Cardiology

Mavacamten associated with increased new and recurrent AF in obstructive HCM

In 160 oHCM patients treated with mavacamten, new AF occurred at 6.4%/year among those without prior AF. Observed 2-year symptomatic AF risk modestly exceeded HCM-AF score predictions (8.2% vs 6.9%). On multivariable analysis, mavacamten treatment was associated with higher new AF risk (HR 3.0, p=0.01). Among patients with prior AF, recurrence rate during treatment was 19.3%/year. 1

A decade of CVOTs shifted practice to a cardiorenal-metabolic framework

CVOTs from 2016–2026 transformed safety trials into evidence of cardiorenal protection beyond glycaemic control. Landmark trials across GLP-1 and SGLT2 inhibitor classes reoriented therapeutic priorities toward CRM care. The review synthesises trajectories, key trial findings, and emerging therapies shaping precision cardiometabolic medicine. 2

Metabolomic indices differentially predict outcomes in HFpEF versus HFrEF

In 1,520 international HF patients, netNO-pEF and netPurine-pEF predicted outcomes in HFpEF, while netACa-rEF and netAA-rEF did so in HFrEF. Every 20% higher netNO-pEF associated with lower mortality in HFpEF (PEOPLE HR 0.64; SHOP HR 0.40). Higher netPurine-pEF and netACa-rEF linked to worse outcomes (e.g., netPurine-pEF PEOPLE HR 1.71). Adding orotic acid to a clinical model modestly improved 2-year mortality prediction (AUROC 0.82→0.83). 3