Cardiology Topics
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Does Running Prevent Coronary Artery Disease?
In this cross-sectional review of the Master Athlete Heart study, the authors found lifelong endurance sport participation was not associated with a more favorable coronary plaque composition vs. a healthy lifestyle. Lifelong endurance athletes exhibited more coronary plaques.
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Direct Oral Anticoagulants vs. Warfarin When Treating Renal Dysfunction
A patient-level meta-analysis of five pivotal trials of direct oral anticoagulants (DOACs) vs. warfarin for patients with atrial fibrillation and creatinine clearance levels ranging from normal to 25 mL/min revealed standard-dose DOACs exhibit superior safety and efficacy compared to adjusted-dose warfarin and lower-dose DOACs.
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Valve Replacement Risk and Lifetime Management of Aortic Valve Disease
The authors of an analysis of more than 31,000 patients from the Society of Thoracic Surgeons’ database identified patients undergoing surgical aortic valve replacement (SAVR) after prior transcutaneous AVR (TAVR) or SAVR. SAVR after TAVR raised the risk of mortality vs. SAVR after SAVR.
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Cardiac MRI Predicts Outcomes in Aortic Regurgitation
Cardiac MRI could be used to make management decisions when treating patients living with chronic, asymptomatic aortic regurgitation with preserved left ventricular function, especially when trying to predict severity and possibility of adverse outcomes.
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Age and Sexual Dimorphism in Aortic Regurgitation
Among patients with chronic, significant aortic regurgitation, women and older men without symptoms indicating the need for aortic valve replacement maintained smaller left ventricular volumes than young men and developed adverse clinical events at lower left ventricular volumes.
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Stroke and a Wide QRS
The ECG in the figure is from an older man who presented with an acute stroke. He denied chest pain. Why is there QRS widening? What might be the clinical implications?
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Unexpected Low Voltage on an ECG
A registry study of hypertrophic cardiomyopathy (HCM) patients and elite athletes in Italy revealed low voltage on ECG is not uncommon in HCM and may be a marker for more left ventricular scarring on cardiac imaging — and a poor prognosis.
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Does One Negative Troponin Measurement Rule Out Acute Coronary Syndrome?
Using a common clinical chest pain algorithm plus a point-of-care troponin measurement for low-risk patients, researchers reported significantly lower healthcare costs. Also, this approach did not seem to result in more major adverse cardiovascular events.
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An Oral PCSK9 Inhibitor — Coming Soon?
A Phase IIb study of four doses of MK-0616, an orally administered PCSK9 inhibitor, compared to placebo showed significant reductions in LDL cholesterol levels without any differences in adverse effects over eight weeks.
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Cardiovascular Outcomes with Bempedoic Acid, a New Statin Alternative
A trial of bempedoic acid vs. placebo for statin-intolerant patients showed bempedoic acid significantly lowered LDL cholesterol levels and prevented more major adverse cardiovascular events after a median follow-up of 41 months. Although nonserious side effects were numerically higher for those on bempedoic acid, serious adverse events were not significantly different from placebo.