Cardiology
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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.
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Treatment Window for Lowering Blood Pressure in Acute ICH
Effective treatment for acute intracerebral hemorrhage (ICH) has remained elusive, with inconclusive results from surgical evacuations, as well as blood pressure management. The investigators performed a pooled analysis of four INTERACT trials that studied the effect of aggressive blood pressure lowering in patients with acute ICH. Ultra-early treatment (< 3 hours from onset) may be beneficial, but most patients are not so quickly diagnosed or treated.
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Contemporary Cardiovascular Disease Deaths in Asian Americans
An analysis of a Centers for Disease Control and Prevention database has shown the cardiovascular disease mortality rate is higher in Asian Americans than in non-Asian Americans and that this excess mortality is particularly prevalent in Filipino Americans.
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SGLT2 Inhibitor Plus Aldosterone Antagonist for HFpEF: Safe? Efficacious?
A prospective, open-label, blinded outcome crossover trial of dapagliflozin plus spironolactone vs. dapagliflozin alone in patients with heart failure with preserved or mildly reduced left ventricular ejection fraction resulted in a greater reduction in natriuretic peptides, which was accompanied by a greater decline in kidney function and a rise in serum potassium.
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ApoB vs. Lp(a): Which Is More Important for CAD Risk?
In U.K. Biobank participants without known atherosclerotic cardiovascular disease or diabetes or taking lipid-lowering therapy, the risk of developing coronary artery disease is best determined by apolipoprotein B particle number, but elevated lipoprotein(a) adds significant risk, so both should be considered.
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The Proton Pump Inhibitor Use and Hypertension Link in Menopausal Women
In a large study, long-term use of proton pump inhibitors in menopausal women was associated with an increased risk of developing hypertension.
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Cardiac Arrest in Young Athletes
Sudden cardiac death in athletes is a rare but potentially fatal event where the heart suddenly stops beating because of electrical disturbances or underlying heart conditions during physical activity.
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Contemporary Cardiovascular Disease Deaths in Asian Americans
An analysis of a Centers for Disease Control and Prevention database has shown the cardiovascular disease mortality rate is higher in Asian Americans than in non-Asian Americans and that this excess mortality is particularly prevalent in Filipino Americans.
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Surgery or Fibrinolysis for Thrombosed Mechanical Valves
A randomized trial of urgent surgery vs. thrombolytic therapy for symptomatic left-sided mechanical valve thrombosis has shown that surgery completely restores valve function in all patients compared to three-quarters of patients with thrombolytic therapy, but at a cost of higher in-hospital complications and mortality.