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 →

Parachute use on jumping from an aircraft does not reduce death or major traumatic injuries when compared with jumping with empty backpacks, according to a new trial published in the British Medical Journal. Continue reading →

A molecular analysis of bacterial contamination on stethoscopes in an intensive care unit conducted by Vincent R. Knecht and his colleagues at University of Pennsylvania Perelman School of Medicine, Philadelphia, has shown that stethoscopes used in an ICU carry bacterial DNA reflecting complex microbial communities that include nosocomially important taxa. Commonly used cleaning practices reduce contamination but are only partially successful at modifying or eliminating these communities. Continue reading →

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 →