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 →

A fascinating cohort study published in JAMA Network Open conducted by QiPing Feng, Ph.D., and colleagues from Vanderbilt University Medical Center in Nashville, Tennessee, refuted previous studies that showed a significant relationship between low levels of Low-density lipoprotein cholesterol (LDL-C) level and sepsis. 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 →

A multi-center randomized, double blind, placebo-controlled, parallel group clinical trial has shown that among patients with acute ST-elevation myocardial infarction (STEMI) presenting within 6 hours of symptoms, adjunctive low-dose intracoronary alteplase given after reperfusion via primary percutaneous intervention does not reduce microvascular obstruction. 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 →

COAPT trial

This prospective, multicenter, open-label, randomized trial aimed to assess the use of transcatheter mitral valve repair in heart failure (HF) patients with mitral regurgitation due to left ventricular dysfunction. A total of 614 patients were randomized to either receiving guideline-directed medical therapy (GDMT) alone or GDMT in addition to transcatheter mitral-valve repair. The primary efficacy endpoint was all hospitalizations due to heart failure at 24 months of follow-up, while the primary safety endpoint was freedom from device-related complications at 12 months of follow-up. The study showed that the device group had a lower risk of hospitalization for HF (HR 0.53, 95% CI 0.4-0.7) and all-cause mortality (HR 0.62, 95% CI 0.46-0.82) at 24 months. Moreover, the rate of freedom from device complications at 12 months was 96.6% which exceeded the prespecified safety threshold. 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 →

A population-based cohort study has shown that patients with a higher serum cholesterol efflux capacity, the capacity of HDL particles to mediate cholesterol efflux from macrophages, have a marked decrease in all-cause mortality as compared to patients with a lower serum cholesterol efflux capacity. 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 →

The results of a systematic review and meta-analysis of randomized controlled trials conducted by Konstantinos Katsanos and his colleagues have showcased an increased risk of death following application of paclitaxel-coated balloons and stents in the femoropopliteal artery of the lower limbs. Further investigations are urgently warranted, the authors state in their publication in Circulation. Continue reading →

The findings of a randomized, controlled, open-label trial conducted by Dr. Hyuk-Jae Chang, Division of Cardiology, Severance Cardiovascular Hospital, Seoul, South Korea and his colleagues, has reported that in stable patients with suspected coronary artery disease (CAD) who are eligible for invasive coronary angiography (ICA), the comparable 1-year major adverse cardiovascular events rates following a selective referral and direct referral strategy were suggestive that both diagnostic approaches were similarly effective. Moreover, in the selective referral strategy, the reduced use of ICA was associated with a greater diagnostic yield, which supported the usefulness of coronary computed tomographic angiography (CCTA) as an efficient and accurate method to guide decisions of ICA performance. The findings were published online in JACC: Cardiovascular Imaging. Continue reading →