Cardiology
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The Natural History of Aortic Stenosis Revisited
A large multi-institution observational study of patients referred for Doppler echocardiography to assess for aortic stenosis has shown that discrepant measurements are not uncommon. When four-year all-cause untreated mortality is considered, the intermediate grades of aortic stenosis behave like the next highest level stenosis, which suggests that we should consider intervening earlier in moderate to severe stenosis.
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Five-Year TAVR vs. SAVR Data Show Encouraging Results, but Do Not Move the Needle for Clinical Decision-Making
The PARTNER 3 trial randomized low-risk patients to transcatheter aortic valve replacement vs. surgical aortic valve replacement. Five-year data show no significant differences in the composite endpoint of death, stroke, or rehospitalization.
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The Hemodynamic Effects of an SGLT2 Inhibitor in Heart Failure with Preserved Ejection Fraction
The authors of a small, placebo-controlled study of 24 weeks of dapagliflozin therapy in patients with heart failure with preserved ejection fraction reported reductions in pulmonary capillary wedge pressure, which may explain the reductions in heart failure hospitalizations or cardiovascular death in larger randomized outcome trials.
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Major Cardiovascular Event Risk Reduction with Pitavastatin in Patients Living with HIV
Among participants living with HIV who are at low-to-moderate risk for cardiovascular disease, those who received pitavastatin were 35% less likely to experience a major adverse cardiovascular event over a follow-up of approximately five years vs. those who received placebo.
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Aberrant Conduction?
How should one interpret the ECG in the figure? Is the rhythm most likely to be a re-entry supraventricular tachycardia with aberrant conduction?
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Computer-Interpreted ECGs Sometimes Miss Acute Coronary Occlusion
Emergency physicians can shield against risk by viewing ECGs of chest pain patients immediately to identify subtle signs of acute coronary occlusion.
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Is the Combination of a GLP-1 Agonist and a SGLT2 Inhibitor Safe?
An analysis of the Harmony Outcomes study and a meta-analysis combining it with the AMPLITUDE-O study of the addition of a glucagon-like peptide 1 receptor agonist (GLP-1 RA) in a subgroup of type 2 diabetes patients on baseline sodium-glucose cotransporter-2 (SGLT2) inhibitor therapy has shown that major adverse cardiovascular events are reduced by GLP-1 RA, regardless of baseline SGLT2 use, and there was no difference in serious adverse events.
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An RNA Shot for Hypertension?
One dose of a new RNA-based drug administered by subcutaneous injection, which blocks hepatic angiotensinogen production, resulted in sustained reductions in blood pressure in patients with hypertension for up to 24 weeks without any serious adverse effects.
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Tachycardia in the Emergency Department: Part II
This issue completes the two-part series on tachycardia. This issue will finish the discussion of additional causes of tachycardia, address management, and conclude by covering some challenging issues with this arrhythmia.
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What Coronary Artery Calcium Score Signifies Secondary Prevention?
A large registry study of individuals without known cardiovascular disease but with known coronary artery CT calcium scores showed those with an Agatston score higher than 300 are at risk of experiencing major cardiac events similar to patients with known cardiovascular disease over five years.