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
Mechanical circulatory support (MCS) is increasingly used in patients with cardiogenic shock, advanced heart failure, and severe respiratory failure; however, anticoagulation management remains challenging due to the competing risks of thrombosis, bleeding, hemolysis, and device dysfunction. In this review, we synthesize contemporary evidence on anticoagulant selection, monitoring strategies, and device-specific management across major MCS platforms, including extracorporeal membrane oxygenation, temporary ventricular assist devices, Impella devices, and durable left ventricular assist devices. Unfractionated heparin remains the cornerstone anticoagulant across most MCS platforms, while anti-factor Xa-guided monitoring is increasingly incorporated into clinical practice in many centers alongside activated partial thromboplastin time and other monitoring modalities. Direct thrombin inhibitors represent important alternatives, particularly for patients with heparin-induced thrombocytopenia or heparin resistance. Recent advances include bicarbonate-based purge strategies for Impella support and evolving antithrombotic approaches in HeartMate 3 recipients, introduced by the ARIES-HM3 trial. Emerging investigational strategies, including direct oral anticoagulants, factor XI/XII inhibition, and precision anticoagulation approaches, show promise for improving hemocompatibility; however, current evidence remains limited, and further prospective studies are required before these strategies can be routinely adopted. Overall, contemporary evidence supports an individualized approach to anticoagulation based on device characteristics, patient-specific risk profiles, and current guideline recommendations, while highlighting important knowledge gaps that warrant further high-quality prospective investigation.
Caregivers of children with tetralogy of Fallot (TOF) frequently seek medical information online to better understand their child’s diagnosis, treatment, and long-term care. Recently, generative artificial intelligence (AI) tools, including Google AI Overview and ChatGPT, have emerged as widely accessible sources of health information. However, the quality, readability, and accuracy of these platforms for caregiver education in congenital heart disease remain poorly characterized. Forty frequently asked caregiver questions regarding TOF were identified using Google’s “People Also Ask” feature. Each question was submitted to ChatGPT-5.5 and entered as a Google search query, generating 80 total responses. Google search output comprised 37 AI Overviews and three organic search excerpts. Responses were evaluated for word count, Flesch Reading Ease (FRE), and Flesch–Kincaid grade level (FKGL). Two independent reviewers assessed response accuracy using a 5-point Likert scale, while one reviewer evaluated educational quality using a modified Ensuring Quality Information for Patients (EQIP) instrument. Compared with Google search output (37 AI Overviews and three organic search excerpts), ChatGPT-5.5 generated significantly longer responses (327.9 ± 117.0 vs. 192.5 ± 85.9 words, p < 0.001), with a higher reading level (FKGL: 23.7 ± 8.5 vs. 15.4 ± 3.6, p < 0.001) and lower readability (FRE: 17.3 ± 14.9 vs. 27.4 ± 11.7, p < 0.001). ChatGPT-5.5 demonstrated higher reviewer-rated accuracy (4.95 ± 0.19 vs. 4.40 ± 0.44, p < 0.001) and higher modified EQIP scores (86.44
