Clinical Cardiology Alert – May 1, 2018
May 1, 2018
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Methamphetamine-associated Pulmonary Hypertension and Cardiomyopathy Are Distinct Diseases
In a large study of methamphetamine users, female sex was associated with presence of pulmonary hypertension, whereas male sex, hypertension, and alcoholism were associated with cardiomyopathy. Both pulmonary hypertension and cardiomyopathy patients exhibited substantially increased mortality.
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Coffin Nail for Omega-3 Fatty Acids?
A meta-analysis of 10 randomized, controlled trials of omega-3 fatty acids for the prevention of coronary heart disease and major vascular events showed no significant effect on fatal and non-fatal coronary heart disease or any major vascular event. These results do not support the use of omega-3 fatty acids supplements in patients with prior coronary heart disease.
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Risk of Endocarditis Revisited
The authors of a population-wide study of hospitalizations and deaths from infective endocarditis (IE) in England confirmed the high risk of IE in certain cardiac conditions, but showed that other conditions thought to be low risk also are at higher risk and found new higher-risk categories not previously identified. Investigators suggested these data should be considered when the antibiotic prophylaxis guidelines are revised.
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The Pulmonary Embolism Rule-out Criteria in Low-risk Patients
A cluster randomized trial of the pulmonary embolism rule-out criteria (PERC) compared to usual care for patients estimated to be at low risk of pulmonary embolus (PE) in EDs showed that PERC was non-inferior to usual care at identifying patients who would be free of symptomatic PE at three months, resulting in less use of healthcare resources.
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Real-world Study of Left Atrial Appendage Occluder Devices Raises New Concerns
A large observational study from France of two devices used commonly for occlusion of the left atrial appendage in patients with atrial fibrillation showed that device-related thrombus was not uncommon and was associated with subsequent stroke.