Cardiology
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Are SGLT2 Inhibitors Effective for HFpEF Patients Without Diabetes?
After comparing empagliflozin vs. placebo for patients with heart failure and preserved left ventricular ejection fraction, researchers found no differences in the significant reduction of the primary outcome of cardiovascular death or heart failure hospitalization over 36 months based on whether patients were diabetic.
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Predicting the Tolerability of Sacubitril/Valsartan in Advanced Heart Failure
An analysis of the sacubitril/valsartan run-in period for chronic, advanced heart failure patients showed 18% could not tolerate the lowest dose, usually because of hypotension or renal dysfunction. Investigators identified six predictors of non-tolerance, which may help clinicians choose the best candidates.
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Provocative Testing with Intracoronary Acetylcholine as Part of Cardiac Catheterization Evaluation
In this systematic review and meta-analysis of invasive coronary provocation testing, intracoronary acetylcholine was found to be a safe procedure, with low rates of major complications.
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Clinical Significance of Mitral Annular Calcification
Researchers found mitral annular calcification to be uncommon, and few experience associated moderate to severe mitral stenosis or regurgitation. However, the latter group recorded a high mortality rate over three years follow-up, which was significantly lower in those who underwent valve interventions, even when corrected for younger age, fewer comorbidities.
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Appropriate Management of Thoracic Aortic Aneurysms
Among patients with arch and descending thoracic aorta aneurysms followed over a mean 20 months, aneurysm-related mortality was predicted by the size and growth rate of the aneurysms, along with age and sex.
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The Value of Stress Testing in Patients with Known Coronary Artery Disease
A comparison of adenosine stress single-photon emission CT, PET, and MRI in stable patients with known coronary artery disease (CAD) showed PET to be more sensitive for detecting invasive fractional flow reserve-identified ischemic lesions. However, the sensitivity was disappointing. Patients with known CAD and new symptoms should be referred directly to invasive coronary angiography.
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Rivaroxaban Monotherapy for Atrial Fibrillation in Coronary Artery Disease Patients
For patients with atrial fibrillation and stable coronary artery disease, rivaroxaban monotherapy was superior to dual therapy for preventing thrombotic and bleeding events and was associated with a lower mortality rate.
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Smoking Cessation After Atrial Fibrillation Diagnosis Could Lower Dementia Risk
A cohort study of patients with atrial fibrillation (AF) in South Korea revealed patients who stopped smoking after AF diagnosis were at lower risk for developing dementia than those who continued smoking.
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Is the Canadian Syncope Risk Score Valid?
Researchers found the Canadian Syncope Risk Score accurately predicts which patients are low risk for discharge. However, since it is driven largely by the physician’s final risk classification at ED discharge, the score’s clinical utility is uncertain.
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Comparing CT Angiography to Invasive Angiography for Stable Chest Pain Patients
A trial of initial coronary CT angiography vs. invasive angiography revealed outcomes over a median 3.5-year follow-up were similar, but procedure-related complications were more common in the invasive group.