Cardiology
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A New Drug for Heart Failure with Preserved Ejection Fraction?
The addition of the nonsteroidal mineralocorticoid receptor antagonist finerenone to standard therapy reduced the incidence of recurrent heart failure and death compared to placebo in patients with heart failure and mildly reduced or preserved left ventricular ejection fraction and was generally well tolerated.
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Look for the Pattern
How would you interpret the two-lead rhythm strip shown in the figure? Hint: Is there a pattern?
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Myocarditis in a Post-COVID World
Myocarditis is a rare, typically self-limited inflammatory condition of the heart. Interest in myocarditis has increased in recent years because of the COVID-19 pandemic and COVID-19 vaccinations both being associated with its development. Paralleling this interest is an increase in misinformation about this condition, its frequency associated with both COVID-19 infection and vaccination, and potential linkage to sudden cardiac death. This review article will trace the history of myocarditis from the pre-COVID-19 era to the present day, with special attention being paid to how social media has driven a large portion of the discussion.
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Risk of Atherosclerotic Coronary Artery Disease in Autoimmune Disorders
A large Danish registry study of patients with autoimmune disease referred for coronary computed tomography angiography compared to those without autoimmune disease has shown that autoimmune disease increases the incidence of atherosclerotic events and that the event rate is influenced by traditional atherosclerotic disease risk factors. These results support aggressive risk factor management in patients with autoimmune disease.
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Are Mineralocorticoid Receptor Antagonists Safe in Heart Failure Patients with Renal Dysfunction?
A post hoc analysis of the RALES and EMPHASIS HF trials has shown that, although treatment of heart failure with reduced left ventricular ejection fraction in patients with mineralocorticoid receptor antagonists can cause a significant deterioration in renal function, the benefits outweigh the adverse effects and should not lead to automatic therapy discontinuation.
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How Old Is Atherosclerosis?
Computed tomography of mummified human remains exhibits vascular calcium in almost 40% across multiple eras and geographies, which included <br />non-elites.
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Marantic Endocarditis Revisited
A single institution case series of cancer-associated thrombotic endocarditis has shown that it most frequently presents as a systemic embolism and is detected largely by transesophageal echocardiography, which displays mobile masses attached to thickened mitral and aortic valves.
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Clarifying the Risk of Aortic Aneurysm Development
A large, cross-sectional study of adults by aortic computed tomography angiography has shown that aortic aneurysms (AAs) are more frequent in men than women. While increasing age and body surface area were common risk factors for AA, hypertension was associated with thoracic AA and hypercholesterolemia and smoking were risk factors for abdominal AA.
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Antithrombotic Treatment for Atrial Fibrillation After Acute Coronary Events
An analysis of the AUGUSTUS trial comparing a P2Y12 inhibitor plus four combinations of double or triple therapy with apixaban, aspirin, and a vitamin K antagonist in patients with atrial fibrillation and a recent acute coronary event or percutaneous coronary intervention has shown that a P2Y12 inhibitor plus apixaban exhibited the lowest rate of major adverse events and major bleeding events.
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Poor Diabetes Control Associated with Poorer Coronary Stent Outcomes
In this large, observational study of diabetic patients with coronary stents, poorer glycemic control as measured by hemoglobin A1c was associated with stepwise hazard for stent failure over a period of more than six years, primarily driven by in-stent restenosis.