Cardiology
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Role of Cardiac MRI in Recurrent Pericarditis
This multicenter study revealed cardiac MRI may be useful in the diagnosis of difficult pericarditis cases, especially if pericardial edema and late gadolinium enhancement are found. Pericardial thickening and elevated C-reactive protein were found to be predictive of recurrent pericarditis and other complications.
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Anatomic vs. Functional Testing in Older Coronary Artery Disease Patients
An analysis of the PROMISE trial by age showed that cardiovascular death or myocardial infarction was predicted by a positive stress test in patients with symptoms suggesting myocardial ischemia who were >age 65 years, but only CT angiography or a calcium score was predictive in symptomatic patients < age 65 years.
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Warfarin or DOACs for Atrial Fibrillation in Chronic Kidney Disease?
A large outpatient observational study of patients with atrial fibrillation and chronic kidney disease who were anticoagulated revealed that, compared to warfarin, direct oral anticoagulants exhibited less all-cause mortality and major bleeding with at least equivalent efficacy at preventing stroke.
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What Device-Detected Atrial Fibrillation Burden Reveals About Stroke Risk
In a retrospective analysis of electronic health record data matched with remote pacemaker and implantable cardioverter-defibrillator recordings of atrial fibrillation episodes, a threshold daily arrhythmia burden portending higher stroke risk was determined over a range of CHA2DS2-VASc scores.
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A ‘Normal’ Initial ECG?
The ECG in the figure was obtained from a 30-year-old man who was admitted to the hospital to “rule out myocardial infarction.” His symptoms of chest discomfort were thought to be atypical and unlikely to be due to a cardiac etiology. His initial ECG (not shown) was interpreted as normal. Evaluation, including serial troponins and stress testing, were deemed normal. Before sending the patient home, the ECG in the figure was obtained.
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Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia)
This is the first FDA-approved oral immunotherapy for desensitizing peanut allergy in children to help reduce the risk of allergic reactions.
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The Safety and Effectiveness of Pyrethroid Insecticides as the Battle Against Mosquitoes Continues
There is a statistical association between a urine test suggestive of exposure to pyrethroid insecticides and increased mortality over the subsequent 14 years.
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Optimal Antithrombic Therapy After PCI for Atrial Fibrillation Patients
In three subgroups of coronary artery disease patients with atrial fibrillation, apixaban plus a P2Y12 inhibitor provided superior safety and similar efficacy outcomes as treatment with warfarin, aspirin, or both for six months.
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Heart Failure-Exacerbating Medications
In a large, diverse cohort of Medicare patients hospitalized for heart failure exacerbations, almost half were on medications known to exacerbate heart failure; more than one-third were on these agents at discharge.
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Using Apple Cider Vinegar for Weight Management on a Restricted Diet
Supplementation with 30 mL of apple cider vinegar combined with a restricted calorie diet may decrease body weight, body mass index, and serum triglyceride levels in people with obesity.