Clinical Cardiology Alert – July 1, 2018
July 1, 2018
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CABANA Trial Reveals New Insights About Ablation for Atrial Fibrillation
Ablation for atrial fibrillation did not reduce the composite endpoint of death, disabling stroke, serious bleeding, or cardiac arrest compared with drug therapy, although adverse events were infrequent and arrhythmia recurrence was reduced significantly.
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Drug-eluting Stents Fare No Better Than Bare-metal Stents in Vein Graft Lesions
The two largest randomized trials to date have shown no advantage to drug-eluting stents compared to bare-metal stents in saphenous vein graft percutaneous interventions.
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Long-term Risk of Transient Atrial Fibrillation After Coronary Artery Bypass Graft Surgery
Investigators compared post-coronary artery bypass graft (CABG) atrial fibrillation (AF) to non-surgical, non-valvular AF in a large cohort derived from the Danish health system database. Despite a lower rate of oral anticoagulant use compared to non-valvular AF patients and equivalent CHA2DS2-VASc scores, post-CABG AF demonstrated a lower risk of thromboembolism, death, and recurrent AF. These data do not support the concept that post-CABG AF is the same as traditional non-valvular AF regarding thromboembolic risk.
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Mortality Risk Score for Degenerative Mitral Regurgitation
An international database of patients with significant degenerative mitral valve regurgitation was used to derive and test a score using clinical and echocardiographic data to estimate mortality with medical and surgical therapy. From seven weighted characteristics, investigators developed a 0-12 score that predicted medical and surgical long-term mortality with high discriminatory ability (C-statistic, 0.78 and 0.81, respectively). Investigators found the score added incremental information to surgical scores and believe that it will be useful for therapeutic decision-making.
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Simple Prediction Tool Facilitates Diagnosis of Heart Failure With Preserved Ejection Fraction
In patients with unexplained dyspnea, a score based on six noninvasive criteria can predict the likelihood of heart failure with preserved ejection fraction.