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

Video Augmented Information Delivery to Patients Undergoing Elective PCI Enhances Patient Awareness and Satisfaction

A new multi-center prospective randomized trial published in the American Heart Journal was able to show that a video presentation may be better at helping patients to understand the procedure and risks associated with percutaneous coronary intervention (PCI) compared to standard patient education pamphlets. Continue reading

Delayed Coronary Obstruction: a post-TAVR Complication

A recently published study in the Journal of American College of Cardiology  concluded that delayed coronary obstruction (DCO) occurring after transcatheter aortic valve replacement (TAVR) is an infrequent complication, associated with a high in-hospital mortality. Continue reading

High Sensitivity Troponin I and Stable Coronary Artery Disease

A recent study published in the Journal of American College of Cardiology found an association between elevated concentrations of high sensitivity troponin I (hsTnI) with increasing prevalence of coronary artery disease (CAD) in stable patients, who were suspected of coronary artery disease and underwent non-emergent coronary computed tomography angiography (CTA).

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Tafamidis, A Real Hope for People with Transthyretin Cardiomyopathy?

On Thursday, March 29th, Pfizer announced positive topline results from ATTR-ACT trial of tafamidis in patients with transthyretin cardiomyopathy. According to Pfizer, “Tafamidis met its primary endpoint, demonstrating a statistically significant reduction in the composite of all-cause mortality and frequency of cardiovascular-related hospitalizations compared to placebo at 30 months. The preliminary safety data showed that tafamidis was generally well tolerated in this population and no new safety signals were identified”. Continue reading

Predictors of Device Related Thrombosis After Transcatheter Left Atrial Appendage Occlusion

In a recent study published in Circulation: Cardiovascular Interventions, Pracon et al. suggested that the incidence of device related thrombosis (DRT) among patients undergoing percutaneous left atrial appendage occlusion is related to patient  (history of thromboembolic events and lower left ventricular ejection fraction) and procedural (deep implantation and larger occluder size) characteristics.

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Assessment of Long-term Outcomes in Patients Undergoing SAVR

A contemporary cohort study recently published in Journal of the American College of Cardiology  highlighted the clinical significance of age and other associated comorbidities in determining the clinical outcome in patients undergoing surgical aortic valve replacement (SAVR). The 10-year mortality rate was found to be considerably high in elderly SAVR recipients of a bioprosthetic valve and almost one-third of the population exhibited subclinical structural valve degeneration (SVD). Continue reading

Does Operator PCI Volume Influence Mortality?

The number of procedures performed by the operator of a Percutaneous Coronary Intervention (PCI) in the previous year has no impact on the 30-day mortality, according to a recent UK study published in the European Heart Journal Continue reading