Clinical Cardiology Alert – September 1, 2025

ApoB vs. Lp(a): Which Is More Important for CAD Risk?

In UK Biobank participants without known atherosclerotic cardiovascular disease or diabetes or taking lipid-lowering therapy, the risk of developing coronary artery disease is best determined by apolipoprotein B particle number, but elevated lipoprotein(a) adds significant risk, so both should be considered.

SGLT2 Inhibitor Plus Aldosterone Antagonist for HFpEF: Safe? Efficacious?

A prospective, open-label, blinded outcome crossover trial of dapagliflozin plus spironolactone vs. dapagliflozin alone in patients with heart failure with preserved or mildly reduced left ventricular ejection fraction resulted in a greater reduction in natriuretic peptides, which was accompanied by a greater decline in kidney function and a rise in serum potassium.

Left Ventricular Size and Outcomes in Aortic Regurgitation

A multinational, retrospective, observational registry study of patients with significant aortic valve regurgitation has shown that left ventricular end-systolic dimension and volume measurements are valuable for risk-stratifying such patients and should be incorporated into the guidelines for when to intervene.

Surgery or Fibrinolysis for Thrombosed Mechanical Valves

A randomized trial of urgent surgery vs. thrombolytic therapy for symptomatic left-sided mechanical valve thrombosis has shown that surgery completely restores valve function in all patients compared to three-quarters of patients with thrombolytic therapy, but at a cost of higher in-hospital complications and mortality.

Contemporary Cardiovascular Disease Deaths in Asian Americans

An analysis of a Centers for Disease Control and Prevention database has shown the cardiovascular disease mortality rate is higher in Asian Americans than in non-Asian Americans and that this excess mortality is particularly prevalent in Filipino Americans.