Cardiology
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Safety and Tolerability of Inclisiran
A pooled analysis of seven relatively short-term ORION studies of inclisiran vs. placebo for lowering low-density lipoprotein cholesterol that assessed safety and tolerability for up to six years showed that inclisiran has similar rates of adverse events, excluding injection site reactions, as placebo treatment and is associated with fewer major adverse cardiovascular events.
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Do Patients with Heart Failure Feel Better on Dapagliflozin?
An analysis of the DETERMINE studies of dapagliflozin vs. placebo in patients with heart failure showed some improvement in self-reported symptoms in those with reduced ejection fraction on dapagliflozin but not in the six-minute walk test. No improvements in symptoms or physical activity levels were found in those with preserved ejection fraction on dapagliflozin.
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A New Intervention Criterion for Ascending Aortic Aneurysm
A large retrospective study from the Yale University Aortic Institute database of unoperated patients with ascending thoracic aneurysms has shown that the risk of an adverse aortic event rises significantly at 5.0 cm to 5.4 cm in maximum diameter and supports moving the guideline for surgical intervention from 5.5 cm to 5.0 cm.
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Anti-Ischemic Therapy for Microvascular Angina
A small, invasive study of coronary microvascular disease patients has shown that those with a coronary flow reserve < 2.5 may benefit from anti-ischemic therapy.
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Atorvastatin vs. Rosuvastatin in Patients with Coronary Artery Disease
A large trial of moderate doses of rosuvastatin vs. atorvastatin in patients with coronary artery disease has shown that both drugs are equivalent at reducing major adverse cardiovascular and cerebral events, but rosuvastatin is associated with higher rates of new- onset diabetes and cataract surgery.
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Apixaban vs. Aspirin for Subclinical Atrial Fibrillation
A randomized controlled trial of apixaban vs. low-dose aspirin therapy for subclinical atrial fibrillation detected by implanted electrophysiologic devices showed that apixaban is associated with fewer strokes, but more major bleeding episodes compared to aspirin.
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Percutaneous Coronary Intervention vs. Placebo for Stable Angina Patients
In this randomized trial of patients with stable angina and objective evidence of ischemia, percutaneous coronary intervention resulted in a significant reduction in angina compared to a placebo procedure.
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Subcutaneous Furosemide Infusion Device
A small patient-applied infuser pump for a pH neutral formulation of furosemide has been developed. A comparison of an intravenous (IV) bolus of furosemide to a five-hour infusion with the pump has been completed and shows that the device is well tolerated and provides similar bioavailability as IV furosemide.
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Upgrading Prior Right Ventricular Pacing in Heart Failure
A randomized, controlled, open-label study of upgrading patients with right ventricular pacemaker-induced left ventricular dysfunction and heart failure to cardiac resynchronization pacing plus an implantable cardioverter defibrillator (ICD) has shown reduced heart failure hospitalization and improvements in left ventricular function compared to ICD placement alone.
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Apixaban Dose in Atrial Fibrillation Patients with Chronic Kidney Disease
A large nationwide health systems database study comparing 5 mg apixaban vs. 2.5 mg twice daily in patients with stage 4/5 chronic kidney disease not on dialysis shows that the 5 mg dose increases the risk of bleeding compared to 2.5 mg without any improvement in the risk of stroke, systemic emboli, or death.