A recent study published in Circulation Stroke conducted by Omran et al. reported that the US hospitalization rates for stroke associated with infective endocarditis and opioid use were stable for roughly about 2 decades but then sharply increased in 2008, coinciding with the emergence of the opioid epidemic. Continue reading →

A study by Zsolt Szijgyarto and his colleagues published in JACC: Cardiovascular Interventions has derived the EuroCTO (CASTLE) from the largest database of CTO cases to date and offers a useful tool for predicting procedural outcomes. The investigators stated that previous CABG, age over 70 years, a blunt stump, severe tortuosity, length of the occlusion, and the extent of calcification were strongly associated with unsuccessful CTO-PCI. Continue reading →

A study by Ference et al. published in JAMA showed that triglyceride-lowering LPL variants and LDL-C–lowering LDLR variants were associated with similar lower risk of CHD per unit difference in ApoB. Therefore, the investigators believe that the clinical benefit of lowering triglyceride and LDL-C levels may be proportional to the absolute change in ApoB. Continue reading →

A recent study published in the New England Journal of Medicine showed that among patients who were scheduled for CABG and had been randomly assigned to undergo bilateral or single internal-thoracic-artery grafting, there was no significant between-group difference in the rate of death from any cause at 10 years in the intention-to-treat analysis. Coronary-artery bypass grafting (CABG) surgery with the use of left internal- thoracic-artery grafts plus vein grafts had been deemed superior to percutaneous coronary intervention in patients with severe coronary artery disease and in those with diabetes. The benefit of using left internal thoracic artery grafts has been attributed to their superior long-term patency as compared with vein grafts. However, it is hypothesized that multiple arterial grafts may result in longer survival than single arterial grafts after coronary-artery bypass grafting (CABG) surgery. In the light of this, the study aimed to evaluate the use of bilateral internal-thoracic-artery grafts for CABG. Continue reading →

An article by Sandhu et al. published in the American Heart Journal reported that on using critical access hospitals (CAHs) as a control group, the introduction of financial penalties was only associated with modest reductions in readmissions and an uncertain association with mortality. Continue reading →

A study published in JACC reported that fractional flow reserve (FFR) computation from coronary computed tomography angiography (CTA) datasets (FFRCT) had higher diagnostic performance as compared with standard coronary CTA, SPECT, and PET for vessel-specific ischemia, provided coronary CTA images were evaluable by FFRCT, whereas PET had a favorable performance in per-patient and intention-to-diagnose analysis. The investigators also stressed that in patients in whom 3-vessel FFRCT could be analyzed, FFRCT held the clinical potential to provide anatomic and hemodynamic significance of coronary lesions. Continue reading →

The FDA issued a Dear Doctor letter while investigating a potential safety signal with paclitaxel-coated balloons and stents used to treat peripheral artery disease. “This review will focus on the causes of death, the paclitaxel dose delivered, and patient characteristics that may impact clinical outcomes. Additional statistical analyses will be performed to clarify the presence and magnitude of any long-term risks,” the letter stated.  Continue reading →

A series of systematic reviews and meta-analyses have depicted how findings from prospective studies and clinical trials associated with relatively high intakes of dietary fiber and whole grains were complementary, and striking dose-response evidence indicated that the relationships to several non-communicable diseases could be causal. According to the publication in The Lancet, the implementation of recommendations to increase dietary fiber intake and to replace refined grains with whole grains is expected to benefit human health. Continue reading →

In the largest study conducted to date for Spontaneous coronary artery dissection (SCAD), the first genetic risk factor was identified. The findings, published in JACC, suggested that this genetic link could contribute to the clinical overlap between SCAD and fibromuscular dysplasia (FMD). Continue reading →

According to a recent publication in JACC: Cardiovascular Interventions, many factors uniquely dissuade women from pursuing interventional cardiology (IC) compared with men, largely related to the culture of IC as a subspecialty. Targeted resolution of these specific factors may provide the most impact in reducing sex imbalances in the field. Continue reading →

According to a study published in JACC: Cardiovascular Interventions, sex, renal failure, and atrial fibrillation affected mortality the most at 3-year follow-up following transcatheter aortic valve replacement (TAVR). In contrast, anticoagulation (mostly given for atrial fibrillation) was found to reduce the risk of bioprosthetic valve dysfunction (BVD) after TAVR. Continue reading →

The results of a fascinating study conducted by Dr. Patricia Iozzo and her colleagues at the Institute of Clinical Physiology, in Pisa, Italy showed that neonatal changes in cardiac morphology were explained by late-trimester maternal body mass index; myocardial glucose overexposure seen in minipigs could justify early human findings. Moreover, long-term effects in minipigs consisted of myocardial insulin resistance, enzymatic alterations, and hyperdynamic systolic function, according to the publication in JACC: Cardiovascular Imaging. Continue reading →

Results from a study conducted by investigators at Stanford University School of Medicine did not support the Hispanic paradox in a highly educated Hispanic population. The study demonstrated that Hispanic and non-Hispanic white (NHW) men and women with high educational attainment had similar atherosclerotic cardiovascular disease risk, subclinical coronary atherosclerosis, and mortality during follow-up. The results were published online in the latest issue of JAMA Cardiology. Continue reading →

A study published in JACC: Cardiovascular Imaging has shown that both left ventricular systolic and diastolic reserves contribute to risk prediction in Heart Failure With Preserved Ejection Fraction (HFpEF). Therefore, the inclusion of the exertional assessment of left ventricular function to diagnostic algorithms may improve the prognostication process in this disease condition. Continue reading →

A study conducted by Dr. Gregg W.Stone and his colleagues from Columbia University Medical Center demonstrated that patients with left main coronary artery disease (LMCAD) and prior cerebrovascular disease (CEVD) compared with those without CEVD have higher rates of stroke and reduced event-free survival after revascularization. In their publication in JACC: Cardiovascular Interventions, they stated that PCI need not be a priori preferred over CABG for LMCAD in patients with known CEVD.  Patients with CEVD should undergo evaluation for both PCI and CABG, with careful consideration of comorbidities, the likelihood of safely achieving complete revascularization, and patient preferences in order to determine the optimal coronary revascularization strategy. Continue reading →

A study published in JAMA cardiology has shown that long-term survival after simple Tetralogy of Fallot (TOF) repair is excellent. Staged repair and non–valve-sparing operations were negatively associated with survival in the early post repair phase but not the late post repair phase. The study, led by Dr. Clayton A. Smith, Emory University School of Medicine is important for patients with repaired TOF and their caretakers and may guide surgical strategies for optimizing the long-term outcomes of this population. Continue reading →

In a study published in JAMA cardiology, the data suggested that somatic mutations in hematopoietic cells, specifically in the most commonly mutated CHIP driver genes TET2 and DNMT3A, could be significantly associated with the progression and poor prognosis of CHF. The study was led by Dr. Lena Dorsheimer from the Department of Medicine, Goethe University Hospital, Frankfurt, Germany. Continue reading →

The two-year results of the ILLUMENATE European randomized clinical trial conducted by Brodmann and her colleagues have displayed a sustained treatment effect with a low-dose drug-coated balloon (DCB) with an optimized coating formulation. This trial, published in JACC Cardiovascular Interventions, has demonstrated, for the first time, a statistically significantly higher primary patency rate for a low-dose DCB versus PTA at 2 years. Continue reading →

The results of a study conducted by Rein et al. have shown that patients with atrial fibrillation on triple therapy experienced high rates of major bleeding compared with patients on dual therapy or monotherapy. The high bleeding rates observed in patients on triple therapy over the age of 90 years or with a CHA₂DS₂-VASc score over 6 or with a history of a major bleeding warranted careful consideration of such therapy in these patients. The results were published online ahead of print in Circulation. Continue reading →

A study conducted by the GBD 2016 Lifetime Risk of Stroke Collaborators demonstrated that the global lifetime risk of stroke from the age of 25 years onward was approximately 25% among both men and women. Moreover, there was geographic variation in the lifetime risk of stroke, with the highest risks in East Asia, Central Europe, and Eastern Europe. The results were published in the New England Journal of Medicine. Continue reading →