Cardiology
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Is the Wearable Cardioverter-defibrillator Ready for Prime Time?
A large German experience with the wearable cardioverter-defibrillator confirms the finding of U.S. registry studies and suggests that the device is useful for patients with reduced left ventricular function at high risk of sudden cardiac death who are not currently good candidates for an implantable cardioverter-defibrillator.
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Coronary CT Angiography Prior to Heart Valve Surgery
A meta-analysis of available studies of coronary CT angiography compared to invasive angiography demonstrates that coronary CT angiography is a reasonable substitute for invasive angiography in patients with low- to intermediate-risk for coronary artery disease and without aortic stenosis undergoing valve surgery.
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Indications for Prophylactic Surgery in Dilated Ascending Aortas Revisited
An observational study of patients with dilated ascending aortas not due to inflammatory or syndromic conditions supports the current guideline recommending clinicians consider prophylactic surgery at ≥ 5.5 cm in diameter, and the risk of dissection or rupture is not greater in those with bicuspid aortic valves.
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Stent Complexity Matters When Choosing Dual Antiplatelet Therapy Duration
A new study shows that increased percutaneous coronary intervention procedural complexity helps risk stratify patients and correlates with the benefit of longer-term dual antiplatelet therapy.
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Ticagrelor vs. Aspirin: Post-TIA and Stroke
The first 90 days after a transient ischemic attack or ischemic stroke is a high-risk period for recurrence of cardiovascular thrombotic events. Even with aspirin treatment, recurrences occur in as many as 10-15% of patients. -
Heart Failure with Recovered Ejection Fraction: A Distinct Phenotype
SYNOPSIS: Patients suffering from systolic heart failure who subsequently improve their ejection fraction experience a more favorable clinical course compared to those presenting with persistently reduced ejection fraction or heart failure with preserved ejection fraction.
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Noninvasive Ventilation Delivered Via Helmet May Decrease Intubation Rates
SYNOPSIS: In this single-center, randomized, clinical trial, among patients suffering from acute respiratory distress syndrome, the use of helmet noninvasive ventilation was associated with a reduction in intubation rates, ICU length of stay, and hospital and 90-day mortality.
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Influence of Sacubitril/Valsartan on 30-day Readmission After Heart Failure
SYNOPSIS: Compared with enalapril, treatment with sacubitril/valsartan is more effective in reducing 30-day readmissions for any cause following discharge from congestive heart failure hospitalization.
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Growing Threat of Pyelonephritis Caused by Antibiotic-resistant Escherichia coli
SYNOPSIS: In patients with acute pyelonephritis due Escherichia coli presenting to one of 10 emergency departments, the prevalence of fluoroquinolone resistance ranged from 6.3% to 19.9%, and the prevalence of extended-spectrum beta-lactamase production was 2.6% to 12.2%. Of those patients with resistant organisms, more than 50% received inactive empiric antibiotics.
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Safely Centralized Telemetry Off-site in a Multi-hospital System
SYNOPSIS: The hospitals in this study outsourced their cardiac telemetry to an off-site central monitoring center without an increase in adverse events.