This is the online version of AHA in 30 Seconds, the latest from the American Heart Association’s scientific sessions.
Hello from New Orleans. Coming from Boston, running on the River Walk this morning felt balmy, not as shockingly hot and humid as it did Friday. I could get used to this, I thought. Then I saw the holiday decorations and remembered it’s November.
To the news: Today we have what my editor calls “two talker studies” about everyday items, coffee and sunshine.
Coffee and atrial fibrillation, reconsidered
I feel pretty secure saying my morning cuppa joe gives me a jolt as it wakes me up. But what does caffeine mean for people whose hearts beat with abnormal rhythms? A study called the DECAF (Does Eliminating Coffee Avoid Fibrillation?) trial (hah) presented here today and published in JAMA Cardiology hoped to answer that question more defnitively than previous research has been able to do.
Observational studies have not found a higher risk of AF episodes after coffee consumption, even though many patients say that’s been a trigger for them. To better understand what’s going on, the new randomized clinical trial involved 200 people with persistent atrial fibrillation who were waiting for a procedure to correct this most common heart rhythm disorder. They all drank at least one cup of coffee a day over the prior five years.
Participants were split into two groups: those who drank at least one cup of coffee a day and those who had to abstain from any form of caffeine. Here’s what they found: The risk of recurrent AF episodes was lower in the coffee drinkers (47%) than in the abstainers (64%).
How could this be? The researchers mentioned some plausible mechanisms, such as caffeine’s blockade of adenosine receptors linked to arrhythmias, its anti-inflammatory properties, and its diuretic, blood pressure-lowering action. The study had limitations, including different recording devices used by participants and the reluctance of some potential participants to either drink or give up caffeine, which could skew the results.
Commenting on the study, Andrea Russo of Cooper University Medical Center said she’d like to see larger studies looking at different doses of caffeine in more than one day and somehow quantifying other caffeinated products, like energy drinks.
“But nonetheless, this is great news about coffee. I love this study,” she said this morning.
Bottom line: “Consumption of coffee and other caffeinated products may be reasonably considered in patients with AF,” the study says.
‘In general, health care was designed by men, for men’
Stacey Rosen is a cardiologist who has been coming to American Heart Association meetings for 30 years. Executive director of Northwell’s Katz Institute for Women’s Health, she now leads the AHA as volunteer president for 2025-2026. We talked yesterday about her research, practice, and mission at AHA. Here’s a sample:
What inspired you to study sex differences?When I finished med school in the mid-80s, there were not that many women in cardiology. And it became clear to me that women were suffering from heart disease and not being treated fairly. We were starting to see more and more women who were either undertreated, misdiagnosed, or more importantly, given treatments that had not really been studied in women.
How far does that blind spot go?It’s everything. Women’s health isn’t just reproductive organs. Every cell in your body has chromosomal makeup that is unique, most of us, XX, XY. And to not see that as a fundamental question when you’re setting up research defining best processes for care, diagnostic testing, treatment options, et cetera, to not have that be the very first question from a biology standpoint just always seemed illogical.
What does the future look like?I think that now is an optimal time to really focus on ways to almost compensate for the years that we weren’t putting sex as a biologic variable in front. This can’t be done by women scientists alone. Our world in cardiology is only 20% female, so that is not going to work.
Read more of our conversation on where she sees the greatest need and what give her hope.
‘Target to treat’ vitamin D helped people avoid another heart attack, study suggests
Low levels of vitamin D have long been linked to poor cardiovascular outcomes, but trying to bring people back up to recommended amounts of the sunshine vitamin has met with little success. A large new study of people who’d recently had a heart attack refined that approach, testing people’s vitamin D counts and giving some of them larger than typical doses to bring them up to or above normal. Compared to a group that received no targeted vitamin D care, people in the treatment group had a 50% lower risk of second heart attacks, according to data presented here today.
“We’re excited with these results but know we have further work to do to validate these findings,” Heidi May, a cardiovascular epidemiologist at Intermountain Health and leader of the study, said in a statement.
The study’s goal was to raise blood levels of vitamin D to more than 40 ng/ml. Among the 630 heart attack patients enrolled at the study’s start, 85% fell below that benchmark. They’re not alone: As many as one-half to two-thirds of people worldwide have low levels of vitamin D.
Following the target-to-treat model, the researchers adjusted vitamin D dosing to hit and maintain optimal levels. More than half of patients needed a first vitamin D dose of 5,000 international units, far above usual supplementation of 600 to 800 IUs. Their vitamin D levels were checked once a year if they had reached a healthy level, or every three months until they did so.
Of the 630 patients enrolled in the clinical trial, 107 experienced a major cardiac event, such as heart attack, heart failure hospitalization, stroke, or death. The risk of a second heart attack was reduced by half in the vitamin D group. The researchers hope a larger study will show whether targeted vitamin D management can lower the risk of other cardiovascular diseases.
A ‘grand slam’ for stopping ATTR-CM damage may reverse it, too, new research suggests
Alnylam Pharmaceuticals’ therapy to halt the a disease caused by misfolded proteins accumulating in the heart has been a success story. A year ago the company reported what it called a “grand slam” when a study showed that vutrisiran, an experimental gene silencer sold as Amvuttra, markedly reduced the risk of death and cardiovascular complications like heart failure in ATTR-CM.
New research presented here today offers hope that after vutrisiran prevents those amyloid proteins from piling up in the heart, it can also shrink those deposits and sweep them away. Cardiac imaging tests are showing more than stabilization in the heart, Alnylam’s chief R&D officer Pushkal Garg told STAT.
“You’re seeing actual improvements in these parameters, not just a prevention of worsening,” he said. “It suggests that actually amyloid can now get removed, that when you stop producing it and depositing more of it, the body’s natural clearance mechanisms can actually pull it out of the heart.”
Two other drugs, Pfizer’s Vyndaqel (tafamidis), and BridgeBio’s Attruby (acoramidus) share a mechanism that stabilize amyloid buildup. Amvuttra works in a different way: it is designed to block the production of the misfolded TTR.
Next up for Alnylam: Learning how to better identify these patients earlier in disease so they might be treated before there’s irreversible damage.
Wait, there’s more news on AFib
Atrial fibrillation (see coffee item above) is a heart rhythm disorder that raises the risk of bleeding and stroke. It affects an estimated 10 to 15 million people in the U.S. and roughly 50 million worldwide. That number is growing, researchers said at a media briefing here on three new trials. Researchers studied procedures, medications, and timing in three preliminary studies:
- The preliminary CLOSURE-AF trial compared standard-of-care medication to a procedure that seals off the small pouch of heart tissue where most blood clots form in people with AF. The researchers found that in older people (78 years old on average), commonly prescribed blood thinners worked better than the procedure to prevent stroke, blood clots, death, or major bleeding.
- The OCEAN randomized trial, published Saturday in the New England Journal of Medicine, compared treatment with rivaroxaban, an anticoagulant sold as Xarelto, to aspirin in people who’d had catheter ablation, a minimally invasive heart procedure to correct irregular heart rhythms. Rivaroxaban did not result in a significantly lower incidence of a composite including stroke than treatment with aspirin. “Now, we can advise patients that it may be safe to stop blood thinners, even if they have a moderate stroke risk,” study leader Atul Verma of McGill University said.
- The OPTIMA trial, also early research, found that giving people with atrial fibrillation a one-month, clot-preventing medication following stent placement was as safe and effective in preventing strokes, heart attack, and death, as a standard year-long treatment regimen.
The cost and reach of CKM syndrome
Almost no one has just one thing wrong, meaning medical diagnoses and treatments often cross specialty lines. The name cardiovascular-kidney-metabolic syndrome, or CKM for short, typifies the need to approach multiple conditions at the same time to improve health. Several abstracts presented this weekend at AHA explored the syndrome.
A sampling:
- Almost half of adolescents with overweight or obesity also had one or more risk factors for CKM (Kaiser Permanente study)
- Young adults 21 to 50 years old (80% of whom had CKM) who cut their calories by 12% improved their health, slowing CKM progression, reversing it, or never developing it, compared to a control group that didn’t change diets. (Baylor, Brigham and Women’s, and Pennington research)
- CKM is costly to health and to health care. Spending for young adults grew by 23% from 2010 to 2019, with heart failure costs rising the most but type 2 diabetes costing the most. (Houston Methodist, University of North Carolina, and London School of Economics)
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
