A 5% Absolute Increase in Influenza Activity Associated with a 24% Increase in Heart Failure Hospitalizations, According to New Study The Atherosclerosis Risk in Communities Study

A study conducted by Sonja Kytömaa and Sheila Hegde of the cardiovascular division, Brigham and Women’s Hospital, Boston, Massachusetts, reported that influenza activity was temporally associated with an increase in HF hospitalizations across 4 influenza seasons. According to the publication in JAMA Cardiology, these data suggested that influenza could contribute to the risk of HF hospitalization in the general population. Continue reading

STOPDAPT-2 Explores Safety and Efficacy of 1-month DAPT Followed by Clopidogrel Monotherapy vs Standard 12-month DAPT After Drug-Eluting Stent Implantation

The results of the STOP-DAPT 2 randomized controlled trial were presented by Dr. Hirotoshi Watanabe at the American College of Cardiology Annual Scientific Session (ACC 2019), at New Orleans, LA. According to the findings, 1-month DAPT was superior to 12-month DAPT in the prevention of net adverse ischemic events. Continue reading

Dapagliflozin and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Prior MI ACC 2019: A Sub-analysis From DECLARE TIMI-58 Trial

According to a presentation by Dr. Marc P. Bonaca at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA on March 18, 2019, patients with type 2 diabetes mellitus (T2DM) and prior MI are at high risk of major adverse cardiovascular events (MACE) and cardiovascular (CV) death/HHF. Dapagliflozin appears to robustly reduce the risk of both composite outcomes in these patients. These results were published online in Circulation. Continue reading

TAVR Using Balloon Expandable Valve Superior To Surgical Aortic Valve Replacement In Low Risk Patients With Severe Aortic Valve Stenosis 1-year trial results presented at the ACC 2019 annual scientific session, New Orleans

A randomized multi-center trial which enrolled 1000 patients from 71 centers around the world has shown that in patients with severe aortic stenosis who are at low surgical risk, the rate of the composite of death, stroke, or rehospitalization at 1 year is significantly lower with transcatheter aortic valve replacement (TAVR) than with surgery. Continue reading

TREAT Trial Addresses the Safety and Efficacy of Ticagrelor Use for STEMI Management in the Setting of Fibrinolytic Therapy ACC 2019: Ticagrelor versus Clopidogrel in Patients with STEMI Treated with Fibrinolytic Therapy

According to the results of the TREAT trial, among patients aged under 75 years with STEMI, administration of ticagrelor after fibrinolytic therapy did not significantly reduce the frequency of cardiovascular events in comparison with clopidogrel. The results of the 12-month analysis were recently published in the Journal of the American College of Cardiology. Continue reading

Total Event Analysis from REDUCE-IT Showcases a Substantial Reduction in the Burden of Ischemic Events, Experts Debate Possible Mechanisms of Action of Icosapent Ethyl Presented at ACC 2019, New Orleans, Los Angeles

The total event analysis from the REDUCE-IT trial, presented at ACC 2019 showed that among statin-treated patients with elevated triglycerides and cardiovascular disease or diabetes, icosapent ethyl substantially reduced the burden of first, subsequent, and total ischemic events. The results are exciting as this is one of the first non-LDL targeted trials to demonstrate a cardiovascular benefit, and is likely to be featured in future guidelines. Continue reading

AUGUSTUS: Less Bleeding and Fewer Hospitalizations Without Significant Differences in Ischemic Events With Apixaban and No Aspirin in Patients With AFib and ACS ACC 2019: Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation

ACC 2019: In patients with atrial fibrillation and a recent acute coronary syndrome or PCI treated with a P2Y12 inhibitor, an antithrombotic regimen that included apixaban, without aspirin, resulted in less bleeding and fewer hospitalizations without signifi­cant differences in the incidence of ischemic events than regimens that included a vitamin K antagonist, aspirin, or both, according to results of the AUGUSTUS trial presented at ACC.19 in New Orleans. The results were also published simultaneously in the New England Journal of Medicine. Continue reading

HeartMate3 Found to be More Superior Than Other LVADs on Endpoints of Stroke, Pump Thrombosis and Bleeding Complications ACC 2019: A Fully Magnetically Levitated Left Ventricular Assist Device — Final Report

The largest LVAD trial ever to be performed, led by Dr. Mandeep Mehra published the final analysis of a fully magnetically levitated left ventricular assist device in the New England Journal of Medicine. According to this, among patients with advanced heart failure, a fully magnetically levitated centrifugal- flow pump has been found to be superior to a mechanical-bearing axial-flow pump in advanced heart failure patients in terms of survival free of disabling stroke or reoperation for removal in case of device malfunction. Continue reading

COAPT Analysis Affirms Quality of Life Advantage of MitraClip for Secondary MR ACC 2019: Health Status After Transcatheter Mitral-Valve Repair in Heart Failure and Secondary Mitral Regurgitation

NEW ORLEANS — Transcatheter repair of functional mitral regurgitation (or secondary MR) with MitraClip improved quality of life and hemodynamics better than optimal medical therapy alone, COAPT trial analyses showed. Indeed, the COAPT QOL study showed that among patients with symptomatic HF and 3+ to 4+ secondary MR receiving maximally-tolerated medical therapy, edge-to-edge TMVr resulted in substantial early and sustained health status improvement compared with medical therapy alone. Continue reading

HEARTLINE: A 180,000 Patient-Strong, Pragmatic, Real World Randomized Trial Assesses the Prowess of Apple Technology in Afib Diagnosis and Improvement of Hard Outcomes Presented at the ACC 2019, New Orleans, LA.

The design of the HEARTLINE randomized trial of up to 180,000 pts for assessing the efficacy of the Apple Watch & educational initiatives to reduce a composite outcome of death, MI and stroke was presented by Dr. C. Michael Gibson, PERFUSE Study Group, Beth Israel Deaconess Medical Center, Boston, Massachusetts, at ACC 2019, in New Orleans,  LA earlier today. The HEARTLINE Study brings together Johnson & Johnson’s health and behavioral science expertise and long heritage in treating cardiovascular disease with Apple’s technology expertise. Emerging technology holds great potential to help identify people at risk for future disease and develop interventions to prevent disease before it occurs. Leveraging a new heart health app from Johnson & Johnson in combination with Apple Watch’s irregular rhythm notifications and ECG app, the HEARTLINE Study will seek to investigate whether this technology can accelerate the diagnosis of AFib and improve outcomes including the prevention of stroke, as well as assess the impact of a medication adherence program. The study will be conducted in the U.S. only and will be designed as a pragmatic randomized controlled research study for individuals age 65 years or older. Continue reading

Findings From a Randomized Controlled Trial May Usher the Adoption of Angiotensin–Neprilysin Inhibition to the Heart-Failure Armamentarium Presented At the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA.

The results of a trial presented by Dr. Adam DeVore at the American College of Cardiology Annual Scientific Session (ACC 2019), New Orleans, LA, reflected that among patients with heart failure with reduced ejection fraction who were hospitalized for acute decompensated heart failure, the initiation of sacubitril–valsartan therapy led to a greater reduction in the NT-proBNP concentration as compared with enalapril therapy. In addition to this, the rates of worsening renal function, hyperkalemia, symptomatic hypotension, and angioedema did not differ significantly between the two arms. Continue reading

Study Depicts Strong Associations Between Social Factors and Mortality Risk Following Coronary Artery Bypass Grafting A Population-Based Cohort Study

According to an observational study posted in the Journal of American Heart Association, there were strong associations between social factors and mortality risk after CABG in both men and women. These results emphasized the importance of developing and implementing secondary prevention strategies for socially disadvantaged CABG patients. Continue reading

Is the Improvement in Fractional Flow Reserve After Percutaneous Coronary Intervention (ΔFFR) Associated With Clinical Outcome and Symptomatic Relief?

In an analysis of two randomized clinical trials published in JAMA cardiology, Fournier et al. reported that the larger the improvement in FFR, the larger the symptomatic relief and the lower the event rate. This was suggestive of the fact that measuring FFR before and after PCI could provide clinically useful information. Continue reading

ALERTS: Use of an Implanted Electrocardiographic Monitoring Device in High-Risk Patients Aids in the Early Detection of ACS Implantable Cardiac Alert System for Early Recognition of ST-Segment Elevation Myocardial Infarction

According to a randomized controlled trial led by Dr. Michael Gibson, PERFUSE Study Group, Beth Israel Deaconess Medical Center, Boston, Massachusetts, the implantable cardiac system was found to detect early ST-segment deviation and alert patients of a potential occlusive event. Although the trial did not meet its pre-specified primary efficacy endpoint, the report published in the Journal of the American College of Cardiology provided evidence that the device was beneficial among high-risk subjects in the identification of asymptomatic events. Continue reading

U.S. Food and Drug Administration (FDA) Continues To Investigate Recall of Contaminated Blood Pressure Medication Potentially carcinogenic nitrosamine impurities found in angiotensin receptor blockers (ARBs)

The US food and drug Administration (FDA) has recently been conducting an investigation on voluntary recalls of multiple generic angiotensin II receptor blocker (ARB) drug products used to treat high blood pressure and heart failure. The recalls initiated in July 2018 and continue to date due to the presence of Nitrosamine impurities, including N-Nitrosodimethylamine (NDMA) and N-Nitrosodiethylamine (NDEA), which are potential human carcinogens in different ARB products. Last week, AurobindoPharma USA notified that it is expanding its recall to include 38 more lots of valsartan and amlodipine/valsartan tablets due to objectionable levels of N-Nitrosodiethylamine (NDEA). This was later followed by an expanded voluntary recall of losartan potassium produced by Hetero Labs (India) when they were found to be contaminated by N-Nitroso-N-methyl-4-aminobutyric acid (NMBA). Camber Pharmaceuticals called back 87 lots of losartan potassium tablets (25 mg, 50 mg and 100 mg), 114 lots of losartan potassium or losartan potassium/hydrochlorothiazide tablets, and one lot of losartan potassium/hydrochlorothiazide tablets. Continue reading

DECISION-CTO Demonstrates No Significant Difference in Death, MI, Stroke, or Any Revascularization with CTO PCI vs. No CTO PCI

The results of the DECISION-CTO trial conducted by Lee et al. showcased that CTO-PCI was feasible with high success rates. In addition to this, there was no difference in the incidence of major adverse cardiovascular events with CTO PCI vs. no CTO-PCI, however, the study was limited by low power for clinical endpoints and high crossover rates between groups. The results were published online in Circulation. Continue reading

Nationwide Comparison of Oral Anticoagulants in Nonvalvular Atrial Fibrillation Patients of Low Body Weight

The first nationwide comparison of the effectiveness and safety of warfarin and direct oral anticoagulants (DOACs) in a large atrial fibrillation (AF) cohort with data on low body weight (LBW) was conducted.  The findings, published in JACC, showed that DOACs are associated with a reduced risk of ischemic stroke, intracranial hemorrhage, hospitalization for gastrointestinal or major bleeds, all-cause death or the composite outcome in patients with LBW (<60kg).  A consistent trend was observed in patients with extremely LBW (<50kg), with the exception of hospitalization for gastrointestinal bleeding. Continue reading

Coronary CTA Provides an Unrivaled Opportunity for More Detailed Analysis in Selected Patients, According to a Study Stress Testing Versus CT Angiography in Patients With Diabetes and Suspected Coronary Artery Disease

According to a recent publication in the Journal of the American College of Cardiology, in diabetic patients presenting with stable chest pain, a computed tomographic angiography (CTA) strategy resulted in fewer adverse cardiovascular outcomes in comparison with a functional testing strategy. The conclusions drawn from the study implied that CTA may be considered as the initial diagnostic modality in this subgroup. Continue reading

AVERT: Apixaban for the Prevention of Venous Thromboembolism in High-Risk Ambulatory Cancer Patients

A study by Marc Carrier and his colleagues published in the New England Journal of Medicine concluded that apixaban therapy resulted in a significantly lower rate of venous thromboembolism as compared to placebo among intermediate-to-high-risk ambulatory patients with cancer who were starting chemotherapy. According to the publication, the investigators also confirmed that the rate of major bleeding episodes was higher with apixaban than with placebo. Continue reading

Early and Late Leaflet Thrombosis Following TAVR A Multicenter Initiative From the OCEAN-TAVI Registry

A real-world multicenter study by Yanagisawa and his colleagues published in Circulation: Cardiovascular Interventions reported that untreated early leaflet thrombosis did not affect the cumulative event rates of death, stroke, and rehospitalization for heart failure. The investigators also stressed on the fact that late leaflet thrombosis was newly detected in patients during the 3-year follow-up period.  Continue reading