The results of the Aspirin in Reducing Events in the Elderly (ASPREE) trial published in the New England Journal of Medicine showcase higher all-cause mortality among apparently healthy older adults receiving daily aspirin as compared to placebo, coupled with the shocking finding of mortality being attributed primarily to cancer, thereby painting a bleak picture of Aspirin (ASA) and heralding an end to its use in primary prevention. Continue reading →

The discovery of Valsartan products that were contaminated with NDMA, in July 2018, in drug products manufactured in China, triggered the withdrawal of all affected products by medical agencies across Europe and the United States. Being one of the most well characterized and potent animal carcinogens known, Pottegard and his colleagues conducted an expedited observational cohort study using the nationwide Danish healthcare registry. They aimed to quantify the potential effects of NDMA contaminated valsartan products in terms of increased cancer risk, in order to provide timely information for regulatory bodies evaluating its carcinogenic effects. Results from this Danish cohort study, published in the BMJ, however, failed to show a significant increase in overall short-term cancer risk due to consumption of NDMA contaminated valsartan. Continue reading →

This video is supported by an unrestricted educational grant.

Findings from a Danish nationwide registry conducted among patients with Atrial Fibrillation (AF), initiated on Vitamin K Antagonists (VKA) for stroke prevention between 1997 and 2011, found that almost one-half of patients with prior good level of VKA control (TTR ≥70%) had TTR <70% during the following year. Additionally, those with a prior TTR of ≥70% had a limited long-term prognostic value for stroke, thromboembolism or major bleeding risk, according to the online publication in JACC. Continue reading →

Findings from an international TAVR registry involving 16 centers and spanning over a decade have important implications for operator training and patient care at centers performing TAVR. The study, published in JACC Cardiovascular Interventions, is a testament to the learning curve that still exists with both greater procedural safety and lower mortality rates reported when TAVR is performed by experienced operators. Additionally, TAVR performed at low annual volume (<50 procedures) institutions is associated with decreased procedural safety and higher patient mortality. This stepwise improvement in patient outcomes bears important implications for operator training and patient care at centers performing TAVR. Continue reading →

This video is supported by an unrestricted educational grant.

Researchers have confirmed that the extent of residual angiographic disease calculated using the residual SYNTAX score (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) or RSS has no association with ischemic events occurring subsequently in patients presenting with ACS. The study, published in JACC, reinforces the concept that functionally complete revascularization is applicable even in ACS patients. Continue reading →

This video is supported by an unrestricted educational grant.

This video is supported by an unrestricted educational grant.

The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study is a UK based trial that reports long-term beneficial effects of antihypertensives and statins in terms of mortality and cardiovascular outcomes after 16 years of follow-up in patients with hypertension. Continue reading →

Results of the BIOSCIENCE study that were presented at the ESC Annual Congress by Dr. Thomas Pilgrim, University Clinic for Cardiology, Bern, Switzerland, show that the 5-year risk of target lesion failure among patients undergoing percutaneous coronary intervention (PCI) is similar after implantation of the ultrathin-strut, biodegradable-polymer sirolimus-eluting stents as compared with thin-strut, durable-polymer, everolimus-eluting stents. However, higher incidence of all-cause and non-cardiovascular mortality in patients treated with the biodegradable polymer sirolimus-eluting-stents as compared with the durable-polymer stents eluting everolimus warrant careful scrutiny in ongoing clinical trials. The announcement of the results of this trial at the ESC was accompanied by a publication in the Lancet. Continue reading →

 In a randomized multi-center clinical trial that enrolled more than 700 patients with multi-vessel coronary artery disease and acute myocardial infarction (MI) with cardiogenic shock, it was shown that percutaneous coronary intervention (PCI) of the culprit lesion only (with the option of staged revascularization of nonculprit lesions) was associated with better clinical outcomes compared to immediate multi-vessel PCI. It was found that at 30 days, there was a 9.5% absolute reduction in the rate of the primary endpoint of death or renal replacement therapy in patients randomized to culprit-lesion only revascularization. Previously DANAMI-3-PRIMULTI, PRAMI, and CvLPRIT trials have suggested that there may be a benefit to complete revascularization but those studies did not enroll patients with hemodynamic instability or cardiogenic shock. Consequently, this led to the inclusion of immediate multi-vessel PCI in the 2015 ACC/AHA/SCAI STEMI guidelines as a Class II-b recommendation (can be considered). Continue reading →

PROMIS-HFpEF (PRevalence Of MIcrovascular dySfunction in Heart Failure with Preserved Ejection Fraction) is an echocardiographic trial showcasing a high prevalence of coronary microvascular dysfunction (CMD) in HFpEF and its association with systemic endothelial dysfunction (RHI, UACR) and markers of HF severity (NT-proBNP and RV dysfunction). The results of the trial were recently published in the European Heart Journal. Continue reading →

The Canadian SCAD Study

The Canadian SCAD study investigated the risk factors and outcomes of spontaneous coronary artery dissection (SCAD). This prospective observational study enrolled 750 non-atherosclerotic SCAD patients from 22 cardiac centers in North America. Continue reading →

The selective serotonin 2c receptor agonist, Lorcaserin has been proven to be effective in the promotion of sustained weight loss through appetite suppression in obese and overweight patients, with no increase in cardiovascular events, according to the CAMELLIA-TIMI 61 (Cardiovascular and Metabolic Effects of Lorcaserin in Overweight and Obese Patients–Thrombolysis in Myocardial Infarction 61) trial, presented at the ESC conference in Munich. Continue reading →