News
Novel Physiology-Based Method of Estimating Myocardial Ischemic Burden
Murai et al. devised a novel physiology-based method of estimating the amount of myocardium subtended by coronary stenosis, which is feasible and can be performed in the catheterization laboratory with a Doppler sensor-equipped guidewire. The study was published in the recent issue of Circulation: Cardiovascular Interventions.
Biologic Therapy for Psoriasis Associated with Reduced Coronary Inflammation
Anti-inflammatory biologic therapy used for the treatment of moderate to severe psoriasis is associated with reduced coronary inflammation in patients with the skin condition. The recent study by Elnabawi et al., published in the Journal of the American Medical Association (JAMA) Cardiology, revealed.
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Fractional Flow Reserve Aids Decision Making for Intermediate Coronary Lesions: 1-Month Data from FORZA Study
Compared with optical coherence tomography (OCT), fractional flow reserve (FFR) was associated with a higher percentage of medical therapy, lower risk of acute kidney injury, shorter hospital stay, and reduced costs at one month among patients with intermediate coronary lesions. The study by Leone et al., recently published in the Journal of American Heart Association, revealed.
Vascular Risk Factors Tied to Unhealthy Brains, Study from UK Biobank Suggests
Vascular risk factors such as smoking, hypertension, and diabetes were associated with poor brain health. The study by Cox et al., recently published in the European Heart Journal, revealed.
IMPROVE-IT Trial: Intensive Lipid-Lowering Cuts CVD Risk in the Elderly
Among patients hospitalized for an acute coronary syndrome (ACS), adding ezetimibe to simvastatin further reduced the risk of cardiovascular events, and the benefit was ten times greater in the elderly than younger individuals. A secondary analysis of the IMPROVE-IT trial, published in JAMA Cardiology, revealed.
TSR1 Gene Associated with Coronary Dissection in A Chinese Cohort
TSR1 gene, encoding a ribosome biogenesis factor required for the maturation of 40S subunit, was identified as a potential cause of spontaneous coronary artery dissection (SCAD) in the study by Sun et al., published in the Journal of the American College of Cardiology.
Nationwide Study Shows New-onset Left Bundle Branch Block After Transcatheter Aortic Valve Replacement Occurred in 15% of Intermediate Risk Patients and Is Associated with Worse 2 Year Outcomes
According to a new nationwide study, new onset left bundle branch block (LBBB) post transcatheter aortic valve replacement (TAVR), a recently established therapy for intermediate risk surgical candidates with symptomatic, severe aortic stenosis, is associated with adverse long term clinical outcomes in patients without baseline conduction disturbances or pacemaker. Based on the findings published in the European Heart Journal, these outcomes include cardiovascular mortality, re-hospitalization, new pacemaker implantation, and worsened left ventricular systolic function in intermediate risk patients.
Silent Myocardial Infarction Prevails Prior to Sudden Cardiac Death, Autopsy Data Suggests
Among individuals who had sudden cardiac death (SCD) due to ischemic cardiac disease, a substantial number had a previously undetected myocardial infarction at autopsy; some of them had electrocardiographic abnormalities prior to the death. The study by Vähätalo et al., published in JAMA Cardiology, revealed.
ORBIT-AF Registry: INR Metrics Associated with Bleeding but Not Ischemia
Among patients with atrial fibrillation (AF) treated with warfarin, clinical risk scores for major bleeding and thrombotic events were more strongly associated with future clinical events than any International Normalized Ratio (INR) metrics for warfarin control. A post hoc analysis of ORBIT-AF study by Dr. Pokorney et al, published in JAMA Cardiology, revealed. Continue reading
Meta-analysis Shows Vitamin D Supplementation Does Not Improve Cardiovascular Outcomes
In the largest updated meta-analysis study conducted to understand the inverse association between low serum vitamin D supplementation and increased cardiovascular disease (CVD) risks, vitamin D supplementation was not associated with reduced major adverse cardiovascular events, individual CVD end points (myocardial infarction, stroke, CVD mortality) or all-cause mortality. The findings published in the Journal of the American Medical Association Cardiology suggest vitamin D supplementation may not confer cardiovascular protection and may not be indicated for this purpose. Continue reading
STS/ACC TVT Registry: Higher Volume Associated with Better TAVR Outcomes
Recent updates from the Centers for Medicare & Medicaid Services (CMS) maintain the volume requirements of the transcatheter aortic-valve replacement (TAVR) programs to qualify for reimbursement. In corroborate with the CMS updates, the latest data from the Society of Thoracic Surgeons/American College of Cardiology (STS/ACC) Transcatheter Valve Therapy (TVT) Registry by Dr. Sreekanth Vemulapalli et al., published in the New England Journal of Medicine, revealed lower 30-day mortality at hospitals with a high procedural volume.
PROMISE Trial: High-Sensitivity Troponins May Assist in Detecting Obstructive CAD in Symptomatic Outpatients
Increasing concentrations of hsTnI are significantly associated with the presence and severity of coronary artery disease (CAD) among stable outpatients with chest pain, an analysis of PROMISE trial indicates. The study, conducted by Prof. James Januzzi et al., is recently published in the June 1, 2019, issue of the Journal of the American College of Cardiology: Cardiovascular Imaging.
Latest Cross-Sectional Study Links Dietary Pattern Specific Protein Biomarkers to Development of Cardiovascular Disease
According to a nationwide cross-sectional study, protein biomarkers along with specific dietary patterns are linked to the development of cardiovascular disease (CVD). These findings, published in the Journal of the American Heart Association, suggest associations between dietary patterns and protein biomarkers have a role in the pathways related to inflammation, endothelial and immune function, cell adhesion and metabolism. Over the years, the role of diet in the prevention of CVD has been scientifically proven; unhealthy dietary components are important risk factors for the total global burden of this comorbidity. Continue reading
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
Study in China Indicates Current Practice of Lipid-Lowering Treatment Needs Improvement
In an article published in the American Heart Journal, Dr. Yueyan Xing emphasized the need to improve on current lipid-lowering treatment practices in patients with a history of myocardial infarction or revascularization. Patients with a previous history of acute coronary syndrome are at a high risk of a recurrent coronary event and death. Lowering low-density lipoprotein cholesterol (LDL-C) in these patients is essential in order to reduce the risk of a recurrent event. The authors used the Improving Care for Cardiovascular Disease in China (CCC) Project to assess current lipid-lowering treatment practices in China.
A Systematic Analysis Attributes Eleven Million Deaths in 2017 to Dietary Risk Factors
A systematic analysis by Dr. Ashkan Afshin and the Global Burden of Disease (GBD) 2017 Diet Collaborators published in the Lancet showed that in 2017, 11 million deaths and 255 million disability-adjusted life years (DALYs) were attributable to dietary risk factors. The leading dietary risk factors were a high intake of sodium, low intake of whole grains, and low intake of fruits. The study provides a clear image of the potential impact of a sub-optimal diet on death and disability.
Randomized Trial Shows That Transcatheter Aortic-valve Replacement is Non-inferior to Surgery in Low Risk Patients
A study by Dr. Jeffrey Popma and colleagues published in the New England Journal of Medicine showed that transcatheter aortic-valve replacement (TAVR) was non-inferior to surgery with respect to death or the occurrence of a disabling stroke by 24 months in the low-risk group of patients with aortic stenosis. Previous studies showed that in patients with severe aortic stenosis who were at high risk of complications or death from surgery, TAVR with a self-expanding supra-annular bioprosthesis had better outcomes than medical therapy or surgery. However, there was not enough evidence to advocate the use of TAVR instead of surgery in a younger, healthier population. The authors aimed to address this knowledge gap through this study.
Transcranial Ultrasound Used As an Adjunct to tPA Fails To Improve Functionality in Ischemic Stroke Patients Sonothrombolysis with ultrasound delivered transcranially via a headframe shows no clinical benefit in ischemic stroke
A randomized, mutilcenter, placebo-controlled, phase 3 clinical trial which enrolled 676 patients (aged 18-80 years) presenting to the ER with acute ischemic stroke assessed the efficacy and safety of transcranial ultrasound (US) as an adjunctive therapy to intravenous tissue plasminogen activator (IV-tPA, administered over 60 minutes) treatment (CLOTBUST-ER trial). The results from the trial, which was stopped due to futility show that although the use of sonothrombolysis was feasible and most likely safe, no clinical benefit was seen at 90 days. Compared with the control group, the adjusted cOR for an improvement in modified Rankin Scale score (mRSC) at 90 days in the intervention group was 1.05 (95% CI 0.77–1.45; p=0.74). Andrei Alexandrov, MD (University of Tennessee Health Science Center, Memphis), and colleagues reported in the April 2019 issue of the Lancet Neurology. Continue reading
Meta-Analysis Affirms Safety and Efficacy of Catheter-Based Renal Denervation for Blood Pressure Reduction
A meta-analysis conducted by Sardar et al. evaluated the change in blood pressure in response to catheter-based renal sympathetic denervation (RSD). The data, published in the Journal of the American College of Cardiology (JACC), suggested that RSD reduces ambulatory systolic blood pressure (ASBP) in patients with hypertension as compared with sham controls. Continue reading
New Study Suggests That Compression Only CPR Is Better Than No CPR
A study by Gabriel Riva and his colleagues published in Circulation assessed the rates of different forms of cardiopulmonary resuscitation (CPR) during three different guideline periods. They showed that there was almost a two-fold increase in the rates of CPR before the arrival of emergency medical services (EMS) as well as a 6-fold higher rate of compression-only CPR (CO-CPR) over time. Additionally, any form of CPR was associated with doubled survival rates when compared to no CPR. These findings support the use of CO-CPR as an option in future CPR guidelines as it is associated with higher CPR rates and higher overall survival in out-of-hospital cardiac arrest when compared to no CPR. Continue reading
