Study Shows Patient Self Reports Overestimated And Pharmacy Fills Underestimated Medication Persistence Agreement and Accuracy of Medication Persistence Identified by Patient Self-report vs Pharmacy Fill A Secondary Analysis of the Cluster Randomized ARTEMIS Trial

In an original investigation done by Dr. Alexander C. Fanaroff et al and recently published in JAMA Cardiology, it was found that there was discordance in medication persistence as measured by patient-reported and the pharmacy fill data. The patient self-reports overestimated and pharmacy fill data underestimated medication persistence. Those who had non-persistence by both measures had the highest rate of major adverse cardiovascular events (MACE). The authors also noted the need for giving preference to interventions that will promote medication-taking behavior. Continue reading

1K Plaque Associated With Lower Future ACS Risk: Case Control Cohort Study (Analysis from ICONIC Study) Association of High-Density Calcified 1K Plaque With Risk of Acute Coronary Syndrome

In an original investigation by Dr. Alexander R. van Rosendael et al recently published in JAMA Cardiology, it was found that the higher-density calcified plaque, referred to as 1K plaque was associated with a reduced risk for future Acute Coronary Syndromes (ACS). The authors also support the hypothesis of plaque stabilization with coronary calcium with the results of this analysis of Incident Coronary Syndromes Identified by Computed Tomography (ICONIC) study and are considerate of different risk stratifications that can be detected in atherosclerotic plaque beyond its burden. Continue reading

Trial Shows Abstinence From Alcohol Can Reduce Recurrence of Atrial Fibrillation In Patients With Paroxysmal Atrial Fibrillation Who Regularly Consume Alcohol

In an original study conducted by Dr. Aleksandr Voskoboinik et al. recently published in The New England Journal of Medicine, it was found that alcohol consumption is a modifiable risk factor for Atrial Fibrillation (AFib) and abstinence from alcohol in people with AFib causes a reduction in burden and recurrence rates of AFib. Continue reading

Mouse Study Shows High Saturated Fat Diet May Promote Arrhythmias By Activating NADPH Oxidase 2 Dietary Saturated Fat Promotes Arrythmia by Activating NADPH Oxidase2

In an original article written by Leroy C. Joseph et al, it was found the molecular mechanisms of cardiac metabolism to arrhythmia and NAPDH Oxidase2(NOX2) deletion or pharmacological inhibition can prevent arrhythmia caused due to the ingestion of a high saturated fat diet. The results of the study were published in Circulation: Arrhythmia and Electrophysiology. Continue reading

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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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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Novel Subcutaneously Administered GpIIb/IIIa Inhibitor (RUC-4) Exhibits Promising Potential As The First Point-of-Contact Therapy of STEMI First human use of a novel subcutaneous platelet GPIIb/IIIa inhibitor (RUC-4) for STEMI point of care treatment

Results of a new ongoing phase 1 study, presented at Transcatheter Cardiovascular Therapeutics (TCT) 2019 San Francisco, showed that as a first point-of-contact therapy for ST-elevation myocardial infarction (STEMI), a novel subcutaneous (SC) GpIIb/IIIa inhibitor, RUC-4, can achieve 80% of platelet inhibition within 15 minutes of the administration.

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Population Based Cohort Study: With or Without AFib, CHA₂DS₂-VASc Score is a Sensitive Predictor and Stratifies the Risk of MACCE 22,000 Patient Study Showed Increased Risk of Ischemic Stroke and New-Onset Atrial Fibrillation in Patients Without Atrial Fibrillation

Giulia Renda et al. recently published in the European Journal of Preventive Cardiology that the CHA2DS2-VASc score is a sensitive measure of predicting new-onset atrial fibrillation (AF) and adverse outcomes in patients with and without atrial fibrillation in the middle-aged patient population. Continue reading

International Ongoing Study Finds Low Prevalence of PE in Patients Presenting to the ER with First Time Syncopal Episode Study Demonstrates Low Incidence of Pulmonary Embolism In Patients Presenting with Syncope to The Emergency Department

In an ongoing diagnostic multicentric prospective study being conducted to evaluate and improve the management of patients in the emergency room (ER) presenting with syncope, an analysis was done to look for the prevalence of pulmonary embolism (PE). Results of the analysis performed by Patrick Badertscher et al were recently published in JACC  and it was found that PE was uncommon in patients admitted to the ER and hence does not need screening in patients presenting with syncope. Continue reading

11,000 Patient Study Demonstrates That Higher 24 hour and Nighttime Blood Pressure Readings Associated With Increased Risk of Cardiac Events

In an original investigation done by Dr.Wen-Yi Yang and his team, the results of which got published in JAMA, concluded that raised 24-hour and nighttime blood pressure (BP) readings are linked to increased risk of death and composite cardiovascular outcomes significantly. They considered it to be an optimal way of measuring risk but noted the difference was small for the improvement in the model.

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Study Shows Preoperative Fractional Flow Reserve Associated with 6-Month Anastomotic Graft Functionality in Patients Undergoing Coronary Artery Bypass Graft IMPAG trial

A team led by Dr David Glineur working in Canada and Europe on the IMpact of Preoperative fractional flow reserve on Arterial bypass Graft anastomotic function(IMPAG) trial published in European Heart Journal  that  fractional flow reserve(FFR) measured  before surgical revascularization and anastomotic function are significantly related to each other at 6 months with a cut-off value of 0.78. They also found that measuring FFR before Coronary Artery Bypass Grafting(CABG)surgery had improved function of the anastomotic graft.

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1.3 Million Patient Study Shows That Even With New Lower Definition for Hypertension, Elevated Systolic and Diastolic Blood Pressure Both Independently Increase Risk of Cardiovascular Events

In a recent original cohort study done by Alexander C. Flint and his team published in the New England Journal of Medicine, it was concluded that systolic hypertension, as well as diastolic hypertension, independently affects the risk of cardiovascular adverse events irrespective of the cutoffs used for hypertension(≥140/90 mm Hg or ≥130/80 mm Hg).

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New Study Reports That 13% of an Internal Medicine Intern’s Time Spent in Direct Patient Care An Assessment of Inpatient Time Allocation Among First-Year Internal Medicine Residents Using Time-Motion Observation

In an observational study published in JAMA Internal Medicine, Dr. Krisda H. Chaiyachati showed that first-year internal medicine residents spent 66% of their time involved in indirect patient care, this included interacting with the patient’s records or recording their work. On average, residents spent 13% of their day directly involved in patient care and 7% doing educational activities. Continue reading

Statin vs Healthy Adherer Effect On Mortality in ASCVD Association of Statin Adherence With Mortality in Patients With Atherosclerotic Cardiovascular Disease

In a vigorous retrospective cohort study published in JAMA, Fatima Rodriguez et al. found an inverse graded association between long-term statin adherence and all-cause mortality using a nationwide sample of the Veterans Affairs Health System, in patients with atherosclerotic cardiovascular disease(ASCVD). The study proposed that there was room for improvement in statin adherence and also stressed on its importance as a measure of secondary prevention of ASCVD. Continue reading

Aspirin Use for Primary Prevention Associated With Lower Risk of Cardiovascular Events and an Increased Risk of Major Bleeding A Systematic Review and Meta-analysis

An original investigation by Zheng et al. published in JAMA showed that the use of aspirin in individuals without cardiovascular disease was associated with a lower risk of cardiovascular events and an increased risk of major bleeding.  This may assist in discussions with patients about aspirin for the primary prevention of cardiovascular events and bleeding.

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Lesser Training In Amateur Marathon Runners Can Lead to Raised Troponins Elevation of Cardiac Troponins After Endurance Running Competitions

A recent article published in Circulation by John Del Coso and his team demonstrated that the cardiac stress during a marathon is higher than the cardiac stress produced by competing in shorter-distance events, at least in athletes with lesser experience and lower training background. The manuscript provides evidence of the relatively-high cardiac stress of marathoners, following a competition.  Reasons for this high cardiac stress after the marathon arise from the combination of a long distance event and the lack of appropriate training in the study sample. Interestingly, athletes with lower running experience and training backgrounds presented much lower values of cardiac stress, as they decided to compete in shorter distances. Continue reading

Inducible Myocardial Ischemia May Be Excluded by Low Levels of High Sensitivity Cardiac Troponin Levels

In an original cohort study by Hammadah et al recently published in Annals of Internal Medicine, it has been found that very low high-sensitivity cardiac troponin(hs-cTn) levels can be used in the exclusion of inducible myocardial ischemia in patients with stable coronary artery disease (CAD).  Moreover, it identifies people with CAD who have a lower risk of ischemia during stress testing and adverse cardiovascular events. Continue reading

Smartphone App May Improve Medication Adherence in Hypertension

A new study published in the Journal of American Medical Association finds that use of a smartphone app can result in a small, but significant improvement in self-reported medication adherence, although it does not affect blood pressure control in patients with hypertension.

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Can a Smartphone Camera Detect Atrial Fibrillation?

An original study published in the Journal of the American Heart Association aimed at finding a novel method for screening patients for atrial fibrillation (AF) using an iPhone. It evaluated the use of the smartphone application ‘Cardiio Rhythm’ in detecting AF by using no physical contact facial photoplethysmographic (PPG) signals. Continue reading