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903. Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy.
作者: Pablo Garcia-Pavia.;Martin S Maron.;Ahmad Masri.;Bela Merkely.;Michael E Nassif.;Maria Luisa Peña-Peña.;Roberto Barriales-Villa.;Ozlem Bilen.;Melissa Burroughs.;Brian Claggett.;Juan Pablo Costabel.;Edileide de Barros Correia.;Anne M Dybro.;Perry Elliott.;Sheila M Hegde.;Neal K Lakdawala.;Gregory D Lewis.;Amy Mann.;Zi Michael Miao.;Ajith Nair.;Steen H Poulsen.;Patricia Reant.;P Christian Schulze.;Scott D Solomon.;Andrew Wang.;Regina Sohn.;Indrias Berhane.;Stephen B Heitner.;Daniel L Jacoby.;Stuart Kupfer.;Fady I Malik.;Amy Wohltman.;Michael A Fifer.; .
来源: N Engl J Med. 2025年393卷10期949-960页
Beta-blockers have been the initial treatment for symptomatic obstructive hypertrophic cardiomyopathy (HCM) despite limited evidence of their efficacy. Aficamten is a cardiac myosin inhibitor that reduces left ventricular outflow tract gradients, improves exercise capacity, and decreases HCM symptoms when added to standard medications. Whether aficamten as monotherapy provides greater clinical benefit than beta-blockers as monotherapy remains unknown.
904. RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults.
作者: Mats C Højbjerg Lassen.;Niklas Dyrby Johansen.;Sine H Christensen.;Negar Aliabadi.;Kristoffer G Skaarup.;Daniel Modin.;Brian L Claggett.;Carsten S Larsen.;Lykke Larsen.;Lothar Wiese.;Michael Dalager-Pedersen.;Matias G Lindholm.;Anne Marie R Jensen.;Maria Dons.;Katrine F Bernholm.;Filip S Davidovski.;Lisa S Duus.;Camilla I Ottosen.;Anne B Nielsen.;Julie H Borchsenius.;Caroline Espersen.;Güldas Köse.;Frederik H Fussing.;Lars Køber.;Scott D Solomon.;Jens Ulrik Stæhr Jensen.;Cyril Jean-Marie Martel.;Bradford D Gessner.;Claudia Schwarz.;Elisa Gonzalez.;Mette Skovdal.;Lawrence H Moulton.;Pingping Zhang.;Elizabeth Begier.;Tor Biering-Sørensen.
来源: N Engl J Med. 2026年394卷2期138-151页
Respiratory syncytial virus (RSV) can cause serious illness in older adults. The bivalent RSV prefusion F protein-based vaccine (RSVpreF) has been shown to prevent RSV-associated respiratory illness, but data from randomized trials with regard to its effect on outcomes involving hospitalization are limited.
905. High-Dose Influenza Vaccine to Reduce Hospitalizations.
作者: Jacobo Pardo-Seco.;Carmen Rodríguez-Tenreiro-Sánchez.;Iago Giné-Vázquez.;Narmeen Mallah.;Susana Mirás-Carballal.;Marta Piñeiro-Sotelo.;Martín Cribeiro-González.;Mónica Conde-Pájaro.;Juan-Manuel González-Pérez.;Irene Rivero-Calle.;Xabier Bello.;Josefina Lorena Razzini.;Ana Dacosta-Urbieta.;Antonio Salas.;Rebecca C Harris.;Matthew M Loiacono.;Robertus van Aalst.;Joan Manel Farré.;Marine Dufournet.;Niklas Dyrby Johansen.;Daniel Modin.;Tor Biering-Sørensen.;Carmen Durán-Parrondo.;Federico Martinón-Torres.; .
来源: N Engl J Med. 2025年393卷23期2303-2312页
Superior protection against laboratory-confirmed influenza has been proved for high-dose inactivated influenza vaccine, as compared with the standard dose, among adults 65 years of age or older. However, data on the relative effectiveness of the high-dose vaccine against severe clinical outcomes, including hospitalizations, are limited.
906. Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction.
作者: Udo Bavendiek.;Anika Großhennig.;Johannes Schwab.;Dominik Berliner.;Andreas Rieth.;Lars S Maier.;Thomas Gaspar.;Nele Henrike Thomas.;Xiaofei Liu.;Sven Schallhorn.;Eleonora Angelini.;Samira Soltani.;Fabian Rathje.;Mircea-Andrei Sandu.;Welf Geller.;Rainer Hambrecht.;Marija Zdravkovic.;Sebastian Philipp.;Dragana Kosevic.;Georg Nickenig.;Daniel Scheiber.;Sebastian Winkler.;Peter Moritz Becher.;Philipp Lurz.;Martin Hülsmann.;Sören Wiesner.;Christoph Schröder.;Barbara Neuhaus.;Anika Seltmann.;Heiko von der Leyen.;Christian Veltmann.;Stefan Störk.;Michael Böhm.;Armin Koch.;Johann Bauersachs.; .
来源: N Engl J Med. 2025年393卷12期1155-1165页
The therapeutic efficacy of the cardiac glycoside digitoxin in patients with heart failure and reduced ejection fraction is not established.
907. Multidomain Rehabilitation for Older Patients with Myocardial Infarction.
作者: Elisabetta Tonet.;Andrea Raisi.;Silvia Zagnoni.;Giorgio Chiaranda.;Giovanni Pasanisi.;Daniela Aschieri.;Paola Emanuela D'Intino.;Rita Pavasini.;Paolo Cimaglia.;Roberta Campana.;Francesco Vitali.;Tommaso Piva.;Gianni Casella.;Serena Caglioni.;Valentina Zerbini.;Giulia Bugani.;Marta Cocco.;Erica Menegatti.;Martina De Raffele.;Simona Mandini.;Donato Martella.;Nicola Pesenti.;Gianni Mazzoni.;Simone Biscaglia.;Stefano Volpato.;Giovanni Grazzi.;Gianluca Campo.; .
来源: N Engl J Med. 2025年393卷10期973-982页
The benefit of rehabilitation interventions in patients who are 65 years of age or older with myocardial infarction and impaired physical performance remains unclear.
908. Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias.
作者: Christian Jøns.;Chaoqun Zheng.;Ulrik C G Winsløw.;Elisabeth M Danielsen.;Tharsika Sakthivel.;Emil A Frandsen.;Hillah Saffi.;Sadjedeh S Vakilzadeh-Hashemi.;Ketil J Haugan.;Niels E Bruun.;Kasper K Iversen.;Helle S Bosselmann.;Niels Risum.;Henning Bundgaard.; .
来源: N Engl J Med. 2025年393卷20期1979-1989页
Hypokalemia and even low-normal plasma potassium levels increase the risk of ventricular arrhythmias among patients with cardiovascular disease. An assessment of a strategy of actively increasing plasma potassium levels to the high-normal range is needed.
909. Reduction of Antihypertensive Treatment in Nursing Home Residents.
作者: Athanase Benetos.;Sylvie Gautier.;Anne Freminet.;Alice Metz.;Carlos Labat.;Ioannis Georgiopoulos.;François Bertin-Hugault.;Jean-Baptiste Beuscart.;Olivier Hanon.;Patrick Karcher.;Patrick Manckoundia.;Jean-Luc Novella.;Abdourahmane Diallo.;Eric Vicaut.;Patrick Rossignol.; .
来源: N Engl J Med. 2025年393卷20期1990-2000页
Among older adults with frailty, evidence on the benefits and risks of discontinuing antihypertensive drugs is limited.
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