Patients with heart failure (HF) who receive influenza vaccination may be at a lower risk of both all-cause mortality and cardiovascular death after adjustment for confounders, according to a large-scale observational nationwide study of Danish citizens. “Annual influenza vaccination may be an effective treatment strategy to improve survival in heart failure,” lead author Daniel Modin (Department of Cardiology, Herlev & Gentofte Hospital, Denmark), and colleagues wrote in their paper recently published in Circulation. Continue reading →

A study by Duk-Woo Park et al. has shown that in patients with significant left main coronary artery (LMCA) disease, as compared with CABG, PCI showed similar rates of death and serious composite outcomes, but a higher rate of target-vessel revascularization at 10 years. Moreover, they demonstrated that CABG showed lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years. Continue reading →

A study conducted by Yongle Xu et al. demonstrated that the superiority of Drug-Coated Balloon (DCB) versus percutaneous transluminal angioplasty (PTA) in the efficacy of femoropopliteal artery disease (FPAD) treatment persists at 24-month follow-up. The findings, which were published online in JACC: Cardiovascular Interventions, also showed that the safety of DCB was equivalent to that of PTA. Continue reading →

Cardiology patients treated in hospitals at the top of U.S. News & World Report rankings had better survival rates, but not necessarily less risk of readmission, researchers found. This study by Wang and his colleagues found that US News & World Report  (USNWR) top-ranked hospitals for cardiovascular care had lower 30-day mortality rates for AMI, HF, and CABG and higher patient satisfaction ratings compared with non-ranked hospitals. However, 30-day readmission rates were either similar (for AMI and CABG) or higher (for HF) at top-ranked compared with non-ranked hospitals. This discrepancy between readmissions and other performance measures raised concern that readmissions may not be an adequate metric of hospital care quality. Continue reading →

The results of a study conducted by Doff B. McElhinney and his colleagues published in JACC showed that endocarditis is an important adverse outcome following Transcatheter Pulmonary Valve Replacement (TVPR) in children and adults with postoperative congenital heart disease involving the right ventricular outflow tract (RVOT). Ongoing efforts to understand, prevent, and optimize management of this complication are paramount in making the best use of TPV therapy. Continue reading →

A study by Essien and his colleagues published in JAMA aimed to determine if there were racial/ethnic differences in the use of oral anticoagulants, particularly direct-acting oral anticoagulants (DOACs), in patients with atrial fibrillation. The findings showcased the fact that after controlling for clinical and socioeconomic factors, black individuals were less likely than white individuals to receive DOACs for atrial fibrillation, with no difference between white and Hispanic groups. Continue reading →

The 5-year outcomes of a trial conducted by Gleason et al. published in JACC demonstrated a similar safety profile, functional recovery, and freedom from severe structural valve deterioration (SVD) for both TAVR and SAVR, consistent with earlier-term reports. These outcomes supported TAVR as a reasonable alternative to SAVR in the high-risk population and its current Class I indication. Continue reading →

In a JACC State-of-the-Art Review by Dr. Lance Gould and his colleagues at UTHealth, Houston, Texas, the pathophysiology of Coronary microvascular disease (CMD) was summarized and an update was provided of diagnostic testing strategies, and classification of CMD into phenotypes according to severity and coexistence with atherosclerosis. Moreover, emerging data highlighting the significance of CMD in specific populations, including obesity and insulin resistance, myocardial injury and heart failure with preserved ejection fraction, and nonobstructive and obstructive coronary artery disease were analyzed. Lastly, the role of CMD as a potential target for novel interventions beyond conventional approaches, representing a new frontier in cardiovascular disease reduction was explored.  Continue reading →

In a report in this issue of the JACC: Cardiovascular Interventions, Dr. John A Dodson and his colleagues from the New York University School of Medicine reported that frail patients had lower use of cardiac catheterization and higher risk of major bleeding (when catheterization was performed) as compared to non-frail patients, thereby drawing attention to clinical strategies to avoid bleeding imperative in this population. Continue reading →

A study published in JACC Cardiovascular Interventions has shown that among patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI), there was no benefit of IV sodium bicarbonate over IV sodium chloride or of acetylcysteine over placebo for the prevention of contrast-associated acute kidney injury (CAAKI) or intermediate-term adverse outcomes. Continue reading →

A European study has revealed that bullying and violence are common at workplaces and those exposed to such stressors are at higher risk of cardiovascular disease (CVD). Psychosocial cardiovascular risk factors such as depression, subclinical depressive symptoms, vital exhaustion, anger, and personality traits such as hostility have been demonstrated as independent predictors of incident cardiovascular disease (CVD). Additionally, social factors associated with increased CVD risk include low socio-economic status, social isolation, low social support, and stress at work or in family life. Psychological and social factors are strongly inter-related and tend to cluster in certain individuals. In the recent most issue of the European Heart Journal, Xu et al. aimed to provide evidence for yet another psychosocial factor involved in CVD risk. Continue reading →

The EMPA-HEART trial showed that empagliflozin resulted in beneficial effects on left ventricular remodeling at 6 months among patients with type 2 diabetes mellitus and stable coronary artery disease (CAD) but normal ejection fraction and without a clear heart failure history. The findings were presented by Dr. Subodh Verma at the American Heart Association Annual Scientific Sessions (AHA 2018) in Chicago, Illinois. Continue reading →

The results of the TRED-HF trial published in The Lancet showed that withdrawal of heart failure medications among patients with dilated cardiomyopathy (DCM) who had recovered their LV function resulted in the relapse of HF. According to Halliday and his colleagues, until robust predictors of relapse are defined, treatment should continue indefinitely. Continue reading →

A randomized clinical trial that was conducted by Paul M Ridker et al. and published in NEJM showed that there was no meaningful association between low dose methotrexate (MTX) administration and a decrease in cardiovascular events. Additionally, MTX usage was associated with adverse effects. Continue reading →

Canakinumab (an IL-B inhibitor) is associated with decreased heart failure (HF) hospitalizations and the composite of heart failure hospitalization and heart-failure related mortality in patients with a history of myocardial infarction (MI) and elevated high-sensitivity C-reactive protein (hsCRP), according to a new study published in Circulation. Continue reading →

Results from a multi-center, randomized, double-blind, double dummy, parallel group clinical trial which enrolled 881 patients with heart failure (HF) with reduced ejection fraction (HFrEF-left ventricular ejection fraction of 40% or less) have shown superior efficacy of Sacubitril–Valsartan combination (Entresto; Novartis) in reducing N-terminal pro-B-type natriuretic peptide compared to Enalapril alone. The patients were hospitalized for acute decompensation of HF, and treatment with Sacubitril–Valsartan achieved a greater reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations without any significant offsetting serious adverse events. Findings from the trial were presented at the 2018 AHA Scientific Session and simultaneously published in the New England Journal of Medicine (NEJM). Continue reading →

The DECLARE–TIMI 58 trial, published in the New England Journal of Medicine and presented at AHA 2018 showed that in patients with type 2 diabetes who had or were at risk for atherosclerotic cardiovascular disease, treatment with dapagliflozin was non-inferior for reduction of MACE as compared to placebo but did result in a lower rate of cardiovascular death or hospitalization for heart failure. Continue reading →

The VITAL trial conducted by Manson et al. showed that supplementation with either n–3 fatty acids at a dose of 1 g/day or vitamin D3 at a dose of 2000 IU/day was not effective for primary prevention of cardiovascular or cancer events among healthy middle-aged men and women over 5 years of follow-up. The results were reported on Saturday at the American Heart Association Scientific Sessions meeting in Chicago and online in the New England Journal of Medicine. Continue reading →

The AHA/ACC 2018 guideline on the management of blood cholesterol, endorsed by at least 10 other medical societies, was published online in the Journal of the American College of Cardiology and in Circulation to coincide with its grand unveiling at the American Heart Association (AHA) Scientific Sessions 2018 in Chicago, Illinois.  Continue reading →

The results of a study presented at AHA 2018 have shown that SGLT2 inhibitors (SGLT2i ) have robust benefits on the reduction of hospitalization for heart failure (HF) and progression of renal disease regardless of existing atherosclerotic cardiovascular disease (ASCVD) or a history of HF. The findings were published online in The Lancet. Continue reading →