JACC Heart Failure Editor's Update, December 2019
December 2019 JACC: Heart Failure—Special Issue: Heart Failure in the Elderly
Clearer assessment of frailty in older heart failure patients and an understanding of its role in the progression of the disease could allow novel treatment strategies to improve outcomes. In this state-of-the-art review, Ambarish Pandey and colleagues look at the burden of frailty, its conceptual underpinnings, and current screening and treatment practices for identifying frailty in heart failure patients. They suggest the development of a comprehensive management approach that addresses multiple domains to improve functional status, quality of life and long-term outcomes.
Frailty Is Intertwined With Heart Failure: Mechanisms, Prevalence, Prognosis, Assessment, and Management
Ambarish Pandey, Gordon Reeves, et al.
Is spironolactone effective and safe in older heart failure patients? Orly Vardeny et al examined data from the TOPCAT trial to determine if there are age-related differences in efficacy and safety outcomes and to add to our understanding of appropriate treatment and management strategies for HFpEF patients.
Influence of Age on Efficacy and Safety of Spironolactone in Heart Failure
Orly Vardeny, Scott D. Solomon, et al.
Cognitive decline is prevalent and debilitating among heart failure patients but challenges in gathering longitudinal data make predictors difficult to establish. Tetz C. Lee et al provide insights from the WARCEF (Warfarin vs Aspirin in Reduced Ejection Fraction) trial. Cognitive function among the WARCEF trial cohort was assessed annually for 3.5 years. The authors looked at changes over time to determine association with heart failure severity and treatment.
Cognitive Decline Over Time in Patients With Systolic Heart Failure: Insights From WARCEF
Tetz C. Lee, Marco R. Di Tullio, et al.
Does LVAD implantation improve outcomes in older adults? Use of LVADs in older adults has increased significantly. Cesar Caraballo and colleagues examined INTERMACS data to determine bleeding risk, likelihood of discharge to home versus rehabilitation facility, and the characteristics of those older adults best suited to LVAD therapy.
Clinical Outcomes After Left Ventricular Assist Device Implantation in Older Adults: An INTERMACS Analysis
Cesar Caraballo, Veli K. Topkara, et al.
As we reflect on 2019 and look forward to 2020, I want to thank our publishing partners at Elsevier, the ACC staff and especially our authors, associate editors, and reviewers. Your thoughtful and diligent work advances our understanding of heart failure and improves the care of our patients. Warm wishes for the holidays.