Cardiology Topics
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To Stress Test or Not Post-PCI
A prespecified subgroup analysis of diabetic patients in the POST-PCI study, which randomized patients post-percutaneous coronary intervention to routine stress testing vs. standard care at one year and followed for two years, has shown that adverse cardiac outcomes and death rates were not improved by routine stress testing.
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Long-Term Follow-Up Confirms Efficacy of Invasive Strategy in Very Old Patients with Non-ST Elevation ACS
In this long-term analysis of patients in the After Eighty Study, with a mean age of 85 years and non-ST-elevation acute coronary syndrome, an invasive strategy showed a reduction in a composite endpoint of major adverse cardiovascular events and was associated with a significant improvement in event-free survival compared with a conservative approach.
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Safety and Tolerability of Inclisiran
A pooled analysis of seven relatively short-term ORION studies of inclisiran vs. placebo for lowering low-density lipoprotein cholesterol that assessed safety and tolerability for up to six years showed that inclisiran has similar rates of adverse events, excluding injection site reactions, as placebo treatment and is associated with fewer major adverse cardiovascular events.
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Do Patients with Heart Failure Feel Better on Dapagliflozin?
An analysis of the DETERMINE studies of dapagliflozin vs. placebo in patients with heart failure showed some improvement in self-reported symptoms in those with reduced ejection fraction on dapagliflozin but not in the six-minute walk test. No improvements in symptoms or physical activity levels were found in those with preserved ejection fraction on dapagliflozin.
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Aberrant Conduction?
How should one interpret the ECG in the figure? Is the rhythm most likely to be a re-entry supraventricular tachycardia with aberrant conduction?
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Major Cardiovascular Event Risk Reduction with Pitavastatin in Patients Living with HIV
Among participants living with HIV who are at low-to-moderate risk for cardiovascular disease, those who received pitavastatin were 35% less likely to experience a major adverse cardiovascular event over a follow-up of approximately five years vs. those who received placebo.
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The Hemodynamic Effects of an SGLT2 Inhibitor in Heart Failure with Preserved Ejection Fraction
The authors of a small, placebo-controlled study of 24 weeks of dapagliflozin therapy in patients with heart failure with preserved ejection fraction reported reductions in pulmonary capillary wedge pressure, which may explain the reductions in heart failure hospitalizations or cardiovascular death in larger randomized outcome trials.
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Computer-Interpreted ECGs Sometimes Miss Acute Coronary Occlusion
Emergency physicians can shield against risk by viewing ECGs of chest pain patients immediately to identify subtle signs of acute coronary occlusion.
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An RNA Shot for Hypertension?
One dose of a new RNA-based drug administered by subcutaneous injection, which blocks hepatic angiotensinogen production, resulted in sustained reductions in blood pressure in patients with hypertension for up to 24 weeks without any serious adverse effects.
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Is the Combination of a GLP-1 Agonist and a SGLT2 Inhibitor Safe?
An analysis of the Harmony Outcomes study and a meta-analysis combining it with the AMPLITUDE-O study of the addition of a glucagon-like peptide 1 receptor agonist (GLP-1 RA) in a subgroup of type 2 diabetes patients on baseline sodium-glucose cotransporter-2 (SGLT2) inhibitor therapy has shown that major adverse cardiovascular events are reduced by GLP-1 RA, regardless of baseline SGLT2 use, and there was no difference in serious adverse events.