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Neurologic Toxicity with Immune Checkpoint Inhibitors

In a nationwide, multicenter, retrospective study of patients with neurologic immune-related adverse events related to immune checkpoint inhibitors, more than half of patients developed a chronic condition associated with a higher rate of severe neurologic disability and mortality.

Migraine Trigger or Prodromal Symptom: Which Came First — the Chocolate or the Craving?

Knowledge of the differentiation between the triggers for a potential migraine attack and the prodromal symptoms of an initiated migraine attack reveals strategies that decrease migraine disability. Recognition of migraine triggers allows for a modification of behavior to avoid precipitating an attack. Recognition of common migraine prodromal symptoms creates an early time window when rapid treatment enhances the therapeutic intervention’s efficacy.

Left Atrial vs. Left Ventricular Parameters for Intervention Decisions

A one-institution study of serial echocardiograms in patients with moderate to severe or severe aortic regurgitation demonstrated that changes in left atrial size and strain changed over time in a similar fashion regardless of sex and age, and were of incremental prognostic value compared to left ventricular size and function.

Screening Relatives of Hypertrophic Cardiomyopathy Patients

A retrospective cohort study of the first-degree relatives of patients with hypertrophic cardiomyopathy (HCM) seen in screening clinics in Denmark has shown that the diagnostic yield of the first visit is 26% and subsequent visits add 4%. The best predictor of the development of HCM in relatives of families with negative genetic findings was maximal left ventricular wall thickness of ≥ 10 mm.

Benefits of Early, Aggressive Cholesterol-Lowering After Myocardial Infarction

A large national registry study of myocardial infarction patients has shown that achieving target levels of non-high-density lipoprotein cholesterol by one month and maintaining them for at least one year reduces subsequent major adverse cardiac events and argues for aggressive early cholesterol management rather than the usual stepwise approach.

Validation of the New American Heart Association’s PREVENT Equations

An analysis of the accuracy of the new American Heart Association PREVENT Equations for predicting 10-year cardiovascular disease mortality in the National Health and Nutrition Examination Survey population has shown excellent discrimination with only modest underprediction and supports its use vs. the pooled cohort equation, which is the current standard.

Benefit of TAVR in Patients with Moderate Aortic Stenosis and Systolic Dysfunction

In this multicenter randomized trial of early transcatheter aortic valve replacement (TAVR) in patients with moderate aortic stenosis, TAVR was not superior to medical surveillance, with TAVR triggered by progression to severe aortic stenosis.

How Does the 12-Lead Help?

You are given the electrocardiogram (ECG) in the figure without the benefit of any history. How would you interpret this tracing? How does the 12-lead ECG help with interpretation of the rhythm?

Xanomeline and Trospium Chloride Capsules (Cobenfy)

The U.S. Food and Drug Administration has approved the first-in-class muscarinic agonist and antagonists for the treatment of schizophrenia in adults. This is the first antipsychotic drug approved in decades and is unique in that it targets cholinergic receptors — unlike traditional agents, which target dopamine receptors.

A New Technique for Predicting Outcomes in Asymptomatic AS

An international study of patients with moderate or asymptomatic severe aortic stenosis has demonstrated that increased amounts of left ventricular fibrosis, as measured by cardiac magnetic resonance imaging, is associated with worse outcomes.