Cardiology Topics
RSSArticles
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Is Endomyocardial Biopsy Still Necessary if Cardiac MRI Is Available?
A multicenter registry study in Europe of patients with suspected myocarditis has shown that, compared to cardiac magnetic resonance imaging, endomyocardial biopsy still is the gold standard, and lower ejection fraction and need for immunosuppressant drugs predicted a worse outcome.
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Outcomes of Low-Risk Bicuspid Aortic Valve Patients Undergoing TAVR
In this prospective, multicenter, single-arm trial, low-surgical risk patients with bicuspid aortic valve anatomy treated with transcatheter aortic valve replacement showed favorable results at three years, with low rates of death and disabling stroke.
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Is Anticoagulation Necessary for Post-CABG Surgery Atrial Fibrillation?
A meta-analysis of non-randomized trials of oral anticoagulant use for new atrial fibrillation (AF) after coronary artery bypass surgery involving almost 1.7 million patients has shown that AF is frequent, but the incidence of thromboembolism, bleeding, and death are low. Oral anticoagulants, when given, do not significantly affect thromboembolism or mortality rates, but they do increase bleeding.
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Indications for Reduced-Dose Direct Oral Anticoagulants
A subgroup analysis of the ENGAGE-AF TIMI 48 study of edoxaban 60 mg/day vs. 30 mg/day compared to warfarin in patients with atrial fibrillation of the group 80 years of age or older has shown that 30 mg/day results in less major bleeding without a concomitant increase in stroke risk compared to 60 mg/day or warfarin.
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Are Mineralocorticoid Receptor Antagonists Safe in Heart Failure Patients with Renal Dysfunction?
A post hoc analysis of the RALES and EMPHASIS HF trials has shown that, although treatment of heart failure with reduced left ventricular ejection fraction patients with mineralocorticoid receptor antagonists can cause a significant deterioration in renal function, the benefits outweigh the adverse effects and should not lead to automatic therapy discontinuation.
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Does Ascending Aorta Size Predict Dissection?
A large Australian database study has shown that, because of the much larger number of patients without severe aortic dilatation, almost all fatal dissections occur in individuals with non-severely dilated aortas — the so-called aortic paradox.
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Chlorthalidone vs. Hydrochlorothiazide for Hypertension
A subgroup analysis of those with prior myocardial infarction or ischemic stroke in the Diuretic Comparison Project for the treatment of hypertension has found that this higher-risk group experiences fewer major adverse cardiovascular events while taking chlorthalidone compared to hydrochlorothiazide, but at the expense of more hypokalemia.
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CVD Risk from Ketogenic Diets
A recent analysis of the UK Biobank data found that subjects on a low-carbohydrate, high-fat diet had higher levels of low-density lipoprotein cholesterol and apolipoprotein B, and an increase in incident major adverse cardiovascular events over a 12-year follow-up than subjects on a standard diet.
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Risk of Atherosclerotic Coronary Artery Disease in Autoimmune Disorders
A large Danish registry study of patients with autoimmune disease referred for coronary computed tomography angiography compared to those without autoimmune disease has shown that autoimmune disease increases the incidence of atherosclerotic events and that the event rate is influenced by traditional atherosclerotic disease risk factors. These results support aggressive risk factor management in patients with autoimmune disease.
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The Role of Pulmonary Hypertension in the Decision to Intervene in Degenerative Mitral Regurgitation
A retrospective observational study of patients with degenerative mitral valve regurgitation has shown that Doppler echocardiographic-determined elevated pulmonary artery systolic pressure is related to mortality independent of the severity of mitral regurgitation, and that this excess mortality can be attenuated by mitral valve surgery.