Month: March 2018
Association of High-Sensitivity Cardiac Troponins (hs-cTn) and the Risk of New-onset Heart Failure
A recent study, published in the Journal of American College of Cardiology, concluded that there is a strong association of high sensitivity cardiac troponin (hs-cTn) with the risk of new-onset heart failure (HF), independent of population at risk, cardiovascular risk factors, and natriuretic peptide levels. Continue reading
Role of Cholesterol Screening and Statin Therapy in Hypercholesterolemia
A nationally representative, cross-sectional study published in Circulation highlighted the importance of cholesterol screening and statin prescription in patients with familial hypercholesterolemia (FH) and other forms of severe dyslipidemia. It was found that despite the high prevalence of cholesterol screening and awareness, only ≈50% of adults with FH are on statin therapy, with even fewer prescribed a high-intensity statin. Continue reading
Do Procedure and Coronary Lesion Characteristics Impact Clinical Outcomes in Atrial Fibrillation Patients Undergoing PCI?
According to a post-hoc analysis of the PIONEER AF-PCI trial that was recently published in the Journal of American College of Cardiology, there was no impact of complex coronary lesions, stent characteristics, or vascular approach on efficacy or safety outcomes among stented atrial fibrillation (AF) patients who received either rivaroxaban or Vitamin K Antagonists (VKA)-based dual or triple therapy. Continue reading
ICON RELOADED: A New Future for NT-proBNP
A multicenter, international, North American study published in the Journal of the American College of Cardiology has indicated that N-terminal pro–B-type natriuretic peptide (NT-proBNP) testing may be valuable in the identification or exclusion of heart failure in emergency department patients with shortness of breath.
SWAP 4 trial: De-escalation of P2Y12 Inhibitors
In a recent article published in The Circulation, it has been found that the use of a loading dose while switching between P2Y12 inhibitors in patients with coronary artery disease is associated with mitigation of the reactivity of platelets. The study has also emphasized that timing of administration of loading dose has no impact on platelet reactivity.
Immune Checkpoint Inhibitors-associated Myocarditis
In a recently published study in the Journal of American College of Cardiology, it was suggested that myocarditis following administration of immune checkpoint inhibitors (ICI) for various cancers is underestimated. Myocarditis occurs early in the course of treatment (~ 30 days), with the majority of cases presenting within 3 months of initiation of therapy. ICI-associated myocarditis responded to high doses (1000 mg) of steroids.
The ICON-RELOADED Study: A New Future for NT-proBNP
Dr. James Januzzi and Dr. C. Michael Gibson Discuss
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HeartMate 3: Magnetic Pump in Advanced Heart Failure
According to a new study published in the New England Journal of Medicine, a fully magnetically levitated centrifugal- flow pump has been found to be superior to a mechanical-bearing axial-flow pump in advanced heart failure patients in terms of survival free of disabling stroke or reoperation for removal in case of device malfunction.
VEST: Wearable cardiac defibrillator decreases mortality post MI
The first randomized trial of the Wearable Cardiac Defibrillator (WCD) was conducted by Dr. Jeffrey Olgin and his colleagues from the University of California and presented at the ACC 2018 in Orlando, Florida. The trial showed that prescribing the WCD was reasonable to protect high-risk patients with a low LVEF (Left ventricular ejection fraction) post-MI until evaluation for an ICD at 40-90 days.
Febuxostat Non-Inferior to Allopurinol in Reduction of MACE but Increases Mortality
In a recent article, published in The New England Journal of Medicine, the rates of major cardiovascular events with febuxosat were similar to allopurinol in patients with gout and concomitant cardiovascular disease. However, the mortality rates either due to cardiovascular deaths or any other cause were higher with febuxostat than allopurinol. Continue reading
Frailty and Conventional Risk Scores in Patients Undergoing TAVR
The usage of combined risk models of frailty and conventional risk scores significantly enhances prediction of one-year mortality in patients undergoing TAVR, according to a recent publication in the Journal of American College of Cardiology.
Intervention in Barbershops Improved Blood Pressure Control
The results of a cluster-randomized trial conducted in black barbershops have been published in the New England Journal of Medicine and were presented by Dr Ronald G. Victor from Los Angeles, California at the ACC 2018 Conference in Orlando. The study showed that health promotion by barbers along with medication management in barbershops by pharmacists, resulted in a larger blood pressure reduction in black male barbershop patrons with uncontrolled hypertension as compared to lifestyle modifications and doctor appointments.
Should Patients with Acute Chest Pain Undergo Noninvasive Testing After the Clinical Diagnosis is Made?
The use of noninvasive cardiac tests such as coronary computed tomographic angiography (CCTA) or stress testing for patients presenting to the emergency department with chest pain is not associated with a better clinical outcome when compared to the conventional method for diagnosing acute coronary syndrome, according to a recent study published in the Journal of American Medical Association. Continue reading
Is Sodium Bicarbonate or N-Acetyl-Cysteine Effective in Preventing Contrast-Induced Nephropathy?
In a recent study published in the New England Journal of Medicine, it was found that amongst patients undergoing angiography, sodium bicarbonate is not better than sodium chloride and neither is acetylcysteine better than oral placebo in the prevention of a composite outcome of death, need for dialysis, or persistent kidney injury. The treatment was also ineffective in reducing the risk of contrast-associated acute kidney injury.
CABG Versus PCI in Multivessel Disease
In a recent study published in The Lancet, it was found that there is a mortality benefit for patients with multivessel disease undergoing CABG compared to PCI. However, the reduction in mortality was not statistically significant in patients with only left main artery disease. With recent advancements in stenting techniques, the benefit of using CABG over PCI has been debatable. Prior to this , no study was powered to compare the mortality benefits between these interventions.
