The American Heart Association Scientific Sessions 2019

The annual meeting of the American Heart Association was held from Nov. 16 to 18 in Philadelphia and attracted more than 20,000 participants from around the world, including cardiovascular specialists, surgeons, nurses, and other health care professionals. The conference featured presentations focusing on the latest advances in cardiovascular medicine and surgery.

In one study, Khadijah Breathett, M.D., of the University of Arizona Sarver Heart Center in Tucson, and colleagues found that racial bias influences the allocation of advanced therapies in heart failure patients.

“In a national study of over 400 health care professionals, social support and adherence were the most important factors contributing to the allocation of advanced heart therapies. These factors were subjectively rather than objectively assessed, as is the case in most institutions,” Breathett said. “When considering an African-American male patient and white male patient with identical clinical and social histories, health care professionals had greater concerns with the African-American patient than the white patient. They felt that the African-American patient was sicker, less likely to adhere to medical recommendations, and less trustworthy.”

According to Breathett, there is an opportunity for reform by investigating whether objective assessments of social support and adherence contribute to equity in the allocation process. Increasing objectivity in advanced heart therapy allocation may lead to health equity.

“Racial bias contributes to inequalities in health care. Racial bias can prevent patients from getting care that is most appropriate for them,” Breathett said. “In this study, racial bias impacted whether or not a heart transplant or ventricular assist device was recommended as treatment for a patient. In order to achieve health equity, our health care system must prioritize reducing bias in clinical decision making.”

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In another study, Nour Makarem, Ph.D., of the Columbia University Vagelos College of Physicians and Surgeons in New York City, and colleagues found that each 1 percent increase in calories after 6 p.m. is associated with poorer overall cardiovascular health and with higher body mass index (BMI), blood pressure, and hemoglobin A1c in women.

The investigators also found that a higher percent of daily calories consumed after 8 p.m. is associated with poorer overall cardiovascular health and with higher BMI and blood pressure.

“This research demonstrates that earlier timing and lower percent calories consumed at evening meals are associated with more favorable cardiovascular health, and may represent a modifiable strategy to lower cardiovascular disease risk,” Makarem said. “However, this research is foundational, and our results warrant confirmation in larger population-based studies with a longer follow-up period.”

One author disclosed financial ties to Jazz Pharmaceuticals.

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Florian Rader, M.D., of the Smidt Heart Institute at Cedars Sinai Medical Center in Los Angeles, and colleagues demonstrated differences in myocardial blood flow regulation with handgrip exercise among tobacco and electronic cigarette smokers when compared with nonsmokers.

“In nonsmokers, we saw large increases in blood flow during exercise, while in tobacco cigarette smokers, this increase was blunted. In e-cigarette smokers, this abnormality was even more pronounced,” Rader said. “Our results suggest that e-cigarette smoking is associated with abnormalities in blood flow regulation (coronary endothelial dysfunction) that may be even more pronounced than those among tobacco cigarette smokers. If our findings can be confirmed in larger studies, this would have serious implications for harmful long-term effects of e-cigarette smoking on the cardiovascular system.”

Two authors disclosed financial ties to Zogenix and ReCor Medical.

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Zunsong Hu, Ph.D., of the University of Tennessee Health Science Center in Memphis, and colleagues found that children of mothers who consumed more fried food and sugar-sweetened beverages during pregnancy are more likely to rapidly gain weight and have obesity in early childhood.

“Maternal dietary pattern during pregnancy represented by fried foods and sugar-sweetened beverages may contribute to rapid early childhood growth and increased risk for obesity in offspring,” Hu said. “Healthy diet recommendations, including decreasing intake of fried food and sugar-sweetened beverages, should be provided to pregnant women with the emphasis that a healthy diet not only benefits the prenatal health but also has long-term health effects on their children.”

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AHA: Impella Use Up for PCI Patients Needing Heart Pump

THURSDAY, Nov. 21, 2019 (HealthDay News) — Impella use is increasing for percutaneous coronary intervention patients treated with mechanical circulatory support, although its use is associated with adverse events, according to a study published online Nov. 17 in Circulation to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Neurohormonal Blockade Beneficial for Patients With LVAD

TUESDAY, Nov. 19, 2019 (HealthDay News) — For patients with heart failure with left ventricular assist devices, neurohormonal blockade is associated with improved survival, according to a study published online Nov. 18 in JAMA Cardiology to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Lower-Target LDL Level Beneficial After Stroke, TIA

TUESDAY, Nov. 19, 2019 (HealthDay News) — For patients with ischemic stroke or transient ischemic attack with evidence of atherosclerosis, those with a target low-density lipoprotein cholesterol level of less than 70 mg/dL have a lower risk for cardiovascular events, according to a study published online Nov. 18 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Risk for Ischemic CV Events Lower With Colchicine After MI

MONDAY, Nov. 18, 2019 (HealthDay News) — Patients with recent myocardial infarction have a lower risk for ischemic cardiovascular events with colchicine versus placebo, according to a study published online Nov. 16 in the New England Journal of Medicine to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Impact of Valsartan Recall Examined for Ontario, Canada

MONDAY, Nov. 18, 2019 (HealthDay News) — The generic valsartan recall has had population-level impacts on patients in Ontario, Canada, according to a research letter published online Nov. 11 in Circulation to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Predictors for Meeting LDL-C, SBP Goals ID’d in ISCHEMIA

MONDAY, Nov. 18, 2019 (HealthDay News) — Predictors of attaining low-density lipoprotein cholesterol and systolic blood pressure goals have been identified, according to a study published online Nov. 13 in Circulation: Cardiovascular Quality and Outcomes. The research was published to coincide with a presentation of results from the ISCHEMIA study at the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Many With Atherosclerotic CVD Not Meeting LDL-C Goals

FRIDAY, Nov. 15, 2019 (HealthDay News) — A high proportion of patients with atherosclerotic cardiovascular disease do not achieve recommended low-density lipoprotein cholesterol goals, according to a study presented at the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Vitamin D, Omega-3 Do Not Cut Heart Failure Hospitalization

THURSDAY, Nov. 14, 2019 (HealthDay News) — Neither vitamin D nor marine omega-3 fatty acid supplementation significantly reduces the rate of first heart failure hospitalization, according to a research letter published online Nov. 11 in Circulation to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Risk for Death Cuts Benefit of Oral Anticoagulants for A-Fib

THURSDAY, Nov. 14, 2019 (HealthDay News) — For older patients with atrial fibrillation, the competing risks for death reduce the net clinical benefit of oral anticoagulation, according to a study published online Nov. 11 in Circulation: Cardiovascular Quality and Outcomes to coincide with the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Intensive BP Control May Increase Life Expectancy

WEDNESDAY, Nov. 13, 2019 (HealthDay News) — Intensive blood pressure control results in an increase in life expectancy, and new hypertension guidelines may be cost-effective only for certain patients, according to two studies presented at the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: About One in Three With ASCVD Not Receiving Flu Shot

TUESDAY, Nov. 12, 2019 (HealthDay News) — About one in three individuals with atherosclerotic cardiovascular disease did not receive an influenza vaccination in the past year, according to a study presented at the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Cardiovascular Risk Factors Tied to Increased Cancer Risk

TUESDAY, Nov. 12, 2019 (HealthDay News) — Cardiovascular risk factors and cardiovascular disease are associated with an increased risk for developing cancer, according to a study presented at the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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AHA: Cannabis Use Disorder Tied to Arrhythmia Hospitalization

TUESDAY, Nov. 12, 2019 (HealthDay News) — Cannabis use disorder is associated with hospitalization for arrhythmia, and marijuana use is associated with an increased risk for young-onset stroke, according to two studies presented at the annual meeting of the American Heart Association, held from Nov. 16 to 18 in Philadelphia.

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