Letters to the Editor
- Atrial fibrillation (AF) will affect at least 12 million people in the United States by 2030. Atrial fibrillation is associated with an increased risk for stroke and death and contributes to substantial costs and resource use.1 Considerable efforts are devoted to optimize AF management and mitigate its negative sequalae. However, the literature suggests the presence of racial disparities in the management of AF in the United States. Recent studies showed that direct oral anticoagulant, pulmonary vein isolation, and left atrial appendage closure are less commonly used among patients of non-White race.
- We thank the authors for their insightful comments on our perspective published in the journal.1 We agree with Dr Modarressi1 that sodium-glucose cotransporter-2 inhibitors indeed represent an important new treatment for patients with heart failure. Although we used the trial definition of major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or stroke) in the text and in the table’s footnote, we acknowledge that this was a secondary and not a primary end point.
- The demonstrated safety and efficacy of transcatheter aortic valve replacement (TAVR) in low-risk patients led to its growing acceptance as a standard therapy for aortic stenosis (AS), regardless of patients' surgical risks.1 However, concerns arose on expanding TAVR to younger patients (<70 years of age), considering the scarce long-term data in this age group and the remaining questions of transcatheter valve durability, coronary reaccess, impact of long-term permanent pacing, and the risk of future surgical aortic valve replacement (SAVR).