Clinical Cardiology Alert – August 1, 2016
August 1, 2016
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Take Two, and Call Me in the Morning?
In a real-world population of atrial fibrillation patients at moderate to high risk of stroke, more than one-third were treated with aspirin as opposed to an oral anticoagulant. Those with conditions related to coronary heart disease were more likely to be treated with aspirin.
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Management of Oral Anticoagulation in Atrial Fibrillation Patients with Worsening Renal Function
Approximately 25% of atrial fibrillation patients in a large trial comparing rivaroxaban to warfarin developed worsening renal failure during follow-up. Those treated with rivaroxaban had less embolic events, but equal bleeding events compared to those on warfarin.
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Does Fludrocortisone Work in Vasovagal Syncope?
A multicenter, randomized, double-blind, controlled trial of fludrocortisone at a range of doses in patients with recurrent vasovagal syncope showed an overall trend toward reduced syncope, which was statistically significant in those who achieved the 0.2 mg daily dose.
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Predictors of Functional Status in Heart Failure with Preserved Ejection Fraction
In a retrospective cohort of patients presenting with heart failure with preserved ejection fraction, functional impairment was primarily driven by body mass index, diastolic dysfunction, and pulmonary vascular disease. New York Heart Association functional class, right ventricular dysfunction, and natriuretic peptide levels were the strongest predictors of death or heart failure hospitalization.
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Early Adverse Events Post-PCI Carry Greatest Mortality Risk
About one in eight patients undergoing successful PCI will suffer MI, stent thrombosis or a clinically relevant bleeding event within two years.