Coronary Microvascular Dysfunction: A Promising Therapeutic Target in Heart Failure with Preserved EF? PROMIS-HFpEF: Results from ESC 2018

PROMIS-HFpEF (PRevalence Of MIcrovascular dySfunction in Heart Failure with Preserved Ejection Fraction) is an echocardiographic trial showcasing a high prevalence of coronary microvascular dysfunction (CMD) in HFpEF and its association with systemic endothelial dysfunction (RHI, UACR) and markers of HF severity (NT-proBNP and RV dysfunction). The results of the trial were recently published in the European Heart Journal. Continue reading

Lorcaserin proven safe as weight loss agent in obese patients CAMELLIA-TIMI 61 trial: Results from ESC 2018, Munich

The selective serotonin 2c receptor agonist, Lorcaserin has been proven to be effective in the promotion of sustained weight loss through appetite suppression in obese and overweight patients, with no increase in cardiovascular events, according to the CAMELLIA-TIMI 61 (Cardiovascular and Metabolic Effects of Lorcaserin in Overweight and Obese Patients–Thrombolysis in Myocardial Infarction 61) trial, presented at the ESC conference in Munich. Continue reading

Cancelled Cath Lab Activation Based on Prehospital EKG, A Single Center Study

A new single-center study has shown that the catheterization laboratory (CCL) activation in response to a prehospital ECG interpreted as ST-segment elevation myocardial infarction (STEMI) can be frequently canceled which represents an economic burden and affects the patient satisfaction negatively. Continue reading

Transcatheter Interatrial shunt device appears safe at 1 year for heart failure with preserved ejection fraction ESC 2018: REDUCE LAP HF-1, 1 year results from phase 2

The 1-year results of a phase 2, sham-controlled RCT have confirmed the safety of a transcatheter interatrial shunt device (IASD; Corvia Medical) with no significant cardiovascular or renal events as compared to those receiving sham control treatment. It has also confirmed the long-term patency of the device. The findings were presented at the ESC and have also been simultaneously published in JAMA Cardiology. Continue reading

Omega-3 fatty acid Supplements Show No Benefit in Cardiovascular Prevention in Diabetes Says ASCEND, the largest and longest placebo controlled trial of omega-3 fatty acids

A randomized trial in patients with diabetes without evidence of cardiovascular disease has shown there to be no significant difference in the risk of serious cardiovascular events in those administered omega−3 fatty acids as compared to placebo. Continue reading

Aspirin Vs Placebo In Cardiovascular Event Reduction In Diabetes ESC 2018: ASCEND trial

A randomized 15,480 patient strong UK based trial comparing Aspirin (ASA) versus placebo in diabetics has shown that the absolute reduction in cardiovascular events from aspirin is offset by a similar absolute increase in major bleeding. Continue reading

Antithrombotic therapy post TAVR: A double edged sword? ESC 2018: Insights from the French TAVI registry

A multicenter, prospective nation-wide French registry evaluated whether oral anticoagulation therapy was an independent correlate of long-term survival and early bioprosthetic valve dysfunction (BVD) in patients who underwent successful Transcatheter Valve Implantation (TAVI). The French registry was launched in 2007 and involved 11,469 patients with a mean duration follow-up was 495±3.5 days. This registry contained 11 years of data and analyzed patients from January 1, 2013, and December 31, 2015. Continue reading

Conservative Management Should be First Line Therapy for SCAD ESC 2018: Canadian SCAD study

Spontaneous coronary artery dissection (SCAD) is an underdiagnosed, poorly misunderstood condition. The predisposing causes and management of this condition are still unclear. To throw light on this, the CANADIAN SCAD cohort study was a large, prospective, multicenter, observational, natural history study that enrolled 750 non-atherosclerotic SCAD patients from 22 centers (20 from Canada and 2 from the US). The key study objective was the analysis of cardiovascular outcomes within the hospital and long-term. Secondary outcomes included the assessment of clinical and angiographic characteristics of patients presenting with SCAD. Continue reading

High LDL Levels Can Increase Cardiovascular Mortality Even in Low Risk Population Results From the Cooper Center Longitudinal Study

A recent study published in Circulation found that higher levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDLC) increased the relative risk of long-term cardiovascular disease (CVD) mortality by 50% to 80%, in healthy participants that were considered to be at a low 10-year risk prior to the beginning of the study. Continue reading

Modifiable risk factor control can eliminate excess cardiovascular risk in Type 2 Diabetes

A Swedish study has found that type 2 diabetics who have five risk-factor variables within the target ranges have little or no excess risk of death, myocardial infarction, or stroke, as compared with the general population. Assessment of risk is based on the presence of five modifiable risk factors: smoking, elevated glycated hemoglobin, elevated low-density lipoprotein cholesterol level, elevated blood pressure and albuminuria. Continue reading

Low Dose Rivaroxaban Plus Aspirin Reduces Major Adverse Limb Events in COMPASS A COMPASS subgroup analysis

According to a new subgroup analysis of the COMPASS trial published in the Journal of the American College of Cardiology, the prevention of Major Adverse Limb Events (MALE) is of utmost importance in patients with lower extremity Peripheral Arterial Disease (PAD) due to its poor prognosis. Additionally, it has been found that the aspirin and rivaroxaban 2.5mg twice daily combination leads to a significant reduction of Major Adverse Limb Events (MALE) in these patients.

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Five year follow up on FFR guided PCI for Stable CAD – What Did We Learn From FAME2?

In the final follow up of the FAME 2 study,  published in The New England Journal of Medicine, five year outcomes were reported comparing percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) to medical therapy alone. The hypothesis had suggested FFR guided PCI would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Continue reading

Coronary Sinus Reducer Implantation Improves Chronic Refractory Angina

A recent study published in the Journal of American College of Cardiology found that implantation of the coronary sinus Reducer is safe and is associated with a reduction of anginal symptoms and improvement of quality of life in patients with refractory angina who were not candidates for further revascularization. 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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More Benefit of Intensive BP Control in Patients with Higher CVD Risk

In a predictive model based substudy of the SPRINT trial published in the Journal of American College of Cardiology, Dr. Robert A. Phillips and his colleagues from Houston Methodist Hospital were able to show that patients with a higher 10-year cardiovascular disease (CVD) risk could achieve more benefit than harm from intensive blood pressure control, with a set target of systolic blood pressure (SBP) of < 130mm Hg. Continue reading

Pre-PCI Impella Device Improves Outcome in Acute MI complicated by Cardiogenic Shock (AMICS)

A non-randomized study published in the American Heart Journal showed increased survival rates in patients with Impella device being used as the first support strategy for patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) when invasive hemodynamic monitoring was used, and at centers with higher Impella implantation volume. Continue reading

The Use of Supplemental Oxygen in Suspected Acute MI is of no Benefit

The use of supplemental oxygen in normoxemic patients with suspected acute myocardial infarction is of no clinical benefit, says a new article in the British Medical Journal. Continue reading

Recent Trends of TAVR in France

In a recent study published in the Journal of the American College of Cardiology, the implementation of Transcatheter Aortic Valve Replacement (TAVR) was investigated in France.

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EAGLES- A Randomized Clinical Trial Showing No Evidence of Smoking Cessation Treatments Association with MACE

EAGLES (Evaluating Adverse Events in a Global Smoking Cessation Study), a randomized clinical trial, published in the Journal of the American Medical Association, provides evidence that smoking cessation medications do not increase the risk of serious cardiovascular events in the general population of smokers. Continue reading

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