American College of Cardiology, March 4 to 6

The American College of Cardiology Annual Scientific Session and Expo
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Medically Reviewed By:
Meeta Shah, M.D.

The annual meeting of the American College of Cardiology was held from March 4 to 6 in New Orleans and attracted more than 12,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in cardiology. The conference highlighted recent advances in the treatment, management, and prevention of cardiovascular diseases, with presentations focusing on novel drugs and surgical approaches to improve the quality of care for patients with cardiovascular diseases.

"This year's session is exciting because it is about science, it's about education, it's about health equity," Katie Berlacher, M.D., of University of Pittsburgh Medical Center and vice chair of the American College of Cardiology Scientific Session, said in an interview with HealthDay. "So there's not one single theme, but many themes that integrate together to give us hopefully the best outcome for all of our patients."

In one study, Katarina Leyba, M.D., of the University of Colorado in Boulder, and colleagues found that marital history appears to be an important predictor of survival in men with heart failure, but not for women with heart failure.

To examine the association between relationship status and all-cause mortality and heart failure, the authors performed a secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) using age-adjusted Cox proportional hazard models. Survival rates from the time of heart failure diagnosis were compared by gender and marital status during an average follow-up period of up to five years among 94 MESA study participants with heart failure at year 10 of the study. The researchers found lifelong bachelors had a significantly higher risk for dying compared with married men, but men who were separated, divorced, or widowed did not. Meanwhile, marital status was not found to be a significant predictor of death in women with heart failure.

"These findings suggest a marriage has some kind of beneficial effect(s) for men that helps them survive longer after developing heart failure. At present, we haven't identified precisely what these effects are, but they could include health-seeking behaviors, family support in older age, nutrition status, or frailty," Leyba said. "The lack of difference in survival between women with different marital histories could indicate either that those factors are not as clinically beneficial in women or possibly that women have fewer deficits in those traits that are impacted through marriage."

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In other research, Joanna Lee, a medical student at the David Tvildiani Medical University in Tbilisi, Georgia, and colleagues found that the odds of long COVID patients developing cardiac complications are more than twofold.

The authors performed a systematic literature review and meta-analysis of 11 studies involving a total of 5.8 million individuals. The researchers found that almost 450,000 long COVID patients had cardiac complications. The most commonly reported clinical symptoms were chest pain, difficulty breathing, palpitations, and fatigue. In addition, individuals reported cardiac diseases such as arrhythmia, heart failure, and thrombosis disorders.

"Cardiac imaging findings suggest myocardial late gadolinium enhancement and decreased left ventricular ejection fraction. The study, however, is limited in drawing definitive conclusions due to a high level of variability of the population study data and the method of data collection which is a common limitation among COVID-19-related meta-analyses," Lee said. "Physicians should be aware of such cardiac complications associated with long COVID and take it into consideration when managing such patients."

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Tabitha Lobo, M.D., of University Hospitals Cleveland Medical Center, and colleagues found that social media friendships may influence an individual's heart health risk.

The authors analyzed 72.2 million Facebook users and studied more than 21 billion friendships to define a social capital index called "economic connectedness," which signified the share of high socioeconomic Facebook friends among individuals of a lower socioeconomic status. The researchers found this data metric to be inversely related to early cardiac mortality. The finding remained true even after adjusting for other common variables known to affect cardiac health such as gender, race, household income, and health conditions (diabetes, smoking, high cholesterol, hypertension, and obesity).

"At a policy level, if we can use data from social media to predict the cardiac risk of the community, we can implement strategies which would allow for more cross-class interactions in order to improve the connectedness in that community and thereby target better health outcomes," Lobo said. "At an individual level, if we can identify people who live in poorly connected areas and are at risk for bad cardiac outcomes, we can connect them with programs to promote more social media friendships and interactions (such as neighborhood-level community organizations, mentorship groups, subsidized housing in highly connected counties, etc.) to reduce their overall cardiac risk."

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Ibrahim Ahmed, M.D., of the Mercy Catholic Medical Center in Darby, Pennsylvania, and colleagues found that starting hormone replacement therapy or gender-affirming hormone therapy is not a risk-free endeavor and that there are cardiovascular risks associated with undergoing this therapy.

In a retrospective review, the authors evaluated cardiovascular risks of gender affirmation therapy. Specifically, from a national database of hospital records, rates of cardiovascular events in more than 21,000 individuals with gender dysphoria were assessed, including 1,675 who had used hormone replacement therapy. The researchers found that hormone replacement therapy was associated with a higher risk for adverse cardiovascular events, especially those related to blood clot formation. However, hormone replacement therapy was not found to be associated with higher rates of mortality.

"We want the patient to be fully informed before starting hormone replacement therapy/gender-affirming hormone therapy, as starting therapy is a big moment in a gender dysphoric patient's life," Ahmed said. "We believe that a thorough review of risks and benefit should be had between a patient and their physician."

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