Blinded Post-PCI Physiologic Assessment Detected Residual Ischemia After Angiographically Successful Result The DEFINE PCI Study

The result of a study, presented at ACC 2019 in March, 2019 and recently published in JACC Interventional Cardiology, showed that despite angiographically successful percutaneous coronary intervention (PCI), physiological assessment detected residual ischemia in 1 out of 4 patients after coronary stenting. The majority of the cases were due to inappropriate focal lesions which seem amenable to treatment with additional PCI.

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20,000 Patient Randomized Trial Shows Ingestion of Anti-hypertensive Medication at Night Associated with Better Blood Pressure Control and Improved Cardiovascular Outcomes

A randomized trial, led by Dr. Ramon Hermida, revealed that the routine ingestion of at least one prescribed anti-hypertensive medication in patients with hypertension led to improved control of ambulatory blood pressure and reduced cardiovascular risk. This study, published in the European Heart Journal, compared ingesting anti-hypertensive medication during two potential time points: upon waking and at bedtime.

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Cardiac Rehabilitation Is Associated With Decreased Hospitalization and Mortality After Cardiac Valve Surgery

Cardiac rehabilitation after cardiac valve surgery is associated with lower hospitalizations and mortality at one year. A recent cohort study of Medicare beneficiaries, published in JAMA Cardiology, revealed. 

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Treatment with Statins, RAAS Inhibitors and Platelet Inhibitors After CABG is Essential, While the Use of Beta-blockers is Questionable: Swedish Study Secondary prevention medications after coronary artery bypass grafting and long-term survival: a population-based longitudinal study from the SWEDEHEART registry

In a recent study published in the European Heart Journal, Erik Björklund et al. found that the secondary prevention medications, such as statins and renin-angiotensin-aldosterone system (RAAS) inhibitors, and platelet inhibitors used after coronary artery bypass grafting (CABG) are essential while the use of B-blockers had no association with survival and is questionable.

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New-Onset AF After TAVR linked To Worse Long-Term Outcomes Compared With Patients With Pre-Existing AF and No AF New-onset AF associated with a higher rate of death, stroke, bleeding and heart failure hospitalizations after TAVR

A registry-based cohort study including 72,660 Medicare patients with and without atrial fibrillation (AF) who underwent non-apical transcatheter aortic valve replacement (TAVR) from 2014 to 2016, has shown that, TAVR patients with new-onset AF have the highest rate of all-cause mortality (32%) compared to patients with pre-existing or no AF (23.3% and 12.8%, respectively). New-onset AF was also associated with an increased risk of bleeding, stroke and heart failure (HF) hospitalizations.

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20-Year Study Shows Statin Use Associated with Reduced Cardiovascular Event Rate in Children with Familial Hypercholesterolemia

A study led by Dr. Ilse Luirink published in the New England Journal of Medicine showed that initiating statins in children with familial hypercholesterolemia slowed the progression of carotid intima-media thickness and reduced the risk of cardiovascular disease in adulthood.

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THEMIS Study: Ticagrelor Plus Aspirin Associated with Lower Ischemic Event Rate but Higher Bleeding Rate Than Aspirin Alone in Patients with Diabetes and Stable Coronary Artery Disease

Use of ticagrelor plus aspirin in patients with stable coronary artery disease and type 2 diabetes significantly lowers the risk of major adverse cardiovascular events compared with aspirin alone, but at the cost of higher major bleeding, according to the THEMIS study. The results were presented at ESC 2019 and published in the New England Journal of Medicine.

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11-Year Follow-Up Study Shows Drug Eluting Devices Safe in Patients with Peripheral Vascular Disease

The results of a real-world safety analysis showed that over a follow-up period of up to 11 years, there was no evidence of increased mortality in patients who underwent endovascular revascularization of peripheral vessels with paclitaxel-based drug-eluting devices (DED). In this analysis, led by Dr. Eva Freisinger published in the European Heart Journal, the investigators offer evidence that conflicts with the data that suggests paclitaxel-based DED is associated with increased mortality risk.

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17 Year Study Shows Changes in Income Can Influence the Occurrence of Cardiovascular Disease

A study led by Mr. Stephen Wang, published in JAMA Cardiology, showed that an income drop over 6 years was associated with an increased incidence of cardiovascular disease over the next 17 years. Additionally, an increase in income over 6 years was associated with a reduced incidence of cardiovascular disease over the same time period. The findings of this paper suggest that changes in income can have an effect on a person’s health.

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ORION-1: 1-Year Follow-Up Data Affirms 2-dose Regimen Using 300 mg of Inclisiran For Persistent LDL-C Lowering 360-day follow-up results published in September edition of JAMA Cardiology

A randomized, double blind, placebo-controlled, phase II clinical trial studying the effect of a novel protein proprotein convertase subtilisin/kexin type 9 (PCSK9) synthesis inhibitor (inclisiran) on serum low density lipoprotein cholesterol (LDL-C) levels has shown that twice a year subcutaneous injections of inclisiran leads to a sustained dose-dependent reduction in serum LDL-C levels over a period of 1 year.

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New 21,000 PCI Study Shows Same-Day Discharge Associated with Reduced Costs But No Difference in Mortality or Readmission Rates in Patients Undergoing Elective PCI

A study led by Dr. Jennifer Rymer published in the American Heart Journal suggested that same-day discharge after an elective percutaneous coronary intervention (PCI) is being increasingly adopted and is associated with reduced costs without an increase in hospital readmission rates or mortality. The data presented in this study would further support the increased adoption of same-day discharge after elective PCI in some patients.

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COAPT: Transcatheter Mitral Valve Repair Is a Cost Effective Treatment In Patients with Heart Failure and Secondary Mitral Valve Regurgitation

New findings from the COAPT study were just published in Circulation and presented at TCT 2019 by Dr. Suzanne J. Baron. The findings of the study suggest that in patients with symptomatic heart failure and secondary mitral regurgitation, transcatheter mitral valve repair (TMVr) increases life expectancy and quality-adjusted life years (QALY) as compared with guideline-directed medical therapy.

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PARTNER 3: TAVR Associated with Better Health Status At 12 Months As Compared to SAVR in Patients with Severe Aortic Stenosis and Low Surgical Risk

Findings from the ongoing PARTNER 3 trial were published in the Journal of the American College of Cardiology and presented at TCT 2019 by Dr. Suzanne J. Baron. The findings of this study further support the use of transcatheter aortic valve replacement (TAVR) over surgical aortic valve replacement (SAVR).

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REMEDIAL III: Urine Flow Rate Guided Hydration Is Superior to Left Ventricular End‐Diastolic Pressure Guided Hydration for Preventing Renal And/Or Pulmonary Edema in Interventional Cardiology Renal insufficiency following contrast media administration trial III: Urine flow rate-guided versus left-ventricular end-diastolic pressure-guided hydration in high-risk patients for contrast-induced acute kidney injury. Rationale and design.

Findings of an ongoing REMEDIAL (REnal Insufficiency Following Contrast MEDIA Administration triaL) III trial have been published recently in Catheter Cardiovasc Interventions and were presented by Dr. Carlo Briguori from Naples, Italy at the TCT-2019 in San Francisco. The study showed that urine flow rate (UFR) guided hydration is superior to left ventricular end‐diastolic pressure (LVEDP)-guided hydration for preventing contrast-induced acute kidney injury (CIAKI) and/or acute pulmonary edema.

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