JACC Associate Editor Theresa McDonagh, MBBCH  speaks with author Akshay S. Desai, MD, FACC about this paper on pulse pressure published in JACC and presented at AHA. In a pooled analysis of 16,950 patients with chronic HFmrEF or HFpEF enrolled from 4 global randomized clinical trials, a J-shaped relationship was observed between SBP and the risk of adverse CV events, with the lowest risk occurring at SBP values between 120 and 130 mmHg. A similar pattern was seen with PP, with the lowest risk found between 50 and 60 mmHg. Both higher SBP and higher PP independently predicted adverse CV events. Notably, PP remained a strong predictor of CV risk, independent of baseline SBP.

Join Dr. Harlan Krumholz and Dr. Milton Packer as they discuss the groundbreaking SUMMIT trial, a study poised to redefine treatment for heart failure with preserved ejection fraction (HFpEF) linked to obesity. Dive into the trial's unique methodology, compelling results, and transformative implications for patient care.

Harlan Krumholz, editor-in-chief of JACC, provides a wrap-up of the JACC papers at the AHA Scientific Sessions in Chicago in 2024. JACC's Obesity Revolution page features various trials to provide perspectives on obesity, including SUMMIT, LookAHEAD, and SELECT. Other studies featured include the DANGER trial; REALIZE-K; AMPLATZER; HELIOS-B; a study on sedentary behaviors from the UK Biobank; systolic pressure and blood pressure in patients with HFpEF; rural and urban differences in cardiovascular mortality from 2010-2022; and the association of hospital cardiologist integration with patient outcomes

JACC Associate Editor Michelle M. Kittleson, MD, PhD, FACC, interviews author Mikhail Kosiborod, MD, FACC about his REALIZE-K study published in JACC and presented at AHA. In participants with HFrEF and hyperkalemia, SZC led to large improvements in the percentage of participants with normokalemia while on optimal spironolactone dose, and reduced risk of hyperkalemia and down-titration/discontinuation of spironolactone. More participants had HF events with SZC than placebo; this difference was limited to those with very high NTproBNP levels.

JACC Associate Editor Marc P. Bonaca, MD, FACC, speaks with author Subodh Verma, MD, PhD, and A. Michael A. Lincoff, MD, FACC, about this brief report published in JACC and presented at AHA. Following CABG surgery there remains a markedly high risk of persistent ischemic events, heart failure, and mortality. Semaglutide consistently reduced all cardiovascular outcomes in this population.

JACC Associate Editor Neha J. Pagidipati, MD, FACC, speaks with author Christopher M. Kramer, MD, FACC about this substudy of the SUMMIT trial published in JACC and presented at AHA, demonstrating that tirzepatide therapy in obesity-related HFpEF led to reduced LV mass and paracardiac adipose tissue as compared to placebo and the change in LV mass paralleled weight loss. These physiologic changes may contribute to the reduction in heart failure events seen in the main SUMMIT trial.

JACC: Associate Editor Michelle M. Kittleson, MD, PhD, FACC, talks with authors Scott Solomon, MD, FACC and. Marianna Fontana, MD, about their study published in JACC and presented at AHA. Outpatient worsening heart failure (HF) (oral diuretic intensification or initiation) is simple to assess and has been shown to be prognostic of mortality in patients with ATTR-CM. In this pre-specified analysis of a contemporary ATTR-CM population, patients with outpatient worsening HF had an increased risk of all-cause mortality and CV events and all-cause mortality, as well as greater deterioration in assessments of functional capacity, health status, and quality of life. Vutrisiran significantly reduced the risk of outpatient worsening HF and the composite of outpatient worsening HF, all-cause mortality, and recurrent CV events compared with placebo.

JACC Deputy Editor Erica S. Spatz, MD, FACC, joins author Rishi Wadhera, MD, to discuss his paper on rural and urban differences in cardiovascular mortality in the United States, and the impact of the COVID-19 pandemic.

JACC Associate Editor Muthiah Vaduganathan, MD speaks with author Ambarish Pandey, MD about the LookAHEAD trial published in JACC and presented at AHA. Among adults with T2D and overweight/obesity in the Look Action for Health in Diabetes (AHEAD) trial, an intensive lifestyle intervention targeting weight loss led to sustained reductions in hs-cTnT at 1- and 4-year follow-up, and a rise in NT-proBNP at 1 year that attenuated at 4 years. After accounting for baseline biomarker levels and baseline and changes in risk factors, longitudinal increase in NT-proBNP was associated with higher risk of ASCVD and incident HF. In contrast, increase in hs-cTnT was significantly associated with ASCVD but not incident HF.

JACC: Associate Editor Celina Yong, MD, interviews author Jacob Eifer Møller, PhD about his DANGER SHOCK paper presented at AHA and published in JACC. The DanGer Shock trial demonstrated reduced mortality in patients with STEMI-related cardiogenic shock treated with a microaxial flow pump (mAFP). This secondary analysis assessed whether age affected survival benefits. Mortality increased incrementally with age, and age was independently associated with outcome. Spline analysis suggested that the risk of mortality was higher in the standard-care group for patients below 77 years, whereas patients aged 77 or older had a higher predicted risk in the mAFP group. Thus, elderly patients may not attain the same benefit from routine treatment with a mAFP as younger patients.

JACC Associate Editor Marc P. Bonaca, MD, FACC, has a discussion with author Sotirios Tsimikas, MD, FACC about this study on phospholipids presented at AHA and published in JACC. In MESA, both OxPL-apoB and Lp(a) were independently associated with prevalent AVC with a significant interaction between the two (p less than 0.01). OxPL-apoB and Lp(a) were associated with incident AVC at 9.5 years when evaluated independently (interaction p less than 0.01). The OxPL-apoB*Lp(a) interaction demonstrated higher odds of prevalent and incident AVC for OxPL-apoB with increasing Lp(a) levels. In the meta-analysis, both OxPL-apoB and Lp(a) were independently associated with faster increase in Vmax, but when evaluated together, only OxPL-apoB remained significant. OxPL-apoB is an independent predictor of the presence, incidence and progression of AVC and established AS and represents a novel therapeutic target for CAVD.