Cardiology
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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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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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Patients Managing Severe Hypertension Should Avoid Drinking Too Much Coffee
Among patients with severe hypertension, drinking two or more cups of coffee a day was associated with twice the risk of death from cardiovascular disease, while green tea did not increase risk.
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Effectiveness of Dietary Supplements on Lipid and Inflammatory Biomarkers
In a comparison of rosuvastatin 5 mg/day, six common dietary supplements marketed for improving heart health, and placebo, none reduced high-sensitivity C-reactive protein levels. Only rosuvastatin significantly reduced LDL cholesterol levels compared to placebo.
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Clip Found to Be Safe and Effective for Alleviating Tricuspid Regurgitation
In this randomized trial of tricuspid transcatheter edge-to-edge repair, the intervention was found to be safe and effective at alleviating tricuspid regurgitation. Quality of life scores improved with intervention compared with medical therapy, although death and heart failure hospitalization rates were not significantly different.
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Improving Statin Tolerance in Elderly Patients
In a post-hoc analysis of the RACING trial, researchers found the combination of moderate-intensity statin and ezetimibe therapy vs. high-intensity statin therapy alone in older subjects resulted in similar reductions in cardiovascular events over three years, but fewer adverse effects with the combination therapy.
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The Best Use of Statins in Patients with Coronary Artery Disease
A randomized, multicenter study of high-intensity statin therapy to a treat-to-target approach in coronary artery disease patients showed no difference in three-year outcomes. These results suggest treating to a target may be more suitable to individual patients compared to blanket high-intensity statin use.
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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.
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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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Double BBB, or Complete AV Block?
The ECG in the figure is from a woman who complained she had been experiencing chest pain for several days. What is the rhythm? Is there complete AV block?