Clinical Cardiology Alert – December 1, 2024

Benefit of TAVR in Patients with Moderate Aortic Stenosis and Systolic Dysfunction

In this multicenter randomized trial of early transcatheter aortic valve replacement (TAVR) in patients with moderate aortic stenosis, TAVR was not superior to medical surveillance, with TAVR triggered by progression to severe aortic stenosis.

Validation of the New American Heart Association’s PREVENT Equations

An analysis of the accuracy of the new American Heart Association PREVENT Equations for predicting 10-year cardiovascular disease mortality in the National Health and Nutrition Examination Survey population has shown excellent discrimination with only modest underprediction and supports its use vs. the pooled cohort equation, which is the current standard.

Benefits of Early, Aggressive Cholesterol-Lowering After Myocardial Infarction

A large national registry study of myocardial infarction patients has shown that achieving target levels of non-high-density lipoprotein cholesterol by one month and maintaining them for at least one year reduces subsequent major adverse cardiac events and argues for aggressive early cholesterol management rather than the usual stepwise approach.

Screening Relatives of Hypertrophic Cardiomyopathy Patients

A retrospective cohort study of the first-degree relatives of patients with hypertrophic cardiomyopathy (HCM) seen in screening clinics in Denmark has shown that the diagnostic yield of the first visit is 26% and subsequent visits add 4%. The best predictor of the development of HCM in relatives of families with negative genetic findings was maximal left ventricular wall thickness of ≥ 10 mm.

Left Atrial vs. Left Ventricular Parameters for Intervention Decisions

A one-institution study of serial echocardiograms in patients with moderate to severe or severe aortic regurgitation demonstrated that changes in left atrial size and strain changed over time in a similar fashion regardless of sex and age, and were of incremental prognostic value compared to left ventricular size and function.