Cardiology
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Are Mineralocorticoid Receptor Antagonists Safe in Heart Failure Patients with Renal Dysfunction?
A post hoc analysis of the RALES and EMPHASIS HF trials has shown that, although treatment of heart failure with reduced left ventricular ejection fraction patients with mineralocorticoid receptor antagonists can cause a significant deterioration in renal function, the benefits outweigh the adverse effects and should not lead to automatic therapy discontinuation.
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Is Artificial Intelligence Coming for Your Job?
A retrospective analysis of plain chest X-ray images in the medical record using deep learning in patients suitable for risk assessment for atherosclerotic cardiovascular disease (ASCVD) has shown similar results as the American College of Cardiology/American Heart Association ASCVD risk calculator for determining who is at sufficient risk to consider statin therapy.
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Empagliflozin Post-Acute Myocardial Infarction
A prespecified further analysis of the EMPACT-MI trial has shown that patients within two weeks of an acute myocardial infarction who are at risk for heart failure who receive empagliflozin compared to placebo have significantly fewer episodes of heart failure hospitalizations over a median follow-up of 18 months.
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Does Ascending Aorta Size Predict Dissection?
A large Australian database study has shown that, because of the much larger number of patients without severe aortic dilatation, almost all fatal dissections occur in individuals with non-severely dilated aortas — the so-called aortic paradox.
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Chlorthalidone vs. Hydrochlorothiazide for Hypertension
A subgroup analysis of those with prior myocardial infarction or ischemic stroke in the Diuretic Comparison Project for the treatment of hypertension has found that this higher-risk group experiences fewer major adverse cardiovascular events while taking chlorthalidone compared to hydrochlorothiazide, but at the expense of more hypokalemia.
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CVD Risk from Ketogenic Diets
A recent analysis of the UK Biobank data found that subjects on a low-carbohydrate, high-fat diet had higher levels of low-density lipoprotein cholesterol and apolipoprotein B, and an increase in incident major adverse cardiovascular events over a 12-year follow-up than subjects on a standard diet.
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Risk of Atherosclerotic Coronary Artery Disease in Autoimmune Disorders
A large Danish registry study of patients with autoimmune disease referred for coronary computed tomography angiography compared to those without autoimmune disease has shown that autoimmune disease increases the incidence of atherosclerotic events and that the event rate is influenced by traditional atherosclerotic disease risk factors. These results support aggressive risk factor management in patients with autoimmune disease.
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The Role of Pulmonary Hypertension in the Decision to Intervene in Degenerative Mitral Regurgitation
A retrospective observational study of patients with degenerative mitral valve regurgitation has shown that Doppler echocardiographic-determined elevated pulmonary artery systolic pressure is related to mortality independent of the severity of mitral regurgitation, and that this excess mortality can be attenuated by mitral valve surgery.
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Cardioversion in Obese Patients
A multicenter, single-blind, randomized clinical trial of dual vs. single defibrillator shocks for cardioverting obese patients with atrial fibrillation showed that dual defibrillation was significantly more effective without any increase in adverse events.
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Are Women with Atrial Fibrillation Still at Higher Risk of Ischemic Stroke?
A Finnish national database study of newly diagnosed atrial fibrillation from 2007-2018 has shown that the independent association of ischemic stroke risk with female sex initially was high but trended downward to nonsignificant at the end of the study. This has implications for the risk stratification of atrial fibrillation patients regarding oral anticoagulation therapy.