/ecls-bij-cardiogene-shock-na-acuut-mi/* This study examined extracorporeal life support (VA-ECMO) in cardiogenic shock complicating acute MI, characterizing outcomes and identifying predictors of survival with this rescue therapy. ## Rivaroxaban Plus Aspirin in Patients With Vascular Disease and Renal Dysfunction: From the COMPASS Trial. *2019-05-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.02.048 · https://hartvaat.nl/2019/05/14/rivaroxaban-plus-aspirine-bij-vaatlijden-met-nierdisfunctie-compass/* This COMPASS subanalysis showed that low-dose rivaroxaban plus aspirin maintains favorable efficacy and safety in patients with vascular disease and renal dysfunction, supporting dual-pathway inhibition in the CKD population. ## Dabigatran dual therapy with ticagrelor or clopidogrel after percutaneous coronary intervention in atrial fibrillation patients with or without acute coronary syndrome: a subgroup analysis from the RE-DUAL PCI trial. *2019-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehz059 · https://hartvaat.nl/2019/05/14/dabigatran-duale-therapie-met-ticagrelor-of-clopidogrel-na-pci-bij-af-re-dual-pc/* This RE-DUAL PCI subanalysis compared outcomes of dabigatran dual therapy with ticagrelor versus clopidogrel as the P2Y12 inhibitor in AF patients after PCI, informing antiplatelet selection within the dual antithrombotic framework. ## Relationship between body mass index and outcomes in patients with atrial fibrillation treated with edoxaban or warfarin in the ENGAGE AF-TIMI 48 trial. *2019-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy861 · https://hartvaat.nl/2019/05/14/bmi-en-uitkomsten-bij-af-behandeld-met-edoxaban-of-warfarine-engage-af-timi-48/* This ENGAGE AF-TIMI 48 analysis showed that the relationship between BMI and outcomes in AF is complex, with both underweight and morbid obesity associated with worse prognosis, regardless of edoxaban versus warfarin treatment. ## When is it appropriate to stop non-vitamin K antagonist oral anticoagulants before catheter ablation of atrial fibrillation? A multicentre prospective randomized study. *2019-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy870 · https://hartvaat.nl/2019/05/14/wanneer-doac-stoppen-voor-af-ablatie-multicenter-analyse/* This multicenter study determined the optimal timing for stopping DOACs before catheter ablation for AF, providing practical guidance on the periprocedural DOAC management that minimizes both thrombotic and bleeding risk. ## Efficacy and safety of reduced-dose non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: a meta-analysis of randomized controlled trials. *2019-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy802 · https://hartvaat.nl/2019/05/14/verlaagde-dosis-doac-bij-af-werkzaamheid-en-veiligheid-meta-analyse/* This meta-analysis evaluated the efficacy and safety of reduced-dose DOACs in AF patients, finding that appropriate dose reduction maintains effectiveness while reducing bleeding, but off-label underdosing may compromise stroke prevention. ## Clinical outcomes, edoxaban concentration, and anti-factor Xa activity of Asian patients with atrial fibrillation compared with non-Asians in the ENGAGE AF-TIMI 48 trial. *2019-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy807 · https://hartvaat.nl/2019/05/14/edoxaban-bij-aziatische-af-patienten-concentraties-en-anti-xa-activiteit/* This ENGAGE AF-TIMI 48 analysis in Asian AF patients characterized edoxaban pharmacokinetics and anti-factor Xa activity, informing dosing considerations for the Asian population with potentially different drug metabolism. ## Association of Gestational Weight Gain With Adverse Maternal and Infant Outcomes. *2019-05-07 · JAMA · https://doi.org/10.1001/jama.2019.3820 · https://hartvaat.nl/2019/05/07/zwangerschapsgewichtstoename-en-maternale-en-neonatale-uitkomsten-jama-meta-anal/* This JAMA meta-analysis characterized the association between gestational weight gain and adverse maternal and infant outcomes, informing the optimal weight gain recommendations during pregnancy for cardiovascular risk reduction. ## Clinical Outcomes in Patients With Acute Decompensated Heart Failure Randomly Assigned to Sacubitril/Valsartan or Enalapril in the PIONEER-HF Trial. *2019-05-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.039331 · https://hartvaat.nl/2019/05/07/sacubitril-valsartan-of-enalapril-bij-acuut-gedecompenseerd-hf-pioneer-hf-klinis/* This PIONEER-HF clinical outcomes analysis confirmed that sacubitril-valsartan initiated during heart failure hospitalization is safe with consistent benefits on heart failure events, supporting the in-hospital ARNI initiation strategy. ## Health Status After Transcatheter Mitral-Valve Repair in Heart Failure and Secondary Mitral Regurgitation: COAPT Trial. *2019-05-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.02.010 · https://hartvaat.nl/2019/05/07/gezondheidsstatus-na-mitraclip-bij-hf-met-secundaire-mr-coapt/* This COAPT analysis showed that transcatheter mitral valve repair significantly improves patient-reported health status and quality of life in patients with heart failure and secondary mitral regurgitation, complementing the hard clinical endpoints. ## Placental growth factor testing to assess women with suspected pre-eclampsia: a multicentre, pragmatic, stepped-wedge cluster-randomised controlled trial. *2019-05-04 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)33212-4 · https://hartvaat.nl/2019/05/04/plgf-voor-beoordeling-van-pre-eclampsie-lancet-parrot-stepped-wedge-trial/* The PARROT trial showed that placental growth factor-based testing for suspected preeclampsia reduces the time to diagnosis and improves clinical outcomes, supporting biomarker-guided management of hypertensive disorders of pregnancy. ## Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients. *2019-05-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1814052 · https://hartvaat.nl/2019/05/02/tavr-met-ballonexpandeerbare-klep-bij-laagrisicopatienten-nejm-partner-3/* The PARTNER 3 trial showed that TAVR with a balloon-expandable valve was superior to surgery for the composite of death, stroke, or rehospitalization at 1 year in patients with severe aortic stenosis at low surgical risk. This landmark result, alongside Evolut Low Risk, established TAVR as a viable alternative to surgery in virtually all aortic stenosis patients. ## Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. *2019-05-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1816885 · https://hartvaat.nl/2019/05/02/tavr-met-zelfexpanderende-klep-bij-laagrisicopatienten-nejm-evolut-low-risk/* The Evolut Low Risk trial demonstrated that self-expanding TAVR was noninferior to surgical aortic-valve replacement in low-surgical-risk patients with severe aortic stenosis for the composite of death or disabling stroke at 24 months. Together with PARTNER 3, this trial extended TAVR as a treatment option across the full spectrum of surgical risk. ## Effect of a Quality of Care Improvement Initiative in Patients With Acute Coronary Syndrome in Resource-Constrained Hospitals in China: A Randomized Clinical Trial. *2019-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.0897 · https://hartvaat.nl/2019/05/01/kwaliteitsverbetering-bij-acs-in-resource-beperkte-ziekenhuizen-jama-cardiology-/* This JAMA Cardiology trial evaluated a quality of care improvement initiative for ACS management in resource-constrained hospitals in China, testing whether structured quality programs can improve outcomes in less-resourced settings. ## Effect of a Multifaceted Quality Improvement Intervention on the Prescription of Evidence-Based Treatment in Patients at High Cardiovascular Risk in Brazil: The BRIDGE Cardiovascular Prevention Cluster Randomized Clinical Trial. *2019-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.0649 · https://hartvaat.nl/2019/05/01/kwaliteitsverbetering-en-evidence-based-prescriptie-bij-hoog-cv-risico-jama-card/* This JAMA Cardiology trial tested whether a multifaceted quality improvement intervention increases evidence-based treatment prescribing in high-risk cardiovascular patients in community practice. ## Thoracoscopic vs. catheter ablation for atrial fibrillation: long-term follow-up of the FAST randomized trial. *2019-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy325 · https://hartvaat.nl/2019/05/01/thoracoscopische-versus-katheterablatie-bij-af-langetermijn-fast-trial/* Long-term FAST trial follow-up comparing thoracoscopic with catheter ablation for atrial fibrillation showed sustained superior freedom from AF with the surgical approach, but at the cost of more procedural complications and longer recovery. ## Frequent premature atrial contractions are associated with atrial fibrillation, brain ischaemia, and mortality: a systematic review and meta-analysis. *2019-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy276 · https://hartvaat.nl/2019/05/01/frequente-premature-atriale-contracties-en-af-hersenischemie-en-mortaliteit-meta/* This meta-analysis showed that frequent premature atrial contractions are associated with increased risk of AF, brain ischemia, and mortality, establishing PAC burden as a clinically meaningful risk marker beyond isolated benign ectopy. ## Effect of a Walnut Diet on Office and 24-Hour Ambulatory Blood Pressure in Elderly Individuals. *2019-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12766 · https://hartvaat.nl/2019/05/01/walnotendieet-en-24-uurs-ambulante-bloeddruk-bij-ouderen/* This study showed that daily walnut consumption modestly reduces 24-hour ambulatory blood pressure in elderly individuals, supporting nut intake as a dietary component of cardiovascular prevention. ## Inflammation markers and risk of developing hypertension: a meta-analysis of cohort studies. *2019-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314216 · https://hartvaat.nl/2019/05/01/inflammatiemarkers-en-risico-op-hypertensie-meta-analyse-van-cohortstudies/* This meta-analysis of cohort studies showed that elevated inflammatory markers (CRP, IL-6, TNF-α) are independently associated with the future development of hypertension, establishing inflammation as a potential modifiable pathway in blood pressure elevation. ## Lifestyle, Glycosylated Hemoglobin A1c, and Survival Among Patients With Stable Ischemic Heart Disease and Diabetes. *2019-04-30 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.067 · https://hartvaat.nl/2019/04/30/leefstijl-hba1c-en-overleving-bij-stabiel-coronairlijden-met-diabetes/* This study examined the interaction between lifestyle factors, HbA1c control, and survival in patients with stable coronary disease and diabetes, showing that comprehensive risk factor management provides additive benefit. ## Cardiovascular Effects of Treatment With the Ketone Body 3-Hydroxybutyrate in Chronic Heart Failure Patients. *2019-04-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.036459 · https://hartvaat.nl/2019/04/30/ketonlichaam-3-hydroxybutyraat-bij-chronisch-hartfalen-cardiovasculaire-effecten/* This study demonstrated that infusion of the ketone body 3-hydroxybutyrate improves cardiac output and left ventricular ejection fraction in patients with chronic heart failure, supporting the metabolic hypothesis that ketone utilization is a beneficial cardiac adaptation. ## Antihyperglycemic and Blood Pressure Effects of Empagliflozin in Black Patients With Type 2 Diabetes Mellitus and Hypertension. *2019-04-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.036568 · https://hartvaat.nl/2019/04/30/empagliflozine-antihyperglycemische-en-bloeddrukeffecten-bij-zwarte-diabetespati/* This analysis of empagliflozin effects specifically in Black patients with type 2 diabetes and hypertension showed comparable blood pressure and glycemic benefits to the overall population, addressing racial representation in SGLT2 inhibitor evidence. ## A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report. *2019-04-25 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1900486 · https://hartvaat.nl/2019/04/25/heartmate-3-lvad-definitief-rapport-nejm-momentum-3-final/* The final MOMENTUM 3 report confirmed the long-term superiority of the HeartMate 3 fully magnetically levitated LVAD over the HeartMate II, with sustained reductions in pump thrombosis, stroke, and reoperations. The data cemented HeartMate 3 as the definitive standard in mechanical circulatory support. ## Contemporary Outcomes Following Coronary Artery Bypass Graft Surgery for Left Main Disease. *2019-04-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.12.090 · https://hartvaat.nl/2019/04/23/hedendaagse-uitkomsten-na-cabg-voor-hoofdstamlijden/* This analysis of contemporary CABG outcomes for left main disease showed that surgical results continue to improve over time, informing the benchmark against which percutaneous intervention is compared. ## Implantable Cardiac Alert System for Early Recognition of ST-Segment Elevation Myocardial Infarction. *2019-04-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.01.014 · https://hartvaat.nl/2019/04/23/implanteerbaar-cardiaal-alertsysteem-voor-vroege-herkenning-van-stemi/* This study evaluated an implantable cardiac alert system for early STEMI recognition, testing whether continuous ECG monitoring with automated alerts can reduce the time to treatment in acute coronary syndromes. ## Comparison of the Effects of Glucagon-Like Peptide Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors for Prevention of Major Adverse Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus. *2019-04-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038868 · https://hartvaat.nl/2019/04/23/glp-1-agonisten-versus-sglt2-remmers-voor-cv-en-renale-preventie-vergelijkende-m/* This comparative meta-analysis showed that GLP-1 receptor agonists predominantly reduce atherosclerotic events (MI, stroke) while SGLT2 inhibitors primarily reduce heart failure hospitalization and renal outcomes. The distinct benefit profiles support tailored drug selection based on individual patient comorbidities. ## Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation. *2019-04-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1817083 · https://hartvaat.nl/2019/04/18/antitrombotische-therapie-na-acs-of-pci-bij-af-nejm-augustus/* The AUGUSTUS trial, using a 2×2 factorial design, demonstrated that apixaban was superior to warfarin (less bleeding) and aspirin offered no ischemic benefit over placebo in patients with atrial fibrillation after ACS or PCI. This trial definitively established dual therapy with a DOAC plus a P2Y12 inhibitor as the preferred antithrombotic strategy. ## Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation. *2019-04-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1900353 · https://hartvaat.nl/2019/04/18/vroege-of-uitgestelde-cardioversie-bij-recent-onset-af-nejm-race-7-acwas/* The RACE 7 ACWAS trial showed that a wait-and-see approach was noninferior to immediate cardioversion for achieving sinus rhythm at 4 weeks in patients with recent-onset symptomatic atrial fibrillation. The results support expectant management as a viable initial strategy in hemodynamically stable patients. ## Association of acute kidney injury and bleeding events with mortality after radial or femoral access in patients with acute coronary syndrome undergoing invasive management: secondary analysis of a randomized clinical trial. *2019-04-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy860 · https://hartvaat.nl/2019/04/14/aki-en-bloedingen-en-mortaliteit-na-radiale-versus-femorale-toegang-bij-acs/* This MATRIX analysis showed that acute kidney injury and bleeding events are both associated with mortality after ACS, and that radial access reduces both complications compared with femoral access. ## Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. *2019-04-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1816897 · https://hartvaat.nl/2019/04/11/coronairangiografie-na-hartstilstand-zonder-st-elevatie-nejm-coact/* The COACT trial demonstrated that immediate coronary angiography did not improve 90-day survival compared with delayed angiography in patients resuscitated from cardiac arrest without ST-segment elevation. The findings argued against routine emergent catheterization in this population. ## Meta-Analysis of Randomized Controlled Trials of Red Meat Consumption in Comparison With Various Comparison Diets on Cardiovascular Risk Factors. *2019-04-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.035225 · https://hartvaat.nl/2019/04/09/rood-vlees-en-cardiovasculaire-risicofactoren-meta-analyse-van-gerandomiseerde-t/* This meta-analysis of randomized trials comparing red meat consumption with various alternative diets found that red meat consumption does not significantly worsen cardiovascular risk factors compared with high-quality plant protein sources, challenging some dietary guidelines. ## Sham-Controlled Randomized Trials of Catheter-Based Renal Denervation in Patients With Hypertension. *2019-04-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.12.082 · https://hartvaat.nl/2019/04/09/sham-gecontroleerde-rct-s-van-renale-denervatie-meta-analyse/* This meta-analysis of sham-controlled renal denervation trials confirmed a significant blood pressure reduction with catheter-based renal denervation versus sham procedures. By including only rigorously designed studies, the analysis provided the most definitive evidence for the biological efficacy of renal denervation. ## Bypass Surgery or Stenting for Left Main Coronary Artery Disease in Patients With Diabetes. *2019-04-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.01.037 · https://hartvaat.nl/2019/04/09/cabg-of-stenting-bij-hoofdstamlijden-bij-diabetes/* This EXCEL subanalysis examined outcomes of CABG versus stenting for left main disease specifically in patients with diabetes, investigating whether diabetes modifies the relative benefit of surgical versus percutaneous revascularization. ## Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis. *2019-04-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.12.072 · https://hartvaat.nl/2019/04/02/inspanningsrevalidatie-bij-hf-ipd-meta-analyse-van-inspanningscapaciteit-en-qol/* This individual patient data meta-analysis of exercise-based cardiac rehabilitation in heart failure confirmed significant improvements in exercise capacity and quality of life, with the benefit consistent across HFrEF and HFpEF phenotypes. ## Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. *2019-04-02 · JAMA · https://doi.org/10.1001/jama.2019.0693 · https://hartvaat.nl/2019/04/02/katheterablatie-versus-antiaritmica-bij-af-mortaliteit-en-cva-jama-cabana/* The CABANA trial found no significant difference between catheter ablation and drug therapy for the primary endpoint of death, stroke, bleeding, or cardiac arrest in patients with atrial fibrillation in the intention-to-treat analysis. However, per-protocol analysis and subsequent analyses suggested ablation superiority, fueling the ongoing debate. ## Effect of Catheter Ablation vs Medical Therapy on Quality of Life Among Patients With Atrial Fibrillation: The CABANA Randomized Clinical Trial. *2019-04-02 · JAMA · https://doi.org/10.1001/jama.2019.0692 · https://hartvaat.nl/2019/04/02/katheterablatie-versus-medicamenteus-bij-af-en-kwaliteit-van-leven-jama-cabana-q/* The CABANA quality-of-life analysis showed that catheter ablation produced significantly greater improvements in quality of life compared with medical therapy in patients with atrial fibrillation, even though the intention-to-treat primary endpoint was neutral. The result highlighted the symptomatic benefit of ablation. ## Randomized Trial Evaluating Percutaneous Coronary Intervention for the Treatment of Chronic Total Occlusion. *2019-04-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.031313 · https://hartvaat.nl/2019/04/02/pci-bij-chronische-totale-occlusie-gerandomiseerde-decision-cto-trial/* The DECISION-CTO trial comparing PCI with optimal medical therapy for chronic total occlusions was stopped early due to slow enrollment and showed no significant difference in clinical outcomes, reflecting the ongoing uncertainty about the clinical value of CTO recanalization. ## Platelet Inhibition With Cangrelor and Crushed Ticagrelor in Patients With ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. *2019-04-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038317 · https://hartvaat.nl/2019/04/02/cangrelor-en-gemalen-ticagrelor-bij-stemi-met-primaire-pci/* This study characterized platelet inhibition with the combination of intravenous cangrelor and crushed oral ticagrelor in STEMI patients, testing a dual rapid-onset antiplatelet strategy for primary PCI. ## Association of Improvement in Fractional Flow Reserve With Outcomes, Including Symptomatic Relief, After Percutaneous Coronary Intervention. *2019-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.0175 · https://hartvaat.nl/2019/04/01/ffr-verbetering-na-pci-en-uitkomsten-inclusief-symptoomverlichting/* This analysis demonstrated that improvement in fractional flow reserve after PCI is associated with better clinical outcomes and symptomatic relief, providing evidence that physiological optimization translates to patient benefit. ## Association of Initial and Serial C-Reactive Protein Levels With Adverse Cardiovascular Events and Death After Acute Coronary Syndrome: A Secondary Analysis of the VISTA-16 Trial. *2019-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2019.0179 · https://hartvaat.nl/2019/04/01/initieel-en-serieel-crp-en-cv-events-en-dood-na-acs-jama-cardiology/* This analysis showed that both initial and serial CRP levels after ACS independently predict cardiovascular events and mortality, supporting inflammatory biomarker monitoring for residual risk assessment. ## Comparison between linear and focal ablation of complex fractionated atrial electrograms in patients with non-paroxysmal atrial fibrillation: a prospective randomized trial. *2019-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy313 · https://hartvaat.nl/2019/04/01/lineaire-versus-focale-cfae-ablatie-bij-niet-paroxysmaal-af/* This study compared linear with focal ablation of complex fractionated atrial electrograms in non-paroxysmal AF, evaluating two approaches to substrate modification beyond pulmonary vein isolation. ## Effect of PR interval and pacing mode on persistent atrial fibrillation incidence in dual chamber pacemaker patients: a sub-study of the international randomized MINERVA trial. *2019-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy286 · https://hartvaat.nl/2019/04/01/pr-interval-en-pacingmodus-en-af-incidentie-bij-tweekamer-pacemaker/* A MINERVA trial substudy evaluated how PR interval and pacing mode influence the incidence of persistent AF in dual-chamber pacemaker patients. The findings inform programming decisions between DDDR and managed ventricular pacing based on intrinsic AV conduction. ## Targeted therapy of underlying conditions improves quality of life in patients with persistent atrial fibrillation: results of the RACE 3 study. *2019-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy311 · https://hartvaat.nl/2019/04/01/upstream-therapie-verbetert-qol-bij-persisterend-af-arrest-af/* This ARREST-AF follow-up showed that targeted therapy of AF risk factors (obesity, fitness, sleep apnea) improves quality of life in patients with persistent AF, demonstrating patient-centered benefits of aggressive upstream management. ## Impact of periprocedural anticoagulation therapy on the incidence of silent stroke after atrial fibrillation ablation in patients receiving direct oral anticoagulants: uninterrupted vs. interrupted by one dose strategy. *2019-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy224 · https://hartvaat.nl/2019/04/01/periprocedurele-antistolling-en-silent-stroke-na-af-ablatie/* This study evaluated the impact of periprocedural anticoagulation strategy (uninterrupted vs interrupted DOAC) on silent stroke incidence after AF ablation, addressing a subtle but clinically relevant safety endpoint. ## Restrictive compared with liberal red cell transfusion strategies in cardiac surgery: a meta-analysis. *2019-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy435 · https://hartvaat.nl/2019/04/01/restrictieve-versus-liberale-transfusie-bij-hartchirurgie-meta-analyse/* This meta-analysis of restrictive versus liberal red blood cell transfusion strategies in cardiac surgery consolidated the evidence supporting restrictive thresholds, confirming that lower hemoglobin triggers do not compromise patient safety. ## Association between mortality and implantable cardioverter-defibrillators by aetiology of heart failure: a propensity-matched analysis of the WARCEF trial. *2019-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12407 · https://hartvaat.nl/2019/04/01/icd-mortaliteit-naar-hartfalenetiologie-propensity-matched-analyse/* This propensity-matched analysis examined whether ICD benefit differs by heart failure etiology (ischemic vs non-ischemic), contributing to the ongoing debate about primary prevention defibrillator use in non-ischemic cardiomyopathy. ## Effect of Morning Exercise With or Without Breaks in Prolonged Sitting on Blood Pressure in Older Overweight/Obese Adults. *2019-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12373 · https://hartvaat.nl/2019/04/01/ochtendbeweging-met-of-zonder-zitonderbrekingen-en-bloeddruk-bij-ouderen/* This study showed that morning exercise combined with intermittent breaks in prolonged sitting provides additive blood pressure lowering in older overweight adults, supporting a combined activity strategy for sedentary hypertensive patients. ## A randomized controlled trial of the effect of spironolactone on left ventricular mass in hemodialysis patients. *2019-04-01 · Kidney international · https://doi.org/10.1016/j.kint.2018.11.025 · https://hartvaat.nl/2019/04/01/spironolacton-en-lv-massa-bij-hemodialysepatienten-gerandomiseerde-trial/* This randomized trial evaluated spironolactone for reducing left ventricular mass in hemodialysis patients, testing MRA therapy in the end-stage kidney disease population where hyperaldosteronism contributes to cardiac hypertrophy. ## Out-of-hospital initiation of hypothermia in ST-segment elevation myocardial infarction: a randomised trial. *2019-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313705 · https://hartvaat.nl/2019/04/01/prehospitale-hypothermie-bij-stemi-gerandomiseerde-trial/* This randomized trial tested prehospital hypothermia initiation in awake STEMI patients for infarct size limitation, evaluating the feasibility of cooling before hospital arrival. ## Intramyocardial Injection of Mesenchymal Precursor Cells and Successful Temporary Weaning From Left Ventricular Assist Device Support in Patients With Advanced Heart Failure: A Randomized Clinical Trial. *2019-03-26 · JAMA · https://doi.org/10.1001/jama.2019.2341 · https://hartvaat.nl/2019/03/26/intramyocardiale-mesenchymale-precursorcellen-en-lvad-weaning-jama/* This JAMA study of intramyocardial mesenchymal precursor cell injection in LVAD patients explored whether regenerative cell therapy can promote sufficient myocardial recovery to enable device weaning. ## B-Type Natriuretic Peptide During Treatment With Sacubitril/Valsartan: The PARADIGM-HF Trial. *2019-03-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2019.01.018 · https://hartvaat.nl/2019/03/26/bnp-tijdens-sacubitril-valsartan-paradigm-hf/* This PARADIGM-HF analysis clarified the differential behavior of BNP versus NT-proBNP during sacubitril-valsartan therapy, showing that BNP rises due to neprilysin inhibition while NT-proBNP falls, affecting clinical interpretation of biomarker-guided therapy. ## Recommended Heart Failure Medications and Adverse Drug Reactions in Women. *2019-03-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037585 · https://hartvaat.nl/2019/03/19/aanbevolen-hf-medicatie-en-bijwerkingen-bij-vrouwen/* This analysis identified sex differences in adverse drug reactions to recommended heart failure medications, showing that women may experience more side effects at standard doses, informing sex-aware dosing strategies. ## Effect of Catheter Ablation vs Antiarrhythmic Medication on Quality of Life in Patients With Atrial Fibrillation: The CAPTAF Randomized Clinical Trial. *2019-03-19 · JAMA · https://doi.org/10.1001/jama.2019.0335 · https://hartvaat.nl/2019/03/19/katheterablatie-versus-antiaritmica-en-kwaliteit-van-leven-bij-af-jama-captaf/* The CAPTAF trial showed that catheter ablation significantly improves quality of life compared with antiarrhythmic medication in patients with AF, providing randomized evidence for the symptom benefit of ablation using quality of life as the primary outcome. ## Management of Patients With Atrial Fibrillation. *2019-03-19 · JAMA · https://doi.org/10.1001/jama.2019.1264 · https://hartvaat.nl/2019/03/19/management-van-af-jama-klinisch-overzicht/* This comprehensive JAMA clinical review provided a practical overview of atrial fibrillation management, covering diagnosis, risk stratification, anticoagulation selection, rate versus rhythm control, and catheter ablation indications for daily clinical practice. ## Lipoprotein(a), PCSK9 Inhibition, and Cardiovascular Risk. *2019-03-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037184 · https://hartvaat.nl/2019/03/19/lp-a-pcsk9-remming-en-cardiovasculair-risico/* This study demonstrated that elevated lipoprotein(a) remains a significant residual cardiovascular risk factor even after PCSK9 inhibition, and that the Lp(a) reduction achieved with evolocumab partially explains its cardiovascular benefit. The findings supported Lp(a) as an independent therapeutic target. ## Safety and Efficacy of Bempedoic Acid to Reduce LDL Cholesterol. *2019-03-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1803917 · https://hartvaat.nl/2019/03/14/bempedoinezuur-voor-ldl-verlaging-nejm-veiligheid-en-werkzaamheid/* This NEJM trial established the safety and LDL-lowering efficacy of bempedoic acid, an oral ACL inhibitor that does not cause muscle-related side effects due to its liver-specific activation. The results positioned bempedoic acid as a promising option for patients intolerant to statins. ## Empagliflozin Reduced Mortality and Hospitalization for Heart Failure Across the Spectrum of Cardiovascular Risk in the EMPA-REG OUTCOME Trial. *2019-03-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037778 · https://hartvaat.nl/2019/03/12/empagliflozine-vermindert-mortaliteit-en-hf-hospitalisatie-over-het-cv-risicospe/* This EMPA-REG OUTCOME analysis showed that empagliflozin's benefit on mortality and heart failure hospitalization was consistent across the full spectrum of cardiovascular risk, including patients with lower baseline risk. The findings supported broad use of SGLT2 inhibitors in diabetic cardiovascular populations. ## Angiotensin Receptor Neprilysin Inhibitor for Functional Mitral Regurgitation. *2019-03-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037077 · https://hartvaat.nl/2019/03/12/arni-bij-functionele-mitralisklepinsufficientie/* This study evaluated sacubitril-valsartan for functional mitral regurgitation, testing whether neurohormonal modulation with ARNI therapy can reduce secondary MR severity through favorable ventricular remodeling. ## Safety and efficacy of a sirolimus-eluting coronary stent with ultra-thin strut for treatment of atherosclerotic lesions (TALENT): a prospective multicentre randomised controlled trial. *2019-03-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32467-X · https://hartvaat.nl/2019/03/09/ultradunne-sirolimus-eluting-stent-lancet-talent-trial/* The TALENT randomized trial compared a sirolimus-eluting stent with ultra-thin struts (Supraflex) against the Xience everolimus-eluting stent, evaluating the next generation of thin-strut coronary stent technology. ## Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial. *2019-03-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)30194-1 · https://hartvaat.nl/2019/03/09/prehospitaal-nitroglycerine-bij-vermoedelijk-ultra-acuut-cva-lancet-right-2/* The RIGHT-2 ambulance-based trial showed that prehospital transdermal glyceryl trinitrate did not improve functional outcomes in patients with ultra-acute presumed stroke, arguing against routine prehospital blood pressure lowering in acute stroke. ## Interval From Initiation of Prasugrel to Coronary Angiography in Patients With Non-ST-Segment Elevation Myocardial Infarction. *2019-03-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.055 · https://hartvaat.nl/2019/03/05/timing-van-prasugrel-start-en-coronairangiografie-bij-nstemi/* This ACCOAST analysis examined the optimal time interval between prasugrel initiation and coronary angiography in NSTEMI, informing the pre-treatment timing strategy for potent P2Y12 inhibition. ## Stress Testing Versus CT Angiography in Patients With Diabetes and Suspected Coronary Artery Disease. *2019-03-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.056 · https://hartvaat.nl/2019/03/05/inspanningstest-versus-ccta-bij-diabetes-met-verdenking-coronairlijden/* This study compared stress testing with CT angiography for evaluating suspected coronary artery disease specifically in diabetic patients, addressing the optimal non-invasive diagnostic strategy in this high-risk population. ## Anti-Inflammatory Therapy With Canakinumab for the Prevention of Hospitalization for Heart Failure. *2019-03-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038010 · https://hartvaat.nl/2019/03/05/canakinumab-ter-preventie-van-hartfalen-hospitalisatie-cantos-analyse/* This CANTOS subanalysis demonstrated that canakinumab reduced heart failure hospitalization in post-MI patients with elevated CRP, providing evidence that anti-inflammatory therapy targeting IL-1β may prevent heart failure development in high-inflammatory-risk patients. ## Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial. *2019-03-02 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(19)30038-8 · https://hartvaat.nl/2019/03/02/intensieve-bloeddrukverlaging-bij-iv-trombolyse-voor-acuut-cva-lancet-enchanted/* The ENCHANTED blood pressure substudy showed that intensive blood pressure lowering (target 130-140 mmHg) during intravenous thrombolysis for acute ischemic stroke did not improve functional outcomes versus guideline-recommended management, though it reduced intracranial hemorrhage. ## Effect of Trimetazidine Dihydrochloride Therapy on Exercise Capacity in Patients With Nonobstructive Hypertrophic Cardiomyopathy: A Randomized Clinical Trial. *2019-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.4847 · https://hartvaat.nl/2019/03/01/trimetazidine-bij-niet-obstructieve-hcm-jama-cardiology-gerandomiseerde-trial/* This trial of trimetazidine in nonobstructive hypertrophic cardiomyopathy tested whether optimizing myocardial energy metabolism improves exercise capacity in patients with the obstructive and nonobstructive forms of HCM. ## Ambulatory heart rate reduction after catheter-based renal denervation in hypertensive patients not receiving anti-hypertensive medications: data from SPYRAL HTN-OFF MED, a randomized, sham-controlled, proof-of-concept trial. *2019-03-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy871 · https://hartvaat.nl/2019/03/01/ambulante-hartfrequentiereductie-na-renale-denervatie-bij-hypertensie-zonder-med/* This SPYRAL analysis showed that renal denervation reduces ambulatory heart rate in addition to blood pressure, suggesting that sympathetic modulation extends beyond vascular tone to cardiac rate regulation. ## Hospital-based quality improvement interventions for patients with heart failure: a systematic review. *2019-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-314129 · https://hartvaat.nl/2019/03/01/ziekenhuisgebaseerde-kwaliteitsinterventies-bij-hartfalen-systematische-review/* This systematic review evaluated hospital-based quality improvement interventions for heart failure, characterizing which implementation strategies effectively improve guideline adherence and clinical outcomes. ## Effects of Bariatric Surgery Versus Medical Therapy on the 24-Hour Ambulatory Blood Pressure and the Prevalence of Resistant Hypertension. *2019-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12290 · https://hartvaat.nl/2019/03/01/bariatrische-chirurgie-versus-medicamenteus-beleid-op-24-uurs-ambulante-bloeddru/* This study compared the effects of bariatric surgery versus medical therapy on 24-hour ambulatory blood pressure and resistant hypertension prevalence, demonstrating that surgical weight loss achieves superior blood pressure control beyond what medications can provide. ## Reducing Dietary Sodium to 1000 mg per Day Reduces Neurovascular Transduction Without Stimulating Sympathetic Outflow. *2019-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12074 · https://hartvaat.nl/2019/03/01/natriumreductie-tot-1000-mg-dag-vermindert-neurovasculaire-transductie-zonder-sy/* This study demonstrated that extreme sodium reduction to 1,000 mg/day reduces neurovascular transduction without triggering compensatory sympathetic activation, supporting aggressive dietary sodium targets for blood pressure management. ## Mediterranean-Style Diet Improves Systolic Blood Pressure and Arterial Stiffness in Older Adults. *2019-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12259 · https://hartvaat.nl/2019/03/01/mediterraan-dieet-verbetert-systolische-bloeddruk-en-arteriele-stijfheid-bij-oud/* This study demonstrated that a Mediterranean-style diet tailored for older adults improves systolic blood pressure and arterial stiffness, providing dietary evidence specifically for the elderly hypertensive population. ## Effect of Patient-Centered Transitional Care Services on Clinical Outcomes in Patients Hospitalized for Heart Failure: The PACT-HF Randomized Clinical Trial. *2019-02-26 · JAMA · https://doi.org/10.1001/jama.2019.0710 · https://hartvaat.nl/2019/02/26/patientgerichte-transitional-care-bij-hf-hospitalisatie-jama-pact-hf/* The PACT-HF trial of patient-centered transitional care services for heart failure patients showed no significant reduction in readmission or death, despite improved patient self-care. The result highlighted the difficulty of reducing heart failure readmissions with transitional care alone. ## Effects of Sacubitril/Valsartan on Biomarkers of Extracellular Matrix Regulation in Patients With HFrEF. *2019-02-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.042 · https://hartvaat.nl/2019/02/26/sacubitril-valsartan-en-biomarkers-van-extracellulaire-matrixregulatie-bij-hfref/* This study showed that sacubitril-valsartan reduces biomarkers of extracellular matrix regulation (collagen turnover, fibrosis) in HFrEF, providing mechanistic evidence for anti-fibrotic effects of combined neprilysin-RAAS inhibition. ## Post-Procedural Bivalirudin Infusion at Full or Low Regimen in Patients With Acute Coronary Syndrome. *2019-02-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.12.023 · https://hartvaat.nl/2019/02/26/postprocedurele-bivalirudine-infusie-bij-acs-vol-versus-laag-regime/* This study compared full-dose versus low-dose post-procedural bivalirudin infusion after PCI in ACS patients, testing whether reduced post-procedural anticoagulation maintains efficacy with less bleeding. ## Low-Dose Methotrexate for the Prevention of Atherosclerotic Events. *2019-02-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1809798 · https://hartvaat.nl/2019/02/21/laaggedoseerd-methotrexaat-voor-preventie-van-atherosclerotische-events-nejm-cir/* The CIRT trial showed that low-dose methotrexate did not reduce cardiovascular events in patients with stable atherosclerosis and type 2 diabetes or metabolic syndrome. The negative result, contrasting with positive canakinumab data from CANTOS, demonstrated that not all anti-inflammatory pathways are relevant to atherosclerotic cardiovascular risk. ## Left Ventricular Unloading During Extracorporeal Membrane Oxygenation in Patients With Cardiogenic Shock. *2019-02-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.10.085 · https://hartvaat.nl/2019/02/19/lv-unloading-tijdens-ecmo-bij-cardiogene-shock/* This study evaluated strategies for left ventricular unloading during VA-ECMO in cardiogenic shock, comparing the outcomes of different mechanical approaches to reduce the deleterious effects of LV distension during extracorporeal support. ## Long-Term Survival Following Multivessel Revascularization in Patients With Diabetes: The FREEDOM Follow-On Study. *2019-02-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.11.001 · https://hartvaat.nl/2019/02/19/langetermijnoverleving-na-multivatenrevascularisatie-bij-diabetes-freedom-follow/* The FREEDOM long-term follow-up confirmed persistent survival advantage of CABG over PCI in patients with diabetes and multivessel coronary disease, with the mortality difference widening beyond the original trial period. The data reinforced CABG as the preferred revascularization strategy in diabetic patients. ## Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies. *2019-02-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy653 · https://hartvaat.nl/2019/02/14/gelijkstelling-van-vier-cv-risicoalgoritmen-na-hercalibratie-ipd-meta-analyse/* This individual participant data meta-analysis compared four cardiovascular risk algorithms after systematic recalibration, showing that after calibration to local populations, all four perform comparably. The finding suggests that algorithm choice matters less than proper calibration. ## Differential Association of Genetic Risk of Coronary Artery Disease With Development of Heart Failure With Reduced Versus Preserved Ejection Fraction. *2019-02-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038602 · https://hartvaat.nl/2019/02/12/genetisch-risico-op-coronairlijden-en-ontwikkeling-van-hfref-versus-hfpef/* This study showed that genetic risk for coronary artery disease has a differential association with the development of HFrEF versus HFpEF, suggesting distinct pathophysiological pathways from coronary disease to different heart failure phenotypes. ## Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial. *2019-02-12 · JAMA · https://doi.org/10.1001/jama.2018.21442 · https://hartvaat.nl/2019/02/12/intensieve-versus-standaard-bloeddrukcontrole-en-waarschijnlijke-dementie-jama-s/* The SPRINT MIND trial found that intensive blood pressure control did not significantly reduce the incidence of probable dementia but did reduce mild cognitive impairment compared with standard treatment. The findings suggested a potential neuroprotective effect of aggressive blood pressure management. ## Angiotensin-Neprilysin Inhibition in Acute Decompensated Heart Failure. *2019-02-07 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1812851 · https://hartvaat.nl/2019/02/07/angiotensine-neprilysineremming-bij-acuut-gedecompenseerd-hf-nejm-pioneer-hf/* The PIONEER-HF trial demonstrated that initiation of sacubitril-valsartan during hospitalization for acute decompensated heart failure was safe and produced significantly greater NT-proBNP reduction compared with enalapril. The results supported in-hospital initiation of ARNI therapy rather than waiting for outpatient transition. ## Glycemic Control, Cardiac Autoimmunity, and Long-Term Risk of Cardiovascular Disease in Type 1 Diabetes Mellitus. *2019-02-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.036068 · https://hartvaat.nl/2019/02/05/glycemische-controle-en-cardiale-auto-immuniteit-bij-diabetes-type-1-en-langeter/* This study examined the relationship between glycemic control, cardiac autoimmunity (anti-cardiac antibodies), and long-term cardiovascular risk in type 1 diabetes, exploring an immune-mediated pathway linking metabolic control to heart disease. ## Performance of the ABC Scores for Assessing the Risk of Stroke or Systemic Embolism and Bleeding in Patients With Atrial Fibrillation in ENGAGE AF-TIMI 48. *2019-02-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038312 · https://hartvaat.nl/2019/02/05/abc-scores-voor-cva-en-bloedingsrisico-bij-af-prestatieverbetering/* This analysis evaluated the performance of the ABC-stroke and ABC-bleeding risk scores incorporating biomarkers (troponin, NT-proBNP) for risk assessment in AF patients, comparing their discrimination with CHA₂DS₂-VASc and HAS-BLED. ## Alirocumab Reduces Total Nonfatal Cardiovascular and Fatal Events: The ODYSSEY OUTCOMES Trial. *2019-02-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.10.039 · https://hartvaat.nl/2019/02/05/alirocumab-vermindert-totale-niet-fatale-cv-en-fatale-events-odyssey-outcomes/* This ODYSSEY OUTCOMES analysis quantified the reduction in total (not just first) cardiovascular events with alirocumab after ACS, showing that the cumulative event burden reduction is substantially greater than the first-event analysis suggests. ## Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. *2019-02-02 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31942-1 · https://hartvaat.nl/2019/02/02/statines-bij-ouderen-lancet-ipd-meta-analyse-van-28-gerandomiseerde-trials/* This meta-analysis of individual participant data from 28 statin trials involving over 186,000 participants provided definitive evidence that statin therapy remains effective and safe in older adults. The proportional reduction in major vascular events per mmol/L LDL cholesterol reduction was similar across age groups, including those over 75. ## Association of Thyroid Function Genetic Predictors With Atrial Fibrillation: A Phenome-Wide Association Study and Inverse-Variance Weighted Average Meta-analysis. *2019-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.4615 · https://hartvaat.nl/2019/02/01/genetische-schildklierfunctievoorspellers-en-af-jama-cardiology-mendeliaanse-ran/* This Mendelian randomization study provided causal evidence linking genetic determinants of thyroid function to atrial fibrillation risk, establishing the thyroid-AF connection at the genomic level. ## Updated systematic review and meta-analysis of the impact of contact force sensing on the safety and efficacy of atrial fibrillation ablation: discrepancy between observational studies and randomized control trial data. *2019-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy266 · https://hartvaat.nl/2019/02/01/contact-force-sensing-en-veiligheid-werkzaamheid-van-af-ablatie-geactualiseerde-/* This updated meta-analysis evaluated whether contact force sensing technology improves AF ablation outcomes, finding that despite widespread adoption, randomized evidence does not consistently demonstrate superior results over conventional approaches. ## Edoxaban and implantable cardiac device interventions: insights from the ENGAGE AF-TIMI 48 trial. *2019-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy253 · https://hartvaat.nl/2019/02/01/edoxaban-en-implanteerbare-cardiale-devices-engage-af-timi-48/* This ENGAGE AF-TIMI 48 analysis confirmed that edoxaban is safe around cardiac device implantation procedures, providing practical data for periprocedural DOAC management during pacemaker and ICD interventions. ## Tricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure: a systematic review and meta-analysis. *2019-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy641 · https://hartvaat.nl/2019/02/01/tricuspidalisinsufficientie-en-mortaliteit-onafhankelijk-van-ph-en-rechterventri/* This systematic review and meta-analysis demonstrated that tricuspid regurgitation severity is independently associated with increased mortality regardless of pulmonary pressures and right heart function, establishing TR as an independent prognostic marker. ## Uninterrupted vs. interrupted periprocedural direct oral anticoagulants for catheter ablation of atrial fibrillation: a prospective randomized single-centre study on post-ablation thrombo-embolic and haemorrhagic events. *2019-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy148 · https://hartvaat.nl/2019/02/01/ononderbroken-versus-onderbroken-doac-bij-af-ablatie-prospectieve-trial/* This prospective randomized trial compared uninterrupted versus interrupted DOAC therapy during catheter ablation for AF, providing safety data for periprocedural anticoagulation management in the direct oral anticoagulant era. ## Comparison of Automated Office Blood Pressure With Office and Out-Off-Office Measurement Techniques. *2019-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12079 · https://hartvaat.nl/2019/02/01/geautomatiseerde-praktijkmeting-versus-andere-bloeddrukmeetmethoden/* This study compared automated office blood pressure measurement with conventional office and ambulatory techniques, establishing the relationship between AOBP readings and out-of-office measurements for clinical decision-making. ## Post-discharge short message service improves short-term clinical outcome and self-care behaviour in chronic heart failure. *2019-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12380 · https://hartvaat.nl/2019/02/01/sms-na-ontslag-verbetert-kortetermijnuitkomsten-en-zelfzorg-bij-chronisch-hf/* This study showed that post-discharge SMS messages improve short-term clinical outcomes and self-care behavior in chronic heart failure patients, supporting simple digital communication for transitional care. ## Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period. *2019-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12366 · https://hartvaat.nl/2019/02/01/herhaalde-levosimendan-infusies-bij-gevorderd-chronisch-hf-in-de-kwetsbare-postd/* This study evaluated repetitive levosimendan infusions in the vulnerable post-discharge period after advanced heart failure hospitalization, testing scheduled inotropic support to prevent early readmission. ## Rapid 5 lb weight gain is not associated with readmission in patients with heart failure. *2019-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12370 · https://hartvaat.nl/2019/02/01/snelle-gewichtstoename-van-2-3-kg-is-niet-geassocieerd-met-heropname-bij-hf/* This study showed that rapid 5-pound weight gain after discharge is not reliably associated with heart failure readmission, challenging the commonly taught self-monitoring weight threshold for early decompensation detection. ## Effect of apixaban compared with warfarin on coagulation markers in atrial fibrillation. *2019-02-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313351 · https://hartvaat.nl/2019/02/01/apixaban-versus-warfarine-en-coagulatiemerkers-bij-af/* This biomarker substudy compared the effects of apixaban versus warfarin on coagulation markers and primary hemostasis biomarkers in AF, providing mechanistic insight into their differential anticoagulant actions. ## Potential spironolactone effects on collagen metabolism biomarkers in patients with uncontrolled blood pressure. *2019-02-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313182 · https://hartvaat.nl/2019/02/01/spironolacton-en-collageenmetabolisme-biomarkers-bij-ongecontroleerde-hypertensi/* This study examined spironolactone's effects on collagen metabolism biomarkers as markers of cardiac fibrosis in patients with uncontrolled blood pressure, exploring anti-fibrotic mechanisms of MRA therapy. ## Bilateral versus Single Internal-Thoracic-Artery Grafts at 10 Years. *2019-01-31 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1808783 · https://hartvaat.nl/2019/01/31/bilaterale-versus-enkele-mammaria-interna-grafts-na-10-jaar-nejm-art/* The 10-year ART trial results showed no significant survival difference between bilateral and single internal thoracic artery grafts in CABG, contrary to the expectation from observational data. The findings did not support routine use of bilateral mammary grafting over single grafting in coronary bypass surgery. ## Coronary Artery Plaque Characteristics Associated With Adverse Outcomes in the SCOT-HEART Study. *2019-01-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.10.066 · https://hartvaat.nl/2019/01/29/coronaire-plaquekenmerken-en-adverse-uitkomsten-scot-heart/* This SCOT-HEART analysis identified specific coronary plaque characteristics on CT angiography (low-attenuation plaque, positive remodeling) that predict future cardiovascular events, supporting CT-based plaque characterization for risk stratification. ## Evaluation of Microvascular Injury in Revascularized Patients With ST-Segment-Elevation Myocardial Infarction Treated With Ticagrelor Versus Prasugrel. *2019-01-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.035931 · https://hartvaat.nl/2019/01/29/microvasculaire-schade-bij-gerevasculariseerde-stemi-met-ticagrelor-versus-prasu/* This cardiac MRI study compared microvascular injury between ticagrelor- and prasugrel-treated STEMI patients, evaluating whether the P2Y12 inhibitor choice affects myocardial tissue-level reperfusion quality. ## Open-Label Randomized Trial Comparing Oral Anticoagulation With and Without Single Antiplatelet Therapy in Patients With Atrial Fibrillation and Stable Coronary Artery Disease Beyond 1 Year After Coronary Stent Implantation. *2019-01-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.036768 · https://hartvaat.nl/2019/01/29/oac-met-of-zonder-antiplaatjes-bij-af-na-pci-1-jaar-gerandomiseerde-trial/* This open-label randomized trial compared oral anticoagulation alone versus OAC plus single antiplatelet therapy in AF patients more than one year after PCI, addressing the optimal late antithrombotic strategy after the initial combination period. ## A Three-Arm Randomized Trial of Different Renal Denervation Devices and Techniques in Patients With Resistant Hypertension (RADIOSOUND-HTN). *2019-01-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037654 · https://hartvaat.nl/2019/01/29/drie-armen-vergelijkende-renale-denervatie-radiosound-htn/* The RADIOSOUND-HTN trial compared radiofrequency and ultrasound renal denervation devices in a three-arm design, providing the first randomized comparison of different energy modalities for catheter-based sympathetic ablation. ## Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. *2019-01-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1812389 · https://hartvaat.nl/2019/01/24/dapagliflozine-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-nejm-declare-t/* The DECLARE-TIMI 58 trial evaluated dapagliflozin in a broad population of patients with type 2 diabetes including those with only cardiovascular risk factors. While dapagliflozin did not significantly reduce MACE, it lowered heart failure hospitalization, confirming the consistent heart failure benefit of SGLT2 inhibitors even in lower-risk populations. ## Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events: A Systematic Review and Meta-analysis. *2019-01-22 · JAMA · https://doi.org/10.1001/jama.2018.20578 · https://hartvaat.nl/2019/01/22/aspirine-voor-primaire-preventie-jama-meta-analyse-van-cv-events-en-bloedingen/* This JAMA meta-analysis of aspirin for primary cardiovascular prevention showed a modest reduction in cardiovascular events offset by increased major bleeding, particularly gastrointestinal and intracranial hemorrhage. The findings informed the paradigm shift against routine aspirin use in primary prevention. ## Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction. *2019-01-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032722 · https://hartvaat.nl/2019/01/22/milde-hypothermie-bij-cardiogene-shock-complicerend-mi/* This study evaluated mild therapeutic hypothermia in cardiogenic shock complicating MI, testing temperature management as a potential adjunctive therapy in the most hemodynamically compromised infarction patients. ## Unloading the Left Ventricle Before Reperfusion in Patients With Anterior ST-Segment-Elevation Myocardial Infarction. *2019-01-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038269 · https://hartvaat.nl/2019/01/15/lv-unloading-voor-reperfusie-bij-anterieure-stemi-dtu-stemi-pilot/* This pilot study investigated left ventricular unloading with the Impella device before coronary reperfusion in anterior STEMI, testing the novel concept that mechanical unloading prior to restoring blood flow may reduce infarct size. ## Ten-Year Clinical Outcomes From a Trial of Three Limus-Eluting Stents With Different Polymer Coatings in Patients With Coronary Artery Disease. *2019-01-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038065 · https://hartvaat.nl/2019/01/15/10-jaarsuitkomsten-van-drie-limus-eluting-stents-coating-vergelijking/* These 10-year results comparing three limus-eluting stents with different polymer coatings provided the longest randomized follow-up for contemporary DES, showing durable safety with both biodegradable and permanent polymer platforms. ## Linagliptin Effects on Heart Failure and Related Outcomes in Individuals With Type 2 Diabetes Mellitus at High Cardiovascular and Renal Risk in CARMELINA. *2019-01-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038352 · https://hartvaat.nl/2019/01/15/linagliptine-en-hartfalenuitkomsten-bij-diabetes-type-2-carmelina/* This CARMELINA analysis confirmed that linagliptin has a neutral effect on heart failure outcomes in high-risk type 2 diabetes patients, maintaining the cardiovascular safety profile of DPP-4 inhibitors without the heart failure signal seen with saxagliptin. ## Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial. *2019-01-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32818-6 · https://hartvaat.nl/2019/01/12/visualisatie-van-asymptomatische-atherosclerose-voor-cv-preventie-lancet-vipviza/* The VIPVIZA pragmatic trial showed that visualizing atherosclerotic disease through ultrasound imaging and communicating the results to patients and doctors improved cardiovascular risk factor management, demonstrating the power of disease visualization for prevention. ## Randomized Trial of Endoscopic or Open Vein-Graft Harvesting for Coronary-Artery Bypass. *2019-01-10 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1812390 · https://hartvaat.nl/2019/01/10/endoscopische-versus-open-veneoogst-bij-cabg-nejm-regroup/* The REGROUP trial demonstrated that endoscopic saphenous vein harvesting was noninferior to open harvesting for vein graft failure after CABG. The result provided reassurance that the less invasive and more widely used endoscopic technique does not compromise graft quality. ## Differential Impact of Heart Failure With Reduced Ejection Fraction on Men and Women. *2019-01-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.09.081 · https://hartvaat.nl/2019/01/08/hfref-differentiele-impact-op-mannen-en-vrouwen/* This study characterized the differential impact of HFrEF on men and women, showing that while women have better survival, they are more likely to be undertreated with guideline-directed therapy, highlighting a persistent care gap. ## Comprehensive Analysis of Stroke in the Long-Term Cohort of the MOMENTUM 3 Study. *2019-01-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037231 · https://hartvaat.nl/2019/01/08/cva-analyse-in-momentum-3-langetermijncohort/* This comprehensive MOMENTUM 3 analysis characterized stroke incidence and risk factors in the HeartMate 3 long-term cohort, informing the prevention and management of cerebrovascular events during LVAD support. ## Fractional flow reserve-guided percutaneous coronary intervention vs. medical therapy for patients with stable coronary lesions: meta-analysis of individual patient data. *2019-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehy812 · https://hartvaat.nl/2019/01/07/ffr-geleide-pci-versus-medicamenteuze-therapie-bij-stabiele-coronairlaesies-meta/* This meta-analysis confirmed that FFR-guided PCI with contemporary drug-eluting stents reduces cardiovascular events compared with medical therapy alone in patients with stable coronary lesions, consolidating the evidence for physiologically guided revascularization. ## Prospective, randomized trial of bioresorbable scaffolds vs. everolimus-eluting stents in patients undergoing coronary stenting for myocardial infarction: the Intracoronary Scaffold Assessment a Randomized evaluation of Absorb in Myocardial Infarction (ISAR-Absorb MI) trial. *2019-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehy710 · https://hartvaat.nl/2019/01/07/bioresorbeerbare-scaffold-versus-ees-bij-stabiel-coronairlijden-prospectieve-tri/* This randomized trial of bioresorbable scaffolds versus everolimus-eluting stents in stable coronary disease added further negative evidence for BRS technology, with higher rates of target lesion failure. ## Withdrawal of pharmacological treatment for heart failure in patients with recovered dilated cardiomyopathy (TRED-HF): an open-label, pilot, randomised trial. *2019-01-05 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32484-X · https://hartvaat.nl/2019/01/05/staken-van-hf-medicatie-bij-herstelde-dilaterende-cardiomyopathie-lancet-tred-hf/* The TRED-HF trial showed that withdrawal of heart failure medications in patients with recovered dilated cardiomyopathy led to relapse of ventricular dysfunction within 6 months in 40% of patients. The results established that heart failure therapy should be continued indefinitely even after apparent cardiac recovery. ## SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. *2019-01-05 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32590-X · https://hartvaat.nl/2019/01/05/sglt2-remmers-voor-primaire-en-secundaire-cv-en-renale-preventie-bij-diabetes-la/* This Lancet meta-analysis of SGLT2 inhibitor trials confirmed class-wide reductions in cardiovascular death, heart failure hospitalization, and kidney disease progression in patients with type 2 diabetes. The analysis demonstrated that heart failure and renal benefits were consistent regardless of baseline atherosclerotic disease or cardiovascular risk. ## Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. *2019-01-03 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1812792 · https://hartvaat.nl/2019/01/03/icosapent-ethyl-en-cardiovasculaire-uitkomsten-bij-hypertriglyceridemie-nejm-red/* The REDUCE-IT trial demonstrated that icosapent ethyl (purified EPA) reduced cardiovascular events by 25% in statin-treated patients with elevated triglycerides and established cardiovascular disease or diabetes. This landmark result established a role for triglyceride-lowering therapy in residual cardiovascular risk reduction. ## Sustainability of Blood Pressure Reduction in Black Barbershops. *2019-01-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.038165 · https://hartvaat.nl/2019/01/02/duurzaamheid-van-bloeddrukeffect-van-kapper-interventie/* This follow-up study showed that the blood pressure reduction achieved through the barber-pharmacist collaborative model is sustained over time, demonstrating the durability of community-based hypertension interventions. ## Randomized All-Comers Evaluation of a Permanent Polymer Zotarolimus-Eluting Stent Versus a Polymer-Free Amphilimus-Eluting Stent. *2019-01-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037707 · https://hartvaat.nl/2019/01/02/permanente-versus-polymeervrije-des-all-comers-gerandomiseerde-trial/* This all-comers randomized trial compared a durable polymer zotarolimus-eluting stent with a novel polymer-free amphilimus-eluting stent, evaluating the newest drug delivery technology in a broad PCI population. ## Evaluation of Macitentan in Patients With Eisenmenger Syndrome. *2019-01-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.033575 · https://hartvaat.nl/2019/01/02/macitentan-bij-eisenmenger-syndroom/* This multicenter study evaluated macitentan in patients with Eisenmenger syndrome, testing whether the dual endothelin receptor antagonist improves hemodynamics and exercise capacity in this complex congenital heart disease population. ## Prevention of Cardiogenic Shock After Acute Myocardial Infarction. *2019-01-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.036536 · https://hartvaat.nl/2019/01/02/preventie-van-cardiogene-shock-na-acuut-mi/* This review discussed strategies for preventing cardiogenic shock after acute MI, covering early risk identification, hemodynamic monitoring, and preventive mechanical circulatory support before hemodynamic collapse. ## Effect of Low-Dose Intracoronary Alteplase During Primary Percutaneous Coronary Intervention on Microvascular Obstruction in Patients With Acute Myocardial Infarction: A Randomized Clinical Trial. *2019-01-01 · JAMA · https://doi.org/10.1001/jama.2018.19802 · https://hartvaat.nl/2019/01/01/laaggedoseerd-intracoronair-alteplase-bij-primaire-pci-jama-t-time/* The T-TIME trial showed that low-dose intracoronary alteplase during primary PCI did not reduce microvascular obstruction in STEMI patients. The negative result dampened enthusiasm for adjunctive intracoronary fibrinolysis during primary PCI. ## Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial. *2019-01-01 · JAMA · https://doi.org/10.1001/jama.2018.19791 · https://hartvaat.nl/2019/01/01/medicatie-copay-vouchers-en-p2y12-gebruik-en-cv-events-na-mi-jama/* This JAMA trial tested whether medication copayment vouchers for P2Y12 inhibitors improve adherence and cardiovascular outcomes after MI, addressing the financial barrier to guideline-recommended antiplatelet therapy. ## Incidence, Characteristics, and Outcomes of Myocardial Infarction in Patients With Peripheral Artery Disease: Insights From the EUCLID Trial. *2019-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.4171 · https://hartvaat.nl/2019/01/01/mi-bij-pav-patienten-incidentie-en-uitkomsten-euclid/* This EUCLID analysis characterized the incidence, types, and outcomes of myocardial infarction in patients with peripheral artery disease, documenting the high cross-territory ischemic event rate in the PAD population. ## Interindividual Variation in Low-Density Lipoprotein Cholesterol Level Reduction With Evolocumab: An Analysis of FOURIER Trial Data. *2019-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.4178 · https://hartvaat.nl/2019/01/01/interindividuele-variatie-in-ldl-verlaging-met-evolocumab-fourier-analyse/* This FOURIER analysis of interindividual variation in LDL cholesterol response to evolocumab showed that most patients achieve substantial LDL lowering, with clinical factors explaining some but not all of the response variability. ## Effect of Linagliptin vs Placebo on Major Cardiovascular Events in Adults With Type 2 Diabetes and High Cardiovascular and Renal Risk: The CARMELINA Randomized Clinical Trial. *2019-01-01 · JAMA · https://doi.org/10.1001/jama.2018.18269 · https://hartvaat.nl/2019/01/01/linagliptine-versus-placebo-bij-diabetes-type-2-met-hoog-cv-en-renaal-risico-jam/* The CARMELINA trial confirmed the cardiovascular and renal safety of linagliptin in patients with type 2 diabetes at high cardiovascular and renal risk. The neutral outcome positioned DPP-4 inhibitors as safe but without the cardiovascular or renal benefits demonstrated by SGLT2 inhibitors and GLP-1 agonists. ## Prevalence and prevention of oesophageal injury during atrial fibrillation ablation: a systematic review and meta-analysis. *2019-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy121 · https://hartvaat.nl/2019/01/01/slokdarmletsel-bij-af-ablatie-prevalentie-en-preventie-meta-analyse/* This systematic review and meta-analysis evaluated the prevalence and prevention strategies for esophageal injury during AF ablation, providing a comprehensive safety assessment for this uncommon but potentially fatal complication. ## Anatomical hotspots of fractionated electrograms in the left and right atrium: do they exist? *2019-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy059 · https://hartvaat.nl/2019/01/01/hotspots-van-gefractioneerde-elektrogrammen-in-linker-en-rechter-atrium-bij-af/* A structured literature review investigated anatomical hotspots of complex fractionated atrial electrograms during AF. The systematic mapping provides foundational data for understanding the rationale and limitations of CFAE-guided ablation strategies. ## Lifetime Risk of Stroke and Coronary Heart Disease Deaths According to Blood Pressure Level: EPOCH-JAPAN (Evidence for Cardiovascular Prevention From Observational Cohorts in Japan). *2019-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11635 · https://hartvaat.nl/2019/01/01/levenslangrisico-op-cva-en-coronairlijden-naar-bloeddrukniveau-epoch-japan/* This EPOCH-JAPAN analysis estimated lifetime risk of stroke and coronary heart disease deaths according to blood pressure level, providing a lifespan perspective that strengthens the case for early and sustained blood pressure management. ## Acute Increases in Serum Creatinine After Starting Angiotensin-Converting Enzyme Inhibitor-Based Therapy and Effects of its Continuation on Major Clinical Outcomes in Type 2 Diabetes Mellitus. *2019-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.12060 · https://hartvaat.nl/2019/01/01/acute-creatininestijging-bij-start-ace-remmer-en-effecten-van-voortzetting-analy/* This study showed that acute creatinine increases after starting ACE inhibitor therapy do not necessarily indicate kidney damage and that continuation of treatment leads to better long-term outcomes than discontinuation, challenging traditional concerns about RAAS inhibitor-related creatinine rises. ## Five-Year Randomized Study Demonstrates Blood Pressure Increases in Young Women With Turner Syndrome Regardless of Estradiol Dose. *2019-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11742 · https://hartvaat.nl/2019/01/01/bloeddrukstijging-bij-jonge-vrouwen-met-turner-syndroom-ongeacht-oestradiol-dosi/* This 5-year randomized study in young women with Turner syndrome showed blood pressure increases regardless of estradiol replacement dose, highlighting the cardiovascular monitoring needs in this genetic condition. ## Implementing myocardial infarction systems of care in low/middle-income countries. *2019-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313398 · https://hartvaat.nl/2019/01/01/implementatie-van-mi-zorgsystemen-in-lage-en-middeninkomenslanden/* This review addressed the challenges and strategies for implementing acute MI care systems in low- and middle-income countries, where the majority of global ischemic heart disease deaths occur. ## Global prevalence of resistant hypertension: a meta-analysis of data from 3.2 million patients. *2019-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313599 · https://hartvaat.nl/2019/01/01/globale-prevalentie-van-therapieresistente-hypertensie-meta-analyse-van-3-2-milj/* This meta-analysis of 3.2 million patients provided the first comprehensive estimate of resistant hypertension prevalence, distinguishing between apparent, pseudo-resistant, and true resistant hypertension. The data quantified the scale of this challenging clinical problem. ## Reaching cardiovascular prevention guideline targets with a polypill-based approach: a meta-analysis of randomised clinical trials. *2019-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313108 · https://hartvaat.nl/2019/01/01/polypil-en-cardiovasculaire-preventie-meta-analyse-van-gerandomiseerde-trials/* This meta-analysis showed that a polypill-based approach significantly improves achievement of ESC cardiovascular prevention guideline targets for blood pressure and LDL cholesterol, supporting the polypill as a tool for overcoming treatment inertia. ## Cardiovascular and Limb Outcomes in Patients With Diabetes and Peripheral Artery Disease: The EUCLID Trial. *2018-12-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.09.078 · https://hartvaat.nl/2018/12/25/cv-en-ledemaat-uitkomsten-bij-diabetes-met-pav-euclid/* This EUCLID analysis characterized the independent cardiovascular and limb risks conferred by diabetes in patients with peripheral artery disease, showing that diabetes amplifies both systemic and limb-specific atherosclerotic complications. ## Integrating the results of the CULPRIT-SHOCK trial in the 2017 ESC ST-elevation myocardial infarction guidelines: viewpoint of the task force. *2018-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehy294 · https://hartvaat.nl/2018/12/21/culprit-shock-integratie-in-2017-esc-stemi-richtlijn-richtlijncommissie-standpun/* This ESC STEMI guideline committee position paper addressed the integration of CULPRIT-SHOCK results into clinical practice, updating recommendations on the revascularization strategy for patients with MI and cardiogenic shock. ## Effects of Liraglutide Versus Placebo on Cardiovascular Events in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease. *2018-12-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.036418 · https://hartvaat.nl/2018/12/18/liraglutide-bij-diabetes-type-2-met-ckd-leader-renale-analyse/* This LEADER subanalysis confirmed that liraglutide reduces cardiovascular events in patients with type 2 diabetes and chronic kidney disease, demonstrating consistent cardiorenal protection in the renally impaired subpopulation. ## Effects of Liraglutide on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus With or Without History of Myocardial Infarction or Stroke. *2018-12-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034516 · https://hartvaat.nl/2018/12/18/liraglutide-cv-uitkomsten-met-of-zonder-eerder-mi-leader/* This LEADER subanalysis showed that liraglutide's cardiovascular benefit is consistent in patients with and without prior myocardial infarction, supporting GLP-1 receptor agonist use across the cardiovascular risk spectrum in type 2 diabetes. ## 2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. *2018-12-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.09.020 · https://hartvaat.nl/2018/12/18/2018-acc-expert-consensus-nieuwe-therapieen-voor-cv-risicoreductie-bij-diabetes-/* The 2018 ACC Expert Consensus provided the first integrated decision pathway for using SGLT2 inhibitors and GLP-1 receptor agonists for cardiovascular risk reduction in patients with type 2 diabetes and established atherosclerotic disease, heart failure, or chronic kidney disease. ## Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation: The ULTIMATE Trial. *2018-12-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.09.013 · https://hartvaat.nl/2018/12/18/ivus-versus-angiografie-geleide-des-implantatie-de-ultimate-trial/* The ULTIMATE trial demonstrated that IVUS-guided drug-eluting stent implantation significantly reduced target vessel failure compared with angiography-guided PCI at 1 year. The results provided randomized evidence supporting routine IVUS use during coronary stenting. ## Transcatheter Mitral-Valve Repair in Patients with Heart Failure. *2018-12-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1806640 · https://hartvaat.nl/2018/12/13/transcatheter-mitraalklepherstel-bij-hartfalen-nejm-coapt/* The COAPT trial showed that transcatheter mitral-valve repair with MitraClip, added to guideline-directed medical therapy, dramatically reduced heart failure hospitalization and all-cause mortality in patients with heart failure and severe secondary mitral regurgitation. The results were practice-changing, establishing a new interventional approach for functional MR. ## Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation. *2018-12-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1805374 · https://hartvaat.nl/2018/12/13/percutaan-herstel-of-medicamenteuze-therapie-bij-secundaire-mr-nejm-mitra-fr/* The MITRA-FR trial showed that transcatheter mitral valve repair with MitraClip did not reduce mortality or heart failure hospitalization compared with medical therapy alone in patients with severe secondary mitral regurgitation and heart failure. The contrasting result with COAPT highlighted the importance of proportionate versus disproportionate MR in patient selection. ## Long-Term Effects of Oxygen Therapy on Death or Hospitalization for Heart Failure in Patients With Suspected Acute Myocardial Infarction. *2018-12-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.036220 · https://hartvaat.nl/2018/12/11/langetermijneffecten-van-zuurstof-op-sterfte-of-hf-hospitalisatie-na-verdenking-/* This long-term DETO2X-AMI analysis showed that supplemental oxygen in suspected acute MI does not reduce mortality or heart failure hospitalization over extended follow-up, confirming the absence of benefit from routine oxygen therapy. ## Early Versus Standard Care Invasive Examination and Treatment of Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. *2018-12-11 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.037152 · https://hartvaat.nl/2018/12/11/vroeg-versus-standaard-invasief-onderzoek-bij-nste-acs-verdict-gerandomiseerde-t/* The VERDICT trial compared very early (within 12 hours) versus standard timing of invasive coronary angiography in NSTE-ACS, finding that earlier intervention did not reduce the primary composite endpoint but may benefit higher-risk patients. ## SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization in the FREEDOM Trial. *2018-12-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.09.046 · https://hartvaat.nl/2018/12/11/syntax-score-bij-diabetes-met-coronaire-revascularisatie-freedom/* This FREEDOM analysis evaluated the role of the SYNTAX score in guiding revascularization decisions in diabetic patients, showing that anatomical complexity modifies the relative benefit of CABG over PCI in diabetes. ## Impact of lesion complexity on peri-procedural adverse events and the benefit of potent intravenous platelet adenosine diphosphate receptor inhibition after percutaneous coronary intervention: core laboratory analysis from 10 854 patients from the CHAMPION PHOENIX trial. *2018-12-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehy562 · https://hartvaat.nl/2018/12/07/laesiecomplexiteit-en-periprocedurele-events-bij-potente-iv-antiplaatjestherapie/* This CHAMPION PHOENIX analysis showed that lesion complexity modifies the relative benefit of cangrelor over clopidogrel during PCI, with greater protection in more complex procedural settings. ## Echocardiographic Screening for Pulmonary Hypertension in Congenital Heart Disease: JACC Review Topic of the Week. *2018-12-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.08.2201 · https://hartvaat.nl/2018/12/04/echocardiografische-screening-op-ph-bij-aangeboren-hartafwijkingen-jacc-review/* This JACC review addressed echocardiographic screening for pulmonary hypertension in patients with congenital heart disease, providing guidance for a population at particularly high risk for developing PH. ## Fractional Flow Reserve Versus Angiographically-Guided Coronary Artery Bypass Grafting. *2018-12-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.09.043 · https://hartvaat.nl/2018/12/04/ffr-versus-angiografie-geleide-cabg/* This study compared FFR-guided versus angiography-guided CABG planning, investigating whether physiological assessment of coronary stenosis severity improves graft patency and clinical outcomes after bypass surgery. ## Estimated 5-Year Number Needed to Treat to Prevent Cardiovascular Death or Heart Failure Hospitalization With Angiotensin Receptor-Neprilysin Inhibition vs Standard Therapy for Patients With Heart Failure With Reduced Ejection Fraction: An Analysis of Data From the PARADIGM-HF Trial. *2018-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.3957 · https://hartvaat.nl/2018/12/01/number-needed-to-treat-met-arni-voor-preventie-van-cv-dood-of-hf-hospitalisatie/* This JAMA Cardiology analysis calculated the estimated 5-year number needed to treat with sacubitril-valsartan versus an ACE inhibitor to prevent cardiovascular death or heart failure hospitalization, providing practical data for clinical decision-making and cost-effectiveness assessment. ## Association of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation: Findings From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II. *2018-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.3945 · https://hartvaat.nl/2018/12/01/ras-etniciteit-en-oac-gebruik-bij-af-orbit-af/* This ORBIT-AF analysis identified racial and ethnic disparities in oral anticoagulant use for AF, showing that Black and Hispanic patients are significantly less likely to receive guideline-recommended anticoagulation. ## Association of Multiple Biomarkers With Risk of All-Cause and Cause-Specific Mortality After Acute Coronary Syndromes: A Secondary Analysis of the PLATO Biomarker Study. *2018-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.3811 · https://hartvaat.nl/2018/12/01/multipele-biomarkers-en-mortaliteitsrisico-na-acs-jama-cardiology/* This analysis of multiple biomarkers (troponin, GDF-15, NT-proBNP, CRP, cystatin C) showed that a multi-biomarker approach improves prediction of all-cause and cause-specific mortality after acute coronary syndrome. ## Influence of Cardiovascular Risk Communication Tools and Presentation Formats on Patient Perceptions and Preferences. *2018-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.3680 · https://hartvaat.nl/2018/12/01/cardiovasculaire-risicocommunicatie-en-patientperceptie-jama-cardiology/* This study evaluated how different cardiovascular risk communication tools and presentation formats affect patient understanding and treatment preferences, informing shared decision-making approaches for statin therapy. ## A randomized controlled trial of atrioventricular junction ablation and cardiac resynchronization therapy in patients with permanent atrial fibrillation and narrow QRS. *2018-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy555 · https://hartvaat.nl/2018/12/01/av-junctieablatie-plus-crt-bij-permanent-af-gerandomiseerde-trial/* This randomized trial demonstrated that AV junction ablation combined with CRT is superior to pharmacological therapy in patients with permanent AF and heart failure, showing improvements in functional capacity and left ventricular function. ## Edoxaban therapy increases treatment satisfaction and reduces utilization of healthcare resources: an analysis from the EdoxabaN vs. warfarin in subjectS UndeRgoing cardiovErsion of atrial fibrillation (ENSURE-AF) study. *2018-12-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy141 · https://hartvaat.nl/2018/12/01/edoxaban-verhoogt-behandeltevredenheid-en-vermindert-zorggebruik-engage-af-timi-/* This ENSURE-AF analysis showed that edoxaban increases treatment satisfaction and reduces healthcare resource utilization compared with warfarin in AF patients undergoing cardioversion. ## Creatinine Rise During Blood Pressure Therapy and the Risk of Adverse Clinical Outcomes in Patients With Type 2 Diabetes Mellitus. *2018-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11944 · https://hartvaat.nl/2018/12/01/creatininestijging-tijdens-bloeddrukbehandeling-en-uitkomsten-bij-diabetes-type-/* This study showed that creatinine rise during antihypertensive therapy in type 2 diabetes does not consistently predict adverse outcomes, suggesting that moderate renal function changes should not always prompt treatment de-escalation. ## Randomized double-blind clinical studies of ularitide and other vasoactive substances in acute decompensated heart failure: a systematic review and meta-analysis. *2018-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12349 · https://hartvaat.nl/2018/12/01/ularitide-en-andere-vasoactieve-stoffen-bij-acuut-hf-systematische-review/* This systematic review compared ularitide and other vasoactive substances in randomized trials for acute decompensated heart failure, synthesizing the evidence for intravenous vasodilator therapy in the acute HF setting. ## The prognosis of mid-range ejection fraction heart failure: a systematic review and meta-analysis. *2018-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12353 · https://hartvaat.nl/2018/12/01/prognose-van-hfmref-systematische-review-en-meta-analyse/* This meta-analysis characterized the prognosis of heart failure with mid-range ejection fraction (HFmrEF), showing intermediate outcomes between HFrEF and HFpEF and supporting its classification as a distinct entity. ## A meta-analysis of MitraClip combined with medical therapy vs. medical therapy alone for treatment of mitral regurgitation in heart failure patients. *2018-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12339 · https://hartvaat.nl/2018/12/01/mitraclip-plus-medicamenteus-versus-medicamenteus-alleen-bij-hf-met-mr-meta-anal/* This meta-analysis of MitraClip versus medical therapy for functional mitral regurgitation in heart failure was published before the COAPT and MITRA-FR results, reflecting the equipoise that existed about percutaneous mitral repair at that time. ## Pro-gastrin-releasing peptide and outcome in patients with heart failure and anaemia: results from the RED-HF study. *2018-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12312 · https://hartvaat.nl/2018/12/01/pro-gastrin-releasing-peptide-en-uitkomsten-bij-hf-met-anemie-red-hf/* This RED-HF analysis investigated pro-gastrin-releasing peptide as a neuroendocrine biomarker in heart failure patients with anaemia and reduced ejection fraction. The neuropeptide showed predictive value for clinical outcomes. ## Liraglutide and weight loss among patients with advanced heart failure and a reduced ejection fraction: insights from the FIGHT trial. *2018-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12334 · https://hartvaat.nl/2018/12/01/liraglutide-en-gewicht-bij-gevorderd-hfref-fight-trial-inzichten/* This FIGHT trial analysis showed that liraglutide does not produce beneficial weight loss in patients with advanced HFrEF, suggesting that the GLP-1 receptor agonist weight loss mechanism is attenuated in the sickest heart failure patients. ## Left ventricular assist device implantation improves glycaemic control: a systematic review and meta-analysis. *2018-12-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12337 · https://hartvaat.nl/2018/12/01/lvad-implantatie-verbetert-glycemische-controle-meta-analyse/* This meta-analysis showed that LVAD implantation improves glycemic control in heart failure patients, revealing an unexpected metabolic benefit of mechanical unloading through improved insulin sensitivity. ## Daily remote ischaemic conditioning following acute myocardial infarction: a randomised controlled trial. *2018-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313091 · https://hartvaat.nl/2018/12/01/dagelijkse-remote-ischemische-conditionering-na-acuut-mi-gerandomiseerde-trial/* This randomized trial tested whether daily remote ischemic conditioning sustained over weeks after acute MI provides long-term cardioprotection, extending the concept from acute intervention to chronic conditioning. ## Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome. *2018-11-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1801174 · https://hartvaat.nl/2018/11/29/alirocumab-en-cardiovasculaire-uitkomsten-na-acs-nejm-odyssey-outcomes/* The ODYSSEY OUTCOMES trial demonstrated that alirocumab significantly reduced recurrent cardiovascular events and all-cause mortality in 18,924 patients with recent acute coronary syndrome on high-intensity statin therapy. This was the second major PCSK9 inhibitor outcomes trial, confirming the clinical benefit of aggressive LDL cholesterol lowering after ACS. ## Metabolomic consequences of genetic inhibition of PCSK9 compared with statin treatment. *2018-11-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034942 · https://hartvaat.nl/2018/11/27/metabolome-consequenties-van-pcsk9-remming-versus-statinetherapie/* This metabolomic study comparing genetic PCSK9 inhibition with statin therapy revealed distinct off-target effects, with statins affecting glucose metabolism while PCSK9 variants selectively lower atherogenic lipoproteins without metabolic side effects. ## Economic and Quality-of-Life Outcomes of Natriuretic Peptide-Guided Therapy for Heart Failure. *2018-11-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.08.2184 · https://hartvaat.nl/2018/11/27/economische-en-qol-uitkomsten-van-nt-probnp-geleide-hf-therapie/* This GUIDE-IT economic analysis showed that NT-proBNP-guided heart failure therapy does not improve cost-effectiveness compared with usual care, consistent with the neutral clinical primary endpoint. ## Effect of lorcaserin on prevention and remission of type 2 diabetes in overweight and obese patients (CAMELLIA-TIMI 61): a randomised, placebo-controlled trial. *2018-11-24 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32328-6 · https://hartvaat.nl/2018/11/24/lorcaserine-en-preventie-remissie-van-diabetes-type-2-bij-obesitas-camellia-timi/* This CAMELLIA-TIMI 61 analysis showed that lorcaserin reduces the incidence and promotes remission of type 2 diabetes in overweight and obese patients, demonstrating that pharmacological weight loss can have metabolic disease-modifying effects. ## Continued vs. interrupted direct oral anticoagulants at the time of device surgery, in patients with moderate to high risk of arterial thrombo-embolic events (BRUISE CONTROL-2). *2018-11-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehy413 · https://hartvaat.nl/2018/11/21/voortzetten-versus-onderbreken-doac-bij-device-chirurgie-bruise-control-2/* The BRUISE CONTROL-2 trial examined whether continuing DOACs versus heparin bridging during pacemaker or ICD surgery reduces pocket hematoma and bleeding complications, extending the uninterrupted anticoagulation approach from warfarin to DOACs. ## Efficacy and safety of LY3298176, a novel dual GIP and GLP-1 receptor agonist, in patients with type 2 diabetes: a randomised, placebo-controlled and active comparator-controlled phase 2 trial. *2018-11-17 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32260-8 · https://hartvaat.nl/2018/11/17/ly3298176-duale-gip-glp-1-agonist-bij-diabetes-type-2-lancet-tirzepatide-fase-2/* This landmark phase 2 trial of tirzepatide (dual GIP/GLP-1 receptor agonist) in type 2 diabetes demonstrated superior HbA1c reduction and weight loss compared with dulaglutide. The results foreshadowed the transformative impact of dual incretin agonism that was later confirmed in the SURPASS and SURMOUNT programs. ## Newer-Generation Ultrathin Strut Drug-Eluting Stents Versus Older Second-Generation Thicker Strut Drug-Eluting Stents for Coronary Artery Disease. *2018-11-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034456 · https://hartvaat.nl/2018/11/13/ultradunne-versus-dikkere-drug-eluting-stents-systematische-review/* This meta-analysis showed that newer-generation ultra-thin strut drug-eluting stents provide superior safety outcomes compared with older thicker-strut second-generation DES, supporting the continued evolution of coronary stent technology toward thinner, more biocompatible designs. ## Effect of Inorganic Nitrite vs Placebo on Exercise Capacity Among Patients With Heart Failure With Preserved Ejection Fraction: The INDIE-HFpEF Randomized Clinical Trial. *2018-11-06 · JAMA · https://doi.org/10.1001/jama.2018.14852 · https://hartvaat.nl/2018/11/06/anorganisch-nitriet-versus-placebo-bij-inspanningscapaciteit-bij-hfpef-jama-indi/* The INDIE-HFpEF trial showed that inhaled inorganic nitrite did not improve exercise capacity or quality of life in patients with HFpEF, another negative result in the long search for effective pharmacotherapy for this heart failure phenotype. ## Coronary computed tomography angiography for heart team decision-making in multivessel coronary artery disease. *2018-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy581 · https://hartvaat.nl/2018/11/01/ct-coronairangiografie-voor-heart-team-besluitvorming-bij-multivatenlijden/* This study explored the use of coronary CT angiography for Heart Team decision-making in multivessel disease, testing whether non-invasive anatomical assessment can guide the PCI-versus-CABG discussion. ## Timing of Loading Dose of Atorvastatin in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes: Insights From the SECURE-PCI Randomized Clinical Trial. *2018-11-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.3408 · https://hartvaat.nl/2018/11/01/timing-van-atorvastatine-oplaaddosis-voor-pci-bij-acs-jama-cardiology/* This analysis explored the optimal timing of statin loading before PCI in ACS patients, evaluating whether pre-procedural timing influences the cardioprotective effect of high-dose atorvastatin. ## One-Year Outcomes after PCI Strategies in Cardiogenic Shock. *2018-11-01 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1808788 · https://hartvaat.nl/2018/11/01/1-jaarsuitkomsten-na-pci-strategieen-bij-cardiogene-shock-nejm-culprit-shock/* The 1-year follow-up of CULPRIT-SHOCK confirmed that culprit-lesion-only PCI remained superior to immediate multivessel PCI in patients with MI and cardiogenic shock, with a sustained reduction in all-cause mortality. These extended results reinforced the change in practice toward a staged revascularization approach. ## Outcomes of persistent and long-standing persistent atrial fibrillation ablation: a systematic review and meta-analysis. *2018-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux297 · https://hartvaat.nl/2018/11/01/uitkomsten-van-ablatie-bij-persisterend-en-langdurig-persisterend-af-meta-analys/* This meta-analysis of ablation outcomes in persistent and longstanding persistent AF documented the expected success rates and predictors of recurrence, helping set realistic expectations for rhythm control in advanced AF. ## Individually tailored vs. standardized substrate modification during radiofrequency catheter ablation for atrial fibrillation: a randomized study. *2018-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux310 · https://hartvaat.nl/2018/11/01/individueel-aangepaste-versus-gestandaardiseerde-substraatmodificatie-bij-rf-abl/* This randomized trial compared individually tailored (voltage-guided) with standardized substrate modification during AF radiofrequency ablation, testing whether personalized ablation targets improve rhythm outcomes. ## Results of the first investigator-initiated randomized clinical trial of nMARQTM, PVACTM, and thoracoscopic ablation for paroxysmal atrial fibrillation. *2018-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux267 · https://hartvaat.nl/2018/11/01/nmarq-pvac-en-thoracoscopische-ablatie-bij-paroxysmaal-af-gerandomiseerde-trial/* This first randomized comparison of three AF ablation techniques (nMARQ, PVAC, and thoracoscopic ablation) provided head-to-head data on these different energy delivery systems for pulmonary vein isolation. ## Quality of life is not improved after mitral valve surgery combined with epicardial left atrial cryoablation as compared with mitral valve surgery alone: a substudy of the double blind randomized SWEDish Multicentre Atrial Fibrillation study (SWEDMAF). *2018-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux253 · https://hartvaat.nl/2018/11/01/kwaliteit-van-leven-na-mitralisklepchirurgie-met-en-zonder-epicardiale-cryoablat/* This study showed that adding epicardial cryoablation to mitral valve surgery does not improve quality of life despite increasing freedom from AF, questioning the value of concomitant surgical ablation when the patient perspective is prioritized. ## Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. *2018-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYP.0000000000000084 · https://hartvaat.nl/2018/11/01/therapieresistente-hypertensie-aha-scientific-statement-over-detectie-evaluatie-/* This AHA scientific statement on resistant hypertension provided updated definitions, diagnostic criteria, evaluation algorithms, and management strategies for above-goal blood pressure despite three antihypertensive drug classes. The document serves as the standard reference for this challenging clinical population. ## Individual participant data analysis of two trials on aldosterone blockade in myocardial infarction. *2018-11-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-312950 · https://hartvaat.nl/2018/11/01/aldosteronblokkade-bij-myocardinfarct-ipd-analyse-van-twee-trials/* This individual patient data analysis of two MRA trials after STEMI provided pooled evidence on the benefit of early aldosterone blockade, informing the role of MRA therapy in the acute MI setting beyond established heart failure. ## Longitudinal change in blood pressure is associated with cardiovascular disease mortality in a Chinese cohort. *2018-11-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312850 · https://hartvaat.nl/2018/11/01/longitudinale-bloeddrukverandering-en-cv-mortaliteit-in-een-chinees-cohort/* This large Chinese cohort study showed that longitudinal blood pressure changes, rather than single measurements, are strongly associated with cardiovascular mortality, supporting dynamic blood pressure monitoring over time. ## Linking Endogenous Factor Xa Activity, a Biologically Relevant Pharmacodynamic Marker, to Edoxaban Plasma Concentrations and Clinical Outcomes in the ENGAGE AF-TIMI 48 Trial. *2018-10-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.033933 · https://hartvaat.nl/2018/10/30/endogene-factor-xa-activiteit-en-edoxaban-farmacodynamische-marker-en-klinische-/* This analysis linked endogenous factor Xa activity as a biologically relevant pharmacodynamic marker for edoxaban, connecting drug plasma concentrations with coagulation pathway inhibition and clinical outcomes. ## Healthcare Resource Use and Cost Implications in the MOMENTUM 3 Long-Term Outcome Study. *2018-10-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.035722 · https://hartvaat.nl/2018/10/30/zorggebruik-en-kosten-in-momentum-3-langetermijnstudie/* This MOMENTUM 3 healthcare resource analysis showed that the HeartMate 3 LVAD is associated with lower overall costs than the HeartMate II, driven by fewer adverse events and shorter hospitalizations. ## Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial. *2018-10-27 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32261-X · https://hartvaat.nl/2018/10/27/albiglutide-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-lancet-harmony-ou/* The Harmony Outcomes trial demonstrated that once-weekly albiglutide reduced major adverse cardiovascular events in patients with type 2 diabetes and established cardiovascular disease. This was the fourth GLP-1 receptor agonist to show cardiovascular benefit, confirming the class effect. ## Blinded outcomes and angina assessment of coronary bioresorbable scaffolds: 30-day and 1-year results from the ABSORB IV randomised trial. *2018-10-27 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32283-9 · https://hartvaat.nl/2018/10/27/absorb-iv-bioresorbeerbare-scaffold-30-daags-en-1-jaarsresultaten/* The ABSORB IV trial with blinded endpoint assessment showed similar rates of angina and target lesion failure at 30 days and 1 year between bioresorbable scaffolds and metallic DES, but the trial was among the last before the device's commercial withdrawal. ## Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2018-10-23 · Circulation · https://doi.org/10.1161/CIR.0000000000000601 · https://hartvaat.nl/2018/10/23/2017-acc-aha-hypertensierichtlijn-systematische-review-circulation/* Circulation publication of the systematic review supporting the 2017 ACC/AHA hypertension guideline, covering the evidence for self-measured blood pressure, ambulatory monitoring, treatment thresholds, and target values that informed the guideline recommendations. ## 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2018-10-23 · Circulation · https://doi.org/10.1161/CIR.0000000000000597 · https://hartvaat.nl/2018/10/23/2017-acc-aha-hypertensierichtlijn-executive-summary/* Executive summary of the 2017 ACC/AHA hypertension guideline, providing the key decision algorithms and recommendations for the diagnosis, evaluation, and management of high blood pressure in adults, including the redefined threshold of 130/80 mmHg. ## 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2018-10-23 · Circulation · https://doi.org/10.1161/CIR.0000000000000596 · https://hartvaat.nl/2018/10/23/2017-acc-aha-hypertensierichtlijn-circulation-editie/* The 2017 ACC/AHA Guideline redefined hypertension as blood pressure ≥130/80 mmHg, lowering the threshold from the previous ≥140/90 mmHg. The guideline introduced new risk-based treatment strategies emphasizing lifestyle modification and pharmacotherapy to more aggressively prevent cardiovascular events. ## Effect of Evolocumab on Coronary Plaque Composition. *2018-10-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.06.078 · https://hartvaat.nl/2018/10/23/evolocumab-en-coronaire-plaquesamenstelling-glagov-beeldvorming/* This GLAGOV substudy analyzed the effect of evolocumab on coronary plaque composition by IVUS, showing that PCSK9 inhibition not only reduces plaque volume but also changes plaque characteristics toward a more stable phenotype. ## Fractional Flow Reserve and Instantaneous Wave-Free Ratio as Predictors of the Placebo-Controlled Response to Percutaneous Coronary Intervention in Stable Single-Vessel Coronary Artery Disease. *2018-10-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.033801 · https://hartvaat.nl/2018/10/23/ffr-en-ifr-als-voorspellers-van-placebo-gecontroleerde-pci-respons-orbita/* This ORBITA substudy assessed whether FFR and iFR predicted the placebo-controlled symptomatic response to PCI in stable angina. The analysis explored whether invasive physiological indices can identify patients most likely to experience genuine symptom relief from revascularization. ## LPA Variants Are Associated With Residual Cardiovascular Risk in Patients Receiving Statins. *2018-10-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.031356 · https://hartvaat.nl/2018/10/23/lpa-varianten-en-residueel-cv-risico-bij-statinebehandelde-patienten/* This genetic study identified LPA gene variants associated with residual cardiovascular risk in statin-treated patients, demonstrating that genetically elevated lipoprotein(a) contributes to atherosclerotic risk that statins cannot address. ## Effects of n-3 Fatty Acid Supplements in Diabetes Mellitus. *2018-10-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1804989 · https://hartvaat.nl/2018/10/18/omega-3-vetzuursupplementen-bij-diabetes-nejm-ascend-omega-3/* The omega-3 component of the ASCEND trial found no significant cardiovascular benefit of n-3 fatty acid supplementation in patients with diabetes over a median of 7.4 years. The result added to the evidence against routine fish oil supplementation for cardiovascular prevention. ## Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. *2018-10-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1804988 · https://hartvaat.nl/2018/10/18/aspirine-voor-primaire-preventie-bij-diabetes-nejm-ascend/* The ASCEND trial showed that aspirin modestly reduced serious vascular events in patients with diabetes without established cardiovascular disease, but this benefit was largely offset by an increase in major bleeding. The results shifted the risk-benefit calculus against routine aspirin use for primary prevention in diabetes. ## Direct Oral Anticoagulants Halve Thromboembolic Events After Cardioversion of AF Compared With Warfarin. *2018-10-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.07.083 · https://hartvaat.nl/2018/10/16/doac-s-halveren-trombo-embolische-events-na-af-cardioversie-versus-warfarine/* This study showed that DOACs halve the risk of thromboembolic events after cardioversion for AF compared with warfarin, supporting DOAC-based anticoagulation as the preferred approach around cardioversion procedures. ## High Coronary Shear Stress in Patients With Coronary Artery Disease Predicts Myocardial Infarction. *2018-10-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.07.075 · https://hartvaat.nl/2018/10/16/hoge-coronaire-shear-stress-voorspelt-myocardinfarct/* This study showed that high coronary wall shear stress, measured invasively, predicts future myocardial infarction in patients with coronary disease, introducing a biomechanical risk factor for plaque rupture beyond traditional stenosis assessment. ## Use of Biomarkers to Predict Specific Causes of Death in Patients With Atrial Fibrillation. *2018-10-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034125 · https://hartvaat.nl/2018/10/16/biomarkers-voor-specifieke-doodsoorzaken-bij-af/* This study used multiple biomarkers (troponin, GDF-15, NT-proBNP) to predict specific causes of death in AF patients, improving the ability to differentiate cardiovascular from non-cardiovascular mortality risk. ## Baseline and on-statin treatment lipoprotein(a) levels for prediction of cardiovascular events: individual patient-data meta-analysis of statin outcome trials. *2018-10-13 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31652-0 · https://hartvaat.nl/2018/10/13/lp-a-baseline-en-on-statin-voor-cv-eventvoorspelling-lancet-ipd-meta-analyse/* This individual patient data meta-analysis from statin trials demonstrated that elevated lipoprotein(a) levels, both at baseline and on statin therapy, independently predict cardiovascular events. The findings established Lp(a) as a residual risk factor that persists despite optimal LDL cholesterol lowering. ## Twenty-Four-Hour Ambulatory Blood Pressure Reduction Patterns After Renal Denervation in the SPYRAL HTN-OFF MED Trial. *2018-10-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.035588 · https://hartvaat.nl/2018/10/09/24-uurs-ambulante-bloeddrukreductie-na-renale-denervatie-spyral-htn-off-med/* This SPYRAL HTN-OFF MED analysis of 24-hour ambulatory blood pressure reduction patterns after renal denervation provided detailed hemodynamic characterization of the blood pressure lowering effect throughout the day and night cycle. ## Hypoglycemia and Elevated Troponin in Patients With Diabetes and Coronary Artery Disease. *2018-10-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.07.067 · https://hartvaat.nl/2018/10/09/hypoglykemie-en-troponine-elevatie-bij-diabetes-met-coronairlijden/* This study demonstrated an association between hypoglycemia and elevated cardiac troponin in diabetic patients with coronary artery disease, identifying glucose variability as a potential trigger for myocardial injury. ## Effects of Sacubitril/Valsartan Versus Irbesartan in Patients With Chronic Kidney Disease. *2018-10-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034818 · https://hartvaat.nl/2018/10/09/sacubitril-valsartan-versus-irbesartan-bij-chronische-nierziekte/* This study compared sacubitril-valsartan with irbesartan in patients with chronic kidney disease, exploring whether the ARNI provides renal benefit beyond standard ARB therapy outside the heart failure setting. ## Thin composite wire strut, durable polymer-coated (Resolute Onyx) versus ultrathin cobalt-chromium strut, bioresorbable polymer-coated (Orsiro) drug-eluting stents in allcomers with coronary artery disease (BIONYX): an international, single-blind, randomised non-inferiority trial. *2018-10-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)32001-4 · https://hartvaat.nl/2018/10/06/resolute-onyx-versus-orsiro-stent-lancet-gerandomiseerde-non-inferioriteitstrial/* This Lancet trial compared two contemporary DES platforms — a durable polymer zotarolimus-eluting stent with a biodegradable polymer sirolimus-eluting stent — providing head-to-head data on the latest stent coating technologies. ## Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease. *2018-10-04 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1808848 · https://hartvaat.nl/2018/10/04/rivaroxaban-bij-hartfalen-met-sinusritme-en-coronairlijden-nejm-commander-hf/* The COMMANDER HF trial showed that low-dose rivaroxaban did not reduce the composite of death, MI, or stroke in patients with heart failure in sinus rhythm and coronary disease. The result indicated that anticoagulation does not benefit heart failure patients without atrial fibrillation. ## Cangrelor in Ticagrelor-Loaded STEMI Patients Undergoing Primary Percutaneous Coronary Intervention. *2018-10-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.07.041 · https://hartvaat.nl/2018/10/02/cangrelor-bij-ticagrelor-geladen-stemi-patienten-tijdens-primaire-pci/* This study investigated the pharmacodynamic interaction between cangrelor and ticagrelor preloading in STEMI patients undergoing primary PCI, addressing the practical question of sequential intravenous-to-oral antiplatelet transition. ## Thrombus Aspiration in Patients With High Thrombus Burden in the TOTAL Trial. *2018-10-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.07.047 · https://hartvaat.nl/2018/10/02/trombusaspiratie-bij-hoge-trombuslast-total-trial/* This TOTAL subanalysis in patients with high thrombus burden during primary PCI for STEMI evaluated whether thrombus aspiration provides benefit specifically in those with the most thrombotic lesions. ## Cardiovascular Outcomes After Lower Extremity Endovascular or Surgical Revascularization: The EUCLID Trial. *2018-10-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.07.046 · https://hartvaat.nl/2018/10/02/cv-uitkomsten-na-endovasculaire-versus-chirurgische-revascularisatie-onderste-le/* This EUCLID trial analysis showed that lower extremity revascularization in PAD patients is associated with increased cardiovascular events, highlighting the systemic nature of atherosclerotic disease and the need for comprehensive secondary prevention. ## Periprocedural Outcomes of Direct Oral Anticoagulants Versus Warfarin in Nonvalvular Atrial Fibrillation. *2018-10-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.031457 · https://hartvaat.nl/2018/10/02/periprocedurele-uitkomsten-van-doac-versus-warfarine-bij-niet-valvulair-af/* This analysis of periprocedural outcomes with DOACs versus warfarin across various procedures (surgery, ablation, dental) in AF patients showed comparable safety, supporting continued DOAC use around most elective procedures. ## One-Year Safety and Clinical Outcomes of a Transcatheter Interatrial Shunt Device for the Treatment of Heart Failure With Preserved Ejection Fraction in the Reduce Elevated Left Atrial Pressure in Patients With Heart Failure (REDUCE LAP-HF I) Trial: A Randomized Clinical Trial. *2018-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.2936 · https://hartvaat.nl/2018/10/01/transcatheter-interatriale-shunt-bij-hfpef-1-jaarsresultaten/* This 1-year follow-up of the interatrial shunt device in HFpEF demonstrated safety and preliminary hemodynamic improvements, providing extended data on this structural intervention for heart failure with preserved ejection fraction. ## Enrollment of Older Patients, Women, and Racial and Ethnic Minorities in Contemporary Heart Failure Clinical Trials: A Systematic Review. *2018-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.2559 · https://hartvaat.nl/2018/10/01/inclusie-van-ouderen-vrouwen-en-minderheden-in-hf-trials-jama-cardiology-review/* This systematic review documented the underrepresentation of older patients, women, and racial/ethnic minorities in heart failure clinical trials, highlighting the gap between trial populations and the real-world disease burden. ## Association of Natriuretic Peptides With Cardiovascular Prognosis in Heart Failure With Preserved Ejection Fraction: Secondary Analysis of the TOPCAT Randomized Clinical Trial. *2018-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.2568 · https://hartvaat.nl/2018/10/01/natriuretische-peptiden-en-cardiovasculaire-prognose-bij-hfpef-topcat/* This TOPCAT analysis demonstrated that natriuretic peptide levels provide strong prognostic value in HFpEF, informing the use of NP thresholds for patient selection in clinical trials and risk stratification in practice. ## Association is not causation: treatment effects cannot be estimated from observational data in heart failure. *2018-10-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy407 · https://hartvaat.nl/2018/10/01/associatie-is-geen-causaliteit-behandeleffecten-bij-hartfalen-en-observationele-/* This important methodological article cautioned against inferring treatment effects from observational studies in heart failure, demonstrating with clear examples how confounding and selection bias can produce misleading conclusions even with advanced statistical adjustment. ## Uninterrupted direct oral anticoagulants vs. uninterrupted vitamin K antagonists during catheter ablation of non-valvular atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials. *2018-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy133 · https://hartvaat.nl/2018/10/01/ononderbroken-doac-versus-vka-bij-af-ablatie-meta-analyse/* This meta-analysis comparing uninterrupted DOACs with uninterrupted VKAs during catheter ablation for AF found similar or lower rates of thromboembolic and bleeding complications with DOACs, consolidating the evidence for periprocedural DOAC use. ## Acute and long-term efficacy and safety with a single cryoballoon application as compared with the standard dual application strategy: a prospective randomized study using the second-generation cryoballoon for pulmonary vein isolation in patients with symptomatic atrial fibrillation. *2018-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy014 · https://hartvaat.nl/2018/10/01/enkele-versus-dubbele-cryoballon-applicatie-bij-af-effectiviteit-en-veiligheid/* This study compared a single cryoballoon application per vein with the standard dual application strategy for AF ablation, testing whether procedural simplification maintains isolation durability. ## Prognostic Value of Masked Uncontrolled Hypertension. *2018-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11499 · https://hartvaat.nl/2018/10/01/prognostische-waarde-van-gemaskeerd-ongecontroleerde-hypertensie/* This study demonstrated the prognostic importance of masked uncontrolled hypertension — where office blood pressure appears controlled but ambulatory readings remain elevated — showing significant associations with cardiovascular events and mortality. ## Hypertension Treatment Effects on Orthostatic Hypotension and Its Relationship With Cardiovascular Disease. *2018-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11337 · https://hartvaat.nl/2018/10/01/hypertensiebehandeling-en-orthostatische-hypotensie-relatie-met-cv-ziekte/* This analysis showed that antihypertensive treatment does not worsen orthostatic hypotension and may actually reduce its cardiovascular consequences, challenging the clinical reluctance to treat blood pressure aggressively in patients with OH. ## Randomized Crossover Trial of the Impact of Morning or Evening Dosing of Antihypertensive Agents on 24-Hour Ambulatory Blood Pressure. *2018-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11101 · https://hartvaat.nl/2018/10/01/ochtend-versus-avonddosering-van-antihypertensiva-gerandomiseerde-crossover-tria/* This randomized crossover trial showed no significant difference between morning and evening dosing of antihypertensive medications on 24-hour ambulatory blood pressure, providing early evidence that dosing time does not matter — a finding later confirmed by the larger TIME trial. ## Left atrial volume and cardiovascular outcomes in systolic heart failure: effect of antithrombotic treatment. *2018-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12331 · https://hartvaat.nl/2018/10/01/linkeratriumvolume-en-cv-uitkomsten-bij-systolisch-hf-antitromboticaeffect/* This study examined the relationship between left atrial volume, cardiovascular outcomes, and antithrombotic treatment in systolic heart failure, exploring whether LA dilation identifies patients who may benefit from anticoagulation. ## Features of atrial fibrillation in wild-type transthyretin cardiac amyloidosis: a systematic review and clinical experience. *2018-10-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12308 · https://hartvaat.nl/2018/10/01/atriumfibrilleren-bij-wild-type-transthyretine-cardiale-amyloidose-review/* This systematic review characterized atrial fibrillation in wild-type transthyretin cardiac amyloidosis, showing that AF is common and clinically significant in this increasingly recognized cause of heart failure in the elderly. ## Estimated individual lifetime benefit from PCSK9 inhibition in statin-treated patients with coronary artery disease. *2018-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312510 · https://hartvaat.nl/2018/10/01/geschat-individueel-levensvoordeel-van-pcsk9-remming-bij-statinebehandelde-cad-p/* This study estimated the individual lifetime benefit of PCSK9 inhibitor therapy in statin-treated patients with stable coronary artery disease, calculating that the absolute benefit varies substantially based on age, risk factors, and residual LDL cholesterol. ## Danegaptide for primary percutaneous coronary intervention in acute myocardial infarction patients: a phase 2 randomised clinical trial. *2018-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312774 · https://hartvaat.nl/2018/10/01/danegaptide-bij-primaire-pci-voor-acuut-mi-fase-2-gerandomiseerde-trial/* This phase 2 trial of danegaptide, a gap junction modulator, during primary PCI for acute MI tested a novel approach to limiting reperfusion injury by modifying intercellular communication during ischemia-reperfusion. ## Effects of supplemental oxygen therapy in patients with suspected acute myocardial infarction: a meta-analysis of randomised clinical trials. *2018-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2018-313089 · https://hartvaat.nl/2018/10/01/zuurstof-bij-verdenking-acuut-mi-meta-analyse-van-gerandomiseerde-trials/* This meta-analysis of randomized trials found no benefit of supplemental oxygen therapy in patients with suspected acute MI without hypoxemia, with a trend toward increased myocardial injury. The cumulative evidence supports withholding oxygen in normoxic MI patients. ## Long-term mortality after blood pressure-lowering and lipid-lowering treatment in patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy study: 16-year follow-up results of a randomised factorial trial. *2018-09-29 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31776-8 · https://hartvaat.nl/2018/09/29/langetermijnmortaliteit-na-bloeddruk-en-lipidenverlaging-bij-hypertensie-ascot-l/* This ASCOT legacy analysis examined long-term mortality effects after 15+ years of follow-up from the original blood pressure and lipid-lowering trial in hypertensive patients. The extended data assessed whether in-trial cardiovascular benefits translated to durable post-trial survival advantages. ## Wearable Cardioverter-Defibrillator after Myocardial Infarction. *2018-09-27 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1800781 · https://hartvaat.nl/2018/09/27/draagbare-cardioverter-defibrillator-na-myocardinfarct-nejm-vest/* The VEST trial showed that a wearable cardioverter-defibrillator did not significantly reduce the primary endpoint of sudden death from cardiac causes within 90 days after MI in patients with reduced ejection fraction. The result tempered enthusiasm for routine WCD use as a bridge to ICD implantation. ## Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery. *2018-09-27 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1808561 · https://hartvaat.nl/2018/09/27/6-maandsuitkomsten-van-restrictieve-versus-liberale-transfusie-bij-hartchirurgie/* The 6-month TRICS III follow-up confirmed that a restrictive transfusion strategy remains noninferior to liberal transfusion in patients undergoing cardiac surgery, supporting conservative transfusion thresholds beyond the immediate perioperative period. ## Edoxaban Versus Warfarin in Latin American Patients With Atrial Fibrillation: The ENGAGE AF-TIMI 48 Trial. *2018-09-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.07.037 · https://hartvaat.nl/2018/09/25/edoxaban-versus-warfarine-bij-latijns-amerikaanse-af-patienten-engage-af-timi-48/* This ENGAGE AF-TIMI 48 subanalysis in Latin American AF patients showed that edoxaban maintains its favorable efficacy and safety profile in this regional population, supporting the generalizability of the DOAC evidence. ## Effect of an siRNA Therapeutic Targeting PCSK9 on Atherogenic Lipoproteins: Prespecified Secondary End Points in ORION 1. *2018-09-25 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034710 · https://hartvaat.nl/2018/09/25/sirna-tegen-pcsk9-en-atherogene-lipoproteinen-orion-1-secundaire-eindpunten/* This ORION-1 secondary analysis showed that inclisiran reduces the full spectrum of atherogenic lipoproteins beyond LDL cholesterol, including VLDL, remnant cholesterol, and apolipoprotein B, suggesting a broad anti-atherogenic lipid profile. ## Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. *2018-09-22 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31924-X · https://hartvaat.nl/2018/09/22/aspirine-voor-primaire-preventie-bij-matig-cv-risico-lancet-arrive/* The ARRIVE trial found that aspirin did not significantly reduce cardiovascular events in patients at moderate cardiovascular risk without established disease, while increasing gastrointestinal bleeding. The result contributed to the shift away from routine aspirin use in primary prevention. ## Efficacy of telemedical interventional management in patients with heart failure (TIM-HF2): a randomised, controlled, parallel-group, unmasked trial. *2018-09-22 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31880-4 · https://hartvaat.nl/2018/09/22/telemedische-interventie-bij-hartfalen-lancet-tim-hf2/* The TIM-HF2 trial demonstrated that structured remote patient management in heart failure reduced the proportion of days lost to unplanned cardiovascular hospitalization or death compared with usual care. The positive result supported the implementation of telemedical monitoring programs in heart failure management. ## Cardiovascular Safety of Lorcaserin in Overweight or Obese Patients. *2018-09-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1808721 · https://hartvaat.nl/2018/09/20/cardiovasculaire-veiligheid-van-lorcaserine-bij-obesitas-nejm-camellia/* The CAMELLIA-TIMI 61 trial confirmed the cardiovascular safety of lorcaserin in overweight and obese patients, showing noninferiority to placebo for MACE. However, the drug was later voluntarily withdrawn due to a cancer safety signal. ## Heart Failure After Ischemic Stroke or Transient Ischemic Attack in Insulin-Resistant Patients Without Diabetes Mellitus Treated With Pioglitazone. *2018-09-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034763 · https://hartvaat.nl/2018/09/18/hartfalen-na-cva-tia-bij-insulineresistente-patienten-behandeld-met-pioglitazon/* This IRIS trial analysis examined the effect of pioglitazone on heart failure incidence after stroke or TIA in insulin-resistant non-diabetic patients, addressing a safety concern of thiazolidinedione therapy. ## High-sensitivity troponin in the evaluation of patients with suspected acute coronary syndrome: a stepped-wedge, cluster-randomised controlled trial. *2018-09-15 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31923-8 · https://hartvaat.nl/2018/09/15/hoog-sensitief-troponine-bij-verdenking-acs-lancet-stepped-wedge-clustergerandom/* This Lancet stepped-wedge trial showed that implementing high-sensitivity troponin testing with lowered diagnostic thresholds in real-world practice identifies more patients with myocardial infarction and may improve clinical outcomes through earlier treatment. ## Ticagrelor plus aspirin for 1 month, followed by ticagrelor monotherapy for 23 months vs aspirin plus clopidogrel or ticagrelor for 12 months, followed by aspirin monotherapy for 12 months after implantation of a drug-eluting stent: a multicentre, open-label, randomised superiority trial. *2018-09-15 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31858-0 · https://hartvaat.nl/2018/09/15/ticagrelor-monotherapie-na-1-maand-dapt-lancet-global-leaders/* The GLOBAL LEADERS trial tested an early switch from DAPT to ticagrelor monotherapy after 1 month versus standard 12-month DAPT after PCI. The strategy did not show superiority for the primary endpoint, but provided safety data for early P2Y12 inhibitor monotherapy that informed subsequent trials. ## Tafamidis Treatment for Patients with Transthyretin Amyloid Cardiomyopathy. *2018-09-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1805689 · https://hartvaat.nl/2018/09/13/tafamidis-bij-transthyretine-amyloid-cardiomyopathie-nejm-attr-act/* The ATTR-ACT trial demonstrated that tafamidis significantly reduced all-cause mortality and cardiovascular hospitalization in patients with transthyretin amyloid cardiomyopathy. As the first proven pharmacological treatment for cardiac amyloidosis, this study transformed a previously untreatable condition into a manageable disease. ## Drug-coated balloons for small coronary artery disease (BASKET-SMALL 2): an open-label randomised non-inferiority trial. *2018-09-08 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31719-7 · https://hartvaat.nl/2018/09/08/drug-coated-balloons-bij-kleine-coronairarterien-lancet-basket-small-2/* The BASKET-SMALL 2 trial demonstrated that drug-coated balloons are noninferior to drug-eluting stents for treating small coronary arteries, establishing a leave-nothing-behind strategy as a viable option in small vessel disease. ## Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial. *2018-09-08 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31714-8 · https://hartvaat.nl/2018/09/08/radiale-versus-femorale-toegang-en-bivalirudine-versus-ufh-bij-acs-lancet-matrix/* The MATRIX trial with its 2×2 factorial design demonstrated that radial access reduced net adverse clinical events compared with femoral access, while bivalirudin did not show significant benefit over unfractionated heparin in invasively managed ACS patients. The results strengthened radial access as the default approach. ## Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. *2018-09-06 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1805971 · https://hartvaat.nl/2018/09/06/ct-coronairangiografie-en-5-jaars-mi-risico-nejm-scot-heart/* The 5-year SCOT-HEART results showed that adding coronary CT angiography to standard care for stable chest pain halved the rate of fatal and nonfatal MI by improving diagnosis and enabling preventive treatment. The findings established CCTA as a first-line investigation for stable chest pain syndromes. ## Cardiac Troponin I and Cardiovascular Risk in Patients With Chronic Obstructive Pulmonary Disease. *2018-09-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.06.051 · https://hartvaat.nl/2018/09/04/troponine-i-en-cardiovasculair-risico-bij-copd/* This study demonstrated that cardiac troponin I levels independently predict cardiovascular events in COPD patients, supporting troponin as a cardiac risk biomarker in the respiratory disease population. ## Ultrathin-strut, biodegradable-polymer, sirolimus-eluting stents versus thin-strut, durable-polymer, everolimus-eluting stents for percutaneous coronary revascularisation: 5-year outcomes of the BIOSCIENCE randomised trial. *2018-09-01 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31715-X · https://hartvaat.nl/2018/09/01/ultradunne-biodegradeerbare-versus-dunne-duurzame-stents-lancet-gerandomiseerde-/* This Lancet non-inferiority trial of ultra-thin biodegradable polymer sirolimus-eluting stents versus thin durable polymer everolimus-eluting stents confirmed similar safety and efficacy, supporting the evolution toward thinner, more biocompatible stent platforms. ## Blood pressure, heart rate, and mortality in chronic obstructive pulmonary disease: the SUMMIT trial. *2018-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy451 · https://hartvaat.nl/2018/09/01/bloeddruk-hartfrequentie-en-mortaliteit-bij-copd-summit-trial/* This SUMMIT trial analysis characterized the relationship between blood pressure, heart rate, and mortality in COPD patients with elevated cardiovascular risk, informing the management of the common cardiopulmonary comorbidity overlap. ## Efficacy and Safety of Further Lowering of Low-Density Lipoprotein Cholesterol in Patients Starting With Very Low Levels: A Meta-analysis. *2018-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.2258 · https://hartvaat.nl/2018/09/01/verdere-ldl-verlaging-bij-reeds-zeer-lage-niveaus-jama-cardiology-meta-analyse/* This JAMA Cardiology meta-analysis showed that further LDL cholesterol lowering in patients already at very low levels continued to reduce cardiovascular events proportionally without excess safety concerns. The data reinforced the 'lower is better' hypothesis even below 1.8 mmol/L. ## Orthostatic hypotension and symptomatic subclinical orthostatic hypotension increase risk of cognitive impairment: an integrated evidence review and analysis of a large older adult hypertensive cohort. *2018-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy418 · https://hartvaat.nl/2018/09/01/orthostatische-hypotensie-verhoogt-risico-op-cognitieve-stoornissen/* This integrated analysis showed that both orthostatic hypotension and symptomatic subclinical orthostatic hypotension are associated with increased risk of cognitive impairment and dementia, linking postural hemodynamic instability to brain health. ## Effect of Infusion of High-Density Lipoprotein Mimetic Containing Recombinant Apolipoprotein A-I Milano on Coronary Disease in Patients With an Acute Coronary Syndrome in the MILANO-PILOT Trial: A Randomized Clinical Trial. *2018-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.2112 · https://hartvaat.nl/2018/09/01/hdl-mimeticum-met-recombinant-apoa-i-milano-en-coronairlijden-jama-cardiology/* This JAMA Cardiology trial of a recombinant apoA-I Milano HDL mimetic showed no improvement in coronary atheroma volume, failing to replicate the earlier promising results and dampening enthusiasm for HDL-based interventions. ## Effect of Serial Infusions of CER-001, a Pre-β High-Density Lipoprotein Mimetic, on Coronary Atherosclerosis in Patients Following Acute Coronary Syndromes in the CER-001 Atherosclerosis Regression Acute Coronary Syndrome Trial: A Randomized Clinical Trial. *2018-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.2121 · https://hartvaat.nl/2018/09/01/cer-001-hdl-mimeticum-en-coronaire-atherosclerose-na-acs-jama-cardiology/* This JAMA Cardiology trial of CER-001, a pre-β HDL mimetic, showed no regression of coronary atherosclerosis after ACS, adding to the negative evidence for HDL-raising strategies as cardiovascular therapeutics. ## Achieved diastolic blood pressure and pulse pressure at target systolic blood pressure (120-140 mmHg) and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials. *2018-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy287 · https://hartvaat.nl/2018/09/01/bereikte-diastolische-bloeddruk-en-polsdruk-bij-streef-sbp-en-cv-uitkomsten-bij-/* This analysis examined achieved diastolic blood pressure and pulse pressure at various systolic targets and their relationship with cardiovascular outcomes, informing the debate about optimal hemodynamic parameters beyond systolic targets. ## Burden of atrial high-rate episodes and risk of stroke: a systematic review. *2018-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux356 · https://hartvaat.nl/2018/09/01/last-van-atriale-high-rate-episodes-en-cva-risico-systematische-review/* This systematic review examined the relationship between the burden (duration and frequency) of device-detected atrial high-rate episodes and stroke risk, finding that higher AF burden is associated with greater stroke risk but that the absolute risk varies considerably. ## Surgical ablation of atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials. *2018-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux336 · https://hartvaat.nl/2018/09/01/chirurgische-af-ablatie-systematische-review-en-meta-analyse-van-rct-s/* This systematic review of randomized trials evaluated concomitant surgical AF ablation during cardiac surgery, assessing the effectiveness of surgical rhythm control as an adjunct to valve or coronary operations. ## Pace-capture-guided ablation after contact-force-guided pulmonary vein isolation: results of the randomized controlled DRAGON trial. *2018-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux319 · https://hartvaat.nl/2018/09/01/pace-capture-geleide-ablatie-na-contact-force-pvi-dragon-gerandomiseerde-trial/* The DRAGON randomized trial tested whether additional pace-capture-guided ablation after contact-force-guided PVI improves AF ablation outcomes, evaluating a gap-targeting strategy for more complete pulmonary vein isolation. ## How Do Home and Clinic Blood Pressure Readings Compare in Pregnancy? *2018-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.10917 · https://hartvaat.nl/2018/09/01/thuis-versus-praktijkbloeddrukmeting-in-de-zwangerschap/* This study compared home with clinic blood pressure readings during pregnancy, showing clinically meaningful discrepancies that affect hypertensive disorder diagnosis and management decisions. ## Cardiac rehabilitation and physical activity: systematic review and meta-analysis. *2018-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312832 · https://hartvaat.nl/2018/09/01/hartrevalidatie-en-lichamelijke-activiteit-systematische-review-en-meta-analyse/* This meta-analysis evaluated the impact of cardiac rehabilitation on physical activity levels, finding that structured CR programs significantly increase daily activity and exercise capacity. The findings reinforce the importance of exercise-based rehabilitation after cardiac events. ## Long-term impact of chronic total occlusion recanalisation in patients with ST-elevation myocardial infarction. *2018-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312698 · https://hartvaat.nl/2018/09/01/langetermijnimpact-van-cto-rekanalisatie-bij-stemi-patienten/* This study evaluated the long-term impact of concurrent CTO recanalization in STEMI patients, providing evidence on whether pursuing complete revascularization of chronic occlusions improves long-term outcomes after primary PCI. ## Apixaban compared to heparin/vitamin K antagonist in patients with atrial fibrillation scheduled for cardioversion: the EMANATE trial. *2018-08-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehy148 · https://hartvaat.nl/2018/08/21/apixaban-versus-heparine-vka-bij-cardioversie-voor-af-emanate-trial/* The EMANATE trial showed that apixaban is as safe as heparin/vitamin K antagonist in AF patients undergoing cardioversion with less than 48 hours of anticoagulation, supporting simplified DOAC-based management around cardioversion procedures. ## Clinical Benefit of Evolocumab by Severity and Extent of Coronary Artery Disease: Analysis From FOURIER. *2018-08-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034309 · https://hartvaat.nl/2018/08/21/klinisch-voordeel-van-evolocumab-naar-ernst-van-coronairlijden-fourier/* This FOURIER analysis demonstrated that the clinical benefit of evolocumab was greatest in patients with the most severe and extensive coronary artery disease, including those with recent MI, multivessel disease, or peripheral arterial disease. The findings supported risk-based prioritization of PCSK9 inhibitor therapy. ## Apixaban in patients at risk of stroke undergoing atrial fibrillation ablation. *2018-08-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehy176 · https://hartvaat.nl/2018/08/21/apixaban-bij-af-ablatie-veiligheid-bij-patienten-met-cva-risico/* This study provided safety data for continuous apixaban use during AF catheter ablation, supporting the feasibility and safety of uninterrupted DOAC anticoagulation in the periprocedural setting. ## Targeted therapy of underlying conditions improves sinus rhythm maintenance in patients with persistent atrial fibrillation: results of the RACE 3 trial. *2018-08-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx739 · https://hartvaat.nl/2018/08/21/behandeling-van-onderliggende-aandoeningen-verbetert-sinusritme-na-af-arrest-af/* The ARREST-AF study demonstrated that targeted therapy of AF risk factors (obesity, sleep apnea, hypertension, diabetes) significantly improves sinus rhythm maintenance after ablation for persistent AF, establishing aggressive risk factor management as an essential adjunct to rhythm control. ## Fixed Low-Dose Triple Combination Antihypertensive Medication vs Usual Care for Blood Pressure Control in Patients With Mild to Moderate Hypertension in Sri Lanka: A Randomized Clinical Trial. *2018-08-14 · JAMA · https://doi.org/10.1001/jama.2018.10359 · https://hartvaat.nl/2018/08/14/drievoudige-lage-dosis-antihypertensivacombinatie-versus-standaardzorg-jama-gera/* This JAMA trial showed that a fixed low-dose triple combination antihypertensive pill achieved substantially better blood pressure control at 6 months compared with usual care in patients with mild-to-moderate hypertension. The results supported initial combination therapy as a strategy to overcome clinical inertia. ## Left Main Revascularization With PCI or CABG in Patients With Chronic Kidney Disease: EXCEL Trial. *2018-08-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.05.057 · https://hartvaat.nl/2018/08/14/hoofdstamrevascularisatie-bij-ckd-pci-versus-cabg-in-de-excel-trial/* This EXCEL subanalysis in patients with CKD undergoing left main revascularization showed comparable outcomes between PCI and CABG in mild CKD, with the benefit of surgery potentially greater in more advanced kidney disease. ## Asymmetric and Symmetric Dimethylarginine Predict Outcomes in Patients With Atrial Fibrillation: An ARISTOTLE Substudy. *2018-08-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.05.058 · https://hartvaat.nl/2018/08/14/adma-en-sdma-voorspellen-uitkomsten-bij-af-aristotle-substudie/* This ARISTOTLE substudy identified asymmetric and symmetric dimethylarginine as predictors of thromboembolism and bleeding in AF patients, establishing nitric oxide pathway biomarkers for risk stratification. ## Screening for Atrial Fibrillation With Electrocardiography: US Preventive Services Task Force Recommendation Statement. *2018-08-07 · JAMA · https://doi.org/10.1001/jama.2018.10321 · https://hartvaat.nl/2018/08/07/ecg-screening-op-af-uspstf-aanbeveling-2018/* The 2018 USPSTF concluded there was insufficient evidence to recommend for or against ECG screening for atrial fibrillation in asymptomatic older adults. The 'I' statement reflected the absence of randomized trials demonstrating that screening-detected AF treatment improves clinical outcomes. ## Screening for Atrial Fibrillation With Electrocardiography: Evidence Report and Systematic Review for the US Preventive Services Task Force. *2018-08-07 · JAMA · https://doi.org/10.1001/jama.2018.4190 · https://hartvaat.nl/2018/08/07/ecg-screening-op-af-uspstf-evidence-report-en-systematische-review/* This USPSTF evidence report systematically reviewed the evidence on ECG screening for atrial fibrillation in asymptomatic adults, evaluating the yield of different screening strategies and the downstream effects on anticoagulation initiation and clinical outcomes. ## Adenosine and Ticagrelor Plasma Levels in Patients With and Without Ticagrelor-Related Dyspnea. *2018-08-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034489 · https://hartvaat.nl/2018/08/07/adenosine-en-ticagrelorspiegels-bij-patienten-met-en-zonder-ticagrelor-dyspneu/* This study investigated the relationship between adenosine and ticagrelor plasma levels in patients with and without ticagrelor-related dyspnea, providing mechanistic insight into this common side effect. ## Oxygen therapy in ST-elevation myocardial infarction. *2018-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy326 · https://hartvaat.nl/2018/08/01/zuurstoftherapie-bij-stemi-overzichtsartikel/* This review evaluated the evidence for oxygen therapy in STEMI in light of DETO2X-AMI and other contemporary trials, concluding that routine supplemental oxygen is not beneficial and may be harmful in normoxemic MI patients. ## Age and outcomes following guided de-escalation of antiplatelet treatment in acute coronary syndrome patients undergoing percutaneous coronary intervention: results from the randomized TROPICAL-ACS trial. *2018-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy332 · https://hartvaat.nl/2018/08/01/leeftijd-en-geleide-de-escalatie-van-antiplaatjestherapie-na-acs-tropical-acs/* This TROPICAL-ACS subanalysis showed that guided DAPT de-escalation is safe and effective across age groups after ACS, supporting the personalized antiplatelet approach in both younger and older patients. ## Nitric oxide for inhalation in ST-elevation myocardial infarction (NOMI): a multicentre, double-blind, randomized controlled trial. *2018-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy232 · https://hartvaat.nl/2018/08/01/inhalatie-stikstofoxide-bij-stemi-nomi-gerandomiseerde-trial/* The NOMI trial of inhaled nitric oxide in STEMI showed no significant reduction in myocardial infarct size, a negative result for this cardioprotective strategy despite promising preclinical data on sGC-cGMP pathway activation. ## The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. *2018-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euy054 · https://hartvaat.nl/2018/08/01/2018-ehra-praktische-gids-doac-s-bij-af-europace-editie/* Europace publication of the 2018 EHRA practical guide for DOAC use in atrial fibrillation, providing the comprehensive reference document for clinical decision-making on DOAC dosing, monitoring, and special populations in parallel with the European Heart Journal edition. ## Benefit of left atrial appendage electrical isolation for persistent and long-standing persistent atrial fibrillation: a systematic review and meta-analysis. *2018-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux372 · https://hartvaat.nl/2018/08/01/linker-hartoorisolatie-bij-persisterend-en-langdurig-persisterend-af-meta-analys/* This systematic review evaluated left atrial appendage electrical isolation as an adjunctive ablation strategy for non-paroxysmal AF, summarizing the evidence for this technique in patients with persistent and longstanding persistent arrhythmia. ## Low frequency electrical muscle stimulation and endothelial function in advanced heart failure patients. *2018-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12293 · https://hartvaat.nl/2018/08/01/laagfrequente-elektrische-spierstimulatie-en-endotheelfunctie-bij-gevorderd-hart/* This double-blind randomised study evaluated low-frequency electrical muscle stimulation as an alternative exercise modality for improving endothelial function and aerobic capacity in patients with advanced chronic heart failure. ## Benefits of Intensive Blood Pressure Treatment in Patients With Type 2 Diabetes Mellitus Receiving Standard but Not Intensive Glycemic Control. *2018-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11408 · https://hartvaat.nl/2018/08/01/intensieve-bloeddrukbehandeling-bij-diabetes-type-2-zonder-intensieve-glycemisch/* This analysis showed that intensive blood pressure treatment provides greater cardiovascular benefit in diabetic patients receiving standard rather than intensive glycemic control, suggesting complementary rather than overlapping protective mechanisms. ## Self-Management of Postnatal Hypertension: The SNAP-HT Trial. *2018-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.10911 · https://hartvaat.nl/2018/08/01/zelfmanagement-van-postnatale-hypertensie-de-snap-ht-trial/* The SNAP-HT trial of blood pressure self-management in the postpartum period after hypertensive pregnancy demonstrated that self-monitoring enables better titration of antihypertensives during the rapidly changing post-delivery period. ## Pharmacological Treatment of Arterial Hypertension in Children and Adolescents: A Network Meta-Analysis. *2018-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.10862 · https://hartvaat.nl/2018/08/01/farmacologische-behandeling-van-hypertensie-bij-kinderen-netwerkmeta-analyse/* This network meta-analysis of antihypertensive medications in children and adolescents provided rare comparative effectiveness data for different drug classes in pediatric hypertension treatment. ## Renin-Angiotensin-Aldosterone Profiles in Pregnant Women With Chronic Hypertension. *2018-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.10854 · https://hartvaat.nl/2018/08/01/raas-profielen-bij-zwangeren-met-chronische-hypertensie/* This study characterized renin-angiotensin-aldosterone profiles in pregnant women with chronic hypertension, providing pathophysiological insights into the hormonal changes that contribute to blood pressure regulation during pregnancy. ## Renal Denervation in Resistant Hypertension and Obstructive Sleep Apnea: Randomized Proof-of-Concept Phase II Trial. *2018-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11180 · https://hartvaat.nl/2018/08/01/renale-denervatie-bij-resistente-hypertensie-met-obstructieve-slaapapneu-proof-o/* This randomized proof-of-concept trial tested renal denervation in patients with resistant hypertension and comorbid obstructive sleep apnea, exploring whether sympathetic modulation improves both blood pressure and sleep-disordered breathing. ## Sympathetic Nerve Traffic Activation in Essential Hypertension and Its Correlates: Systematic Reviews and Meta-Analyses. *2018-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.11038 · https://hartvaat.nl/2018/08/01/sympathische-zenuwactivatie-bij-essentiele-hypertensie-meta-analyse/* This systematic review and meta-analysis confirmed that sympathetic nerve activation is present in essential hypertension, providing pathophysiological support for sympatholytic therapies and renal denervation in hypertension management. ## Long-term effects of patiromer for hyperkalaemia treatment in patients with mild heart failure and diabetic nephropathy on angiotensin-converting enzymes/angiotensin receptor blockers: results from AMETHYST-DN. *2018-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12292 · https://hartvaat.nl/2018/08/01/langetermijn-patiromer-bij-hyperkaliemie-met-mild-hf-en-diabetische-nefropathie/* This study evaluated long-term patiromer effects on potassium levels and RAAS inhibitor use in patients with mild heart failure and diabetic nephropathy, demonstrating sustained potassium management that enables optimal neurohormonal blockade. ## Characteristics and long-term prognosis of patients with heart failure and mid-range ejection fraction compared with reduced and preserved ejection fraction: a systematic review and meta-analysis. *2018-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12283 · https://hartvaat.nl/2018/08/01/kenmerken-en-prognose-van-hfmref-versus-hfref-en-hfpef-langetermijn/* This meta-analysis compared the clinical characteristics and long-term prognosis of HFmrEF with HFrEF and HFpEF, positioning the intermediate ejection fraction category and its distinct prognostic profile. ## The impact of aerobic exercise training with vascular occlusion in patients with chronic heart failure. *2018-08-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12285 · https://hartvaat.nl/2018/08/01/inspanningstraining-met-vasculaire-occlusie-bij-chronisch-hartfalen/* This study evaluated aerobic exercise training with blood flow restriction (vascular occlusion) in chronic heart failure, testing whether low-load training with restricted blood flow achieves comparable benefits to conventional exercise. ## Opportunistic screening for heart failure with natriuretic peptides in patients with atrial fibrillation: a meta-analysis of individual participant data of four screening studies. *2018-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312781 · https://hartvaat.nl/2018/08/01/opportunistische-hf-screening-met-natriuretische-peptiden-bij-af-ipd-meta-analys/* This individual patient data meta-analysis evaluated opportunistic heart failure screening with natriuretic peptides in AF patients, showing that NT-proBNP can identify unrecognized HF in the AF population where symptoms overlap. ## Coronary intervention door-to-balloon time and outcomes in ST-elevation myocardial infarction: a meta-analysis. *2018-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312517 · https://hartvaat.nl/2018/08/01/door-to-balloon-tijd-en-uitkomsten-bij-stemi-meta-analyse/* This meta-analysis quantified the relationship between door-to-balloon time and outcomes in STEMI, confirming that shorter reperfusion times are associated with better survival and reinforcing the importance of rapid primary PCI systems. ## Outcomes in anticoagulated patients with atrial fibrillation and with mitral or aortic valve disease. *2018-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312272 · https://hartvaat.nl/2018/08/01/uitkomsten-bij-af-met-oac-bij-mitralis-of-aortakleplijden/* This ARISTOTLE subanalysis assessed the outcomes and treatment effect of apixaban versus warfarin in AF patients with concomitant mitral or aortic valve disease, supporting DOAC use in the valvular AF setting. ## Antithrombotic Therapy in Patients With Atrial Fibrillation Treated With Oral Anticoagulation Undergoing Percutaneous Coronary Intervention: A North American Perspective-2018 Update. *2018-07-31 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034722 · https://hartvaat.nl/2018/07/31/antitrombotische-therapie-bij-af-met-oac-na-pci-aha-scientific-statement/* This AHA scientific statement on antithrombotic therapy in AF patients on anticoagulation undergoing PCI integrated evidence from PIONEER AF-PCI, RE-DUAL PCI, and AUGUSTUS to provide practical guidance on dual versus triple antithrombotic strategies in this challenging clinical scenario. ## B-Type Natriuretic Peptide Assessment in Patients Undergoing Revascularization for Left Main Coronary Artery Disease: Analysis From the EXCEL Trial. *2018-07-31 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.033631 · https://hartvaat.nl/2018/07/31/bnp-bij-linker-hoofdstamrevascularisatie-excel-analyse/* This EXCEL analysis evaluated BNP assessment in patients undergoing left main revascularization, showing that baseline natriuretic peptide levels predict outcomes and may inform the PCI-versus-CABG decision. ## Canagliflozin and Heart Failure in Type 2 Diabetes Mellitus: Results From the CANVAS Program. *2018-07-31 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034222 · https://hartvaat.nl/2018/07/31/canagliflozine-en-hartfalen-bij-diabetes-type-2-canvas-programma/* This CANVAS heart failure analysis confirmed that canagliflozin reduces heart failure hospitalization and cardiovascular death in patients with type 2 diabetes, with consistent benefit regardless of baseline heart failure history. The data added to the growing evidence for SGLT2 inhibitors as heart failure preventive therapy. ## Effect of Escitalopram vs Placebo Treatment for Depression on Long-term Cardiac Outcomes in Patients With Acute Coronary Syndrome: A Randomized Clinical Trial. *2018-07-24 · JAMA · https://doi.org/10.1001/jama.2018.9422 · https://hartvaat.nl/2018/07/24/escitalopram-versus-placebo-bij-depressie-na-acs-en-langetermijn-cardiale-uitkom/* This JAMA follow-up of escitalopram treatment for depression after ACS examined whether antidepressant therapy improves long-term cardiac outcomes, addressing the cardiovascular implications of treating comorbid depression in coronary patients. ## Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization. *2018-07-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.04.071 · https://hartvaat.nl/2018/07/24/cva-incidentie-na-cabg-versus-pci/* This comparison of stroke rates after surgical versus percutaneous coronary revascularization showed higher perioperative stroke with CABG but lower long-term ischemic stroke, relevant to the choice between revascularization strategies. ## Baricitinib for systemic lupus erythematosus: a double-blind, randomised, placebo-controlled, phase 2 trial. *2018-07-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31363-1 · https://hartvaat.nl/2018/07/21/baricitinib-bij-sle-lancet-fase-2-dubbelblinde-trial/* This Lancet phase 2 trial of baricitinib (JAK1/JAK2 inhibitor) in systemic lupus erythematosus is relevant to cardio-immunology given the elevated cardiovascular risk in SLE and the cardiovascular monitoring needs during JAK inhibition. ## Five-Year Outcomes with PCI Guided by Fractional Flow Reserve. *2018-07-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1803538 · https://hartvaat.nl/2018/07/19/5-jaarsuitkomsten-van-ffr-geleide-pci-nejm-fame-2/* The 5-year FAME 2 results confirmed the sustained benefit of FFR-guided PCI over medical therapy alone in patients with stable coronary disease and hemodynamically significant stenoses. The long-term data strengthened the role of fractional flow reserve in guiding revascularization decisions. ## Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA. *2018-07-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1800410 · https://hartvaat.nl/2018/07/19/clopidogrel-plus-aspirine-bij-acuut-ischemisch-cva-en-hoogrisico-tia-nejm-point/* The POINT trial showed that short-term dual antiplatelet therapy with clopidogrel plus aspirin reduced recurrent stroke compared with aspirin alone in patients with minor ischemic stroke or high-risk TIA, though with increased bleeding risk. Together with CHANCE, the trial defined the evidence base for early DAPT in minor stroke. ## Concomitant Oral Anticoagulant and Nonsteroidal Anti-Inflammatory Drug Therapy in Patients With Atrial Fibrillation. *2018-07-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.04.063 · https://hartvaat.nl/2018/07/17/oac-plus-nsaid-bij-af-risico-op-ernstige-bloedingen/* This study quantified the bleeding risk of concomitant oral anticoagulant and NSAID use in AF patients, demonstrating a substantially elevated hemorrhagic risk that underscores the importance of minimizing NSAID exposure during anticoagulation. ## Reduction of low density lipoprotein-cholesterol and cardiovascular events with proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors and statins: an analysis of FOURIER, SPIRE, and the Cholesterol Treatment Trialists Collaboration. *2018-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx450 · https://hartvaat.nl/2018/07/14/ldl-verlaging-en-cv-events-met-pcsk9-remmers-meta-analyse-van-gerandomiseerde-tr/* This meta-analysis quantified the relationship between LDL cholesterol reduction with PCSK9 inhibitors and cardiovascular event reduction, confirming proportional benefit consistent with the statin trials. The analysis strengthened the evidence that the mechanism of LDL lowering is less important than the magnitude of reduction. ## Effect of a Home-Based Wearable Continuous ECG Monitoring Patch on Detection of Undiagnosed Atrial Fibrillation: The mSToPS Randomized Clinical Trial. *2018-07-10 · JAMA · https://doi.org/10.1001/jama.2018.8102 · https://hartvaat.nl/2018/07/10/draagbare-ecg-plakker-voor-af-detectie-thuis-jama-mstops-gerandomiseerde-trial/* The mSToPS trial showed that a wearable continuous ECG monitoring patch significantly increased detection of undiagnosed atrial fibrillation compared with routine care. The study demonstrated the feasibility and yield of home-based, consumer-oriented AF screening technology. ## Association of IL-8 With Infarct Size and Clinical Outcomes in Patients With STEMI. *2018-07-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.04.053 · https://hartvaat.nl/2018/07/10/il-8-en-infarctgrootte-en-klinische-uitkomsten-bij-stemi/* This study showed that IL-8 levels are associated with infarct size and clinical outcomes in STEMI, identifying another inflammatory biomarker in the acute MI pathway. ## Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction. *2018-07-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.04.051 · https://hartvaat.nl/2018/07/10/epinefrine-versus-norepinefrine-bij-cardiogene-shock-na-acuut-mi/* This study compared epinephrine with norepinephrine for cardiogenic shock after acute MI, finding higher rates of refractory shock with epinephrine. The results inform vasopressor selection in this critically ill population. ## Fatal or Irreversible Bleeding and Ischemic Events With Rivaroxaban in Acute Coronary Syndrome. *2018-07-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.04.055 · https://hartvaat.nl/2018/07/10/fatale-of-irreversibele-bloedingen-en-ischemische-events-met-rivaroxaban-bij-acs/* This ACS analysis separated fatal or irreversible bleeding and ischemic events from reversible ones in rivaroxaban-treated patients, providing a clinically meaningful assessment of the most consequential complications of antithrombotic therapy. ## Residual Inflammatory Risk on Treatment With PCSK9 Inhibition and Statin Therapy. *2018-07-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034645 · https://hartvaat.nl/2018/07/10/residueel-inflammatoir-risico-bij-pcsk9-remming-plus-statine/* This study quantified the residual inflammatory risk that persists after maximum LDL cholesterol lowering with PCSK9 inhibition and statins, demonstrating that elevated hsCRP remains an independent predictor of events even at very low LDL levels. The results provided the rationale for adding anti-inflammatory therapy to lipid-lowering strategies. ## Inflammatory and Cholesterol Risk in the FOURIER Trial. *2018-07-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.034032 · https://hartvaat.nl/2018/07/10/inflammatie-en-cholesterol-in-de-fourier-trial/* This FOURIER analysis showed that inflammatory risk (elevated hsCRP) and cholesterol risk (elevated LDL) independently contribute to cardiovascular events, and that patients with dual residual risk despite PCSK9 inhibition had the highest event rates. The findings integrated the lipid and inflammation hypotheses of atherosclerosis. ## Japan-United States of America Harmonized Assessment by Randomized Multicentre Study of OrbusNEich's Combo StEnt (Japan-USA HARMONEE) study: primary results of the pivotal registration study of combined endothelial progenitor cell capture and drug-eluting stent in patients with ischaemic coronary disease and non-ST-elevation acute coronary syndrome. *2018-07-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehy275 · https://hartvaat.nl/2018/07/07/orbusneich-combo-stent-japan-usa-harmonee-gerandomiseerde-multicenter-trial/* The HARMONEE pivotal trial evaluated the Combo sirolimus-eluting stent with endothelial progenitor cell capture technology, testing whether promoting endothelialization alongside antiproliferative drug elution improves stent healing. ## A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions. *2018-07-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehy220 · https://hartvaat.nl/2018/07/07/revascularisatie-versus-optimale-medicamenteuze-therapie-bij-cto-gerandomiseerde/* This randomized multicenter trial comparing PCI with optimal medical therapy for chronic total coronary occlusions found improved quality of life and angina relief with revascularization but no significant difference in hard clinical endpoints. The results supported PCI for CTOs as a symptom-driven strategy. ## Clinical impact of rotor ablation in atrial fibrillation: a systematic review. *2018-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux370 · https://hartvaat.nl/2018/07/01/rotorablatie-bij-atriumfibrilleren-systematische-review/* This systematic review evaluated the clinical impact of rotor ablation for AF, finding insufficient consistent evidence to support routine rotor-targeted ablation as a primary AF treatment strategy. ## Ultrasound-guided versus conventional femoral venipuncture for catheter ablation of atrial fibrillation: a multicentre randomized efficacy and safety trial (ULTRA-FAST trial). *2018-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux175 · https://hartvaat.nl/2018/07/01/echogeleide-versus-conventionele-femorale-venepunctie-bij-af-ablatie-gerandomise/* This multicenter randomized trial showed that ultrasound-guided femoral venipuncture reduces vascular complications during AF catheter ablation compared with conventional landmark-based access, supporting routine use of ultrasound guidance. ## Hypertension in HIV-Infected Adults: Novel Pathophysiologic Mechanisms. *2018-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.10893 · https://hartvaat.nl/2018/07/01/hypertensie-bij-hiv-nieuwe-pathofysiologische-mechanismen/* This review discussed the novel pathophysiological mechanisms underlying hypertension in HIV-infected adults, including immune activation, antiretroviral drug effects, and metabolic dysfunction unique to the HIV population. ## Differing associations for sport versus occupational physical activity and cardiovascular risk. *2018-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312594 · https://hartvaat.nl/2018/07/01/sport-versus-beroepsmatige-lichamelijke-activiteit-en-cardiovasculair-risico/* This study demonstrated that sport and occupational physical activity have differing associations with cardiovascular risk, with sport activity being protective while heavy occupational activity may paradoxically increase risk. ## MEDI0382, a GLP-1 and glucagon receptor dual agonist, in obese or overweight patients with type 2 diabetes: a randomised, controlled, double-blind, ascending dose and phase 2a study. *2018-06-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30726-8 · https://hartvaat.nl/2018/06/30/glp-1-glucagon-duale-agonist-bij-obesitas-met-diabetes-type-2-lancet-fase-2/* This Lancet phase 2 trial of MEDI0382, a dual GLP-1/glucagon receptor agonist, showed clinically meaningful weight loss and glucose improvement in obese patients with type 2 diabetes, exploring a new class of incretin-based combination therapeutics. ## Phase 3 Trial of Ibrutinib plus Rituximab in Waldenström's Macroglobulinemia. *2018-06-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1802917 · https://hartvaat.nl/2018/06/21/ibrutinib-plus-rituximab-bij-waldenstrom-nejm-fase-3-trial/* This NEJM trial of ibrutinib plus rituximab in Waldenström's macroglobulinemia is relevant to cardio-oncology due to the well-documented association between ibrutinib therapy and atrial fibrillation and hypertension. ## A meta-analysis of continuous positive airway pressure therapy in prevention of cardiovascular events in patients with obstructive sleep apnoea. *2018-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx597 · https://hartvaat.nl/2018/06/21/cpap-en-cardiovasculaire-events-bij-obstructieve-slaapapneu-meta-analyse/* This meta-analysis found that CPAP therapy does not significantly reduce major cardiovascular events in patients with obstructive sleep apnea, disappointing expectations that treating nocturnal airway obstruction would translate to cardiovascular protection. ## Impact of Cardioprotective Therapies on the Edema-Based Area at Risk by CMR in Reperfused STEMI. *2018-06-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.04.016 · https://hartvaat.nl/2018/06/19/cardioprotectieve-therapieen-en-area-at-risk-bij-gereperfuseerd-stemi-cmr-analys/* This CMR study assessed the impact of cardioprotective therapies on the edema-based area at risk in reperfused STEMI, evaluating whether the salvageable myocardium is affected by various protective interventions. ## Determinants of long-term clinical outcomes in patients with angina but without obstructive coronary artery disease: a systematic review and meta-analysis. *2018-06-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy185 · https://hartvaat.nl/2018/06/14/langetermijnuitkomsten-bij-angina-zonder-obstructief-coronairlijden-systematisch/* This systematic review characterized the long-term clinical outcomes of patients with angina but without obstructive coronary artery disease, showing that this common presentation is not entirely benign and carries meaningful cardiovascular risk. ## Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL 2 Study. *2018-06-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.03.009 · https://hartvaat.nl/2018/06/12/sglt2-remmers-en-cardiovasculaire-events-de-cvd-real-2-real-world-studie/* The CVD-REAL 2 study provided real-world evidence from 6 countries confirming that SGLT2 inhibitor use is associated with lower cardiovascular events and mortality compared with other glucose-lowering drugs in type 2 diabetes, extending the trial evidence to routine clinical practice. ## Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial. *2018-06-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30832-8 · https://hartvaat.nl/2018/06/09/dabigatran-bij-myocardschade-na-niet-cardiale-chirurgie-lancet-manage-trial/* The MANAGE trial showed that low-dose dabigatran reduced the composite of vascular events in patients with myocardial injury after non-cardiac surgery (MINS), providing the first randomized evidence for anticoagulation therapy in this common but undertreated perioperative complication. ## Endovascular ultrasound renal denervation to treat hypertension (RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomised, sham-controlled trial. *2018-06-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)31082-1 · https://hartvaat.nl/2018/06/09/endovasculaire-echografie-renale-denervatie-lancet-radiance-htn-solo/* The RADIANCE-HTN SOLO trial showed that endovascular ultrasound-based renal denervation significantly reduced daytime ambulatory blood pressure compared with a sham procedure in patients with hypertension not receiving antihypertensive medication. The second-generation ultrasound approach demonstrated improved procedural precision. ## Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. *2018-06-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30951-6 · https://hartvaat.nl/2018/06/09/renale-denervatie-met-antihypertensiva-lancet-spyral-htn-on-med-6-maandsresultat/* The SPYRAL HTN-ON MED 6-month results demonstrated that renal denervation significantly reduced blood pressure in patients with uncontrolled hypertension who were also receiving antihypertensive medications. The finding confirmed additive blood pressure lowering on top of drug therapy. ## Comparison of Reduced-Dose Prasugrel and Standard-Dose Clopidogrel in Elderly Patients With Acute Coronary Syndromes Undergoing Early Percutaneous Revascularization. *2018-06-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032180 · https://hartvaat.nl/2018/06/05/verlaagde-dosis-prasugrel-versus-standaard-clopidogrel-bij-oudere-acs-patienten/* This comparison of reduced-dose prasugrel with standard clopidogrel in elderly ACS patients undergoing early invasive management showed prasugrel had similar ischemic efficacy but more bleeding, informing antiplatelet selection in the older population. ## Association of Fibroblast Growth Factor 23 With Recurrent Cardiovascular Events in Patients After an Acute Coronary Syndrome: A Secondary Analysis of a Randomized Clinical Trial. *2018-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.0653 · https://hartvaat.nl/2018/06/01/fgf-23-en-recidiverende-cv-events-na-acs/* This study identified FGF-23 as a predictor of recurrent cardiovascular events after ACS, establishing this phosphate-regulating hormone as a novel biomarker linking mineral metabolism to cardiovascular risk. ## Social Worker-Aided Palliative Care Intervention in High-risk Patients With Heart Failure (SWAP-HF): A Pilot Randomized Clinical Trial. *2018-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.0589 · https://hartvaat.nl/2018/06/01/maatschappelijk-werker-palliatieve-zorg-bij-hoogrisico-hf-swap-hf-pilot/* This SWAP-HF pilot trial tested a social worker-led palliative care intervention for high-risk heart failure patients, demonstrating feasibility and preliminary evidence for improved quality of life with early palliative care integration. ## Effects of Sacubitril/Valsartan on Physical and Social Activity Limitations in Patients With Heart Failure: A Secondary Analysis of the PARADIGM-HF Trial. *2018-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.0398 · https://hartvaat.nl/2018/06/01/sacubitril-valsartan-en-fysieke-en-sociale-activiteitsbeperkingen-bij-hf-paradig/* This PARADIGM-HF secondary analysis showed that sacubitril-valsartan significantly improves physical and social activity limitations compared with enalapril in HFrEF, demonstrating patient-centered functional benefits. ## Impact of Intensive Versus Standard Blood Pressure Management by Tertiles of Blood Pressure in SPRINT (Systolic Blood Pressure Intervention Trial). *2018-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10646 · https://hartvaat.nl/2018/06/01/intensieve-versus-standaard-bloeddruk-naar-tertielen-in-sprint/* This SPRINT analysis stratified the benefit of intensive blood pressure treatment by baseline blood pressure tertiles, showing that patients across all starting pressures benefit from intensive management. ## Influence of Gestational Age at Initiation of Antihypertensive Therapy: Secondary Analysis of CHIPS Trial Data (Control of Hypertension in Pregnancy Study). *2018-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10689 · https://hartvaat.nl/2018/06/01/amenorroe-duur-bij-start-antihypertensiva-in-de-zwangerschap-chips-secundaire-an/* This CHIPS secondary analysis examined whether gestational age at antihypertensive therapy initiation influences outcomes in chronic hypertension during pregnancy, evaluating the timing of treatment start. ## Simultaneously Measured Interarm Blood Pressure Difference and Stroke: An Individual Participants Data Meta-Analysis. *2018-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.118.10923 · https://hartvaat.nl/2018/06/01/interarmbloeddrukverschil-en-beroerte-ipd-meta-analyse/* This individual patient data meta-analysis showed that simultaneously measured interarm blood pressure difference predicts stroke risk, supporting routine bilateral measurement as a simple screening tool for vascular asymmetry. ## Haemodynamic effects of levosimendan in advanced but stable chronic heart failure. *2018-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12272 · https://hartvaat.nl/2018/06/01/hemodynamische-effecten-van-levosimendan-bij-gevorderd-stabiel-chronisch-hartfal/* This study characterized the hemodynamic effects of levosimendan in advanced but stable chronic heart failure, evaluating the rationale for intermittent inotropic support in the outpatient advanced HF setting. ## Insights into implementation of sacubitril/valsartan into clinical practice. *2018-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12258 · https://hartvaat.nl/2018/06/01/implementatie-van-sacubitril-valsartan-in-de-klinische-praktijk-inzichten/* This practice analysis provided insights into the real-world implementation of sacubitril-valsartan in heart failure clinics, identifying barriers (hypotension, renal concerns) and facilitators for achieving guideline-recommended ARNI uptake. ## Acute heart failure following myocardial infarction: complement activation correlates with the severity of heart failure in patients developing cardiogenic shock. *2018-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12266 · https://hartvaat.nl/2018/06/01/complementactivatie-bij-acuut-hartfalen-na-mi-correlatie-met-ernst/* This study showed that complement activation correlates with heart failure severity following acute MI, providing immunological insights into the pathogenesis of post-infarction cardiac dysfunction. ## Evaluation of an individualized dose titration regimen of patiromer to prevent hyperkalaemia in patients with heart failure and chronic kidney disease. *2018-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12265 · https://hartvaat.nl/2018/06/01/geindividualiseerd-patiromer-doseringsregime-bij-hf-met-ckd-en-hyperkaliemie/* This study evaluated an individualized patiromer dosing regimen for preventing hyperkalemia in heart failure patients with CKD, demonstrating that tailored potassium management enables optimized RAAS inhibitor therapy. ## Safety profile and efficacy of ivabradine in heart failure due to Chagas heart disease: a post hoc analysis of the SHIFT trial. *2018-06-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12240 · https://hartvaat.nl/2018/06/01/ivabradine-bij-hartfalen-door-chagas-ziekte-shift-post-hoc-analyse/* This SHIFT post-hoc analysis confirmed the safety and efficacy of ivabradine in heart failure due to Chagas cardiomyopathy, extending the evidence for heart rate reduction to this specific tropical cardiomyopathy. ## Atrial fibrillation prevention: an appraisal of current evidence. *2018-06-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-311546 · https://hartvaat.nl/2018/06/01/preventie-van-atriumfibrilleren-beoordeling-van-huidig-bewijs/* This comprehensive review evaluated the evidence for AF prevention, covering lifestyle modifications (weight loss, exercise, alcohol reduction), pharmacological upstream therapy, and structural interventions for reducing AF incidence. ## Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2018-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYP.0000000000000067 · https://hartvaat.nl/2018/06/01/systematische-review-voor-de-2017-acc-aha-hypertensierichtlijn-hypertension-edit/* Hypertension journal publication of the systematic review underlying the 2017 ACC/AHA blood pressure guideline, covering the evidence base for revised definitions, treatment thresholds, and management strategies. ## Genome-wide association study of PR interval in Hispanics/Latinos identifies novel locus at ID2. *2018-06-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312045 · https://hartvaat.nl/2018/06/01/gwas-van-pr-interval-bij-hispanic-latino-s-nieuw-locus-bij-id2/* The first genome-wide association study of PR interval in Hispanic/Latino populations identified a novel genetic locus at ID2 associated with atrial and atrioventricular nodal conduction, addressing an underrepresented group in cardiac genetics research. ## Drug-eluting stents versus bare-metal stents in saphenous vein grafts: a double-blind, randomised trial. *2018-05-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30801-8 · https://hartvaat.nl/2018/05/19/des-versus-bms-in-veneuze-bypass-grafts-lancet-dubbelblinde-trial/* This Lancet double-blind trial compared drug-eluting with bare-metal stents specifically in saphenous vein grafts, providing unique evidence for stent selection in the bypass graft setting where the lesion biology differs from native coronary disease. ## Effect of Liraglutide on Cardiovascular Events in Patients With Type 2 Diabetes Mellitus and Polyvascular Disease: Results of the LEADER Trial. *2018-05-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.118.033898 · https://hartvaat.nl/2018/05/15/liraglutide-bij-diabetes-type-2-met-polyvasculaire-ziekte-leader-analyse/* This LEADER subanalysis in patients with polyvascular disease showed that liraglutide reduces cardiovascular events even in the highest-risk diabetic patients with multiple vascular territories affected, supporting GLP-1 agonist use across the cardiovascular risk spectrum. ## Platelet Count Affects Efficacy of Folic Acid in Preventing First Stroke. *2018-05-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.02.072 · https://hartvaat.nl/2018/05/15/trombocytenaantal-beinvloedt-werkzaamheid-van-foliumzuur-bij-cva-preventie/* This study showed that platelet count modifies the efficacy of folic acid in preventing first stroke in hypertensive patients, informing personalized approaches to cerebrovascular prevention. ## Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2018-05-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.11.004 · https://hartvaat.nl/2018/05/15/systematische-review-voor-de-2017-acc-aha-hypertensierichtlijn/* This systematic review provided the evidence foundation for the 2017 ACC/AHA hypertension guideline, addressing questions about self-monitored blood pressure, ambulatory monitoring, treatment thresholds, and target goals that shaped the updated recommendations. ## Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials. *2018-05-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehy162 · https://hartvaat.nl/2018/05/14/dubbele-versus-triple-antitrombotische-therapie-bij-af-na-pci-meta-analyse/* This systematic meta-analysis confirmed that dual antithrombotic therapy (DOAC plus P2Y12 inhibitor, without aspirin) reduces bleeding compared with triple therapy in AF patients after PCI, with similar ischemic event rates. The analysis supported the paradigm shift toward aspirin-free regimens. ## Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock: A Systematic Review and Meta-analysis. *2018-05-08 · JAMA · https://doi.org/10.1001/jama.2018.4528 · https://hartvaat.nl/2018/05/08/vasopressine-plus-catecholamines-en-af-bij-distributieve-shock-jama-meta-analyse/* This JAMA meta-analysis showed that adding vasopressin to catecholamine vasopressors in distributive shock is associated with reduced atrial fibrillation incidence, identifying a potential antiarrhythmic benefit of dual vasopressor strategy. ## High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial. *2018-05-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032615 · https://hartvaat.nl/2018/05/08/hoog-versus-laaggedoseerd-pitavastatine-bij-stabiel-coronairlijden-real-cad/* The REAL-CAD superiority trial showed that high-dose pitavastatin reduces cardiovascular events compared with low-dose in Japanese patients with stable coronary disease, confirming the 'more is better' principle for statin therapy in an Asian population. ## Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association. *2018-05-08 · Circulation · https://doi.org/10.1161/CIR.0000000000000564 · https://hartvaat.nl/2018/05/08/spontane-coronaire-arterie-dissectie-aha-scientific-statement/* This AHA scientific statement provided the first comprehensive review of spontaneous coronary artery dissection (SCAD), covering epidemiology, pathophysiology, diagnosis, and management of this increasingly recognized cause of acute coronary syndrome, particularly in young women. ## Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury. *2018-05-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030112 · https://hartvaat.nl/2018/05/08/nierfunctieverslechtering-bij-acuut-hartfalen-met-agressieve-diurese-geen-tubula/* This study demonstrated that worsening renal function during aggressive diuresis for acute heart failure does not reflect tubular injury and is not associated with adverse outcomes. The finding supports pursuing effective decongestion despite transient creatinine rises. ## Report of an ESC-EAPCI Task Force on the evaluation and use of bioresorbable scaffolds for percutaneous coronary intervention: executive summary. *2018-05-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx488 · https://hartvaat.nl/2018/05/07/esc-eapci-taskforce-rapport-over-bioresorbeerbare-scaffolds-executive-summary/* This ESC-EAPCI Task Force report provided an official position statement on bioresorbable scaffolds following the accumulating safety concerns, recommending restricted use and providing guidance for managing patients with implanted devices. ## Pharmacogenomic Approach to Selecting Antiplatelet Therapy in Patients With Acute Coronary Syndromes: The PHARMCLO Trial. *2018-05-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.02.029 · https://hartvaat.nl/2018/05/01/farmacogenomisch-gestuurd-antiplaatjestherapie-bij-acs-pharmclo-trial/* The PHARMCLO trial of pharmacogenomic-guided antiplatelet selection in ACS was among the first to show that genotype-directed therapy reduces ischemic events, pioneering the application of pharmacogenomics in acute coronary care. ## Ticagrelor vs Clopidogrel After Fibrinolytic Therapy in Patients With ST-Elevation Myocardial Infarction: A Randomized Clinical Trial. *2018-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.0612 · https://hartvaat.nl/2018/05/01/ticagrelor-versus-clopidogrel-na-fibrinolyse-bij-stemi-jama-cardiology-gerandomi/* This randomized trial comparing ticagrelor with clopidogrel after fibrinolytic therapy in STEMI assessed whether the more potent P2Y12 inhibitor is safe in the post-fibrinolysis setting, a population excluded from the original PLATO trial. ## Risk stratification of cardiovascular and heart failure hospitalizations using integrated device diagnostics in patients with a cardiac resynchronization therapy defibrillator. *2018-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux206 · https://hartvaat.nl/2018/05/01/risicostratificatie-met-geintegreerde-devicediagnostiek-bij-hartfalen/* This study evaluated integrated CRT-D device diagnostics for risk stratification of cardiovascular hospitalizations, testing whether automated multi-parameter algorithms can provide actionable early warning of clinical deterioration. ## The prognostic benefit of cardiac resynchronization therapy is greater in concordant vs. discordant left bundle branch block in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT). *2018-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw446 · https://hartvaat.nl/2018/05/01/crt-voordeel-bij-concordant-versus-discordant-linksbundeltakblok-esc-hf-pilot/* This analysis showed that the prognostic benefit of CRT is significantly greater in patients with concordant versus discordant left bundle branch block, refining the ECG criteria for optimal CRT candidate selection. ## Preconception Blood Pressure Levels and Reproductive Outcomes in a Prospective Cohort of Women Attempting Pregnancy. *2018-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10705 · https://hartvaat.nl/2018/05/01/bloeddruk-voor-conceptie-en-reproductieve-uitkomsten/* This prospective study showed that elevated preconception blood pressure is associated with adverse reproductive outcomes, establishing blood pressure as a modifiable factor for fertility and pregnancy health. ## Effect of Lowering Diastolic Pressure in Patients With and Without Cardiovascular Disease: Analysis of the SPRINT (Systolic Blood Pressure Intervention Trial). *2018-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10177 · https://hartvaat.nl/2018/05/01/verlaging-van-diastolische-druk-bij-patienten-met-en-zonder-cardiovasculaire-zie/* This SPRINT analysis evaluated the effect of diastolic blood pressure lowering in patients with and without cardiovascular disease, providing data on the J-curve concern for diastolic hypotension during intensive systolic treatment. ## Relationship of Sodium Intake and Blood Pressure Varies With Energy Intake: Secondary Analysis of the DASH (Dietary Approaches to Stop Hypertension)-Sodium Trial. *2018-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10602 · https://hartvaat.nl/2018/05/01/natriuminname-en-bloeddruk-varieren-met-energie-inname-dash-secundaire-analyse/* This DASH secondary analysis showed that the relationship between sodium intake and blood pressure varies with total energy intake, suggesting that sodium density (mg/kcal) may be a more relevant metric than absolute sodium consumption. ## Blood Pressure Measurement in SPRINT (Systolic Blood Pressure Intervention Trial). *2018-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10479 · https://hartvaat.nl/2018/05/01/bloeddrukmeting-in-sprint-methodologische-overwegingen/* This analysis of blood pressure measurement methodology in SPRINT clarified the automated office blood pressure technique used, addressing concerns about how SPRINT blood pressure readings translate to standard clinical office measurements. ## Simple six-item clinical score improves risk prediction capability of stress echocardiography. *2018-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312122 · https://hartvaat.nl/2018/05/01/klinische-score-verbetert-risicostratificatie-bij-stressechocardiografie/* This study developed a simple 6-item clinical score that improves risk prediction beyond wall motion abnormalities during stress echocardiography, enhancing the prognostic yield of this common cardiac imaging test. ## Mortality and morbidity in acutely ill adults treated with liberal versus conservative oxygen therapy (IOTA): a systematic review and meta-analysis. *2018-04-28 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30479-3 · https://hartvaat.nl/2018/04/28/liberale-versus-conservatieve-zuurstoftherapie-bij-acuut-zieke-volwassenen-lance/* The IOTA systematic review demonstrated that liberal supplemental oxygen therapy increases mortality in acutely ill adults across a range of conditions. This paradigm-shifting analysis led to conservative oxygen targets becoming standard practice in acute care. ## High-Target Versus Low-Target Blood Pressure Management During Cardiopulmonary Bypass to Prevent Cerebral Injury in Cardiac Surgery Patients: A Randomized Controlled Trial. *2018-04-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030308 · https://hartvaat.nl/2018/04/24/hoge-versus-lage-bloeddrukstreefwaarden-tijdens-cardiopulmonale-bypass-en-cerebr/* This randomized trial compared high versus low blood pressure targets during cardiopulmonary bypass for prevention of cerebral injury in cardiac surgery, addressing the optimal hemodynamic management during on-pump procedures. ## The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. *2018-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehy136 · https://hartvaat.nl/2018/04/21/2018-ehra-praktische-gids-voor-doac-gebruik-bij-af/* The 2018 EHRA Practical Guide updated recommendations for DOAC use in atrial fibrillation, covering dosing, drug interactions, perioperative management, and special populations. The document serves as the primary clinical reference for day-to-day DOAC prescribing decisions in AF. ## Subclinical device-detected atrial fibrillation and stroke risk: a systematic review and meta-analysis. *2018-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx731 · https://hartvaat.nl/2018/04/21/subklinisch-device-gedetecteerd-af-en-cva-risico-meta-analyse/* This meta-analysis quantified the stroke risk associated with subclinical device-detected atrial fibrillation, finding a significantly elevated but lower absolute risk than clinical AF. The analysis informed the debate about anticoagulation for subclinical AF that was tested in NOAH-AFNET 6 and ARTESIA. ## Telemonitoring-based feedback improves adherence to non-vitamin K antagonist oral anticoagulants intake in patients with atrial fibrillation. *2018-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx762 · https://hartvaat.nl/2018/04/21/telemonitoring-verbetert-doac-therapietrouw-bij-af/* This study showed that telemonitoring-based feedback improves DOAC adherence in AF patients, demonstrating that digital monitoring and patient engagement tools can address the common problem of medication non-compliance. ## PulmOnary vein isolation With vs. without continued antiarrhythmic Drug trEatment in subjects with Recurrent Atrial Fibrillation (POWDER AF): results from a multicentre randomized trial. *2018-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx666 · https://hartvaat.nl/2018/04/21/pvi-met-versus-zonder-antiaritmica-bij-recidiverend-af-powder-af/* The POWDER-AF trial investigated whether continuing antiarrhythmic drugs after successful pulmonary vein isolation provides additional benefit over ablation alone, addressing the routine use of post-ablation antiarrhythmic therapy. ## Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis. *2018-04-17 · JAMA · https://doi.org/10.1001/jama.2018.3024 · https://hartvaat.nl/2018/04/17/sglt2-remmers-glp-1-agonisten-en-dpp-4-remmers-vergelijkende-cardiovasculaire-me/* This JAMA comparative meta-analysis showed that SGLT2 inhibitors and GLP-1 receptor agonists both reduce cardiovascular death, MI, and stroke compared with DPP-4 inhibitors in patients with type 2 diabetes. The analysis distinguished the distinct cardiovascular benefit profiles of each drug class and established their clinical superiority. ## Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis. *2018-04-17 · JAMA · https://doi.org/10.1001/jama.2018.2525 · https://hartvaat.nl/2018/04/17/uitgangs-ldl-en-mortaliteitsreductie-na-ldl-verlaging-jama-meta-analyse/* This JAMA systematic review found that the absolute reduction in cardiovascular mortality from LDL-lowering therapy is proportional to the baseline LDL level, while total mortality benefit is seen primarily in patients with higher baseline LDL. The analysis informed risk-based treatment decisions. ## Impact of Cardiovascular Risk on the Relative Benefit and Harm of Intensive Treatment of Hypertension. *2018-04-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.01.074 · https://hartvaat.nl/2018/04/17/cardiovasculair-risico-en-relatief-voordeel-van-intensieve-hypertensiebehandelin/* This analysis from SPRINT examined how baseline cardiovascular risk modifies the absolute benefit and harm of intensive blood pressure treatment, demonstrating that higher-risk patients gain more absolute benefit while maintaining a favorable risk-benefit ratio. ## NT-proBNP (N-Terminal pro-B-Type Natriuretic Peptide)-Guided Therapy in Acute Decompensated Heart Failure: PRIMA II Randomized Controlled Trial (Can NT-ProBNP-Guided Therapy During Hospital Admission for Acute Decompensated Heart Failure Reduce Mortality and Readmissions?). *2018-04-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.029882 · https://hartvaat.nl/2018/04/17/nt-probnp-geleide-therapie-bij-acuut-gedecompenseerd-hartfalen-prima-ii/* The PRIMA II trial showed that NT-proBNP-guided therapy in acute decompensated heart failure did not improve outcomes compared with clinically guided management, adding to the evidence against routine biomarker-guided treatment titration in acute HF. ## Sildenafil for improving outcomes in patients with corrected valvular heart disease and persistent pulmonary hypertension: a multicenter, double-blind, randomized clinical trial. *2018-04-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx700 · https://hartvaat.nl/2018/04/14/sildenafil-bij-persisterende-pulmonale-hypertensie-na-klepchirurgie/* This multicenter study evaluated sildenafil for persistent pulmonary hypertension after corrected valvular heart disease, testing phosphodiesterase-5 inhibition for residual PH in the post-surgical setting. ## Two-Year Outcomes with a Magnetically Levitated Cardiac Pump in Heart Failure. *2018-04-12 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1800866 · https://hartvaat.nl/2018/04/12/heartmate-3-2-jaarsresultaten-bij-gevorderd-hartfalen-nejm-momentum-3/* The 2-year MOMENTUM 3 results confirmed the sustained superiority of the HeartMate 3 magnetically levitated LVAD over the HeartMate II, with significantly fewer adverse events including pump thrombosis, stroke, and bleeding. The data cemented HeartMate 3 as the standard of care in mechanical circulatory support. ## Lack of Association Between Heart Failure and Incident Cancer. *2018-04-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.01.069 · https://hartvaat.nl/2018/04/10/geen-verband-tussen-hartfalen-en-kankerincidentie/* This study found no association between heart failure and incident cancer risk, providing reassurance against the proposed link between HF and malignancy that had raised concerns in observational studies. ## Reversing the Cardiac Effects of Sedentary Aging in Middle Age-A Randomized Controlled Trial: Implications For Heart Failure Prevention. *2018-04-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030617 · https://hartvaat.nl/2018/04/10/sedentaire-veroudering-omkeren-op-middelbare-leeftijd-gerandomiseerde-trial-voor/* This randomized trial showed that a 2-year intensive exercise program in sedentary middle-aged adults reversed the cardiac stiffening associated with aging, with implications for preventing HFpEF. The study demonstrated a modifiable window for cardiovascular fitness intervention. ## Benefit of Adding Ezetimibe to Statin Therapy on Cardiovascular Outcomes and Safety in Patients With Versus Without Diabetes Mellitus: Results From IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). *2018-04-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030950 · https://hartvaat.nl/2018/04/10/ezetimibe-bij-diabetes-versus-zonder-diabetes-improve-it-subanalyse/* This IMPROVE-IT subanalysis showed that the cardiovascular benefit of adding ezetimibe to statin therapy after ACS is greater in patients with diabetes than without, supporting more aggressive LDL lowering in the diabetic ACS population. ## Effect of statins and non-statin LDL-lowering medications on cardiovascular outcomes in secondary prevention: a meta-analysis of randomized trials. *2018-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx566 · https://hartvaat.nl/2018/04/07/statines-en-niet-statine-ldl-verlagers-en-cardiovasculaire-uitkomsten-meta-analy/* This meta-analysis comparing statins with non-statin LDL-lowering therapies for secondary prevention confirmed that cardiovascular benefit is proportional to the magnitude of LDL cholesterol reduction regardless of the mechanism of lowering, supporting the treat-to-target approach. ## 2017 Update of ESC/EAS Task Force on practical clinical guidance for proprotein convertase subtilisin/kexin type 9 inhibition in patients with atherosclerotic cardiovascular disease or in familial hypercholesterolaemia. *2018-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx549 · https://hartvaat.nl/2018/04/07/2017-esc-eas-praktische-gids-voor-pcsk9-remming/* The 2017 ESC/EAS practical guidance update for PCSK9 inhibitor therapy integrated results from FOURIER and ODYSSEY OUTCOMES to provide clinicians with practical recommendations on patient selection, treatment initiation, and monitoring for PCSK9 inhibitor therapy. ## A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops. *2018-04-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1717250 · https://hartvaat.nl/2018/04/05/bloeddrukverlaging-bij-kappersbezoek-nejm-clustergerandomiseerde-trial/* This innovative NEJM trial demonstrated that a barber-facilitated, pharmacist-led hypertension intervention in black barbershops substantially reduced blood pressure in black men with uncontrolled hypertension. The community-based approach addressed the persistent disparity in hypertension control among black men. ## Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial. *2018-04-03 · JAMA · https://doi.org/10.1001/jama.2018.2444 · https://hartvaat.nl/2018/04/03/oplaaddosis-atorvastatine-voor-pci-jama-gerandomiseerde-trial/* This JAMA trial showed that a loading dose of atorvastatin prior to planned PCI did not reduce major cardiovascular events in patients with ACS, arguing against routine statin loading before coronary intervention. ## The 2017 American College of Cardiology/American Heart Association Clinical Practice Guideline for High Blood Pressure in Adults. *2018-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2018.0005 · https://hartvaat.nl/2018/04/01/2017-acc-aha-richtlijn-voor-hoge-bloeddruk-bij-volwassenen-jama-cardiology-overz/* This JAMA Cardiology overview of the 2017 ACC/AHA hypertension guideline discussed the paradigm shift of redefining hypertension at ≥130/80 mmHg, the implications for patient populations, treatment thresholds, and the integration of SPRINT evidence into clinical practice. ## Fibrin clot properties independently predict adverse clinical outcome following acute coronary syndrome: a PLATO substudy. *2018-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehy013 · https://hartvaat.nl/2018/04/01/fibrinestoleigenschappen-en-klinische-uitkomsten-na-acs-plato-substudie/* This PLATO substudy showed that fibrin clot properties independently predict adverse clinical outcomes after ACS, identifying a novel thrombotic biomarker beyond traditional platelet and coagulation measures. ## Spironolactone Versus Clonidine as a Fourth-Drug Therapy for Resistant Hypertension: The ReHOT Randomized Study (Resistant Hypertension Optimal Treatment). *2018-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10662 · https://hartvaat.nl/2018/04/01/spironolacton-versus-clonidine-als-vierde-middel-bij-resistente-hypertensie-reho/* The ReHOT trial compared spironolactone with clonidine as fourth-line therapy for resistant hypertension, finding that spironolactone achieved better ambulatory blood pressure control. The result supported spironolactone as the preferred add-on agent. ## Single-dose intravenous iron in Southeast Asian heart failure patients: A pilot randomized placebo-controlled study (PRACTICE-ASIA-HF). *2018-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12250 · https://hartvaat.nl/2018/04/01/eenmalig-intraveneus-ijzer-bij-hartfalen-in-zuidoost-azie-practice-asia-hf-pilot/* This pilot randomized trial of single-dose IV iron in Southeast Asian heart failure patients assessed the safety and initial efficacy of iron repletion in a population with high iron deficiency prevalence. ## The impact of a dose of the angiotensin receptor blocker valsartan on post-myocardial infarction ventricular remodelling. *2018-04-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12249 · https://hartvaat.nl/2018/04/01/valsartan-en-linkerkamerremodellering-na-mi/* This study examined the impact of valsartan dose on post-MI ventricular remodeling, testing whether achieving higher doses of ARB therapy provides additional structural cardiac benefit beyond lower-dose treatment. ## Differences in relative and absolute effectiveness of oral P2Y 12 inhibition in men and women: a meta-analysis and modelling study. *2018-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-312003 · https://hartvaat.nl/2018/04/01/sekseverschillen-in-effectiviteit-van-orale-p2y12-remmers-meta-analyse/* This meta-analysis examined sex differences in the effectiveness of newer P2Y12 inhibitors versus clopidogrel in ACS, evaluating whether women derive equal antiplatelet benefit from potent P2Y12 inhibition. ## 6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial. *2018-03-31 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30493-8 · https://hartvaat.nl/2018/03/31/6-versus-12-maanden-dapt-na-pci-bij-acs-lancet-netwerkmeta-analyse/* This Lancet meta-analysis compared 6-month versus 12-month or longer DAPT after PCI in ACS patients and found that shorter DAPT reduced bleeding without significantly increasing ischemic events. The data supported individualized DAPT duration based on patient-level bleeding and ischemic risk assessment. ## Cardiac Resynchronization Therapy in Patients With Heart Failure and Narrow QRS Complexes. *2018-03-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.01.042 · https://hartvaat.nl/2018/03/27/crt-bij-hartfalen-met-smal-qrs-complex/* This study confirmed that CRT is not effective in heart failure patients with narrow QRS complexes, reinforcing the guideline requirement for QRS width ≥130 ms as a prerequisite for cardiac resynchronization therapy. ## High-Density Lipoprotein Subspecies Defined by Presence of Apolipoprotein C-III and Incident Coronary Heart Disease in Four Cohorts. *2018-03-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.031276 · https://hartvaat.nl/2018/03/27/hdl-subspecies-met-apoliproteine-c-iii-en-coronairlijden-vier-cohorten/* This study distinguished HDL subspecies based on apolipoprotein C-III content and their differential association with coronary heart disease, showing that HDL-associated apoC-III identifies a dysfunctional HDL subpopulation. ## Effects of Ticagrelor, Prasugrel, or Clopidogrel at Steady State on Endothelial Function. *2018-03-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.01.027 · https://hartvaat.nl/2018/03/20/effecten-van-ticagrelor-prasugrel-of-clopidogrel-op-endotheelfunctie/* This study compared the steady-state effects of ticagrelor, prasugrel, and clopidogrel on endothelial function, characterizing differential pleiotropic (non-antiplatelet) effects across the three P2Y12 inhibitors. ## Bivalirudin or Heparin in Patients Undergoing Invasive Management of Acute Coronary Syndromes. *2018-03-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2018.01.033 · https://hartvaat.nl/2018/03/20/bivalirudine-of-heparine-bij-invasief-acs-management/* This study compared bivalirudin with unfractionated heparin in invasively managed ACS patients, providing additional comparative data on anticoagulation during coronary intervention in the acute setting. ## Digoxin and Mortality in Patients With Atrial Fibrillation. *2018-03-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.12.060 · https://hartvaat.nl/2018/03/13/digoxine-en-mortaliteit-bij-patienten-met-atriumfibrilleren/* This study explored the association between digoxin use and mortality in AF patients, contributing to the long-standing controversy about digoxin safety in the contemporary treatment of atrial fibrillation. ## Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet). *2018-03-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030088 · https://hartvaat.nl/2018/03/13/caloriearm-vegetarisch-versus-mediterraan-dieet-voor-gewicht-en-cv-profiel-cardi/* The CARDIVEG crossover study showed that a low-calorie vegetarian diet and a Mediterranean diet produce comparable improvements in body weight and cardiovascular risk profiles, supporting both dietary patterns for cardiometabolic health. ## Effect of Distinct Lifestyle Interventions on Mobilization of Fat Storage Pools: CENTRAL Magnetic Resonance Imaging Randomized Controlled Trial. *2018-03-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030501 · https://hartvaat.nl/2018/03/13/leefstijlinterventies-en-mobilisatie-van-vetstapeling-central-mri-gerandomiseerd/* The CENTRAL MRI trial used magnetic resonance imaging to compare how different lifestyle interventions (Mediterranean diet, exercise, dietary polyphenols) differentially mobilize specific body fat depots, advancing precision nutrition for cardiovascular risk. ## Effects of Bariatric Surgery in Obese Patients With Hypertension: The GATEWAY Randomized Trial (Gastric Bypass to Treat Obese Patients With Steady Hypertension). *2018-03-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032130 · https://hartvaat.nl/2018/03/13/bariatrische-chirurgie-bij-obese-patienten-met-hypertensie-gateway-gerandomiseer/* The GATEWAY trial showed that bariatric surgery (Roux-en-Y gastric bypass) reduced the number of antihypertensive medications needed by more than 50% in obese patients with hypertension, with a substantial proportion achieving medication-free remission. The results established bariatric surgery as a treatment for obesity-related hypertension. ## Efficacy and Safety of the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation and Concomitant Aspirin Therapy: A Meta-Analysis of Randomized Trials. *2018-03-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028513 · https://hartvaat.nl/2018/03/13/doac-s-bij-af-met-ckd-systematische-review-werkzaamheid-en-veiligheid/* This systematic review evaluated the efficacy and safety of DOACs in AF patients with chronic kidney disease, providing the evidence synthesis for DOAC prescribing in the challenging population with combined AF and renal impairment. ## Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial. *2018-03-10 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30309-X · https://hartvaat.nl/2018/03/10/zelfgemeten-bloeddruk-met-of-zonder-telemonitoring-voor-medicatietitratie-lancet/* The TASMINH4 trial demonstrated that self-monitored blood pressure for antihypertensive medication titration, with or without telemonitoring, achieved better blood pressure control than usual care at 12 months. The results supported patient-directed blood pressure management strategies. ## Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data. *2018-03-10 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(18)30423-9 · https://hartvaat.nl/2018/03/10/cabg-versus-pci-met-stenting-bij-coronairlijden-lancet-10-jaarsfollow-up-systema/* This Lancet meta-analysis of individual patient data from randomized trials demonstrated that CABG was associated with significantly lower 10-year mortality compared with PCI in patients with multivessel and left main coronary disease, particularly those with diabetes or complex anatomy. The findings reinforced CABG as the preferred strategy for complex coronary disease. ## Improving Assessment of Drug Safety Through Proteomics: Early Detection and Mechanistic Characterization of the Unforeseen Harmful Effects of Torcetrapib. *2018-03-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028213 · https://hartvaat.nl/2018/03/06/proteomics-voor-vroege-detectie-van-geneesmiddelveiligheid-lessen-van-hf-trials/* This study demonstrated that proteomics can enable early detection and mechanistic characterization of adverse drug effects, advancing safety biomarker development for novel cardiovascular therapeutics. ## Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes: A Systematic Review and Meta-analysis. *2018-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.5306 · https://hartvaat.nl/2018/03/01/doac-plus-antiplaatjestherapie-voor-secundaire-preventie-na-acs-meta-analyse/* This JAMA Cardiology meta-analysis showed that adding a DOAC to antiplatelet therapy after ACS reduced ischemic events but significantly increased major bleeding. The analysis quantified the risk-benefit trade-off that subsequently guided the COMPASS strategy of very-low-dose rivaroxaban. ## Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals. *2018-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.5205 · https://hartvaat.nl/2018/03/01/omega-3-vetzuursupplementen-en-cv-risico-jama-cardiology-meta-analyse-van-10-tri/* This JAMA Cardiology meta-analysis of 10 randomized trials involving nearly 78,000 participants found no significant association between marine omega-3 fatty acid supplementation and cardiovascular events. The results challenged widespread consumer use of fish oil supplements for heart health. ## Outpatient Worsening Heart Failure as a Target for Therapy: A Review. *2018-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.5250 · https://hartvaat.nl/2018/03/01/poliklinische-verslechtering-van-hartfalen-als-therapiedoel-jama-cardiology-revi/* This JAMA Cardiology review discussed outpatient worsening heart failure as an underrecognized but important therapeutic target, arguing that non-hospitalized deterioration events deserve more attention in clinical trials and guideline-directed management. ## Cause-of-death analysis in patients with cardiac resynchronization therapy with or without a defibrillator: a systematic review and proportional meta-analysis. *2018-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux094 · https://hartvaat.nl/2018/03/01/doodsoorzaken-bij-crt-met-en-zonder-defibrillator-meta-analyse/* This meta-analysis of cause-specific mortality in CRT-P versus CRT-D patients provided data relevant to the ongoing debate about whether the defibrillator component adds meaningful survival benefit on top of resynchronization therapy. ## Predictors of successful chronic total occlusion percutaneous coronary interventions: a systematic review and meta-analysis. *2018-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-311986 · https://hartvaat.nl/2018/03/01/voorspellers-van-succesvolle-cto-pci-systematische-review-en-meta-analyse/* This meta-analysis identified positive and negative predictors of technical success for chronic total occlusion PCI, providing a practical framework for case selection and procedural planning in CTO intervention. ## Randomised controlled trial of two advanced and extended cardiac rehabilitation programmes. *2018-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-311681 · https://hartvaat.nl/2018/03/01/twee-geavanceerde-en-verlengde-hartrevalidatieprogramma-s-gerandomiseerde-trial/* The OPTICARE randomized trial compared two extended cardiac rehabilitation programs with standard care, evaluating whether advanced and prolonged rehabilitation provides incremental cardiovascular risk reduction. ## Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis. *2018-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-311652 · https://hartvaat.nl/2018/03/01/medicamenteuze-behandeling-en-uitkomsten-bij-hfpef-systematische-review-en-meta-/* This systematic review and meta-analysis evaluated all drug treatments studied in HFpEF and found that while no single therapy significantly reduced mortality, some agents (including MRAs and ARBs) showed modest reductions in heart failure hospitalization. The analysis highlighted the unmet therapeutic need that SGLT2 inhibitors later addressed. ## Genetics, Lifestyle, and Low-Density Lipoprotein Cholesterol in Young and Apparently Healthy Women. *2018-02-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032479 · https://hartvaat.nl/2018/02/20/genetica-leefstijl-en-ldl-cholesterol-bij-jonge-gezonde-vrouwen/* This study examined the interplay between genetics, lifestyle factors, and LDL cholesterol in young apparently healthy women, supporting the concept that early lipid assessment and lifestyle modification can reduce lifelong cardiovascular risk. ## Sex Difference in Patients With Ischemic Heart Failure Undergoing Surgical Revascularization: Results From the STICH Trial (Surgical Treatment for Ischemic Heart Failure). *2018-02-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030526 · https://hartvaat.nl/2018/02/20/sekseverschillen-bij-ischemisch-hartfalen-na-cabg-stich-trial/* This STICH subanalysis found that female sex is not an independent risk factor for poor outcomes after CABG in ischemic heart failure when adjusted for baseline characteristics, suggesting that women should not be denied surgical revascularization based on sex alone. ## Pulmonary Arterial Hypertension-Related Morbidity Is Prognostic for Mortality. *2018-02-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.12.010 · https://hartvaat.nl/2018/02/20/morbiditeit-bij-pulmonaal-arteriele-hypertensie-als-prognostische-marker-voor-mo/* This study demonstrated that PAH-related morbidity events (hospitalization, functional decline) independently predict mortality, supporting the inclusion of disease-progression endpoints in clinical trials beyond traditional time-to-event outcomes. ## New-Onset Atrial Fibrillation After PCI or CABG for Left Main Disease: The EXCEL Trial. *2018-02-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.12.012 · https://hartvaat.nl/2018/02/20/nieuw-onset-af-na-pci-of-cabg-bij-hoofdstamziekte-excel-trial/* This EXCEL subanalysis showed that new-onset AF occurs more frequently after CABG than after PCI for left main disease, identifying a procedural advantage of percutaneous intervention for arrhythmia avoidance. ## Stroke Risk in Patients With Reduced Ejection Fraction After Myocardial Infarction Without Atrial Fibrillation. *2018-02-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.12.011 · https://hartvaat.nl/2018/02/20/cva-risico-bij-verminderde-ef-na-mi-zonder-af/* This study identified risk factors for stroke in patients with reduced ejection fraction after MI without atrial fibrillation, informing the consideration of anticoagulation in the post-MI cardiomyopathy population. ## Effect of a Quality Improvement Intervention on Clinical Outcomes in Patients in India With Acute Myocardial Infarction: The ACS QUIK Randomized Clinical Trial. *2018-02-13 · JAMA · https://doi.org/10.1001/jama.2017.21906 · https://hartvaat.nl/2018/02/13/kwaliteitsverbeteringsinterventie-bij-acuut-mi-in-india-jama-acs-quik/* The ACS QUIK trial showed that a locally adapted quality improvement intervention did not significantly reduce major cardiovascular events in patients with acute MI in India, highlighting the challenges of implementing standardized ACS protocols in diverse healthcare settings. ## Compliance With Guideline-Directed Medical Therapy in Contemporary Coronary Revascularization Trials. *2018-02-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.11.068 · https://hartvaat.nl/2018/02/13/richtlijngetrouwe-medicamenteuze-therapie-in-contemporaine-revascularisatietrial/* This analysis documented suboptimal compliance with guideline-directed medical therapy across contemporary coronary revascularization trials, highlighting that even in controlled trial settings, pharmacotherapy optimization remains incomplete. ## A biomarker-based risk score to predict death in patients with atrial fibrillation: the ABC (age, biomarkers, clinical history) death risk score. *2018-02-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx584 · https://hartvaat.nl/2018/02/07/abc-doodsscore-bij-af-biomarkergebaseerde-risicoscore-voor-mortaliteit/* This study derived and validated the ABC death risk score (Age, Biomarkers, Clinical history) for mortality prediction in atrial fibrillation, complementing the existing ABC bleeding score and providing a comprehensive biomarker-based risk assessment tool. ## Ticagrelor for Secondary Prevention of Atherothrombotic Events in Patients With Multivessel Coronary Disease. *2018-02-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.11.050 · https://hartvaat.nl/2018/02/06/ticagrelor-voor-secundaire-preventie-bij-multivaten-coronairlijden/* This PEGASUS subanalysis showed that ticagrelor provides particular benefit in post-MI patients with multivessel coronary disease, identifying the highest-risk anatomical subgroup for extended antiplatelet therapy. ## A sirolimus-eluting bioabsorbable polymer-coated stent (MiStent) versus an everolimus-eluting durable polymer stent (Xience) after percutaneous coronary intervention (DESSOLVE III): a randomised, single-blind, multicentre, non-inferiority, phase 3 trial. *2018-02-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)33103-3 · https://hartvaat.nl/2018/02/03/sirolimus-eluting-bioabsorbeerbare-stent-versus-everolimus-eluting-stent-na-mi-l/* This Lancet trial compared a sirolimus-eluting bioabsorbable polymer stent (MiStent) with a durable polymer everolimus-eluting stent, evaluating a next-generation biocompatible coating technology for coronary intervention. ## Catheter Ablation for Atrial Fibrillation with Heart Failure. *2018-02-01 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1707855 · https://hartvaat.nl/2018/02/01/katheterablatie-bij-af-met-hartfalen-nejm-castle-af/* The CASTLE-AF trial showed that catheter ablation for atrial fibrillation significantly reduced the composite of death and heart failure hospitalization compared with medical therapy in patients with both AF and heart failure. This landmark result established ablation as a disease-modifying intervention in the AF-heart failure overlap population. ## Cardiovascular Outcomes According to Urinary Albumin and Kidney Disease in Patients With Type 2 Diabetes at High Cardiovascular Risk: Observations From the SAVOR-TIMI 53 Trial. *2018-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.4228 · https://hartvaat.nl/2018/02/01/cv-uitkomsten-naar-albumin-en-nierziekte-bij-diabetes-type-2-met-hoog-cv-risico/* This analysis showed that urinary albumin levels and kidney disease status modify cardiovascular outcomes in high-risk type 2 diabetes patients, supporting routine albuminuria screening for comprehensive cardiorenal risk assessment. ## Association of Lipoprotein(a) With Risk of Recurrent Ischemic Events Following Acute Coronary Syndrome: Analysis of the dal-Outcomes Randomized Clinical Trial. *2018-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.3833 · https://hartvaat.nl/2018/02/01/lipoproteine-a-en-recidiverende-ischemische-events-na-acs-dal-outcomes-analyse/* This JAMA Cardiology analysis from a post-ACS cohort demonstrated that elevated lipoprotein(a) independently predicts recurrent ischemic events, establishing Lp(a) as a residual risk factor that persists after acute coronary syndrome regardless of LDL cholesterol management. ## Effects of empagliflozin on risk for cardiovascular death and heart failure hospitalization across the spectrum of heart failure risk in the EMPA-REG OUTCOME® trial. *2018-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx511 · https://hartvaat.nl/2018/02/01/empagliflozine-en-cv-dood-en-hf-hospitalisatie-over-het-hf-spectrum-empa-reg-out/* This EMPA-REG OUTCOME analysis showed that empagliflozin reduced cardiovascular death and heart failure hospitalization across the spectrum of heart failure risk, including patients without prior heart failure. The results foreshadowed the subsequent dedicated heart failure trials with SGLT2 inhibitors. ## Differential effects of PCSK9 variants on risk of coronary disease and ischaemic stroke. *2018-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx373 · https://hartvaat.nl/2018/02/01/differentiele-effecten-van-pcsk9-varianten-op-coronairlijden-versus-ischemisch-c/* This genetic study showed that PCSK9 variants have differential effects on coronary heart disease versus ischemic stroke risk, suggesting that PCSK9-mediated LDL lowering may have variable impact across different vascular territories. ## Dabigatran vs. warfarin in relation to the presence of left ventricular hypertrophy in patients with atrial fibrillation- the Randomized Evaluation of Long-term anticoagulation therapY (RE-LY) study. *2018-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux022 · https://hartvaat.nl/2018/02/01/dabigatran-versus-warfarine-bij-af-met-linkerventrikelhypertrofie-re-ly/* This RE-LY subanalysis tested whether LV hypertrophy modifies the comparative efficacy of dabigatran versus warfarin in AF, evaluating structural cardiac disease as a treatment effect modifier. ## Autonomic regulation therapy to enhance myocardial function in heart failure patients: the ANTHEM-HFpEF study. *2018-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12241 · https://hartvaat.nl/2018/02/01/autonome-regulatietherapie-bij-hfpef-anthem-hfpef/* The ANTHEM-HFpEF study of vagus nerve stimulation in HFpEF explored autonomic neuromodulation as a therapeutic approach for this challenging heart failure phenotype, testing whether restoring autonomic balance improves cardiac function. ## Accuracy of Blood Pressure Measurement Devices in Pregnancy: A Systematic Review of Validation Studies. *2018-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10295 · https://hartvaat.nl/2018/02/01/nauwkeurigheid-van-bloeddrukmeters-in-de-zwangerschap-systematische-review/* This systematic review of blood pressure monitor validation studies in pregnancy highlighted that many commonly used devices have not been specifically validated for use during pregnancy, raising concerns about measurement accuracy in obstetric hypertension. ## Amount or intensity? Potential targets of exercise interventions in patients with heart failure with preserved ejection fraction. *2018-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12227 · https://hartvaat.nl/2018/02/01/hoeveelheid-of-intensiteit-van-inspanning-bij-hfpef/* This study explored whether exercise amount or intensity is more important for improving outcomes in HFpEF, informing the design of optimal physical activity prescriptions for this challenging condition. ## The prognostic value of brain natriuretic peptide in patients with heart failure and left ventricular ejection fraction higher than 60%: a sub-analysis of the J-MELODIC study. *2018-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12206 · https://hartvaat.nl/2018/02/01/bnp-prognostische-waarde-bij-hartfalen-met-lvef-35/* This study evaluated the prognostic value of BNP in heart failure patients with relatively preserved ejection fraction (>35%), refining natriuretic peptide-based risk stratification for the HFmrEF/HFpEF population. ## Diagnostic and prognostic benefits of computed tomography coronary angiography using the 2016 National Institute for Health and Care Excellence guidance within a randomised trial. *2018-02-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-311508 · https://hartvaat.nl/2018/02/01/ct-coronairangiografie-volgens-2016-nice-richtlijn-diagnostisch-en-prognostisch-/* This study evaluated the diagnostic and prognostic benefits of CT coronary angiography according to the 2016 NICE guidelines for chest pain assessment, providing real-world validation of guideline-based CCTA use. ## Recovery free of heart failure after acute coronary syndrome and coronary revascularization. *2018-02-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12197 · https://hartvaat.nl/2018/02/01/herstel-zonder-hartfalen-na-acs-en-revascularisatie/* This study characterized recovery from heart failure after acute coronary syndrome and coronary revascularization, identifying factors associated with freedom from HF events after successful treatment. ## 1-Year Outcomes of Patients Undergoing Primary Angioplasty for Myocardial Infarction Treated With Prasugrel Versus Ticagrelor. *2018-01-30 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.11.008 · https://hartvaat.nl/2018/01/30/prasugrel-versus-ticagrelor-bij-primaire-pci-voor-mi-1-jaarsuitkomsten/* The PRAGUE-18 1-year results showed no significant difference between prasugrel and ticagrelor in patients undergoing primary PCI for MI, an early comparison preceding the definitive ISAR-REACT 5 results. ## Clinical Outcomes and Cost-Effectiveness of Fractional Flow Reserve-Guided Percutaneous Coronary Intervention in Patients With Stable Coronary Artery Disease: Three-Year Follow-Up of the FAME 2 Trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation). *2018-01-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.031907 · https://hartvaat.nl/2018/01/30/kosteneffectiviteit-van-ffr-geleide-pci-bij-stabiele-coronairlijden/* This cost-effectiveness analysis confirmed that FFR-guided PCI is economically favorable compared with angiography-guided PCI in stable coronary disease, with lower healthcare costs driven by reduced unnecessary stenting. ## Three-Year Outcomes With the Absorb Bioresorbable Scaffold: Individual-Patient-Data Meta-Analysis From the ABSORB Randomized Trials. *2018-01-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.031843 · https://hartvaat.nl/2018/01/30/absorb-bioresorbeerbare-scaffold-3-jaarsresultaten-ipd-meta-analyse/* This individual patient data meta-analysis of all ABSORB bioresorbable scaffold trials at 3 years confirmed definitively that the device is inferior to metallic everolimus-eluting stents in safety, particularly for late and very late scaffold thrombosis. ## Transcatheter Interatrial Shunt Device for the Treatment of Heart Failure With Preserved Ejection Fraction (REDUCE LAP-HF I [Reduce Elevated Left Atrial Pressure in Patients With Heart Failure]): A Phase 2, Randomized, Sham-Controlled Trial. *2018-01-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032094 · https://hartvaat.nl/2018/01/23/transcatheter-interatriale-shunt-bij-hfpef-reduce-lap-hf-i/* The REDUCE LAP-HF I trial evaluated a transcatheter interatrial shunt device for HFpEF, testing whether reducing left atrial pressure through a controlled shunt can improve hemodynamics and symptoms in this challenging heart failure phenotype. ## Low-Density Lipoprotein Cholesterol Lowering With Evolocumab and Outcomes in Patients With Peripheral Artery Disease: Insights From the FOURIER Trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk). *2018-01-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032235 · https://hartvaat.nl/2018/01/23/ldl-verlaging-met-evolocumab-en-uitkomsten-bij-pav-fourier-inzichten/* This FOURIER subanalysis in patients with peripheral artery disease showed that evolocumab reduces both cardiovascular and limb-related events, extending the benefit of PCSK9 inhibition to the peripheral vascular population. ## Canagliflozin for Primary and Secondary Prevention of Cardiovascular Events: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study). *2018-01-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032038 · https://hartvaat.nl/2018/01/23/canagliflozine-voor-primaire-en-secundaire-cardiovasculaire-preventie-canvas/* This CANVAS analysis demonstrated that canagliflozin provided cardiovascular benefit in both primary and secondary prevention populations with type 2 diabetes, though the magnitude was greater in those with established cardiovascular disease. The findings informed the positioning of SGLT2 inhibitors across the cardiovascular risk spectrum. ## Cardiovascular Outcomes and Safety of Empagliflozin in Patients With Type 2 Diabetes Mellitus and Peripheral Artery Disease: A Subanalysis of EMPA-REG OUTCOME. *2018-01-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.032031 · https://hartvaat.nl/2018/01/23/empagliflozine-bij-diabetes-type-2-met-perifeer-vaatlijden-empa-reg-outcome/* This EMPA-REG OUTCOME subanalysis showed that empagliflozin's cardiovascular benefit is preserved in diabetic patients with peripheral arterial disease, a particularly high-risk population with elevated limb and cardiovascular event rates. ## Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. *2018-01-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32409-1 · https://hartvaat.nl/2018/01/20/rivaroxaban-met-of-zonder-aspirine-bij-stabiel-perifeer-vaatlijden-lancet-compas/* This COMPASS substudy confirmed that low-dose rivaroxaban with or without aspirin reduced major adverse limb events and cardiovascular outcomes in patients with stable peripheral or carotid artery disease. The findings extended the dual-pathway inhibition strategy specifically to the peripheral arterial disease population. ## Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial. *2018-01-20 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32458-3 · https://hartvaat.nl/2018/01/20/rivaroxaban-met-of-zonder-aspirine-bij-stabiel-coronairlijden-lancet-compass/* The COMPASS trial demonstrated that low-dose rivaroxaban plus aspirin significantly reduced cardiovascular death, stroke, and MI compared with aspirin alone in patients with stable coronary or peripheral artery disease. This dual-pathway inhibition strategy established a new paradigm in secondary prevention for chronic atherosclerotic disease. ## Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid Obesity: The SLEEVEPASS Randomized Clinical Trial. *2018-01-16 · JAMA · https://doi.org/10.1001/jama.2017.20313 · https://hartvaat.nl/2018/01/16/laparoscopische-sleeve-gastrectomie-versus-gastric-bypass-bij-obesitas-jama-5-ja/* This JAMA 5-year comparison showed comparable weight loss between laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in patients with morbid obesity, supporting both procedures as effective long-term options for surgical weight management. ## Prognostic Value of High-Sensitivity Troponin T in Chronic Heart Failure: An Individual Patient Data Meta-Analysis. *2018-01-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.031560 · https://hartvaat.nl/2018/01/16/hoog-sensitief-troponine-t-bij-chronisch-hartfalen-individuele-patientdata-meta-/* This individual patient data meta-analysis established the continuous prognostic value of high-sensitivity troponin T in chronic heart failure, quantifying the incremental risk prediction beyond natriuretic peptides and providing clinical troponin thresholds. ## Effect of Intravenous Fentanyl on Ticagrelor Absorption and Platelet Inhibition Among Patients Undergoing Percutaneous Coronary Intervention: The PACIFY Randomized Clinical Trial (Platelet Aggregation With Ticagrelor Inhibition and Fentanyl). *2018-01-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.031678 · https://hartvaat.nl/2018/01/16/intraveneus-fentanyl-en-ticagrelorabsorptie-bij-pci/* This study showed that intravenous fentanyl delays ticagrelor absorption and attenuates platelet inhibition during PCI, adding to the evidence for opioid-antiplatelet drug interactions in the catheterization laboratory. ## Risks of Overinterpreting Interim Data: Lessons From the TOTAL Trial (Thrombectomy With PCI Versus PCI Alone in Patients With STEMI). *2018-01-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030656 · https://hartvaat.nl/2018/01/09/risico-s-van-overinterpretatie-van-interimdata-lessen-uit-de-total-trial/* This analysis discussed the risks of overinterpreting interim trial data using the TOTAL thrombectomy trial as a case study, providing methodological lessons for clinical trial conduct and reporting. ## Influence of Baseline Diastolic Blood Pressure on Effects of Intensive Compared With Standard Blood Pressure Control. *2018-01-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030848 · https://hartvaat.nl/2018/01/09/diastolische-bloeddruk-en-intensieve-bloeddrukcontrole-sprint-analyse/* This SPRINT analysis examined whether the benefits of intensive blood pressure lowering are attenuated in patients with low baseline diastolic blood pressure, finding that intensive treatment remains beneficial without excess harm in patients with low DBP. ## Empagliflozin and Clinical Outcomes in Patients With Type 2 Diabetes Mellitus, Established Cardiovascular Disease, and Chronic Kidney Disease. *2018-01-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028268 · https://hartvaat.nl/2018/01/09/empagliflozine-bij-diabetes-type-2-met-cardiovasculaire-ziekte-en-ckd-empa-reg-o/* This EMPA-REG OUTCOME subanalysis showed that empagliflozin reduced cardiovascular events and slowed renal decline in patients with the triple burden of type 2 diabetes, established cardiovascular disease, and chronic kidney disease, demonstrating the greatest absolute benefit in this high-risk population. ## 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). *2018-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx393 · https://hartvaat.nl/2018/01/07/2017-esc-richtlijn-voor-stemi-management/* The 2017 ESC Guidelines for ST-elevation myocardial infarction updated recommendations for reperfusion strategy, antithrombotic therapy, and secondary prevention. The document reinforced primary PCI as the preferred strategy, defined quality-of-care time targets, and integrated contemporary evidence on dual antiplatelet therapy duration. ## Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial. *2018-01-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32714-9 · https://hartvaat.nl/2018/01/06/pci-bij-stabiele-angina-lancet-orbita-dubbelblinde-gerandomiseerde-trial/* ORBITA was the first double-blind, placebo-controlled randomized trial of PCI versus a sham procedure in stable angina. PCI did not significantly improve exercise time beyond the placebo effect, challenging the assumed symptomatic benefit of PCI in stable coronary artery disease and transforming the evidence-based discussion around elective intervention. ## Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial. *2018-01-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32713-7 · https://hartvaat.nl/2018/01/06/drug-eluting-stents-bij-oudere-patienten-met-coronairlijden-lancet-senior-trial/* The SENIOR trial confirmed that drug-eluting stents reduce ischemic events compared with bare-metal stents in elderly patients (≥75 years) with coronary artery disease, supporting universal DES use regardless of age and with shortened DAPT duration. ## Genetic Association of Lipids and Lipid Drug Targets With Abdominal Aortic Aneurysm: A Meta-analysis. *2018-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.4293 · https://hartvaat.nl/2018/01/01/genetische-associatie-van-lipiden-en-lipide-doelwitten-met-abdominaal-aorta-aneu/* This JAMA Cardiology meta-analysis identified genetic associations between lipid levels, lipid-modifying drug targets, and abdominal aortic aneurysm risk, providing insights into the pathogenesis and potential pharmacological targets for AAA. ## Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials. *2018-01-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx564 · https://hartvaat.nl/2018/01/01/betablokkers-bij-hfref-hfmref-en-hfpef-individuele-patientanalyse/* This individual patient-level analysis across multiple trials demonstrated that beta-blockers significantly reduce mortality in HFrEF but showed no benefit in patients with mid-range or preserved ejection fraction. The analysis defined the EF boundary below which beta-blocker therapy is effective. ## 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary. *2018-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux275 · https://hartvaat.nl/2018/01/01/2017-af-ablatieconsensus-samenvatting/* Executive summary of the 2017 international expert consensus on catheter and surgical ablation of atrial fibrillation, providing a concise version of the comprehensive document with key recommendations on indications, techniques, and periprocedural management. ## 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. *2018-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux274 · https://hartvaat.nl/2018/01/01/2017-hrs-ehra-ecas-aphrs-solaece-expertconsensus-katheter-en-chirurgische-af-abl/* The 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on AF ablation provided comprehensive guidance on indications, techniques, endpoints, and complications for catheter and surgical ablation of atrial fibrillation. The document serves as the standard reference for electrophysiology practice. ## Left atrial volume predicts atrial fibrillation recurrence after radiofrequency ablation: a meta-analysis. *2018-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux013 · https://hartvaat.nl/2018/01/01/linkeratriumvolume-voorspelt-af-recidief-na-radiofrequentieablatie-meta-analyse/* This meta-analysis confirmed that left atrial volume (rather than diameter alone) independently predicts AF recurrence after radiofrequency ablation, supporting volumetric assessment for patient selection. ## Endocardial left ventricular pacing for cardiac resynchronization: systematic review and meta-analysis. *2018-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw381 · https://hartvaat.nl/2018/01/01/endocardiale-linkerkamer-pacing-voor-crt-systematische-review-en-meta-analyse/* This meta-analysis of endocardial versus epicardial LV pacing for CRT evaluated whether endocardial lead positioning improves resynchronization response and clinical outcomes compared with conventional coronary sinus approaches. ## Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation. *2018-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw329 · https://hartvaat.nl/2018/01/01/supraventriculaire-ectopie-na-af-ablatie-voorspelt-recidief/* This study showed that a higher burden of supraventricular ectopic complexes early after AF catheter ablation predicts long-term arrhythmia recurrence, identifying an early monitoring marker for re-intervention candidacy. ## Influence of energy source on early atrial fibrillation recurrences: a comparison of cryoballoon vs. radiofrequency current energy ablation with the endpoint of unexcitability in pulmonary vein isolation. *2018-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw307 · https://hartvaat.nl/2018/01/01/energiebron-en-vroeg-af-recidief-cryoballon-versus-radiofrequentie/* This comparison of early AF recurrence rates between second-generation cryoballoon and radiofrequency ablation characterized the post-ablation inflammatory response and its influence on early rhythm outcomes. ## Adrenal Vein Sampling Is the Preferred Method to Select Patients With Primary Aldosteronism for Adrenalectomy: Con Side of the Argument. *2018-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09294 · https://hartvaat.nl/2018/01/01/bijniervenesampling-als-voorkeursmethode-bij-primair-hyperaldosteronisme/* This article presented the argument against adrenal vein sampling as the preferred method for selecting primary aldosteronism patients for adrenalectomy, discussing alternative non-invasive approaches. ## Effect of Sacubitril/Valsartan on Exercise-Induced Lipid Metabolism in Patients With Obesity and Hypertension. *2018-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10224 · https://hartvaat.nl/2018/01/01/sacubitril-valsartan-en-inspanningsgemedieerd-lipidenmetabolisme-bij-obesitas-me/* This study examined the effect of sacubitril-valsartan on exercise-induced lipid metabolism in patients with obesity and hypertension, exploring metabolic mechanisms of ARNI benefit beyond hemodynamic effects. ## Quality-of-Life After Everolimus-Eluting Stents or Bypass Surgery for Left-Main Disease: Results From the EXCEL Trial. *2017-12-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.10.036 · https://hartvaat.nl/2017/12/26/kwaliteit-van-leven-na-ees-of-cabg-bij-hoofdstamlijden-excel-qol/* This EXCEL quality-of-life analysis compared patient-reported outcomes after PCI versus CABG for left main disease, showing that both strategies provide substantial symptom relief with differences in recovery trajectory. ## PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock. *2017-12-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1710261 · https://hartvaat.nl/2017/12/21/pci-strategieen-bij-acuut-mi-met-cardiogene-shock-nejm-culprit-shock/* The CULPRIT-SHOCK trial demonstrated that culprit-lesion-only PCI was superior to immediate multivessel PCI in patients with acute MI and cardiogenic shock, reducing the composite of death and severe renal failure at 30 days. This finding reversed prevailing practice of routine complete revascularization in cardiogenic shock. ## A common missense variant of LILRB5 is associated with statin intolerance and myalgia. *2017-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx467 · https://hartvaat.nl/2017/12/21/lilrb5-variant-geassocieerd-met-statine-intolerantie-en-myalgie/* This genetic study identified a common LILRB5 missense variant associated with statin intolerance and myalgia, advancing the pharmacogenomic understanding of statin-associated muscle symptoms. ## Surgical Versus Percutaneous Coronary Revascularization in Patients With Diabetes and Acute Coronary Syndromes. *2017-12-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.10.029 · https://hartvaat.nl/2017/12/19/chirurgische-versus-percutane-revascularisatie-bij-diabetes-met-acs/* This analysis compared CABG with PCI specifically in diabetic patients presenting with acute coronary syndromes, extending the FREEDOM-established surgical superiority to the acute setting. ## 5-Year Outcomes After Left Atrial Appendage Closure: From the PREVAIL and PROTECT AF Trials. *2017-12-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.10.021 · https://hartvaat.nl/2017/12/19/5-jaarsuitkomsten-na-linker-hartoorsluiting-prevail-en-protect-af/* Combined 5-year results from PREVAIL and PROTECT AF showed that percutaneous left atrial appendage closure with the Watchman device was noninferior to warfarin for stroke prevention in atrial fibrillation, with lower rates of hemorrhagic stroke and cardiovascular mortality. The long-term data supported LAA closure as an alternative to lifelong anticoagulation. ## Prevention of Stroke with the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary Syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial). *2017-12-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.029095 · https://hartvaat.nl/2017/12/19/cva-preventie-met-ezetimibe-bij-acs-improve-it-analyse/* This IMPROVE-IT subanalysis showed that adding ezetimibe to statin therapy after ACS reduces stroke risk proportionally to the LDL cholesterol reduction achieved, confirming that the stroke prevention benefit of lipid lowering extends to non-statin agents. ## Percutaneous short-term active mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials. *2017-12-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx363 · https://hartvaat.nl/2017/12/14/mechanische-ondersteuning-bij-cardiogene-shock-systematische-review-en-meta-anal/* This systematic review and meta-analysis of short-term active mechanical circulatory support devices in cardiogenic shock found limited evidence for mortality benefit but significant complications, highlighting the need for the large randomized trials that followed. ## Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. *2017-12-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.10.011 · https://hartvaat.nl/2017/12/12/natriumreductie-en-dash-dieet-naar-uitgangs-bloeddruk/* This analysis from the original DASH trials showed that both sodium reduction and the DASH diet provide greater blood pressure lowering in patients with higher baseline blood pressure, supporting targeted dietary interventions for those who would benefit most. ## Effect of Technique on Outcomes Following Bioresorbable Vascular Scaffold Implantation: Analysis From the ABSORB Trials. *2017-12-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.09.1106 · https://hartvaat.nl/2017/12/12/implantatiechniek-en-uitkomsten-van-bioresorbeerbare-scaffolds-absorb-analyses/* This pooled ABSORB analysis showed that optimal implantation technique (proper sizing, high-pressure post-dilation) significantly improves bioresorbable scaffold outcomes, identifying operator-dependent factors that contributed to the device's clinical limitations. ## 3-Year Clinical Outcomes With Everolimus-Eluting Bioresorbable Coronary Scaffolds: The ABSORB III Trial. *2017-12-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.10.010 · https://hartvaat.nl/2017/12/12/3-jaarsresultaten-van-bioresorbeerbare-scaffolds-absorb-iii-trial/* The ABSORB III 3-year results showed increasing rates of scaffold thrombosis with the bioresorbable vascular scaffold compared with the Xience metallic stent. This late safety signal contributed to the commercial withdrawal of the Absorb device. ## Abdominal Obesity Is Associated With an Increased Risk of All-Cause Mortality in Patients With HFpEF. *2017-12-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.09.1111 · https://hartvaat.nl/2017/12/05/abdominale-obesitas-en-totale-mortaliteit-bij-hfpef/* This study demonstrated that abdominal obesity independently predicts all-cause mortality in HFpEF patients, supporting waist circumference as a risk assessment measure complementary to BMI in the obesity-HFpEF phenotype. ## J Curve in Patients Randomly Assigned to Different Systolic Blood Pressure Targets: An Experimental Approach to an Observational Paradigm. *2017-12-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030342 · https://hartvaat.nl/2017/12/05/j-curve-bij-gerandomiseerde-bloeddrukstreefwaarden-sprint-experimentele-analyse/* This experimental SPRINT analysis addressed the J-curve concern by showing that low blood pressure achieved through randomization to intensive treatment was not associated with increased cardiovascular risk, distinguishing treatment-induced from disease-related hypotension. ## Clinical Efficacy and Safety of Evolocumab in High-Risk Patients Receiving a Statin: Secondary Analysis of Patients With Low LDL Cholesterol Levels and in Those Already Receiving a Maximal-Potency Statin in a Randomized Clinical Trial. *2017-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.3944 · https://hartvaat.nl/2017/12/01/evolocumab-bij-hoogrisicopatienten-met-laag-ldl-op-statine-fourier-subanalyse/* This FOURIER subanalysis examined the incremental benefit of evolocumab in patients already achieving low LDL levels on statin therapy, showing continued cardiovascular risk reduction even when baseline LDL is below traditional targets. ## Effect of Chewing vs Swallowing Ticagrelor on Platelet Inhibition in Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial. *2017-12-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.3868 · https://hartvaat.nl/2017/12/01/kauwen-versus-slikken-van-ticagrelor-en-plaatjesremming-bij-stemi/* This randomized trial showed that chewing ticagrelor achieves faster and more complete platelet inhibition than swallowing intact tablets in STEMI patients, providing a practical pharmacological strategy for overcoming delayed drug absorption in acute MI. ## Single lead atrial vs. dual chamber pacing in sick sinus syndrome: extended register-based follow-up in the DANPACE trial. *2017-12-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw364 · https://hartvaat.nl/2017/12/01/enkelvoudige-versus-tweekamer-pacing-bij-sick-sinus-syndroom-danpace-langetermij/* This extended DANPACE follow-up compared single-lead atrial with dual-chamber pacing in sick sinus syndrome, providing long-term data on the optimal pacing mode for this common bradycardia indication. ## Enjoyment of Spicy Flavor Enhances Central Salty-Taste Perception and Reduces Salt Intake and Blood Pressure. *2017-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09950 · https://hartvaat.nl/2017/12/01/voorkeur-voor-pikant-eten-versterkt-zoutwaarneming-en-vermindert-zoutinname-en-b/* This innovative study showed that enjoyment of spicy flavors enhances central salty-taste perception and leads to reduced salt intake and lower blood pressure, identifying a dietary strategy for population-level sodium reduction. ## Placental Growth Factor as a Prognostic Tool in Women With Hypertensive Disorders of Pregnancy: A Systematic Review. *2017-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10150 · https://hartvaat.nl/2017/12/01/placental-growth-factor-als-prognostisch-instrument-bij-hypertensieve-zwangersch/* This systematic review evaluated placental growth factor (PlGF) as a prognostic biomarker in hypertensive disorders of pregnancy, supporting its clinical utility for predicting adverse outcomes beyond the diagnostic setting. ## Central Iliac Arteriovenous Anastomosis for Uncontrolled Hypertension: One-Year Results From the ROX CONTROL HTN Trial. *2017-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10142 · https://hartvaat.nl/2017/12/01/centrale-iliacale-av-anastomose-bij-ongecontroleerde-hypertensie-rox-control-htn/* One-year results of the ROX CONTROL HTN trial showed sustained blood pressure reduction with a central iliac arteriovenous anastomose device for resistant hypertension, testing a novel device-based approach targeting central hemodynamics. ## Revascularisation compared with initial medical therapy for non-ST-elevation acute coronary syndromes in the elderly: a meta-analysis. *2017-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-311233 · https://hartvaat.nl/2017/12/01/revascularisatie-versus-medicamenteus-beleid-bij-nste-acs-bij-ouderen-meta-analy/* This meta-analysis comparing revascularization with initial medical therapy in elderly patients with NSTE-ACS found a survival benefit with invasive management, providing evidence for active intervention in older acute coronary syndrome patients. ## Integrated care in atrial fibrillation: a systematic review and meta-analysis. *2017-12-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310952 · https://hartvaat.nl/2017/12/01/geintegreerde-zorg-bij-atriumfibrilleren-systematische-review-en-meta-analyse/* This meta-analysis demonstrated that integrated, multidisciplinary AF care models improve clinical outcomes including mortality and hospitalization compared with usual care, supporting the structured approach to AF management endorsed by contemporary guidelines. ## Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery. *2017-11-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1711818 · https://hartvaat.nl/2017/11/30/restrictieve-versus-liberale-bloedtransfusie-bij-hartchirurgie-nejm-trics-iii/* The TRICS III trial demonstrated that a restrictive red-cell transfusion strategy (hemoglobin threshold <7.5 g/dL) was noninferior to a liberal strategy (<9.5 g/dL) for the composite of death, MI, stroke, or renal failure in patients undergoing cardiac surgery. The findings support restrictive transfusion thresholds in cardiac surgical patients. ## Impact of Coronary Computed Tomography Angiography Findings on Initiation of Cardioprotective Medications. *2017-11-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.029994 · https://hartvaat.nl/2017/11/28/ct-coronairangiografie-en-initiatie-van-cardioprotectieve-medicatie/* This study showed that coronary CT angiography findings significantly influence the initiation of cardioprotective medications, with CCTA serving as a catalyst for evidence-based preventive therapy in patients with subclinical coronary disease. ## Inhaled Xenon Attenuates Myocardial Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest: The Xe-Hypotheca Trial. *2017-11-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.09.1088 · https://hartvaat.nl/2017/11/28/xenon-inhalatie-vermindert-myocardschade-bij-overlevenden-van-hartstilstand-xe-h/* The Xe-Hypotheca trial tested whether inhaled xenon combined with hypothermia provides additional neuroprotection in comatose survivors of out-of-hospital cardiac arrest, exploring noble gas therapy for post-resuscitation brain injury. ## Double Kissing Crush Versus Provisional Stenting for Left Main Distal Bifurcation Lesions: DKCRUSH-V Randomized Trial. *2017-11-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.09.1066 · https://hartvaat.nl/2017/11/28/double-kissing-crush-versus-provisional-stenting-bij-hoofdstambifurcatie-dkcrush/* The DKCRUSH-V trial demonstrated that the double kissing crush stenting technique was superior to provisional stenting for distal left main bifurcation lesions, reducing target lesion failure at 1 year. The results changed the recommended bifurcation approach for left main PCI. ## Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation. *2017-11-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028753 · https://hartvaat.nl/2017/11/28/schildklierfunctie-en-risico-op-af-subclinische-hypothyreoidie/* This study demonstrated that thyroid function variation within the normal range and subclinical hypothyroidism are associated with increased risk of atrial fibrillation, identifying thyroid status as a modifiable risk factor for AF. ## Association of High-Sensitivity Cardiac Troponin I Concentration With Cardiac Outcomes in Patients With Suspected Acute Coronary Syndrome. *2017-11-21 · JAMA · https://doi.org/10.1001/jama.2017.17488 · https://hartvaat.nl/2017/11/21/hoog-sensitief-troponine-i-en-uitkomsten-bij-verdenking-acs-jama-studie/* This JAMA study examined the prognostic value of high-sensitivity cardiac troponin I at concentrations below conventional MI thresholds, demonstrating a continuous relationship between troponin level and cardiac risk in patients with suspected ACS. ## The effect of sacubitril/valsartan compared to olmesartan on cardiovascular remodelling in subjects with essential hypertension: the results of a randomized, double-blind, active-controlled study. *2017-11-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx525 · https://hartvaat.nl/2017/11/21/sacubitril-valsartan-versus-olmesartan-en-cardiovasculaire-remodellering-bij-hyp/* This PARAMETER follow-up analysis showed that sacubitril-valsartan improved cardiovascular remodeling parameters (aortic stiffness, left ventricular mass) compared with olmesartan in essential hypertension, suggesting structural cardiovascular benefits of combined neprilysin-RAAS inhibition. ## Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial. *2017-11-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehx508 · https://hartvaat.nl/2017/11/21/bloeddrukeffecten-van-ibuprofen-naproxen-en-celecoxib-bij-artritis-precision-abp/* The PRECISION-ABPM substudy showed differential blood pressure effects among NSAIDs, with celecoxib having the most favorable profile (minimal BP increase) compared with ibuprofen (significant increase) and naproxen. The 24-hour ambulatory data informed NSAID selection in hypertensive patients. ## Prognostic Value of Coronary Artery Calcium in the PROMISE Study (Prospective Multicenter Imaging Study for Evaluation of Chest Pain). *2017-11-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030578 · https://hartvaat.nl/2017/11/21/coronair-calcium-en-prognostische-waarde-bij-pijn-op-de-borst-promise-studie/* This PROMISE analysis confirmed the prognostic value of coronary artery calcium scoring in patients evaluated for stable chest pain, showing that CAC adds incremental prediction beyond clinical risk factors and functional testing. ## Type of Atrial Fibrillation and Outcomes in Patients With Heart Failure and Reduced Ejection Fraction. *2017-11-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.09.027 · https://hartvaat.nl/2017/11/14/af-type-en-uitkomsten-bij-hfref/* This study investigated how the type of AF (paroxysmal vs persistent vs permanent) affects outcomes in patients with heart failure and reduced ejection fraction, finding that AF type independently influences prognosis in the HF population. ## Timing of Angiography and Outcomes in High-Risk Patients With Non-ST-Segment-Elevation Myocardial Infarction Managed Invasively: Insights From the TAO Trial (Treatment of Acute Coronary Syndrome With Otamixaban). *2017-11-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.029779 · https://hartvaat.nl/2017/11/14/timing-van-angiografie-bij-hoogrisico-nstemi-acuity-analyse/* This ACUITY analysis examined the optimal timing of coronary angiography in high-risk NSTEMI patients (GRACE score >140), providing data on whether earlier intervention improves outcomes in the highest-acuity ACS population. ## Low-Density Lipoprotein Cholesterol Lowering for the Primary Prevention of Cardiovascular Disease Among Men With Primary Elevations of Low-Density Lipoprotein Cholesterol Levels of 190 mg/dL or Above: Analyses From the WOSCOPS (West of Scotland Coronary Prevention Study) 5-Year Randomized Trial and 20-Year Observational Follow-Up. *2017-11-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.027966 · https://hartvaat.nl/2017/11/14/ldl-verlaging-voor-primaire-preventie-bij-mannen-met-primaire-ldl-verhoging/* This study evaluated LDL cholesterol lowering for primary cardiovascular prevention in men with primary LDL elevations ≥190 mg/dL, showing significant cardiovascular risk reduction with statin therapy in this genetically high-risk population. ## Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial. *2017-11-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32281-X · https://hartvaat.nl/2017/11/11/renale-denervatie-zonder-antihypertensiva-lancet-spyral-htn-off-med/* The SPYRAL HTN-OFF MED trial demonstrated that catheter-based renal denervation significantly reduced blood pressure compared with sham control in patients with hypertension who were not taking antihypertensive medications. This proof-of-concept study revived renal denervation research after the negative SYMPLICITY HTN-3 results. ## Optical frequency domain imaging vs. intravascular ultrasound in percutaneous coronary intervention (OPINION trial): one-year angiographic and clinical results. *2017-11-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx351 · https://hartvaat.nl/2017/11/07/optische-frequentiedomeinbeeldvorming-versus-ivus-bij-pci-opinion-trial/* The OPINION trial compared optical frequency domain imaging (OFDI) with IVUS for guiding PCI, demonstrating that these two intravascular imaging modalities produce comparable clinical outcomes and can be used interchangeably. ## Impact of design of coronary stents and length of dual antiplatelet therapies on ischaemic and bleeding events: a network meta-analysis of 64 randomized controlled trials and 102 735 patients. *2017-11-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx437 · https://hartvaat.nl/2017/11/07/stentontwerp-en-dapt-duur-effect-op-ischemie-en-bloedingen-netwerkmeta-analyse/* This network meta-analysis examined the interaction between coronary stent design (durable vs biodegradable polymer) and DAPT duration on ischemic and bleeding outcomes, exploring whether stent technology influences the optimal antiplatelet duration. ## Age and Outcomes of Primary Prevention Implantable Cardioverter-Defibrillators in Patients With Nonischemic Systolic Heart Failure. *2017-11-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028829 · https://hartvaat.nl/2017/11/07/leeftijd-en-uitkomsten-van-primaire-preventie-icd-bij-niet-ischemisch-hartfalen-/* This DANISH subanalysis showed that the benefit of primary prevention ICDs in nonischemic heart failure is modified by age, with younger patients (<68 years) deriving significant mortality benefit while older patients did not. The finding supports age-based ICD selection criteria. ## Assessment of Remote Heart Rhythm Sampling Using the AliveCor Heart Monitor to Screen for Atrial Fibrillation: The REHEARSE-AF Study. *2017-11-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030583 · https://hartvaat.nl/2017/11/07/alivecor-kardia-voor-af-screening-de-rehearse-af-studie/* The REHEARSE-AF study demonstrated that remote heart rhythm monitoring using the AliveCor Kardia device increases AF detection compared with routine care, pioneering the use of consumer-grade ECG technology for population-level AF screening. ## Impact of total occlusion of culprit artery in acute non-ST elevation myocardial infarction: a systematic review and meta-analysis. *2017-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx418 · https://hartvaat.nl/2017/11/01/totale-occlusie-van-de-culprit-arterie-bij-nstemi-meta-analyse/* This meta-analysis showed that total occlusion of the culprit artery in acute NSTEMI is more common than previously recognized and is associated with worse outcomes, supporting the consideration of earlier invasive management in this subgroup. ## Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study. *2017-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx175 · https://hartvaat.nl/2017/11/01/switchen-van-dapt-na-acs-de-topic-trial/* The TOPIC trial demonstrated that switching from potent P2Y12 inhibitors to clopidogrel one month after ACS reduced bleeding complications without increasing ischemic events. The study provided early evidence supporting a de-escalation strategy in the post-acute ACS phase. ## Defibrillation thresholds with right pectoral implantable cardioverter defibrillators and impact of waveform tuning (the Tilt and Tune trial). *2017-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw306 · https://hartvaat.nl/2017/11/01/defibrillatie-drempelwaarden-bij-rechtspectorale-icd-en-golfvorm-tuning/* This randomised study assessed defibrillation thresholds with right pectoral ICD implantation and evaluated whether waveform tuning optimisation improves defibrillation efficacy in this configuration. ## Time Course of Change in Blood Pressure From Sodium Reduction and the DASH Diet. *2017-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10017 · https://hartvaat.nl/2017/11/01/tijdsverloop-van-bloeddrukverandering-door-zoutreductie-en-dash-dieet/* This study quantified the time course of blood pressure change following sodium reduction and the DASH diet, showing that most of the benefit occurs within the first week, supporting rapid dietary interventions for blood pressure management. ## Rationale and study design of intravenous loop diuretic administration in acute heart failure: DIUR-AHF. *2017-11-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12226 · https://hartvaat.nl/2017/11/01/iv-lisdiuretica-bij-acuut-hartfalen-diur-ahf-studieontwerp/* The DIUR-AHF study protocol describes a randomised trial comparing continuous infusion versus intermittent bolus administration of intravenous loop diuretics in acute heart failure, assessing decongestion efficacy, diuretic efficiency, and long-term prognosis. ## Novel Mechanism for Buffering Dietary Salt in Humans: Effects of Salt Loading on Skin Sodium, Vascular Endothelial Growth Factor C, and Blood Pressure. *2017-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10003 · https://hartvaat.nl/2017/11/01/zoutbuffering-in-de-huid-bij-mensen-een-nieuw-mechanisme/* This study described a novel mechanism for dietary salt buffering in human skin, showing that sodium is stored in skin tissue and triggers VEGF-C-mediated lymphangiogenesis, fundamentally changing the understanding of sodium homeostasis. ## Systolic Blood Pressure Visit-to-Visit Variability and Major Adverse Outcomes in Atrial Fibrillation: The AFFIRM Study (Atrial Fibrillation Follow-Up Investigation of Rhythm Management). *2017-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.10106 · https://hartvaat.nl/2017/11/01/bloeddrukvariabiliteit-en-uitkomsten-bij-af-affirm-studie/* This AFFIRM analysis showed that systolic blood pressure visit-to-visit variability independently predicts major adverse events in AF patients, identifying a novel risk factor in the anticoagulated AF population. ## Relative and Combined Prognostic Importance of On-Treatment Mean and Visit-to-Visit Blood Pressure Variability in ONTARGET and TRANSCEND Patients. *2017-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09714 · https://hartvaat.nl/2017/11/01/gemiddelde-bloeddruk-en-visit-to-visit-variabiliteit-als-gecombineerde-voorspell/* This ONTARGET/TRANSCEND analysis demonstrated that both mean blood pressure and visit-to-visit variability independently predict cardiovascular outcomes, supporting assessment of both parameters for comprehensive blood pressure risk evaluation. ## Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission. *2017-11-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12157 · https://hartvaat.nl/2017/11/01/klinische-presentatie-bij-eerste-hartfalenhospitalisatie-voorspelt-geen-heropnam/* This study showed that the clinical presentation pattern at first heart failure hospitalization does not predict the nature of future readmissions, challenging the assumption that HF phenotype is stable over time. ## Labetalol Versus Nifedipine as Antihypertensive Treatment for Chronic Hypertension in Pregnancy: A Randomized Controlled Trial. *2017-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09972 · https://hartvaat.nl/2017/11/01/labetalol-versus-nifedipine-bij-chronische-hypertensie-in-de-zwangerschap-gerand/* This randomized trial comparing labetalol with nifedipine for chronic hypertension in pregnancy provided head-to-head comparative data on the two most commonly used antihypertensive agents in this population, informing drug selection during pregnancy. ## Sildenafil During Pregnancy: A Preclinical Meta-Analysis on Fetal Growth and Maternal Blood Pressure. *2017-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09690 · https://hartvaat.nl/2017/11/01/sildenafil-tijdens-de-zwangerschap-preklinische-meta-analyse-over-foetale-groei-/* This preclinical meta-analysis evaluated the effects of sildenafil on fetal growth and maternal blood pressure during pregnancy, providing safety data relevant to the ongoing clinical investigation of PDE5 inhibitors for fetal growth restriction. ## Renin-angiotensin blockade in heart failure with preserved ejection fraction: a systematic review and meta-analysis. *2017-11-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12204 · https://hartvaat.nl/2017/11/01/raas-blokkade-bij-hfpef-systematische-review-en-meta-analyse/* This meta-analysis of renin-angiotensin blockade in HFpEF found modest reductions in heart failure hospitalization but no mortality benefit with ACE inhibitors or ARBs. The analysis highlighted the limited efficacy of conventional neurohormonal therapy in preserved ejection fraction. ## Hypertension Control in Adults With Diabetes Mellitus and Recurrent Cardiovascular Events: Global Results From the Trial Evaluating Cardiovascular Outcomes With Sitagliptin. *2017-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09482 · https://hartvaat.nl/2017/11/01/hypertensiecontrole-bij-diabetes-met-recidiverende-cv-events-tecos-globale-resul/* This TECOS global analysis of hypertension control in diabetic patients with recurrent cardiovascular events showed that blood pressure remains suboptimally controlled in a substantial proportion despite the increased risk, identifying treatment gaps. ## Rehospitalization after intermittent levosimendan treatment in advanced heart failure patients: a meta-analysis of randomized trials. *2017-11-01 · ESC heart failure · https://doi.org/10.1002/ehf2.12177 · https://hartvaat.nl/2017/11/01/rehospitalisatie-na-intermitterend-levosimendan-bij-gevorderd-hartfalen-meta-ana/* This meta-analysis evaluated intermittent levosimendan administration in advanced heart failure, assessing whether repeated infusions improve quality of life and reduce rehospitalization in patients with refractory disease. ## Lesion Complexity and Outcomes of Extended Dual Antiplatelet Therapy After Percutaneous Coronary Intervention. *2017-10-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.09.011 · https://hartvaat.nl/2017/10/31/laesiecomplexiteit-en-uitkomsten-van-verlengde-dapt-na-pci/* This analysis showed that patients with complex coronary lesion anatomy derive greater relative benefit from extended DAPT, supporting lesion complexity as a factor in personalizing antiplatelet therapy duration. ## Clinical efficacy and safety of achieving very low LDL-cholesterol concentrations with the PCSK9 inhibitor evolocumab: a prespecified secondary analysis of the FOURIER trial. *2017-10-28 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32290-0 · https://hartvaat.nl/2017/10/28/zeer-lage-ldl-concentraties-met-evolocumab-lancet-fourier-subanalyse/* This prespecified FOURIER analysis confirmed the 'lower is better' principle for LDL cholesterol, showing that patients achieving LDL levels below 0.5 mmol/L with evolocumab had the greatest cardiovascular risk reduction without safety concerns. The findings supported setting very low LDL targets in high-risk patients. ## Effect of interleukin-1β inhibition with canakinumab on incident lung cancer in patients with atherosclerosis: exploratory results from a randomised, double-blind, placebo-controlled trial. *2017-10-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32247-X · https://hartvaat.nl/2017/10/21/canakinumab-en-longkankerincidentie-bij-atherosclerose-lancet-cantos-exploratief/* This exploratory CANTOS analysis unexpectedly revealed that canakinumab significantly reduced incident lung cancer in post-MI patients, suggesting that IL-1β-mediated inflammation plays a role in cancer progression. The finding opened a new line of investigation into anti-inflammatory cancer prevention. ## Ultrathin, bioresorbable polymer sirolimus-eluting stents versus thin, durable polymer everolimus-eluting stents in patients undergoing coronary revascularisation (BIOFLOW V): a randomised trial. *2017-10-21 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32249-3 · https://hartvaat.nl/2017/10/21/ultradunne-bioresorbeerbare-versus-dunne-duurzame-polymer-stents-lancet-bioscien/* This Lancet trial compared ultra-thin bioresorbable polymer sirolimus-eluting stents with thin durable polymer everolimus-eluting metallic stents, evaluating whether newer stent designs with degradable coatings improve long-term outcomes. ## Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation. *2017-10-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1708454 · https://hartvaat.nl/2017/10/19/dubbele-antitrombotische-therapie-met-dabigatran-na-pci-bij-af-nejm-re-dual-pci/* The RE-DUAL PCI trial showed that dual antithrombotic therapy with dabigatran plus a P2Y12 inhibitor (without aspirin) significantly reduced bleeding compared with triple therapy in patients with atrial fibrillation who underwent PCI. Together with PIONEER AF-PCI, this trial established the paradigm shift toward dropping aspirin in this population. ## Low-Dose Ticagrelor Versus Clopidogrel in Patients With Prior Myocardial Infarction. *2017-10-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.08.031 · https://hartvaat.nl/2017/10/17/laaggedoseerd-ticagrelor-versus-clopidogrel-na-eerder-mi/* This comparison of low-dose ticagrelor with clopidogrel in patients with prior MI explored a dose-reduction strategy that may provide the antiplatelet benefit of newer agents with a side-effect profile closer to clopidogrel. ## Catheter Ablation Versus Medical Rate Control in Atrial Fibrillation and Systolic Dysfunction: The CAMERA-MRI Study. *2017-10-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.08.041 · https://hartvaat.nl/2017/10/17/katheterablatie-versus-frequentiecontrole-bij-af-met-systolische-disfunctie-came/* The CAMERA-MRI study showed that catheter ablation improved left ventricular function compared with rate control in AF patients with systolic dysfunction, assessed by cardiac MRI. The results supported ablation as a therapeutic strategy for AF-related cardiomyopathy. ## Efficacy and Safety of a Pharmaco-Invasive Strategy With Half-Dose Alteplase Versus Primary Angioplasty in ST-Segment-Elevation Myocardial Infarction: EARLY-MYO Trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction). *2017-10-17 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.030582 · https://hartvaat.nl/2017/10/17/farmaco-invasieve-strategie-met-halve-dosis-alteplase-versus-primaire-pci-bij-st/* This study evaluated a pharmaco-invasive strategy using half-dose alteplase versus primary angioplasty for STEMI, testing whether a fibrinolytic-facilitated approach can serve as an alternative when timely primary PCI is not available. ## Gut microbe-generated metabolite trimethylamine-N-oxide as cardiovascular risk biomarker: a systematic review and dose-response meta-analysis. *2017-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx342 · https://hartvaat.nl/2017/10/14/tmao-als-cardiovasculaire-risicobiomarker-systematische-review-en-meta-analyse/* This systematic review and dose-response meta-analysis established trimethylamine-N-oxide (TMAO), a gut microbiome-derived metabolite, as an emerging cardiovascular risk biomarker with a graded relationship between circulating levels and cardiovascular events. ## A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial. *2017-10-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32165-7 · https://hartvaat.nl/2017/10/14/multifacet-interventie-voor-oac-gebruik-bij-af-lancet-impact-af/* The IMPACT-AF trial showed that a multifaceted educational intervention significantly improved oral anticoagulant use in AF patients across diverse international settings, demonstrating that quality improvement programs can close the anticoagulation treatment gap. ## Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial. *2017-10-14 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)32155-4 · https://hartvaat.nl/2017/10/14/geleide-de-escalatie-van-antiplaatjestherapie-na-acs-met-pci-lancet-tropical-acs/* The TROPICAL-ACS trial showed that guided de-escalation from prasugrel to clopidogrel based on platelet function testing after ACS with PCI was noninferior to standard potent P2Y12 inhibition for ischemic events, while reducing bleeding. The results supported personalized antiplatelet de-escalation. ## Intracoronary autologous bone marrow cell transfer after myocardial infarction: the BOOST-2 randomised placebo-controlled clinical trial. *2017-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx188 · https://hartvaat.nl/2017/10/14/intracoronaire-beenmergceltransfer-na-mi-de-boost-2-gerandomiseerde-trial/* The BOOST-2 randomized placebo-controlled trial of intracoronary bone marrow cell transfer after MI showed no sustained improvement in LVEF at 6 months, adding to the neutral evidence for stem cell therapy after acute myocardial infarction. ## Pulmonary Artery Pressure-Guided Management of Patients With Heart Failure and Reduced Ejection Fraction. *2017-10-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.08.010 · https://hartvaat.nl/2017/10/10/pulmonalisdrukgeleide-therapie-bij-hfref/* This study evaluated CardioMEMS-guided pulmonary artery pressure management specifically in patients with HFrEF, refining the evidence for hemodynamic monitoring in the most guideline-directed subpopulation of heart failure. ## Characterization of the Average Daily Ischemic and Bleeding Risk After Primary PCI for STEMI. *2017-10-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.08.018 · https://hartvaat.nl/2017/10/10/dagelijks-ischemie-en-bloedingsrisico-na-primaire-pci-voor-stemi/* This study characterized the time-dependent daily ischemic and bleeding risk profiles after primary PCI for STEMI, showing that both risks peak early and decline differently over time, informing the DAPT duration decision. ## Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery: A Randomized Clinical Trial. *2017-10-10 · JAMA · https://doi.org/10.1001/jama.2017.14172 · https://hartvaat.nl/2017/10/10/geindividualiseerd-versus-standaard-bloeddrukbeleid-bij-hoog-risico-chirurgiepat/* This JAMA trial demonstrated that individualized blood pressure management based on patient-specific targets during high-risk surgery reduced postoperative organ dysfunction compared with standard management, supporting personalized hemodynamic strategies. ## 2017 Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. *2017-10-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.07.745 · https://hartvaat.nl/2017/10/03/2017-acc-gerichte-update-niet-statinetherapie-voor-ldl-verlaging/* The 2017 ACC focused update on non-statin therapies integrated FOURIER results on evolocumab into the LDL-cholesterol management pathway, providing updated guidance on when to add ezetimibe and PCSK9 inhibitors for patients not achieving LDL targets on statin therapy. ## Randomized Comparison of Ridaforolimus- and Zotarolimus-Eluting Coronary Stents in Patients With Coronary Artery Disease: Primary Results From the BIONICS Trial (BioNIR Ridaforolimus-Eluting Coronary Stent System in Coronary Stenosis). *2017-10-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028885 · https://hartvaat.nl/2017/10/03/ridaforolimus-versus-zotarolimus-eluting-stents-gerandomiseerde-primaire-resulta/* This randomized trial compared ridaforolimus-eluting with zotarolimus-eluting coronary stents, evaluating a novel antiproliferative agent on a cobalt alloy platform for coronary artery disease treatment. ## Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis: A Systematic Review and Meta-analysis. *2017-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.2895 · https://hartvaat.nl/2017/10/01/pci-versus-cabg-bij-linker-hoofdstamstenose-jama-cardiology-systematische-review/* This JAMA Cardiology meta-analysis comparing PCI with CABG for left main coronary artery stenosis found similar rates of the composite of death, MI, and stroke at up to 5 years, but higher rates of repeat revascularization with PCI. The aggregated analysis informed shared decision-making for left main disease. ## Visit-to-visit variability of blood pressure and cardiovascular outcomes in patients with stable coronary heart disease. Insights from the STABILITY trial. *2017-10-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx250 · https://hartvaat.nl/2017/10/01/visit-to-visit-bloeddrukvariabiliteit-bij-stabiel-coronairlijden-stability-inzic/* This STABILITY trial analysis confirmed that visit-to-visit blood pressure variability predicts cardiovascular events in patients with stable coronary heart disease, independent of mean blood pressure levels. ## Short-term dabigatran interruption before cardiac rhythm device implantation: multi-centre experience from the RE-LY trial. *2017-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw409 · https://hartvaat.nl/2017/10/01/korte-dabigatran-onderbreking-voor-device-implantatie-re-ly-multicenterervaring/* This multicenter analysis from RE-LY provided practical guidance on short-term dabigatran interruption around cardiac device implantation, informing the periprocedural anticoagulation management in the DOAC era. ## Efficacy and safety of antazoline in the rapid cardioversion of paroxysmal atrial fibrillation (the AnPAF Study). *2017-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw384 · https://hartvaat.nl/2017/10/01/antazoline-voor-snelle-cardioversie-van-paroxysmaal-af-de-anpaf-studie/* The AnPAF study demonstrated that antazoline, a first-generation antihistaminic agent, provides rapid cardioversion of paroxysmal AF with a favorable safety profile, offering an alternative to conventional antiarrhythmic drugs. ## Termination of persistent atrial fibrillation during pulmonary vein isolation: insight from the MAGIC-AF trial. *2017-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw266 · https://hartvaat.nl/2017/10/01/terminatie-van-persisterend-af-tijdens-pvi-inzichten-uit-magic-af/* This MAGIC-AF analysis examined AF termination during PVI for persistent AF, investigating whether achieving sinus rhythm during the procedure predicts long-term ablation success. ## Visit-to-Visit Office Blood Pressure Variability and Cardiovascular Outcomes in SPRINT (Systolic Blood Pressure Intervention Trial). *2017-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09788 · https://hartvaat.nl/2017/10/01/visit-to-visit-bloeddrukvariabiliteit-en-cv-uitkomsten-in-sprint/* This SPRINT analysis showed that greater visit-to-visit blood pressure variability is independently associated with worse cardiovascular outcomes, suggesting that blood pressure stability may be as important as the mean level achieved. ## Long-term mortality and prehospital tirofiban treatment in patients with ST elevation myocardial infarction. *2017-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2017-311181 · https://hartvaat.nl/2017/10/01/langetermijnmortaliteit-en-prehospitale-tirofibanbehandeling-bij-stemi/* This On-TIME 2 subgroup analysis evaluated long-term mortality outcomes in STEMI patients who received prehospital tirofiban, assessing the durability of early glycoprotein IIb/IIIa inhibitor treatment benefit. ## Effect of interleukin-6 inhibition on coronary microvascular and endothelial function in myocardial infarction. *2017-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310875 · https://hartvaat.nl/2017/10/01/il-6-remming-en-coronaire-microvasculaire-en-endotheelfunctie-bij-myocardinfarct/* This study evaluated the effect of IL-6 inhibition on coronary microvascular and endothelial function after myocardial infarction, exploring a targeted anti-inflammatory approach to improve vascular recovery in the post-MI period. ## Cardiovascular outcomes with an inhaled beta2-agonist/corticosteroid in patients with COPD at high cardiovascular risk. *2017-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310897 · https://hartvaat.nl/2017/10/01/inhalatiecorticosteroid-beta-2-agonist-en-cardiovasculaire-uitkomsten-bij-copd/* This study assessed cardiovascular outcomes with inhaled beta-2 agonist/corticosteroid therapy in COPD patients at high cardiovascular risk, addressing the important cardiopulmonary safety question for commonly prescribed respiratory medications. ## Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. *2017-09-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1612917 · https://hartvaat.nl/2017/09/28/exenatide-eenmaal-per-week-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-ne/* The EXSCEL trial confirmed the cardiovascular safety (noninferiority) of once-weekly exenatide in patients with type 2 diabetes but did not demonstrate superiority over placebo for MACE reduction. The result positioned exenatide as cardiovascularly neutral among GLP-1 receptor agonists. ## Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease. *2017-09-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1706444 · https://hartvaat.nl/2017/09/28/anacetrapib-bij-atherosclerotisch-vaatlijden-nejm-hps3-timi55-reveal/* The REVEAL trial demonstrated that anacetrapib, a CETP inhibitor, modestly reduced major coronary events in statin-treated patients with atherosclerotic vascular disease. Unlike earlier failed CETP inhibitors, anacetrapib lowered LDL and raised HDL, but the marginal benefit was insufficient to pursue clinical development. ## Oxygen Therapy in Suspected Acute Myocardial Infarction. *2017-09-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1706222 · https://hartvaat.nl/2017/09/28/zuurstoftherapie-bij-vermoedelijk-acuut-myocardinfarct-nejm-deto2x-ami/* The DETO2X-AMI trial showed that routine supplemental oxygen therapy did not reduce 1-year mortality in patients with suspected acute MI who were not hypoxemic at baseline. This large registry-based trial overturned decades of routine oxygen use in acute coronary care. ## Reducing Arterial Stiffness Independently of Blood Pressure: The VaSera Trial. *2017-09-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.07.765 · https://hartvaat.nl/2017/09/26/verlaging-van-arteriele-stijfheid-onafhankelijk-van-bloeddruk-de-vasera-trial/* The VaSera trial investigated whether arterial stiffness can be reduced independently of blood pressure lowering, exploring a therapeutic approach targeting vascular aging as a distinct cardiovascular risk factor. ## Application of the Statin-Associated Muscle Symptoms-Clinical Index to a Randomized Trial on Statin Myopathy. *2017-09-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.07.767 · https://hartvaat.nl/2017/09/26/sams-ci-score-toegepast-op-gerandomiseerde-trial-over-statine-myopathie/* This study applied the Statin-Associated Muscle Symptoms Clinical Index (SAMS-CI) to a randomized trial, refining the diagnostic approach for distinguishing true statin myopathy from nocebo-driven symptom reporting. ## Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: International Insights From the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). *2017-09-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.027252 · https://hartvaat.nl/2017/09/26/secundaire-cardiovasculaire-preventie-bij-diabetes-type-2-tecos-internationale-i/* This international TECOS analysis of secondary cardiovascular prevention patterns in diabetes identified substantial gaps in risk factor management across different regions, highlighting opportunities to improve preventive care. ## Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. *2017-09-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1707914 · https://hartvaat.nl/2017/09/21/anti-inflammatoire-therapie-met-canakinumab-bij-atherosclerose-nejm-cantos/* The CANTOS trial provided the first direct proof that anti-inflammatory therapy reduces cardiovascular events independently of lipid lowering. In 10,061 post-MI patients with elevated CRP, canakinumab (an IL-1β monoclonal antibody) significantly reduced recurrent cardiovascular events, definitively validating the inflammatory hypothesis of atherosclerosis. ## Bivalirudin versus Heparin Monotherapy in Myocardial Infarction. *2017-09-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1706443 · https://hartvaat.nl/2017/09/21/bivalirudine-versus-heparine-monotherapie-bij-myocardinfarct-nejm-validate-swede/* The VALIDATE-SWEDEHEART trial demonstrated no advantage of bivalirudin over heparin monotherapy during PCI for acute myocardial infarction treated predominantly via radial access. The results simplified anticoagulation practice during primary PCI by supporting standard heparin. ## Effect of a Community Health Worker-Led Multicomponent Intervention on Blood Pressure Control in Low-Income Patients in Argentina: A Randomized Clinical Trial. *2017-09-19 · JAMA · https://doi.org/10.1001/jama.2017.11358 · https://hartvaat.nl/2017/09/19/community-health-worker-interventie-voor-bloeddrukcontrole-in-argentina-jama-tri/* This JAMA trial demonstrated that a community health worker-led multicomponent intervention significantly improved blood pressure control in low-income patients, establishing a scalable model for hypertension management in underserved populations. ## Effects of the Selective Sodium-Glucose Cotransporter 2 Inhibitor Empagliflozin on Vascular Function and Central Hemodynamics in Patients With Type 2 Diabetes Mellitus. *2017-09-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.029529 · https://hartvaat.nl/2017/09/19/empagliflozine-en-vasculaire-functie-en-centrale-hemodynamiek-bij-diabetes-type-/* This mechanistic study demonstrated that empagliflozin improves vascular function and central hemodynamics in patients with type 2 diabetes, providing pathophysiological insights into the cardiovascular benefits of SGLT2 inhibition beyond glucose lowering. ## Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke. *2017-09-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1705915 · https://hartvaat.nl/2017/09/14/pfo-sluiting-of-antistolling-versus-antiplaatjestherapie-na-cva-nejm-reduce/* The REDUCE trial showed that PFO closure reduced recurrent ischemic stroke compared with antiplatelet therapy alone in patients with cryptogenic stroke and echocardiographic features of right-to-left shunt. Together with CLOSE and RESPECT, the trial confirmed the benefit of PFO closure in selected stroke patients. ## Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke. *2017-09-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1707404 · https://hartvaat.nl/2017/09/14/pfo-sluiting-of-antiplaatjestherapie-bij-cryptogeen-cva-nejm-close/* The CLOSE trial demonstrated that PFO closure combined with antiplatelet therapy significantly reduced recurrent stroke compared with antiplatelet therapy alone in patients with cryptogenic stroke and PFO with associated atrial septal aneurysm or large interatrial shunt. This was one of three landmark trials establishing PFO closure as standard of care. ## Efficacy and Safety of Ticagrelor Over Time in Patients With Prior MI in PEGASUS-TIMI 54. *2017-09-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.07.768 · https://hartvaat.nl/2017/09/12/werkzaamheid-en-veiligheid-van-ticagrelor-over-tijd-na-mi-pegasus-timi-54/* This PEGASUS-TIMI 54 analysis showed that ticagrelor's ischemic risk reduction in patients with prior MI is consistent over the treatment duration, supporting sustained long-term antiplatelet therapy. ## Prognostic Significance of Central Apneas Throughout a 24-Hour Period in Patients With Heart Failure. *2017-09-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.07.740 · https://hartvaat.nl/2017/09/12/centrale-apneus-gedurende-24-uur-en-prognose-bij-hartfalen/* This study showed that central apneas throughout a 24-hour period (not just during sleep) predict outcomes in heart failure, suggesting that daytime central apneas carry similar prognostic significance to nocturnal events. ## Physical Activity and Prognosis in the TOPCAT Trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist). *2017-09-12 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028002 · https://hartvaat.nl/2017/09/12/lichamelijke-activiteit-en-prognose-bij-hfpef-topcat-analyse/* This TOPCAT analysis showed that higher physical activity is associated with better prognosis in patients with HFpEF, supporting exercise as a therapeutic and prognostic intervention in preserved ejection fraction heart failure. ## Ivabradine in Children With Dilated Cardiomyopathy and Symptomatic Chronic Heart Failure. *2017-09-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.07.725 · https://hartvaat.nl/2017/09/05/ivabradine-bij-kinderen-met-dilaterende-cardiomyopathie-en-symptomatisch-hartfal/* This study of ivabradine in children with dilated cardiomyopathy and heart failure was among the few pediatric heart failure trials, exploring selective heart rate reduction as a treatment strategy in this underserved population. ## Cardiovascular Risk Following Fertility Therapy: Systematic Review and Meta-Analysis. *2017-09-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.07.753 · https://hartvaat.nl/2017/09/05/cardiovasculair-risico-na-fertiliteitstherapie-systematische-review-en-meta-anal/* This systematic review and meta-analysis summarized data on cardiovascular risk following fertility therapy, evaluating whether assisted reproductive technologies are associated with long-term cardiovascular complications. ## Early Use of N-acetylcysteine With Nitrate Therapy in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction Reduces Myocardial Infarct Size (the NACIAM Trial [N-acetylcysteine in Acute Myocardial Infarction]). *2017-09-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.027575 · https://hartvaat.nl/2017/09/05/n-acetylcysteine-met-nitraat-bij-primaire-pci-voor-stemi/* This study tested whether combining N-acetylcysteine with nitrate therapy during primary PCI for STEMI provides additional cardioprotection, exploring antioxidant strategies for limiting reperfusion injury. ## Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF Randomized Clinical Trial. *2017-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.2198 · https://hartvaat.nl/2017/09/01/spironolacton-bij-acuut-hartfalen-de-athena-hf-gerandomiseerde-trial/* The ATHENA-HF trial showed that high-dose spironolactone (100 mg) in acute heart failure did not improve natriuretic peptide levels or clinical outcomes compared with low-dose or no spironolactone, arguing against aggressive MRA dosing in the acute setting. ## Late thrombotic events after bioresorbable scaffold implantation: a systematic review and meta-analysis of randomized clinical trials. *2017-09-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx155 · https://hartvaat.nl/2017/09/01/late-trombotische-events-na-bioresorbeerbare-scaffold-meta-analyse-van-gerandomi/* This meta-analysis quantified the risk of late thrombotic events after bioresorbable scaffold implantation, demonstrating a significantly higher rate of very late scaffold thrombosis compared with metallic everolimus-eluting stents. ## Is echocardiography valid and reproducible in patients with atrial fibrillation? A systematic review. *2017-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/eux027 · https://hartvaat.nl/2017/09/01/validiteit-en-reproduceerbaarheid-van-echocardiografie-bij-af-systematische-revi/* This systematic review evaluated the validity and reproducibility of echocardiographic measurements in patients with atrial fibrillation, addressing the technical challenges of cardiac imaging in irregular rhythms. ## Rationale and design of the BUDAPEST-CRT Upgrade Study: a prospective, randomized, multicentre clinical trial. *2017-09-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw193 · https://hartvaat.nl/2017/09/01/budapest-crt-upgrade-study-studieontwerp-voor-crt-upgrade/* This protocol described the BUDAPEST-CRT Upgrade Study, a randomized trial testing CRT upgrade in patients with right ventricular pacing-induced cardiomyopathy, addressing a common clinical scenario lacking randomized evidence. ## Impact of stroke volume on cardiovascular risk during progression of aortic valve stenosis. *2017-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310917 · https://hartvaat.nl/2017/09/01/slagvolume-en-cardiovasculair-risico-bij-progressie-van-aortaklepstenose/* This study showed that low stroke volume during aortic stenosis progression is an independent predictor of cardiovascular mortality, supporting the clinical importance of low-flow states in valvular heart disease risk assessment. ## Long-term outcomes of provisional stenting compared with a two-stent strategy for bifurcation lesions: a meta-analysis of randomised trials. *2017-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310929 · https://hartvaat.nl/2017/09/01/provisional-versus-twee-stentstrategie-bij-bifurcatielaesies-meta-analyse/* This meta-analysis of randomized trials comparing provisional stenting with a two-stent strategy for coronary bifurcation lesions showed similar long-term outcomes, supporting the simpler provisional approach as the default strategy. ## Efficacy of Rosuvastatin in Children With Homozygous Familial Hypercholesterolemia and Association With Underlying Genetic Mutations. *2017-08-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.06.058 · https://hartvaat.nl/2017/08/29/rosuvastatine-bij-kinderen-met-homozygote-familiaire-hypercholesterolemie/* This study evaluated rosuvastatin efficacy in children with homozygous FH stratified by underlying genetic mutations, showing that LDL-receptor activity determines statin responsiveness in this severe genetic disorder. ## Effect of Intensive Blood-Pressure Treatment on Patient-Reported Outcomes. *2017-08-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1611179 · https://hartvaat.nl/2017/08/24/intensieve-bloeddrukbehandeling-en-patientgerapporteerde-uitkomsten-nejm-sprint-/* This SPRINT analysis found no substantial difference in patient-reported outcomes (including physical functioning, mental health, and treatment satisfaction) between intensive and standard blood pressure treatment, addressing concerns that aggressive blood pressure lowering might impair quality of life. ## Efficacy and Safety of Degludec versus Glargine in Type 2 Diabetes. *2017-08-24 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1615692 · https://hartvaat.nl/2017/08/24/degludec-versus-glargine-bij-diabetes-type-2-nejm-devote-werkzaamheid-en-veiligh/* The DEVOTE trial confirmed the cardiovascular safety of insulin degludec compared with insulin glargine in patients with type 2 diabetes at high cardiovascular risk, while demonstrating significantly fewer severe hypoglycemic episodes with degludec. ## Effect of Natriuretic Peptide-Guided Therapy on Hospitalization or Cardiovascular Mortality in High-Risk Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. *2017-08-22 · JAMA · https://doi.org/10.1001/jama.2017.10565 · https://hartvaat.nl/2017/08/22/natriuretisch-peptide-geleide-therapie-bij-hoogrisico-hartfalen-jama-guide-it/* The GUIDE-IT trial showed that NT-proBNP-guided heart failure therapy did not improve outcomes compared with usual care in high-risk HFrEF patients. The result suggested that biomarker-guided titration does not add benefit when clinicians already provide intensive evidence-based management. ## Comparative efficacy and safety of reperfusion therapy with fibrinolytic agents in patients with ST-segment elevation myocardial infarction: a systematic review and network meta-analysis. *2017-08-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)31441-1 · https://hartvaat.nl/2017/08/19/vergelijking-van-fibrinolytica-bij-stemi-lancet-netwerkmeta-analyse/* This Lancet network meta-analysis compared the efficacy and safety of different fibrinolytic agents for STEMI, providing a comparative effectiveness framework for settings where primary PCI is unavailable. ## Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials. *2017-08-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)31490-3 · https://hartvaat.nl/2017/08/19/optimale-timing-van-invasieve-strategie-bij-nste-acs-lancet-meta-analyse/* This Lancet meta-analysis of randomized trials examined the optimal timing of invasive strategy in non-ST-elevation ACS, finding that very early intervention (within 24 hours) reduced recurrent ischemia in high-risk patients but did not significantly reduce death or MI compared with delayed intervention. ## 2-year outcomes with the Absorb bioresorbable scaffold for treatment of coronary artery disease: a systematic review and meta-analysis of seven randomised trials with an individual patient data substudy. *2017-08-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)31470-8 · https://hartvaat.nl/2017/08/19/absorb-bioresorbeerbare-scaffold-lancet-2-jaars-systematische-review-en-meta-ana/* This Lancet systematic review of 2-year Absorb bioresorbable scaffold outcomes showed accumulating evidence of inferior safety compared with metallic DES, including higher rates of scaffold thrombosis and target lesion failure. ## Cognitive Function in a Randomized Trial of Evolocumab. *2017-08-17 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1701131 · https://hartvaat.nl/2017/08/17/cognitieve-functie-in-de-fourier-trial-met-evolocumab-nejm-ebbinghaus/* The EBBINGHAUS cognitive substudy of FOURIER demonstrated that evolocumab and very low LDL cholesterol levels did not adversely affect cognitive function over a median of 19 months. The results provided important reassurance about the neurocognitive safety of aggressive PCSK9 inhibition. ## Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. *2017-08-17 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1611925 · https://hartvaat.nl/2017/08/17/canagliflozine-en-cardiovasculaire-en-renale-events-bij-diabetes-type-2-nejm-can/* The CANVAS Program showed that canagliflozin reduced the composite of cardiovascular death, nonfatal MI, and nonfatal stroke in patients with type 2 diabetes at high cardiovascular risk, while also slowing the progression of albuminuria. The trial confirmed the cardiovascular benefit as a class effect of SGLT2 inhibitors. ## Particulate Matter Exposure and Stress Hormone Levels: A Randomized, Double-Blind, Crossover Trial of Air Purification. *2017-08-15 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.026796 · https://hartvaat.nl/2017/08/15/fijnstofblootstelling-en-stresshormoonspiegels-gerandomiseerde-luchtzuiveringstr/* This randomized double-blind crossover trial used air purifiers to demonstrate that particulate matter exposure increases stress hormone levels, providing a mechanistic link between air pollution and cardiovascular risk through sympathetic activation. ## Survival After Isolated Post-Operative Troponin Elevation. *2017-08-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.06.023 · https://hartvaat.nl/2017/08/15/overleving-na-geisoleerde-postoperatieve-troponine-elevatie/* This study characterized the survival implications of isolated troponin elevation after non-cardiac surgery, quantifying the long-term mortality risk associated with perioperative myocardial injury without overt clinical events. ## Foley catheterisation versus oral misoprostol for induction of labour in hypertensive women in India (INFORM): a multicentre, open-label, randomised controlled trial. *2017-08-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)31367-3 · https://hartvaat.nl/2017/08/12/foley-katheter-versus-misoprostol-voor-inleiden-bij-hypertensieve-zwangeren-in-i/* The INFORM Lancet trial compared Foley catheter with oral misoprostol for labor induction in hypertensive women in India, providing evidence relevant to managing delivery timing in preeclampsia in low-resource settings. ## Prasugrel or Ticagrelor in ST-Segment-Elevation Myocardial Infarction Patients With Diabetes Mellitus. *2017-08-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028745 · https://hartvaat.nl/2017/08/08/prasugrel-of-ticagrelor-bij-stemi-met-diabetes/* This analysis compared prasugrel with ticagrelor specifically in STEMI patients with diabetes, investigating whether the optimal P2Y12 inhibitor choice differs in this high-risk subpopulation. ## Effects of Canagliflozin on Cardiovascular Biomarkers in Older Adults With Type 2 Diabetes. *2017-08-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.06.016 · https://hartvaat.nl/2017/08/08/canagliflozine-en-cardiovasculaire-biomarkers-bij-oudere-diabetespatienten/* This study examined the effects of canagliflozin on cardiovascular biomarkers in older diabetic patients, showing favorable changes in natriuretic peptides and inflammatory markers that provide mechanistic insight into SGLT2 inhibitor cardioprotection. ## 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. *2017-08-08 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.04.025 · https://hartvaat.nl/2017/08/08/2017-acc-aha-hfsa-gerichte-update-hartfalenmanagement-jacc-editie/* JACC publication of the 2017 focused update for heart failure management, simultaneously published with the Circulation version, providing updated recommendations for ARNI therapy and biomarker-guided treatment strategies in heart failure. ## 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. *2017-08-08 · Circulation · https://doi.org/10.1161/CIR.0000000000000509 · https://hartvaat.nl/2017/08/08/2017-acc-aha-hfsa-gerichte-update-hartfalenmanagement-circulation-editie/* The 2017 ACC/AHA/HFSA focused update for heart failure management updated recommendations for sacubitril-valsartan (ARNI) use in HFrEF, provided guidance on new heart failure biomarkers, and refined staging and treatment algorithms based on contemporary evidence. ## Remote management of heart failure using implantable electronic devices. *2017-08-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx227 · https://hartvaat.nl/2017/08/07/remote-management-van-hartfalen-met-implanteerbare-devices-overzicht/* The REM-HF review assessed the clinical and cost-effectiveness of remote heart failure monitoring using implantable electronic devices, summarizing the evidence for telemonitoring-guided therapy in the device-managed HF population. ## Standard vs. intensified management of heart failure to reduce healthcare costs: results of a multicentre, randomized controlled trial. *2017-08-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx259 · https://hartvaat.nl/2017/08/07/standaard-versus-geintensiveerd-hartfalenmanagement-en-zorgkosten-gerandomiseerd/* This multicenter randomized trial compared standard versus intensified heart failure management programs on healthcare costs, evaluating whether individualized profiling and more frequent monitoring reduce the economic burden of heart failure. ## Biased ligand of the angiotensin II type 1 receptor in patients with acute heart failure: a randomized, double-blind, placebo-controlled, phase IIB, dose ranging trial (BLAST-AHF). *2017-08-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx196 · https://hartvaat.nl/2017/08/07/trv027-biased-ligand-van-de-angiotensine-ii-receptor-bij-acuut-hartfalen-gerando/* This randomized trial of TRV027, a biased ligand of the angiotensin II type 1 receptor, in acute heart failure tested a novel pharmacological approach that selectively activates beneficial downstream signaling while blocking detrimental pathways. ## Accuracy of Cuff-Measured Blood Pressure: Systematic Reviews and Meta-Analyses. *2017-08-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.05.064 · https://hartvaat.nl/2017/08/01/nauwkeurigheid-van-manchetbloeddrukmeting-systematische-review-en-meta-analyse/* This systematic review evaluated the accuracy of cuff-based blood pressure measurement against intra-arterial reference, revealing clinically significant discrepancies that have implications for hypertension diagnosis and treatment targets. ## Cost-Effectiveness of Long-Term Ticagrelor in Patients With Prior Myocardial Infarction: Results From the PEGASUS-TIMI 54 Trial. *2017-08-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.05.063 · https://hartvaat.nl/2017/08/01/kosteneffectiviteit-van-langdurig-ticagrelor-na-mi-pegasus-timi-54/* This PEGASUS-TIMI 54 cost-effectiveness analysis showed that long-term ticagrelor therapy in post-MI patients provides acceptable value for money across different healthcare systems, supporting the economic case for extended antiplatelet therapy. ## Associations Between Adding a Radial Artery Graft to Single and Bilateral Internal Thoracic Artery Grafts and Outcomes: Insights From the Arterial Revascularization Trial. *2017-08-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.027659 · https://hartvaat.nl/2017/08/01/radiale-arterie-graft-als-aanvulling-op-mammaria-interna-grafts-bij-cabg/* This ART trial analysis evaluated whether adding a radial artery graft to single or bilateral internal thoracic artery grafts improves CABG outcomes, refining the evidence for total arterial revascularization strategies. ## Effect of Intensive Blood Pressure Lowering on Left Ventricular Hypertrophy in Patients With Hypertension: SPRINT (Systolic Blood Pressure Intervention Trial). *2017-08-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028441 · https://hartvaat.nl/2017/08/01/intensieve-bloeddrukverlaging-en-linkerventrikelhypertrofie-sprint-echocardiogra/* This SPRINT echocardiographic substudy showed that intensive blood pressure lowering was more effective than standard treatment in reducing left ventricular mass and the prevalence of LVH, suggesting that aggressive blood pressure control may provide direct myocardial benefit. ## Effect of vitamin D on all-cause mortality in heart failure (EVITA): a 3-year randomized clinical trial with 4000 IU vitamin D daily. *2017-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx235 · https://hartvaat.nl/2017/08/01/vitamine-d-en-mortaliteit-bij-hartfalen-de-evita-3-jaars-gerandomiseerde-trial/* The EVITA trial showed that 4,000 IU daily vitamin D supplementation did not reduce all-cause mortality in heart failure patients despite correcting vitamin D deficiency. This definitive negative result argued against vitamin D as a heart failure therapy. ## Low-density lipoprotein cholesterol targeting with pitavastatin + ezetimibe for patients with acute coronary syndrome and dyslipidaemia: the HIJ-PROPER study, a prospective, open-label, randomized trial. *2017-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx162 · https://hartvaat.nl/2017/08/01/ldl-cholesterol-streefwaarden-met-pitavastatine-ezetimibe-bij-acs-met-dyslipidem/* This Japanese randomized trial showed that pitavastatin plus ezetimibe combination therapy achieves lower LDL cholesterol than pitavastatin monotherapy in ACS patients with dyslipidemia, supporting early intensive combination lipid therapy after acute coronary events. ## Cardiometabolic Determinants of Carotid and Aortic Distensibility From Childhood to Early Adulthood. *2017-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09027 · https://hartvaat.nl/2017/08/01/cardiometabole-determinanten-van-carotis-en-aortadistensibiliteit-van-kindertijd/* This longitudinal study tracked the development of arterial stiffness from childhood to early adulthood, showing that cardiometabolic risk factors present in youth predict vascular aging trajectories. ## Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive Patients: A Post Hoc Analysis of the Renal Substudy of CSPPT (China Stroke Primary Prevention Trial). *2017-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09404 · https://hartvaat.nl/2017/08/01/foliumzuurtherapie-en-nieuwe-proteinurie-bij-chinese-hypertensieve-patienten-csp/* This CSPPT post-hoc analysis showed that folic acid supplementation added to enalapril reduces new-onset proteinuria in Chinese hypertensive patients, suggesting a renoprotective synergy between RAAS inhibition and folate. ## Prognostic Value of Variability in Systolic Blood Pressure Related to Vascular Events and Premature Death in Type 2 Diabetes Mellitus: The ADVANCE-ON Study. *2017-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09359 · https://hartvaat.nl/2017/08/01/bloeddrukvariabiliteit-en-vasculaire-events-bij-diabetes-type-2/* This study demonstrated that visit-to-visit systolic blood pressure variability predicts vascular events and premature death in diabetic patients, adding variability to the list of blood pressure parameters requiring clinical attention. ## Predicting the risk of bleeding during dual antiplatelet therapy after acute coronary syndromes. *2017-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310090 · https://hartvaat.nl/2017/08/01/voorspelling-van-bloedingsrisico-tijdens-dapt-na-acs/* This study evaluated bleeding risk prediction scores during dual antiplatelet therapy after ACS, comparing available models to identify the most accurate tool for balancing ischemic protection against hemorrhagic risk. ## N-terminal pro B-type natriuretic peptide in systematic screening for atrial fibrillation. *2017-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310236 · https://hartvaat.nl/2017/08/01/nt-probnp-bij-systematische-screening-op-atriumfibrilleren/* This study evaluated NT-proBNP as a pre-screening tool for systematic AF detection in the community, showing that elevated natriuretic peptide levels can efficiently identify individuals most likely to have undiagnosed arrhythmia. ## Drug-eluting stents versus bare-metal stents in acute myocardial infarction with cardiogenic shock. *2017-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310403 · https://hartvaat.nl/2017/08/01/des-versus-bms-bij-acuut-mi-met-cardiogene-shock/* This study compared drug-eluting with bare-metal stents in patients with acute MI complicated by cardiogenic shock, testing whether the benefits of DES extend to the most hemodynamically unstable patients. ## Genetic and Pharmacologic Inactivation of ANGPTL3 and Cardiovascular Disease. *2017-07-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1612790 · https://hartvaat.nl/2017/07/20/genetische-en-farmacologische-inactivatie-van-angptl3-en-cardiovasculaire-ziekte/* This NEJM study showed that genetic loss-of-function variants in ANGPTL3 are associated with reduced plasma lipid levels and lower cardiovascular risk, providing the genetic foundation for pharmacological ANGPTL3 inhibition as a cardiovascular prevention strategy. ## Cardiovascular and Metabolic Effects of ANGPTL3 Antisense Oligonucleotides. *2017-07-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1701329 · https://hartvaat.nl/2017/07/20/angptl3-antisense-oligonucleotiden-cardiovasculaire-en-metabole-effecten-nejm/* This NEJM study demonstrated that antisense oligonucleotides targeting ANGPTL3 effectively reduced triglycerides, LDL cholesterol, and other atherogenic lipoproteins in humans. The results established ANGPTL3 as a novel therapeutic target for comprehensive lipid lowering. ## Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial. *2017-07-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.05.030 · https://hartvaat.nl/2017/07/18/palliatieve-zorg-bij-hartfalen-de-pal-hf-gerandomiseerde-trial/* The PAL-HF trial showed that specialized palliative care integrated with standard heart failure management improved quality of life, depression, anxiety, and spiritual well-being in patients with advanced heart failure. The results supported formal palliative care integration in heart failure programs. ## Lower Risk of Heart Failure and Death in Patients Initiated on Sodium-Glucose Cotransporter-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL Study (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors). *2017-07-18 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.029190 · https://hartvaat.nl/2017/07/18/sglt2-remmers-en-lager-risico-op-hartfalen-en-sterfte-versus-andere-glucoseverla/* This large real-world study demonstrated that patients initiated on SGLT2 inhibitors had lower rates of heart failure hospitalization and death compared with those started on other glucose-lowering drugs, providing early observational confirmation of the cardiovascular benefits seen in clinical trials. ## Prediction of sudden and non-sudden cardiac death in post-infarction patients with reduced left ventricular ejection fraction by periodic repolarization dynamics: MADIT-II substudy. *2017-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx161 · https://hartvaat.nl/2017/07/14/voorspelling-van-plotse-versus-niet-plotse-hartdood-na-mi-met-verminderde-lvef/* This study tested Periodic Repolarization Dynamics (PRD), a novel ECG marker of sympathetic activity, for predicting sudden versus non-sudden cardiac death in post-MI patients with reduced LVEF, exploring improved risk stratification for ICD candidacy. ## Adjuvant Pertuzumab and Trastuzumab in Early HER2-Positive Breast Cancer. *2017-07-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1703643 · https://hartvaat.nl/2017/07/13/adjuvant-pertuzumab-en-trastuzumab-bij-vroege-her2-positieve-borstkanker-nejm-ap/* The APHINITY trial of adjuvant pertuzumab plus trastuzumab in early HER2-positive breast cancer is relevant to cardio-oncology due to the additive cardiotoxicity risk of dual HER2 blockade on top of anthracycline-based chemotherapy. ## Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement. *2017-07-11 · JAMA · https://doi.org/10.1001/jama.2017.7171 · https://hartvaat.nl/2017/07/11/gedragscounseling-voor-gezonde-voeding-en-beweging-ter-cv-preventie-jama-uspstf-/* This JAMA evidence review for the USPSTF assessed the effectiveness of behavioral counseling on diet and physical activity for cardiovascular disease prevention in adults, informing population-level lifestyle intervention recommendations. ## Association of Positive Airway Pressure With Cardiovascular Events and Death in Adults With Sleep Apnea: A Systematic Review and Meta-analysis. *2017-07-11 · JAMA · https://doi.org/10.1001/jama.2017.7967 · https://hartvaat.nl/2017/07/11/positieve-luchtwegdruk-en-cv-events-bij-slaapapneu-jama-meta-analyse/* This JAMA meta-analysis found that positive airway pressure therapy for sleep apnea did not significantly reduce cardiovascular events or mortality in patients with obstructive or central sleep apnea. The results tempered expectations about the cardiovascular benefits of CPAP/BPAP therapy. ## Arterial Stiffening With Exercise in Patients With Heart Failure and Preserved Ejection Fraction. *2017-07-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.05.029 · https://hartvaat.nl/2017/07/11/arteriele-verstijving-bij-inspanning-bij-hfpef/* This study demonstrated that arterial stiffening during exercise is exaggerated in HFpEF patients, linking abnormal vascular-ventricular coupling during exertion to the exercise intolerance that defines this heart failure phenotype. ## Arterial Remodeling After Bioresorbable Scaffolds and Metallic Stents. *2017-07-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.05.028 · https://hartvaat.nl/2017/07/04/arteriele-remodellering-na-bioresorbeerbare-scaffolds-versus-metallic-stents/* This imaging study characterized arterial remodeling after bioresorbable scaffolds compared with metallic stents, documenting the late luminal enlargement and expansive vascular healing unique to bioresorbable technology. ## Effect of Long-Term Metformin and Lifestyle in the Diabetes Prevention Program and Its Outcome Study on Coronary Artery Calcium. *2017-07-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.025483 · https://hartvaat.nl/2017/07/04/langetermijn-metformine-en-leefstijl-en-coronair-calcium-diabetes-prevention-pro/* This Diabetes Prevention Program analysis examined the effects of long-term metformin and lifestyle intervention on coronary artery calcium progression, assessing whether metabolic prevention strategies reduce subclinical atherosclerosis. ## Systolic Blood Pressure Reduction and Risk of Cardiovascular Disease and Mortality: A Systematic Review and Network Meta-analysis. *2017-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.1421 · https://hartvaat.nl/2017/07/01/systolische-bloeddrukreductie-en-cv-risico-netwerkmeta-analyse/* This JAMA Cardiology network meta-analysis quantified the cardiovascular risk reduction associated with different magnitudes of systolic blood pressure lowering, informing the debate about optimal targets across various antihypertensive treatment strategies. ## Impact of the SYNTAX scores I and II in patients with diabetes and multivessel coronary disease: a pooled analysis of patient level data from the SYNTAX, PRECOMBAT, and BEST trials. *2017-07-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehx138 · https://hartvaat.nl/2017/07/01/syntax-scores-en-uitkomsten-bij-diabetes-met-multivatenlijden-gepoolde-analyse/* This pooled patient-level analysis assessed the impact of SYNTAX scores I and II on outcomes after PCI versus CABG in diabetic patients with multivessel disease, refining the revascularization strategy selection for the diabetic population. ## Efficacy of Catheter Ablation for Nonparoxysmal Atrial Fibrillation. *2017-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.0901 · https://hartvaat.nl/2017/07/01/werkzaamheid-van-katheterablatie-bij-niet-paroxysmaal-atriumfibrilleren-jama-car/* This JAMA Cardiology review evaluated the efficacy of catheter ablation specifically for non-paroxysmal AF (persistent and longstanding persistent), summarizing the evidence for ablation in these more challenging AF subtypes. ## One-Year Mortality for Bivalirudin vs Heparins Plus Optional Glycoprotein IIb/IIIa Inhibitor Treatment Started in the Ambulance for ST-Segment Elevation Myocardial Infarction: A Secondary Analysis of the EUROMAX Randomized Clinical Trial. *2017-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.5975 · https://hartvaat.nl/2017/07/01/1-jaarsmortaliteit-bivalirudine-versus-heparine-in-de-ambulance-bij-stemi-matrix/* This JAMA Cardiology analysis of 1-year mortality with bivalirudin versus heparin initiated in the ambulance for STEMI provided extended follow-up on the optimal anticoagulation strategy for prehospital PCI management. ## Cardiac resynchronization therapy: mechanisms of action and scope for further improvement in cardiac function. *2017-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw136 · https://hartvaat.nl/2017/07/01/crt-werkingsmechanismen-en-mogelijkheden-voor-verdere-verbetering/* This comprehensive review described the mechanisms of action of CRT and identified opportunities for further optimization, covering electrical resynchronization, AV optimization, and multisite pacing strategies. ## Efficacy and Safety of Quarter-Dose Blood Pressure-Lowering Agents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. *2017-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09202 · https://hartvaat.nl/2017/07/01/kwartdosis-antihypertensiva-systematische-review-en-meta-analyse/* This systematic review and meta-analysis of quarter-dose blood pressure-lowering agents showed that ultra-low-dose antihypertensive combinations provide meaningful blood pressure reduction with minimal side effects, building the evidence base for the low-dose combination approach. ## Risk of Cardiovascular Events in Patients With Diabetes Mellitus on β-Blockers. *2017-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09259 · https://hartvaat.nl/2017/07/01/cardiovasculair-risico-bij-diabetes-op-betablokkers/* This study examined the cardiovascular risk implications of beta-blocker use in diabetic patients, addressing the metabolic effects of beta-blockers that may counteract the benefits of intensive glycemic control. ## Heterogeneity in Early Responses in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial). *2017-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09221 · https://hartvaat.nl/2017/07/01/heterogeniteit-in-vroege-respons-op-antihypertensiva-allhat/* This ALLHAT analysis examined heterogeneity in early blood pressure responses to different antihypertensive classes, finding clinically meaningful variation that may guide personalized drug selection strategies. ## Effects of dabigatran according to age in atrial fibrillation. *2017-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310358 · https://hartvaat.nl/2017/07/01/dabigatran-naar-leeftijd-bij-atriumfibrilleren-re-ly-analyse/* This RE-LY age-stratified analysis examined the effects and safety of dabigatran across different age groups in AF, providing dosing guidance for the elderly and informing the age-dependent risk-benefit balance of anticoagulation. ## Two-year outcomes of bioresorbable vascular scaffold versus drug-eluting stents in coronary artery disease: a meta-analysis. *2017-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310886 · https://hartvaat.nl/2017/07/01/bioresorbeerbare-scaffold-versus-des-2-jaars-meta-analyse/* This meta-analysis of 2-year outcomes confirmed inferior safety of bioresorbable vascular scaffolds compared with drug-eluting stents, with higher rates of definite/probable scaffold thrombosis, contributing to the evidence that led to device withdrawal. ## Hospitalization for Recently Diagnosed Versus Worsening Chronic Heart Failure: From the ASCEND-HF Trial. *2017-06-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.04.043 · https://hartvaat.nl/2017/06/27/hospitalisatie-voor-nieuw-gediagnosticeerd-versus-verslechterend-chronisch-hartf/* This ASCEND-HF analysis compared outcomes between patients hospitalized for newly diagnosed versus chronically worsening heart failure, showing that long-term chronic HF survivors have different risk profiles and treatment responses. ## Adverse events associated with unblinded, but not with blinded, statin therapy in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm (ASCOT-LLA): a randomised double-blind placebo-controlled trial and its non-randomised non-blind extension phase. *2017-06-24 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)31075-9 · https://hartvaat.nl/2017/06/24/bijwerkingen-bij-niet-geblindeerde-versus-geblindeerde-statinetherapie-lancet-as/* This Lancet analysis from ASCOT demonstrated that statin-attributed side effects were reported significantly more often during the unblinded extension phase than during the original blinded trial, providing direct evidence that the nocebo effect drives most perceived statin intolerance. ## Heart Rate and Rhythm and the Benefit of Beta-Blockers in Patients With Heart Failure. *2017-06-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.04.001 · https://hartvaat.nl/2017/06/20/hartfrequentie-en-ritme-en-het-voordeel-van-betablokkers-bij-hartfalen/* This analysis examined the interaction between heart rate, rhythm (sinus rhythm vs AF), and beta-blocker benefit in heart failure, providing insights into which patients derive the most benefit from heart rate lowering. ## Cholesterol Efflux Capacity, High-Density Lipoprotein Particle Number, and Incident Cardiovascular Events: An Analysis From the JUPITER Trial (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin). *2017-06-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.025678 · https://hartvaat.nl/2017/06/20/cholesteroleffluxcapaciteit-hdl-deeltjesaantal-en-cv-events-jupiter-analyse/* This JUPITER analysis examined cholesterol efflux capacity and HDL particle number as predictors of cardiovascular events, exploring whether functional HDL measures better explain cardiovascular risk than HDL cholesterol concentration alone. ## Bioresorbable Scaffolds versus Metallic Stents in Routine PCI. *2017-06-15 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1614954 · https://hartvaat.nl/2017/06/15/bioresorbeerbare-scaffolds-versus-metallic-stents-bij-routine-pci-nejm-aida/* The AIDA trial showed that bioresorbable vascular scaffolds had significantly higher rates of device thrombosis compared with metallic drug-eluting stents in routine PCI. This safety concern contributed to the withdrawal of bioresorbable scaffolds from widespread clinical use. ## Randomized trial of switching from prescribed non-selective non-steroidal anti-inflammatory drugs to prescribed celecoxib: the Standard care vs. Celecoxib Outcome Trial (SCOT). *2017-06-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw387 · https://hartvaat.nl/2017/06/14/overschakelen-van-niet-selectieve-nsaid-s-naar-celecoxib-de-scot-trial/* This randomized trial investigated the cardiovascular safety of switching from non-selective NSAIDs to celecoxib, providing comparative safety data relevant to anti-inflammatory drug selection in patients with cardiovascular risk factors. ## Myocardial Damage in Patients With Deferred Stenting After STEMI: A DANAMI-3-DEFER Substudy. *2017-06-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.03.601 · https://hartvaat.nl/2017/06/13/myocardschade-bij-uitgestelde-stenting-na-stemi-danami-3-defer-substudie/* This DANAMI-3-DEFER substudy evaluated myocardial damage in patients with deferred versus immediate stent implantation after STEMI, providing tissue-level outcomes for the delayed stenting strategy. ## Daily remote monitoring of implantable cardioverter-defibrillators: insights from the pooled patient-level data from three randomized controlled trials (IN-TIME, ECOST, TRUST). *2017-06-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx015 · https://hartvaat.nl/2017/06/07/dagelijkse-telemonitoring-van-icd-s-gepoolde-analyse-van-drie-gerandomiseerde-tr/* This pooled patient-level analysis of three randomized trials examined whether daily remote monitoring of implantable cardioverter-defibrillators improves clinical outcomes through earlier detection of arrhythmias and device-related issues. ## Clinical efficacy of intravitreal aflibercept versus panretinal photocoagulation for best corrected visual acuity in patients with proliferative diabetic retinopathy at 52 weeks (CLARITY): a multicentre, single-blinded, randomised, controlled, phase 2b, non-inferiority trial. *2017-06-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)31193-5 · https://hartvaat.nl/2017/06/03/intravitreaal-aflibercept-versus-panretinale-fotocoagulatie-bij-proliferatieve-d/* This Lancet study compared intravitreal aflibercept with panretinal photocoagulation for diabetic retinopathy, contributing to the ophthalmological management evidence relevant to diabetes cardiovascular care. ## Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials. *2017-06-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)30754-7 · https://hartvaat.nl/2017/06/03/bereikte-bloeddruk-en-cv-uitkomsten-bij-hoogrisicopatienten-ontarget-transcend/* This ONTARGET/TRANSCEND analysis revealed a J-curve relationship between achieved blood pressure and cardiovascular outcomes in high-risk patients, with both very high and very low blood pressure associated with increased risk. The findings informed the debate about optimal blood pressure targets. ## Effect of Monthly High-Dose Vitamin D Supplementation on Cardiovascular Disease in the Vitamin D Assessment Study : A Randomized Clinical Trial. *2017-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.0175 · https://hartvaat.nl/2017/06/01/maandelijks-hooggedoseerd-vitamine-d-en-cardiovasculaire-ziekte-gerandomiseerde-/* This large randomized trial showed that monthly high-dose vitamin D supplementation did not reduce the incidence of cardiovascular disease, definitively closing the door on vitamin D supplementation as a cardiovascular prevention strategy. ## Effect of Baseline Nutritional Status on Long-term Multivitamin Use and Cardiovascular Disease Risk: A Secondary Analysis of the Physicians' Health Study II Randomized Clinical Trial. *2017-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.0176 · https://hartvaat.nl/2017/06/01/voedingsstatus-en-langetermijn-multivitaminegebruik-en-cv-risico-phs-ii-analyse/* This JAMA Cardiology secondary analysis from the Physicians' Health Study II showed that baseline nutritional status does not modify the null effect of multivitamin supplementation on cardiovascular disease prevention. ## Primary Prevention Implantable Cardioverter Defibrillators in Patients With Nonischemic Cardiomyopathy: A Meta-analysis. *2017-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.0630 · https://hartvaat.nl/2017/06/01/primaire-preventie-icd-bij-niet-ischemische-cardiomyopathie-meta-analyse/* This JAMA Cardiology meta-analysis of primary prevention ICD trials in nonischemic cardiomyopathy found conflicting evidence on mortality benefit, reflecting the impact of improved medical therapy since earlier trials. The analysis highlighted uncertainty about ICD benefit in the era of contemporary heart failure management. ## Effect of Short Procedural Duration With Bivalirudin on Increased Risk of Acute Stent Thrombosis in Patients With STEMI: A Secondary Analysis of the HORIZONS-AMI Randomized Clinical Trial. *2017-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.5669 · https://hartvaat.nl/2017/06/01/korte-procedureduur-met-bivalirudine-en-risico-op-acute-stenttrombose-bij-stemi/* This JAMA Cardiology analysis examined whether short procedural duration with bivalirudin affects the risk of acute stent thrombosis in STEMI patients, addressing a potential interaction between anticoagulation duration and thrombotic risk. ## The impact of ischaemic stroke on atrial fibrillation-related healthcare cost: a systematic review. *2017-06-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw093 · https://hartvaat.nl/2017/06/01/impact-van-ischemisch-cva-op-af-gerelateerde-zorgkosten-systematische-review/* This systematic review quantified the impact of ischemic stroke on AF-related healthcare costs, showing that stroke is the dominant cost driver and reinforcing the economic case for effective stroke prevention in AF. ## Temporal Trends in Adverse Events After Everolimus-Eluting Bioresorbable Vascular Scaffold Versus Everolimus-Eluting Metallic Stent Implantation: A Meta-Analysis of Randomized Controlled Trials. *2017-05-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028479 · https://hartvaat.nl/2017/05/30/tijdstrends-in-complicaties-van-bioresorbeerbare-versus-metallic-stents/* This analysis of temporal trends in adverse events after bioresorbable scaffolds showed an increasing risk of scaffold thrombosis over time compared with metallic stents, providing key safety data that contributed to the device's market withdrawal. ## Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting. *2017-05-30 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024436 · https://hartvaat.nl/2017/05/30/polygene-risicoscore-en-relatief-voordeel-van-statinetherapie-primaire-preventie/* This study demonstrated that a polygenic risk score identifies patients with higher atherosclerotic burden who derive greater relative benefit from statin therapy, supporting the concept of genetics-guided cardiovascular prevention. ## Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery. *2017-05-25 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1616218 · https://hartvaat.nl/2017/05/25/levosimendan-bij-lv-disfunctie-voor-hartchirurgie-nejm-levo-cts/* The LEVO-CTS trial showed that preoperative levosimendan did not improve outcomes in patients with left ventricular dysfunction undergoing cardiac surgery, with no reduction in the composite of death, renal failure, perioperative MI, or mechanical circulatory support use. ## Hemocompatibility-Related Outcomes in the MOMENTUM 3 Trial at 6 Months: A Randomized Controlled Study of a Fully Magnetically Levitated Pump in Advanced Heart Failure. *2017-05-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028303 · https://hartvaat.nl/2017/05/23/hemocompatibiliteitsuitkomsten-van-heartmate-3-na-6-maanden-momentum-3/* Six-month MOMENTUM 3 hemocompatibility results showed significantly fewer pump thrombosis, stroke, and bleeding events with the HeartMate 3 compared with the HeartMate II. The magnetically levitated design's superior blood-handling properties translated to measurable clinical benefit. ## Radiation Exposure and Vascular Access in Acute Coronary Syndromes: The RAD-Matrix Trial. *2017-05-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.03.018 · https://hartvaat.nl/2017/05/23/stralingsblootstelling-en-vasculaire-toegang-bij-acs-rad-matrix-trial/* The RAD-Matrix trial compared radiation exposure between radial and femoral access for PCI in ACS, addressing operator and patient safety concerns related to the increasingly preferred radial approach. ## Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease. *2017-05-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1609581 · https://hartvaat.nl/2017/05/18/evacetrapib-en-cardiovasculaire-uitkomsten-bij-hoog-vasculair-risico-nejm-accele/* The ACCELERATE trial showed that evacetrapib, a CETP inhibitor, substantially raised HDL cholesterol and lowered LDL cholesterol but did not reduce cardiovascular events in high-risk patients. This was the fourth CETP inhibitor trial to fail, contributing to the understanding that HDL cholesterol raising per se does not confer cardiovascular benefit. ## Effect of Ularitide on Cardiovascular Mortality in Acute Heart Failure. *2017-05-18 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1601895 · https://hartvaat.nl/2017/05/18/ularitide-en-cardiovasculaire-mortaliteit-bij-acuut-hartfalen-nejm-true-ahf/* The TRUE-AHF trial demonstrated that ularitide (synthetic urodilatin) did not reduce cardiovascular mortality in patients with acute heart failure, despite acute hemodynamic improvement. The failure of another vasodilator strategy reinforced the difficulty of translating acute physiological effects into mortality benefit in AHF. ## Effect of Oral Iron Repletion on Exercise Capacity in Patients With Heart Failure With Reduced Ejection Fraction and Iron Deficiency: The IRONOUT HF Randomized Clinical Trial. *2017-05-16 · JAMA · https://doi.org/10.1001/jama.2017.5427 · https://hartvaat.nl/2017/05/16/oraal-ijzer-bij-hfref-met-ijzerdeficientie-jama-ironout-hf/* The IRONOUT-HF trial showed that oral iron polysaccharide did not improve exercise capacity or NT-proBNP levels in patients with HFrEF and iron deficiency. The negative result established that oral iron is ineffective for heart failure, directing clinical practice toward intravenous iron formulations. ## Multiple Comorbidities and Response to Cardiac Resynchronization Therapy: MADIT-CRT Long-Term Follow-Up. *2017-05-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.03.531 · https://hartvaat.nl/2017/05/16/comorbiditeiten-en-crt-respons-madit-crt-langetermijnfollow-up/* This MADIT-CRT long-term analysis demonstrated that multiple comorbidities attenuate the response to CRT but do not eliminate the benefit, informing patient selection for cardiac resynchronization in the presence of competing conditions. ## Primary Prevention With Statin Therapy in the Elderly: New Meta-Analyses From the Contemporary JUPITER and HOPE-3 Randomized Trials. *2017-05-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.117.028271 · https://hartvaat.nl/2017/05/16/statines-voor-primaire-preventie-bij-ouderen-meta-analyse-van-jupiter-en-hope-3/* This meta-analysis of JUPITER and HOPE-3 focused specifically on elderly participants, confirming that statin therapy for primary prevention reduces cardiovascular events in older adults. The contemporary trial data strengthened the case for statins in the elderly population. ## Serial Measurement of High-Sensitivity Troponin I and Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus in the EXAMINE Trial (Examination of Cardiovascular Outcomes With Alogliptin Versus Standard of Care). *2017-05-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024632 · https://hartvaat.nl/2017/05/16/serieel-hoog-sensitief-troponine-i-en-cv-uitkomsten-bij-diabetes-type-2-examine/* This EXAMINE trial analysis showed that serial high-sensitivity troponin I changes predict cardiovascular outcomes in patients with type 2 diabetes after ACS, supporting dynamic troponin monitoring for risk assessment. ## Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI. *2017-05-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1700445 · https://hartvaat.nl/2017/05/11/ifr-of-ffr-bij-pci-nejm-define-flair/* The DEFINE-FLAIR trial confirmed that iFR-guided PCI was noninferior to FFR-guided PCI for a composite of death, MI, or unplanned revascularization at 1 year. Together with iFR-SWEDEHEART, this trial established the dual evidence base for using iFR as a guideline-endorsed alternative to FFR in catheterization laboratory practice. ## Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. *2017-05-11 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1616540 · https://hartvaat.nl/2017/05/11/instantaneous-wave-free-ratio-versus-ffr-voor-pci-indicatie-nejm-ifr-swedeheart/* The iFR-SWEDEHEART trial demonstrated that the instantaneous wave-free ratio (iFR) was noninferior to fractional flow reserve (FFR) for guiding PCI decisions, with similar rates of death, MI, and unplanned revascularization at 1 year. The study validated iFR as an adenosine-free alternative for physiological lesion assessment. ## Ranolazine After Incomplete Percutaneous Coronary Revascularization in Patients With Versus Without Diabetes Mellitus: RIVER-PCI Trial. *2017-05-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.02.056 · https://hartvaat.nl/2017/05/09/ranolazine-na-incomplete-pci-bij-diabetes-versus-zonder-diabetes-river-pci/* This RIVER-PCI subanalysis found no significant difference in ranolazine efficacy between diabetic and non-diabetic patients with incomplete revascularization, despite the theoretical glycemic benefit in the diabetic population. ## Effect of Aggressive Blood Pressure Control on the Recurrence of Atrial Fibrillation After Catheter Ablation: A Randomized, Open-Label Clinical Trial (SMAC-AF [Substrate Modification With Aggressive Blood Pressure Control]). *2017-05-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.026230 · https://hartvaat.nl/2017/05/09/agressieve-bloeddrukcontrole-en-recidief-van-af-na-ablatie-gerandomiseerde-trial/* This randomized trial showed that aggressive blood pressure control significantly reduces AF recurrence after catheter ablation, establishing blood pressure management as an important adjunctive strategy for rhythm control. ## Clinically significant bleeding with low-dose rivaroxaban versus aspirin, in addition to P2Y12 inhibition, in acute coronary syndromes (GEMINI-ACS-1): a double-blind, multicentre, randomised trial. *2017-05-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)30751-1 · https://hartvaat.nl/2017/05/06/bloedingen-met-laaggedoseerd-rivaroxaban-versus-aspirine-naast-p2y12-atlas-acs-2/* This Lancet analysis from ATLAS ACS 2-TIMI 51 characterized clinically significant bleeding with low-dose rivaroxaban versus aspirin in combination with P2Y12 inhibition after ACS, quantifying the bleeding trade-off of dual-pathway inhibition. ## Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease. *2017-05-04 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1615664 · https://hartvaat.nl/2017/05/04/evolocumab-en-klinische-uitkomsten-bij-cardiovasculaire-ziekte-nejm-fourier/* The FOURIER trial demonstrated that evolocumab, a PCSK9 monoclonal antibody, significantly reduced cardiovascular events in 27,564 patients with atherosclerotic cardiovascular disease already receiving statin therapy. The trial provided definitive evidence that further LDL cholesterol lowering below conventional targets translates into clinical benefit. ## Myocardial Infarction Risk After Discontinuation of Thienopyridine Therapy in the Randomized DAPT Study (Dual Antiplatelet Therapy). *2017-05-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024835 · https://hartvaat.nl/2017/05/02/mi-risico-na-stoppen-van-thienopyridine-dapt-studie/* This DAPT study analysis identified an increased MI risk during the period immediately after thienopyridine discontinuation, characterizing the rebound phenomenon and informing the timing and counseling around antiplatelet therapy cessation. ## Long-term Safety and Efficacy of Achieving Very Low Levels of Low-Density Lipoprotein Cholesterol : A Prespecified Analysis of the IMPROVE-IT Trial. *2017-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.0083 · https://hartvaat.nl/2017/05/01/langetermijnveiligheid-van-zeer-lage-ldl-cholesterolniveaus-improve-it-analyse/* This prespecified IMPROVE-IT analysis showed that achieving very low LDL cholesterol levels (as low as 30 mg/dL) with ezetimibe/simvastatin was safe over 6 years without excess adverse events. The safety data provided reassurance for the growing practice of aggressive LDL lowering. ## Effect of Ischemic Postconditioning During Primary Percutaneous Coronary Intervention for Patients With ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial. *2017-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2017.0022 · https://hartvaat.nl/2017/05/01/ischemische-postconditionering-bij-primaire-pci-voor-stemi-jama-cardiology/* This JAMA Cardiology trial tested ischemic postconditioning during primary PCI for STEMI, evaluating whether controlled brief reocclusions after stent deployment reduce infarct size through cardioprotective conditioning. ## Is epicardial fat depot associated with atrial fibrillation? A systematic review and meta-analysis. *2017-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw398 · https://hartvaat.nl/2017/05/01/epicardiaal-vet-en-atriumfibrilleren-systematische-review-en-meta-analyse/* This systematic review and meta-analysis showed that epicardial fat depot volume is associated with atrial fibrillation risk, supporting the concept that pericardial adiposity contributes to the arrhythmic atrial substrate. ## Cryoablation vs. radiofrequency ablation for treatment of paroxysmal atrial fibrillation: a systematic review and meta-analysis. *2017-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw330 · https://hartvaat.nl/2017/05/01/cryoablatie-versus-radiofrequentieablatie-bij-paroxysmaal-af-systematische-revie/* This systematic review and meta-analysis provided updated evidence comparing cryoablation with radiofrequency ablation for paroxysmal AF, confirming comparable outcomes after the landmark FIRE AND ICE trial results. ## Data mining experiments on the Angiotensin II-Antagonist in Paroxysmal Atrial Fibrillation (ANTIPAF-AFNET 2) trial: 'exposing the invisible'. *2017-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw084 · https://hartvaat.nl/2017/05/01/data-mining-van-de-antipaf-afnet-2-trial-angiotensine-ii-antagonisten-en-paroxys/* Data-mining experiments on the ANTIPAF-AFNET 2 trial dataset explored hidden correlations between estimated AF risk factors and clinical parameters in patients with paroxysmal atrial fibrillation treated with angiotensin II antagonists. ## Ablation index, a novel marker of ablation lesion quality: prediction of pulmonary vein reconnection at repeat electrophysiology study and regional differences in target values. *2017-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw105 · https://hartvaat.nl/2017/05/01/ablatie-index-als-marker-voor-ablatielaesiekwaliteit-voorspelling-van-pv-reconne/* This study evaluated the ablation index as a novel composite marker of lesion quality during AF ablation, showing that it predicts pulmonary vein reconnection at repeat procedures better than conventional force-time integral metrics. ## Influence of automatic frequent pace-timing adjustments on effective left ventricular pacing during cardiac resynchronization therapy. *2017-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw108 · https://hartvaat.nl/2017/05/01/automatische-pacing-timingaanpassingen-en-effectieve-lv-pacing-bij-crt/* This study evaluated the impact of the AdaptivCRT algorithm on effective left ventricular pacing by comparing morphological consistency of ventricular depolarisations and pacing percentage in CRT patients randomised to adaptive versus echo-optimised programming. ## Dose-Response Association Between Physical Activity and Incident Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies. *2017-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08994 · https://hartvaat.nl/2017/05/01/lichamelijke-activiteit-en-incidentie-van-hypertensie-dosis-responsemeta-analyse/* This systematic review and meta-analysis established a dose-response relationship between physical activity and incident hypertension, demonstrating that the greatest risk reduction occurs with moderate activity levels and plateaus at higher intensities. ## Sustained Reduction of Blood Pressure With Baroreceptor Activation Therapy: Results of the 6-Year Open Follow-Up. *2017-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.117.09086 · https://hartvaat.nl/2017/05/01/aanhoudende-bloeddrukreductie-met-baroreceptoractivatietherapie-6-jaarsfollow-up/* Six-year follow-up of baroreflex activation therapy for resistant hypertension showed sustained blood pressure reduction, providing the longest-term data supporting this device-based approach for treatment-resistant blood pressure. ## Continuing or Temporarily Stopping Prestroke Antihypertensive Medication in Acute Stroke: An Individual Patient Data Meta-Analysis. *2017-05-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07982 · https://hartvaat.nl/2017/05/01/voortzetten-of-tijdelijk-stoppen-van-antihypertensiva-bij-acuut-cva-ipd-meta-ana/* This individual patient data meta-analysis examined whether continuing or temporarily stopping prestroke antihypertensive medication in acute stroke affects outcomes. The analysis addressed a common clinical dilemma with significant implications for acute stroke care. ## A nested case-control study of the association between melatonin secretion and incident myocardial infarction. *2017-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-310098 · https://hartvaat.nl/2017/05/01/melatoninesecretie-en-myocardinfarctrisico-geneste-case-controlstudie/* This nested case-control study investigated the association between melatonin secretion and myocardial infarction risk, testing the cardioprotective hypothesis of the circadian hormone. ## Uninterrupted Dabigatran versus Warfarin for Ablation in Atrial Fibrillation. *2017-04-27 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1701005 · https://hartvaat.nl/2017/04/27/ononderbroken-dabigatran-versus-warfarine-bij-af-ablatie-nejm-re-circuit/* The RE-CIRCUIT trial demonstrated that uninterrupted dabigatran was significantly safer than uninterrupted warfarin during catheter ablation for atrial fibrillation, with substantially fewer major bleeding events. The results established DOAC-based anticoagulation as the preferred strategy for periprocedural management during AF ablation. ## Quality of Life After Surgery or DES in Patients With 3-Vessel or Left Main Disease. *2017-04-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.02.031 · https://hartvaat.nl/2017/04/25/kwaliteit-van-leven-na-chirurgie-of-des-bij-drienvaten-of-hoofdstamlijden/* This SYNTAX quality-of-life analysis compared patient-reported outcomes after CABG versus PCI with DES in three-vessel or left main disease, providing the symptom and functional perspective alongside hard clinical endpoints. ## Bleeding-Related Deaths in Relation to the Duration of Dual-Antiplatelet Therapy After Coronary Stenting. *2017-04-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.02.029 · https://hartvaat.nl/2017/04/25/bloedingsgerelateerde-sterfte-naar-dapt-duur-na-coronaire-stenting/* This analysis quantified the risk of bleeding-related death associated with extended DAPT after coronary stenting, providing the mortality data needed to balance the ischemic protection against bleeding harm of prolonged antiplatelet therapy. ## Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes. *2017-04-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1612836 · https://hartvaat.nl/2017/04/20/frequentie-van-evidence-based-retinopathiescreening-bij-diabetes-type-1-nejm/* This NEJM study determined that personalized retinopathy screening intervals based on risk stratification in type 1 diabetes are safe and can reduce the frequency of screening without missing clinically significant disease progression. ## Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients. *2017-04-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1701488 · https://hartvaat.nl/2017/04/20/cardiovasculaire-werkzaamheid-en-veiligheid-van-bococizumab-bij-hoogrisicopatien/* The SPIRE cardiovascular outcomes trials of bococizumab showed that despite initial LDL cholesterol reduction, the development of anti-drug antibodies led to loss of efficacy and no sustained cardiovascular benefit. The program was terminated, underscoring the importance of durable, non-immunogenic PCSK9 inhibition. ## Lipid-Reduction Variability and Antidrug-Antibody Formation with Bococizumab. *2017-04-20 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1614062 · https://hartvaat.nl/2017/04/20/ldl-reductievariabiliteit-en-antilichaamvorming-bij-bococizumab-nejm/* This NEJM study showed that bococizumab, a humanized PCSK9 monoclonal antibody, triggered anti-drug antibody formation that progressively attenuated its LDL-lowering effect. The immunogenicity issue led to the drug's discontinuation and highlighted the advantage of fully human antibodies like evolocumab and alirocumab. ## Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction. *2017-04-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.02.027 · https://hartvaat.nl/2017/04/18/risicostratificatie-bij-cardiogene-shock-na-acuut-myocardinfarct/* This study developed risk stratification tools for patients with cardiogenic shock after acute MI, identifying prognostic factors that can guide the intensity of mechanical circulatory support and treatment escalation decisions. ## Early Invasive Versus Selective Strategy for Non-ST-Segment Elevation Acute Coronary Syndrome: The ICTUS Trial. *2017-04-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.02.023 · https://hartvaat.nl/2017/04/18/vroeg-invasief-versus-selectieve-strategie-bij-nste-acs-ictus-trial-langetermijn/* Long-term ICTUS follow-up comparing early invasive with selective invasive strategy in NSTE-ACS showed no significant long-term difference in outcomes, contributing to the nuanced understanding of invasive timing in acute coronary syndromes. ## Vericiguat in patients with worsening chronic heart failure and preserved ejection fraction: results of the SOluble guanylate Cyclase stimulatoR in heArT failurE patientS with PRESERVED EF (SOCRATES-PRESERVED) study. *2017-04-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw593 · https://hartvaat.nl/2017/04/14/vericiguat-bij-verslechterend-chronisch-hfpef-socrates-preserved-resultaten/* The SOCRATES-PRESERVED trial of vericiguat in patients with worsening chronic HFpEF explored the sGC stimulator mechanism in preserved ejection fraction, providing early dose-finding data that informed the subsequent VICTORIA trial design. ## SERAPHIN haemodynamic substudy: the effect of the dual endothelin receptor antagonist macitentan on haemodynamic parameters and NT-proBNP levels and their association with disease progression in patients with pulmonary arterial hypertension. *2017-04-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx025 · https://hartvaat.nl/2017/04/14/macitentan-en-hemodynamiek-bij-pah-seraphin-hemodynamische-substudie/* This SERAPHIN hemodynamic substudy characterized the effects of macitentan on pulmonary hemodynamics and NT-proBNP in PAH, providing invasive assessment of the dual endothelin receptor antagonist's vascular effects. ## Effect of breathing oxygen-enriched air on exercise performance in patients with precapillary pulmonary hypertension: randomized, sham-controlled cross-over trial. *2017-04-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehx099 · https://hartvaat.nl/2017/04/14/zuurstofverrijkte-lucht-en-inspanningsprestatie-bij-precapillaire-pulmonale-hype/* This randomized trial tested whether breathing oxygen-enriched air improves exercise performance in patients with precapillary pulmonary hypertension, evaluating supplemental oxygen as an exercise tolerance intervention. ## Systolic blood pressure, cardiovascular outcomes and efficacy and safety of sacubitril/valsartan (LCZ696) in patients with chronic heart failure and reduced ejection fraction: results from PARADIGM-HF. *2017-04-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw570 · https://hartvaat.nl/2017/04/14/systolische-bloeddruk-en-werkzaamheid-van-sacubitril-valsartan-bij-chronisch-hfr/* This analysis examined the relationship between systolic blood pressure and the efficacy and safety of sacubitril-valsartan in HFrEF, providing guidance for prescribing in patients with low or high baseline blood pressure. ## Inclisiran in Patients at High Cardiovascular Risk with Elevated LDL Cholesterol. *2017-04-13 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1615758 · https://hartvaat.nl/2017/04/13/inclisiran-bij-patienten-met-hoog-cv-risico-en-verhoogd-ldl-nejm-orion-1/* The ORION-1 trial showed dose-dependent, sustained reductions in LDL cholesterol with inclisiran, a synthetic siRNA targeting PCSK9, in patients at high cardiovascular risk. A single injection produced LDL reductions of up to 53% lasting 6 months, advancing the concept of RNA interference-based lipid-lowering therapy. ## Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation. *2017-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehx048 · https://hartvaat.nl/2017/04/07/radiale-versus-femorale-toegang-bij-acs-met-en-zonder-st-elevatie/* This analysis compared radial versus femoral access in patients with acute coronary syndromes stratified by the presence of ST-segment elevation, supporting the shift toward transradial access across the full ACS spectrum. ## Three, six, or twelve months of dual antiplatelet therapy after DES implantation in patients with or without acute coronary syndromes: an individual patient data pairwise and network meta-analysis of six randomized trials and 11 473 patients. *2017-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw627 · https://hartvaat.nl/2017/04/07/drie-zes-of-twaalf-maanden-dapt-na-des-met-of-zonder-acs-meta-analyse/* This meta-analysis compared three, six, and twelve months of DAPT after DES implantation separately for patients with and without ACS, finding that optimal DAPT duration differs by clinical presentation and that shorter durations may be appropriate for lower-risk patients. ## Body-Weight Fluctuations and Outcomes in Coronary Disease. *2017-04-06 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1606148 · https://hartvaat.nl/2017/04/06/gewichtsfluctuaties-en-cardiovasculaire-uitkomsten-bij-coronairlijden-nejm/* This NEJM study demonstrated that body weight fluctuations are independently associated with higher mortality and cardiovascular events in patients with coronary disease, suggesting that weight stability may be an important therapeutic target in secondary prevention. ## Exercise Training in Patients With Chronic Heart Failure and Atrial Fibrillation. *2017-04-04 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.01.032 · https://hartvaat.nl/2017/04/04/inspanningstraining-bij-chronisch-hartfalen-met-atriumfibrilleren/* This study evaluated the safety and efficacy of aerobic exercise training in patients with the dual burden of chronic heart failure and atrial fibrillation, a common but understudied combination in rehabilitation research. ## Limited left atrial surgical ablation effectively treats atrial fibrillation but decreases left atrial function. *2017-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw106 · https://hartvaat.nl/2017/04/01/beperkte-chirurgische-linkeratriumablatie-bij-af-effectief-maar-vermindert-la-fu/* This study showed that limited surgical ablation of the left atrium effectively treats AF but impairs LA contractile function, highlighting the trade-off between rhythm control and atrial mechanical consequences. ## Additional electrodes on the Quartet™ LV lead provide more programmable pacing options than bipolar and tripolar equivalents. *2017-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw039 · https://hartvaat.nl/2017/04/01/aanvullende-elektroden-op-de-quartet-lv-lead-bieden-meer-crt-programmeringsmogel/* A meta-analysis of five trials demonstrated that additional electrodes on the quadripolar Quartet left ventricular lead provide more programmable pacing vectors and greater spatial coverage than bipolar and tripolar equivalents in cardiac resynchronisation therapy. ## Role of adenosine-guided pulmonary vein isolation in patients undergoing catheter ablation for atrial fibrillation: a meta-analysis. *2017-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw201 · https://hartvaat.nl/2017/04/01/rol-van-adenosine-geleide-pvi-bij-katheterablatie-voor-af-meta-analyse/* This meta-analysis evaluated whether adenosine testing after initial pulmonary vein isolation adds value by unmasking dormant conduction, finding insufficient evidence to support routine adenosine challenge during AF ablation. ## Association of Fenofibrate Therapy With Long-term Cardiovascular Risk in Statin-Treated Patients With Type 2 Diabetes. *2017-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.4828 · https://hartvaat.nl/2017/04/01/fenofibraat-en-langetermijn-cardiovasculair-risico-bij-statinebehandelde-diabete/* This ACCORD-Lipid post-trial follow-up examined the long-term cardiovascular effects of fenofibrate in statin-treated diabetic patients, finding no sustained benefit on cardiovascular events despite triglyceride reduction. ## Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study. *2017-04-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehw203 · https://hartvaat.nl/2017/04/01/polymeervrije-biolimus-stent-bij-hoog-bloedingsrisico-met-acs-leaders-free-subst/* This Leaders Free substudy evaluated polymer-free biolimus-coated stents with only 1 month of DAPT in high-bleeding-risk ACS patients, demonstrating the feasibility of ultra-short antiplatelet therapy even in the acute coronary setting. ## Impact of Medication Adherence on the Effect of Renal Denervation: The SYMPATHY Trial. *2017-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08818 · https://hartvaat.nl/2017/04/01/medicatietrouw-en-het-effect-van-renale-denervatie-de-sympathy-trial/* The SYMPATHY trial demonstrated that the effectiveness of renal denervation is strongly influenced by medication adherence, highlighting that non-compliance with antihypertensive drugs can confound the assessment of device-based blood pressure therapy. ## Optimal Systolic Blood Pressure Levels for Primary Prevention of Stroke in General Hypertensive Adults: Findings From the CSPPT (China Stroke Primary Prevention Trial). *2017-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08499 · https://hartvaat.nl/2017/04/01/optimale-systolische-bloeddruk-voor-primaire-cva-preventie-bij-hypertensie-csppt/* This CSPPT analysis investigated optimal systolic blood pressure targets for primary stroke prevention in Chinese hypertensive adults, contributing population-specific data to the global debate on blood pressure targets. ## Oscillatory whole-body vibration improves exercise capacity and physical performance in pulmonary arterial hypertension: a randomised clinical study. *2017-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-309852 · https://hartvaat.nl/2017/04/01/oscillerende-whole-body-vibratie-verbetert-inspanningscapaciteit-bij-pah/* This randomized trial showed that oscillatory whole-body vibration improves exercise capacity and physical performance in patients with pulmonary arterial hypertension, providing a novel supportive therapy alongside targeted PAH medications. ## Haemodynamic effects of riociguat in inoperable/recurrent chronic thromboembolic pulmonary hypertension. *2017-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-309621 · https://hartvaat.nl/2017/04/01/hemodynamische-effecten-van-riociguat-bij-inoperabel-cteph/* This study characterized the hemodynamic effects of riociguat in patients with inoperable or recurrent chronic thromboembolic pulmonary hypertension, documenting pulmonary vascular improvements with sGC stimulation. ## Non-major bleeding with apixaban versus warfarin in patients with atrial fibrillation. *2017-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-309901 · https://hartvaat.nl/2017/04/01/niet-ernstige-bloedingen-met-apixaban-versus-warfarine-bij-af/* This ARISTOTLE analysis described the incidence, location, and clinical impact of non-major bleeding with apixaban versus warfarin in AF, characterizing the full bleeding spectrum beyond major hemorrhagic events. ## Intracoronary nitrite suppresses the inflammatory response following primary percutaneous coronary intervention. *2017-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-309748 · https://hartvaat.nl/2017/04/01/intracoronair-nitriet-onderdrukt-de-inflammatoire-respons-na-primaire-pci/* This study showed that intracoronary sodium nitrite suppresses the inflammatory response after primary PCI for STEMI, providing mechanistic evidence for nitric oxide-mediated cardioprotection during acute myocardial reperfusion. ## Fractional Flow Reserve-Guided Multivessel Angioplasty in Myocardial Infarction. *2017-03-30 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1701067 · https://hartvaat.nl/2017/03/30/ffr-geleide-multivaten-pci-bij-myocardinfarct-nejm-compare-acute/* The COMPARE-ACUTE trial demonstrated that FFR-guided complete revascularization at the time of primary PCI for STEMI reduced future revascularization compared with culprit-only PCI. The study provided early evidence supporting complete revascularization guided by physiology in the acute MI setting. ## Cardiovascular Outcomes With Minute Ventilation-Targeted Adaptive Servo-Ventilation Therapy in Heart Failure: The CAT-HF Trial. *2017-03-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2017.01.041 · https://hartvaat.nl/2017/03/28/adaptieve-servoventilatie-bij-hartfalen-de-cat-hf-trial/* The CAT-HF randomized trial evaluated adaptive servo-ventilation for sleep apnea in hospitalized heart failure patients, testing whether treating nocturnal respiratory disturbances improves cardiovascular outcomes in acute HF. ## Edoxaban for the Prevention of Thromboembolism in Patients With Atrial Fibrillation and Bioprosthetic Valves. *2017-03-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.026714 · https://hartvaat.nl/2017/03/28/edoxaban-bij-af-met-bioprothese-hartkleppen-trombo-emboliepreventie/* This study of edoxaban in AF patients with bioprosthetic heart valves expanded the evidence base for DOAC use beyond native valve disease, contributing to the growing data supporting anticoagulation alternatives to warfarin in prosthetic valve patients. ## Short-Term Effects of Tolvaptan in Patients With Acute Heart Failure and Volume Overload. *2017-03-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.12.035 · https://hartvaat.nl/2017/03/21/kortetermijneffecten-van-tolvaptan-bij-acuut-hartfalen-met-volume-overbelasting/* This study evaluated the short-term effects of tolvaptan (vasopressin receptor antagonist) on fluid balance and symptoms in acute heart failure with volume overload, testing aquaretic therapy as an adjunct to loop diuretics. ## Valvular Heart Disease Patients on Edoxaban or Warfarin in the ENGAGE AF-TIMI 48 Trial. *2017-03-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.12.031 · https://hartvaat.nl/2017/03/21/kleplijden-en-edoxaban-versus-warfarine-bij-af-engage-af-timi-48/* This ENGAGE AF-TIMI 48 subanalysis in AF patients with valvular heart disease confirmed the safety and efficacy of edoxaban compared with warfarin, extending the evidence for DOAC use in this common concomitant condition. ## Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease. *2017-03-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.12.038 · https://hartvaat.nl/2017/03/21/doac-s-bij-af-met-kleplijden-jacc-review/* This comprehensive JACC review addressed DOAC use in AF patients with various forms of valvular heart disease, providing a framework for anticoagulant selection across the spectrum from native valve disease to prosthetic valves. ## Sudden Cardiac Death in Patients With Ischemic Heart Failure Undergoing Coronary Artery Bypass Grafting: Results From the STICH Randomized Clinical Trial (Surgical Treatment for Ischemic Heart Failure). *2017-03-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.026075 · https://hartvaat.nl/2017/03/21/plotse-hartdood-bij-ischemisch-hartfalen-na-cabg-stich-resultaten/* This STICH analysis examined sudden cardiac death rates in patients with ischemic heart failure undergoing CABG, investigating whether revascularization reduces the risk of fatal arrhythmias in this high-risk population. ## A novel risk prediction score in atrial fibrillation for a net clinical outcome from the ENGAGE AF-TIMI 48 randomized clinical trial. *2017-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehw565 · https://hartvaat.nl/2017/03/21/nieuwe-risicovoorspellingsscore-bij-af-voor-netto-klinisch-resultaat-engage-af-t/* This ENGAGE AF-TIMI 48 analysis developed a novel risk score for net clinical outcome (combining ischemic and bleeding events) in AF, helping guide the choice between DOAC and VKA therapy based on individual patient characteristics. ## Efficacy and Safety of Tolvaptan in Patients Hospitalized With Acute Heart Failure. *2017-03-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.09.004 · https://hartvaat.nl/2017/03/21/werkzaamheid-en-veiligheid-van-tolvaptan-bij-gehospitaliseerd-acuut-hartfalen/* This study evaluated tolvaptan, a vasopressin-2 receptor antagonist, in patients hospitalized with acute heart failure, testing whether aquaresis improves decongestion and clinical outcomes beyond standard diuretic therapy. ## Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial. *2017-03-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw525 · https://hartvaat.nl/2017/03/14/afweging-myocardinfarct-versus-bloedingstype-en-mortaliteit-na-acs-tra-2p-timi-5/* This analysis compared the mortality impact of different types of myocardial infarction versus different types of bleeding after ACS, quantifying the relative clinical importance of ischemic versus hemorrhagic events to inform the DAPT risk-benefit balance. ## Three Arterial Grafts Improve Late Survival: A Meta-Analysis of Propensity-Matched Studies. *2017-03-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.025453 · https://hartvaat.nl/2017/03/14/drie-arteriele-grafts-verbeteren-langetermijnoverleving-meta-analyse-van-propens/* This meta-analysis of propensity-matched studies showed that using three arterial grafts in CABG improves long-term survival compared with conventional strategies using fewer arterial conduits, supporting a more aggressive arterial revascularization approach. ## Quarter-dose quadruple combination therapy for initial treatment of hypertension: placebo-controlled, crossover, randomised trial and systematic review. *2017-03-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(17)30260-X · https://hartvaat.nl/2017/03/11/kwartdosis-viervoudige-combinatietherapie-als-initiele-hypertensiebehandeling-la/* This Lancet crossover trial demonstrated that a quarter-dose quadruple combination pill achieved substantially greater blood pressure reduction than monotherapy in hypertension, establishing the pharmacological rationale for low-dose multi-drug combinations as initial therapy. ## Risk of stroke in chronic heart failure patients with preserved ejection fraction, but without atrial fibrillation: analysis of the CHARM-Preserved and I-Preserve trials. *2017-03-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw509 · https://hartvaat.nl/2017/03/07/cva-risico-bij-chronisch-hartfalen-met-behouden-ef-zonder-af-charm-analyse/* This CHARM analysis examined stroke risk in HFpEF patients without atrial fibrillation, finding a non-negligible stroke rate that raised questions about the potential role of anticoagulation even in AF-free heart failure patients. ## Prognostic implications of left ventricular global longitudinal strain in heart failure patients with narrow QRS complex treated with cardiac resynchronization therapy: a subanalysis of the randomized EchoCRT trial. *2017-03-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw506 · https://hartvaat.nl/2017/03/07/lv-global-longitudinal-strain-en-prognose-bij-hartfalen-met-smal-qrs-en-crt/* This study showed that LV global longitudinal strain has prognostic implications in heart failure patients with narrow QRS treated with CRT, potentially identifying responders beyond QRS-width-based selection criteria. ## Effect of Current Dietary Recommendations on Weight Loss and Cardiovascular Risk Factors. *2017-03-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.089 · https://hartvaat.nl/2017/03/07/dieetaanbevelingen-en-gewichtsverlies-en-cardiovasculaire-risicofactoren/* This study evaluated the effect of current dietary recommendations emphasizing fruit, vegetables, and whole grains on weight loss and cardiovascular risk factors, comparing different dietary approaches for cardiovascular prevention. ## Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial. *2017-03-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw526 · https://hartvaat.nl/2017/03/07/contractiliteitssensor-geleide-crt-optimalisatie-respond-crt-trial/* The RESPOND-CRT trial evaluated contractility sensor-guided CRT optimization, testing whether individualized AV and VV delay programming using a sensor-based algorithm improves response rates in heart failure patients. ## Five-Year Outcome After Implantation of Zotarolimus- and Everolimus-Eluting Stents in Randomized Trial Participants and Nonenrolled Eligible Patients: A Secondary Analysis of a Randomized Clinical Trial. *2017-03-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.5190 · https://hartvaat.nl/2017/03/01/5-jaarsuitkomsten-van-zotarolimus-en-everolimus-eluting-stents-trial-en-real-wor/* This JAMA Cardiology 5-year comparison of zotarolimus- and everolimus-eluting stents in both randomized trial participants and real-world patients showed equivalent long-term safety and efficacy across these contemporary DES platforms. ## Cardiopoietic cell therapy for advanced ischaemic heart failure: results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial. *2017-03-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehw543 · https://hartvaat.nl/2017/03/01/cardiopoietische-celtherapie-bij-gevorderd-ischemisch-hartfalen-c-cure-39-weeksr/* The C-CURE trial of cardiopoietic stem cell therapy in advanced ischemic heart failure showed preliminary efficacy signals at 39 weeks, though the improvement in functional capacity requires confirmation in larger trials. ## Cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation: an updated meta-analysis of randomized and observational studies. *2017-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw262 · https://hartvaat.nl/2017/03/01/cryoballon-versus-radiofrequentieablatie-bij-paroxysmaal-af-geactualiseerde-meta/* This updated meta-analysis of randomized and observational studies comparing cryoballoon with radiofrequency ablation for paroxysmal AF confirmed equivalent efficacy and safety, supporting both approaches as standard options. ## Association of pre-ablation level of potential blood markers with atrial fibrillation recurrence after catheter ablation: a meta-analysis. *2017-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw088 · https://hartvaat.nl/2017/03/01/bloedmarkers-voor-ablatie-en-af-recidief-meta-analyse/* This meta-analysis identified pre-ablation blood biomarkers associated with AF recurrence after catheter ablation, including CRP, NT-proBNP, and fibrosis markers, informing patient selection for rhythm control procedures. ## Effect of fixed-rate vs. rate-RESPONSIve pacing on exercise capacity in patients with permanent, refractory atrial fibrillation and left ventricular dysfunction treated with atrioventricular junction aBLation and bivEntricular pacing (RESPONSIBLE): a prospective, multicentre, randomized, single-blind study. *2017-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw035 · https://hartvaat.nl/2017/03/01/vaste-versus-responsieve-pacingfrequentie-bij-permanent-af-met-pacemakerindicati/* This randomized trial compared rate-responsive with fixed-rate pacing after AV junction ablation and biventricular pacing in permanent refractory AF, evaluating whether rate adaptation improves exercise capacity in CRT-treated patients. ## Twenty-Four-Hour Blood Pressure Monitoring to Predict and Assess Impact of Renal Denervation: The DENERHTN Study (Renal Denervation for Hypertension). *2017-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08448 · https://hartvaat.nl/2017/03/01/24-uurs-bloeddrukmonitoring-bij-renale-denervatie-denerhtn-studie/* The DENERHTN ambulatory blood pressure analysis evaluated 24-hour monitoring as a tool to predict and assess the impact of renal denervation, showing that ambulatory measurements are essential for accurate blood pressure assessment. ## Effects of Sacubitril/Valsartan Versus Olmesartan on Central Hemodynamics in the Elderly With Systolic Hypertension: The PARAMETER Study. *2017-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08556 · https://hartvaat.nl/2017/03/01/sacubitril-valsartan-versus-olmesartan-op-centrale-hemodynamiek-bij-ouderen-para/* The PARAMETER study compared sacubitril-valsartan with olmesartan on central hemodynamics in elderly patients with systolic hypertension, showing superior central blood pressure reduction with the ARNI, suggesting potential benefit through reduced central aortic stiffness. ## Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial. *2017-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-309781 · https://hartvaat.nl/2017/03/01/katheterablatie-als-eerstelijnsbehandeling-bij-paroxysmaal-af-5-jaarsresultaten/* This 5-year follow-up of a randomized trial showed that catheter ablation as first-line therapy for paroxysmal AF maintained superior rhythm control compared with antiarrhythmic drugs over the long term, providing early evidence for the ablation-first approach. ## Myocardial Recovery in Patients With Systolic Heart Failure and Autoantibodies Against β1-Adrenergic Receptors. *2017-02-28 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.11.067 · https://hartvaat.nl/2017/02/28/myocardiaal-herstel-bij-systolisch-hartfalen-met-auto-antilichamen-tegen-1-adren/* This study examined myocardial recovery in heart failure patients with autoantibodies against beta-1 adrenergic receptors, exploring an autoimmune mechanism that may identify a reversible subpopulation of dilated cardiomyopathy. ## High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction. *2017-02-28 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.022924 · https://hartvaat.nl/2017/02/28/hoog-intensieve-intervaltraining-bij-hartfalen-met-verminderde-ejectiefractie/* This study compared high-intensity interval training with moderate continuous training and standard care in HFrEF, finding that HIIT did not provide additional benefit in reversing cardiac remodeling or improving functional capacity beyond moderate exercise. ## Effect of Fibrinogen Concentrate on Intraoperative Blood Loss Among Patients With Intraoperative Bleeding During High-Risk Cardiac Surgery: A Randomized Clinical Trial. *2017-02-21 · JAMA · https://doi.org/10.1001/jama.2016.21037 · https://hartvaat.nl/2017/02/21/fibrinogeenconcentraat-bij-intraoperatief-bloedverlies-tijdens-hoog-risico-hartc/* This JAMA trial showed that fibrinogen concentrate did not reduce intraoperative blood loss during high-risk cardiac surgery compared with placebo, arguing against routine empiric use of this hemostatic agent. ## Clinical and Echocardiographic Characteristics and Cardiovascular Outcomes According to Diabetes Status in Patients With Heart Failure and Preserved Ejection Fraction: A Report From the I-Preserve Trial (Irbesartan in Heart Failure With Preserved Ejection Fraction). *2017-02-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024593 · https://hartvaat.nl/2017/02/21/diabetesstatus-en-cardiovasculaire-uitkomsten-bij-hfpef-klinische-en-echocardiog/* This analysis examined how diabetes modifies clinical characteristics, echocardiographic findings, and cardiovascular outcomes in patients with HFpEF, showing that diabetic HFpEF may represent a distinct pathophysiological phenotype. ## Genetic Obesity and the Risk of Atrial Fibrillation: Causal Estimates from Mendelian Randomization. *2017-02-21 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024921 · https://hartvaat.nl/2017/02/21/genetische-obesitas-en-risico-op-atriumfibrilleren-mendeliaanse-randomisatie/* This Mendelian randomization study provided causal evidence that genetically determined higher BMI increases the risk of atrial fibrillation, establishing obesity as a modifiable causal risk factor for AF development. ## Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. *2017-02-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1600869 · https://hartvaat.nl/2017/02/16/bariatrische-chirurgie-versus-intensieve-medicamenteuze-therapie-bij-diabetes-5-/* The 5-year outcomes from the STAMPEDE trial confirmed the superiority of bariatric surgery over intensive medical therapy for glycemic control in patients with type 2 diabetes and obesity, with higher rates of diabetes remission and better cardiovascular risk profiles. These long-term data cemented metabolic surgery as a durable diabetes treatment option. ## Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease Other Than Significant Mitral Stenosis and Mechanical Valves: A Meta-Analysis. *2017-02-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.026793 · https://hartvaat.nl/2017/02/14/doac-s-bij-af-met-kleplijden-excl-significante-mitralisstenose-meta-analyse/* This meta-analysis confirmed the safety and efficacy of DOACs in atrial fibrillation patients with valvular heart disease other than significant mitral stenosis or mechanical heart valves, supporting DOAC use in the broad spectrum of 'valvular' AF. ## Mediterranean Diet Improves High-Density Lipoprotein Function in High-Cardiovascular-Risk Individuals: A Randomized Controlled Trial. *2017-02-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.023712 · https://hartvaat.nl/2017/02/14/mediterraan-dieet-verbetert-hdl-functie-bij-hoog-cardiovasculair-risico-gerandom/* This randomized trial from the PREDIMED study showed that a Mediterranean diet not only raises HDL cholesterol levels but also improves HDL functionality including cholesterol efflux capacity and antioxidant properties, providing mechanistic insight into the diet's cardiovascular benefit. ## Cholesterol Levels Should Play a More Important Role in Identifying Statin Recipients. *2017-02-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.022146 · https://hartvaat.nl/2017/02/14/cholesterolniveaus-en-de-rol-bij-het-identificeren-van-statinenontvangers/* This analysis argued that cholesterol levels should play a more prominent role in identifying statin candidates, advocating for a lipid-based rather than purely risk-based approach to primary prevention treatment decisions. ## Low-Dose Aspirin for Primary Prevention of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: 10-Year Follow-Up of a Randomized Controlled Trial. *2017-02-14 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.025760 · https://hartvaat.nl/2017/02/14/laaggedoseerde-aspirine-voor-primaire-cardiovasculaire-preventie-bij-diabetes-ty/* This 10-year follow-up of low-dose aspirin for primary prevention in type 2 diabetes showed that any initial cardiovascular benefit diminished over time while bleeding risk accumulated, contributing to the evidence against routine aspirin use in primary prevention. ## Mode of Death in Heart Failure With Preserved Ejection Fraction. *2017-02-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.078 · https://hartvaat.nl/2017/02/07/doodsoorzaken-bij-hartfalen-met-behouden-ejectiefractie/* This analysis characterized specific modes of death in HFpEF patients, revealing that non-cardiovascular causes (particularly non-cardiac) account for a larger proportion of deaths in HFpEF compared with HFrEF, informing the understanding of this heterogeneous syndrome. ## ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2016 Appropriate Use Criteria for Coronary Revascularization in Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and the Society of Thoracic Surgeons. *2017-02-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.034 · https://hartvaat.nl/2017/02/07/acc-aats-aha-2016-criteria-voor-gepaste-coronaire-revascularisatie-bij-acs-en-st/* These updated appropriate use criteria for coronary revascularization provided consensus recommendations on the appropriateness of PCI and CABG across various clinical scenarios in both acute coronary syndromes and stable ischemic heart disease. ## Intrapericardial Left Ventricular Assist Device for Advanced Heart Failure. *2017-02-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1602954 · https://hartvaat.nl/2017/02/02/intrapericardiale-lvad-bij-gevorderd-hartfalen-nejm/* This NEJM study reported on a newer intrapericardial LVAD designed for less invasive implantation, representing the next generation of miniaturized mechanical circulatory support devices for advanced heart failure. ## A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure. *2017-02-02 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1610426 · https://hartvaat.nl/2017/02/02/volledig-magnetisch-zwevende-circulatoire-pomp-bij-gevorderd-hartfalen-nejm-mome/* The MOMENTUM 3 trial demonstrated that the HeartMate 3, a fully magnetically levitated centrifugal-flow LVAD, was superior to the axial-flow HeartMate II in patients with advanced heart failure, with significantly fewer pump thrombosis events and reoperation. This established the HeartMate 3 as the standard of care in mechanical circulatory support. ## Vernakalant is superior to ibutilide for achieving sinus rhythm in patients with recent-onset atrial fibrillation: a randomized controlled trial at the emergency department. *2017-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw052 · https://hartvaat.nl/2017/02/01/vernakalant-versus-ibutilide-voor-sinusritme-bij-recent-onset-af-gerandomiseerde/* This randomized trial showed that vernakalant is superior to ibutilide for achieving sinus rhythm in patients with recent-onset atrial fibrillation, providing head-to-head comparative data for intravenous cardioversion agents. ## European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS). *2017-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw242 · https://hartvaat.nl/2017/02/01/ehra-eacpr-positiedocument-beheer-van-patienten-met-af-en-acute-coronaire-events/* This EHRA/EACPR joint position paper provided recommendations for managing patients with concurrent atrial fibrillation and acute coronary syndromes, addressing the complex intersection of anticoagulation and antiplatelet therapy. ## Reduction in unnecessary ventricular pacing fails to affect hard clinical outcomes in patients with preserved left ventricular function: a meta-analysis. *2017-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw221 · https://hartvaat.nl/2017/02/01/reductie-van-onnodige-ventriculaire-pacing-en-klinische-uitkomsten-bij-behouden-/* This meta-analysis showed that reduction in unnecessary right ventricular pacing through device algorithms does not improve hard clinical endpoints in patients with preserved LV function, questioning the clinical impact of pacing minimization. ## Stepwise mass screening for atrial fibrillation using N-terminal pro b-type natriuretic peptide: the STROKESTOP II study design. *2017-02-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw319 · https://hartvaat.nl/2017/02/01/stapsgewijze-massascreening-op-af-met-nt-probnp-strokestop-ii-studieontwerp/* This protocol paper described the STROKESTOP II study design for stepwise AF screening using NT-proBNP as a pre-selection tool before intensive ECG monitoring, establishing the methodology for this biomarker-enriched screening approach. ## Evaluation of Ischemic and Bleeding Risks Associated With 2 Parenteral Antiplatelet Strategies Comparing Cangrelor With Glycoprotein IIb/IIIa Inhibitors: An Exploratory Analysis From the CHAMPION Trials. *2017-02-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.4556 · https://hartvaat.nl/2017/02/01/cangrelor-versus-gpiib-iiia-remmers-ischemie-en-bloedingsrisico-s-vergeleken/* This JAMA Cardiology analysis compared the ischemic and bleeding risks of cangrelor versus glycoprotein IIb/IIIa inhibitors during PCI, providing comparative data for these two parenteral antiplatelet strategies. ## On-Treatment Blood Pressure and Cardiovascular Outcomes in Older Adults With Isolated Systolic Hypertension. *2017-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08600 · https://hartvaat.nl/2017/02/01/bereikte-bloeddruk-en-cardiovasculaire-uitkomsten-bij-oudere-patienten-met-geiso/* This analysis examined optimal on-treatment blood pressure targets in older adults with isolated systolic hypertension, investigating the J-curve phenomenon and the risk of overtreatment in this vulnerable population. ## Effect of Uric Acid-Lowering Agents on Endothelial Function: A Randomized, Double-Blind, Placebo-Controlled Trial. *2017-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08488 · https://hartvaat.nl/2017/02/01/urinezuurverlagende-middelen-en-endotheelfunctie-gerandomiseerde-trial/* This randomized placebo-controlled trial showed that uric acid-lowering agents improve endothelial function in hyperuricemic overweight and obese adults, supporting the concept that uric acid contributes to vascular dysfunction and hypertension. ## Evidence for Reverse Causality in the Association Between Blood Pressure and Cardiovascular Risk in Patients With Chronic Kidney Disease. *2017-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08386 · https://hartvaat.nl/2017/02/01/reverse-causality-in-de-associatie-bloeddruk-cardiovasculair-risico-bij-ckd/* This study provided evidence for reverse causality in the association between low blood pressure and adverse cardiovascular outcomes in advanced CKD, suggesting that the J-curve in this population reflects sicker patients rather than a treatment hazard. ## Recurrent Hospitalization Among Patients With Atrial Fibrillation Undergoing Intracoronary Stenting Treated With 2 Treatment Strategies of Rivaroxaban or a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy. *2017-01-24 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.025783 · https://hartvaat.nl/2017/01/24/heropnames-bij-af-patienten-na-stenting-twee-antitromboticastrategieen-vergeleke/* This analysis examined recurrent hospitalization rates in AF patients with coronary stents treated with different antithrombotic regimens, comparing VKA-based triple therapy with alternative strategies. ## Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump for Treating Cardiogenic Shock: Meta-Analysis. *2017-01-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.026 · https://hartvaat.nl/2017/01/24/percutane-mechanische-ondersteuning-versus-iabp-bij-cardiogene-shock-meta-analys/* This meta-analysis summarized the available evidence comparing percutaneous mechanical circulatory support with intra-aortic balloon pump for cardiogenic shock, pooling outcomes across the limited randomized data. ## Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction. *2017-01-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.022 · https://hartvaat.nl/2017/01/24/percutane-mechanische-circulatoire-ondersteuning-versus-iabp-bij-cardiogene-shoc/* This study compared percutaneous mechanical circulatory support devices (Impella, TandemHeart) with intra-aortic balloon pump in cardiogenic shock after acute MI, evaluating whether more powerful hemodynamic support improves survival in this setting. ## Cangrelor With and Without Glycoprotein IIb/IIIa Inhibitors in Patients Undergoing Percutaneous Coronary Intervention. *2017-01-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.055 · https://hartvaat.nl/2017/01/17/cangrelor-met-en-zonder-gpiib-iiia-remmers-bij-pci/* This analysis evaluated the safety and efficacy of combining cangrelor with glycoprotein IIb/IIIa inhibitors during PCI, characterizing the double antiplatelet intensification strategy in high-risk interventional settings. ## Oxidized Phospholipids on Apolipoprotein B-100 and Recurrent Ischemic Events Following Stroke or Transient Ischemic Attack. *2017-01-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.057 · https://hartvaat.nl/2017/01/17/geoxideerde-fosfolipiden-op-apob-100-en-recidiverende-ischemische-events-na-cva/* This study showed that oxidized phospholipids on apolipoprotein B-100 predict recurrent ischemic events after stroke or TIA, identifying a novel lipid-inflammatory biomarker for cerebrovascular secondary prevention. ## Dual Antiplatelet Therapy Versus Aspirin Monotherapy in Diabetics With Multivessel Disease Undergoing CABG: FREEDOM Insights. *2017-01-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.043 · https://hartvaat.nl/2017/01/17/dapt-versus-aspirine-monotherapie-bij-diabetes-met-multivatenlijden-na-cabg-free/* This FREEDOM subanalysis examined the role of dual antiplatelet therapy after CABG in diabetic patients with multivessel disease, evaluating whether DAPT adds benefit beyond aspirin alone in the post-surgical setting. ## 2-Year Outcomes of High Bleeding Risk Patients After Polymer-Free Drug-Coated Stents. *2017-01-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.009 · https://hartvaat.nl/2017/01/17/2-jaarsuitkomsten-van-drug-coated-stents-zonder-polymeer-bij-hoog-bloedingsrisic/* This study reported 2-year outcomes of polymer-free drug-coated stents in high-bleeding-risk patients, demonstrating durable safety with only 1 month of DAPT in this vulnerable population. ## Efficacy and safety of left atrial appendage closure versus medical treatment in atrial fibrillation: a network meta-analysis from randomised trials. *2017-01-15 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-309782 · https://hartvaat.nl/2017/01/15/linker-hartoorsluiting-versus-medicamenteuze-behandeling-bij-af-netwerkmeta-anal/* This network meta-analysis compared percutaneous left atrial appendage closure with various oral anticoagulant regimens for stroke prevention in AF, providing a comprehensive efficacy and safety comparison across all available strategies. ## Thrombus Aspiration in ST-Segment-Elevation Myocardial Infarction: An Individual Patient Meta-Analysis: Thrombectomy Trialists Collaboration. *2017-01-10 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.025371 · https://hartvaat.nl/2017/01/10/trombusaspiratie-bij-stemi-individuele-patientdata-meta-analyse/* This individual patient data meta-analysis from the Thrombectomy Trialists Collaboration definitively showed that routine thrombus aspiration during primary PCI for STEMI does not improve clinical outcomes and may increase stroke risk. The findings ended the widespread practice of routine thrombectomy during primary PCI. ## Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. *2017-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw325 · https://hartvaat.nl/2017/01/07/verminderd-bloeddrukverlagend-effect-van-renale-denervatie-bij-geisoleerde-systo/* This analysis showed that catheter-based renal denervation has reduced blood pressure-lowering efficacy in patients with isolated systolic hypertension, likely due to different pathophysiology in arterial stiffness-driven hypertension. ## A Highly Durable RNAi Therapeutic Inhibitor of PCSK9. *2017-01-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1609243 · https://hartvaat.nl/2017/01/05/inclisiran-een-langwerkende-rna-interferentie-pcsk9-remmer-nejm/* This first-in-human phase 1 trial of inclisiran, an RNA interference therapeutic targeting PCSK9 synthesis, showed that a single subcutaneous injection produced durable, dose-dependent reductions in PCSK9 protein and LDL cholesterol lasting up to 6 months. The study opened a new era of twice-yearly lipid-lowering therapy. ## Association of Traditional Cardiovascular Risk Factors With Venous Thromboembolism: An Individual Participant Data Meta-Analysis of Prospective Studies. *2017-01-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024507 · https://hartvaat.nl/2017/01/03/traditionele-cv-risicofactoren-en-veneuze-trombo-embolie-individuele-patientdata/* This large individual patient data meta-analysis examined the association between traditional cardiovascular risk factors and venous thromboembolism, finding that obesity and diabetes but not hypercholesterolemia are significantly associated with VTE risk. ## Reduced Risk of Hyperkalemia During Treatment of Heart Failure With Mineralocorticoid Receptor Antagonists by Use of Sacubitril/Valsartan Compared With Enalapril: A Secondary Analysis of the PARADIGM-HF Trial. *2017-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.4733 · https://hartvaat.nl/2017/01/01/verminderd-hyperkaliemierisico-met-mra-door-sacubitril-valsartan-bij-hartfalen/* This analysis showed that sacubitril-valsartan reduces the risk of hyperkalemia during MRA treatment in heart failure patients, potentially facilitating safer use of full-dose mineralocorticoid receptor antagonist therapy. ## Guidelines for Listing Candidates for Heart Transplant: A 10-Year Update. *2017-01-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.3756 · https://hartvaat.nl/2017/01/01/richtlijnen-voor-listing-van-harttransplantatiekandidaten-10-jaarsupdate/* These updated JAMA Cardiology guidelines for heart transplant listing incorporated contemporary evidence on mechanical circulatory support, donor selection, and post-transplant management, providing revised criteria for candidacy in the era of modern heart failure therapy. ## Rationale and design of AXAFA-AFNET 5: an investigator-initiated, randomized, open, blinded outcome assessment, multi-centre trial to comparing continuous apixaban to vitamin K antagonists in patients undergoing atrial fibrillation catheter ablation. *2017-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw368 · https://hartvaat.nl/2017/01/01/axafa-afnet-5-apixaban-versus-vka-bij-af-ablatie-studieprotocol/* This protocol paper described the AXAFA-AFNET 5 trial design comparing apixaban with VKA for periprocedural anticoagulation during AF catheter ablation, establishing the methodology for this important safety study. ## Development of Left Ventricular Hypertrophy in Treated Hypertensive Outpatients: The Campania Salute Network. *2017-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08158 · https://hartvaat.nl/2017/01/01/ontwikkeling-van-linkerventrikelhypertrofie-bij-behandelde-hypertensie-campania-/* This study documented the development of new left ventricular hypertrophy in treated hypertensive outpatients, showing that LVH can progress despite blood pressure therapy and identifying predictors of treatment failure. ## Effects of Sacubitril/Valsartan (LCZ696) on Natriuresis, Diuresis, Blood Pressures, and NT-proBNP in Salt-Sensitive Hypertension. *2017-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08484 · https://hartvaat.nl/2017/01/01/sacubitril-valsartan-en-natriurese-diurese-en-bloeddruk-bij-zoutgevoelige-hypert/* This mechanistic study of sacubitril-valsartan in salt-sensitive hypertension showed enhanced natriuresis, diuresis, and blood pressure reduction, providing pathophysiological insight into ARNI effects on sodium handling. ## Effect of Intensive Versus Standard Clinic-Based Hypertension Management on Ambulatory Blood Pressure: Results From the SPRINT (Systolic Blood Pressure Intervention Trial) Ambulatory Blood Pressure Study. *2017-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08076 · https://hartvaat.nl/2017/01/01/intensieve-versus-standaard-bloeddrukcontrole-op-ambulante-bloeddruk-sprint-resu/* This SPRINT ambulatory blood pressure analysis showed that the intensive treatment arm achieved only modestly lower 24-hour blood pressure compared with standard care, suggesting that the larger office blood pressure difference may overestimate the true blood pressure separation between treatment strategies. ## Blood Pressure Reduction and Secondary Stroke Prevention: A Systematic Review and Metaregression Analysis of Randomized Clinical Trials. *2017-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08485 · https://hartvaat.nl/2017/01/01/bloeddrukverlaging-en-secundaire-cva-preventie-meta-regressieanalyse/* This systematic review and meta-regression quantified the relationship between blood pressure reduction and secondary stroke prevention, establishing a continuous dose-response for the protective effect of antihypertensive therapy after cerebrovascular events. ## Genome-Wide and Gene-Based Meta-Analyses Identify Novel Loci Influencing Blood Pressure Response to Hydrochlorothiazide. *2017-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08267 · https://hartvaat.nl/2017/01/01/genoomwijde-meta-analyse-van-bloeddrukrespons-op-hydrochloorthiazide/* This genome-wide meta-analysis identified novel genetic loci influencing the antihypertensive response to hydrochlorothiazide, advancing pharmacogenomic approaches to personalized diuretic therapy selection. ## Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies. *2017-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw141 · https://hartvaat.nl/2017/01/01/percutane-linker-hartoorsluiting-munchen-consensusdocument-over-definities-en-ei/* This Munich consensus document standardized definitions, endpoints, and data collection requirements for percutaneous LAA occlusion research, addressing the heterogeneity that had complicated comparison of LAAO studies. ## Randomized Trial of Bilateral versus Single Internal-Thoracic-Artery Grafts. *2016-12-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1610021 · https://hartvaat.nl/2016/12/29/bilaterale-versus-enkelvoudige-a-mammaria-interna-grafts-nejm-art-trial/* The ART trial compared bilateral versus single internal thoracic artery grafts in patients undergoing CABG. At 5 years, bilateral grafting did not significantly improve survival over single grafting, though the study was underpowered due to crossover. The results informed but did not resolve the debate over bilateral mammary artery use. ## HotBalloon Ablation of the Pulmonary Veins for Paroxysmal AF: A Multicenter Randomized Trial in Japan. *2016-12-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.037 · https://hartvaat.nl/2016/12/27/hotballoon-pulmonaalvene-ablatie-bij-paroxysmaal-af-japanse-multicenter-trial/* This Japanese multicenter randomized trial compared HotBalloon ablation with radiofrequency ablation for pulmonary vein isolation in paroxysmal AF, evaluating a thermal balloon technology developed as an alternative to cryoballoon. ## High-Sensitivity Cardiac Troponin, Statin Therapy, and Risk of Coronary Heart Disease. *2016-12-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.10.020 · https://hartvaat.nl/2016/12/27/hoog-sensitief-troponine-statinetherapie-en-risico-op-coronairlijden/* This study explored the relationship between high-sensitivity troponin levels, statin use, and coronary heart disease risk, investigating whether troponin can serve as a biomarker to guide statin therapy initiation. ## Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI. *2016-12-22 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1611594 · https://hartvaat.nl/2016/12/22/preventie-van-bloedingen-bij-af-patienten-die-pci-ondergaan-nejm-pioneer-af-pci/* The PIONEER AF-PCI trial demonstrated that rivaroxaban-based regimens significantly reduced clinically significant bleeding compared with standard triple therapy in patients with atrial fibrillation undergoing PCI with stenting. This was the first randomized trial to challenge the triple antithrombotic paradigm in AF patients requiring coronary stenting. ## Alirocumab in patients with heterozygous familial hypercholesterolaemia undergoing lipoprotein apheresis: the ODYSSEY ESCAPE trial. *2016-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehw388 · https://hartvaat.nl/2016/12/21/alirocumab-bij-heterozygoot-fh-met-lipoproteine-aferese-odyssey-escape/* The ODYSSEY ESCAPE trial showed that alirocumab reduced the frequency of lipoprotein apheresis treatments by 75% in patients with heterozygous FH, demonstrating a pharmaceutical alternative to this burdensome procedure. ## The benefit of adding ezetimibe to statin therapy in patients with prior coronary artery bypass graft surgery and acute coronary syndrome in the IMPROVE-IT trial. *2016-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehw377 · https://hartvaat.nl/2016/12/21/ezetimibe-bij-post-cabg-patienten-met-acs-improve-it-subanalyse/* This IMPROVE-IT subanalysis showed that patients with prior CABG derive particular benefit from adding ezetimibe to statin therapy after ACS, reflecting their higher baseline cardiovascular risk and greater potential for LDL lowering. ## Comparative safety and efficacy of statins for primary prevention in human immunodeficiency virus-positive patients: a systematic review and meta-analysis. *2016-12-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv734 · https://hartvaat.nl/2016/12/21/statines-voor-primaire-preventie-bij-hiv-positieve-patienten-systematische-revie/* This systematic review and meta-analysis evaluated the comparative safety and efficacy of different statins for primary cardiovascular prevention in HIV-positive patients, addressing the drug interaction challenges unique to antiretroviral therapy. ## Ticagrelor Versus Clopidogrel in Comatose Survivors of Out-of-Hospital Cardiac Arrest Undergoing Percutaneous Coronary Intervention and Hypothermia: A Randomized Study. *2016-12-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024872 · https://hartvaat.nl/2016/12/20/ticagrelor-versus-clopidogrel-bij-comateuze-overlevenden-van-reanimatie-met-pci/* This study compared ticagrelor with clopidogrel in comatose survivors of out-of-hospital cardiac arrest undergoing PCI, addressing the specific pharmacological challenge of antiplatelet dosing in unconscious patients. ## Bleeding Events Before Coronary Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. *2016-12-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.09.957 · https://hartvaat.nl/2016/12/20/bloedingen-voor-coronairangiografie-bij-nste-acs/* This study characterized the incidence and prognostic impact of bleeding events occurring before coronary angiography in NSTE-ACS, showing that upstream antithrombotic-related bleeding significantly worsens outcomes. ## Off-Label Dosing of Non-Vitamin K Antagonist Oral Anticoagulants and Adverse Outcomes: The ORBIT-AF II Registry. *2016-12-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.09.966 · https://hartvaat.nl/2016/12/20/off-label-doac-dosering-en-ongunstige-uitkomsten-orbit-af-ii-register/* This ORBIT-AF II registry analysis showed that off-label DOAC dosing — both underdosing and overdosing — was common in clinical practice and associated with worse outcomes. The findings highlighted the importance of adherence to recommended dosing criteria for NOACs. ## Five-Year Outcomes after Off-Pump or On-Pump Coronary-Artery Bypass Grafting. *2016-12-15 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1601564 · https://hartvaat.nl/2016/12/15/off-pump-versus-on-pump-cabg-5-jaarsresultaten-nejm-coronary-trial/* The 5-year CORONARY results showed no significant difference between off-pump and on-pump CABG for the composite of death, stroke, MI, or renal failure. The large-scale, long-term data supported both surgical approaches as equivalent in skilled centers. ## Infarct size and left ventricular remodelling after preventive percutaneous coronary intervention. *2016-12-15 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308660 · https://hartvaat.nl/2016/12/15/infarctgrootte-en-linkerkamerremodellering-na-preventieve-pci/* This study examined the effect of preventive PCI of non-culprit lesions on infarct size and LV remodeling, comparing complete with culprit-only revascularization on myocardial tissue-level outcomes. ## Safety and Tolerability of CSL112, a Reconstituted, Infusible, Plasma-Derived Apolipoprotein A-I, After Acute Myocardial Infarction: The AEGIS-I Trial (ApoA-I Event Reducing in Ischemic Syndromes I). *2016-12-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.025687 · https://hartvaat.nl/2016/12/13/csl112-gereconstitueerd-apoliproteine-a-i-na-acuut-mi-veiligheid-en-verdraagbaar/* This study established the safety and tolerability of CSL112, a reconstituted plasma-derived apoA-I infusion, after acute MI, providing the foundation for the subsequent AEGIS cardiovascular outcomes trial. ## Effect of Evolocumab on Progression of Coronary Disease in Statin-Treated Patients: The GLAGOV Randomized Clinical Trial. *2016-12-13 · JAMA · https://doi.org/10.1001/jama.2016.16951 · https://hartvaat.nl/2016/12/13/evolocumab-en-progressie-van-coronairlijden-bij-statinebehandelde-patienten-jama/* The GLAGOV trial demonstrated using intravascular ultrasound that evolocumab, added to statin therapy, significantly reduced atherosclerotic plaque volume in coronary arteries. This provided direct imaging evidence that PCSK9 inhibition induces plaque regression, supporting the concept that lower LDL cholesterol levels translate to plaque stabilization. ## Reductions in Atherogenic Lipids and Major Cardiovascular Events: A Pooled Analysis of 10 ODYSSEY Trials Comparing Alirocumab With Control. *2016-12-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024604 · https://hartvaat.nl/2016/12/13/alirocumab-en-reductie-in-atherogene-lipiden-en-cardiovasculaire-events-10-odyss/* This pooled analysis of 10 ODYSSEY trials demonstrated a continuous relationship between alirocumab-induced reductions in atherogenic lipids and major cardiovascular events, supporting the LDL-lowering hypothesis with PCSK9 inhibitor-specific data. ## Chronic Oral Study of Myosin Activation to Increase Contractility in Heart Failure (COSMIC-HF): a phase 2, pharmacokinetic, randomised, placebo-controlled trial. *2016-12-10 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)32049-9 · https://hartvaat.nl/2016/12/10/omecamtiv-mecarbil-bij-chronisch-hartfalen-lancet-cosmic-hf-fase-2-trial/* The COSMIC-HF phase 2 trial of omecamtiv mecarbil in chronic heart failure demonstrated dose-dependent improvements in cardiac function (systolic ejection time, stroke volume) without dose-limiting adverse effects, advancing this novel mechanism toward phase 3 development. ## Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease. *2016-12-08 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1610227 · https://hartvaat.nl/2016/12/08/everolimus-eluting-stents-of-bypasschirurgie-bij-hoofdstamcoronairlijden-nejm-ex/* The EXCEL trial compared everolimus-eluting stents with CABG in patients with left main coronary artery disease of low-to-intermediate complexity. PCI was noninferior to CABG for the composite of death, stroke, or MI at 3 years, establishing percutaneous intervention as a viable alternative in selected left main disease. ## Outcomes and costs of left atrial appendage closure from randomized controlled trial and real-world experience relative to oral anticoagulation. *2016-12-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw048 · https://hartvaat.nl/2016/12/07/linker-hartoorsluiting-uitkomsten-en-kosten-van-trial-en-real-world-versus-orale/* This analysis compared outcomes and costs of percutaneous left atrial appendage closure versus oral anticoagulation in AF patients from both randomized trial and real-world data, informing the value proposition of structural stroke prevention. ## Treatment With Dalcetrapib Modifies the Relationship Between High-Density Lipoprotein Cholesterol and C-Reactive Protein. *2016-12-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.09.932 · https://hartvaat.nl/2016/12/06/dalcetrapib-wijzigt-de-relatie-tussen-hdl-cholesterol-en-crp/* This analysis showed that dalcetrapib (a CETP modulator) modifies the relationship between HDL cholesterol and CRP, suggesting that HDL-inflammation interaction may explain the variable cardiovascular effects of CETP inhibition. ## Prognostic Implications of Changes in N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Heart Failure. *2016-12-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.09.931 · https://hartvaat.nl/2016/12/06/prognostische-implicaties-van-nt-probnp-veranderingen-bij-hartfalen/* This study demonstrated that serial NT-proBNP changes in heart failure patients provide incremental prognostic information beyond single baseline measurements, supporting dynamic biomarker monitoring for risk stratification. ## Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure: A Scientific Statement From the American Heart Association. *2016-12-06 · Circulation · https://doi.org/10.1161/CIR.0000000000000450 · https://hartvaat.nl/2016/12/06/comorbiditeiten-bij-hartfalen-hypertensie-obesitas-diabetes-hyperlipidemie-en-me/* This AHA scientific statement addressed the contributory role and management of comorbidities (hypertension, obesity, diabetes, dyslipidemia, and sleep apnea) in heart failure, providing an integrated framework for comorbidity-driven heart failure prevention and treatment. ## Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. *2016-12-03 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)32052-9 · https://hartvaat.nl/2016/12/03/pci-versus-cabg-bij-onbeschermde-hoofdstamstenose-lancet-noble-trial/* The NOBLE trial showed that CABG was superior to PCI for the composite of all-cause mortality, nonprocedural MI, stroke, or repeat revascularization at 5 years in patients with unprotected left main stenosis. Together with EXCEL, NOBLE informed the ongoing debate about optimal revascularization strategy for left main disease. ## Ten-year clinical outcomes of first-generation drug-eluting stents: the Sirolimus-Eluting vs. Paclitaxel-Eluting Stents for Coronary Revascularization (SIRTAX) VERY LATE trial. *2016-12-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehw343 · https://hartvaat.nl/2016/12/01/tienjaarsuitkomsten-van-eerste-generatie-drug-eluting-stents-ses-versus-pes/* This 10-year comparison of first-generation sirolimus- versus paclitaxel-eluting stents provided historical long-term data on the earliest DES platforms, documenting the late risks that drove the development of newer-generation devices. ## Impact of Empagliflozin on Blood Pressure in Patients With Type 2 Diabetes Mellitus and Hypertension by Background Antihypertensive Medication. *2016-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07703 · https://hartvaat.nl/2016/12/01/empagliflozine-en-bloeddruk-bij-diabetes-type-2-met-hypertensie-naar-achtergrond/* This analysis of the EMPA-REG BP trial showed that empagliflozin significantly reduces blood pressure in patients with type 2 diabetes and hypertension, with the effect maintained across different background antihypertensive regimens. ## Associations Between Fetal Imprinted Genes and Maternal Blood Pressure in Pregnancy. *2016-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08261 · https://hartvaat.nl/2016/12/01/associaties-tussen-foetale-geimprinte-genen-en-maternale-bloeddruk-in-de-zwanger/* This genetic-epidemiological study examined associations between fetal imprinted gene polymorphisms and maternal blood pressure during pregnancy in two birth cohorts. The findings provide insight into feto-maternal interactions in gestational blood pressure regulation. ## Markers of Vascular Dysfunction After Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis. *2016-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07907 · https://hartvaat.nl/2016/12/01/vasculaire-disfunctiemarkers-na-hypertensieve-zwangerschapsaandoeningen-meta-ana/* This systematic review and meta-analysis identified markers of persistent vascular dysfunction after hypertensive disorders of pregnancy, supporting the concept that preeclampsia and gestational hypertension cause lasting vascular damage linked to future cardiovascular risk. ## Gaps in Hypertension Guidelines in Low- and Middle-Income Versus High-Income Countries: A Systematic Review. *2016-12-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08290 · https://hartvaat.nl/2016/12/01/lacunes-in-hypertensierichtlijnen-in-lage-en-middeninkomenslanden-systematische-/* This systematic review identified gaps in hypertension guidelines for low- and middle-income countries compared with high-income settings, highlighting the need for locally adapted recommendations that address resource constraints. ## Efficacy and safety of rivaroxaban compared with vitamin K antagonists for peri-procedural anticoagulation in catheter ablation of atrial fibrillation: a systematic review and meta-analysis. *2016-12-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv408 · https://hartvaat.nl/2016/12/01/rivaroxaban-versus-vka-bij-periprocedurele-antistolling-rond-af-ablatie/* This study compared rivaroxaban with VKA for periprocedural anticoagulation during AF catheter ablation, providing early comparative safety and efficacy data for DOAC use in the ablation setting. ## Impact of Body Mass Index on the Accuracy of N-Terminal Pro-Brain Natriuretic Peptide and Brain Natriuretic Peptide for Predicting Outcomes in Patients With Chronic Heart Failure and Reduced Ejection Fraction: Insights From the PARADIGM-HF Study (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial). *2016-11-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024976 · https://hartvaat.nl/2016/11/29/bmi-en-nauwkeurigheid-van-nt-probnp-en-bnp-voor-diagnose-van-acuut-hartfalen/* This study showed that BMI significantly impacts the diagnostic accuracy of natriuretic peptides for acute heart failure, with obese patients having lower BNP and NT-proBNP levels at equivalent disease severity, requiring adjusted diagnostic thresholds. ## A Prospective Natural History Study of Coronary Atherosclerosis Using Fractional Flow Reserve. *2016-11-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.08.055 · https://hartvaat.nl/2016/11/29/natuurlijk-beloop-van-coronaire-atherosclerose-met-ffr-prospectieve-studie/* This prospective natural history study used fractional flow reserve to characterize the progression of coronary atherosclerosis over time, providing insights into which lesions progress to cause clinical events. ## "Off-Hours" Versus "On-Hours" Presentation in ST-Segment Elevation Myocardial Infarction: CHAMPION PHOENIX Findings. *2016-11-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.08.023 · https://hartvaat.nl/2016/11/29/presentatie-buiten-kantoortijden-versus-tijdens-kantoortijden-bij-stemi-champion/* This CHAMPION PHOENIX analysis compared outcomes of STEMI patients presenting during off-hours versus on-hours, evaluating whether presentation timing affects PCI quality and clinical results in the contemporary era. ## Performance and Validation of a Novel Biomarker-Based Stroke Risk Score for Atrial Fibrillation. *2016-11-29 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.022802 · https://hartvaat.nl/2016/11/29/biomarkergebaseerde-cva-risicoscore-bij-atriumfibrilleren-validatie/* This validation study confirmed that the biomarker-based ABC stroke risk score (incorporating troponin and NT-proBNP) improves stroke prediction in AF patients beyond the CHA₂DS₂-VASc score, supporting biomarker-enhanced risk stratification. ## Very thin strut biodegradable polymer everolimus-eluting and sirolimus-eluting stents versus durable polymer zotarolimus-eluting stents in allcomers with coronary artery disease (BIO-RESORT): a three-arm, randomised, non-inferiority trial. *2016-11-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)31920-1 · https://hartvaat.nl/2016/11/26/ultradunne-biodegradeerbare-versus-duurzame-polymer-des-lancet-gerandomiseerde-t/* This Lancet trial compared ultra-thin biodegradable polymer drug-eluting stents with durable polymer stents, evaluating whether newer stent designs with shorter polymer exposure reduce late adverse events after PCI. ## Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial. *2016-11-26 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)31922-5 · https://hartvaat.nl/2016/11/26/oct-versus-ivus-versus-angiografie-bij-coronaire-stentimplantatie-lancet-ilumien/* The ILUMIEN III trial compared OCT, IVUS, and angiography guidance for coronary stent implantation and found that OCT-guided PCI achieved minimum stent expansion comparable to IVUS and superior to angiography. The first large randomized comparison of all three imaging modalities. ## Plasma Lipidomic Profiles Improve on Traditional Risk Factors for the Prediction of Cardiovascular Events in Type 2 Diabetes Mellitus. *2016-11-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.023233 · https://hartvaat.nl/2016/11/22/plasma-lipidomiek-verbetert-cardiovasculaire-risicovoorspelling-bij-diabetes-typ/* This study demonstrated that plasma lipidomic profiling improves cardiovascular event prediction beyond traditional risk factors in type 2 diabetes, advancing the concept of comprehensive lipid phenotyping for risk assessment. ## Recommendations for Management of Clinically Significant Drug-Drug Interactions With Statins and Select Agents Used in Patients With Cardiovascular Disease: A Scientific Statement From the American Heart Association. *2016-11-22 · Circulation · https://doi.org/10.1161/CIR.0000000000000456 · https://hartvaat.nl/2016/11/22/management-van-klinisch-significante-geneesmiddelinteracties-met-statines-aha-aa/* This AHA scientific statement provided recommendations for managing clinically significant drug interactions with statins, covering interactions with commonly used cardiovascular medications and strategies to minimize the risk of myopathy and rhabdomyolysis. ## Prasugrel Versus Ticagrelor in Patients With Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention: Multicenter Randomized PRAGUE-18 Study. *2016-11-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024823 · https://hartvaat.nl/2016/11/22/prasugrel-versus-ticagrelor-bij-acuut-mi-met-primaire-pci-multicenter-trial/* This head-to-head comparison of prasugrel versus ticagrelor in acute MI patients treated with primary PCI was among the first direct comparative effectiveness studies of these newer P2Y12 inhibitors, preceding the definitive ISAR-REACT 5 trial. ## Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. *2016-11-15 · JAMA · https://doi.org/10.1001/jama.2016.15450 · https://hartvaat.nl/2016/11/15/statines-voor-primaire-cardiovasculaire-preventie-uspstf-aanbeveling/* The USPSTF recommendation endorsed statin use for primary cardiovascular prevention in adults aged 40–75 with at least one CVD risk factor and a 10-year risk of 10% or greater. The guideline defined evidence-based thresholds for initiating statin therapy in adults without established cardiovascular disease. ## Statins for Prevention of Cardiovascular Disease in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. *2016-11-15 · JAMA · https://doi.org/10.1001/jama.2015.15629 · https://hartvaat.nl/2016/11/15/statines-voor-primaire-cardiovasculaire-preventie-uspstf-evidence-report/* This JAMA systematic review and evidence report for the USPSTF evaluated the benefits and harms of statin therapy for primary prevention of cardiovascular disease, providing the evidence base for the recommendation to use statins in adults with elevated CVD risk. ## Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. *2016-11-10 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1607141 · https://hartvaat.nl/2016/11/10/semaglutide-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-nejm-sustain-6/* The SUSTAIN-6 trial showed that once-weekly semaglutide significantly reduced the composite of cardiovascular death, nonfatal MI, and nonfatal stroke versus placebo in patients with type 2 diabetes. Together with LEADER, this study established the GLP-1 receptor agonist class as a pillar of cardiovascular prevention in diabetes. ## Untreated Hypertension: A Powerful Risk Factor for Lobar and Nonlobar Intracerebral Hemorrhage in Whites, Blacks, and Hispanics. *2016-11-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024073 · https://hartvaat.nl/2016/11/08/onbehandelde-hypertensie-als-risicofactor-voor-lobaire-en-non-lobaire-hersenbloe/* This study showed that untreated hypertension is a powerful risk factor for both lobar and nonlobar intracerebral hemorrhage across white, Black, and Hispanic populations, with racial/ethnic differences in the attributable risk. ## Distribution of Estimated 10-Year Risk of Recurrent Vascular Events and Residual Risk in a Secondary Prevention Population. *2016-11-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.021314 · https://hartvaat.nl/2016/11/08/residueel-vasculair-risico-bij-secundaire-preventie-verdeling-van-10-jaarsrisico/* This analysis quantified the distribution of residual cardiovascular risk in secondary prevention patients, identifying the proportion who remain at high risk despite optimal therapy and the factors that contribute to residual risk. ## An evaluation of the effect of an angiotensin-converting enzyme inhibitor on the growth rate of small abdominal aortic aneurysms: a randomized placebo-controlled trial (AARDVARK). *2016-11-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw257 · https://hartvaat.nl/2016/11/07/ace-remmer-en-groeisnelheid-van-kleine-abdominale-aorta-aneurysmata-gerandomisee/* The AARDVARK trial showed that ACE inhibitor therapy does not reduce the growth rate of small abdominal aortic aneurysms, a negative result for pharmacological aneurysm management. ## Left Atrial Appendage Isolation in Patients With Longstanding Persistent AF Undergoing Catheter Ablation: BELIEF Trial. *2016-11-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.07.770 · https://hartvaat.nl/2016/11/01/linker-hartoorisolatie-bij-langdurig-persisterend-af-de-belief-trial/* The BELIEF randomized trial investigated whether adding electrical left atrial appendage isolation to standard catheter ablation improves outcomes in patients with longstanding persistent AF, the most challenging AF subtype. ## Should Patients With Cardiovascular Risk Factors Receive Intensive Treatment of Hypertension to <120/80 mm Hg Target? An Antagonist View From the HOPE-3 Trial (Heart Outcomes Evaluation-3). *2016-11-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.023264 · https://hartvaat.nl/2016/11/01/intensieve-bloeddrukbehandeling-120-80-mmhg-antagonist-standpunt/* This contra perspective argued against universal intensive blood pressure targets of <120/80 mmHg, citing risks of overtreatment, adverse effects, and the limited applicability of SPRINT to many patient populations. ## Should Patients With Cardiovascular Risk Factors Receive Intensive Treatment of Hypertension to <120/80 mm Hg Target? A Protagonist View From the SPRINT Trial (Systolic Blood Pressure Intervention Trial). *2016-11-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.023263 · https://hartvaat.nl/2016/11/01/intensieve-bloeddrukbehandeling-120-80-mmhg-bij-cardiovasculair-risico-protagoni/* This pro perspective argued for intensive blood pressure treatment to <120/80 mmHg in patients with cardiovascular risk factors, based on SPRINT evidence and the continuous relationship between blood pressure and cardiovascular risk. ## Ten-Year Outcomes After Coronary Artery Bypass Grafting According to Age in Patients With Heart Failure and Left Ventricular Systolic Dysfunction: An Analysis of the Extended Follow-Up of the STICH Trial (Surgical Treatment for Ischemic Heart Failure). *2016-11-01 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024800 · https://hartvaat.nl/2016/11/01/tienjaarsuitkomsten-na-cabg-naar-leeftijd-bij-hartfalen-met-lv-systolische-disfu/* This STICH 10-year analysis examined the interaction between patient age and the survival benefit of CABG in ischemic heart failure with reduced ejection fraction, informing revascularization decision-making in older heart failure patients. ## Fluid status telemedicine alerts for heart failure: a randomized controlled trial. *2016-11-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehw099 · https://hartvaat.nl/2016/11/01/vochtstatustelemonitoring-bij-hartfalen-gerandomiseerde-trial/* This randomized trial evaluated telemonitoring of fluid status for early detection of heart failure decompensation, testing whether automated alerts based on thoracic impedance changes prevent hospitalizations. ## The Role of the Autonomic Nervous System in the Regulation of Aortic Stiffness. *2016-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08035 · https://hartvaat.nl/2016/11/01/rol-van-het-autonome-zenuwstelsel-bij-regulatie-van-aortastijfheid/* This series of three studies investigated the autonomic nervous system's role in regulating aortic stiffness, showing that sympathetic activity directly contributes to arterial stiffening beyond its blood pressure effects. ## The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study): Is Severe Hypertension Just an Elevated Blood Pressure? *2016-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07862 · https://hartvaat.nl/2016/11/01/chips-trial-is-ernstige-hypertensie-in-de-zwangerschap-meer-dan-alleen-verhoogde/* This CHIPS analysis examined whether severe hypertension during pregnancy represents a distinct clinical phenotype with different treatment responses, providing nuanced guidance for managing the most dangerous pregnancy-related blood pressure elevations. ## Long-Term Mortality in Hypertensive Patients With Coronary Artery Disease: Results From the US Cohort of the International Verapamil (SR)/Trandolapril Study. *2016-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07854 · https://hartvaat.nl/2016/11/01/langetermijnmortaliteit-bij-hypertensie-met-coronairlijden-invest-us-cohort/* This long-term analysis of the US INVEST cohort showed that both excessively high and low achieved systolic blood pressure levels are associated with increased mortality in hypertensive coronary disease patients, informing the J-curve debate. ## Physician-Pharmacist Collaborative Management: Narrowing the Socioeconomic Blood Pressure Gap. *2016-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.08043 · https://hartvaat.nl/2016/11/01/arts-apotheker-samenwerkingsmodel-verkleint-sociaaleconomische-bloeddrukverschil/* This study demonstrated that physician-pharmacist collaborative management improves blood pressure control specifically in socioeconomically disadvantaged populations, narrowing the disparities gap through team-based care. ## Resistant Hypertension: Insights on Evaluation and Management in the Post-SPRINT (Systolic Blood Pressure Intervention Trial) Era. *2016-11-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07316 · https://hartvaat.nl/2016/11/01/therapieresistente-hypertensie-na-sprint-evaluatie-en-management/* This review discussed the evaluation and management of resistant hypertension in the context of SPRINT results, integrating intensive blood pressure targets with the diagnostic and therapeutic approach to treatment-resistant blood pressure. ## 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. *2016-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euw295 · https://hartvaat.nl/2016/11/01/2016-esc-af-richtlijn-europace-editie/* Simultaneous Europace publication of the 2016 ESC atrial fibrillation guidelines, ensuring broad dissemination to the electrophysiology community alongside the European Heart Journal publication. ## Flecainide-metoprolol combination reduces atrial fibrillation clinical recurrences and improves tolerability at 1-year follow-up in persistent symptomatic atrial fibrillation. *2016-11-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv462 · https://hartvaat.nl/2016/11/01/flecainide-metoprolol-combinatie-vermindert-af-recidieven-1-jaarsresultaten/* This study showed that the flecainide-metoprolol combination reduces AF recurrence and improves tolerability compared with either agent alone, supporting a synergistic antiarrhythmic approach for paroxysmal atrial fibrillation. ## Effect of Aldosterone Antagonism on Exercise Tolerance in Heart Failure With Preserved Ejection Fraction. *2016-10-25 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.07.763 · https://hartvaat.nl/2016/10/25/aldosteronantagonisme-en-inspanningstolerantie-bij-hfpef/* This study evaluated the effect of aldosterone antagonism on exercise tolerance in HFpEF, showing modest improvement in functional capacity with spironolactone, supporting a role for MRA therapy in improving HFpEF symptoms. ## Edoxaban versus enoxaparin-warfarin in patients undergoing cardioversion of atrial fibrillation (ENSURE-AF): a randomised, open-label, phase 3b trial. *2016-10-22 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)31474-X · https://hartvaat.nl/2016/10/22/edoxaban-versus-enoxaparine-warfarine-bij-cardioversie-van-af-ensure-af-trial/* The ENSURE-AF randomized trial demonstrated that edoxaban is comparable to enoxaparin-warfarin for the prevention of cardiovascular events in patients with AF undergoing cardioversion, simplifying the anticoagulation approach around electrical cardioversion. ## Platelet function monitoring to adjust antiplatelet therapy in elderly patients stented for an acute coronary syndrome (ANTARCTIC): an open-label, blinded-endpoint, randomised controlled superiority trial. *2016-10-22 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)31323-X · https://hartvaat.nl/2016/10/22/plaatjesfunctiemonitoring-voor-antiplaatjesaanpassing-bij-oudere-acs-patienten-a/* The ANTARCTIC randomized trial showed that platelet function-guided adjustment of antiplatelet therapy in elderly patients with ACS after stenting did not improve clinical outcomes compared with standard treatment, arguing against routine platelet function monitoring. ## Arterial Effects of Canakinumab in Patients With Atherosclerosis and Type 2 Diabetes or Glucose Intolerance. *2016-10-18 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.07.768 · https://hartvaat.nl/2016/10/18/canakinumab-en-arteriele-effecten-bij-atherosclerose-met-diabetes-of-glucosetole/* This study examined the arterial effects of canakinumab (IL-1β inhibitor) in patients with atherosclerosis and type 2 diabetes, assessing whether anti-inflammatory therapy produces measurable changes in arterial wall inflammation and plaque composition. ## Effect of Postextubation High-Flow Nasal Cannula vs Noninvasive Ventilation on Reintubation and Postextubation Respiratory Failure in High-Risk Patients: A Randomized Clinical Trial. *2016-10-18 · JAMA · https://doi.org/10.1001/jama.2016.14194 · https://hartvaat.nl/2016/10/18/high-flow-neuscanule-versus-non-invasieve-ventilatie-na-extubatie-jama-trial/* This JAMA trial compared high-flow nasal cannula with noninvasive ventilation for preventing reintubation and postextubation respiratory failure, informing respiratory support strategies in critically ill patients including those with cardiac conditions. ## Early invasive versus non-invasive treatment in patients with non-ST-elevation acute coronary syndrome (FRISC-II): 15 year follow-up of a prospective, randomised, multicentre study. *2016-10-15 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)31276-4 · https://hartvaat.nl/2016/10/15/vroeg-invasief-versus-conservatief-bij-nste-acs-15-jaarsfollow-up-frisc-ii/* The 15-year FRISC-II follow-up, one of the longest from any ACS trial, demonstrated sustained survival benefit of an early invasive strategy in patients with non-ST-elevation acute coronary syndrome. The durable result reinforced the importance of early invasive management. ## 'Ten Commandments' from the 2016 ESC/EAS Guidelines for the management of dyslipidaemias. *2016-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw415 · https://hartvaat.nl/2016/10/14/de-tien-geboden-van-de-2016-esc-eas-dyslipidemierichtlijn/* This concise summary distilled the ten key clinical messages from the 2016 ESC/EAS dyslipidaemia guidelines, covering risk-based LDL targets, statin intensity, and the role of emerging non-statin therapies including PCSK9 inhibitors. ## 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. *2016-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw272 · https://hartvaat.nl/2016/10/14/2016-esc-eas-richtlijn-voor-het-management-van-dyslipidemieen/* The 2016 ESC/EAS Guidelines for dyslipidaemia management defined risk-stratified LDL-cholesterol targets and treatment strategies including high-intensity statins and emerging therapies such as PCSK9 inhibitors. This framework established the treat-to-target paradigm that underpins contemporary lipid-lowering practice. ## No effect of PCSK9 inhibitor alirocumab on the incidence of diabetes in a pooled analysis from 10 ODYSSEY Phase 3 studies. *2016-10-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw292 · https://hartvaat.nl/2016/10/14/geen-effect-van-pcsk9-remmer-alirocumab-op-diabetes-incidentie-odyssey-analyse/* This pooled analysis of 10 ODYSSEY phase 3 studies found no increased incidence of diabetes with alirocumab, providing reassurance that PCSK9 inhibitors do not share the diabetogenic effect observed with statins. ## Percutaneous Intervention for Concurrent Chronic Total Occlusions in Patients With STEMI: The EXPLORE Trial. *2016-10-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.07.744 · https://hartvaat.nl/2016/10/11/pci-van-chronische-totale-occlusie-bij-stemi-met-multivatenlijden-explore-trial/* The EXPLORE trial investigated whether PCI of a concurrent chronic total occlusion in a non-infarct-related artery improves outcomes in STEMI patients who have already undergone primary PCI of the culprit lesion. ## Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. *2016-10-11 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.07.745 · https://hartvaat.nl/2016/10/11/natriuminname-en-totale-mortaliteit-over-20-jaar-trials-of-hypertension-preventi/* This 20-year follow-up from the Trials of Hypertension Prevention demonstrated a direct relationship between sodium intake and all-cause mortality, providing among the longest-term evidence linking dietary sodium to cardiovascular outcomes. ## 'Ten Commandments' of 2016 ESC Guidelines for the management of atrial fibrillation. *2016-10-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw370 · https://hartvaat.nl/2016/10/07/de-tien-geboden-van-de-2016-esc-af-richtlijn/* This concise summary of the 2016 ESC AF guidelines distilled the ten most important clinical messages for day-to-day management of atrial fibrillation, covering anticoagulation, rate and rhythm control, and comorbidity management. ## 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. *2016-10-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw210 · https://hartvaat.nl/2016/10/07/2016-esc-richtlijn-voor-atriumfibrilleren-in-samenwerking-met-eacts/* The 2016 ESC Guidelines for atrial fibrillation management introduced the integrated AF-BETTER approach, covering anticoagulation, rate and rhythm control, and comorbidity management. This foundational document shaped modern AF care with structured pathways for DOAC use, catheter ablation referral, and comprehensive upstream therapy. ## Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial. *2016-10-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw285 · https://hartvaat.nl/2016/10/07/cryoballon-versus-radiofrequentieablatie-bij-paroxysmaal-af-herinterventierate-e/* This FIRE AND ICE follow-up analysis compared reintervention rates, rehospitalization, and quality of life after cryoballoon versus radiofrequency ablation for paroxysmal AF, providing extended outcome data beyond the primary efficacy endpoint. ## Association Between Low-Density Lipoprotein Cholesterol-Lowering Genetic Variants and Risk of Type 2 Diabetes: A Meta-analysis. *2016-10-04 · JAMA · https://doi.org/10.1001/jama.2016.14568 · https://hartvaat.nl/2016/10/04/ldl-cholesterolverlagende-genetische-varianten-en-risico-op-diabetes-type-2-jama/* This JAMA meta-analysis demonstrated that genetic variants in NPC1L1 and HMGCR that lower LDL cholesterol are associated with increased type 2 diabetes risk, mirroring the diabetogenic effect observed with statin therapy. The finding established a causal link between LDL-lowering mechanisms and diabetes susceptibility. ## Impact of Optimal Medical Therapy in the Dual Antiplatelet Therapy Study. *2016-10-04 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024531 · https://hartvaat.nl/2016/10/04/impact-van-optimale-medicamenteuze-therapie-in-de-dapt-studie/* This DAPT study analysis examined the interaction between background medical therapy (statins, ACE inhibitors, beta-blockers) and the benefit of extended DAPT, assessing whether optimal medical therapy modifies the antiplatelet duration decision. ## Prolonged vs Short Duration of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With or Without Peripheral Arterial Disease: A Subgroup Analysis of the PRODIGY Randomized Clinical Trial. *2016-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.2811 · https://hartvaat.nl/2016/10/01/langere-versus-korte-dapt-na-pci-met-en-zonder-periprocedureel-mi-jama-cardiolog/* This JAMA Cardiology analysis examined whether optimal DAPT duration differs in patients with versus without periprocedural MI after PCI, exploring whether procedural complications modify the benefit of extended antiplatelet therapy. ## Adult Stem Cell Therapy and Heart Failure, 2000 to 2016: A Systematic Review. *2016-10-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.2225 · https://hartvaat.nl/2016/10/01/volwassen-stamceltherapie-bij-hartfalen-2000-2016-jama-cardiology-systematische-/* This systematic review evaluated 16 years of clinical research on adult stem cell therapy for heart failure, summarizing the evidence for different cell types, delivery methods, and clinical outcomes in this evolving field. ## Catheter ablation for atrial fibrillation in hypertrophic cardiomyopathy: a systematic review and meta-analysis. *2016-10-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2016-309406 · https://hartvaat.nl/2016/10/01/katheterablatie-bij-af-met-hypertrofische-cardiomyopathie-systematische-review-e/* This systematic review and meta-analysis evaluated catheter ablation for AF in HCM patients, providing updated evidence on the success rates and safety of this procedure in hypertrophic cardiomyopathy. ## The Cost Implications of Less Tight Versus Tight Control of Hypertension in Pregnancy (CHIPS Trial). *2016-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07466 · https://hartvaat.nl/2016/10/01/kostenimplicaties-van-minder-strikte-versus-strikte-bloeddrukcontrole-bij-zwange/* This cost analysis of the CHIPS trial showed that less tight versus tight blood pressure control in pregnancy does not significantly differ in healthcare costs, informing resource allocation for obstetric hypertension management. ## Autonomic Blockade Reverses Endothelial Dysfunction in Obesity-Associated Hypertension. *2016-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07681 · https://hartvaat.nl/2016/10/01/autonome-blokkade-herstelt-endotheeldisfunctie-bij-obesitasgerelateerde-hyperten/* This study demonstrated that combined autonomic blockade reverses endothelial dysfunction in obesity-associated hypertension, providing mechanistic evidence that sympathetic overactivity mediates vascular impairment in obese hypertensive patients. ## Increased Systolic and Diastolic Blood Pressure Is Associated With Altered Gut Microbiota Composition and Butyrate Production in Early Pregnancy. *2016-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07910 · https://hartvaat.nl/2016/10/01/bloeddruk-en-darmmicrobioom-veranderde-samenstelling-en-butyraat-bij-hypertensie/* This study demonstrated an association between elevated blood pressure in pregnancy and altered gut microbiota composition with reduced butyrate-producing bacteria, exploring the microbiome-hypertension axis during gestation. ## Dietary Flaxseed Reduces Central Aortic Blood Pressure Without Cardiac Involvement but Through Changes in Plasma Oxylipins. *2016-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07834 · https://hartvaat.nl/2016/10/01/lijnzaad-verlaagt-centrale-aortabloeddruk-via-veranderingen-in-plasma-oxylipinen/* This study from the FlaxPAD trial showed that dietary flaxseed reduces central aortic blood pressure through changes in plasma oxylipins rather than cardiac mechanisms, identifying a nutritional approach targeting vascular function. ## Cardiovascular Risk in Hypertension in Relation to Achieved Blood Pressure Using Automated Office Blood Pressure Measurement. *2016-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07721 · https://hartvaat.nl/2016/10/01/cardiovasculair-risico-bij-hypertensie-in-relatie-tot-bereikte-bloeddruk-met-gea/* This study evaluated cardiovascular risk in hypertensive patients using automated office blood pressure measurement (AOBP), providing data relevant to interpreting SPRINT-era blood pressure targets in clinical practice. ## Orthostatic Hypotension in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Blood Pressure Trial: Prevalence, Incidence, and Prognostic Significance. *2016-10-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07474 · https://hartvaat.nl/2016/10/01/orthostatische-hypotensie-in-de-accord-bloeddruk-trial-prevalentie-en-klinische-/* This ACCORD analysis characterized orthostatic hypotension in diabetic patients receiving intensive blood pressure therapy, showing that OH is common and associated with adverse events but does not negate the benefit of intensive treatment. ## Omega-3 fatty acids do not alter P-wave parameters in electrocardiogram or expression of atrial connexins in patients undergoing coronary artery bypass surgery. *2016-10-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv398 · https://hartvaat.nl/2016/10/01/omega-3-vetzuren-en-p-golfparameters-of-atriale-connexinen-bij-hartchirurgie/* This study demonstrated that omega-3 polyunsaturated fatty acid supplementation does not alter ECG P-wave parameters or atrial connexin expression in patients undergoing coronary artery bypass surgery. The findings do not support omega-3 supplementation for perioperative AF prevention. ## Drug-Eluting or Bare-Metal Stents for Coronary Artery Disease. *2016-09-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1607991 · https://hartvaat.nl/2016/09/29/drug-eluting-of-bare-metal-stents-bij-coronairlijden-nejm-norstent-trial/* The NORSTENT trial compared contemporary drug-eluting stents with bare-metal stents in a broad population of patients with coronary artery disease. No significant difference was found in the composite of death and MI at 6 years, though DES significantly reduced repeat revascularization, informing the ongoing debate about stent selection. ## Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure. *2016-09-29 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1608029 · https://hartvaat.nl/2016/09/29/icd-implantatie-bij-niet-ischemisch-systolisch-hartfalen-nejm-danish-trial/* The DANISH trial found that prophylactic ICD implantation did not significantly reduce all-cause mortality in patients with nonischemic systolic heart failure, though there was a reduction in sudden cardiac death. This result challenged the routine use of primary prevention ICDs in dilated cardiomyopathy and reshaped clinical decision-making for device therapy. ## Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis. *2016-09-27 · JAMA · https://doi.org/10.1001/jama.2016.13985 · https://hartvaat.nl/2016/09/27/ldl-c-verlaging-en-cardiovasculaire-risicoreductie-jama-systematische-review-en-/* This JAMA systematic review and meta-analysis examined the relationship between LDL cholesterol lowering and cardiovascular risk reduction across different therapeutic interventions. The findings supported the principle that clinical benefit is proportional to the absolute LDL reduction achieved, regardless of the mechanism of lowering. ## Long-Term Follow-Up of the Randomized (BIOMArCS-2) Glucose Trial: Intensive Glucose Regulation in Hyperglycemic Acute Coronary Syndrome. *2016-09-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.023480 · https://hartvaat.nl/2016/09/27/intensieve-glucoseregulatie-bij-hyperglycemisch-acs-langetermijnfollow-up-biomar/* Long-term follow-up of the BIOMArCS-2 Glucose Trial showed that intensive glucose regulation in hyperglycemic MI patients does not provide lasting cardiovascular benefit compared with standard care. ## Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS Study (Does Optical Coherence Tomography Optimize Results of Stenting). *2016-09-27 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024393 · https://hartvaat.nl/2016/09/27/oct-geleide-pci-optimalisatie-bij-nste-acs-gerandomiseerde-trial/* This randomized trial showed that OCT-guided PCI optimization does not significantly improve clinical outcomes compared with angiography-guided PCI in NSTE-ACS patients, an early negative result for routine OCT guidance. ## 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. *2016-09-27 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.05.011 · https://hartvaat.nl/2016/09/27/2016-acc-aha-hfsa-gerichte-update-nieuwe-farmacologische-hartfalentherapie/* The 2016 ACC/AHA/HFSA focused update introduced new recommendations for pharmacological heart failure therapy, most notably endorsing sacubitril-valsartan (ARNI) for HFrEF based on the PARADIGM-HF results. This update marked the entry of neprilysin inhibition into guideline-directed heart failure treatment. ## Clinical Implications of Complete Left-Sided Reverse Remodeling With Cardiac Resynchronization Therapy: A MADIT-CRT Substudy. *2016-09-20 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.06.051 · https://hartvaat.nl/2016/09/20/volledig-linkszijdig-reverse-remodelling-bij-crt-madit-crt-substudie/* This MADIT-CRT substudy characterized the clinical implications of complete left-sided reverse remodeling with CRT, showing that super-responders who normalize LV volumes and function have excellent long-term prognosis. ## Adherence to Antihypertensive Treatment and the Blood Pressure-Lowering Effects of Renal Denervation in the Renal Denervation for Hypertension (DENERHTN) Trial. *2016-09-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.022922 · https://hartvaat.nl/2016/09/20/medicatietrouw-en-bloeddrukeffecten-van-renale-denervatie-rsd-pathway-2-analyse/* This DENERHTN analysis examined the relationship between antihypertensive medication adherence and the blood pressure-lowering effects of renal denervation, highlighting that non-adherence is a major confounder in renal denervation trials. ## Prevention of Stroke with Ticagrelor in Patients with Prior Myocardial Infarction: Insights from PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54). *2016-09-20 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.024637 · https://hartvaat.nl/2016/09/20/cva-preventie-met-ticagrelor-na-myocardinfarct-pegasus-timi-54-inzichten/* This PEGASUS-TIMI 54 analysis showed that ticagrelor reduces stroke risk in patients with prior MI, demonstrating a cerebrovascular benefit of extended P2Y12 inhibitor therapy beyond coronary event reduction. ## Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage. *2016-09-15 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1603460 · https://hartvaat.nl/2016/09/15/intensieve-bloeddrukverlaging-bij-acute-hersenbloeding-nejm-atach-2-trial/* The ATACH-2 trial showed that intensive blood pressure lowering to a target of 110–139 mmHg did not improve outcomes compared with standard treatment (140–179 mmHg) in patients with acute intracerebral hemorrhage and was associated with more renal adverse events. The results established that very aggressive blood pressure reduction is not beneficial in acute ICH. ## Clopidogrel Versus Ticagrelor for Antiplatelet Maintenance in Diabetic Patients Treated With Percutaneous Coronary Intervention: Results of the CLOTILDIA Study (Clopidogrel High Dose Versus Ticagrelor for Antiplatelet Maintenance in Diabetic Patients). *2016-09-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.023743 · https://hartvaat.nl/2016/09/13/clopidogrel-versus-ticagrelor-bij-diabetes-na-pci-gerandomiseerde-trial/* This randomized comparison of clopidogrel versus ticagrelor for antiplatelet maintenance in diabetic PCI patients provided head-to-head data on these P2Y12 inhibitors in the diabetic population. ## Edoxaban Versus Warfarin in Atrial Fibrillation Patients at Risk of Falling: ENGAGE AF-TIMI 48 Analysis. *2016-09-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.06.034 · https://hartvaat.nl/2016/09/13/edoxaban-versus-warfarine-bij-af-patienten-met-valrisico-engage-af-timi-48-analy/* This ENGAGE AF-TIMI 48 analysis showed that edoxaban maintains a favorable risk-benefit profile compared with warfarin even in AF patients at increased risk of falling, providing evidence against withholding anticoagulation based solely on perceived fall risk. ## Ganglion Plexus Ablation in Advanced Atrial Fibrillation: The AFACT Study. *2016-09-13 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.06.036 · https://hartvaat.nl/2016/09/13/ganglionplexusablatie-bij-gevorderd-atriumfibrilleren-de-afact-studie/* The AFACT study showed that additional ganglion plexus ablation during AF catheter ablation does not improve outcomes in patients with advanced AF, while increasing procedural complications. ## Pharmacodynamic Comparison of Prasugrel Versus Ticagrelor in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The OPTIMUS (Optimizing Antiplatelet Therapy in Diabetes Mellitus)-4 Study. *2016-09-13 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.023402 · https://hartvaat.nl/2016/09/13/prasugrel-versus-ticagrelor-bij-diabetes-type-2-met-coronairlijden-optimus-4-stu/* This pharmacodynamic comparison showed that both prasugrel and ticagrelor effectively overcome the enhanced platelet reactivity seen in diabetic patients, with prasugrel providing slightly greater inhibition in this high-risk population. ## Outcomes After Percutaneous Coronary Intervention or Bypass Surgery in Patients With Unprotected Left Main Disease. *2016-09-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.06.024 · https://hartvaat.nl/2016/09/06/pci-versus-cabg-bij-onbeschermde-hoofdstamziekte-uitkomsten/* This study compared outcomes after PCI versus CABG for unprotected left main coronary disease using contemporary data, contributing to the evolving evidence base for revascularization strategy selection in this high-risk anatomy. ## Consistent Reduction in Periprocedural Myocardial Infarction With Cangrelor as Assessed by Multiple Definitions: Findings From CHAMPION PHOENIX (Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition). *2016-09-06 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.020829 · https://hartvaat.nl/2016/09/06/consistente-reductie-in-periprocedureel-mi-met-cangrelor-champion-analyses/* This pooled CHAMPION analysis confirmed that cangrelor consistently reduces periprocedural MI compared with clopidogrel across multiple MI definitions, supporting the use of this intravenous P2Y12 inhibitor during PCI. ## Duration of Dual Antiplatelet Therapy: A Systematic Review for the 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. *2016-09-06 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.512 · https://hartvaat.nl/2016/09/06/duur-van-dapt-systematische-review-voor-de-acc-aha-gerichte-update-2016/* This systematic review provided the evidence foundation for the 2016 ACC/AHA focused update on DAPT duration after PCI, evaluating the benefits and risks of extended versus standard dual antiplatelet therapy across different stent generations and clinical scenarios. ## Apixaban 5 mg Twice Daily and Clinical Outcomes in Patients With Atrial Fibrillation and Advanced Age, Low Body Weight, or High Creatinine: A Secondary Analysis of a Randomized Clinical Trial. *2016-09-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.1829 · https://hartvaat.nl/2016/09/01/apixaban-5-mg-bij-af-met-hoge-leeftijd-laag-gewicht-of-hoog-creatinine-aristotle/* This ARISTOTLE subanalysis showed that standard-dose apixaban 5 mg twice daily maintained favorable outcomes in AF patients with characteristics that would typically prompt dose reduction (advanced age, low body weight, or renal impairment), raising concerns about unnecessary off-label dose reduction. ## Beneficial effect of a polyphenol-rich diet on cardiovascular risk: a randomised control trial. *2016-09-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-309218 · https://hartvaat.nl/2016/09/01/polyfenolrijk-dieet-en-cardiovasculair-risico-gerandomiseerde-trial/* This randomized trial demonstrated that a polyphenol-rich diet reduces cardiovascular risk factors including blood pressure and inflammatory markers, supporting dietary polyphenol intake as a modifiable component of cardiovascular prevention. ## Angiotensin-Converting Enzyme Inhibitor Use and Major Cardiovascular Outcomes in Type 2 Diabetes Mellitus Treated With the Dipeptidyl Peptidase 4 Inhibitor Alogliptin. *2016-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07797 · https://hartvaat.nl/2016/09/01/ace-remmers-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-met-dpp-4-remmers/* This study examined the interaction between ACE inhibitors and DPP-4 inhibitors on cardiovascular outcomes in type 2 diabetes, investigating whether concomitant RAAS-incretin therapy provides synergistic or antagonistic effects. ## More Versus Less Intensive Blood Pressure-Lowering Strategy: Cumulative Evidence and Trial Sequential Analysis. *2016-09-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07608 · https://hartvaat.nl/2016/09/01/intensievere-versus-minder-intensieve-bloeddrukverlaging-cumulatief-bewijs-en-tr/* This cumulative meta-analysis with trial sequential analysis provided robust evidence that intensive blood pressure lowering reduces major cardiovascular events and death compared with less intensive treatment, confirming that the evidence threshold for benefit has been definitively crossed. ## Treatment with patiromer decreases aldosterone in patients with chronic kidney disease and hyperkalemia on renin-angiotensin system inhibitors. *2016-09-01 · Kidney international · https://doi.org/10.1016/j.kint.2016.04.019 · https://hartvaat.nl/2016/09/01/patiromer-verlaagt-aldosteron-bij-ckd-patienten-met-hyperkaliemie-op-raas-remmer/* This study showed that patiromer, in addition to lowering potassium, reduces aldosterone levels in CKD patients with hyperkalemia on RAAS inhibitor therapy, suggesting a secondary benefit through aldosterone suppression. ## Comparison of Dabigatran and Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: The RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulant Therapy). *2016-08-23 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.020950 · https://hartvaat.nl/2016/08/23/dabigatran-versus-warfarine-bij-af-met-kleplijden-re-ly-analyse/* This RE-LY subanalysis confirmed that dabigatran maintains its favorable efficacy and safety compared with warfarin in AF patients with concomitant valvular heart disease (excluding mechanical valves and significant mitral stenosis), supporting DOAC use in this population. ## Acute Aortic Dissection and Intramural Hematoma: A Systematic Review. *2016-08-16 · JAMA · https://doi.org/10.1001/jama.2016.10026 · https://hartvaat.nl/2016/08/16/acute-aortadissectie-en-intramuraal-hematoom-jama-systematische-review/* This comprehensive JAMA systematic review of acute aortic dissection and intramural hematoma covered diagnosis, management, and prognosis, providing a reference framework for this life-threatening cardiovascular emergency. ## 1-Year Outcomes With Intracoronary Abciximab in Diabetic Patients Undergoing Primary Percutaneous Coronary Intervention. *2016-08-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.05.078 · https://hartvaat.nl/2016/08/16/intracoronair-abciximab-bij-diabetespatienten-met-primaire-pci-1-jaarsresultaten/* This study examined 1-year outcomes of intracoronary abciximab administration in diabetic STEMI patients undergoing primary PCI, testing targeted antiplatelet delivery for a high-risk population. ## Bioabsorbable Intracoronary Matrix for Prevention of Ventricular Remodeling After Myocardial Infarction. *2016-08-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.05.053 · https://hartvaat.nl/2016/08/16/bio-absorbeerbare-intracoronaire-matrix-ter-preventie-van-ventriculaire-remodell/* This study evaluated a bioabsorbable intracoronary matrix designed to prevent LV remodeling after large MI, testing a novel injectable biomaterial approach for structural myocardial support. ## Lipid Screening in Childhood and Adolescence for Detection of Familial Hypercholesterolemia: Evidence Report and Systematic Review for the US Preventive Services Task Force. *2016-08-09 · JAMA · https://doi.org/10.1001/jama.2016.6176 · https://hartvaat.nl/2016/08/09/lipidescreening-bij-kinderen-voor-familiaire-hypercholesterolemie-uspstf-evidenc/* This systematic evidence review for the USPSTF focused on detecting familial hypercholesterolemia through lipid screening in childhood and adolescence, evaluating the sensitivity and specificity of different screening approaches and the benefits of early treatment. ## Lipid Screening in Childhood and Adolescence for Detection of Multifactorial Dyslipidemia: Evidence Report and Systematic Review for the US Preventive Services Task Force. *2016-08-09 · JAMA · https://doi.org/10.1001/jama.2016.6423 · https://hartvaat.nl/2016/08/09/lipidescreening-bij-kinderen-voor-multifactoriele-dyslipidemie-uspstf-evidence-r/* This USPSTF evidence report evaluated lipid screening in children and adolescents for detecting multifactorial dyslipidemia, assessing the diagnostic yield and downstream health effects of universal versus selective childhood lipid testing. ## Screening for Lipid Disorders in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. *2016-08-09 · JAMA · https://doi.org/10.1001/jama.2016.9852 · https://hartvaat.nl/2016/08/09/lipidescreening-bij-kinderen-en-adolescenten-uspstf-aanbeveling/* The USPSTF recommendation statement on lipid screening in children and adolescents addressed the evidence for universal versus selective screening and the potential for identifying familial hypercholesterolemia and other lipid disorders in the pediatric population. ## Effect of a single dose of the interleukin-6 receptor antagonist tocilizumab on inflammation and troponin T release in patients with non-ST-elevation myocardial infarction: a double-blind, randomized, placebo-controlled phase 2 trial. *2016-08-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehw171 · https://hartvaat.nl/2016/08/07/il-6-receptorantagonist-tocilizumab-bij-nstemi-effect-op-inflammatie-en-troponin/* This study showed that a single dose of tocilizumab, an IL-6 receptor antagonist, significantly reduced inflammation markers and attenuated troponin T release in patients with acute STEMI, providing proof-of-concept for targeted anti-inflammatory therapy in acute MI. ## Effects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial. *2016-08-02 · JAMA · https://doi.org/10.1001/jama.2016.10260 · https://hartvaat.nl/2016/08/02/liraglutide-en-klinische-stabiliteit-bij-gevorderd-hartfalen-met-verminderde-ef-/* This JAMA trial showed that liraglutide did not improve clinical stability in patients with advanced HFrEF, contrary to expectations from the diabetes cardiovascular trials. The results highlighted that the cardiac benefits of GLP-1 agonists may not extend to the most advanced heart failure populations. ## Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction: The OMEGA-REMODEL Randomized Clinical Trial. *2016-08-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.019949 · https://hartvaat.nl/2016/08/02/omega-3-vetzuren-en-linkerkamerremodellering-na-acuut-mi-omega-remodel-trial/* The OMEGA-REMODEL trial demonstrated that omega-3 fatty acid supplementation after acute MI reduces left ventricular remodeling, with improvements in myocardial fibrosis and systolic function detected by cardiac MRI beyond standard post-MI therapy. ## Does the Baseline Coronary Lesion Length Impact Outcomes With IVUS-Guided Percutaneous Coronary Intervention? *2016-08-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.05.042 · https://hartvaat.nl/2016/08/02/impact-van-coronaire-laesielengte-op-uitkomsten-bij-ivus-geleide-pci/* This study examined whether baseline coronary lesion length impacts outcomes with IVUS-guided PCI, addressing the role of lesion complexity in determining the value of intravascular imaging guidance. ## A Digital Health Intervention to Lower Cardiovascular Risk: A Randomized Clinical Trial. *2016-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.1035 · https://hartvaat.nl/2016/08/01/digitale-gezondheidsinterventie-voor-cardiovasculaire-risicoverlaging-gerandomis/* This JAMA Cardiology trial showed that a digital health intervention using text messaging and lifestyle coaching reduces cardiovascular risk factors in South Asian individuals, demonstrating the potential of mobile technology for CVD prevention in high-risk populations. ## Continuous Dose-Response Association Between Sedentary Time and Risk for Cardiovascular Disease: A Meta-analysis. *2016-08-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.1567 · https://hartvaat.nl/2016/08/01/sedentair-gedrag-en-cardiovasculair-risico-continue-dosis-responsrelatie-in-meta/* This JAMA Cardiology meta-analysis established a continuous dose-response relationship between sedentary time and cardiovascular disease risk, with each additional hour of daily sitting time incrementally increasing cardiovascular events and mortality. ## 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). *2016-08-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehw106 · https://hartvaat.nl/2016/08/01/2016-europese-richtlijnen-voor-cardiovasculaire-preventie-in-de-klinische-prakti/* The Sixth Joint European Guidelines on cardiovascular disease prevention provided a comprehensive framework for risk stratification using the SCORE system, lifestyle interventions, and pharmacological prevention. This multi-society document established risk-category-specific treatment targets and remains the standard reference for preventive cardiology in Europe. ## Effect of prior clopidogrel use on outcomes in medically managed acute coronary syndrome patients. *2016-08-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308840 · https://hartvaat.nl/2016/08/01/eerder-clopidogrelgebruik-en-uitkomsten-bij-conservatief-behandeld-acs/* This study examined how prior clopidogrel use affects long-term outcomes in conservatively managed ACS patients, evaluating whether antiplatelet treatment history modifies the benefit of continued therapy. ## Effects of Magnesium Supplementation on Blood Pressure: A Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials. *2016-08-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07664 · https://hartvaat.nl/2016/08/01/magnesiumsuppletie-en-bloeddruk-meta-analyse-van-dubbelblinde-placebogecontrolee/* This meta-analysis of randomized double-blind placebo-controlled trials demonstrated that magnesium supplementation significantly lowers blood pressure, with dose-dependent effects. The findings support magnesium as an adjunctive nutritional strategy for blood pressure management. ## APOL1 renal-risk variants associate with reduced cerebral white matter lesion volume and increased gray matter volume. *2016-08-01 · Kidney international · https://doi.org/10.1016/j.kint.2016.04.027 · https://hartvaat.nl/2016/08/01/apol1-nierrisicovarianten-en-cerebrale-wittestoflaesies/* This study showed that APOL1 renal risk variants are associated with altered cerebral white and gray matter volumes, suggesting that the genetic risk for kidney disease also affects brain structure through shared vascular mechanisms. ## Reduced risk of myocardial infarct and revascularization following coronary artery bypass grafting compared with percutaneous coronary intervention in patients with chronic kidney disease. *2016-08-01 · Kidney international · https://doi.org/10.1016/j.kint.2016.03.033 · https://hartvaat.nl/2016/08/01/cabg-versus-pci-en-risico-op-myocardinfarct-en-revascularisatie-bij-ckd-patiente/* This study compared the risk of MI and revascularization after CABG versus PCI in patients with chronic kidney disease, showing that CABG provides superior protection against recurrent coronary events in this high-risk renal population. ## Hospitalizations in patients with atrial fibrillation: an analysis from ROCKET AF. *2016-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv404 · https://hartvaat.nl/2016/08/01/hospitalisaties-bij-atriumfibrilleren-analyse-uit-rocket-af/* This ROCKET AF analysis characterized hospitalization patterns in AF patients, finding that hospitalizations are frequent, predominantly for cardiovascular causes, and represent a major driver of healthcare costs in the AF population. ## Serum 25-hydroxyvitamin D and the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. *2016-08-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv395 · https://hartvaat.nl/2016/08/01/vitamine-d-en-incidentie-van-atriumfibrilleren-de-aric-studie/* This ARIC cohort analysis found no significant prospective association between serum vitamin D levels and incident atrial fibrillation, contributing to the negative evidence for vitamin D as a modifiable AF risk factor. ## Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. *2016-07-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1515920 · https://hartvaat.nl/2016/07/28/empagliflozine-en-progressie-van-nierziekte-bij-diabetes-type-2-nejm-empa-reg-re/* A prespecified renal analysis from the EMPA-REG OUTCOME trial showed that empagliflozin significantly slowed the progression of kidney disease in patients with type 2 diabetes, reducing incident or worsening nephropathy and the need for renal-replacement therapy. These findings, alongside the cardiovascular benefits, launched the SGLT2 inhibitor revolution in cardiorenal medicine. ## Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. *2016-07-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1603827 · https://hartvaat.nl/2016/07/28/liraglutide-en-cardiovasculaire-uitkomsten-bij-diabetes-type-2-nejm-leader-trial/* The LEADER trial demonstrated that liraglutide, a GLP-1 receptor agonist, significantly reduced cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke compared with placebo in patients with type 2 diabetes at high cardiovascular risk. This landmark study established GLP-1 receptor agonists as a cornerstone of cardiovascular risk reduction in diabetes. ## Atherothrombotic Risk Stratification and the Efficacy and Safety of Vorapaxar in Patients With Stable Ischemic Heart Disease and Previous Myocardial Infarction. *2016-07-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.019861 · https://hartvaat.nl/2016/07/26/atherotrombotische-risicostratificatie-en-vorapaxar-bij-stabiel-ischemisch-hartl/* This analysis stratified the efficacy and safety of vorapaxar by atherothrombotic risk in patients with stable ischemic heart disease, identifying which risk profiles derive the greatest net benefit from PAR-1 antagonism. ## Higher Visit-to-Visit Low-Density Lipoprotein Cholesterol Variability Is Associated With Lower Cognitive Performance, Lower Cerebral Blood Flow, and Greater White Matter Hyperintensity Load in Older Subjects. *2016-07-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.020627 · https://hartvaat.nl/2016/07/19/visit-to-visit-ldl-cholesterolvariabiliteit-en-cognitieve-functie/* This study showed that higher visit-to-visit variability in LDL cholesterol is associated with lower cognitive performance and increased white matter hyperintensities, linking lipid instability to neurocognitive outcomes. ## Comparison of Clinical Outcomes and Adverse Events Associated With Glucose-Lowering Drugs in Patients With Type 2 Diabetes: A Meta-analysis. *2016-07-19 · JAMA · https://doi.org/10.1001/jama.2016.9400 · https://hartvaat.nl/2016/07/19/glucoseverlagende-medicatie-en-cardiovasculaire-events-bij-diabetes-type-2-jama-/* This comprehensive JAMA network meta-analysis compared clinical outcomes and adverse events across all glucose-lowering drug classes in type 2 diabetes. The analysis provided a reference framework for comparing the relative efficacy and safety of metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 agonists, and insulin. ## Serial Cardiac Troponin Measured Using a High-Sensitivity Assay in Stable Patients With Ischemic Heart Disease. *2016-07-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.04.046 · https://hartvaat.nl/2016/07/19/serieel-cardiaal-troponine-met-hoog-sensitieve-assay-bij-stabiel-ischemisch-hart/* This study evaluated the prognostic value of serial high-sensitivity troponin measurements in stable patients with ischemic heart disease, exploring whether dynamic troponin changes predict future cardiovascular events beyond single measurements. ## Comparison of Immature Platelet Count to Established Predictors of Platelet Reactivity During Thienopyridine Therapy. *2016-07-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.04.056 · https://hartvaat.nl/2016/07/19/immatuur-plaatjesaantal-versus-gevestigde-voorspellers-van-plaatjesreactiviteit-/* This study compared the immature platelet count with established predictors of platelet reactivity during thienopyridine loading. The novel biomarker showed predictive value for antiplatelet response, potentially informing personalised antiplatelet therapy. ## Influence of Sacubitril/Valsartan (LCZ696) on 30-Day Readmission After Heart Failure Hospitalization. *2016-07-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.04.047 · https://hartvaat.nl/2016/07/19/sacubitril-valsartan-en-30-daagse-heropname-na-hartfalenhospitalisatie/* This analysis showed that sacubitril-valsartan reduces 30-day heart failure readmission rates after hospitalization, addressing a high-priority quality metric in heart failure care. ## Effects of a transitional palliative care model on patients with end-stage heart failure: a randomised controlled trial. *2016-07-15 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308638 · https://hartvaat.nl/2016/07/15/transitional-palliatieve-zorg-bij-eindstadium-hartfalen-gerandomiseerde-trial/* This randomized trial demonstrated that a home-based transitional palliative care model for end-stage heart failure patients reduces symptom burden and improves quality of life after hospital discharge, supporting integrated palliative care delivery. ## 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. *2016-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw128 · https://hartvaat.nl/2016/07/14/2016-esc-richtlijn-voor-diagnostiek-en-behandeling-van-acuut-en-chronisch-hartfa/* The 2016 ESC Guidelines established a comprehensive framework for diagnosing and treating acute and chronic heart failure. This landmark document introduced the HFmrEF category (LVEF 40–49%), structured pharmacological treatment algorithms, and laid the foundation for the quadruple therapy approach that defines modern heart failure management. ## Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs. *2016-07-14 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1513614 · https://hartvaat.nl/2016/07/14/ablatie-versus-escalatie-van-antiaritmica-bij-ventriculaire-tachycardie-nejm-van/* This randomized trial demonstrated that catheter ablation of ventricular tachycardia was superior to escalation of antiarrhythmic drugs for reducing recurrent VT in patients with ischemic cardiomyopathy and an ICD. The findings support an ablation-first strategy for sustained VT despite initial antiarrhythmic therapy. ## A randomized controlled study of finerenone vs. eplerenone in patients with worsening chronic heart failure and diabetes mellitus and/or chronic kidney disease. *2016-07-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehw132 · https://hartvaat.nl/2016/07/14/finerenon-versus-eplerenon-bij-hartfalen-met-diabetes-en-verslechterende-nierfun/* This early randomized comparison of finerenone with eplerenone in patients with worsening heart failure and diabetes showed that finerenone was well tolerated with a dose-dependent reduction in NT-proBNP. The study provided the foundation for the subsequent FIDELIO and FIGARO programs. ## Effects of Prasugrel Versus Clopidogrel on Coronary Microvascular Function in Patients Undergoing Elective PCI. *2016-07-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.04.039 · https://hartvaat.nl/2016/07/12/prasugrel-versus-clopidogrel-en-coronaire-microvasculaire-functie-bij-electieve-/* This study compared the effects of prasugrel versus clopidogrel on coronary microvascular function in patients undergoing elective PCI, exploring differential pleiotropic effects of P2Y12 inhibitors on the microvasculature. ## Vagus Nerve Stimulation for the Treatment of Heart Failure: The INOVATE-HF Trial. *2016-07-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.525 · https://hartvaat.nl/2016/07/12/nervus-vagus-stimulatie-bij-hartfalen-de-inovate-hf-trial/* The INOVATE-HF trial of chronic vagus nerve stimulation in HFrEF showed no benefit on mortality or heart failure events despite promising preclinical data on autonomic modulation. The negative result tempered enthusiasm for neural stimulation as a heart failure therapy. ## Randomized, Controlled Trial of an Advance Care Planning Video Decision Support Tool for Patients With Advanced Heart Failure. *2016-07-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.021937 · https://hartvaat.nl/2016/07/05/advance-care-planning-video-bij-gevorderd-hartfalen-gerandomiseerde-trial/* This randomized trial of a video decision support tool for advance care planning in advanced heart failure showed that video-based education improves patient understanding and changes preferences regarding resuscitation and end-of-life care. ## On-Treatment Outcomes in Patients With Worsening Renal Function With Rivaroxaban Compared With Warfarin: Insights From ROCKET AF. *2016-07-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.021890 · https://hartvaat.nl/2016/07/05/verslechterende-nierfunctie-en-uitkomsten-met-rivaroxaban-versus-warfarine-rocke/* This ROCKET AF analysis examined outcomes in AF patients with worsening renal function, showing that rivaroxaban maintains its favorable profile compared with warfarin even when kidney function declines during treatment. ## Impact of Renal Function on Outcomes With Edoxaban in the ENGAGE AF-TIMI 48 Trial. *2016-07-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.116.022361 · https://hartvaat.nl/2016/07/05/nierfunctie-en-uitkomsten-met-edoxaban-in-de-engage-af-timi-48-trial/* This ENGAGE AF-TIMI 48 analysis showed that edoxaban maintains favorable efficacy and safety compared with warfarin across different levels of renal function, with dose reduction providing appropriate adjustment for patients with renal impairment. ## Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation in Relation to Renal Function Over Time: Insights From the ARISTOTLE Randomized Clinical Trial. *2016-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.1170 · https://hartvaat.nl/2016/07/01/apixaban-versus-warfarine-bij-af-in-relatie-tot-nierfunctie-aristotle-analyse/* This ARISTOTLE subanalysis demonstrated that apixaban maintains its favorable efficacy and safety profile compared with warfarin across different levels of renal function in AF patients, providing dosing confidence in mild-to-moderate renal impairment. ## Long-term Tolerability of Ticagrelor for the Secondary Prevention of Major Adverse Cardiovascular Events: A Secondary Analysis of the PEGASUS-TIMI 54 Trial. *2016-07-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.1017 · https://hartvaat.nl/2016/07/01/langetermijnverdraagbaarheid-van-ticagrelor-voor-secundaire-cardiovasculaire-pre/* This PEGASUS-TIMI 54 tolerability analysis showed that long-term ticagrelor therapy is generally well tolerated, with dyspnea and bleeding as the main reasons for discontinuation, informing the practical management of extended antiplatelet therapy. ## Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis. *2016-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-309203 · https://hartvaat.nl/2016/07/01/chocoladeconsumptie-en-risico-op-myocardinfarct-prospectieve-studie-en-meta-anal/* This prospective study and meta-analysis examined the association between chocolate consumption and myocardial infarction risk, evaluating the cardiovascular implications of dietary cocoa flavanoid intake. ## Remote ischaemic conditioning and healthcare system delay in patients with ST-segment elevation myocardial infarction. *2016-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308980 · https://hartvaat.nl/2016/07/01/remote-ischemische-conditionering-en-vertraging-van-het-zorgsysteem-bij-stemi/* This study investigated whether remote ischemic conditioning mitigates the detrimental effect of healthcare system delay on myocardial salvage in STEMI, exploring cardioprotection specifically in prolonged ischemia scenarios. ## Native valve disease in patients with non-valvular atrial fibrillation on warfarin or rivaroxaban. *2016-07-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308120 · https://hartvaat.nl/2016/07/01/natief-kleplijden-bij-af-patienten-op-warfarine-of-rivaroxaban/* This study characterized the prevalence and impact of native valve disease in patients classified as having non-valvular AF treated with warfarin or rivaroxaban, informing DOAC prescribing in borderline valvular conditions. ## Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension: A Systematic Review and Meta-Analysis. *2016-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07218 · https://hartvaat.nl/2016/07/01/luchtvervuiling-en-hypertensie-systematische-review-en-meta-analyse/* This systematic review and meta-analysis examined the association between short-term and long-term air pollution exposure and hypertension risk, providing evidence that ambient air pollutants may be a modifiable environmental risk factor for blood pressure elevation. ## Independent and Joint Effect of Brachial-Ankle Pulse Wave Velocity and Blood Pressure Control on Incident Stroke in Hypertensive Adults. *2016-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.07023 · https://hartvaat.nl/2016/07/01/polsgolfsnelheid-en-bloeddrukcontrole-als-onafhankelijke-voorspellers-van-cva-bi/* This study demonstrated the independent and joint effects of arterial stiffness (pulse wave velocity) and blood pressure control on stroke risk, showing that vascular stiffness adds prognostic information beyond blood pressure levels. ## The Association Between Antihypertensive Medication Nonadherence and Visit-to-Visit Variability of Blood Pressure: Findings From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. *2016-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06960 · https://hartvaat.nl/2016/07/01/medicatie-non-adherentie-en-visit-to-visit-bloeddrukvariabiliteit-target-bp-stud/* This TARGET BP analysis showed that non-adherence to antihypertensive medication is a significant contributor to visit-to-visit blood pressure variability, linking a modifiable factor to this emerging cardiovascular risk predictor. ## Will Exercise Advice Be Sufficient for Treatment of Young Adults With Prehypertension and Hypertension? A Systematic Review and Meta-Analysis. *2016-07-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07431 · https://hartvaat.nl/2016/07/01/bewegingsadvies-als-behandeling-van-prehypertensie-en-hypertensie-bij-jongvolwas/* This systematic review and meta-analysis examined whether exercise advice alone is sufficient for treating prehypertension and hypertension in young adults, evaluating the effectiveness of lifestyle modification without pharmacotherapy in this demographic. ## Long-term evaluation of dabigatran 150 vs. 110 mg twice a day in patients with non-valvular atrial fibrillation. *2016-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv312 · https://hartvaat.nl/2016/07/01/langetermijnevaluatie-van-dabigatran-150-versus-110-mg-bij-niet-valvulair-af/* This long-term comparison of dabigatran 150 mg versus 110 mg twice daily in patients with non-valvular AF from the RE-LY extension study provided insights into the sustained efficacy and safety of both dose levels over extended follow-up. ## Are implantable cardiac monitors the 'gold standard' for atrial fibrillation detection? A prospective randomized trial comparing atrial fibrillation monitoring using implantable cardiac monitors and DDDRP permanent pacemakers in post atrial fibrillation ablation patients. *2016-07-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv367 · https://hartvaat.nl/2016/07/01/implanteerbare-monitors-als-goudstandaard-voor-af-detectie-gerandomiseerde-verge/* This prospective randomized trial compared implantable cardiac monitors with other AF detection methods, testing the assumption that continuous implantable monitoring is the gold standard for arrhythmia surveillance. ## Effect of Escitalopram on All-Cause Mortality and Hospitalization in Patients With Heart Failure and Depression: The MOOD-HF Randomized Clinical Trial. *2016-06-28 · JAMA · https://doi.org/10.1001/jama.2016.7635 · https://hartvaat.nl/2016/06/28/escitalopram-bij-hartfalen-en-depressie-de-mood-hf-trial/* This JAMA trial showed that escitalopram did not reduce all-cause mortality or hospitalization in heart failure patients with comorbid depression, despite evidence that depression worsens heart failure outcomes. The negative result argued against routine SSRI use for cardiovascular benefit in this population. ## Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial. *2016-06-28 · JAMA · https://doi.org/10.1001/jama.2016.7050 · https://hartvaat.nl/2016/06/28/intensieve-versus-standaard-bloeddrukcontrole-bij-75-plussers-sprint-subanalyse/* This SPRINT subgroup analysis in adults aged 75 years and older showed that intensive blood pressure control (systolic <120 mmHg) significantly reduced cardiovascular events and all-cause mortality compared with standard treatment. The results provided the first strong evidence for aggressive blood pressure targets in the elderly. ## Strategies to attenuate micro-vascular obstruction during P-PCI: the randomized reperfusion facilitated by local adjunctive therapy in ST-elevation myocardial infarction trial. *2016-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehw136 · https://hartvaat.nl/2016/06/21/strategieen-om-microvasculaire-obstructie-te-verminderen-bij-primaire-pci-relief/* This randomized trial tested local adjuvant therapies to reduce microvascular obstruction during primary PCI for STEMI, exploring whether intracoronary treatments can improve myocardial salvage beyond mechanical reperfusion alone. ## Myocardial blush and microvascular reperfusion following manual thrombectomy during percutaneous coronary intervention for ST elevation myocardial infarction: insights from the TOTAL trial. *2016-06-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehw157 · https://hartvaat.nl/2016/06/21/myocardiale-blush-en-microvasculaire-reperfusie-na-handmatige-trombectomie-bij-s/* This study examined the effect of manual thrombectomy on myocardial blush grade and microvascular reperfusion during primary PCI for STEMI, assessing whether mechanical clot removal improves microvascular flow. ## The Effectiveness of Pharmacist Interventions on Cardiovascular Risk: The Multicenter Randomized Controlled RxEACH Trial. *2016-06-21 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.528 · https://hartvaat.nl/2016/06/21/apothekerinterventies-en-cardiovasculair-risico-de-multicenter-rxeach-trial/* This multicenter randomized trial demonstrated that pharmacist-led interventions targeting cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking) significantly improved risk factor control compared with usual care. The results supported interprofessional collaborative care models. ## Low-Dose versus Standard-Dose Intravenous Alteplase in Acute Ischemic Stroke. *2016-06-16 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1515510 · https://hartvaat.nl/2016/06/16/lage-versus-standaarddosis-alteplase-bij-acuut-ischemisch-cva-nejm-enchanted-tri/* This NEJM trial comparing low-dose with standard-dose intravenous alteplase in acute ischemic stroke found that the lower dose was not noninferior for functional outcome, settling the question of whether dose reduction could improve the safety-efficacy balance of thrombolysis. ## Early Intravenous Beta-Blockers in Patients With ST-Segment Elevation Myocardial Infarction Before Primary Percutaneous Coronary Intervention. *2016-06-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.522 · https://hartvaat.nl/2016/06/14/vroege-intraveneuze-betablokkade-voor-primaire-pci-bij-stemi/* This study evaluated the impact of early intravenous beta-blockers administered before primary PCI in STEMI on infarct size and clinical outcomes, contributing data on the timing of beta-blocker therapy in the reperfusion era. ## Ticagrelor for Prevention of Ischemic Events After Myocardial Infarction in Patients With Peripheral Artery Disease. *2016-06-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.524 · https://hartvaat.nl/2016/06/14/ticagrelor-ter-preventie-van-ischemische-events-bij-mi-patienten-met-perifeer-va/* This PEGASUS-TIMI 54 analysis in patients with prior MI and peripheral artery disease showed that ticagrelor provides significant ischemic risk reduction in this high-risk dual-vascular-disease population. ## Reduction in Ischemic Events With Ticagrelor in Diabetic Patients With Prior Myocardial Infarction in PEGASUS-TIMI 54. *2016-06-14 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.529 · https://hartvaat.nl/2016/06/14/reductie-van-ischemische-events-met-ticagrelor-bij-diabetes-na-myocardinfarct-pe/* This PEGASUS-TIMI 54 subanalysis showed that ticagrelor added to aspirin provides particular benefit in diabetic patients with prior MI, with a greater absolute reduction in ischemic events reflecting their higher baseline risk. ## Ixmyelocel-T for patients with ischaemic heart failure: a prospective randomised double-blind trial. *2016-06-11 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)30137-4 · https://hartvaat.nl/2016/06/11/ixmyelocel-t-bij-ischemisch-hartfalen-lancet-dubbelblinde-gerandomiseerde-trial/* This Lancet trial of ixmyelocel-T, an autologous bone marrow-derived cell therapy, in patients with ischemic heart failure explored regenerative medicine as a treatment approach for myocardial repair. ## Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation. *2016-06-09 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1602014 · https://hartvaat.nl/2016/06/09/cryoballon-versus-radiofrequentieablatie-bij-paroxysmaal-atriumfibrilleren-nejm-/* The FIRE AND ICE trial demonstrated that cryoballoon ablation was noninferior to radiofrequency ablation for pulmonary vein isolation in patients with drug-refractory paroxysmal atrial fibrillation. The study established cryoablation as an equally effective and potentially simpler alternative for the treatment of paroxysmal AF. ## Ischemia and Infarction in STEMI Patients With Multivessel Disease: Insights From the CvLPRIT Nuclear Substudy. *2016-06-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.544 · https://hartvaat.nl/2016/06/07/ischemie-en-infarct-bij-stemi-met-multivatenlijden-cvlprit-nucleaire-substudie/* This CvLPRIT nuclear imaging substudy characterized the extent of ischemia and infarction in STEMI patients with multivessel disease, informing the discussion about complete revascularization by quantifying the ischemic burden in nonculprit territories. ## Importance of Clinical Worsening of Heart Failure Treated in the Outpatient Setting: Evidence From the Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure Trial (PARADIGM-HF). *2016-06-07 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.020729 · https://hartvaat.nl/2016/06/07/klinische-verslechtering-van-poliklinisch-behandeld-hartfalen-paradigm-hf-analys/* This PARADIGM-HF analysis highlighted the prognostic importance of clinical worsening events managed in the outpatient setting, demonstrating that non-hospitalized heart failure deterioration carries significant risk and should be included in outcome assessment. ## Effects of Vitamin D on Cardiac Function in Patients With Chronic HF: The VINDICATE Study. *2016-06-07 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.508 · https://hartvaat.nl/2016/06/07/vitamine-d-bij-chronisch-hartfalen-de-vindicate-studie/* The VINDICATE study showed that vitamin D supplementation improves left ventricular function in patients with chronic heart failure and documented vitamin D deficiency, suggesting a role for vitamin D repletion as an adjunct to standard HF therapy. ## The novel biomarker-based ABC (age, biomarkers, clinical history)-bleeding risk score for patients with atrial fibrillation: a derivation and validation study. *2016-06-04 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)00741-8 · https://hartvaat.nl/2016/06/04/abc-bloedingsscore-bij-atriumfibrilleren-de-nieuwe-biomarkergebaseerde-risicosco/* This Lancet study derived and validated the ABC (Age, Biomarkers, Clinical history) bleeding risk score for patients with atrial fibrillation on anticoagulation. The biomarker-based score improved prediction of major bleeding beyond the conventional HAS-BLED score. ## Association of a Family History of Coronary Heart Disease With Initiation of Statin Therapy in Individuals at Intermediate Risk: Post Hoc Analysis of a Randomized Clinical Trial. *2016-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.0227 · https://hartvaat.nl/2016/06/01/familiaire-belasting-en-statine-initiatie-bij-intermediair-cardiovasculair-risic/* This HOPE-3 analysis examined the role of family history in the decision to initiate statin therapy in intermediate-risk individuals, exploring whether genetic predisposition modifies the benefit of primary prevention. ## Percutaneous Coronary Intervention in Patients With Insulin-Treated and Non-Insulin-Treated Diabetes Mellitus: Secondary Analysis of the TUXEDO Trial. *2016-06-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.0305 · https://hartvaat.nl/2016/06/01/pci-bij-insulinebehandelde-versus-niet-insulinebehandelde-diabetes-freedom-trial/* This FREEDOM secondary analysis showed that PCI outcomes differ between insulin-treated and non-insulin-treated diabetic patients, with insulin-dependent diabetes conferring particularly high risk and greater relative benefit from CABG. ## Prevention of cardiac dysfunction during adjuvant breast cancer therapy (PRADA): a 2 × 2 factorial, randomized, placebo-controlled, double-blind clinical trial of candesartan and metoprolol. *2016-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehw022 · https://hartvaat.nl/2016/06/01/preventie-van-cardiale-disfunctie-bij-borstkankerbehandeling-de-prada-trial/* The PRADA 2×2 factorial trial investigated cardioprotective strategies (candesartan and metoprolol) during adjuvant breast cancer therapy with anthracyclines and trastuzumab, exploring pharmacological prevention of cancer treatment-related cardiotoxicity. ## Improved outcome with repeated intracoronary injection of bone marrow-derived cells within a registry: rationale for the randomized outcome trial REPEAT. *2016-06-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv559 · https://hartvaat.nl/2016/06/01/herhaalde-intracoronaire-beenmergcelinjectie-bij-hartfalen-resultaten-uit-een-re/* This registry analysis suggested that repeated intracoronary bone marrow cell injections improve outcomes in post-infarction heart failure, providing the rationale for a dose-escalation approach to cardiac regenerative therapy. ## Modest Salt Reduction Lowers Blood Pressure and Albumin Excretion in Impaired Glucose Tolerance and Type 2 Diabetes Mellitus: A Randomized Double-Blind Trial. *2016-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06637 · https://hartvaat.nl/2016/06/01/matige-zoutreductie-verlaagt-bloeddruk-en-albuminurie-bij-gestoorde-glucosetoler/* This randomized trial demonstrated that modest salt restriction lowers blood pressure and urinary albumin excretion in patients with impaired glucose tolerance and type 2 diabetes, supporting dietary sodium reduction in the diabetic population. ## Chronic Nebivolol Treatment Suppresses Endothelin-1-Mediated Vasoconstrictor Tone in Adults With Elevated Blood Pressure. *2016-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06979 · https://hartvaat.nl/2016/06/01/chronische-nebivololbehandeling-onderdrukt-endotheline-1-gemedieerde-vasoconstri/* This study showed that chronic nebivolol treatment suppresses endothelin-1-mediated vasoconstriction in adults with elevated blood pressure, characterizing a vasodilatory mechanism specific to this third-generation beta-blocker. ## Selective Heart Rate Reduction With Ivabradine Increases Central Blood Pressure in Stable Coronary Artery Disease. *2016-06-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.116.07250 · https://hartvaat.nl/2016/06/01/selectieve-hartfrequentieverlaging-met-ivabradine-verhoogt-centrale-bloeddruk-bi/* This study showed that ivabradine paradoxically increases central blood pressure despite reducing heart rate in patients with stable coronary disease, raising questions about the hemodynamic consequences of selective heart rate reduction. ## Long-term effects following 4 years of randomized treatment with atorvastatin in patients with type 2 diabetes mellitus on hemodialysis. *2016-06-01 · Kidney international · https://doi.org/10.1016/j.kint.2015.12.033 · https://hartvaat.nl/2016/06/01/langetermijneffecten-van-atorvastatine-bij-diabetes-type-2-op-hemodialyse-4d-tri/* This long-term follow-up of the 4D trial showed no delayed cardiovascular benefit of atorvastatin in diabetic hemodialysis patients, contributing to the evidence that statin therapy has limited efficacy in the end-stage kidney disease population. ## Mid-term clinical and echocardiographic evaluation of super responders with and without pacing: the preliminary results of a prospective, randomized, single-centre study. *2016-06-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv129 · https://hartvaat.nl/2016/06/01/crt-super-responders-met-en-zonder-pacing-middellangetermijnresultaten/* This preliminary study evaluated CRT super-responders with and without continued pacing, investigating whether patients who achieve near-normal LV function can safely reduce pacing dependency. ## Diagnostic Ultrasound Impulses Improve Microvascular Flow in Patients With STEMI Receiving Intravenous Microbubbles. *2016-05-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.542 · https://hartvaat.nl/2016/05/31/diagnostische-ultrageluidspulsen-verbeteren-microvasculaire-flow-bij-stemi-met-m/* This study demonstrated that diagnostic ultrasound impulses during intravenous microbubble infusion can improve microvascular flow in STEMI patients, exploring sonothrombolysis as an adjunctive reperfusion strategy. ## DAPT Score Utility for Risk Prediction in Patients With or Without Previous Myocardial Infarction. *2016-05-31 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.485 · https://hartvaat.nl/2016/05/31/dapt-score-validatie-bij-patienten-met-en-zonder-eerder-myocardinfarct/* This validation study showed that the DAPT score can identify patients who benefit from extended dual antiplatelet therapy regardless of prior MI history, supporting its use as a clinical decision tool for antiplatelet duration. ## Deferred versus conventional stent implantation in patients with ST-segment elevation myocardial infarction (DANAMI 3-DEFER): an open-label, randomised controlled trial. *2016-05-28 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)30072-1 · https://hartvaat.nl/2016/05/28/uitgestelde-versus-conventionele-stentimplantatie-bij-stemi-danami-3-defer-trial/* The DANAMI-3-DEFER trial compared deferred versus immediate stent implantation after thrombus aspiration in STEMI patients, testing whether delaying stenting reduces microvascular obstruction and improves outcomes. ## Blood-Pressure Lowering in Intermediate-Risk Persons without Cardiovascular Disease. *2016-05-26 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1600175 · https://hartvaat.nl/2016/05/26/bloeddrukverlaging-bij-personen-met-intermediair-risico-zonder-cardiovasculaire-/* The blood pressure-lowering arm of HOPE-3 showed that candesartan/hydrochlorothiazide did not significantly reduce cardiovascular events overall in intermediate-risk persons, but did reduce events in those with the highest tertile of baseline systolic blood pressure. The findings support targeting blood pressure treatment to those with elevated levels even in primary prevention. ## Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease. *2016-05-26 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1600176 · https://hartvaat.nl/2016/05/26/cholesterolverlaging-bij-personen-met-intermediair-risico-zonder-cardiovasculair/* The cholesterol-lowering arm of HOPE-3 demonstrated that rosuvastatin significantly reduced cardiovascular events in intermediate-risk individuals without prior cardiovascular disease. The trial established that statin therapy benefits a broader population than previously tested, including those with modest LDL elevations. ## Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease. *2016-05-26 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1600177 · https://hartvaat.nl/2016/05/26/bloeddruk-en-cholesterolverlaging-bij-personen-zonder-cardiovasculaire-ziekte-ho/* The HOPE-3 trial showed that combined blood pressure and cholesterol lowering with rosuvastatin plus candesartan/hydrochlorothiazide reduced cardiovascular events by 29% in intermediate-risk persons without cardiovascular disease. The benefit was driven primarily by lipid lowering, with blood pressure lowering adding benefit mainly in those with elevated baseline pressures. ## Papillary Muscle Approximation Versus Restrictive Annuloplasty Alone for Severe Ischemic Mitral Regurgitation. *2016-05-24 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.478 · https://hartvaat.nl/2016/05/24/papillairspierbenadering-versus-restrictieve-annuloplastiek-bij-ernstige-ischemi/* This randomized study compared papillary muscle approximation plus annuloplasty with restrictive annuloplasty alone for severe ischemic mitral regurgitation, testing whether subvalvular repair reduces MR recurrence after surgery. ## The impact of atrial fibrillation type on the risk of thromboembolism, mortality, and bleeding: a systematic review and meta-analysis. *2016-05-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehw007 · https://hartvaat.nl/2016/05/21/af-type-en-risico-op-trombo-embolie-mortaliteit-en-bloedingen-systematische-revi/* This systematic review and meta-analysis examined whether the type of atrial fibrillation (paroxysmal, persistent, or permanent) independently affects the risk of thromboembolism, mortality, and bleeding, informing the debate about AF classification and stroke risk assessment. ## The modified stepwise ablation guided by low-dose ibutilide in chronic atrial fibrillation trial (The MAGIC-AF Study). *2016-05-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehw003 · https://hartvaat.nl/2016/05/21/stapsgewijze-ablatie-gestuurd-door-laaggedoseerd-ibutilide-bij-chronisch-af-magi/* The MAGIC-AF study tested a modified stepwise ablation approach using low-dose ibutilide to unmask genuine CFAE targets during persistent AF ablation, aiming to improve the specificity of substrate modification. ## Rate Control versus Rhythm Control for Atrial Fibrillation after Cardiac Surgery. *2016-05-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1602002 · https://hartvaat.nl/2016/05/19/frequentiecontrole-versus-ritmecontrole-bij-af-na-hartchirurgie-nejm-trial/* This NEJM trial compared rate control with rhythm control for atrial fibrillation occurring after cardiac surgery, addressing the optimal management strategy for this common postoperative complication. The results informed the standard approach to post-surgical AF. ## Two-Year Outcomes of Surgical Treatment of Moderate Ischemic Mitral Regurgitation. *2016-05-19 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1602003 · https://hartvaat.nl/2016/05/19/chirurgische-behandeling-van-matige-ischemische-mitralisklepinsufficientie-2-jaa/* Two-year results from this NEJM trial showed no significant difference between CABG alone and CABG plus mitral valve repair in patients with moderate ischemic mitral regurgitation. The findings supported a conservative approach of CABG alone in moderate functional MR. ## Biodegradable Polymer-Based Sirolimus-Eluting Stents With Differing Elution and Absorption Kinetics: The PANDA III Trial. *2016-05-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.03.475 · https://hartvaat.nl/2016/05/17/biodegradeerbare-sirolimus-eluting-stents-de-panda-iii-trial/* The PANDAS III randomized trial compared two biodegradable polymer sirolimus-eluting stents with different drug elution and polymer absorption kinetics, testing whether these design parameters affect clinical outcomes. ## Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure. *2016-05-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.058 · https://hartvaat.nl/2016/05/17/verminderde-cardiac-index-is-niet-de-primaire-oorzaak-van-nierdisfunctie-bij-har/* This study demonstrated that reduced cardiac index is not the dominant driver of renal dysfunction in heart failure, finding that venous congestion contributes more significantly to kidney impairment than forward flow reduction. ## SCAI/ACC/HRS Institutional and Operator Requirements for Left Atrial Appendage Occlusion. *2016-05-17 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.12.001 · https://hartvaat.nl/2016/05/17/institutionele-en-operateurvereisten-voor-linker-hartoorocclusie-scai-acc-hrs-st/* This SCAI/ACC/HRS document established institutional and operator requirements for left atrial appendage occlusion procedures in AF patients, defining the minimum standards for safe and effective LAAO implantation. ## Improvement in Clinical Outcomes With Biventricular Versus Right Ventricular Pacing: The BLOCK HF Study. *2016-05-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.051 · https://hartvaat.nl/2016/05/10/biventriculaire-versus-rechterkamerpacing-klinische-verbetering-in-de-block-hf-s/* The BLOCK HF study demonstrated that biventricular pacing (CRT) is superior to conventional right ventricular pacing in patients with AV block and left ventricular systolic dysfunction, establishing CRT as the preferred pacing modality when ventricular pacing is required in this population. ## Validation of BARC Bleeding Criteria in Patients With Acute Coronary Syndromes: The TRACER Trial. *2016-05-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.056 · https://hartvaat.nl/2016/05/10/validatie-van-barc-bloedingscriteria-bij-acuut-coronair-syndroom-tracer-trial/* This TRACER trial analysis validated the BARC bleeding classification in ACS patients, confirming the clinical utility of standardized bleeding definitions for comparing antithrombotic therapy safety across trials. ## Impact of the Timing of Metoprolol Administration During STEMI on Infarct Size and Ventricular Function. *2016-05-10 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.050 · https://hartvaat.nl/2016/05/10/timing-van-metoprolol-bij-stemi-effect-op-infarctgrootte-en-ventrikelfunctie/* This study examined the impact of timing of intravenous metoprolol administration during STEMI on infarct size and ventricular function, exploring whether earlier beta-blocker delivery before reperfusion provides greater cardioprotection. ## Perioperative Rosuvastatin in Cardiac Surgery. *2016-05-05 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1507750 · https://hartvaat.nl/2016/05/05/perioperatief-rosuvastatine-bij-hartchirurgie-nejm-trial/* This NEJM trial showed that perioperative rosuvastatin did not reduce perioperative myocardial damage after cardiac surgery and was associated with a higher incidence of acute kidney injury. The results argued against routine perioperative statin loading in cardiac surgery patients. ## Crushed Prasugrel Tablets in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention: The CRUSH Study. *2016-05-03 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.045 · https://hartvaat.nl/2016/05/03/gemalen-prasugrel-bij-stemi-met-primaire-pci-de-crush-studie/* The CRUSH study showed that crushed prasugrel tablets achieve faster platelet inhibition than intact tablets in STEMI patients undergoing primary PCI, providing a practical strategy for overcoming delayed oral drug absorption in acute MI. ## Diabetes Mellitus and Prevention of Late Myocardial Infarction After Coronary Stenting in the Randomized Dual Antiplatelet Therapy Study. *2016-05-03 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.016783 · https://hartvaat.nl/2016/05/03/diabetes-en-preventie-van-laat-myocardinfarct-na-stenting-dapt-studie/* This DAPT study analysis showed that continued thienopyridine therapy beyond 12 months after stenting reduces late MI in diabetic patients, identifying diabetes as a modifier of the benefit from extended dual antiplatelet therapy. ## Intracoronary Gene Transfer of Adenylyl Cyclase 6 in Patients With Heart Failure: A Randomized Clinical Trial. *2016-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.0008 · https://hartvaat.nl/2016/05/01/intracoronaire-adenylylcyclase-6-gentherapie-bij-hartfalen-gerandomiseerde-trial/* This JAMA Cardiology randomized trial of intracoronary adenylyl cyclase 6 gene transfer in heart failure was among the first cardiac gene therapy trials, evaluating the safety and efficacy of direct myocardial gene delivery. ## Association Between Sitagliptin Use and Heart Failure Hospitalization and Related Outcomes in Type 2 Diabetes Mellitus: Secondary Analysis of a Randomized Clinical Trial. *2016-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.0103 · https://hartvaat.nl/2016/05/01/sitagliptine-en-hartfalenrisico-bij-diabetes-type-2-secundaire-analyse-tecos-tri/* This TECOS trial subanalysis showed no increased risk of heart failure hospitalization with sitagliptin in patients with type 2 diabetes, providing reassurance about DPP-4 inhibitor safety regarding heart failure in this class. ## Association of Lipoproteins, Insulin Resistance, and Rosuvastatin With Incident Type 2 Diabetes Mellitus : Secondary Analysis of a Randomized Clinical Trial. *2016-05-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2016.0096 · https://hartvaat.nl/2016/05/01/lipoproteinen-insulineresistentie-en-rosuvastatine-bij-incident-type-2-diabetes/* This JAMA Cardiology analysis explored the association between lipoprotein profiles, insulin resistance, and rosuvastatin-associated new-onset diabetes, providing mechanistic insights into the diabetogenic effect of statin therapy. ## Percent reduction in LDL cholesterol following high-intensity statin therapy: potential implications for guidelines and for the prescription of emerging lipid-lowering agents. *2016-05-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehw046 · https://hartvaat.nl/2016/05/01/procentuele-ldl-verlaging-bij-hoogintensieve-statinetherapie-implicaties-voor-ri/* This analysis examined the variability in percentage LDL cholesterol reduction achieved with high-intensity statin therapy, showing that a significant proportion of patients fail to achieve the expected ≥50% reduction. The findings have implications for guideline-based LDL target strategies. ## Safety and efficacy of LY3015014, a monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9): a randomized, placebo-controlled Phase 2 study. *2016-05-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv707 · https://hartvaat.nl/2016/05/01/ly3015014-een-nieuw-monoklonaal-pcsk9-antilichaam-gerandomiseerde-fase-2-trial/* This randomized trial of LY3015014, a PCSK9 monoclonal antibody, demonstrated dose-dependent LDL cholesterol lowering in patients with hypercholesterolemia, expanding the clinical data on PCSK9 inhibitor therapy during early class development. ## Genetic testing and blood biomarkers in paediatric pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. *2016-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2014-307238 · https://hartvaat.nl/2016/05/01/genetische-diagnostiek-en-biomarkers-bij-pediatrische-pulmonale-hypertensie-expe/* This expert consensus on genetic testing and blood biomarkers in pediatric pulmonary hypertension provided recommendations for the diagnostic evaluation of childhood-onset pulmonary arterial hypertension, including BMPR2 and related gene testing. ## Cardiac MR and CT imaging in children with suspected or confirmed pulmonary hypertension/pulmonary hypertensive vascular disease. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. *2016-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308246 · https://hartvaat.nl/2016/05/01/cardiale-mri-en-ct-bij-kinderen-met-pulmonale-hypertensie-expertconsensus/* This expert consensus statement addressed the role of cardiac MRI and CT in diagnosing pulmonary hypertension and pulmonary vascular disease in children, providing imaging guidance for this heterogeneous pediatric condition. ## A systematic review of the main mechanisms of heart failure disease management interventions. *2016-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308551 · https://hartvaat.nl/2016/05/01/werkzame-mechanismen-van-disease-management-bij-hartfalen-systematische-review/* This systematic review identified the core mechanisms underlying effective heart failure disease management programs, finding that multidisciplinary coordination, patient education, self-management support, and structured follow-up are the key components. ## Therapeutic hypothermia in ST elevation myocardial infarction: a systematic review and meta-analysis of randomised control trials. *2016-05-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308559 · https://hartvaat.nl/2016/05/01/therapeutische-hypothermie-bij-stemi-systematische-review-en-meta-analyse/* This systematic review and meta-analysis of randomized trials found that therapeutic hypothermia does not significantly reduce infarct size in STEMI patients, a negative result for this cardioprotective strategy despite promising preclinical data. ## Catheter ablation of atrial fibrillation in chronic heart failure: state-of-the-art and future perspectives. *2016-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv368 · https://hartvaat.nl/2016/05/01/katheterablatie-van-af-bij-chronisch-hartfalen-state-of-the-art-en-toekomstpersp/* This comprehensive review of catheter ablation for AF in chronic heart failure summarized the state of the art and future perspectives, covering patient selection, procedural techniques, and the evolving evidence for rhythm control in the HF-AF overlap population. ## Mineralocorticoid receptor antagonists and atrial fibrillation: a meta-analysis. *2016-05-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv366 · https://hartvaat.nl/2016/05/01/mineralocorticoidreceptorantagonisten-en-atriumfibrilleren-meta-analyse/* This meta-analysis showed that mineralocorticoid receptor antagonists reduce the incidence and recurrence of atrial fibrillation, supporting an anti-remodeling and antifibrotic mechanism that extends to atrial substrate modification. ## Fluticasone furoate and vilanterol and survival in chronic obstructive pulmonary disease with heightened cardiovascular risk (SUMMIT): a double-blind randomised controlled trial. *2016-04-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)30069-1 · https://hartvaat.nl/2016/04/30/fluticason-vilanterol-en-overleving-bij-copd-met-verhoogd-cardiovasculair-risico/* This Lancet trial examined the cardiovascular safety and survival effects of inhaled corticosteroid/LABA combination therapy in COPD patients with heightened cardiovascular risk. The study addressed the important interface between respiratory and cardiovascular disease management. ## Ticagrelor Improves Peripheral Arterial Function in Acute Coronary Syndrome Patients: Relationship With Adenosine Plasma Level. *2016-04-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.023 · https://hartvaat.nl/2016/04/26/ticagrelor-verbetert-perifere-arteriele-functie-bij-acs-relatie-met-adenosinespi/* This study showed that ticagrelor improves peripheral arterial function in ACS patients, possibly through adenosine-mediated vasodilation — a pleiotropic effect distinct from its antiplatelet mechanism. ## Early Aldosterone Blockade in Acute Myocardial Infarction: The ALBATROSS Randomized Clinical Trial. *2016-04-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.033 · https://hartvaat.nl/2016/04/26/vroege-aldosteronblokkade-bij-acuut-myocardinfarct-de-albatross-trial/* The ALBATROSS trial showed that early aldosterone blockade with spironolactone in acute MI does not improve outcomes when given to all patients regardless of heart failure or LV dysfunction status, limiting MRA use in acute MI to the established HF indication. ## Ablation Versus Amiodarone for Treatment of Persistent Atrial Fibrillation in Patients With Congestive Heart Failure and an Implanted Device: Results From the AATAC Multicenter Randomized Trial. *2016-04-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.019406 · https://hartvaat.nl/2016/04/26/ablatie-versus-amiodaron-bij-persisterend-af-met-hartfalen-en-icd-gerandomiseerd/* This randomized trial comparing catheter ablation with amiodarone in patients with persistent AF, heart failure, and an ICD showed that ablation was superior for maintaining sinus rhythm and improving left ventricular function in this challenging population. ## Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention. *2016-04-26 · JAMA · https://doi.org/10.1001/jama.2016.3775 · https://hartvaat.nl/2016/04/26/predictieregel-voor-voordeel-en-schade-van-dapt-na-1-jaar-pci-jama-validatiestud/* This JAMA study developed and validated the DAPT Score, a clinical decision tool that stratifies the individual risk-benefit balance of extended dual antiplatelet therapy after PCI. The score identifies patients who benefit from prolonged DAPT and those at excess bleeding risk. ## Aliskiren, Enalapril, or Aliskiren and Enalapril in Heart Failure. *2016-04-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1514859 · https://hartvaat.nl/2016/04/21/aliskiren-enalapril-of-de-combinatie-bij-hartfalen-nejm-atmosphere-trial/* This NEJM trial showed that aliskiren (a direct renin inhibitor) was neither superior nor noninferior to enalapril in HFrEF, and the combination increased adverse events without clinical benefit. The results effectively ended development of direct renin inhibition for heart failure. ## Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy. *2016-04-21 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1602001 · https://hartvaat.nl/2016/04/21/coronaire-bypasschirurgie-bij-ischemische-cardiomyopathie-nejm-stich-trial/* The extended follow-up of the STICH trial showed that CABG plus medical therapy significantly reduced all-cause mortality compared with medical therapy alone in patients with ischemic cardiomyopathy and reduced ejection fraction. This 10-year result established the survival benefit of revascularization in ischemic heart failure. ## EMBRACE STEMI study: a Phase 2a trial to evaluate the safety, tolerability, and efficacy of intravenous MTP-131 on reperfusion injury in patients undergoing primary percutaneous coronary intervention. *2016-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv597 · https://hartvaat.nl/2016/04/21/mtp-131-bij-reperfusieschade-na-stemi-de-embrace-stemi-fase-2a-trial/* The EMBRACE STEMI phase 2a trial tested MTP-131 (elamipretide), a mitochondria-targeted peptide, for limiting reperfusion injury after STEMI, exploring subcellular cardioprotection during primary PCI. ## Growth differentiation factor-15 level predicts major bleeding and cardiovascular events in patients with acute coronary syndromes: results from the PLATO study. *2016-04-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv491 · https://hartvaat.nl/2016/04/21/gdf-15-voorspelt-bloedingen-en-cardiovasculaire-events-bij-acuut-coronair-syndro/* This study identified GDF-15 as a dual predictor of both major bleeding and cardiovascular events in ACS patients, establishing this growth factor as a comprehensive risk biomarker in acute coronary care. ## Effect of Statin Treatment on Modifying Plaque Composition: A Double-Blind, Randomized Study. *2016-04-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.014 · https://hartvaat.nl/2016/04/19/statinebehandeling-en-plaquesamenstelling-dubbelblinde-gerandomiseerde-studie/* This double-blind randomized study used multimodality intravascular imaging to characterize how statin therapy alters coronary plaque composition, providing direct evidence of plaque stabilization through lipid-core shrinkage and fibrous cap thickening. ## Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease. *2016-04-19 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.02.026 · https://hartvaat.nl/2016/04/19/ct-coronairangiografie-voor-het-sturen-van-beleid-bij-coronairlijden/* This randomized trial tested whether adding coronary CT angiography to standard care improves clinical management of patients with coronary disease, evaluating the impact of anatomical information on treatment decisions and outcomes. ## Effect of Losmapimod on Cardiovascular Outcomes in Patients Hospitalized With Acute Myocardial Infarction: A Randomized Clinical Trial. *2016-04-19 · JAMA · https://doi.org/10.1001/jama.2016.3609 · https://hartvaat.nl/2016/04/19/losmapimod-en-cardiovasculaire-uitkomsten-na-acuut-myocardinfarct-jama-trial/* This JAMA trial showed that losmapimod, a p38 MAP kinase inhibitor, did not reduce cardiovascular events after acute MI, a negative result for this anti-inflammatory target that is distinct from the IL-1β pathway targeted by canakinumab. ## Efficacy and Tolerability of Evolocumab vs Ezetimibe in Patients With Muscle-Related Statin Intolerance: The GAUSS-3 Randomized Clinical Trial. *2016-04-19 · JAMA · https://doi.org/10.1001/jama.2016.3608 · https://hartvaat.nl/2016/04/19/evolocumab-versus-ezetimibe-bij-statine-intolerante-patienten-de-gauss-3-trial/* The GAUSS-3 trial demonstrated that evolocumab was significantly more effective than ezetimibe for LDL cholesterol lowering in patients with confirmed statin-associated muscle symptoms, without causing similar muscle-related adverse events. The study established PCSK9 inhibitors as an effective option for statin-intolerant patients. ## Trends in Enrollment, Clinical Characteristics, Treatment, and Outcomes According to Age in Non-ST-Segment-Elevation Acute Coronary Syndromes Clinical Trials. *2016-04-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.017299 · https://hartvaat.nl/2016/04/19/trends-in-behandeling-en-uitkomsten-bij-nste-acs-naar-leeftijd/* This analysis of age-related trends in NSTE-ACS clinical trials documented persistent underrepresentation of older patients alongside improvements in treatment intensity across age groups, highlighting the ongoing evidence gap in the elderly. ## The Prognostic Value of Residual Coronary Stenoses After Functionally Complete Revascularization. *2016-04-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.01.056 · https://hartvaat.nl/2016/04/12/prognostische-waarde-van-residuele-coronairstenosen-na-functioneel-complete-reva/* This study examined the prognostic value of residual coronary stenoses after functionally complete revascularization, exploring whether angiographic completeness metrics add predictive value beyond functional assessment. ## Relationship Between Infarct Size and Outcomes Following Primary PCI: Patient-Level Analysis From 10 Randomized Trials. *2016-04-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.01.069 · https://hartvaat.nl/2016/04/12/infarctgrootte-en-uitkomsten-na-primaire-pci-patientanalyse-uit-10-trials/* This patient-level pooled analysis from 10 randomized STEMI trials quantified the relationship between infarct size and clinical outcomes, establishing that infarct size is an independent predictor of mortality and heart failure after primary PCI. ## Proton-Pump Inhibitors Reduce Gastrointestinal Events Regardless of Aspirin Dose in Patients Requiring Dual Antiplatelet Therapy. *2016-04-12 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.12.068 · https://hartvaat.nl/2016/04/12/protonpompremmers-verminderen-gastro-intestinale-events-ongeacht-aspirinedosis-b/* This COGENT analysis confirmed that proton pump inhibitors reduce gastrointestinal events in patients on dual antiplatelet therapy regardless of aspirin dose, supporting routine PPI co-prescription during DAPT. ## Pioglitazone after Ischemic Stroke or Transient Ischemic Attack. *2016-04-07 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1506930 · https://hartvaat.nl/2016/04/07/pioglitazon-na-ischemisch-cva-of-tia-gerandomiseerde-nejm-trial/* The IRIS trial showed that pioglitazone reduced the risk of recurrent stroke and MI in patients with recent ischemic stroke or TIA and insulin resistance but without diabetes. The results established thiazolidinedione-based insulin sensitization as a secondary prevention strategy in cerebrovascular disease. ## Ischaemic risk and efficacy of ticagrelor in relation to time from P2Y12 inhibitor withdrawal in patients with prior myocardial infarction: insights from PEGASUS-TIMI 54. *2016-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehv531 · https://hartvaat.nl/2016/04/07/ischemisch-risico-en-werkzaamheid-van-ticagrelor-in-relatie-tot-stoptijd-p2y12-r/* This PEGASUS-TIMI 54 analysis showed that the risk reduction with ticagrelor is greater in patients who discontinued P2Y12 inhibitor therapy more recently, supporting timely reinitiation of antiplatelet therapy after a gap. ## The effect of cangrelor and access site on ischaemic and bleeding events: insights from CHAMPION PHOENIX. *2016-04-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehv498 · https://hartvaat.nl/2016/04/07/cangrelor-en-toegangsplaats-effect-op-ischemische-en-bloedingsevents-champion-ph/* This CHAMPION PHOENIX analysis evaluated whether cangrelor's efficacy and safety differ by vascular access site (radial vs femoral), finding consistent antiplatelet benefit regardless of the PCI access approach. ## Enhancing Cardiac Rehabilitation With Stress Management Training: A Randomized, Clinical Efficacy Trial. *2016-04-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.018926 · https://hartvaat.nl/2016/04/05/hartrevalidatie-versterkt-met-stressmanagementtraining-gerandomiseerde-trial/* This randomized trial demonstrated that adding stress management training to standard cardiac rehabilitation provides clinically relevant improvements in cardiovascular outcomes, supporting psychological intervention as a component of comprehensive cardiac recovery. ## Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS): a randomised, controlled, open-label, phase 3 trial. *2016-04-02 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)01238-6 · https://hartvaat.nl/2016/04/02/bevacizumab-bij-pleuramesothelioom-de-maps-trial/* The MAPS Lancet trial showed that adding bevacizumab to cisplatin-pemetrexed improves overall survival in newly diagnosed pleural mesothelioma, relevant to cardiology due to the cardiovascular monitoring needs during anti-VEGF therapy. ## Oral Anticoagulant Therapy Prescription in Patients With Atrial Fibrillation Across the Spectrum of Stroke Risk: Insights From the NCDR PINNACLE Registry. *2016-04-01 · JAMA cardiology · https://doi.org/10.1001/jamacardio.2015.0374 · https://hartvaat.nl/2016/04/01/orale-antistolling-bij-atriumfibrilleren-over-het-spectrum-van-beroerterisico-ga/* This GARFIELD-AF registry analysis revealed substantial underuse of anticoagulation in AF patients across the stroke risk spectrum, with many high-risk patients receiving no anticoagulation and many low-risk patients receiving unnecessary treatment. ## Prognostic Effect of the Nocturnal Blood Pressure Fall in Hypertensive Patients: The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) Meta-Analysis. *2016-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06981 · https://hartvaat.nl/2016/04/01/prognostisch-effect-van-nachtelijke-bloeddrukdaling-bij-hypertensie-de-abc-h-stu/* This multicenter study evaluated the prognostic significance of the nocturnal blood pressure fall pattern (dipping) using ambulatory monitoring, showing that non-dipping independently predicts cardiovascular events after adjusting for 24-hour blood pressure. ## Effects of Different Dietary Interventions on Blood Pressure: Systematic Review and Meta-Analysis of Randomized Controlled Trials. *2016-04-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06853 · https://hartvaat.nl/2016/04/01/effecten-van-dieetinterventies-op-bloeddruk-systematische-review-en-meta-analyse/* This comprehensive meta-analysis compared the blood pressure-lowering effects of different dietary interventions, including DASH, Mediterranean, low-sodium, and vegetarian diets, providing a comparative effectiveness framework for nutritional hypertension management. ## The effect of increasing inspired oxygen on exercise performance in patients with chronic heart failure. *2016-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308932 · https://hartvaat.nl/2016/04/01/effect-van-extra-zuurstof-op-inspanningsprestatie-bij-chronisch-hartfalen/* This study assessed the effects of increasing inspired oxygen on exercise performance in chronic heart failure patients, testing whether supplemental oxygen improves functional capacity beyond normoxic conditions. ## Safety and efficacy of ticagrelor and clopidogrel in primary percutaneous coronary intervention. *2016-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308963 · https://hartvaat.nl/2016/04/01/veiligheid-en-werkzaamheid-van-ticagrelor-versus-clopidogrel-bij-primaire-pci-vo/* This PLATO subanalysis in STEMI patients undergoing primary PCI confirmed that ticagrelor provides consistent benefits over clopidogrel in the acute MI setting, supporting its use as the preferred P2Y12 inhibitor during primary intervention. ## Biomarkers of inflammation and risk of cardiovascular events in anticoagulated patients with atrial fibrillation. *2016-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308887 · https://hartvaat.nl/2016/04/01/biomarkers-van-inflammatie-en-cardiovasculair-risico-bij-patienten-met-atriumfib/* This study evaluated the relationship between inflammatory biomarkers and cardiovascular events in anticoagulated AF patients, exploring whether inflammation identifies additional risk beyond traditional thromboembolism scores. ## Cardiovascular effects and safety of long-term colchicine treatment: Cochrane review and meta-analysis. *2016-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308542 · https://hartvaat.nl/2016/04/01/cardiovasculaire-effecten-en-veiligheid-van-langdurig-colchicinegebruik-cochrane/* This Cochrane review and meta-analysis of cardiovascular effects of long-term colchicine treatment found substantial reductions in cardiovascular events with an acceptable safety profile. The systematic evidence provided early support for colchicine as an anti-inflammatory cardiovascular therapy. ## Implications of ischaemic area at risk and mode of reperfusion in ST-elevation myocardial infarction. *2016-04-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308075 · https://hartvaat.nl/2016/04/01/ischemisch-risicogebied-en-reperfusiemethode-bij-stemi-klinische-implicaties/* This study examined the implications of ischemic area at risk and reperfusion mode in STEMI, comparing pharmacological and mechanical reperfusion strategies for patients presenting early after symptom onset. ## Outcomes of catheter ablation of atrial fibrillation in patients with hypertrophic cardiomyopathy: a systematic review and meta-analysis. *2016-04-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv339 · https://hartvaat.nl/2016/04/01/katheterablatie-bij-atriumfibrilleren-met-hypertrofische-cardiomyopathie-meta-an/* This systematic review and meta-analysis evaluated the outcomes of catheter ablation for AF in patients with hypertrophic cardiomyopathy, a condition with high AF prevalence and unique substrate characteristics. ## Drug-Eluting Versus Bare-Metal Stents During PCI in Patients With End-Stage Renal Disease on Dialysis. *2016-03-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.104 · https://hartvaat.nl/2016/03/29/drug-eluting-versus-bare-metal-stents-bij-pci-patienten-met-eindstadium-nierziek/* This study compared drug-eluting with bare-metal stents specifically in dialysis patients undergoing PCI, testing whether the benefit of DES extends to this high-risk population with accelerated in-stent disease. ## Acute Treatment With Omecamtiv Mecarbil to Increase Contractility in Acute Heart Failure: The ATOMIC-AHF Study. *2016-03-29 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.01.031 · https://hartvaat.nl/2016/03/29/omecamtiv-mecarbil-bij-acuut-hartfalen-de-atomic-ahf-studie/* The ATOMIC-AHF phase 2 study of omecamtiv mecarbil in acute heart failure demonstrated proof-of-concept for cardiac myosin activation as a treatment strategy, showing dose-dependent improvements in systolic function without adverse hemodynamic effects. ## Spontaneous MI After Non-ST-Segment Elevation Acute Coronary Syndrome Managed Without Revascularization: The TRILOGY ACS Trial. *2016-03-22 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2016.01.034 · https://hartvaat.nl/2016/03/22/spontaan-myocardinfarct-na-nstemi-zonder-revascularisatie-trilogy-acs-trial/* This TRILOGY ACS analysis characterized the incidence and impact of spontaneous recurrent MI in conservatively managed ACS patients, quantifying the residual ischemic risk in the medical-management-only population. ## Incorporating a Genetic Risk Score Into Coronary Heart Disease Risk Estimates: Effect on Low-Density Lipoprotein Cholesterol Levels (the MI-GENES Clinical Trial). *2016-03-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.020109 · https://hartvaat.nl/2016/03/22/genetische-risicoscore-en-ldl-cholesterolbehandeling-bij-coronairlijden/* This study tested whether incorporating a genetic risk score for coronary heart disease into clinical risk assessment changes health behaviors or LDL cholesterol levels, exploring the behavioral impact of genomic risk information. ## Do Self-Management Interventions Work in Patients With Heart Failure? An Individual Patient Data Meta-Analysis. *2016-03-22 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.018006 · https://hartvaat.nl/2016/03/22/zelfmanagementinterventies-bij-hartfalen-individuele-patientdata-meta-analyse/* This individual patient data meta-analysis of self-management interventions in heart failure found modest but significant benefits on mortality and hospitalization, particularly for programs that included phone-based follow-up and individualized education. ## Cardiovascular outcomes at different on-treatment blood pressures in the hypertensive patients of the VALUE trial. *2016-03-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv633 · https://hartvaat.nl/2016/03/21/cardiovasculaire-uitkomsten-bij-verschillende-bereiktestreefdrukken-in-de-value-/* This VALUE trial analysis examined the relationship between achieved blood pressure levels and cardiovascular outcomes in high-risk hypertensive patients, informing the debate about optimal blood pressure targets and the potential existence of a J-curve. ## Calcium upregulation by percutaneous administration of gene therapy in patients with cardiac disease (CUPID 2): a randomised, multinational, double-blind, placebo-controlled, phase 2b trial. *2016-03-19 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(16)00082-9 · https://hartvaat.nl/2016/03/19/serca2a-gentherapie-bij-hartfalen-de-cupid-2-trial/* The CUPID 2 trial of intracoronary SERCA2a gene therapy in advanced heart failure showed no improvement in clinical outcomes, despite promising preclinical data. The negative result highlighted the challenges of cardiac gene therapy and the gap between laboratory and clinical benefit. ## Safer Prescribing--A Trial of Education, Informatics, and Financial Incentives. *2016-03-17 · The New England journal of medicine · https://doi.org/10.1056/NEJMsa1508955 · https://hartvaat.nl/2016/03/17/veiliger-voorschrijven-educatie-informatica-en-financiele-prikkels-in-de-eerstel/* This NEJM trial demonstrated that a combined intervention of education, clinical informatics, and financial incentives significantly reduced high-risk prescribing in primary care, providing a model for improving medication safety at the system level. ## Long-Term Results of Stenting versus Endarterectomy for Carotid-Artery Stenosis. *2016-03-17 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1505215 · https://hartvaat.nl/2016/03/17/langetermijnresultaten-van-stenting-versus-endarteriectomie-bij-carotisstenose/* Long-term CREST results showed no significant difference between carotid stenting and endarterectomy over 10 years of follow-up for the composite of stroke, MI, and death. The durability data supported both approaches as viable options for carotid revascularization. ## Predicting Persistent Left Ventricular Dysfunction Following Myocardial Infarction: The PREDICTS Study. *2016-03-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.12.042 · https://hartvaat.nl/2016/03/15/voorspelling-van-persisterende-lv-disfunctie-na-myocardinfarct-de-predicts-studi/* The PREDICTS study identified clinical and imaging predictors of persistent severe LV dysfunction after myocardial infarction, informing the timing and selection of patients for ICD implantation based on early post-MI assessment. ## Platelet Inhibition With Ticagrelor 60 mg Versus 90 mg Twice Daily in the PEGASUS-TIMI 54 Trial. *2016-03-15 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.12.062 · https://hartvaat.nl/2016/03/15/plaatjesremming-met-ticagrelor-60-mg-versus-90-mg-in-de-pegasus-timi-54-trial/* This PEGASUS-TIMI 54 pharmacodynamic analysis compared platelet inhibition with ticagrelor 60 mg versus 90 mg twice daily, showing that both doses achieve substantial P2Y12 receptor inhibition with a better bleeding profile at the lower dose. ## 2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. *2016-03-15 · Circulation · https://doi.org/10.1161/CIR.0000000000000336 · https://hartvaat.nl/2016/03/15/2015-acc-aha-scai-gerichte-update-primaire-pci-bij-stemi/* The 2015 ACC/AHA/SCAI focused update on primary PCI for STEMI updated recommendations on door-to-balloon time targets, radial access, mechanical thrombectomy, and antithrombotic adjunctive therapy during primary percutaneous coronary intervention. ## Invasive versus conservative strategy in patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris (After Eighty study): an open-label randomised controlled trial. *2016-03-12 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)01166-6 · https://hartvaat.nl/2016/03/12/invasieve-versus-conservatieve-strategie-bij-80-plussers-met-nstemi-gerandomisee/* This Lancet trial specifically targeted patients aged 80 and older with NSTEMI or unstable angina, comparing invasive versus conservative strategies. As one of the few randomized trials in the very elderly, it provided critical evidence for invasive management decisions in the oldest cardiac patients. ## Effect of Naltrexone-Bupropion on Major Adverse Cardiovascular Events in Overweight and Obese Patients With Cardiovascular Risk Factors: A Randomized Clinical Trial. *2016-03-08 · JAMA · https://doi.org/10.1001/jama.2016.1558 · https://hartvaat.nl/2016/03/08/naltrexon-bupropion-en-cardiovasculaire-events-bij-obesitas-gerandomiseerde-tria/* This JAMA cardiovascular safety trial of naltrexone-bupropion in overweight and obese patients showed no excess cardiovascular risk, though the trial was terminated early. The incomplete data contributed to ongoing uncertainty about the cardiovascular safety of weight-loss medications. ## Acute Limb Ischemia and Outcomes With Vorapaxar in Patients With Peripheral Artery Disease: Results From the Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in Patients With Atherosclerosis-Thrombolysis in Myocardial Infarction 50 (TRA2°P-TIMI 50). *2016-03-08 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.019355 · https://hartvaat.nl/2016/03/08/acute-ledischemie-en-vorapaxar-bij-perifeer-arterieel-vaatlijden-tra-2p-timi-50-/* This TRA 2°P-TIMI 50 analysis characterized the incidence and outcomes of acute limb ischemia in peripheral artery disease patients, evaluating whether vorapaxar (a PAR-1 antagonist) reduces this devastating complication. ## Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. *2016-03-05 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)01225-8 · https://hartvaat.nl/2016/03/05/bloeddrukverlaging-ter-preventie-van-hart-en-vaatziekten-systematische-review-en/* This comprehensive Lancet meta-analysis quantified the cardiovascular benefit of blood pressure lowering regardless of baseline blood pressure, showing proportional risk reduction per 10 mmHg decrease in systolic pressure. The findings support treating cardiovascular risk rather than blood pressure thresholds alone. ## Impact of CYP2C19 Metabolizer Status on Patients With ACS Treated With Prasugrel Versus Clopidogrel. *2016-03-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.12.036 · https://hartvaat.nl/2016/03/01/cyp2c19-metaboliseerdersstatus-en-uitkomsten-bij-acs-prasugrel-versus-clopidogre/* This study examined the impact of CYP2C19 metabolizer status on platelet reactivity and clinical outcomes in ACS patients treated with prasugrel versus clopidogrel, showing that prasugrel overcomes the genetic resistance that limits clopidogrel efficacy. ## Bioresorbable Coronary Scaffold Thrombosis: Multicenter Comprehensive Analysis of Clinical Presentation, Mechanisms, and Predictors. *2016-03-01 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.12.019 · https://hartvaat.nl/2016/03/01/bioresorbeerbare-scaffold-trombose-multicenteranalyse-van-klinische-presentatie-/* This multicenter analysis characterized the incidence, mechanisms, and predictors of bioresorbable vascular scaffold thrombosis, identifying key risk factors that contributed to the eventual withdrawal of first-generation bioresorbable devices. ## Patterns and Correlates of Baseline Thiazide-Type Diuretic Prescription in the Systolic Blood Pressure Intervention Trial. *2016-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06851 · https://hartvaat.nl/2016/03/01/voorschrijfpatronen-van-thiazidediuretica-in-de-sprint-trial/* This SPRINT analysis documented that thiazide-type diuretics, despite being recommended first-line agents, are underutilized in clinical practice, with prescribing patterns influenced by provider specialty and patient characteristics. ## Taurine Supplementation Lowers Blood Pressure and Improves Vascular Function in Prehypertension: Randomized, Double-Blind, Placebo-Controlled Study. *2016-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06624 · https://hartvaat.nl/2016/03/01/taurinesuppletie-verlaagt-bloeddruk-en-verbetert-vaatfunctie-bij-prehypertensie/* This randomized placebo-controlled trial showed that taurine supplementation lowers blood pressure and improves vascular function in individuals with prehypertension, providing the first clinical evidence for this amino acid as an antihypertensive. ## Effect of supplemental oxygen exposure on myocardial injury in ST-elevation myocardial infarction. *2016-03-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308636 · https://hartvaat.nl/2016/03/01/effect-van-aanvullende-zuurstoftoediening-op-myocardschade-bij-stemi/* This study showed that supplemental oxygen therapy may increase myocardial injury in patients with STEMI who are not hypoxemic, providing evidence for a dose-response relationship between oxygen exposure and troponin release in acute MI. ## Pharmacogenomic Genome-Wide Meta-Analysis of Blood Pressure Response to β-Blockers in Hypertensive African Americans. *2016-03-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06345 · https://hartvaat.nl/2016/03/01/farmacogenomische-meta-analyse-van-bloeddrukrespons-op-betablokkers-bij-afro-ame/* This pharmacogenomic GWAS of blood pressure response to beta-blockers in hypertensive African Americans identified genetic variants that may explain differential drug responsiveness across racial groups. ## The lung impedance monitoring in treatment of chronic heart failure (the LIMIT-CHF study). *2016-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv293 · https://hartvaat.nl/2016/03/01/intrathoracale-impedantiemonitoring-bij-chronisch-hartfalen-de-limit-chf-studie/* The LIMIT-CHF study evaluated intrathoracic impedance monitoring alerts from implantable devices for guiding empirical heart failure treatment, testing whether early congestion detection prevents hospitalizations. ## The impact of adjunctive complex fractionated atrial electrogram ablation and linear lesions on outcomes in persistent atrial fibrillation: a meta-analysis. *2016-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv351 · https://hartvaat.nl/2016/03/01/aanvullende-cfae-ablatie-en-lineaire-laesies-bij-persistend-atriumfibrilleren-me/* This meta-analysis showed that adding complex fractionated atrial electrogram ablation or linear lesions to pulmonary vein isolation in persistent AF does not consistently improve outcomes, questioning routine substrate modification strategies. ## First clinical trial of specific IKACh blocker shows no reduction in atrial fibrillation burden in patients with paroxysmal atrial fibrillation: pacemaker assessment of BMS 914392 in patients with paroxysmal atrial fibrillation. *2016-03-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv263 · https://hartvaat.nl/2016/03/01/eerste-trial-met-specifieke-ikach-blokker-toont-geen-reductie-in-af-last-bij-par/* This first clinical trial of BMS 914392, a selective IKACh channel blocker, in patients with pacemakers and paroxysmal AF showed no significant reduction in AF burden, a negative result for this ion channel target. ## Variables Measured During Cardiopulmonary Exercise Testing as Predictors of Mortality in Chronic Systolic Heart Failure. *2016-02-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.11.050 · https://hartvaat.nl/2016/02/23/inspanningstestvariabelen-als-mortaliteitsvoorspellers-bij-chronisch-systolisch-/* This study simultaneously evaluated multiple cardiopulmonary exercise test variables for predicting mortality in chronic systolic heart failure, identifying the most useful prognostic parameters beyond peak oxygen consumption alone. ## Safety and Efficacy of Everolimus- Versus Sirolimus-Eluting Stents: 5-Year Results From SORT OUT IV. *2016-02-23 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.11.051 · https://hartvaat.nl/2016/02/23/everolimus-versus-sirolimus-eluting-stents-5-jaarsresultaten-sort-out-iv/* Five-year SORT OUT IV results confirmed comparable long-term safety and efficacy between everolimus-eluting and sirolimus-eluting stents, supporting either contemporary DES platform for routine coronary intervention. ## Effects of Ticagrelor Versus Clopidogrel in Troponin-Negative Patients With Low-Risk ACS Undergoing Ad Hoc PCI. *2016-02-16 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.11.044 · https://hartvaat.nl/2016/02/16/ticagrelor-versus-clopidogrel-bij-troponine-negatieve-laagrisico-acs-met-ad-hoc-/* This pharmacodynamic study compared ticagrelor with clopidogrel in low-risk ACS patients undergoing ad-hoc PCI with negative troponins, evaluating antiplatelet efficacy in the lowest-acuity coronary intervention population. ## Body Mass Index, Abdominal Fatness, and Heart Failure Incidence and Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. *2016-02-16 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.016801 · https://hartvaat.nl/2016/02/16/bmi-abdominale-adipositas-en-hartfalen-systematische-review-en-dosis-responsmeta/* This systematic review and dose-response meta-analysis quantified the association between BMI, abdominal fatness, and heart failure incidence and mortality, establishing that both general and central obesity independently predict heart failure risk. ## Efficacy of Antiarrhythmic Drugs Short-Term Use After Catheter Ablation for Atrial Fibrillation (EAST-AF) trial. *2016-02-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehv501 · https://hartvaat.nl/2016/02/14/kortdurend-antiaritmica-na-katheterablatie-voor-atriumfibrilleren-east-af-trial/* The EAST-AF trial showed that 90 days of antiarrhythmic drug therapy after catheter ablation for AF did not reduce atrial arrhythmia recurrence at 1 year, questioning the routine use of short-term antiarrhythmic drugs in the post-ablation blanking period. ## Mobile Phone Text Messages to Support Treatment Adherence in Adults With High Blood Pressure (SMS-Text Adherence Support [StAR]): A Single-Blind, Randomized Trial. *2016-02-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.017530 · https://hartvaat.nl/2016/02/09/sms-berichten-ter-ondersteuning-van-therapietrouw-bij-hoge-bloeddruk-de-star-tri/* The StAR trial found that automated SMS text messages for treatment adherence support modestly improved blood pressure control in hypertensive patients, demonstrating the potential and limitations of simple mobile health interventions. ## Effect of Intensive Versus Usual Blood Pressure Control on Kidney Function Among Individuals With Prior Lacunar Stroke: A Post Hoc Analysis of the Secondary Prevention of Small Subcortical Strokes (SPS3) Randomized Trial. *2016-02-09 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.019657 · https://hartvaat.nl/2016/02/09/intensieve-versus-standaard-bloeddrukcontrole-en-nierfunctie-na-lacunair-herseni/* This SPS3 post-hoc analysis showed that intensive blood pressure lowering does not accelerate kidney function decline in patients with prior lacunar stroke and preserved eGFR, providing reassurance about renal safety of aggressive BP targets. ## A Comprehensive Lifestyle Peer Group-Based Intervention on Cardiovascular Risk Factors: The Randomized Controlled Fifty-Fifty Program. *2016-02-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.033 · https://hartvaat.nl/2016/02/09/peergroepinterventie-voor-cardiovasculaire-risicofactoren-de-fifty-fifty-trial/* This randomized trial demonstrated that a comprehensive lifestyle intervention incorporating peer support achieves significant improvements in cardiovascular risk factors, supporting group-based behavioral change programs for cardiovascular prevention. ## Generalizability of SPRINT Results to the U.S. Adult Population. *2016-02-09 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.037 · https://hartvaat.nl/2016/02/09/generaliseerbaarheid-van-sprint-resultaten-naar-de-algemene-bevolking/* This analysis assessed the generalizability of SPRINT results to the broader US adult hypertensive population, estimating how many Americans would be eligible for and potentially benefit from intensive blood pressure treatment. ## The impact of proprotein convertase subtilisin-kexin type 9 serine protease inhibitors on lipid levels and outcomes in patients with primary hypercholesterolaemia: a network meta-analysis. *2016-02-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehv563 · https://hartvaat.nl/2016/02/07/impact-van-pcsk9-remmers-op-lipidenniveaus-en-uitkomsten-netwerkmeta-analyse/* This network meta-analysis of PCSK9 inhibitor trials quantified the comparative lipid-lowering effects of evolocumab and alirocumab versus placebo and ezetimibe in primary hypercholesterolemia, establishing the magnitude of LDL reduction and early cardiovascular benefit signals. ## Everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting metallic stents: a meta-analysis of randomised controlled trials. *2016-02-06 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)00979-4 · https://hartvaat.nl/2016/02/06/bioresorbeerbare-versus-metallic-stents-meta-analyse-van-gerandomiseerde-trials/* This meta-analysis of randomized trials comparing bioresorbable scaffolds with metallic everolimus-eluting stents found similar short-term efficacy but raised early safety concerns about scaffold thrombosis that later led to market withdrawal. ## Kidney-Failure Risk Projection for the Living Kidney-Donor Candidate. *2016-02-04 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1510491 · https://hartvaat.nl/2016/02/04/risicoprojectie-voor-nierfalen-bij-levende-nierdonorkandidaten/* This NEJM study developed and validated a kidney-failure risk projection tool for living kidney donor candidates, enabling simultaneous assessment of multiple risk factors for end-stage renal disease. The tool supports evidence-based evaluation of donor candidacy beyond individual risk factor screening. ## Efficacy of Low-Dose Chlorthalidone and Hydrochlorothiazide as Assessed by 24-h Ambulatory Blood Pressure Monitoring. *2016-02-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.083 · https://hartvaat.nl/2016/02/02/vergelijking-chlorthalidon-en-hydrochloorthiazide-op-24-uurs-ambulante-bloeddruk/* This randomized study compared the 24-hour blood pressure-lowering efficacy of low-dose chlorthalidone versus hydrochlorothiazide using ambulatory monitoring, providing comparative pharmacodynamic data for the two most commonly used thiazide-type diuretics. ## Cyclosporine A in Reperfused Myocardial Infarction: The Multicenter, Controlled, Open-Label CYCLE Trial. *2016-02-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.081 · https://hartvaat.nl/2016/02/02/ciclosporine-a-bij-gereperfuseerd-myocardinfarct-de-multicenter-cycle-trial/* The CYCLE trial showed that cyclosporine A did not improve ST-segment resolution in patients with reperfused myocardial infarction, adding to the neutral evidence for mitochondrial permeability transition pore inhibition as a cardioprotective strategy. ## Reduction in Total Cardiovascular Events With Ezetimibe/Simvastatin Post-Acute Coronary Syndrome: The IMPROVE-IT Trial. *2016-02-02 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.077 · https://hartvaat.nl/2016/02/02/reductie-in-totale-cardiovasculaire-events-met-ezetimibe-simvastatine-na-acs-imp/* This IMPROVE-IT analysis demonstrated a significant reduction in total cardiovascular events with ezetimibe added to simvastatin versus simvastatin alone after acute coronary syndrome. The results strengthened the evidence that LDL cholesterol lowering beyond statin monotherapy provides incremental clinical benefit. ## Aerobic Interval Training Reduces the Burden of Atrial Fibrillation in the Short Term: A Randomized Trial. *2016-02-02 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.018220 · https://hartvaat.nl/2016/02/02/aerobe-intervaltraining-vermindert-de-last-van-atriumfibrilleren-gerandomiseerde/* This randomized trial showed that aerobic interval training significantly reduces AF burden in patients with atrial fibrillation, despite the paradoxical association between high-level endurance exercise and AF. The results support structured exercise as a therapeutic intervention for AF. ## Regional cardiac dysfunction and outcome in patients with left ventricular dysfunction, heart failure, or both after myocardial infarction. *2016-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv558 · https://hartvaat.nl/2016/02/01/regionale-hartdisfunctie-en-prognose-na-myocardinfarct-met-lv-disfunctie-of-hart/* This study showed that regional myocardial strain assessed by speckle tracking echocardiography provides incremental prognostic value beyond global LVEF and strain measures in patients with LV dysfunction and heart failure. ## Comparison of right ventricular septal pacing and right ventricular apical pacing in patients receiving cardiac resynchronization therapy defibrillators: the SEPTAL CRT Study. *2016-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv422 · https://hartvaat.nl/2016/02/01/rechterkamerseptumpacing-versus-apexpacing-bij-crt-defibrillator-gerandomiseerde/* This randomized study compared right ventricular septal with apical lead positioning in CRT patients, evaluating whether lead location optimization in the right ventricle improves resynchronization outcomes. ## Influence of ejection fraction on outcomes and efficacy of spironolactone in patients with heart failure with preserved ejection fraction. *2016-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv464 · https://hartvaat.nl/2016/02/01/invloed-van-ejectiefractie-op-uitkomsten-van-spironolacton-bij-hfpef/* This subanalysis explored spironolactone efficacy in HFpEF patients stratified by ejection fraction, finding that benefit may be concentrated in those with lower LVEF within the preserved range, informing the debate about MRA use in HFpEF. ## Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction. *2016-02-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv436 · https://hartvaat.nl/2016/02/01/peri-infarctpacing-ter-preventie-van-linkerkamerremodellering-na-groot-myocardin/* This randomized study of peri-infarct zone pacing in patients with large MI tested whether localized electrical stimulation prevents adverse LV remodeling, exploring a novel device-based approach to limit post-infarction heart failure. ## A SPRINT to the finish, or just the beginning? Implications of the SPRINT results for nephrologists. *2016-02-01 · Kidney international · https://doi.org/10.1016/j.kint.2015.12.024 · https://hartvaat.nl/2016/02/01/sprint-resultaten-en-implicaties-voor-de-nefrologie/* This analysis assessed the implications of SPRINT results for nephrology practice, discussing how intensive blood pressure control affects kidney outcomes and the balance of cardiovascular benefit versus renal risk in CKD patients. ## Role of Adding Spironolactone and Renal Denervation in True Resistant Hypertension: One-Year Outcomes of Randomized PRAGUE-15 Study. *2016-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06526 · https://hartvaat.nl/2016/02/01/spironolacton-versus-renale-denervatie-bij-therapieresistente-hypertensie-prague/* This randomized study compared renal denervation with spironolactone addition in patients with true resistant hypertension, providing the first head-to-head comparison of device-based versus pharmacological fourth-line antihypertensive strategies. ## Mineralocorticoid Receptor Activation Contributes to the Supine Hypertension of Autonomic Failure. *2016-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06617 · https://hartvaat.nl/2016/02/01/mineralocorticoidreceptoractivatie-draagt-bij-aan-supiene-hypertensie-bij-autono/* This study showed that mineralocorticoid receptor activation contributes to paradoxical supine hypertension in primary autonomic failure, identifying a therapeutic target for this challenging condition. ## Effects of β-Blockers With and Without Vasodilating Properties on Central Blood Pressure: Systematic Review and Meta-Analysis of Randomized Trials in Hypertension. *2016-02-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06467 · https://hartvaat.nl/2016/02/01/betablokkers-met-en-zonder-vasodilaterende-eigenschappen-en-centrale-bloeddruk-m/* This systematic review and meta-analysis showed that vasodilating beta-blockers (nebivolol, carvedilol) lower central blood pressure more effectively than traditional beta-blockers, suggesting differential vascular effects within the drug class. ## Niacin therapy and the risk of new-onset diabetes: a meta-analysis of randomised controlled trials. *2016-02-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-308055 · https://hartvaat.nl/2016/02/01/nicotinezuurtherapie-en-het-risico-op-diabetes-meta-analyse-van-gerandomiseerde-/* This meta-analysis confirmed that niacin therapy raises glucose levels and increases the risk of new-onset diabetes, a finding that contributed to the decline of niacin use for cardiovascular prevention. ## Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial. *2016-01-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)00723-0 · https://hartvaat.nl/2016/01/30/hemodynamische-telemonitoring-bij-chronisch-hartfalen-volledige-champion-resulta/* Complete follow-up results from the CHAMPION trial confirmed that pulmonary artery pressure-guided management sustained reductions in heart failure hospitalization over the full study period. The data strengthened the evidence for implantable hemodynamic monitoring in chronic heart failure. ## Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. *2016-01-30 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)00805-3 · https://hartvaat.nl/2016/01/30/intensieve-bloeddrukverlaging-en-cardiovasculaire-en-renale-uitkomsten-systemati/* This updated Lancet meta-analysis showed that intensive blood pressure lowering reduces cardiovascular events and mortality proportionally to the magnitude of blood pressure reduction, even at levels previously considered normal. The findings supported more aggressive targets than those endorsed by contemporary guidelines. ## Two-Year Outcomes of Surgical Treatment of Severe Ischemic Mitral Regurgitation. *2016-01-28 · The New England journal of medicine · https://doi.org/10.1056/NEJMoa1512913 · https://hartvaat.nl/2016/01/28/mitralisklepchirurgie-bij-ernstige-ischemische-mitralisklepinsufficientie-2-jaar/* This NEJM trial found that at 2 years, mitral valve replacement was associated with better outcomes than repair in patients with severe ischemic mitral regurgitation, driven by a high rate of recurrent MR after repair. The results challenged the repair-first dogma in functional mitral regurgitation. ## Effects of P-Selectin Antagonist Inclacumab in Patients Undergoing Coronary Artery Bypass Graft Surgery: SELECT-CABG Trial. *2016-01-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.071 · https://hartvaat.nl/2016/01/26/p-selectine-antagonist-inclacumab-bij-coronaire-bypasschirurgie-select-cabg-tria/* The SELECT-CABG trial tested inclacumab, a P-selectin antagonist, for reducing perioperative myocardial injury during CABG, exploring anti-adhesion molecule therapy for surgical cardioprotection. ## Relative Wall Thickness and the Risk for Ventricular Tachyarrhythmias in Patients With Left Ventricular Dysfunction. *2016-01-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.076 · https://hartvaat.nl/2016/01/26/relatieve-wanddikte-en-risico-op-ventriculaire-tachyaritmieen-bij-linkerkamerdis/* This study showed that relative wall thickness, a measure of left ventricular geometry, predicts ventricular tachyarrhythmias in patients with LV dysfunction, potentially improving risk stratification for ICD therapy. ## Prognostic Implications of Long-Chain Acylcarnitines in Heart Failure and Reversibility With Mechanical Circulatory Support. *2016-01-26 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.079 · https://hartvaat.nl/2016/01/26/langketen-acylcarnitines-bij-hartfalen-prognostische-waarde-en-reversibiliteit-m/* This study showed that long-chain acylcarnitines in heart failure have prognostic value and are partially reversible with mechanical circulatory support, linking metabolic perturbations to disease severity and therapeutic response. ## Polypharmacy and the Efficacy and Safety of Rivaroxaban Versus Warfarin in the Prevention of Stroke in Patients With Nonvalvular Atrial Fibrillation. *2016-01-26 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.018544 · https://hartvaat.nl/2016/01/26/polyfarmacie-en-werkzaamheid-van-rivaroxaban-versus-warfarine-bij-atriumfibrille/* This ROCKET AF analysis showed that polypharmacy does not significantly modify the relative efficacy and safety of rivaroxaban versus warfarin in AF, supporting DOAC use regardless of the number of concomitant medications. ## Effect of the REG1 anticoagulation system versus bivalirudin on outcomes after percutaneous coronary intervention (REGULATE-PCI): a randomised clinical trial. *2016-01-23 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)00515-2 · https://hartvaat.nl/2016/01/23/reg1-anticoagulatiesysteem-versus-bivalirudine-bij-pci-de-regulate-pci-trial/* This randomized trial evaluated the REG1 anticoagulation system, a novel RNA aptamer-based factor IXa inhibitor with its reversal agent, versus bivalirudin during PCI, testing a fundamentally new anticoagulation mechanism. ## Clinical outcomes in patients with ST-segment elevation myocardial infarction treated with everolimus-eluting stents versus bare-metal stents (EXAMINATION): 5-year results of a randomised trial. *2016-01-23 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)00548-6 · https://hartvaat.nl/2016/01/23/everolimus-eluting-stent-versus-bare-metal-stent-bij-stemi-5-jaarsresultaten-exa/* Long-term results from the EXAMINATION trial showed that everolimus-eluting stents provide durable clinical benefit compared with bare-metal stents in patients with STEMI, supporting universal drug-eluting stent use in primary PCI. ## Ascertainment, classification, and impact of neoplasm detection during prolonged treatment with dual antiplatelet therapy with prasugrel vs. clopidogrel following acute coronary syndrome. *2016-01-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv611 · https://hartvaat.nl/2016/01/21/neoplasiedetectie-bij-langdurige-dapt-met-prasugrel-versus-clopidogrel-triton-ti/* This TRITON-TIMI 38 analysis evaluated neoplasm detection during prolonged DAPT for ACS, finding no significant increase in cancer incidence with prasugrel compared with clopidogrel, addressing an early safety concern. ## Causes of late mortality with dual antiplatelet therapy after coronary stents. *2016-01-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv614 · https://hartvaat.nl/2016/01/21/doodsoorzaken-bij-langdurige-dapt-na-coronaire-stents/* This DAPT study analysis examined specific causes of late mortality in patients receiving prolonged thienopyridine after drug-eluting stents, identifying the mechanisms underlying the all-cause mortality signal with extended dual antiplatelet therapy. ## Efficacy and safety of ticagrelor for long-term secondary prevention of atherothrombotic events in relation to renal function: insights from the PEGASUS-TIMI 54 trial. *2016-01-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv482 · https://hartvaat.nl/2016/01/21/ticagrelor-bij-nierfunctiestoornissen-langetermijnpreventie-na-myocardinfarct-pe/* This PEGASUS-TIMI 54 analysis examined the interaction between renal function and the efficacy of long-term ticagrelor therapy, showing consistent benefit across kidney function categories with an expected increase in bleeding at lower eGFR. ## Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial. *2016-01-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv481 · https://hartvaat.nl/2016/01/21/stoppen-of-doorgaan-met-clopidogrel-12-maanden-na-drug-eluting-stent-optidual-tr/* The OPTIDUAL randomized trial investigated whether continuing clopidogrel beyond 12 months after drug-eluting stent placement is superior to stopping it. The open-label study contributed to the ongoing debate about optimal DAPT duration. ## Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials. *2016-01-21 · European heart journal · https://doi.org/10.1093/eurheartj/ehv443 · https://hartvaat.nl/2016/01/21/langdurige-duale-antiplaatjestherapie-bij-patienten-met-eerder-myocardinfarct-me/* This meta-analysis examined prolonged dual antiplatelet therapy in patients with prior MI, showing that extended DAPT provides particular benefit in this high-risk subgroup by reducing recurrent ischemic events at the cost of increased bleeding. ## Efficacy and Safety of Cangrelor in Women Versus Men During Percutaneous Coronary Intervention: Insights From the Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION PHOENIX) Trial. *2016-01-19 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.017300 · https://hartvaat.nl/2016/01/19/werkzaamheid-en-veiligheid-van-cangrelor-bij-vrouwen-versus-mannen-tijdens-pci-c/* This CHAMPION trials subgroup analysis showed that cangrelor provides similar efficacy and safety in women and men during PCI, confirming sex-neutral benefit of this intravenous antiplatelet agent. ## Morphine delays and attenuates ticagrelor exposure and action in patients with myocardial infarction: the randomized, double-blind, placebo-controlled IMPRESSION trial. *2016-01-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehv547 · https://hartvaat.nl/2016/01/14/morfine-vertraagt-en-vermindert-de-werking-van-ticagrelor-bij-myocardinfarct-de-/* This randomized placebo-controlled trial demonstrated that intravenous morphine delays and attenuates ticagrelor exposure and antiplatelet effect in patients with myocardial infarction, highlighting a clinically important drug-drug interaction during acute ACS management. ## A randomized double-blind control study of early intra-coronary autologous bone marrow cell infusion in acute myocardial infarction: the REGENERATE-AMI clinical trial†. *2016-01-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehv493 · https://hartvaat.nl/2016/01/14/intracoronaire-beenmergcelinfusie-bij-acuut-myocardinfarct-de-regenerate-ami-tri/* This double-blind randomized study of early intracoronary bone marrow cell infusion after acute MI found no significant improvement in left ventricular function, contributing to the growing neutral evidence for stem cell therapy in acute cardiac disease. ## Everolimus-eluting bioresorbable stent vs. durable polymer everolimus-eluting metallic stent in patients with ST-segment elevation myocardial infarction: results of the randomized ABSORB ST-segment elevation myocardial infarction-TROFI II trial. *2016-01-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehv500 · https://hartvaat.nl/2016/01/14/bioresorbeerbare-versus-metallic-everolimus-eluting-stent-bij-stemi-gerandomisee/* This randomized study compared the bioresorbable Absorb scaffold with metallic everolimus-eluting stents specifically in STEMI patients, testing the first-generation bioresorbable technology in the thrombotic acute MI setting. ## 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). *2016-01-14 · European heart journal · https://doi.org/10.1093/eurheartj/ehv320 · https://hartvaat.nl/2016/01/14/2015-esc-richtlijn-voor-acute-coronaire-syndromen-zonder-persisterende-st-elevat/* The 2015 ESC guidelines for NSTEMI and unstable angina pectoris updated risk stratification tools, the timing of invasive management, and antithrombotic strategies. The document provided structured pathways for diagnosis, early risk assessment, and treatment selection based on individual patient risk profiles. ## Outcomes after thrombus aspiration for ST elevation myocardial infarction: 1-year follow-up of the prospective randomised TOTAL trial. *2016-01-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)00448-1 · https://hartvaat.nl/2016/01/09/trombusaspiratie-bij-stemi-1-jaarsfollow-up-van-de-total-trial/* One-year follow-up of the largest randomized thrombus aspiration trial in STEMI showed no benefit on clinical outcomes, consistent with the neutral primary results. The extended data helped resolve the debate about long-term effects of routine thrombectomy during primary PCI. ## Ranolazine in patients with incomplete revascularisation after percutaneous coronary intervention (RIVER-PCI): a multicentre, randomised, double-blind, placebo-controlled trial. *2016-01-09 · Lancet (London, England) · https://doi.org/10.1016/S0140-6736(15)00459-6 · https://hartvaat.nl/2016/01/09/ranolazine-bij-incomplete-revascularisatie-na-pci-de-river-pci-trial/* The RIVER-PCI trial showed that ranolazine did not improve outcomes in patients with incomplete revascularization after PCI, a common clinical scenario associated with increased mortality and recurrent ischemia. ## Association between pre-operative statin use and major cardiovascular complications among patients undergoing non-cardiac surgery: the VISION study. *2016-01-07 · European heart journal · https://doi.org/10.1093/eurheartj/ehv456 · https://hartvaat.nl/2016/01/07/preoperatief-statinegebruik-en-cardiovasculaire-complicaties-bij-niet-cardiale-c/* This international prospective cohort study examined the association between preoperative statin use and major cardiovascular complications within 30 days of non-cardiac surgery, informing perioperative medication management. ## Causes of Death Following PCI Versus CABG in Complex CAD: 5-Year Follow-Up of SYNTAX. *2016-01-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.043 · https://hartvaat.nl/2016/01/05/doodsoorzaken-na-pci-versus-cabg-bij-complex-coronairlijden-5-jaarsfollow-up-van/* This first analysis of specific causes of death from a randomized PCI versus CABG trial showed that the 5-year mortality difference in complex coronary disease was driven by a higher rate of cardiac death with PCI. The SYNTAX data informed subsequent revascularization decision-making based on anatomical complexity. ## Coronary CT Angiography for Suspected ACS in the Era of High-Sensitivity Troponins: Randomized Multicenter Study. *2016-01-05 · Journal of the American College of Cardiology · https://doi.org/10.1016/j.jacc.2015.10.045 · https://hartvaat.nl/2016/01/05/ct-coronairangiografie-bij-verdenking-acs-in-het-tijdperk-van-hoog-sensitief-tro/* This randomized multicenter study evaluated whether early coronary CT angiography improves outcomes compared with contemporary standard care in patients with suspected acute coronary syndrome in the era of high-sensitivity troponin assays. ## Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. *2016-01-05 · JAMA · https://doi.org/10.1001/jama.2015.17346 · https://hartvaat.nl/2016/01/05/calorierestrictie-of-aerobe-training-bij-obese-ouderen-met-hfpef-effect-op-vo2-p/* This JAMA trial compared caloric restriction with aerobic exercise training for improving peak oxygen consumption and quality of life in obese older patients with HFpEF. The study provided early evidence that targeted weight management and exercise can improve the functional capacity of obesity-related heart failure. ## Effects of Ranolazine on Angina and Quality of Life After Percutaneous Coronary Intervention With Incomplete Revascularization: Results From the Ranolazine for Incomplete Vessel Revascularization (RIVER-PCI) Trial. *2016-01-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.019768 · https://hartvaat.nl/2016/01/05/ranolazine-bij-angina-en-kwaliteit-van-leven-na-pci-met-incomplete-revascularisa/* This RIVER-PCI post-hoc analysis found that ranolazine does not significantly improve angina or quality of life in patients with incomplete revascularization after PCI, a negative result for this anti-ischemic agent. ## Varenicline for Smoking Cessation in Hospitalized Patients With Acute Coronary Syndrome. *2016-01-05 · Circulation · https://doi.org/10.1161/CIRCULATIONAHA.115.019634 · https://hartvaat.nl/2016/01/05/varenicline-voor-stoppen-met-roken-bij-patienten-opgenomen-met-acuut-coronair-sy/* This multicenter randomized trial showed that varenicline initiated during hospitalization for ACS significantly improves smoking cessation rates at 6 months, demonstrating the effectiveness of in-hospital smoking intervention. ## Association of persistent or worsened echocardiographic dyssynchrony with unfavourable clinical outcomes in heart failure patients with narrow QRS width: a subgroup analysis of the EchoCRT trial. *2016-01-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv418 · https://hartvaat.nl/2016/01/01/persisterende-echocardiografische-dyssynchronie-voorspelt-ongunstige-uitkomsten-/* This EchoCRT analysis showed that persistent or worsened echocardiographic dyssynchrony in heart failure patients with narrow QRS is associated with unfavorable outcomes, exploring the mechanistic basis of the trial's negative result. ## 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). *2016-01-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv317 · https://hartvaat.nl/2016/01/01/2015-esc-ers-richtlijn-voor-diagnostiek-en-behandeling-van-pulmonale-hypertensie/* The 2015 ESC/ERS guidelines for pulmonary hypertension established a comprehensive framework for classification, diagnosis, and treatment of all forms of pulmonary hypertension. The document defined hemodynamic criteria, diagnostic pathways, and evidence-based treatment algorithms including combination therapy. ## Exercise training improves peak oxygen consumption and haemodynamics in patients with severe pulmonary arterial hypertension and inoperable chronic thrombo-embolic pulmonary hypertension: a prospective, randomized, controlled trial. *2016-01-01 · European heart journal · https://doi.org/10.1093/eurheartj/ehv337 · https://hartvaat.nl/2016/01/01/inspanningstraining-verbetert-zuurstofopname-en-hemodynamiek-bij-ernstige-pulmon/* This prospective randomized study was the first to invasively assess the effects of exercise training on right heart hemodynamics and pulmonary circulation in patients with severe pulmonary arterial hypertension, demonstrating improvements in peak oxygen consumption and cardiac output. ## Association of Central Versus Brachial Blood Pressure With Target-Organ Damage: Systematic Review and Meta-Analysis. *2016-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06066 · https://hartvaat.nl/2016/01/01/centrale-versus-perifere-bloeddruk-en-doelorgaanschade-systematische-review-en-m/* This systematic review and meta-analysis compared the association of central versus brachial blood pressure with preclinical target organ damage, providing evidence that central pressure may be a more accurate marker of hemodynamic stress on vital organs. ## Achieved Blood Pressure and Outcomes in the Secondary Prevention of Small Subcortical Strokes Trial. *2016-01-01 · Hypertension (Dallas, Tex. : 1979) · https://doi.org/10.1161/HYPERTENSIONAHA.115.06480 · https://hartvaat.nl/2016/01/01/bereikte-bloeddruk-en-uitkomsten-in-de-sps3-trial-bij-lacunaire-herseninfarcten/* This SPS3 trial analysis examined the relationship between achieved systolic blood pressure and cardiovascular outcomes in patients with small subcortical strokes, exploring the J-curve phenomenon in secondary stroke prevention. ## Adding point of care ultrasound to assess volume status in heart failure patients in a nurse-led outpatient clinic. A randomised study. *2016-01-01 · Heart (British Cardiac Society) · https://doi.org/10.1136/heartjnl-2015-307798 · https://hartvaat.nl/2016/01/01/point-of-care-echografie-voor-volumebeoordeling-bij-hartfalen-in-een-verpleegkun/* This randomized study showed that adding point-of-care ultrasound (pleural effusion, IVC assessment) by specialized nurses to routine heart failure outpatient care improves volume status assessment beyond standard clinical evaluation. ## Intrathoracic pressure swings induced by simulated obstructive sleep apnoea promote arrhythmias in paroxysmal atrial fibrillation. *2016-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euv122 · https://hartvaat.nl/2016/01/01/gesimuleerde-obstructieve-slaapapneu-bevordert-ritmestoornissen-bij-paroxysmaal-/* This interventional crossover study simulated obstructive sleep apnea-induced intrathoracic pressure swings during AF catheter ablation, demonstrating that OSA-like mechanical stress can directly trigger arrhythmias in susceptible atria. ## Catheter ablation restores decreased plasma miR-409-3p and miR-432 in atrial fibrillation patients. *2016-01-01 · Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · https://doi.org/10.1093/europace/euu366 · https://hartvaat.nl/2016/01/01/katheterablatie-herstelt-verlaagde-plasma-mir-409-3p-en-mir-432-bij-atriumfibril/* This study identified specific plasma microRNA expression changes in atrial fibrillation patients before and after catheter ablation. Ablation restored decreased miR-409-3p and miR-432 levels, offering potential biomarkers for monitoring therapeutic response.