Clinical Cardiology Alert – January 1, 2021
January 1, 2021
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What Causes MINOCA?
A systematic imaging protocol of coronary angiography, optical coherence tomography, and cardiac MRI in women clinically diagnosed with myocardial infarction with non-obstructive coronary artery disease revealed a cause in 84%, with three-quarters exhibiting an ischemic etiology.
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Left Ventricular Size, Function Predictors of Outcomes in Chronic Aortic Regurgitation
In a large cohort of asymptomatic patients with hemodynamically significant chronic aortic regurgitation, volumetric left ventricular size and function measurements were equally discriminant in identifying patients at higher risk for mortality vs. traditional linear measurements.
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Time is of the Essence with Colchicine Treatment of Myocardial Infarction
An analysis of the COLCOT study of colchicine administration after myocardial infarction (MI) showed the benefit of this therapy for preventing subsequent cardiovascular events was greatest when therapy was initiated within three days after MI onset.
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Expanding Uses for Direct Oral Anticoagulants: Bioprosthetic Heart Valves?
A randomized, controlled trial of rivaroxaban vs. warfarin in patients with atrial fibrillation and a bioprosthetic valve revealed rivaroxaban is noninferior to warfarin for the prevention of major cardiovascular events and the avoidance of major bleeding events over 12 months.
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A New Treatment for Refractory Hyperlipidemia
In patients with familial hypercholesterolemia who are not at target LDL cholesterol levels on maximum-tolerated doses of statins and PCSK9 inhibitors, evinacumab, which inhibits angiopoietin-like 3, reduces LDL by more than 50% at the highest doses with few side effects requiring drug discontinuation vs. placebo.