Clinical Cardiology Alert – May 1, 2015
May 1, 2015
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Utility of the New Cholesterol Guidelines
The American College of Cardiology/American Heart Association (ACC/AHA) released new guidelines for the use of statin drugs to prevent atherosclerotic cardiovascular disease (CVD) in 2013.
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Atrial Fibrillation Risk Scores and Anticoagulation Treatment
Several guidelines recommend using the CHA2DS2-VASc score for determining the risk of stroke in patients with atrial fibrillation (AF), but the treatment recommendations are not the same in all guidelines.
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Unintended Consequences of Public Reporting of Procedure Outcomes
Public reporting of clinical outcomes associated with cardiovascular care has been touted as a means to improve health care delivery and patient outcomes.
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Blood Transfusion After Cardiac Surgery
Due to the cost of blood transfusions and the lack of data supporting liberal transfusion policies, newer guidelines recommend more restrictive transfusion thresholds (e.g., hemoglobin < 7 g/dL). However, many believe cardiac surgery is an exception due to the myocardium’s high oxygen requirement.
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Paravalvular Leaks and TAVR Outcomes
Moderate or severe paravalvular regurgitation (PVR) has been reported in up to one-quarter of patients following transcatheter aortic valve replacement (TAVR) and has been associated with a higher 1-year mortality. Whether PVR is the cause of increased mortality or is simply associated with mortality is unclear.
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Intravenous Iron Shows Long-term Benefit in Patients with Heart Failure and Iron Deficiency
Iron deficiency (ID) is common in patients with heart failure (HF), and its presence is associated with reductions in functional capacity, quality of life, and survival. Several clinical trials have shown improved outcomes in patients with HF and ID who are treated with IV iron. However, these trials only administered IV iron for short periods of time, and the long-term effects of IV iron in these patients are not well understood.