Clinical Cardiology
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Is Earlier Better With Oral P2Y12 Inhibition in STEMI Patients?
In a large retrospective analysis of patients in Sweden treated with primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction, a propensity-matched group of patients who received oral P2Y12 inhibitors at initial medical contact did not show improved outcomes vs. those receiving these agents at the time of PCI.
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Early vs. Delayed Cardioversion: A Nonshocking Result
For patients presenting to an ED with recent-onset atrial fibrillation, using rate control and outpatient cardioversion only as needed was associated with a high rate of spontaneous conversion within 48 hours of arrhythmia onset and noninferior short-term outcomes compared to immediate cardioversion in the ED.
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Informed Consent for Cardiac Catheterization: Is Shared Decision-Making an Illusion?
Researchers studied how well patients retain the information imparted during the informed consent process for cardiac catheterization and concluded that shared decision-making as currently practiced is not particularly robust.
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What Echo Measures Predict Progression of Mitral Valve Prolapse?
A study of patients with mitral valve prolapse and mild to moderate mitral regurgitation showed that over a 4.5-year follow-up period, only mitral annular diameter among several echo parameters predicted the development of severe mitral regurgitation.
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When to Operate on Chronic Aortic Regurgitation Patients
A retrospective observational study of patients with moderate to severe aortic regurgitation followed for five years showed that symptoms or a left ventricular end-systolic dimension index > 20 mm/m2 were multivariate predictors of death.
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Sacubitril-Valsartan Reduces Functional Mitral Regurgitation
In patients with chronic heart failure and functional mitral regurgitation, sacubitril/valsartan was associated with greater reduction in mitral regurgitation compared to valsartan alone.
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The Promise and Perils of the Apple Heart Study
A large study with virtual enrollment of Apple Watch users helped illustrate the positive predictive value of wearable, pulse-based atrial fibrillation detection technology, as well as the ability to enroll and follow huge numbers of research subjects in a short period.
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The Right Ventricle During Heart Failure With Preserved Left Ventricular Ejection Fraction
A retrospective longitudinal study of heart failure with reduced left ventricular ejection fraction shows that right ventricular function deteriorates more rapidly than left ventricular function and is associated with increased mortality.
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New Insights Into Young Acute Myocardial Infarction Patients
A retrospective contemporary review of STEMI patients younger than 35 years of age shows that these patients are predominantly overweight men who smoke (some abuse drugs and present with dyslipidemia).
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Transcatheter Mitral Valve Replacement
A large registry study of transcatheter mitral valve replacement showed excellent results in failed bioprostheses but less overall success in failed mitral valve repairs with rings and conditions associated with mitral annular calcium.