Cardiology
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Top Heart Medication Could Help Alcohol Use Disorder Patients
Spironolactone is known to block mineralocorticoid receptors, an action believed to reduce alcohol cravings.
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Irregular Sleep Could Cause More Inflammation
Those who slept few hours per night exhibited troubling signs of improper immune system function in a small study.
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Limitation of Tidal Volume Is Cardioprotective Among Mechanically Ventilated Patients Undergoing Cardiac Surgery
In this experimental study, rising tidal volume increased right ventricular afterload.
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Importance of Discordant Grading of Moderate Aortic Stenosis
A study of patients with moderate aortic stenosis by Doppler echocardiographic calculated valve area revealed 40% exhibit discordant measures, where pressure gradient is lower than expected. These patients died more often than those with concordant measurements, especially those where the discrepancy was caused by low flow.
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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.
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REVIVED Shows No PCI Benefit for Patients with Coronary Disease, Reduced EF
Researchers randomly assigned patients with an ejection fraction ≤ 35% and severe coronary disease to percutaneous coronary intervention or optimal medical therapy alone. After 3.4 years median follow-up, researchers noted no significant differences between groups in terms of all-cause death or heart failure hospitalization.
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Hot Trials from the European Society of Cardiology Annual Congress
Below are some highlights from four key studies presented in Barcelona, Spain, between Aug. 26 and Aug. 29, 2022, along with Dr. Crawford’s personal commentary on each.
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Appropriate Management of Thoracic Aortic Aneurysms
Among patients with arch and descending thoracic aorta aneurysms followed over a mean of 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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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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Those Anterior T Waves
The ECG in the figure was obtained from a man in his 60s who was seen in the field for new chest pain. How might one interpret this tracing?