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Most atrial fibrillation patients with comorbidities do not receive all the guideline-directed medical therapies (GDMT) they are eligible for, but new evidence from the DCRI suggests use of these therapies is associated with better outcomes in populations with certain comorbidities.

In a finding that suggests less is more, researchers led by the DCRI found that the drugs apixaban and clopidogrel — without aspirin — comprise the safest treatment regimen for certain patients with atrial fibrillation (AF). The finding, which applies specifically to patients with AF who have had a heart attack and/or are undergoing percutaneous coronary intervention, should reassure clinicians and patients that dropping aspirin results in no significant increase in ischemic events such as heart attacks, strokes and blood clots.

One-year follow-up results show that a newer, non-invasive technology to evaluate heart pain provided a reliable way to identify which patients had dangerous artery blockages, according to a study co-led by the DCRI. The findings, reported Sunday at the annual College of Cardiology meeting in New Orleans, suggest that fractional flow reserve CT (FFR-CT) scans are effective in helping doctors determine which patients need more aggressive treatments.

Starting heart failure patients on the compound sacubitril/valsartan instead of enalapril after they have been discharged from the hospital led to an improvement in biomarkers of heart stress, according to a study led by the DCRI. The finding, from an additional analysis of a study called PIONEER-HF, described changes in a heart failure biomarker called NT-proBNP when switching from enalapril to sacubitril/valsartan.

Care for older adults with heart failure can be optimized using a four-domain framework including medical, mind, physical function, and social environment. About 5.7 million adults in the United States and at least 26 million worldwide have heart failure. Heart failure is the number one cause of hospitalization in older adults, accounting for $123 billion per year in Medicare spending.

New research shows that although racial disparities have diminished in recent years, gender disparities are still common.

Only approximately half of patients with chronic kidney disease and atrial fibrillation were treated with oral anticoagulants (OACs), and this proportion decreased significantly as kidney disease became more severe.

High-sensitivity troponin, an assay that is relatively new in the U.S., allows providers to assess low-risk chest pain patients more quickly and determine whether they have had a heart attack or myocardial infarction.

Less than 10 percent of the treatment recommendations U.S. doctors rely on to manage care for heart patients are based on evidence gained from multiple large, randomized clinical trials — the gold standard for obtaining scientific data. In fact, the proportion of well-supported recommendations for heart care has actually declined compared to 10 years ago, when an earlier analysis found a similar dearth of rigorous studies supporting treatment guidelines. The latest study, led by the DCRI, appears online March 15 in JAMA.

Catheter ablation, a common cardiovascular procedure, appears no more effective than drug therapies in preventing strokes, deaths, and other complications in patients with atrial fibrillation. However, patients who get the procedure experience much greater symptom relief and long-term improvements in the quality of life, including  fewer recurrences of the condition and fewer hospitalizations, than those who get only drugs. The findings are from two new studies published in the March 15 issue of JAMA.