In older patients with acute coronary syndromes (ACS), frailty predicts adverse outcomes, but whether radial access retains its lower complication rate in patients with frailty is unknown. We examined outcomes by access site and frailty status and whether frailty modified the association between access site and outcomes. We retrospectively studied 227 consecutive patients aged ≥ 70 years, irrespective of frailty status, who underwent percutaneous coronary intervention for ACS at a single center between January 2014 and June 2016. Frailty was screened at admission with the Dutch safety management system (Veiligheidsmanagementsysteem [VMS]) frailty instrument (frailty: VMS score ≥ 1). Primary endpoints were 1-year all-cause mortality and a 30-day composite outcome of death, vascular complications, bleeding, re-infarction and stroke. Effect modification was tested with interaction terms. Access was femoral in 122 (53.7
Cardiac troponin is recognized as a strong predictor of mortality in patients with acute heart failure (AHF). The aim of this study was to evaluate the prognostic impact of high-sensitivity cardiac troponin I (hs-cTnI) on mortality risk in patients with AHF in relation to inflammatory, congestion, and renal indices. We enrolled 431 patients (79 ± 10 years, 51
Older patients often present with complex coronary artery disease alongside multiple comorbidities. There is limited data on the outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in octogenarians. We aim to investigate the in-hospital and 1-year outcomes following successful CTO-PCI in octogenarians. Consecutive patients who had successful CTO-PCI at a single center between 01.2017 and 12.2022 were divided into two groups: octogenarians (age ≥ 80 and < 90 years, n = 123) and a control group (age < 80 years, n = 612). Periprocedural complications, in-hospital major adverse cardiac and cerebrovascular events (MACCE), and 1-year target lesion failure (TLF) were investigated. Octogenarians had a higher prevalence of arterial hypertension (96.7
Previous studies have demonstrated the efficacy and safety of mavacamten in patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM), primarily outside of Canada, with limited Canadian real-world data evidence. The MAVEN study aimed to describe the real-world effectiveness of mavacamten in Canadian patients with oHCM. This multi-center, retrospective physician survey of patient charts included 115 patients with oHCM who initiated mavacamten between January 2023 and November 2024 across five Canadian sites. Effectiveness was assessed by changes in clinical characteristics and outcomes, including New York Heart Association (NYHA) functional class, resting and Valsalva left ventricular outflow tract (rLVOT and vLVOT, respectively) gradients, and left ventricular ejection fraction (LVEF), from treatment initiation to the most recent available assessment. Baseline demographic and clinical characteristics were consistent with previously published data (median age 63.0 years; 66.1
Patients with heart failure (HF) with reduced ejection fraction (HFrEF) remain at high risk of cardiovascular (CV) death and hospitalization following a worsening heart-failure event. Data on vericiguat, a prescription oral medication used to treat symptomatic chronic HF, in adult Indian patients are limited. Adults with chronic HFrEF and a worsening heart-failure event were enrolled in a prospective, multicenter, open-label, single-arm phase IV study design. Participants received vericiguat in addition to foundational medical therapy (FMT) and were followed for approximately 48 weeks. The primary endpoint was CV death or first hospitalization for HF. Secondary endpoints included CV death, first hospitalization for HF, all-cause death or first hospitalization for HF, all-cause death and safety outcomes. Of 231 patients who underwent screening, 205 received vericiguat and comprised the safety analysis set; of these, 203 patients constituted the full analysis set. The mean age of participants was 58 years. Baseline use of angiotensin receptor–neprilysin inhibitors and sodium–glucose cotransporter-2 inhibitors was 52.7
