Cardiology
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Hot Trials from the European Society of Cardiology Annual Congress
Some highlights from two key studies presented in Barcelona, Spain, between Aug. 26 and Aug. 29, 2022, along with Dr. Crawford’s personal commentary on both.
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Importance of Medication Adherence in Ischemic Heart Disease
The results of a subanalysis of the ISCHEMIA trial indicated about one-quarter of patients in both conservative and invasive strategy groups were nonadherent to recommended medical therapy at baseline. Nonadherence was associated with worse health status in both groups at baseline and after one year.
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Ejection Fraction and Outcomes in Bicuspid Aortic Valve Disease
A study of patients with bicuspid aortic valve and moderate or more aortic valve disease revealed the cutpoint for considering aortic valve replacement should be moved from < 50% to < 60% in the guidelines.
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Is Routine Stress Testing After Coronary Revascularization Necessary?
A multicentered study of routine stress testing at one year post-percutaneous coronary revascularization compared to usual care in patients with at least one high-risk coronary anatomic or clinical feature failed to show improved clinical outcomes at two years follow-up.
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The Dental Procedure-Infective Endocarditis Link Controversy Continues
Infective endocarditis was more common with dental surgery or tooth extractions in the preceding four weeks in high-risk patients. Researchers abrogated this risk with antibiotic prophylaxis before the procedure.
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Cerebral Embolic Protection Device Disappoints in TAVR/Stroke Trial
In this largest-to-date randomized trial of stroke prevention in transcatheter aortic valve replacement patients, use of the Sentinel cerebral embolic protection device did not significantly affect the incidence of periprocedural stroke.
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Reviewing Pediatric Arrhythmias
Although pediatric arrhythmias are uncommon, it is essential to recognize which ones require diagnostic evaluation and therapy and which ones do not. Frequently, there are normal variations on pediatric ECGs that do not require a significant evaluation, but recognizing critical arrhythmias in pediatric patients is a must-know for providers.
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Where Are the P Waves?
The ECG in the figure was obtained from a previously healthy young woman with “palpitations.” How would one interpret this two-lead rhythm strip? Is there a conduction disorder?
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Understanding Statin-Related Muscle Pain and Cardiovascular Benefits
A review of large-scale, randomized, double-blind trials of statin therapy suggested statins are responsible for only a small excess of muscle pain symptoms in patients taking these drugs.
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Statins Plus Ezetimibe vs. Statins Alone
A comparison of rosuvastatin 10 mg/day plus ezetimibe (10 mg/day) to 20 mg/day of rosuvastatin alone showed non-inferiority in three-year major cardiovascular outcomes, with lower LDL cholesterol levels and fewer episodes of drug discontinuation or dose reductions in the combination therapy group.