Top

Published in:

Open Access 01-12-2020 | Review

Sex-Based Differences in Coronary and Structural Percutaneous Interventions

Authors: Ashley Mohadjer, Garrett Brown, Syed R. Shah, Charishma Nallapati, Nida Waheed, Anthony A. Bavry, Ki Park

Published in: Cardiology and Therapy | Issue 2/2020

Abstract

In the current state of interventional cardiology, the ability to offer advanced therapies to patients who historically were not surgical candidates has grown exponentially in the last few decades. As therapies have expanded in complex coronary and structural interventions, the nuances of treating certain populations have emerged. In particular, the role of sex-based anatomic and outcome differences has been increasingly recognized. As guidelines for cardiovascular prevention and treatment for certain conditions may vary by sex, therapeutic interventions in the structural and percutaneous coronary areas may also vary. In this review, we aim to discuss these differences, the current literature available on these topics, and areas of focus for the future.

O'Connor SA, Morice MC, Gilard M, Leon MB, Webb JG, Dvir D, et al. Revisiting sex equality with transcatheter aortic valve replacement outcomes: a collaborative, patient-level meta-analysis of 11,310 patients. J Am Coll Cardiol. 2015;66(3):221–8.PubMed

Kochanek KD, Murphy SL, Xu J, Tejada-Vera B. Deaths: final data for 2014. Natl Vital Stat Rep. 2016;65(4):1–122.PubMed

Graham G. Acute coronary syndromes in women: recent treatment trends and outcomes. Clin Med Insights Cardiol. 2016;10:1–10.PubMedPubMedCentral

Cook NR, Paynter NP, Eaton CB, Manson JE, Martin LW, Robinson JG, et al. Comparison of the Framingham and Reynolds Risk scores for global cardiovascular risk prediction in the multiethnic Women's Health Initiative. Circulation. 2012;125(14):1748–56.PubMedPubMedCentral

Bugiardini R, Bairey Merz CN. Angina with “normal” coronary arteries: a changing philosophy. JAMA. 2005;293(4):477–84.PubMed

Pepine CJ, Ferdinand KC, Shaw LJ, Light-McGroary KA, Shah RU, Gulati M, et al. Emergence of nonobstructive coronary artery disease: a woman's problem and need for change in definition on angiography. J Am Coll Cardiol. 2015;66(17):1918–33.PubMedPubMedCentral

Reynolds HR, Srichai MB, Iqbal SN, Slater JN, Mancini GB, Feit F, et al. Mechanisms of myocardial infarction in women without angiographically obstructive coronary artery disease. Circulation. 2011;124(13):1414–25.PubMedPubMedCentral

Chokshi NP, Iqbal SN, Berger RL, Hochman JS, Feit F, Slater JN, et al. Sex and race are associated with the absence of epicardial coronary artery obstructive disease at angiography in patients with acute coronary syndromes. Clin Cardiol. 2010;33(8):495–501.PubMedPubMedCentral

Han SH, Bae JH, Holmes DR Jr, Lennon RJ, Eeckhout E, Barsness GW, et al. Sex differences in atheroma burden and endothelial function in patients with early coronary atherosclerosis. Eur Heart J. 2008;29(11):1359–69.PubMed

10.

Pepine CJ, Kerensky RA, Lambert CR, Smith KM, von Mering GO, Sopko G, et al. Some thoughts on the vasculopathy of women with ischemic heart disease. J Am Coll Cardiol. 2006;47(3 Suppl):S30–S3535.PubMed

11.

Taqueti VR. Sex differences in the coronary system. Adv Exp Med Biol. 2018;1065:257–78.PubMedPubMedCentral

12.

Stramba-Badiale M, Fox KM, Priori SG, Collins P, Daly C, Graham I, et al. Cardiovascular diseases in women: a statement from the policy conference of the European Society of Cardiology. Eur Heart J. 2006;27(8):994–1005.PubMed

13.

Ghare MI, Chandrasekhar J, Mehran R, Ng V, Grines C, Lansky A. Sex disparities in cardiovascular device evaluations: strategies for recruitment and retention of female patients in clinical device trials. JACC Cardiovasc Interv. 2019;12(3):301–8.PubMed

14.

Alexander KP, Chen AY, Roe MT, Newby LK, Gibson CM, Allen-LaPointe NM, et al. Excess dosing of antiplatelet and antithrombin agents in the treatment of non-ST-segment elevation acute coronary syndromes. JAMA. 2005;294(24):3108–16.PubMed

15.

Cowley MJ, Mullin SM, Kelsey SF, Kent KM, Gruentzig AR, Detre KM, et al. Sex differences in early and long-term results of coronary angioplasty in the NHLBI PTCA Registry. Circulation. 1985;71(1):90–7.PubMed

16.

Vakili BA, Kaplan RC, Brown DL. Sex-based differences in early mortality of patients undergoing primary angioplasty for first acute myocardial infarction. Circulation. 2001;104(25):3034–8.PubMed

17.

Meijer A, Conradi HJ, Bos EH, Thombs BD, van Melle JP, de Jonge P. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of research. Gen Hosp Psychiatry. 2011;33(3):203–16.PubMed

18.

Mehran R, Pocock SJ, Nikolsky E, Clayton T, Dangas GD, Kirtane AJ, et al. A risk score to predict bleeding in patients with acute coronary syndromes. J Am Coll Cardiol. 2010;55(23):2556–66.PubMed

19.

Potts J, Sirker A, Martinez SC, Gulati M, Alasnag M, Rashid M, et al. Persistent sex disparities in clinical outcomes with percutaneous coronary intervention: insights from 6.6 million PCI procedures in the United States. PLoS ONE. 2018;13(9):e0203325.PubMedPubMedCentral

20.

Subherwal S, Bach RG, Chen AY, Gage BF, Rao SV, Newby LK, et al. Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score. Circulation. 2009;119(14):1873–82.PubMedPubMedCentral

21.

Duvernoy CS, Smith DE, Manohar P, Schaefer A, Kline-Rogers E, Share D, et al. Gender differences in adverse outcomes after contemporary percutaneous coronary intervention: an analysis from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) percutaneous coronary intervention registry. Am Heart J. 2010;159(4):677–83.PubMed

22.

Fath-Ordoubadi F, Barac Y, Abergel E, Danzi GB, Kerner A, Nikolsky E, et al. Gender impact on prognosis of acute coronary syndrome patients treated with drug-eluting stents. Am J Cardiol. 2012;110(5):636–42.PubMed

23.

Jacobs AK, Johnston JM, Haviland A, Brooks MM, Kelsey SF, Holmes DR Jr, et al. Improved outcomes for women undergoing contemporary percutaneous coronary intervention: a report from the National Heart, Lung, and Blood Institute Dynamic registry. J Am Coll Cardiol. 2002;39(10):1608–14.PubMed

24.

Singh M, Rihal CS, Gersh BJ, Roger VL, Bell MR, Lennon RJ, et al. Mortality differences between men and women after percutaneous coronary interventions. A 25-year, single-center experience. J Am Coll Cardiol. 2008;51(24):2313–20.PubMedPubMedCentral

25.

Greenberg MA, Mueller HS. Why the excess mortality in women after PTCA? Circulation. 1993;87(3):1030–2.PubMed

26.

Manoukian SV. Predictors and impact of bleeding complications in percutaneous coronary intervention, acute coronary syndromes, and ST-segment elevation myocardial infarction. Am J Cardiol. 2009;104(5 Suppl):9C–15C.PubMed

27.

Kinnaird TD, Stabile E, Mintz GS, Lee CW, Canos DA, Gevorkian N, et al. Incidence, predictors, and prognostic implications of bleeding and blood transfusion following percutaneous coronary interventions. Am J Cardiol. 2003;92(8):930–5.PubMed

28.

Stone GW, McLaurin BT, Cox DA, Bertrand ME, Lincoff AM, Moses JW, et al. Bivalirudin for patients with acute coronary syndromes. N Engl J Med. 2006;355(21):2203–16.PubMed

29.

Stone GW, Witzenbichler B, Guagliumi G, Peruga JZ, Brodie BR, Dudek D, et al. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med. 2008;358(21):2218–30.PubMed

30.

Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2007;357(20):2001–155.PubMed

31.

Giustino G, Harari R, Baber U, Sartori S, Stone GW, Leon MB, et al. Long-term safety and efficacy of new-generation drug-eluting stents in women with acute myocardial infarction: from the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration. JAMA Cardiol. 2017;2(8):855–62.PubMedPubMedCentral

32.

Giustino G, Mastoris I, Baber U, Sartori S, Stone GW, Leon MB, et al. Correlates and impact of coronary artery calcifications in women undergoing percutaneous coronary intervention with drug-eluting stents: from the Women in Innovation and Drug-Eluting Stents (WIN-DES) Collaboration. JACC Cardiovasc Interv. 2016;9(18):1890–901.PubMed

33.

Shah SR, Fatima M, Dharani AM, Shahnawaz W, Shah SA. Bioresorbable vascular scaffold versus metallic stent in percutaneous coronary intervention: results of the AIDA trial. J Community Hosp Intern Med Perspect. 2017;7(5):307–8.PubMedPubMedCentral

34.

Byrne RA, Joner M, Kastrati A. Stent thrombosis and restenosis: what have we learned and where are we going? The Andreas Gruntzig Lecture ESC 2014. Eur Heart J. 2015;36(47):3320–31.PubMedPubMedCentral

35.

Macaya F, Peral V, Alameda M, Pascual M, Gomez-Jaume A, Asmarats L, et al. Bioresorbable scaffolds to treat spontaneous coronary artery dissection. Circ Cardiovasc Interv. 2016;9(1):e003133.PubMed

36.

Thourani VH, Kodali S, Makkar RR, Herrmann HC, Williams M, Babaliaros V, et al. Transcatheter aortic valve replacement versus surgical valve replacement in intermediate-risk patients: a propensity score analysis. Lancet. 2016;387(10034):2218–25.PubMed

37.

Heer T, Hochadel M, Schmidt K, Mehilli J, Zahn R, Kuck KH, et al. Sex differences in percutaneous coronary intervention-insights from the Coronary Angiography and PCI Registry of the German Society of Cardiology. J Am Heart Assoc. 2017;6(3):e004972.PubMedPubMedCentral

38.

Gul B, Shah T, Head SJ, Chieffo A, Hu X, Li F, et al. Revascularization options for females with multivessel coronary artery disease: a meta-analysis of randomized controlled trials. JACC Cardiovasc Interv. 2020;13:1009–100.PubMed

39.

Sharma V, Jadhav ST, Harcombe AA, Kelly PA, Mozid A, Bagnall A, et al. Impact of proctoring on success rates for percutaneous revascularisation of coronary chronic total occlusions. Open Heart. 2015;2(1):e000228.PubMedPubMedCentral

40.

Mannem S, Rattanawong P, Riangwiwat T, Vutthikraivit W, Putthapiban P, Sukhumthammarat W, et al. Sex difference and outcome after percutaneous intervention in patients with chronic total occlusion: a systematic review and meta-analysis. Cardiovasc Revasc Med. 2020;21(1):25–31.PubMed

41.

Osnabrugge RL, Mylotte D, Head SJ, Van Mieghem NM, Nkomo VT, LeReun CM, et al. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study. J Am Coll Cardiol. 2013;62(11):1002–12.PubMed

42.

Carabello BA, Paulus WJ. Aortic stenosis. Lancet. 2009;373(9667):956–66.PubMed

43.

Simard L, Cote N, Dagenais F, Mathieu P, Couture C, Trahan S, et al. Sex-related discordance between aortic valve calcification and hemodynamic severity of aortic stenosis: is valvular fibrosis the explanation? Circ Res. 2017;120(4):681–91.PubMed

44.

Williams M, Kodali SK, Hahn RT, Humphries KH, Nkomo VT, Cohen DJ, et al. Sex-related differences in outcomes after transcatheter or surgical aortic valve replacement in patients with severe aortic stenosis: Insights from the PARTNER Trial (Placement of Aortic Transcatheter Valve). J Am Coll Cardiol. 2014;63(15):1522–8.PubMed

45.

Bach DS, Radeva JI, Birnbaum HG, Fournier AA, Tuttle EG. Prevalence, referral patterns, testing, and surgery in aortic valve disease: leaving women and elderly patients behind? J Heart Valve Dis. 2007;16(4):362–9.PubMed

46.

Elhmidi Y, Piazza N, Mazzitelli D, Wottke M, Lange R, Bleiziffer S. Sex-related differences in 2197 patients undergoing isolated surgical aortic valve replacement. J Card Surg. 2014;29(6):772–8.PubMed

47.

Kulik A, Lam BK, Rubens FD, Hendry PJ, Masters RG, Goldstein W, et al. Gender differences in the long-term outcomes after valve replacement surgery. Heart. 2009;95(4):318–26.PubMed

48.

Stewart BF, Siscovick D, Lind BK, Gardin JM, Gottdiener JS, Smith VE, et al. Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study. J Am Coll Cardiol. 1997;29(3):630–4.PubMed

49.

Eggebrecht H, Bestehorn M, Haude M, Schmermund A, Bestehorn K, Voigtlander T, et al. Outcomes of transfemoral transcatheter aortic valve implantation at hospitals with and without on-site cardiac surgery department: insights from the prospective German aortic valve replacement quality assurance registry (AQUA) in 17 919 patients. Eur Heart J. 2016;37(28):2240–8.PubMed

50.

Holmes DR Jr, Brennan JM, Rumsfeld JS, Dai D, O'Brien SM, Vemulapalli S, et al. Clinical outcomes at 1 year following transcatheter aortic valve replacement. JAMA. 2015;313(10):1019–28.PubMed

51.

Vlastra W, Chandrasekhar J, Garcia Del Blanco B, Tchetche D, de Brito FS Jr., Barbanti M, et al. Sex differences in transfemoral transcatheter aortic valve replacement. J Am Coll Cardiol. 2019;74(22):2758–67.PubMed

52.

Naoum C, Blanke P, Dvir D, Pibarot P, Humphries K, Webb J, et al. Clinical outcomes and imaging findings in women undergoing TAVR. JACC Cardiovasc Imaging. 2016;9(4):483–93.PubMed

53.

Buellesfeld L, Stortecky S, Kalesan B, Gloekler S, Khattab AA, Nietlispach F, et al. Aortic root dimensions among patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. JACC Cardiovasc Interv. 2013;6(1):72–83.PubMed

54.

Barbanti M, Yang TH, Rodes Cabau J, Tamburino C, Wood DA, Jilaihawi H, et al. Anatomical and procedural features associated with aortic root rupture during balloon-expandable transcatheter aortic valve replacement. Circulation. 2013;128(3):244–53.PubMed

55.

Mihos CG, Klassen SL, Yucel E. Sex-specific considerations in women with aortic stenosis and outcomes after transcatheter aortic valve replacement. Curr Treat Options Cardiovasc Med. 2018;20(7):52.PubMed

56.

Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada H, O'Hair D, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. N Engl J Med. 2019;380(18):1706–15.PubMed

57.

Ewe SH, Muratori M, Delgado V, Pepi M, Tamborini G, Fusini L, et al. Hemodynamic and clinical impact of patient–prosthesis mismatch after transcatheter aortic valve implantation. J Am Coll Cardiol. 2011;58(18):1910–8.PubMed

58.

Ribeiro HB, Webb JG, Makkar RR, Cohen MG, Kapadia SR, Kodali S, et al. Predictive factors, management, and clinical outcomes of coronary obstruction following transcatheter aortic valve implantation: insights from a large multicenter registry. J Am Coll Cardiol. 2013;62(17):1552–62.PubMed

59.

Azarbaijani Y, O'Callaghan K, Sanders WE, Wu C, Laschinger J, Marinac-Dabic D, et al. Sex-specific outcomes after transcatheter aortic valve replacement: a review of the literature. Cardiol Rev. 2018;26(2):73–81.PubMed

60.

Saito Y, Nazif T, Baumbach A, Tchetche D, Latib A, Kaple R, et al. Adjunctive antithrombotic therapy for patients with aortic stenosis undergoing transcatheter aortic valve replacement. JAMA Cardiol. 2020;5(1):92–101.PubMed

61.

Conrotto F, D'Ascenzo F, Presbitero P, Humphries KH, Webb JG, O'Connor SA, et al. Effect of gender after transcatheter aortic valve implantation: a meta-analysis. Ann Thorac Surg. 2015;99(3):809–16.PubMed

62.

Flaherty MP, Grubb KJ. Transcatheter aortic valve replacement: focus on sex-related differences in outcomes. Am J Cardiovasc Drugs. 2015;15(2):95–101.PubMed

63.

Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med. 2019;380(18):1695–705.PubMed

64.

Chieffo A, Petronio AS, Mehilli J, Chandrasekhar J, Sartori S, Lefevre T, et al. Acute and 30-day outcomes in women after TAVR: results from the WIN-TAVI (Women's INternational Transcatheter Aortic Valve Implantation) Real-World Registry. JACC Cardiovasc Interv. 2016;9(15):1589–600.PubMed

65.

Park K, Wu P, Gulati M. Obstetrics and gynecological history: a missed opportunity for cardiovascular risk assessment. JACC Case Rep. 2020;2(1):161–3.

66.

Merk DR, Emrich FC, Mohr FW, Seeburger J. Transcatheter mitral valve repair: where are we? Expert Rev Cardiovasc Ther. 2014;12(12):1379–81.PubMed

67.

Gammie JS, Sheng S, Griffith BP, Peterson ED, Rankin JS, O'Brien SM, et al. Trends in mitral valve surgery in the United States: results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg. 2009;87(5):1431–7 (discussion 37–9).PubMed

68.

Thourani VH, Weintraub WS, Guyton RA, Jones EL, Williams WH, Elkabbani S, et al. Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement: effect of age and concomitant coronary artery bypass grafting. Circulation. 2003;108(3):298–304.PubMed

69.

Akins CW, Hilgenberg AD, Buckley MJ, Vlahakes GJ, Torchiana DF, Daggett WM, et al. Mitral valve reconstruction versus replacement for degenerative or ischemic mitral regurgitation. Ann Thorac Surg. 1994;58(3):668–75 (discussion 75-6).PubMed

70.

Cohn LH, Kowalker W, Bhatia S, DiSesa VJ, St John-Sutton M, Shemin RJ, et al. Comparative morbidity of mitral valve repair versus replacement for mitral regurgitation with and without coronary artery disease. 1988. Updated in 1995. Ann Thorac Surg. 1995;60(5):1452–3.PubMed

71.

Craver JM, Cohen C, Weintraub WS. Case-matched comparison of mitral valve replacement and repair. Ann Thorac Surg. 1990;49(6):964–9.PubMed

72.

Enriquez-Sarano M, Schaff HV, Orszulak TA, Tajik AJ, Bailey KR, Frye RL. Valve repair improves the outcome of surgery for mitral regurgitation. A multivariate analysis. Circulation. 1995;91(4):1022–8.PubMed

73.

Silvestry FE, Rodriguez LL, Herrmann HC, Rohatgi S, Weiss SJ, Stewart WJ, et al. Echocardiographic guidance and assessment of percutaneous repair for mitral regurgitation with the Evalve MitraClip: lessons learned from EVEREST I. J Am Soc Echocardiogr. 2007;20(10):1131–40.PubMed

74.

Feldman T, Kar S, Elmariah S, Smart SC, Trento A, Siegel RJ, et al. Randomized comparison of percutaneous repair and surgery for mitral regurgitation: 5-year results of EVEREST II. J Am Coll Cardiol. 2015;66(25):2844–54.PubMed

75.

Stone GW, Lindenfeld J, Abraham WT, Kar S, Lim DS, Mishell JM, et al. Transcatheter mitral-valve repair in patients with heart failure. N Engl J Med. 2018;379(24):2307–18.PubMed

76.

Obadia JF, Messika-Zeitoun D, Leurent G, Iung B, Bonnet G, Piriou N, et al. Percutaneous repair or medical treatment for secondary mitral regurgitation. N Engl J Med. 2018;379(24):2297–306.PubMed

77.

Gafoor S, Sievert H, Maisano F, Baldus S, Schaefer U, Hausleiter J, et al. Gender in the ACCESS-EU registry: a prospective, multicentre, non-randomised post-market approval study of MitraClip(R) therapy in Europe. EuroIntervention. 2016;12(2):e257–e264264.PubMed

78.

Maisano F, Franzen O, Baldus S, Schafer U, Hausleiter J, Butter C, et al. Percutaneous mitral valve interventions in the real world: early and 1-year results from the ACCESS-EU, a prospective, multicenter, nonrandomized post-approval study of the MitraClip therapy in Europe. J Am Coll Cardiol. 2013;62(12):1052–61.PubMed

79.

Geis NA, Puls M, Lubos E, Zuern CS, Franke J, Schueler R, et al. Safety and efficacy of MitraClip therapy in patients with severely impaired left ventricular ejection fraction: results from the German transcatheter mitral valve interventions (TRAMI) registry. Eur J Heart Fail. 2018;20(3):598–608.PubMed

80.

Pighi M, Estevez-Loureiro R, Maisano F, Ussia GP, Dall'Ara G, Franzen O, et al. Immediate and 12-month outcomes of ischemic versus nonischemic functional mitral regurgitation in patients treated with MitraClip (from the 2011 to 2012 Pilot Sentinel Registry of Percutaneous Edge-To-Edge Mitral Valve Repair of the European Society of Cardiology). Am J Cardiol. 2017;119(4):630–7.PubMed

81.

Attizzani GF, Ohno Y, Capodanno D, Cannata S, Dipasqua F, Imme S, et al. Gender-related clinical and echocardiographic outcomes at 30-day and 12-month follow-up after MitraClip implantation in the GRASP registry. Catheter Cardiovasc Interv. 2015;85(5):889–97.PubMed

82.

Giustino G, Overbey J, Taylor D, Ailawadi G, Kirkwood K, DeRose J, et al. Sex-based differences in outcomes after mitral valve surgery for severe ischemic mitral regurgitation: from the Cardiothoracic Surgical Trials Network. JACC Heart Fail. 2019;7(6):481–90.PubMedPubMedCentral

83.

Szerlip M. Transcatheter aortic valve replacement: only one of the advantages of being female. J Am Coll Cardiol. 2016;68(25):2745–6.PubMed

Title: Sex-Based Differences in Coronary and Structural Percutaneous Interventions
Authors: Ashley Mohadjer
Garrett Brown
Syed R. Shah
Charishma Nallapati
Nida Waheed
Anthony A. Bavry
Ki Park
Publication date: 01-12-2020
Publisher: Springer Healthcare
Published in: Cardiology and Therapy / Issue 2/2020
Print ISSN: 2193-8261
Electronic ISSN: 2193-6544
DOI: https://doi.org/10.1007/s40119-020-00176-5

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sex-Based Differences in Coronary and Structural Percutaneous Interventions

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2020

A Call for a New Paradigm for Diabetes Care in the Era of Sodium–Glucose Cotransporter 2 Inhibitors (SGLT2i)

Home-Based Cardiac Rehabilitation (HBCR) In Post-TAVR Patients: A Prospective, Single-Center, Cohort, Pilot Study

A Phase 4, Open-Label, Single-Arm Study Assessing the Efficacy and Safety of Ivabradine in African American Patients with Heart Failure and Reduced Ejection Fraction

Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study

Hypochloraemia in Patients with Heart Failure: Causes and Consequences

Cardiovascular Implications and Therapeutic Considerations in COVID-19 Infection

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page