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Treating Small Vessel PCNSV with Cyclophosphamide

In this single-center study, 26 adults with biopsy-confirmed small vessel primary central nervous system vasculitis (PCNSV) were followed for a median of 49 months. Patients receiving early treatment with cyclophosphamide within three months of immunosuppression initiation achieved remission faster than those receiving conservative initial treatment with corticosteroids, either as monotherapy or with azathioprine, mycophenolate, or methotrexate. Retrospective design, treatment selection bias, small sample size, and clinicopathologic heterogeneity limit therapeutic inferences and highlight the need for prospective trials.

The RSV Turning Point: Implementing Preventive Tools in Everyday Practice

Respiratory syncytial virus (RSV) causes significant morbidity in infants and older adults. This review outlines new preventive measures, including RSV vaccines for pregnant women and older adults, and monoclonal antibody prophylaxis (nirsevimab) for infants. Clinical guidance addresses patient concerns, administration timing, and indications by age and risk. With these tools, primary care providers can better prevent RSV complications across vulnerable populations.

Is Sex Still an Important Variable in Stroke Risk with Atrial Fibrillation?

An analysis of a very large database of patients with recent-onset atrial fibrillation has shown that whether sex was included in the formulas to predict thromboembolic risk and guide the use of oral anticoagulants probably is not as important as it was decades ago.

New Injectable Cholesterol-Lowering Drug Trial

A comparison of inclisiran therapy to placebo and ezetimibe therapy over six months in primary prevention patients at low risk of atherosclerotic cardiovascular disease and not taking lipid-lowering therapy has shown that inclisiran subcutaneously every six months reduces low-density lipoprotein cholesterol more than ezetimibe and is comparable to the reported results of high-dose statins taken daily.

CT Coronary Artery Calcium Progression After an Initial Score of Zero

A large Korean study of asymptomatic subjects undergoing more than one computed tomography (CT) coronary calcium scoring scan as part of an employment-based health screening has shown that most had scores of 0, and that during a maximum follow-up of 12 years, the majority stayed at 0 on a repeat scan. Also, in those with a coronary artery calcium score of 0 initially, clinically significant scores (> 100) were only found in 4% of scans at 10-year follow-up.

Shortened DAPT Followed by Reduced-Dose Prasugrel Monotherapy Notches a Win in ACS Patients

In this study of acute coronary syndrome (ACS) patients, one month of dual antiplatelet therapy (DAPT) followed by reduced-dose prasugrel monotherapy led to a reduction in major bleeding events compared to 12 months of DAPT, without a corresponding increase in ischemic events.

Artificial Intelligence ECG Analysis to Rule Out Acute Myocardial Infarction

A large Korean study of an artificial intelligence electrocardiogram (ECG) interpretation algorithm for identifying patients with acute myocardial infarction showed a high degree of accuracy for diagnosing acute myocardial infarction and identifying patients at risk for 30-day major adverse cardiac events in an emergency department setting, which was similar or superior to standard risk stratification methods.

What Kind of Block?

The electrocardiogram in the figure was obtained from an older adult who presented for evaluation of syncope. What kind of atrioventricular (AV) block is present? Or is the rhythm something other than an AV block?

Nipocalimab-aahu Injection (Imaavy)

The U.S. Food and Drug Administration has approved a neonatal Fc-receptor (FcRn) blocker for the treatment of generalized myasthenia gravis. Nipocalimab-aahu is a recombinant human immunoglobulin G1 lambda monoclonal antibody directed at FcRn with high affinity and selectivity.

TIA Is Associated with Accelerated Cognitive Decline

The study investigators looked at data from a prospective study of 30,239 Black and white community-dwelling persons aged 45 years or older with cognitive evaluations over the phone every other year until 2022. The researchers documented patients who had transient ischemic attack (TIA) or stroke, and demonstrated that persons who had TIA had a cognitive decline trajectory similar to those patients who had a definite diagnosis of stroke.