Clinical Cardiology Alert – June 1, 2024

Can Coronary Stenting in Stable Atherosclerotic Coronary Disease Prevent Future Adverse Events?

In this randomized, open-label trial of patients with primarily stable atherosclerotic coronary disease, stenting compared with medical therapy of nonobstructive lesions with imaging markers of plaque vulnerability resulted in a lower incidence of the composite endpoint of cardiac death, target-vessel myocardial infarction, ischemia-driven target vessel revascularization, or hospitalization for unstable or progressive angina at two years.

Transcatheter Myotomy for Left Ventricular Outflow Tract Obstruction

Initial experience with a new transcutaneous transcatheter electrosurgery device using intramyocardial guidewires to create left ventricular upper septum myotomies to enlarge the outflow tract in symptomatic patients with hypertrophic cardiomyopathy, and potentially to enhance transcatheter left heart valve replacement when outflow tract obstruction compromises the procedure, is described in this report from a single center.

Is Weight Loss the Key to Heart Health?

The second trial of semaglutide in obese patients with heart failure and preserved left ventricular ejection fraction, this one in people with type 2 diabetes, also has shown significant improvements in symptoms and exercise function with significantly fewer adverse effects than placebo-treated patients.

Are Beta-Blockers Post-MI Still Necessary?

A large, multicenter, international, randomized clinical trial of long-term beta-blocker therapy vs. no such therapy in contemporary acute myocardial infarction patients who had coronary artery angiography-guided therapy and left ventricular ejection fractions ≥ 50% found no differences in the primary endpoint of all-cause mortality and recurrent myocardial infarction.

Do We Need to Stop Renin-Angiotensin Inhibition Before Non-Cardiac Surgery?

A randomized study of stopping vs. continuing renin-angiotensin system inhibitors prior to elective non-cardiac surgery in older patients did not decrease the incidence of myocardial injury and may have increased the incidence of hypertensive adverse events.