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Cardiac Rehabilitation Is Associated With Decreased Hospitalization and Mortality After Cardiac Valve Surgery
Cardiac rehabilitation after cardiac valve surgery is associated with lower hospitalizations and mortality at one year. A recent cohort study of Medicare beneficiaries, published in JAMA Cardiology, revealed.
THEMIS Study: Ticagrelor Plus Aspirin Associated with Lower Ischemic Event Rate but Higher Bleeding Rate Than Aspirin Alone in Patients with Diabetes and Stable Coronary Artery Disease
Use of ticagrelor plus aspirin in patients with stable coronary artery disease and type 2 diabetes significantly lowers the risk of major adverse cardiovascular events compared with aspirin alone, but at the cost of higher major bleeding, according to the THEMIS study. The results were presented at ESC 2019 and published in the New England Journal of Medicine.
17 Year Study Shows Changes in Income Can Influence the Occurrence of Cardiovascular Disease
A study led by Mr. Stephen Wang, published in JAMA Cardiology, showed that an income drop over 6 years was associated with an increased incidence of cardiovascular disease over the next 17 years. Additionally, an increase in income over 6 years was associated with a reduced incidence of cardiovascular disease over the same time period. The findings of this paper suggest that changes in income can have an effect on a person’s health.
EXCEL Trial: Five-Year Data Suggests PCI Non-Inferior to CABG in Patients with Left Main Coronary Artery Disease
The results of a randomized controlled trial led by Dr. Gregg W. Stone presented at TCT 2019 and published in the New England Journal of Medicine showed that in patients with left main coronary artery disease of low or intermediate complexity, there was no significant difference in the composite endpoint of death, stroke, or myocardial infarction at 5 years in patients who received either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
The COMPLETE Timing Substudy: A Randomized Trial of Complete Staged Revascularization Vs. Infarct Artery PCI Alone in Patients With Acute Myocardial Infarction and Multivessel Disease – Importance of Revascularization Timing
The results of a substudy of the COMPLETE Trial were presented at TCT 2019 by Dr. David Wood, an interventional cardiologist, and Professor of Medicine at the University of British Columbia, Canada. The analyses revealed that compared with culprit-lesion only PCI, the timing of complete revascularization, whether performed early during the index hospitalization or after discharge have similar benefits on major cardiovascular events.
SCOPE I: ACURATE Neo (Self-Expanding TAVR System) Struggles to Have An Edge On SAPIEN 3 (Balloon-Expandable TAVR System)
Results of a randomized trial presented at TCT 2019 and simultaneously published in The Lancet, showed that TAVR with the self-expanding ACURATE neo (Boston Scientific) did not meet non-inferiority compared to the balloon-expandable SAPIEN 3 (Edwards Lifesciences) in terms of early safety and clinical efficacy outcomes.
EWTOPIA 75 Trial: Lowering LDL-Cholesterol with Ezetimibe Prevents Cardiovascular Events in the Elderly
Individuals older than 75 years treated with ezetimibe had a significantly lower risk of atherosclerotic cardiovascular events over 4 years compared with standard care, according to the results of the EWTOPIA 75 trial recently published in Circulation.
REVELATION Trial: Paclitaxel-Coated Balloon Angioplasty is Non-Inferior To The Routinely Conducted Drug-Eluting Stenting in STEMI Patients A 9 months follow-up Single-Centered Randomized Clinical Trial
According to a recent study based on the REVELATION Trial, conducted by Nicola S. Vos et al. and published in JACC, Paclitaxel-coated balloon angioplasty was documented to be non-inferior to the routine drug-eluting stenting (DES) in ST-segment elevation myocardial infarction (STEMI) patients.
PolyIran Trial: Polypill Prevents Cardiovascular Events PolyIran Trial: Fixed-Dose Combination Therapy With Aspirin, a Statin and Two Anti-hypertensives Reduced Cardiovascular Events As Compared to Non-Pharmacological Intervention
A four-component polypill, including aspirin, atorvastatin, hydrochlorothiazide, and enalapril or valsartan, effectively reduced major cardiovascular events in a real-life setting study. The results of the PolyIran trial by Roshandel G. et al. was published in Lancet.
10-Year Study Demonstrates Increased Rate of Cognitive Decline In Patients with Elevated Carotid Artery Pulse Intensity
A study led by Dr. Scott Chiesa published in the European Heart Journal showed that an elevated carotid artery intensity in mid-to-late life was associated with a faster rate of cognitive decline over long-term follow-up. This association was independent of other known cardiovascular risk factors.
Nationwide Study Shows New-onset Left Bundle Branch Block After Transcatheter Aortic Valve Replacement Occurred in 15% of Intermediate Risk Patients and Is Associated with Worse 2 Year Outcomes
According to a new nationwide study, new onset left bundle branch block (LBBB) post transcatheter aortic valve replacement (TAVR), a recently established therapy for intermediate risk surgical candidates with symptomatic, severe aortic stenosis, is associated with adverse long term clinical outcomes in patients without baseline conduction disturbances or pacemaker. Based on the findings published in the European Heart Journal, these outcomes include cardiovascular mortality, re-hospitalization, new pacemaker implantation, and worsened left ventricular systolic function in intermediate risk patients.
Meta-analysis Shows Vitamin D Supplementation Does Not Improve Cardiovascular Outcomes
In the largest updated meta-analysis study conducted to understand the inverse association between low serum vitamin D supplementation and increased cardiovascular disease (CVD) risks, vitamin D supplementation was not associated with reduced major adverse cardiovascular events, individual CVD end points (myocardial infarction, stroke, CVD mortality) or all-cause mortality. The findings published in the Journal of the American Medical Association Cardiology suggest vitamin D supplementation may not confer cardiovascular protection and may not be indicated for this purpose. Continue reading
New Study Demonstrates Significant Burden of New Onset Atrial Fibrillation in Patients Undergoing Aortic Valve Replacement
A study led by Dr. Rajat Kalra published in JAMA Internal Medicine showed that new-onset atrial fibrillation is a significant burden on patients after aortic valve replacement either through trans-jugular aortic valve implantation (TAVI) or aortic valve replacement (AVR). Additionally, the investigators demonstrated that atrial fibrillation (AF) was higher after AVR than after TAVI.
PARTNER 3 Trial: Lower Risk of Death, Stroke and Rehospitalization in Patients with Severe Aortic Stenosis and Low Surgical Risk Treated with TAVR
A randomized controlled trial led by Dr. M.J. Mack, published in the New England Journal of Medicine, showed that in patients with severe aortic stenosis and a low surgical risk, treatment with transcatheter aortic valve replacement (TAVR) with a balloon expandable valve was associated with a lower risk of stroke, death or rehospitalization by 1 year when compared to surgery.
Cohort Study Shows That a New HDL Apolipoproteomic Score Correlates with Both Risk of Coronary Artery Disease and Risk of Cardiovascular Death
In a study led by Dr. Pradeep Natarajan showed that an HDL apolipoproteomic score is associated with coronary artery disease (CAD). Additionally, the study published in the Journal of the American College of Cardiology showed that among individuals with CAD, this score is independently associated with cardiovascular death.
Cohort Study with 27 Years of Follow Up Shows Oral Infections in Children Is Associated with Sub-clinical Atherosclerosis
A study led by Dr. Pirkko Pussinen demonstrated that clinical signs of oral infection during childhood were associated with subclinical atherosclerosis in adulthood. The paper published in JAMA Network Open suggests that childhood oral infection may be a modifiable risk factor for adult cardiovascular disease.
Nationwide Study Shows Pharmacy Closure Associated with Significant Decrease in Adherence to Cardiovascular Medications
According to a new national study led by Dr. Dima M. Qato that was recently published in JAMA Network Open, among 3.1 million Americans 50 years and older filling cardiovascular medications at pharmacies that eventually closed, there was a significant and immediate decline in medication adherence. This change in adherence persisted over 12 months and was prominent among older adults living in neighborhoods with fewer pharmacies.
Study Suggests ICU Care May Be Overutilized in Stable STEMI Patients
A study led by Dr. Jay S. Shavadia published in JACC: Cardiovascular Interventions showed that although more than 80% of stable patients with an ST-elevation myocardial infarction (STEMI) were treated in the intensive care unit (ICU), the risk of developing a complication requiring ICU care was around 16%. These findings suggest that implementing a risk-based triage strategy could be a better alternative to the current strategy where patients with STEMI are typically admitted to the ICU.
New Study Reports That 13% of an Internal Medicine Intern’s Time Spent in Direct Patient Care An Assessment of Inpatient Time Allocation Among First-Year Internal Medicine Residents Using Time-Motion Observation
In an observational study published in JAMA Internal Medicine, Dr. Krisda H. Chaiyachati showed that first-year internal medicine residents spent 66% of their time involved in indirect patient care, this included interacting with the patient’s records or recording their work. On average, residents spent 13% of their day directly involved in patient care and 7% doing educational activities. 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
