Mass General Brigham Heart Experts Provide Data and Insights on Treatment and Prevention at ESC Congress 2025

Elevated Inflammation Detectable in Women Without Other Risk Factors for Cardiovascular Disease

Speaker: Paul M. Ridker, MD, MPH

What: Researchers have defined a new clinical term called “SMURF-Less but Inflamed” to describe women who have had heart attacks or strokes without having “standard modifiable risk factors” (SMuRFs) such as smoking, high blood pressure, high cholesterol, or diabetes. To better detect the risk of a heart attack for these individuals, researchers recommend broad hsCRP screening alongside cholesterol testing in early adulthood. This conclusion is based on data from 12,530 healthy women who were followed for 30 years as part of the Women’s Health Study. Results indicated that those with elevated inflammation (hsCRP > 3 mg/L) had a 77% higher lifetime risk of coronary heart disease, 39% higher risk of stroke, and 52% higher risk of major cardiovascular events compared to their peers.

Read more in a Mass General Brigham press release and simultaneous publication in The European Heart Journal.

Prioritizing Heart Failure Prevention and Addressing Disparities in Cardiovascular Health

Speakers:

• Muthiah Vaduganathan, MD, MPH (Overview of the Heart Failure Series)
• John Ostrominski, MD (Opportunities to Incorporate heart Failure Prevention Strategies)

What: In a presentation accompanying a three-part series published in The Lancet, experts emphasized the importance of preventing heart failure. Investigators described the lifetime burden of heart failure and introduced a framework for screening patients to assess their risk of disease and detect early signs. They detailed the prevention of heart failure after Myocardial Infarction. Lastly, investigators underscored the need for integrated management to reduce risk, emphasizing that heart failure isn’t solely a result of a large heart attacks; other forms of cardiovascular disease, along with kidney and metabolic diseases, are increasingly common causes of heart failure.

Read more in a Mass General Brigham press release and simultaneous publication in The Lancet.

SGLT2 Inhibitors During Heart Failure Hospitalization Reduce Adverse Outcomes

Speaker: David Berg, MD, MPH

What: The DAPA ACT HF-TIMI tested whether starting dapagliflozin (an SGLT2 inhibitor) during hospitalization for heart failure could reduce early adverse outcomes. Researchers concluded that initiating the medication during heart failure hospitalization is safe and may improve survival and early post-discharge outcomes. While the results of the primary analysis did not reach statistical significance, in a pre-specified analysis of three recent trials evaluating SGLT2 inhibitors, the researchers found that the medication reduced the early risk of cardiovascular death or worsening heart failure and of all-cause death.

Read more in a simultaneous publication in Circulation.

Triglycerides Drop for Patients Taking Olezarsen

Speaker: Brian Bergmark, MD

What: A new medication called olezarsen has been developed to reduce triglyceride levels, fats in the blood that raise the risk of heart disease and pancreatitis. This study examines the impact of the medication on nearly 1,478 patients with high triglycerides and increased cardiovascular risk. After six months of receiving olezarsen, patients had a drop in triglyceride levels by about 60% compared to placebo, and almost 9-in-10 patients on olezarsen reached normal triglyceride levels. The medication had other benefits, such as minimal side effects and improving other harmful blood fats.

Read more in a simultaneous publication in The New England Journal of Medicine.

Long-Term Treatment with Apixaban Reduces Risk of Recurrent Events in Patients with Provoked Venous Thromboembolism

Speaker: Gregory Piazza, MD

What: Researchers found that, compared with placebo, low intensity apixaban (a blood thinner) reduced the risk of recurrence of venous thromboembolism (VTE) over 12 months in patients with provoked VTE and one enduring risk factor for recurrent events. Use of the drug at this dose did not increase the risk of major bleeding events.

Read more in a simultaneous publication in The New England Journal of Medicine.

GLP1 Medications Aid Patients with Heart Failure with Preserved Ejection Fraction

Speaker: Nils Krüger, PhD

What: GLP-1 weight loss medications semaglutide and tirzepatide could provide benefits for patients with heart failure who have obesity and type 2 diabetes. Using data from over 90,000 patients, researchers found that GLP-1 medications reduced the chances of hospitalization for heart failure or death by over 40% in comparison to sitagliptin (another diabetes drug). Both medicines had acceptable safety profiles.

Read more in a Mass General Brigham press release and simultaneous publication in JAMA.

An Intervention for Sustainable Blood Pressure Control in rural South Africa

Speaker: Thomas Andrew Gaziano, MD

What: A home-based care model that brings blood pressure care into people’s homes in rural South Africa could help manage hypertension more than standard clinic visits. Researchers randomly assigned adults with high blood pressure to receive usual clinical care, home visits from community health workers with self-monitoring, or have blood pressure readings sent to nurses automatically. Those in home-based programs had the best blood pressure control in comparison to those in clinic groups. This method improved average blood pressure, side effects, and patient retention.

Read more in The New England Journal of Medicine.

Aortic Valve Replacement Improves Survival for Patients with Severe Disease Even When Symptoms Are Not Present

Presenter: Jason Wasfy, MD

What: Researchers performed the largest known analysis of clinical outcomes in individuals with severe aortic stenosis and left ventricular hypertrophy (LVH). Left untreated, aortic stenosis (AS) is inevitably lethal, but the optimal timing of aortic valve replacement (AVR) is controversial. Trial results and evolving guidelines are broadening the indications for AVR in asymptomatic individuals with severe AS, and clinicians need to know which patients to prioritize.  Researchers set out to assess mortality rates for individuals with asymptomatic severe AS and LVH treated with AVR, using clinical data from over 1.2 million echocardiograms. They found that AVR is associated with improved survival in asymptomatic individuals with severe AS and LVH, even when left ventricular ejection fraction is normal, suggesting that clinicians and individuals with LVH should prioritize individuals with LVH for AVR for severe AS when symptoms aren’t present.

Read more in The European Journal of Cardio-Thoracic Surgery.