Cardiology Topics
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Psychiatric Medications and Long QT Syndrome: A Safe Combination?
A retrospective study of patients with electrocardiogram long QT interval syndrome and psychiatric disease suggests that with proper pharmacologic treatment and counseling, the patients can be treated safely with psychiatric drugs known to increase the QT interval.
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Preventing Ventricular Arrhythmias with Potassium
A Danish randomized trial of augmenting serum potassium by diet or medications compared to usual care in patients with an implantable cardioverter defibrillator (ICD) has shown that modest increases in potassium resulted in a reduction in the composite endpoint of appropriate ICD therapy or hospitalizations for arrhythmias or heart failure, or death.
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Is Anticoagulation Necessary in Pulmonary Arterial Hypertension?
A large French national registry observational study of the use of anticoagulants in patients with pulmonary artery hypertension of diverse etiologies enrolled over 11 years, and a meta-analysis of this study and four other national registry studies, showed that there was no association between anticoagulant use and survival.
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Efficacy of Adding Aspirin to OACs for CAD Patients
A randomized, placebo-controlled trial of adding aspirin to oral anticoagulant therapy in patients with chronic coronary artery disease at high risk of atherothrombotic complications and major bleeding was stopped early because aspirin increased the risk of all-cause mortality. In addition, aspirin was associated with an increase in atherothrombotic complications and major bleeding.
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Mechanical Aspiration for RSIE: Finally, Some Data to Inform a Growing Practice
In this registry of patients undergoing mechanical aspiration for right-sided infective endocarditis, technical success rates were high, with a modest but significant rate of procedural complications. Further research with randomized trials will be needed to better define proper patient selection.
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What Are Hyperacute T-Waves and What Do They Mean?
A retrospective study of emergency department patients suspected of having an acute coronary syndrome has shown that a computer system for determining a new quantitative high-amplitude electrocardiogram (ECG) T-wave score has a high specificity and reasonable sensitivity for identifying patients with acute coronary occlusion that performs as well as ECG ST-elevation myocardial infarction criteria.
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Statins for Abdominal Aortic Aneurysms
An analysis of two large, abdominal aortic aneurysm (AAA) screening populations from Denmark has shown that high-dose statin therapy reduces the rate of AAA growth, the need for repair, and adverse outcomes, such as rupture and death.
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Withdrawing Heart Failure Medications After Restoring Sinus Rhythm in AF Cardiomyopathy Patients
A small trial of withdrawing guideline-directed medical therapy (GDMT) for reduced ejection fraction (EF) heart failure in patients with atrial fibrillation in whom EF recovered after restoration of normal sinus rhythm has shown that withdrawal of GDMT was not associated with a decline in EF over 12 months in most patients.
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Beta-Blocker Interruption Post-MI
An analysis of the secondary outcomes in the French multicentered study of beta-blocker withdrawal in patients with uncomplicated myocardial infarction after one year led to increases in heart rate and blood pressure with potentially deleterious outcomes, especially in patients with a history of hypertension.
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Routine CCTA Imaging of Left Main PCI Patients Falls Short in Randomized Trial
In this randomized trial of patients undergoing left main percutaneous coronary intervention, routine surveillance coronary computed tomography angiography six months after intervention did not reduce the composite endpoint of all-cause death, myocardial infarction (MI), unstable angina, or stent thrombosis at 18 months, but was associated with fewer spontaneous MIs and more imaging-triggered revascularization procedures.