A renowned figure in interventional cardiology and cardiovascular research, Dr. Mehran brings a wealth of experience and a global perspective to her leadership role. Holding an endowed professorship in cardiovascular clinical research and outcomes at the Icahn School of Medicine at Mount Sinai, she also serves as the director of the Women’s Heart and Vascular Center. This multidisciplinary center focuses on the unique cardiovascular needs of women, a population that has historically been underrepresented in cardiovascular research and care protocols. Dr. Mehran’s clinical and academic roles emphasize her commitment to precision medicine tailored to diverse patient populations.

Her leadership at the ACC underscores a strategic focus on expanding global partnerships and fostering member engagement to drive innovation and professional growth. The College, through initiatives such as the National Cardiovascular Data Registry (NCDR) and its suite of JACC journals, has established itself as an authoritative source of evidence-based guidelines and cardiovascular education worldwide. Under her guidance, the ACC aims to deepen collaborations across borders to tackle cardiovascular disease more effectively on a global scale.

Dr. Mehran’s scientific contributions are prolific and impactful. She has led multiple landmark clinical trials and global studies that have shaped contemporary interventional cardiology practices. Her research has addressed critical aspects of cardiovascular disease management, including novel stent technologies, antithrombotic therapies, and risk stratification models. These efforts have increasingly been focused on stratifying therapy to optimize outcomes and reduce procedural complications especially among high-risk patient cohorts.

Particularly notable is her advocacy for elevating women’s roles in medicine, both as practitioners and as patients underserved by traditional cardiovascular paradigms. As the founder and chief scientific officer of the Cardiovascular Research Foundation and the founder of Women as One—a nonprofit dedicated to advancing women in cardiology—Dr. Mehran actively promotes gender equity in academic medicine and clinical research leadership. This dual commitment enhances the ACC’s efforts to address disparities in cardiovascular health and professional development within the field.

Her extensive publication record, with thousands of peer-reviewed articles and guideline contributions, illustrates a deep engagement with evidence synthesis and dissemination. Being recognized by Clarivate Analytics as one of the world’s most highly cited scientific minds for eight consecutive years speaks to the seminal influence of Dr. Mehran’s findings in advancing cardiology knowledge and clinical practice.

Throughout her tenure in the ACC prior to her presidency, Dr. Mehran held substantive leadership roles including chairing the Interventional Section Leadership Council and serving on the Board of Trustees. Her involvement has been crucial to shaping the College’s strategic direction and clinical guideline development, aligning expert consensus with real-world practice needs. Dr. Mehran’s leadership style is characterized by a collaborative approach, leveraging diverse expertise to foster innovation and inclusivity.

Her accolades reflect a career distinguished by medical leadership and scientific excellence. Among the numerous awards are the ACC’s Bernadine Healy Leadership in Cardiovascular Disease Award and the Nanette Wenger Award for Excellence in Medical Leadership from WomenHeart. International recognition includes the Ellis Island Medal of Honor and the European Society of Cardiology Silver Medal, highlighting her global impact on cardiovascular medicine.

The transition to Dr. Mehran’s presidency will be formally enacted during the Convocation Ceremony of the ACC’s Annual Scientific Session in New Orleans, scheduled for March 28-30, 2026. This event will also usher in new officers who will collaborate to steer the global cardiovascular community toward enhanced education, research, and patient care initiatives.

Dr. Mehran’s presidency promises to invigorate the ACC’s commitment to fostering scientific rigor and compassionate care. As cardiovascular disease remains the leading cause of mortality worldwide, the College’s efforts under her leadership to integrate cutting-edge research with clinical application are timely and essential. The evolving landscape of cardiovascular medicine, including advances in molecular cardiology, precision imaging, and digital health, will likely be areas of focus and growth during her term.

The ACC continues to be a beacon of innovation, education, and advocacy in cardiovascular medicine. Dr. Roxana Mehran’s stewardship exemplifies the intersection of clinical excellence, research leadership, and commitment to equity, positioning the College to make transformative strides in understanding and combating cardiovascular diseases globally.

Subject of Research: Cardiovascular medicine, interventional cardiology, women’s cardiovascular health, clinical guidelines development

Article Title: Dr. Roxana Mehran Assumes Presidency of the American College of Cardiology: A New Era in Global Cardiovascular Leadership

News Publication Date: Not specified (anticipated 2026)

Web References: American College of Cardiology

Image Credits: American College of Cardiology

Keywords: Roxana Mehran, American College of Cardiology, cardiovascular care, interventional cardiology, Women’s Heart and Vascular Center, cardiovascular research, clinical guidelines, cardiovascular disease prevention, Women as One, global cardiovascular partnerships

Heart failure afflicts an estimated 64 million individuals globally, representing one of the most pervasive cardiovascular disorders. The study, a collaborative effort involving more than 10,000 patients across 41 countries, meticulously differentiated between individuals admitted for acute heart failure episodes and those receiving scheduled outpatient care for chronic manifestations of the disease. Data were collected from 2018 to 2020, offering a contemporary lens on patient outcomes.

What distinguishes this research is its comprehensive approach, simultaneously tracking mortality rates, hospital readmissions, and dissecting the specific etiologies of both death and rehospitalization. Central to the investigation was an analysis of the ejection fraction—a critical measure of the heart’s pumping efficacy—categorized into reduced, mildly reduced, and preserved function groups. This stratification allowed the researchers to correlate cardiac performance with patient prognoses in unprecedented detail.

The statistics are sobering: during initial hospitalization for acute heart failure, 5.1% of patients succumbed, highlighting the immediate risks associated with severe cardiac decompensation. However, survivors remained vulnerable. In the subsequent year, mortality rates diverged significantly based on ejection fraction status. Those with reduced ejection fraction endured the highest mortality risk, suggesting a direct relationship between diminished ventricular contractile function and fatal outcomes.

Equally compelling is the rehospitalization data. Among acute heart failure patients with reduced ejection fraction, a staggering 44% were readmitted at least once during the following year, illustrating the chronic, relapsing nature of the disease in this subgroup. Conversely, among outpatients with preserved ejection fraction, only 18% faced readmission, indicating that cardiac function preservation correlates with more stable clinical trajectories.

Professor Lars Lund of Karolinska Institutet, the study’s principal author, elaborated on these findings, noting that patients hospitalized for acute episodes exhibit approximately twice the risk of readmission and thrice the risk of mortality compared to those managed in outpatient settings. This pronounced disparity accentuates the critical influence of acute decompensation events on long-term patient outcomes.

These data bear significant ramifications for healthcare planning and resource allocation. Understanding the nuanced interplay between ejection fraction and patient outcomes is imperative for tailoring follow-up regimens and optimizing therapeutic interventions. The study advocates for heightened vigilance and customized care pathways, particularly for individuals presenting with acute heart failure and impaired systolic function.

Moreover, the study’s design as an observational registry observational study, underscores the real-world applicability of the findings. By encompassing diverse patient populations across multiple healthcare settings, the research transcends the limitations of controlled clinical trials, providing insights directly relevant to everyday clinical practice.

The clinical community has long recognized heart failure as a heterogenous syndrome, with variable phenotypes driven by underlying cardiac mechanics. This investigation adds critical granularity, reinforcing the prognostic weight of ejection fraction categorization and its potential to guide both prognostic assessments and therapeutic decision-making.

Funding for the study came from leading pharmaceutical entities; importantly, the authors declare no conflicts of interest, ensuring the integrity and impartiality of the findings. This transparency bolsters confidence in the study’s conclusions and their applicability to clinical guidelines.

In conclusion, the study illuminates the formidable challenges inherent in managing acute heart failure, especially among those with severely reduced ejection fraction. It signals a clarion call for improved surveillance, individualized care plans, and innovative treatments to mitigate the high risks of death and hospital readmission. As heart failure continues to exert a tremendous global health burden, these insights promise to shape the future landscape of cardiovascular medicine.

Subject of Research: People
Article Title: Outcomes of heart failure with reduced, mildly reduced, or preserved ejection fraction: the ESC HF III registry
News Publication Date: 25-Feb-2026
Web References: http://dx.doi.org/10.1093/eurheartj/ehaf1074
References:
Lars H. Lund, Aldo P Maggioni, Maria G Crespo-Leiro, Cecile Laroche, Israel Gotsman, Belma Pojskic, Eleonora B. Vataman, Lucica Grigorica, Hamayak Sisakian, Duska Glavas, Dulce A. Brito, Stefan Anker, Ovidiu Chioncel, Gerasimos Filippatos, Mitja Lainscak, Theresa A. McDonagh, Alexandre Mebazaa, Massimo Piepoli, Frank Ruschitzka, Gianluigi Savarese, Petar M. Seferović, Marco Metra, Giuseppe Rosano, European Heart Journal, online 25 February 2026, doi: 10.1093/eurheartj/ehaf1074.
Keywords: Heart failure, Cardiology, Cardiovascular disease, Health and medicine

Indonesia’s National Health Insurance system, established to provide equitable healthcare access to its vast population, operates with various membership categories, primarily categorized into subsidized and non-subsidized memberships. These classifications inherently influence the quality and extent of healthcare services members can access, a factor that profoundly impacts patient outcomes, particularly for chronic and acute cardiovascular diseases such as ischemic heart disease and stroke. The study utilized a comprehensive dataset of insurance claims to analyze how these different membership types correlate with patterns in service utilization, treatment quality, and survival rates.

One of the most striking findings of the study is the stark disparity in hospital admission rates for IHD and stroke patients across the two primary NHI membership types. Patients under the subsidized scheme – often representing lower socioeconomic groups – had significantly lower hospital admission rates than their non-subsidized counterparts. Given the acute nature of ischemic cardiovascular events, delayed or reduced hospitalization may critically worsen prognosis, underscoring a systemic inequality that exacerbates health outcomes based on financial or social status within the insurance framework.

Beyond hospital admissions, the research revealed important differences in the timeliness and intensity of rehabilitation services received post-discharge by different membership groups. Rehabilitation is pivotal in reducing disability and improving long-term functionality following stroke and IHD incidents. The subsidized NHI members consistently received fewer rehabilitation sessions, signaling a gap not merely in acute care but extending into long-term recovery and quality of life—a gap likely perpetuating cycles of disability and dependence in already vulnerable populations.

Pharmacological treatment patterns also varied notably. The study found that subsidized members were less likely to be prescribed or adhere to optimal secondary prevention medications like antiplatelets, statins, and antihypertensives. This difference may stem from accessibility issues, affordability constraints, or systemic biases in healthcare delivery, contributing to higher risks of recurrent cardiovascular events and mortality among subsidized patients. The implications for chronic disease management within large-scale public health programs are profound, calling for targeted interventions to ensure equity in medication access and adherence support.

Mortality outcomes further emphasized the gravity of these disparities. Mortality rates for ischemic heart disease and stroke were consistently higher among subsidized NHI members across the study period. This alarming finding not only highlights the immediate human cost of insurance-based healthcare inequality but also portends escalating burdens on Indonesia’s healthcare system, economy, and social fabric if left unaddressed. The study contextualizes mortality trends within broader social determinants of health, emphasizing systemic obstacles beyond clinical care.

Regional variability within Indonesia’s vast archipelago also emerged as a critical factor. The research demonstrated that disparities were more pronounced in rural and less-developed regions where healthcare infrastructure is less robust, compounding the disadvantages faced by subsidized insurance members. Geographic disparities introduce an additional layer of complexity for health policymakers, indicating that insurance reforms alone may be insufficient without concurrent investments in regional healthcare capacity.

Methodologically, the research employed rigorous quantitative analyses of insurance claims, integrating advanced statistical models to control for confounding factors such as age, sex, comorbidities, and socioeconomic status. This robust approach allowed for a nuanced understanding of the interplay between insurance status and health outcomes, providing a credible evidence base for stakeholders aiming to reform Indonesia’s health insurance policies and clinical care pathways for cardiovascular diseases.

Importantly, the study offers crucial insights into potential systemic interventions that could bridge these disparities. Suggestions include revising subsidy frameworks to expand access to comprehensive care, enhancing patient education regarding chronic disease management, and improving the availability of essential medications and rehabilitation services especially in underserved rural areas. Implementing such measures could reduce mortality, improve quality of life, and alleviate the socioeconomic toll of ischemic heart disease and stroke.

The timing of this research is particularly pertinent given Indonesia’s ongoing efforts to achieve Universal Health Coverage (UHC). While the National Health Insurance scheme has succeeded in expanding coverage, this study underscores that coverage alone is insufficient without equitable service provision. Addressing these disparities aligns with global priorities set by the World Health Organization and the Sustainable Development Goals, particularly those focused on reducing premature mortality from non-communicable diseases.

Beyond Indonesia, the findings have broader relevance for low- and middle-income countries (LMICs) grappling with similar dual burdens of expanding insurance coverage while ensuring equitable healthcare quality. The study provides a cautionary tale illustrating how differences in insurance design and implementation can engender unintended inequalities, urging that equity must be a central pillar in health financing reforms globally.

The study further highlights the crucial role of data infrastructure and health information systems in identifying and monitoring disparities. Indonesia’s capacity to leverage insurance claims data for health system research demonstrates a growing maturity in data-driven policymaking, serving as a model for other countries aiming to tailor interventions based on empirical evidence rather than anecdote.

From a clinical perspective, the research draws attention to the necessity for tailored care pathways that account for insurance and socioeconomic status. Healthcare providers must be sensitized to disparities in resource availability and patient adherence risks, integrating multidisciplinary approaches to optimize outcomes. This may involve stronger linkages between hospital care, community health workers, and social support services to create resilient patient-centered care models.

In summary, this extensive investigation into the inequities associated with Indonesia’s National Health Insurance types provides a foundational understanding of how financial and systemic factors shape cardiovascular health outcomes. The implications ripple far beyond Indonesia, pressing health policymakers worldwide to critically examine how insurance schemes are structured and delivered. Equitable access to not only coverage but timely, high-quality care and rehabilitation remains the keystone to combating the growing global burden of ischemic heart disease and stroke.

As cardiovascular disease remains a leading cause of mortality and morbidity worldwide, studies like this illuminate the pathways through which health systems can either entrench or alleviate disparities. The evidence presented calls for urgent action, blending policy reform with innovative care delivery to bridge gaps and save lives in Indonesia and comparable contexts facing the challenge of equitable health service provision.

Subject of Research: Disparities in health services and outcomes associated with National Health Insurance membership types among ischemic heart disease and stroke patients in Indonesia.

Article Title: Disparities in health services and outcomes by National Health Insurance membership type for ischemic heart disease and stroke in Indonesia: analysis of claims, 2017–2022.

Article References:
Darmawan, E.S., Hasibuan, S.R., Permanasari, V.Y. et al. Disparities in health services and outcomes by National Health Insurance membership type for ischemic heart disease and stroke in Indonesia: analysis of claims, 2017–2022. Glob Health Res Policy 10, 33 (2025). https://doi.org/10.1186/s41256-025-00432-y

Image Credits: AI Generated

DOI: https://doi.org/10.1186/s41256-025-00432-y