American Heart Association, Nov. 5-7

The annual meeting of the American Heart Association was held this year from Nov. 5 to 7 and attracted participants from around the world, including cardiovascular specialists, surgeons, and nurses as well as other health care professionals. The conference featured presentations focusing on the latest advances in cardiovascular medicine and surgery.

In one study, Kristen A. Harris, M.D., of the University Hospitals Cleveland Medical Center, and colleagues found social vulnerability to be associated with an increased presence of cardiometabolic risk factors among pregnant women.

The authors aimed to gain insight into the relationship between social vulnerability and the frequency with which pregnant women were entering pregnancy with cardiometabolic risk factors. These prepregnancy risk factors included type 2 diabetes, high blood pressure, tobacco use, and obesity, all of which could increase the chances of poor outcomes of cardiovascular origin. Data from 19 million pregnancies in 577 U.S. counties were evaluated (2016 to 2020). The researchers found that women with increased social vulnerability were more likely to have prepregnancy diabetes, hypertension, and obesity.

"As we move towards improving on these outcomes among pregnant women, social vulnerability has to be explored further as well," Harris said. "This study has important implications as well for future public health intervention in the realm of improving pregnancy outcomes."

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Issam Motairek, M.D., of the University Hospitals Cleveland Medical Center, and colleagues found neighborhood walkability to be associated with a lower prevalence of cardiovascular disease and risk factors, which may be partially explained by increased physical activity in these neighborhoods.

By utilizing the Environmental Protection Agency's smart location database, the authors generated a population-weighted walkability index for more than 70,000 U.S. census tracts ranging from 1 (least walkable) to 20 (most walkable). These data were then matched to census tract prevalence of coronary artery disease (CAD) and cardiovascular risk factors, including hypertension, dyslipidemia, obesity, and diabetes. The mean prevalence for each of the cardiovascular health indicators was calculated according to quartiles of the walkability index.

The researchers found that the prevalence of CAD decreased from 7.0 to 5.4 percent in a stepwise manner across walkability quartiles Q1 (least walkable) through Q4 (most walkable). Similar trends were observed for cardiovascular risk factors, including hypertension (35.5 to 29.7 percent), dyslipidemia (34.5 to 29.7 percent), obesity (35.0 to 30.2 percent), and type 2 diabetes (11.6 to 10.6 percent).

"The association between walkability and CAD prevalence remained significant even after adjusting for age, sex, and U.S. Centers for Disease Control and Prevention Social Vulnerability Index, a well-established metric of socioeconomic status," Motairek said. "It's important that public health officials consider the health implications of urban designs that encourage walkability."

Two authors disclosed financial ties to Rightway Health, Amgen, Novartis, Esperion, and/or Novo Nordisk.

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Michael A. Portman, M.D., of Seattle Children’s Hospital and the University of Washington School of Medicine, and colleagues found that the oral anticoagulant edoxaban is safe and demonstrates a similar effect in inhibiting clot formation as standard of care (SOC) among children with heart disease requiring anticoagulation.

The authors conducted a randomized trial evaluating the safety of edoxaban (once daily) compared to SOC in children with heart disease requiring anticlotting medication. The occurrence of bleeding or clotting events was assessed in those administered edoxaban or SOC during a three-month period. All children provided edoxaban or SOC could continue edoxaban for an additional nine months. The researchers found that edoxaban could be used safely in children with heart disease, with the advantage of oral once-daily dosing and without the disadvantage of frequent blood testing or injections.

"This study is important in that edoxaban provides convenience for parents, who do not need to be concerned that certain foods might affect the medication," Portman said. "They also do not need to give injections, and edoxaban is given only once a day, unlike other direct oral anticoagulants, which is important for busy children and their families."

The study was funded by Daiichi Sankyo, the manufacturer of edoxaban.

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Rayan S. El-Zein, D.O., of the University of Missouri-Kansas City, and colleagues found that living in food deserts is a major barrier to obtaining appropriate treatments and improving outcomes in patients with peripheral arterial disease (PAD).

The authors assessed data from 11,907 adults with PAD between 2015 and 2021. Treatments and outcomes were compared for individuals based on their access to healthy and affordable foods. The researchers found that individuals with PAD who lived in food deserts, or areas with low income and poor access to grocery stores, had an increased risk for death. In addition, the likelihood of achieving optimal medical therapy, including an antiplatelet, a statin, a renin-angiotensin inhibitor, and tobacco abstention, was reduced in those living in low-income areas. Furthermore, factors such as female sex, malnutrition, chronic obstructive pulmonary disease, and chronic kidney disease were all associated with lower rates of optimal medical therapy.

"The scope of PAD treatment to lower cardiovascular risk and improve PAD-related health must reach beyond clinic visits, prescriptions, and procedures. We also have an opportunity to screen for food insecurity in the clinical setting, which is not standard practice at this time," El-Zein said. "Our results underscore the importance of screening for social and environmental barriers faced by patients with PAD, and remaining vigilant for the opportunity to optimize medical care among those who are underserved or disadvantaged."

One author disclosed financial ties to Inari Medical, Shockwave Medical, and Abbott Vascular.

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AHA: Consciousness, Awareness May Occur During Cardiac Arrest

THURSDAY, Nov. 17, 2022 (HealthDay News) -- Consciousness has been captured during cardiac arrest, according to a study presented at the American Heart Association Resuscitation Science Symposium 2022, held from Nov. 5 to 6 as part of the annual meeting of the American Heart Association. The study has been accepted for publication in a future issue of Circulation.

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AHA: Other Defibrillation Strategies Studied for Refractory V-Fib

WEDNESDAY, Nov. 9, 2022 (HealthDay News) -- For patients with refractory ventricular fibrillation during out-of-hospital cardiac arrest, use of double sequential external defibrillation or vector-change defibrillation results in better survival to hospital discharge compared with standard defibrillation, according to a study published online Nov. 6 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Strategies Compared for Treating Chronic Limb-Threatening Ischemia

TUESDAY, Nov. 8, 2022 (HealthDay News) -- For patients with chronic limb-threatening ischemia, an initial strategy of surgical revascularization is better than endovascular therapy for those with a single segment of great saphenous vein that could be used for surgery, according to a study published online Nov. 7 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Lowering TGs With Pemafibrate Does Not Cut CV Risk in T2DM

TUESDAY, Nov. 8, 2022 (HealthDay News) -- For patients with type 2 diabetes, hypertriglyceridemia, and low high-density lipoprotein cholesterol levels, the incidence of cardiovascular events is not lower with pemafibrate versus placebo, according to a study published online Nov. 5 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Baxdrostat Studied in Treatment-Resistant Hypertension

TUESDAY, Nov. 8, 2022 (HealthDay News) -- Patients with treatment-resistant hypertension who receive baxdrostat versus placebo have dose-dependent reductions in systolic blood pressure at 12 weeks, according to a study published online Nov. 7 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Environmental Exposures Tied to CVD Deaths in the U.S., U.K.

MONDAY, Nov. 7, 2022 (HealthDay News) -- Exposure to environmental toxins may contribute to cardiovascular disease deaths in the United States and the United Kingdom, according to a study presented at the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Vaping Tied to Negative Effects on Cardiovascular Function

MONDAY, Nov. 7, 2022 (HealthDay News) -- Significant negative effects on cardiovascular function are seen for people who vape, according to two studies based on the cross-sectional Cardiac and Lung E-cig Smoking study and presented at the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Those With, at Risk for CVD Less Likely to Use Wearables

FRIDAY, Nov. 4, 2022 (HealthDay News) -- Individuals with, or at risk for, cardiovascular disease, are less likely to use wearable devices that monitor and track health or physical activity, according to a study presented at the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Heart Disease Death Rates in U.S. Spiked in 2020

FRIDAY, Nov. 4, 2022 (HealthDay News) -- Deaths from heart disease increased in 2020 in the United States, following a steady decline from 2010 to 2019, according to a study presented at the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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AHA: Once-Daily Edoxaban Seems Safe for Pediatric Cardiac Patients

FRIDAY, Nov. 4, 2022 (HealthDay News) -- Once-daily edoxaban seems safe and effective for pediatric patients with cardiac disease, according to a study presented at the American Heart Association Scientific Sessions 2022, held from Nov. 5 to 7 in Chicago.

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